Giving Birth to an Obstetrical Service

On August 27th, it will be 165 years since the first baby was born at The Mount Sinai Hospital in 1856. The mother was a Mrs. Lichtenstein. She named the baby Isaac Touro, in honor of a Hospital benefactor, Judah Touro (1775-1854), who had helped support the young Jews’ Hospital in New York, as Mount Sinai was then known. (Judah Touro also gave money for the founding of Touro Infirmary in New Orleans and today’s Touro College and University System is named for Judah and his father Isaac.)

Isaac Touro Lichtenstein was one of two babies born in the Hospital during its first year of operation. Until the 1920s, most babies were born at home or in one of the specialized women and child care hospitals around the City. This meant that many general hospitals, including Mount Sinai, never felt the need to add a formal obstetrical service to their offerings, thus limiting the number of babies born at the hospital over the years.

By the 1920s, as hospital births began to rise around the country, the Mount Sinai medical staff started to talk to the Board of Trustees about adding obstetrics. As the doctors saw it, the problems arising from not having babies born at the Hospital were: the Gynecology staff could not admit their obstetrical patients to Mount Sinai; there was no obstetrical training for the GYN residents, nor was there training for the pediatrics residents in newborn care. The last also applied to The Mount Sinai Hospital School of Nursing, which affiliated with the Sloane Hospital for Women so students could fill the gap in their education.

While the Trustees were increasingly sympathetic with the request to add an obstetrical service, it wasn’t until the middle of the 1940s that concrete plans were made for the erection of a new building to house obstetrics and gynecology, today’s Klingenstein Pavilion on Fifth Avenue. Every new building demands a fundraising campaign to make it a reality. Mount Sinai had just finished a major expansion that ended in 1922, with the addition of a new School of Nursing building and a semi-private pavilion seen as the next priorities. When these two buildings opened, the Depression was in full swing, which sapped Hospital and potential donor resources. This was followed quickly by World War II, but by the mid-1940s, the Hospital could see a window of opportunity on the horizon.

A fundraising campaign was begun when the war ended and on July 22, 1948, ground was broken for three buildings: the Klingenstein Pavilion, and the Atran and Berg Laboratories. In 1952, the obstetrical service started to operate as the building slowly opened. July marked the start of Mount Sinai’s first Prenatal Clinic, and the first prenatal clinic for women with diabetes in New York City started in the fall. The first OB patients were admitted in October, with the first baby born October 29, 1952 – 96 years after Isaac Touro Lichtenstein.

The Centenary of Radiation Oncology at Mount Sinai Morningside

Among the several anniversaries the Mount Sinai Health System will celebrate this year, is the centenary of the establishment of the Radiotherapeutic Department at our Morningside campus. The Department was established under the direction of Dr. Francis Carter Wood, who was the Hospital’s Pathologist, and the director of that Department beginning in 1910 when it separated from the Medical Service, until 1948.

Wood was born in 1869 in Columbus, Ohio, into a medical family – his grandfather was Dr. Francis Carter of Columbus, and his great-grandfather, Dr. Francis Boake Carter, was the founder of Starling Medical College in Columbus, now a part of the Ohio State University. Grandson Francis Carter Wood graduated from Ohio State University in 1891. He enrolled in the College of Physicians and Surgeons in New York, and graduated in 1894. Between 1894 and 1896, when he joined the faculty of clinical pathology at Columbia University, he continued his studies in Vienna and Berlin. He was a friend of Mme. Currie’s, whom he probably met during this time, and became interested in radium therapy.

He returned home to join the staff of St. Luke’s Hospital in 1897, eventually becoming the Hospital Pathologist. Wood’s interest in radium therapy led him to become a pioneer in the use of X-rays and radium therapy for the treatment of cancer. In 1905 the X-ray department, which until that time had been under the Pathology Department, formalized as its own service, under Wood’s direction.

Dr. Wood established the Radiotherapeutic Department in 1921, while remaining director of Pathology. The department started with six Associates training under Wood’s leadership. Within 5 years, the department was handling over 1,000 patients a year. Wood served as director of both departments until his retirement in 1948.

Upon his death in 1951 at the age of 81, Donald S. Childs, M.D wrote of Wood, “His greatest contributions were educating the public to a proper attitude toward cancer, disproving sensational but false “cures” for the disease, and developing the three most effective methods of treating cancer – surgery, x-rays, and radium.”

A View from 100 Years Ago

I recently spent some time reviewing the President’s Report section of the Annual Report of The Mount Sinai Hospital from 1921 (linked here, starting on page 190).  The President then was George Blumenthal, a devoted trustee, and a smart businessman who had recently guided the Hospital through a major expansion program, the uncertainties of World War I, and the influenza epidemic of 1918. Reading the report reminded me of the joys – and problems – with reading primary historical sources: it is very easy in hindsight to see connections between two times that may not be related, and simple observations can seem very prescient.

Don’t get me wrong, parts of the report are very dated and irrelevant to today: the Hospital was unable to afford radium to use in patient treatment, and so that service was not provided. There was also a section on issues related to fund raising through the Federation of Jewish Charities (today’s UJA-Federation). But still, there were many issues that would seem familiar to our current leaders. The Hospital was perennially short of money, but after the epidemic and the war, wages were rising quickly for what today would be called “essential workers”.  Adding to this was a restrictive immigration policy that limited the labor pool. The inability to hire as many trained nurses as they needed was a continuing struggle as well, something the whole country recognizes today.

George Blumenthal, President of The Mount Sinai Hospital from 1911-1938

And yet Blumenthal made the case – as we do today – for why private hospitals like Mount Sinai deserve the philanthropic support of the people. He says:

It is absolutely essential that private institutions like Mount Sinai should be leaders of progress in hospital work…. To discover, test and demonstrate new methods of treatment is recognized as one of the functions of private institutions and it is one of the strongest reasons for their existence and constitutes their most important claim on the generosity of the public which supports them.

A couple of pages later, Blumenthal makes a bold statement about the importance of Mount Sinai being a teaching hospital. At this time it had loose clinical ties to both Columbia and NYU. He envisioned something more:

A Hospital possessing the clinical and laboratory resources of Mount Sinai should have university affiliation or if this be impracticable should independently utilize its organization for teaching purposes, for in no other way can the fullest benefits be derived from the intensive study of interesting, varied and often perplexing clinical material. We hope the day is not very far off when work on these lines can be done either through affiliation with one of the many teaching institutions located in our city or by independent action.

And “independent action” it was. Even with academic affiliations with various medical schools, in the 1950s Mount Sinai was not satisfied that they were living up to their potential in terms of training the next generation of physician/scientists or using their immense clinical material for creating new medical knowledge to advance patient care. In 1963, the Trustees received a charter to create their own medical and graduate schools. The Mount Sinai School of Medicine opened in 1968.

Elise Galloway – A Roosevelt Nurse for Life

Nurses’ Week has come and gone, but it is always worthwhile to celebrate our healthcare warriors and shine a light on their accomplishments. This post would like to highlight Elise Galloway, a 1906 graduate of the Roosevelt Hospital School of Nursing who went on to be a Roosevelt nurse for her whole career.

Elise Galloway

Galloway was born in Garrison, New York in 1878. The farmhouse she and her family lived in until the 1920s still stands on the property of the Garrison Grist Mill Historic District site.  As a student, she would have worked one of two shifts – 7a.m. to 7p.m. or the reverse – 7p.m. to 7a.m.  Nursing students generally had one half day off a week, two hourly breaks a day and time on Sundays for church. The bulk of their training would be on their assigned ward. Their responsibilities included daily grooming and washing of patients’ faces, hands and feet, weekly sponge bathing, taking temperatures and noting that and any other particular changes in the patients’ condition, changing dressings, and serving patients their meals and preparing additional special dishes, if a patient needed supplemental nourishment. Nurses would join the Attending Physician on rounds, noting instructions and assisting as needed. Student nurses would also have weekly lectures in anatomy, physiology, Materia Medica, gynecology, the digestive system, the practice of medicine, the ethics of private nursing, and surgical diseases and emergencies.

 

 RHSON Class of 1906 – I believe she is sitting below Miss Samuels who is in the back row, fifth woman in from the left.

 

Galloway graduated with the class of 1906, and began working at Roosevelt right out of school. Miss Mary Alexander Samuels, was the exacting Directress of Nursing in charge of both the nursing staff and the nursing school. Miss Samuels, considered a keen observer, recognized Galloway’s fine nursing skills, and heard about her reputation for reliability and an ability to catch on quickly – a necessary skill for a job that was learned by doing. She assigned Galloway as nurse supervisor over the Syms Operating Theatre.

The Syms Theatre, opened in 1892, was one of the most advanced operating theaters in the country and had very high standards. Medical students from the College of Physicians and Surgeons, located across the street from the Hospital, trained there, and visiting surgeons frequently came to observe surgical procedures in its sky-lighted amphitheater. As Nurse Supervisor, Galloway had to make sure all her student nurses knew how to properly sterilize instruments, suture materials, towels, and sheets for surgery, something that was a long and complex process at that time, as well as how to work with the surgeons during a procedure. Galloway, noted as being a patient and kind teacher, earned the nickname, “Mother Galloway,” used by students and doctors alike.

Her Hospital service was interrupted only twice in her career – the first time was in 1915, for six months, while Galloway volunteered to work in France with the American Ambulance Corps, prior to the formal U.S. entry into World War I.  When the U.S. joined the conflict, Galloway served as a member of Base Hospital 15, which was composed of doctors, nurses, and support staff all drawn from Roosevelt Hospital’s personnel.  She served as the Nursing Supervisor, organizing the operating room staff much as she did in the Syms Theatre.

 

Officers and Nurses of Base Hospital 15. Elise Galloway is on the left, standing next to the Unit Head wearing the Mountie-type hat.

 

The unit remained in Chaumont, France for most of the war. However, Galloway, along with another nurse and, two doctors spent about ten weeks at a French evacuation hospital at the French front near Vasney, where she experienced air raids at close range in exchange for valuable experience in wound treatment techniques.

Returning home to the Syms Theatre and New York, doctors knew her as an invaluable assistant and friend; nurses knew her as an excellent teacher. She was said to have an unfailing good temper, always calm, retaining poise in any emergency, and very unselfish, presenting the profession of nursing nobly and exemplifying the spirit of service and high standards that nursing is strives for.

The alumni newsletter notes that Elise Galloway left Roosevelt Hospital after an operation in the summer of 1933, and died in the Hospital on September 20, 1934 after an illness of several months.

Announcement: Our New Catalog

The Aufses Archives is excited to announce its new online catalog. Based in AtoM, the catalog will make available records for all our archival material and provide direct access to our digital objects. 

Graphic reading "The Arthur H. Aufses, Jr., MD Archives Catalog - Discover what is in our catalog" against a collage of images of the hospital buildings that are part of the Mount Sinai Health System

What does this mean for researchers?  

Our new catalog has several new features: 

  • A more complete view of our holdings: This is the first time all of our material will be described together in one place, regardless of format and digitization status. All our publicly available material will have a record, whether or not it has been fully processed or has a complete finding aid. (An archival record is like a record for a book in a library catalog – you might not be able to download the whole book from the catalog, but you can see that they have it and how to access it.) 
  • Centralized digital resources: All our digital material will be in one place, regardless of its original format. Researchers will only have to search in one place for our digital material. This includes our web archives collection.
  • Names, subjects, genres: Looking for something really specific? Search results can be filtered and faceted to include specific people, topics, and formats represented in the archival material. 
  • Improved searching: Material will be findable via keyword searching, within and across collections. Advanced search will be particularly helpful for those searching for material within a particular date range. 

Screenshot of search results showing top-level records in the catalog

When can I use it?  

The catalog will go live on June 1, 2021, with the majority of our archival records. Our digitized audiovisual and image collections will be added over the course of Summer 2021. Our born-digital and digitized records then will be incorporated starting in Fall 2021, with a project completion date in early 2022. 

I need help using the new catalog — and I have feedback!  

Contact us! We’re happy to help you find what you’re looking for. 

Update: As of June 1, 2021, the Archives Catalog is live and available here.

Poor People Only

The Mount Sinai Hospital created its Dispensary/Out Patient Department in 1875 when it established four clinics:  the Gynecology Clinic, the Children’s Clinic, as well as ones for Medicine and Surgery. Then as now, these clinics were designed to treat people with health needs that did not require a hospital stay. The Hospital traditionally had a long waiting list for admission, and this was seen as a way to help those they could before their conditions worsened. (In addition, in 1884, Mount Sinai Hospital created what it called the “Outdoor Visiting Physicians” to actually go to people’s homes to care for them there. Medicines were provided from the Hospital pharmacy.)

The Hospital was a charity organization and highly dependent on keeping costs down and maximizing donations to support its work. While there were a few patients willing and able to pay something for their care, the vast majority were treated free of charge both on the in-patient side as well as in the Dispensary. Since funds were so limited, Mount Sinai tried to take steps to ensure that their efforts were helping those most in need. One of those steps was to post a sign in the Dispensary that said, “Poor People Only Treated Here”. It eventually became clear that this sign was disrespectful to the people who used the clinic, and 140 years ago, on May 8, 1881, the Board of Directors of the Hospital decided to look into having the sign removed. Unfortunately, the Board minutes do not tell us if it was actually taken down.

The need to closely watch expenditures and try to reserve their services for the most needy continued to plague the Hospital leaders for decades. The beginnings of health insurance in the early decades of the 20th century helped, but it was really the implementation of Medicare and Medicaid in the mid-1960s that relieved hospitals of much of the burden of the costs of charity care.

The entrance to the MSH Dispensary, 1890

The Mount Sinai Hospital OPD Admissions desk in 1951

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.


Dr. Marie Nyswander, Early Leader in Methadone Maintenance Treatment

Women have been active contributors to Mount Sinai Beth Israel since its founding in 1890. From the Ladies’ Auxiliary formed in MSBI’s first year of operation, to the first female House Staff member Dr. Nettie Shapiro in 1909, to so many on our front lines today, women’s contributions have always been essential to the operation of the hospital. This year for Women’s History Month, we’ll be featuring Dr. Marie Nyswander (1919-1986), a psychiatrist and an early leader in methadone maintenance in the treatment of heroin addiction. 

Dr. Nyswander was born in Reno, Nevada, and graduated from Sarah Lawrence College (1941) and Cornell University Medical College (1945). From there she joined the Public Health Service in Lexington, Kentucky, where she first worked with patients with addiction issues. She later received psychiatry training at New York Medical College, and published a book, The Drug Addict As A Patient, in 1956. The book was among the first which argued for treating addiction as a medical problem, rather than a moral failing, likely influenced by the dramatic increase chemotheraputic treatments for psychiatric disorders in the 1950s. She went on to chair the New York City Mayor’s Advisory Board on Narcotics in 1959 and worked at a clinic in East Harlem throughout the early 1960s, alongside her own private practice 

Photograph of Drs. Nyswander and Dole

Photograph of Drs. Nyswander and Dole

In 1964, she was invited by Dr. Vincent Dole, a physician at Rockefeller Hospital, to join a study on the biology of addiction, which ultimately led to the discovery of methadone as a treatment for heroin addiction. Drs. Nyswander and Dole married in 1965. From the late-1960s until her death in 1986, she was affiliated with Beth Israel Hospital, where thousands were eventually treated through the Methadone Maintenance Treatment Program. She also served on the President’s Advisory Board for Mental Health during the Carter administration. Both she and her work with Dr. Dole received many honors. 

Headline reads: "Methadone Credited With Rehabilitating 850 Addicts"

Article from January 20, 1969 issue of “Drug Topics”

Dr. Nyswander was a fierce defender of what has been a controversial treatment since its inception. Though detractors argue that methadone replaces one opioid addiction for another, Nyswander and Dole saw that abstinence-focused treatments were not always effective and that the symptoms of withdrawal caused by detoxification were needlessly challenging and painful for the patient. Methadone, an opioid itself, prevents drug cravings and blocks the ‘high’ of heroin.

Dr. Nyswander passed away in 1986 at the age of 67.

 

Sources: 

Courtwright, David T., “The prepared mind: Marie Nyswander, methadone maintenance, and the metabolic theory of addiction,” Addiction 92, vol. 3 (1997): 257-265. Accessed March 23, 2021. 

Dole, Vincent, Biographical photographs, Arthur H. Aufses, Jr., MD Archives at the Icahn School of Medicine at Mount Sinai, New York, NY. 

“Dr. Marie Nyswander Dies at 67; Expert in Treating Drug Addicts,” The New York Times (New York, N.Y.), April 21, 1986. Accessed March 23, 2021. 

Methadone Maintenance Treatment Program clippings, AA088.S003.SS001.B003.F029 – AA088.S003.SS001.B003.F047, Mount Sinai Beth Israel collection, Arthur H. Aufses, Jr., MD Archives at the Icahn School of Medicine at Mount Sinai, New York, NY.  

Doris Siegel, Pioneer Social Worker

In April we celebrate both Women’s History Month and national Social Work Month. So it is fitting that we highlight a woman at Mount Sinai who was also a pioneer in social work, Miss Doris Siegel (1914-1971). Mount Sinai’s Department of Social Services (later Social Work) was created in 1907 and, since it was still a new field of service, the Department was initially managed by a series of nurses. By the mid-20th century, this was no longer the case, and in 1954, Doris Siegel was named Director of the Department. During her tenure, she updated and expanded the services of the Department, and spent time on broadening educational efforts in social work.

Doris Siegel, 1969

When Mount Sinai School of Medicine was forming in the 1960s, a new entity was created called the Department of Community Medicine (today’s Department of Environmental Medicine and Public Health). In 1968 the Social Services was moved into Community Medicine as the Division of Social Work. In this new role, the mission of Social Work was to support the School through innovative community service programs, research, and participation in medical student education. (They had been training nursing students from the beginning.) These were all activities that staff in Social Work had been doing for many years, and being an official part of the School supported and encouraged them to continue.

In 1969, social work at Mount Sinai as an academic enterprise was recognized with the creation of the Edith J. Baerwald Professor of Community Medicine (Social Work), the first endowed chair in social work in an American school of medicine. (It was a gift of Jane B. Aron, a Trustee at Mount Sinai and a long-time supporter of Mount Sinai’s Department of Social Work.) Doris Siegel was installed in the chair at a special convocation ceremony in 1969, making her the first woman named to an endowed chair at Mount Sinai. She died two short years later, but is still remembered today as a “Pioneer in Social Work.”

The Baerwald Chair remained in the Division of Social Work through the tenure of two more Directors, Helen Rehr and Gary Rosenberg. Meanwhile, the broader Department had evolved and changed its named several times. In 2017, the Baerwald Chair in Social Work became the Baerwald Professor of Environmental Medicine and Public Health.