This year we’re discussing aspects of Mount Sinai’s history as a community by joining forces with the Institute for Equity and Justice in Health Sciences Education through a series of three Chats for Change programs. In this post I’ll provide some background about what Chats for Change is, how it came to be, the Institute team we’re working with this year, and what the Archives brought to table.
About Chats for Change
In 2015, Mount Sinai launched the Racism and Bias Initiative (RBI) to center underrepresented voices and experiences, recognize the historical underpinnings of racism and bias in medicine, and explicitly address and undo racism and bias in all functional areas of the medical school. Beginning in the fall of 2018, the Department of Medical Education launched “Chats for Change”—a series of dialogues centered on racism and bias in medicine.
Chats for Change was developed in response to medical education staff, faculty, and medical students who wanted dedicated time to engage in a dialogue as a community and deepen their understanding of and ability to address racism. These sessions were based on the notion that in order to respond to racism and to be anti-racist, we must engage in dialogue, learning, and action. Participants include staff, faculty, and students from across the School and Health System. There is also a National Chats for Change available to all medical schools in North America.
The Process
How does this work? The structure of Chats for Change remains the same regardless of the topic. Held over Zoom, facilitators provide some introductory background information and review the grounding assumptions for the dialogue about to take place. The grounding assumptions that I find change the power dynamics are “everyone here is all we need” and “refrain from expecting experts or others to know best.” In both education and healthcare, there is deeply ingrained respect for and deference to expertise. Asking participants to shift out of this mindset is a challenge and requires intentional interactions outside the traditional norms and hierarchy.
The facilitators review the process and hen there is a brief check-in to get everyone acquainted. The next portion is framing and defining that day’s topic with a brief presentation, about ten minutes long.
We then review norms for the breakout groups in which the participants are about to participate:
All of us are taught misinformation about our own group(s) and about members of other groups
We agree not to blame ourselves or others for the misinformation we have been taught, and to accept responsibility for not repeating misinformation after we have learned otherwise
The participants enter the breakout rooms with some questions to guide their discussion, keeping in mind that there will be a debrief with the whole group afterwards to share any themes, insights, similarities and/or differences (as shown on the slide here). Every session ends by asking “given today’s dialogue, what do you need to learn and unlearn?”, followed by a request for feedback and a preview of the next week’s topic.
2024 Spring/Summer Season
In planning the 2024 Chats for Change season, Leona Hess, PhD, MSW, Co-Director of the Institute, invited me (the Aufses Archives’ director) to join in on brainstorming topics for discussion.
For this year, we arrived at the following groupings:
Series on Understanding Islamophobia and Antisemitism
Given the horrific increase in hate crimes against Muslim and Jewish people, it’s imperative for us to commit to deeper understanding and reflection.
Antiracism Fellow Series
This year’s Institute for Equity and Justice in Health Sciences Education Antiracism Fellows will introduce new topics, challenging all of us to critically examine pressing contemporary issues and the role of medical students.
Mount Sinai History Series
Pulling from resources in the Aufses Archives, we will uncover how Mount Sinai’s past shows up in our present, how equitable treatment regardless of the ability to pay is a relatively new concept, and how our patient populations have been recorded and reported at different moments in our hospitals’ histories.
Rejuvenate and Restore (R&R) Series
With everything going on, we can still find time for joy, future dreaming, and collective care.
In addition to these series, there were one-off chats on decolonizing global health, cybersafety, the rural vs. urban divide, and much more.
Mount Sinai History Series
The first Mount Sinai History Series took place on April 23rd, exploring the question, How Does Our Past Show Up in Our Present? by reflecting on our hospitals’ and medical school’s founding charters, articles of incorporation, and mission statements.
At Mount Sinai we often cite our origin story, the opening of Jews’ Hospital in New York in 1855, as a core element of our identity: to treat those who were refused treatment elsewhere (at the time, people of Jewish faith, and accident victims). As a health system, we are now multiple hospitals and a medical school. Pulled from resources in the Aufses Archives, we considered how the histories of these institutions shape us today. To do this, I started with a quote from the Charter of the Jews’ Hospital (which became Mount Sinai Hospital in 1866).
New York State Charter of the Jews’ Hospital in New York
January 16, 1852
We have associated and hereby do associate ourselves into a benevolent, charitable and scientific Society… to be known… by the name of The Jews’ Hospital in New York… the particular business, purpose and object of such… will be the medical and surgical aid to persons of the Jewish persuasion.
Quote from the 1852 Charter
First Mission Statement of The Mount Sinai Medical Center
1979
The focus was on the mission statements and articles of incorporation that state the reasons why the hospitals were created and what they were intending to do. I have found that these statements do resonate with our values and mission today, so I wanted to see how others felt. We asked the Chats participants, “what parts of our legacies most resonate with you?” There was a good discussion.
The second session, Unified Care?, was about how patients have historically been segregated by ability to pay and other factors. This was co-hosted by Dr. David Muller, Director of the Institute for Equity and Justice in Health Sciences Education. We are working towards health equity, we want everyone to have the same care, but there has always been a way of dividing patients that persists today. Goal was to show past practices–the general open ward layout, transition to semi-private rooms, and entirely private care–that demonstrate how we evolved into the patient placements we see in today’s hospitals.
The final session, Who Sought Treatment, took place in August and covered how hospitals have tracked and reported demographics of the patients who sought treatment. Today we are familiar with tracking patient outcomes by identities, such as race or gender–but this has not always been the case. As New York’s demographics have changed through time, so too have the data recorded about people seeking medical care. We looked at hospital reporting to see how patient populations have been recorded and reported at different moments in our hospitals’ histories. We reflected on how our practices have evolved.
As Mount Sinai Hospital was established to care for immigrants, nativity was most frequently reported. The sex, occupation, age, and other categories were also typically tabulated.
Report on patients from Mount Sinai Hospital’s 1866 Annual Report, page 24
Listed: Number of admitted and refused in a single month (over the course of the year) and age.
Report on patients from the 1866 Annual Report, page 25
Listed: civil Condition, term of Residence in the U.S., nativity, and occupation.
Beth Israel Hospital Annual Report from 1903 stated, “the nativities of the patients reveal at once the broad spirit prevailing in the management of the Hospital. Beth Israel knows no difference in creed, class or color, when suffering humanity appeals to it for aid and relief?”
St. Luke’s Hospital Annual report, 1910
Listed nationality and religious denominations, and occupations of patients.
Mount Sinai is based in East Harlem, over half of the population are of Puerto Rican and Dominican ancestry. This document shows when the hospital first became cognizant of the growing population and demographic shifts in the late 1920s. The language is not current, and we say Latino instead of “‘Spanish’ nativity.”
I am so grateful to Leona, David, and the team (Jay especially), who were incredibly supportive partners. They have a the structure of Chats for Change in place, facilitate adeptly, handle the logistics seamlessly—piloting the Mount Sinai History series could not have happened without their partnership.
Some of you may have read the sad story about the murder of a woman in the Justice Story column of the Daily News on Sunday. It is about how Irma Pradier thought she was going to run off with her boyfriend to California, but instead she was found murdered the next day along the Harlem Speedway, today known as the Harlem River Drive. I was particularly interested in this because it noted that she had been a maid at The Mount Sinai Hospital, and had even lived at the Hospital. I also realized that she had been hired before 1937, which meant there was a good chance the Aufses Archives had some record about her in our one existing employee logbook, which dates from 1882-1937. This lists all persons hired to work at Mount Sinai, which would exclude the medical staff who were generally not paid anything, or worked under a contract model.
And I was right!
Below is a portion of the page from our logbook that includes Irma Pradier. You can see from this she was hired February 13, 1934 and she lived ‘In,’ which would have meant the Employee Dormitory that faced 99th St., near Madison Ave. (across from today’s Atran and Berg buildings.) She was hired to be a Maid in the OPD (Out-Patient Department) for $35/month. (She would have also received a free meal as part of her compensation.) When she resigned on July 19, 1937, she had advanced to $47/month. As the News‘ article says, her reason for leaving is listed as “Going to Calif.” And the rest is history, or at least, an article in the Sunday Daily News.
The Irma Pradier entry from The Mount Sinai Hospital Employee Logbook
*The book is organized chronologically under each letter of the alphabet. Every entry was done by hand by an employee of the Personnel Office. This was THE official employment history of each worker. The blue bottom edge is from a long ago ink spill that saturated the pages. Note the other reasons for leaving employment. Some are fascinating!
This is a guest blog post by summer intern, Lily Stowe-Alekman. Lily is a junior at Smith College where she studies History, Archives, and the Study of Women and Gender.
Even before given access to traditional pathways of change, women at The Mount Sinai Hospital have worked to make change in the institution. From the opening of The Mount Sinai Hospital in 1855, the wives and daughters of the Board of Trustees worked to provide services in order to provide comfort to patients and to address their social and emotional well-being. By 1917, the first year that women were allowed on the Board, the role of women, and their expectations of that role, had substantially changed. The growing power of women was expressed by the creation of their own organization to exert influence over the life of the Hospital, the Social Service Auxiliary. And according to Helen Rehr, DSW, the second Edith J. Baerwald Professor of Community Medicine (Social Work), they were a force to be reckoned with.1 When prompted in an interview about the Auxiliary, “…they weren’t social butterflies having their tea. That’s not an image you would draw,” Rehr responded “Not these women, never. In the 28 years that I’ve known them I don’t recall having tea with them. No, they were women who came with a commitment to the social organization.” Hortense Hirsch, who served on the Auxiliary Board and Board of Trustees as one of the first woman able to be a Trustee, is a powerful example of the trailblazing women of the Auxiliary Board.
A portrait of Hortense Hirsch, circa 1960.
In 1923, Mrs. Hortense Hirsch (1887-1990) began her work with the Social Services Auxiliary (today’s Auxiliary Board), of which she would continue to be a member for sixty-five years, including a tenure as president from 1951-1956. From there, she was elected to the Board of Trustees in 1932, where she remained until becoming an honorary trustee in 1986. She sat on several committees of the Board, including as a member of the Committee on Building Maintenance and Equipment, Vice-Chairman of the Committee on Social Service, Chairman of the Committee on Convalescent Care, and as a member of the Committee on Ladies’ Auxiliary. Hirsch was president of the Neustadter Home for Convalescents beginning in 1937 when the Home affiliated with Mount Sinai, until she stepped down from the post in 1953.
A photograph of (from left to right) Helen Benjamin, member of the Women’s Auxiliary Board; Mrs. Edith Lehman, the first President of the Auxiliary Board from 1916-1917, Mrs. Ruth Cook, President from 1917-51; and Mrs. Hortense Hirsch, the presiding President of the Board at the fiftieth anniversary of the Auxiliary Board in 1956. Helen Benjamin holds a picture of the first social work volunteer from 1907.
Hortense Hirsch lived to be 103 years old, and by all accounts she remained steadfast in her dedication to social work and volunteerism for her whole life. After she graduated from Smith College in 1907 at the age of 19, she married Walter Hirsch and then moved to New York City in 1909. She began her work as a volunteer at Mount Sinai in 1917. The Federation of Jewish Philanthropies later referred to her as the “honorary ‘Dean of Social Work Volunteers.’” As a thoroughly involved volunteer and then Auxiliary Board member, Hirsch dedicated many hours to the hospital. Dr. Helen Rehr remarked in 1982, “The demands on her were great, but she always rose to it. There was no question on that score.”
Portrait of Hortense Hirsch, circa 1976.
Hortense Hirsch’s personality leaps off the pages of archival materials. When at Smith College, she maintained her own horse and buggy, which was against the rules, by paying a farmer for boarding, effectively evading the administration. In a New York Times article documenting her 100th birthday celebration, her daughter Carol Kridel told them, that while Hirsch was too ill to attend and she had to stay in bed, she was still “wearing a pink bedjacket and a pink bow in her silver hair.” The article also includes a story of Hirsch “[coming] to her 85thbirthday and [tossing] her skirts high to show she approved of the latest rage—hotpants.”
Hortense Hirsch’s work on the Social Service and Women’s Auxiliary Board helped to transform the hospital. She worked tirelessly as a volunteer and board member. Hirsch’s work and legacy came from and continued those of the women who originally found pathways to affect changes at The Mount Sinai Hospital in the late 1800s. Hirsch served on the Board of Trustees, an opportunity that was not available to the women of previous generations. As Dr. Helen Rehr stated, “the Mrs. Hirsches are an outgrowth of that group of women who were the wives of the board of trustees” and ultimately transformed the hospital in the process.
This is a guest blog post by summer intern, Lily Stowe-Alekman. Lily is a junior at Smith College where she studies History, Archives, and the Study of Women and Gender.
As a summer intern with the Arthur H. Aufses, Jr., MD Archives, I have become acquainted with Mount Sinai’s history and the efforts that go into preserving its legacy. One of the projects I have worked on is cataloging The Mount Sinai Hospital News, an in-house tabloid-style newsletter for Mount Sinai employees. Colleen Stapleton, Patient Navigator for the Liver Education & Action Program at Mount Sinai, volunteered with the Archives this spring and digitized the newsletters from 1958-71. In my work cataloging, I read some really entertaining stories that offered a glimpse into the personal lives of people who worked in The Mount Sinai Hospital (later Medical Center), whether that be birth announcements of their children, quirky stories about the things employees did outside of the hospital, or articles about celebratory dinners and ceremonies. One can also not forget the hospital’s bowling team.
While cataloging in July, I came across a story that made me pause because it felt like a full circle moment. The October 1971 issue of The Mount Sinai Medical Center News featured an article called “Everyone Talks about Mount Sinai’s Glorious History; Dr. Al Lyons, Arch Archivist, Does Something About It.” This article has history of the Aufses Archives and is within the archive. While the Aufses Archives is a site of historical preservation, it has its own history as well.
Caption: The objects featured in the article header are still in the Arthur H. Aufses Jr. MD Archives today!
The creation of what is now the Arthur H. Aufses, Jr., MD Archives is due to the work and advocacy of Dr. Albert S. Lyons in the 1960s to 1980s. Over this time, Dr. Lyons advocated for the need of creating the archive and in 1986, secured its future with the hiring of a full-time archivist, Barbara Niss, who remains the Director today. Dr. Lyons (1912-2006) spent over sixty years of his life working at Mount Sinai. He began as a surgical resident at Mount Sinai Hospital in 1938. He went on to become the founder and Chief of the Intestinal Rehabilitation Clinic and worked to help support patient needs post-surgery. He was also a Clinical Professor of Surgery at the Mount Sinai School of Medicine. He wrote a well-known book, Medicine: An Illustrated History, a volume of over six hundred pages, charting medicine from the prehistoric era to the twentieth century.
Beyond his clinical work, Dr. Lyons was committed to Mount Sinai’s institutional history and to history of medicine in general. He taught the History of Medicine elective courses in the medical school. In the 1960s, he convinced the hospital board to collect the institutional history of the hospital. In 1966, he was made Hospital Archivist by Mr. Gustave L. Levy, the Chairman of the Board of Trustees. Dr. Lyons’ passion for preserving the history of The Mount Sinai Hospital overlapped with the discussions and planning of Mount Sinai School of Medicine, which welcomed its first students in the fall of 1968. In 1970, he was given the official title of Medical Center Archivist. Dr. Lyons also contributed a broad range of valuable materials to the Archives, including over eighty-five oral history interviews dating to 1965, a formative time for the field of oral history as well as for the Medical Center, as the School planned for and welcomed its first students.
In October of 1971, The Mount Sinai Medical Center News wrote about Dr. Lyons’ archival work. The article highlights the work and efforts of Dr. Lyons and serves as a call to action of sorts for the archive. Dr. Lyons is quoted in the first line as saying, “When in doubt, don’t throw it out.” He goes on to say that “too much of Mount Sinai’s past has already gone up in smoke,” due to people throwing out items without realizing their significance. He stresses as well that ordinary everyday materials are archival. He stresses that history is not necessarily in the distant past, that the events of the previous day are history. In this sense, Dr. Lyons de-mystifies the archives by showing that it should be in connection with the present moment and is not a disconnected abstract institution. The closing paragraph of the article instructs readers, “If you’ve uncovered some papers or objects you think may be worth saving, are planning some event to make current Medical History, etc. Drop Dr. Lyons a note.” In turn, “He and the Future will thank you!”
Aufses, Arthur H., Jr., and Barbara Niss. This House of Noble Deeds: The Mount Sinai Hospital, 1852-2002, New York University Press, 2002. ProQuest Ebook Central, xi.
“Everyone Talks About Mount Sinai’s Glorious History; Dr. Al Lyons, Arch Archivist, Does Something About It.” Mount Sinai Medical Center News. October 1971. 5, 10.
Founded in 1892, the early history of Mount Sinai Beth Israel Hospital was decorated with a series of success stories in the treatment of disease. Against the background of Manhattan’s Lower East Side, then affected by poverty, close living quarters, and dangerous working conditions, its residents, largely recent Jewish immigrants, were made vulnerable to many of the contagious diseases of that era. In its first years, Beth Israel contributed research to combat the typhoid epidemic of 1906-1907, established an after-care clinic to children affected by the 1916 polio epidemic, and is credited with finding the cure for trachoma, which had previously been a cause to turn away new immigrants at Ellis Island.
Only twenty-five years after Beth Israel’s opening, the United States was embroiled in the first World War. The Hospital encouraged its medical staff to join the Medical Reserve Corps, with approximately half of its doctors signing up. The Hospital had also encouraged its nurses, physicians and other staff to join the war effort.
This left Beth Israel in a precarious position when the 1918 Influenza epidemic reached New York City. Being chronically understaffed, Beth Israel’s Medical Board contacted the Department of Health for advice. The response was simply: “There is nothing to advise except the use of gauze masks which did not always prevent the disease.” In November 1918, the Hospital eliminated visiting hours, curtailed teaching hours, and turned the Male Medical Ward over to the Department of Health to use as an isolation facility for the pandemic. (The DOH never used the facility because they were similarly understaffed.)
Female ward of Beth Israel Hospital, Jefferson and Cherry Street, circa 1910
Ultimately, Beth Israel was only able to admit twenty-nine influenza patients. (Update: This number is disputed in other sources.) Seven members of the House Staff were awarded $25 (approximately $500 today) for “self-sacrificing services performed” and the Hospital offered special incentive pay to doctors and nurses to help combat the fact that they were understaffed.
Despite the limited patient intake, Beth Israel’s contributions to the 1918 flu pandemic were still impactful. In December 1918, Superintendent of the Hospital, Louis J. Frank, contacted Presidents Roosevelt and Taft to encourage universal nursing training in the education of women, likely in response to the chronic under-staffing at this time. By January 1919, many of the patients in the Hospital were admitted for “post-influenzal complications” leading to the care of many affected by the pandemic.
Sources:
Beth Israel Medical Center. The First Hundred Years: Beth Israel Medical Center. 1990. p. 35 – 36.
