Levy Library

New Global Health Web Site

I recently looked at a new website devoted to global health.  It is still a work in progress, but it is of interest since it includes unique video interviews with the people who went into the field and worked on eradicating disease. 

The web site was created by the Centers for Disease Control and Prevention and Emory University in an effort to document and preserve public health history.  It is called The Global Health Chronicles: An inside look at public health efforts to prevent, control and eradicate global diseases. The content consists of oral histories, unpublished documents, photographs and artifacts.  The site is http://globalhealthchronicles.org.

The initial chronicle is devoted to the eradication of smallpox.  There are 50 oral history interviews and 30 presentations at seminars held in conjunction with two reunions of staff who worked in the field during the eradication program.  Two other chronicles are in the process of completion: Malaria and Guinea Worm disease.  The focus of the web site is somewhat limited, centering on the role of the CDC and the United States, and does not reflect the hundreds of thousands of health workers who were the backbone of the effort.  Still, the project is not static and will add materials as they becomes available from archives and medical facilities around the world.

Check it out.

Mount Sinai in LIFE

As an archivist, I am kind of schizophrenic about the web.  I fight hard against the easy - and totally wrong - assumption that, "Everything is on the web."  NO, it's not. And even though archivists are certainly working hard to put more and more of our primary resources online, at this point we are lucky to make overview descriptions of our collections available, let alone the documents themselves.

Still, there are a lot of neat things out there that are fun to look at.  One I just played with is the complete run of LIFE Magazine, made available by Google Books.  I did my usual Mount Sinai seach and found a few articles of interest.  In the February 10, 1947 issue are photographs taken at Mount Sinai documenting a research project in gastroenterology.  The article is called "Inside the Stomach."  In the November 2, 1959 issue there is an interesting article on medical costs called "The Challenge of Mounting Expenses." (Very interesting reading to see what they were saying on health care costs 50 years ago.)  In this article they use two images taken at Mount Sinai, one showing our new 25 million volt betatron used in treating tumors, and the other showing a man at work in our kitchen.  The latter was used to demonstrate the rising cost of hospital personnel.  The caption notes that the employee is a $42.50 a week helper, which comes out to $2,210/year if you do the math!

There are also two articles in LIFE Magazine centered around famous Mount Sinai physicians, Drs. Bela Schick (October 28, 1957 issue) and Samuel Rosen (July 27, 1962 issue).  Dr. Schick was Director of Pediatrics from 1923-42. He helped establish the concept of allergy (and coined the term), and developed the Schick test that allowed doctors to test for immunity to diptheria.  This was the focus of a massive public health campaign in the 1930s, with the tagline of, "Have You Been Schicked?"  Dr. Rosen was an otolaryngologist who in 1952 re-discovered and popularized the procedure of mobilization of the stapes to cure deafness in otosclerosis.  He also was well known for travelling around the world to study the impact of the sounds of modern society on hearing loss.  The LIFE story discusses his trip to Africa to study the hearing of isolated tribes.  Rosen also travelled to Georgia in Eastern Europe and was one of the first westerners into China in the early 1970s. 

So, while not everything is on the web, thanks Google Books for adding another interesting piece to the puzzle.

Oops! Historical Truths Versus Historical Facts

    Recently I was processing some minutes from Mount Sinai's Social Service Auxiliary (today's Auxiliary Board).  This group of dedicated women was founded in 1916 to support the Social Service Department here and it has funded scores of projects around the Hospital and Medical Center over the years, most devoted to understanding and improving the experience of the patient.  (One obvious exception was when they paid one half of my salary my first year here to help underwrite the creation of the Archives.  Thanks!)  Anyway, I was perusing the Report of the Social Service Dept. for 1917 and it noted that the department was formed in 1906 (knew that) and was one of the first such programs in the country (knew that) and the first social worker hired was a graduate of The Mount Sinai Hospital Training School for Nurses (knew that), Miss Rose Johnson.  Wait, what?!  For years now people who have studied the history of the Hospital and the department have all noted that Jennie Greenthal, also a graduate of our school, was the first social worker hired here in 1906.  Who was Rose Johnson?!

    This set me off to look through the records that I have that might shed light on this.  I searched the Board of Directors (now Trustees) minutes for 1905-06: nothing on this but endlessy fascinating. (The doctors asked the Directors to please study the administrative functions because the floors were dirty and the food was bad.  The Directors disagreed, but it wasn't long after this that new people were brought in to oversee the housekeeping, laundry, and food service.  Hmm.)  I checked the annual reports for 1905-1908 and no social worker is noted until the report covering 1907.  So I went back to the minutes of the Board and started searching the minutes from 1907.  For good measure, I also searched the Executive Committee of the Board for 1907. And that's when I realized that we had probably been wrong about this for the last 90 years! 

    In the July 15, 1907 minutes of the Executive Committee, the Superintendent of the Hospital reported that he had made "arrangements for the summer months with Miss Greenthal to act as social Nurse and friendly Visitor in the wards".  Later that year, Mr. Paul Warburg offered to give $1,000 to support the efforts of the now named Social Welfare Department, and that is what is reported in the 1907 annual report. Another source says that Rose Johnson, RN, took over from Miss Greenthal after the summer.

    But why had we ever started using the 1906 date?  Well, we knew we were an early program in the new field of medical social work (the first was in 1905) and memories are not perfect.  In fact, I have some typed notes from an interview with Jennie Greenthal where she says that she started the social work department in 1906.  But this was 30 years after the fact and the surviving documentation does not support that.  Perhaps they started talking about doing this in 1906; certainly Dr. Goldwater was very interested in this new area of hospital work.  We'll never know exactly how the earlier date crept in, but I, for one, am convinced that our Social Service Department began in 1907 and we've been wrong all of these years. 

    Now I wonder if anything else could be mis-dated.....   

Tough Times - Then and Now

The papers continue to be full of stories about the adjustments people and corporations are making in these hard economic times.  Certainly health care institutions are not immune to these conditions.  I thought it might be of interest to look at what Mount Sinai did during the Great Depression. 

In 1931, The Mount Sinai Hospital cut staff salaries, although they grew again slowly as the 1930s progressed.  That same year we opened a Consultation Service to aid people of moderate means.  Private physicians could refer patients with difficult diagnoses to Mount Sinai for a full work-up for a small fixed fee ($15 at first).  All of the results, and hopefully a diagnosis, would then be sent to the community physician for follow-up and care of the patient.  This service was ended in 1958. 

In 1933, Mount Sinai's Social Work Department established a work room to help the morale and rehabilitation of unemployed patients. Patients were taught skills and some got jobs.  The program produced goods that were sold, with the patient getting 1/3 of the money while the rest supported the work room. Women were taught to sew so they could make clothes for their families, but not necessarily to get a job. This program became permanent in 1941 and was transferred to the Dept. of Rehabilitation Medicine in 1955.

The Nursing Department began the option for private nurses to work either an 8 or a 12 hour shift, trying to provide work to more people, although it was not popular at first. During these years, the School of Nursing received fewer applications, perhaps due to the times.  In 1934, the Hospital lowered the rates on some private rooms, creating more at the $8, $9, and $10 per day level.  They also lowered the cost of a pint of whisky or sherry from $2 to $1 - for medicinal purposes only, of course!  In response to New Deal legislation, we also implemented the 8 hour day for all non-medical staff and hired more graduate nurses for our wards.  Overall during the Depression, our clinic volume rose and the number of in-patient days went down.

And, in a move strangely  similar to today's Mount Sinai, during the tough economic times of the 1930s, Mount Sinai chose to renovate and enlarge its facilties to better position themselves for the future.

Records Management Comes to Mount Sinai

Usually I write about something from Mount Sinai's past.  I try to show its relevance to the present day, but it is still looking back. Today I want to tell you a little about a very forward-looking program in which the Archives Division of the Library is involved, and that is rolling out a records and information management program for The Mount Sinai Medical Center.  We have hired our first ever professional Records Manager, Miriam Gianni, and she is working with our Records Consultant, Dr. William Saffady. They are visiting offices around the Medical Center, to see what records are created and stored. From those interviews they will draft retention schedules of how long records need to be kept. At the end of that process, departments will be able to actively manage the records they create and be able to more easily find the information they need when they need it.  In other words: throw things away, free up office space, become more information efficient.  An ancillary but important gain from this initiative in the future will be allowing the institution to finally tame the off-site storage tiger that costs us thousands and thousands of dollars every year.  Each department is appointing a records coordinator to work with our Records Manager.  Maybe you will see Miriam and Bill in your area soon. 

Weather and Mount Sinai

Part of the appeal of blogging is the ability to make timely reference to what's going on right now. Here in New York, one of the biggest topics is the weather: have you ever seen so much rain? Does the sun even exist?!  But what does that have to do with hospitals? Well, it turns out weather has impacted Mount Sinai quite a few times in the past. One of the earliest examples is the Blizzard of 1888, when only one Consulting physician, Emil Gruening, could make it to the Hospital, then located at Lexington Ave. and 66th Street. (It was also felt that the Blizzard added to an increase in cases of mastoiditis. Ironically, Gruening did the first successful mastoidectomy in the U.S. in 1892.)

    Fifty years ago, in 1959, there was an electrical blackout due to the heat and demands on the power grid. In 1977 lightening caused Con Ed to lose power across the city for more than a day. More recently, there was the heat wave in August of 2003 that brought on a City-wide blackout. This emergency saw Mount Sinai's medical students pitching in to do various tasks, including directing traffic on 98th and Madison and carrying food to patients. So, even weather has a Mount Sinai connection.

NLM's Turning the Pages Online

There are some things that you see online that just make you say, WOW!  One such thing may be found on the website of the National Library of Medicine, in the Turning the Pages Online section (http://archive.nlm.nih.gov/proj/ttp/intro.htm).  On these pages can be found six famous titles in the history of medicine, brought to life by technology. The titles include Vesalius's De Humani Corporis Fabrica and Conrad Gesner’s Historiae Animalium.  Viewers can literally turn the pages of these wonderful sources and see every page of the volumes in high resolution images.  In addition, there are added features that help explain or highlight various sections of the text and images, making the experience more rich.  These books had once been available only to scholars who could travel to scattered libraries.  Now they are online and available to anyone with a good Internet connection.  Check it out and be amazed!

Play Ball!

It's spring and baseball season is upon us once more. (Go Mets!)  It is a time when thousands of average people dig out their cleats, grab their glove and head for the field.  For years, Mount Sinai has supported teams and entire leagues in a variety of sports, from bowling to basketball, but baseball (and softball) are the two that are still around.  This photo shows a Mount Sinai sponsored baseball team.  We have no information about this image except what can be inferred from the picture itself, but that can supply a few choice details.  Such as: this was probably taken in the 1940s, as evidenced by the man in the suit in the middle, Joseph Turner, MD, the Director of The Mount Sinai Hospital until 1948.  Which leads to another interesting fact: it took major league baseball until 1947 to allow an African-American player to join (Jackie Robinson, of course).   Mount Sinai seems to have reached that milestone sooner than that, truly reflecting the diversity of its staff.  Play ball!

The Swine Flu and Mount Sinai

The current news about the growing swine flu outbreak brings to mind an earlier epidemic in 1976 that saw a Mount Sinai physician playing a lead role.  Edwin D. Kilbourne, MD was Chairman of Mount Sinai's Dept. of Mirobiology at the time, and was known as the first to develop a genetically engineered vaccine (1970).  An infectious disease expert, Kilbourne was sought out by the federal government when it seemed that an epidemic of swine flu was beginning.  Kilbourne and colleagues developed a vaccine for the new strain and millions of people were vaccinated.  Unfortunately, hundreds of new cases of Guillain-Barré syndrome were soon reported, and the question then became: was the vaccine the cause? 

ScienceInsider has just published a little interview with Kilbourne where he talks about the events of 1976 and his current thoughts on what happened. http://blogs.sciencemag.org/scienceinsider/2009/04/retrospective-w.html  It provides a little window on infectious disease control and public health policy. The photo here shows Kilbourne getting his own vaccination in 1976.  The media attention was such that camera crews turned out to film him in the Annenberg lobby getting his shot.

Harvard History of Medicine Site

If you are interested in a broad summary of medical concepts and catastrophes of the past by topic or just want browse for odd tidbits about our medical forefathers, "Contagion: Historical Views of Diseases and Epidemics” is a good place to start.  In January Harvard launched this new collection of digital images in the history of epidemiology and infectious disease.  "Contagion” includes more than 500,000 pages of digitized books, serials, pamphlets, incunabula, and manuscripts and contributes to the understanding of the global, social history, and public policy implications of disease.  It also offers important historical perspectives on the science and the public policy of epidemiology today.  The website, http://ocp.hul.harvard.edu/contagion, contains historical documents on a myriad of topics including the 19th Century Cholera Epidemics; The Great Plague of London, 1665; The Boston Smallpox Epidemic, 1721; Spanish Influenza in North America, 1918-1919; Syphilis, 1494-1923; Tropical Diseases and the Construction of the Panama Canal, 1904-1914; Tuberculosis in Europe and North America, 1800-1922; The Yellow Fever Epidemic in Philadelphia, 1793; as well as general materials on people of note.  E. Du Rocher