Abstract
This book tells us lots about the founding of Johns Hopkins Hospital and Medical School. Hopkins (1795–1873) was a Baltimore banker who met the philanthropist George Peabody at the house of John Work Garrett (1820–1884) and bequeathed funds for a university, hospital and medical school. Mary Elizabeth Garrett (1854–1915), daughter of John, donated the necessary additional funds on condition that women be admitted to the school on the same terms as men and indeed eventually this did come about.
John Shaw Billings planned the hospital on a pavilion basis with good air circulation to reduce cross-infection. He hired William Welch as the first Dean and in due course William Osler as first Chief of Medicine and William Stewart Halsted as first Chair of Surgery. Osler has a cult following and his dedication to hard work, to teaching at the bedside and in the postmortem room, and his keenness as a reader and writer of philosophising in medicine, are all laid out here but together with assertions of his racism. The athletic Halsted, father of American Surgery, became reclusive and addicted to cocaine and then to morphine. He introduced the design and use of surgical gloves.
Jesse William Lazear died during his experimentation with mosquitos and yellow fever, raising questions now about the validity of the concept of informed consent, called into question where payment is made, and the concept now styled by the General Medical Council as appropriate (rather than informed) consent. Miasma and cross-infection were regarded as the mechanisms of infection before the mosquito was recognised, much later, and following the report of malarial transmission by Ross. Volunteers need to be promised medical treatment if they are damaged by research, a very important point.
Max Brödel, artist and illustrator, noted that in medical drawing full comprehension must precede execution and this differentiates the strict depiction of objects by using photography since important points can be emphasised and distracting detail omitted. Dorothy Reed Mendenhall was an early microscopist who unpacked the tuberculosis theory of Hodgkin Disease. Yet anther innovator.
Helen Taussig, profoundly deaf as a result of childhood infection, could listen to her young patients’ hearts by touch. She developed the specialty of pediatric cardiology and also the subclavian to pulmonary artery anastomosis for babies who were blue on account of Fallot's Tetralogy; the operation bears her name with that of Alfred Blalock. Vivien Thomas was technician to Blalock and developed the technical aspects of this operation for blue babies. Thomas helps exemplify the racial desegregation later known to have been necessary at this institution.
This reviewer takes issue as in other books with the unhelpful running headings and layout of references; the ease of the reader should be paramount. Nevertheless, this volume provides a good read of shortish biographies that help us understand some of the many advances in twentieth century America and it is a pleasure to read.