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Department Publications
Department History (1913—1930)
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1858-1912 1913-1930 1931-1942 1943-1958 1959-1968 1969-1970 1971-1985 1986-2006 |
1913-1930 City-State Machine Politicians Nibble at the Research and Educational Hospitals— and Swallow the Infirmary Whole
Fortunately for ophthalmology at the old P. & S., Casey Wood joined the faculty in 1899 and remained throughout this low ebb in the Infirmary's usefulness. In 1913, when the College of Physicians and Surgeons of Chicago became the University of Illinois College of Medicine and the College adopted departmental organization, Wood became Head of Ophthalmology, holding that position until 1917. Recently described as "one of the most colorful and outstanding figures in ophthalmology at the turn of the century, not only in Chicago but nationally and internationally as well," Wood was a scholar's scholar, distinguished as an ornithologist, a bibliophile and a linguist. His 1896 publication implicating methyl alcohol in the etiology of toxic amblyopia is considered a classic work. Wood was editor at various times of the Ophthalmic Record, the Annals of Ophthalmology, and the American Journal of Ophthalmology (of which he was a founder in 1884); of A System of Ophthalmic Therapeutics (1909), A System of Ophthalmic Operations (1911), and the seventeen-volume American Encyclopedia of Ophthalmology (1914- 1920). In 1929 he translated into English the earliest printed book on ophthalmology, De oculis eorumque egritudinibus et curis, written by the 12th-century physician, Benvenuto Grassi, and first published in Ferrara in 1474.
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Casey Wood, Faculty, College of Physicians and Surgeons of Chicago/University of Illinois College of Medicine, 1899-1917; Professor and Head of Ophthalmology, University of Illinois College of Medicine, 1913-1917 |
Wood organized the ornithological titles at the British Museum and prepared its first catalog describing that collection. Traveling widely in pursuit of this interest, he collected specimens in British Guiana, the Caribbean, the South Pacific, India, Ceylon, Australia, and New Zealand. Out of this work came what he considered his major publication: The Fundus Oculi of Birds, Especially as Viewed by the Ophthalmoscope (1917). Wood retired from the College in 1925, spending much of his last decade at the Vatican Library in the translation of medieval European and Arabic ophthalmic manuscripts.
William Elliott Gamble, who joined the P. & S. faculty in 1898, was an ophthalmologist of more practical bent—and one with Infirmary ties. He remained on the Illinois faculty for many years, acting briefly as Department Head in the early 1920s. Gamble's Infirmary position—and his loyalty to the University—proved crucial in enabling David Kinley, University President from 1920 to 1930, to discover the nature of the mysterious opposition that developed early in Kinley's administration, when he tried to bring in the Infirmary as one of the projected Research and Educational Hospitals of the University.
With Governor Lowden's reorganization of the state government in 1917, the Infirmary had come under the aegis of the giant new Department of Public Welfare, which carried a host of social responsibilities including the care of crippled children, the blind and the deaf. In 1919, Kinley's predecessor, President Edmund J. James (1904-1920), despairing of finding any other way to provide the hospital which the College of Medicine needed to survive, had signed an agreement of cooperation with the Director of Public Welfare. Under its terms Public Welfare was to construct and maintain a set of hospital buildings in which charges of the State (by reason of physical or mental illness) could receive treatment by University faculty and staff. A second part of the University's charge was a commitment to research into the causes of disease and disability, in order to advance the possibilities of prevention. The agreement included specific provision for Public Welfare to build a new home for the Infirmary at the College, adjacent to the other proposed hospital units. As it happened, it was this proposal that brought the entire agreement to grief, resulting in many years of delay before even the first of the clinical units were completed (the General Hospital and the Surgical Institute for Crippled Children).
President Kinley had barely taken up his duties as Edmund James' successor when the election of 1920 brought into power three men whose combined presence in their respective new positions spelled disaster for James' statesmanlike plan to secure hospital facilities for the College of Medicine. Inaugurating what proved to be one of the most corrupt and sordid eras in Chicago and Illinois political history were the new Governor, Len Small; a new member of the University Board of Trustees (and its president twice in the next few years), William Lincoln Noble; and the new Director of the State Department of Public Welfare, Judge Chauncey H. Jenkins. "For the next nine years," Kinley's biographer tells us, the new University President "struggled to keep politics out of Medical College affairs as politicians grasping for money, patronage, and power made it impossible for the two agencies (the Department of Public Welfare and the University of Illinois) to work in an atmosphere of cooperation."
Integral to this tale of the University's failure to gain control of the Illinois Eye and Ear Infirmary during the 1920s is the interaction of these three— Governor Small, Trustee-President and Infirmary Chief-of-Staff Noble, and Public Welfare Director Jenkins—with several lesser characters out of the dark pages of Chicago history. The first is William Hale Thompson (who modestly called himself ''Big Bill, the Builder"), Mayor of Chicago between 1915 and 1923 and again from 1927 until 1931. The second is Fred Lundin, Thompson's patronage chieftain. By virtue of Lundin's ability to shin his patronage machine with lightning speed, ever ready to accommodate the highest bidder, he became the stealthy power behind several additional thrones, including those of Governor Small and his successor, Louis L. Emmerson. A third is John Dill Robertson, the powerful Commissioner of Health of Chicago and a determined foe of the College of Medicine all the way back to its pre-Illinois days as the old P. & S. Robertson was a graduate and later proprietor and President of the Bennett College of Eclectic Medicine and Surgery, which Flexnerian reformism forced into merger with Loyola. He had fought the affiliation between the University and the P. & S. beginning in 1897. He had joined in bringing the suit which prevented the University from acquiring the P. & S. in 1911. And he had even attempted to corner P. & S. stock in 1912 - 1913, in order to prevent the alumni from making their school a gin to the Trustees of the University.
Robertson's role in obstructing the creation of the Research and Educational Hospitals can perhaps find philosophical justification on the grounds (which he often used) that just as there was no "state sect of religion" in Illinois, so should there be no "state sect of medicine"; that Illinois should not support one school of healing (the "regular" schools represented by the (P. & S.) at the expense of opposing schools (homeopathy, for example; or Robertson's own eclecticism). But it is also true that Robertson was closely allied with Fred Lundin, whose insatiable appetite for patronage positions with which to wheel and deal made him hunger for control of the existing Infirmary and of non-academic appointments in any new hospitals the University of Illinois might secure. It may have been for either of these reasons, or perhaps for both, that Robertson, arm in arm with patronage chieftain Lundin, led the conspiracy to obstruct the University's plan.
In the case of our ophthalmologist-villain, William Lincoln Noble, there is no question of an exculpatory philosophical motive. Although a medical graduate of Rush and the first resident to be trained at the Infirmary (1888), Noble never practiced a specialty and was never as interested in medicine as he was in politics. Soon after taking his M.D. in 1888, he began building a power base through essentially political appointments: as ''County Physician'' of Cook County; as Superintendent of the Cook County Insane Asylum; as Chief of Staff at various times at the Illinois Eye and Ear Infirmary (where he is open credited with re-organizing the staff after Holmes' retirement); as "Extramural Surgeon" of the old P. & S. (in 1910); as a member of the professional committee for medicine in the State Department of Registration and Education (1916- 1920).
The capstone to Noble's political career was his election to the University Board of Trustees for two successive terms (1921 to 1933) and his presidency of the Board from 1923 to1925. From the time of his election as a Trustee (ostensibly to see that the College of Medicine was properly managed!), Noble steadily opposed the construction of the Research and Educational Hospitals. The University did not need hospitals, he said, but should instead devote itself to research. (He had earlier accused the College of Medicine of producing researchers instead of practitioners. The medical press of the state, controlled for many years by his close cronies, hounded the College with each charge in its turn, and with others which Noble supplied to them from time to time.)
Kinley's biographer has found compelling evidence that Noble collaborated in obstructing the University's hospital plan because he did not want the Infirmary moved. Any change would have interfered with his use of the institution as its Chief of Staff. (Noble admitted as much to the Board of Trustees in 1931.) Because of the Infirmary's location, it was little used for research by University faculty. Noble apparently wanted so much to keep it that way that he was willing to thwart the entire Research and Educational Hospitals project in order to do so.
According to William Elliott Gamble, who served on the College faculty and also on the Infirmary staff, Noble, despite his title as Chief of Staff, never saw patients, serving rather as liaison between the Infirmary and the Chicago and Cook County politicians. It was to retain this involvement in the patronage pie that Noble connived to keep the Infirmary out of University control, sacrificing the other planned hospitals as well, if that was necessary to achieve his personal objective.
Although President Kinley was largely unaware of this murky background, he recognized, from the beginning of his administration, the fragility of the agreement of cooperation as a basis for the long-term development of hospitals for the University. As a legal document, the agreement was "not worth the paper it was written on," he said, for it depended entirely on the good will of both parties. Nonetheless, Kinley attempted to shepherd its implementation as rapidly as possible. The College of Medicine had to have a hospital. Indeed, in the eyes of accreditation officials, the College should have had at least 200 beds some years before.
Kinley got his first glimpse of the difficulties ahead while attending the legislative session of 1921. There he received notice of "injunction proceedings against the inclusion of the eye and ear hospital" in the agreement of cooperation between the University and the Department of Public Welfare. In ensuing discussions, Kinley was unable to persuade Welfare Director Jenkins that the Department should transfer the Infirmary to the College, as agreed in 1919. The two men instead drained a tentative plan whereby the Infirmary would remain in its old location, with Jenkins supplying enough typical cases for study to fill those Research and Educational Hospital beds assigned to eye, ear, nose and throat work. When Kinley sent Jenkins a copy of this agreement for his signature, however, Jenkins refused to ratify it. After three years of fruitless prodding, Kinley abandoned the project. The modified agreement was never executed.
This new evidence about Jenkins and Noble should go far to correct historical explanations formerly adduced for the failure of the University to gain control of the Infirmary in the twenties. The merger attempt did not fail, as one account has it, "because of vehement resistance by the Infirmary staff to relinquishing its autonomy and privileges." Some Infirmary staff members did press legal actions to prevent a merger, but it seems almost certain from the evidence we now have that those who did so were acting on the urging—if not the orders—of Chief-of Staff William Lincoln Noble.
Another explanation places responsibility for the failed merger effort on Edward Vail Lapham Brown, who was Head of Ophthalmology at the College of Medicine from 1917 to 1925. One of only three Chicagoans to serve as President of the American Ophthalmological Society (1940), Brown in 1920 established what has been called the "first adequate post-graduate clinical course in ophthalmology" in the city. It may be true that Brown riled Noble (and perhaps other Infirmary personnel as well) when he "invaded" the Infirmary while organizing the post-graduate course. Reportedly he "proceeded to take over its facilities without regard to precedent and tradition long established." The "dispossessed" rushed to court, according to this account, with a resulting "complete dissolution between the two institutions.'' All of this may have happened, but the evidence places primary responsibility elsewhere than on Brown's alleged impetuosity. The merger effort failed because Noble and Jenkins worked with Governor Small to make it fail, while John Dill Robertson and Fred Lundin cheered from the sidelines.
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Edward Vail Lapham Brown, Faculty, University of Illinois College of Medicine, 1917—1945; Professor and Head of Ophthalmology, 1917—1925 |
Once Noble had anchored the Infirmary in its 53-year-old building at Adams and Peoria, secure against transfer to the College of Medicine, he set out to find money for the repairs it urgently needed. Knowing that Representative Thomas Curran, chairman of the House Appropriations Committee, proposed to cut $400,000 from the University's Armory addition, Noble tried to get this money for his Infirmary improvements. Although still President of the Board of Trustees at this time (1925), he lobbied to get Curran's bill through the legislature and to the Governor ahead of the University appropriations bill.
President Kinley now proved to be an apt student of the Chicago hard-ball politics Noble forced him to play. He managed to rally enough supporters to defeat this maneuver, but he admitted to a close friend that it distressed him to find "treason in our own household." Noble's presence on the Board of Trustees made it awkward for Kinley to expose his behavior, even when the President had amassed overwhelming evidence of Noble's complicity in various efforts to undermine University goals. In February 1925 Kinley directly asked Noble's opinion about the evasive behavior of Judge Jenkins. Noble's failure to reply confirmed Kinley's worst suspicions.
Encountering repeated delays in construction of the initial hospitals promised by Public Welfare, Kinley soon tired of Jenkins' vague explanations and went directly to Governor Small. Small responded by arranging to drain a timetable, in collaboration with Jenkins, Kinley and a committee representing the College of Medicine. Although the dedication of the General Hospital took place in the spring of 1924, as the timetable prescribed, the buildings were not ready for occupancy until that fall—and even then they contained none of the promised equipment.
At Kinley's prodding, Jenkins advertised bids for equipping the new buildings—then held them without taking action. The University Architect got the bids transferred to the Purchasing Department, but this turned out to be the domain of Governor Small's son, whose continued inaction eventually forced the Trustees to authorize the use of $60,000 of University funds for equipment. As Kinley had noted in a memo after meeting with Small, it appeared that every possible means would be used "quietly to delay and block the opening of these hospitals" until the 1925 session of the legislature, when those who wished to control them expected to be invulnerable to attack by the University.
(At one point in this unthinkable story, an outraged Kinley told Governor Small that Small's friend, Dr. John Dill Robertson, "was interfering and injecting politics into the matter" and that the hospital superintendent recently appointed on Robertson's recommendation "was a ward politician, knowing no more about the management of the hospital than the governor or I myself.")
Small's promises to intercede on behalf of the University meant little, coming from the man who had tried to control the election of University Trustees and place John Dill Robertson in the Board presidency (an attempt foiled by the Alumni Association). The only concession forthcoming in response to Kinley's heroic pushing and prodding was the opening of a small section (50 beds) of one hospital unit. Here the University admitted its first patients on April 1, 1925—despite inadequate staff and the absence of shades and screens at the windows. In 1927 there were 150 beds in use; three years later, as Kinley led office, only 175 beds had been assigned, although the new building had space for 400 to 450.
The politics of calculated delay persisted under Roy Ide, who succeeded Jenkins as Director of Public Welfare in 1927. Ide allowed a hospital appropriation of $175,000 to lapse, despite urgent need by the College of Medicine for equipment and additional buildings. In 1927 Kinley tried to end the impasse by persuading the Governor to ask the legislature to transfer the hospitals to University control. Perhaps Governor Small agreed to the transfer because he had by that time broken with his Chicago political allies, Fred Lundin and John Dill Robertson.
At a special legislative session in May 1928, Small (who had by then lost the Republican primary and become a lame-duck Governor) urged legislators to give the University full control of the Hospitals. The transfer measure passed easily in the Senate, but again ran into interference from Trustee Noble. Despite the fact that ongoing delays prevented many qualified Illinoisans from obtaining a medical education; despite the danger of erosion among a long-suffering faculty which had been promised clinical facilities for more than a decade, Noble traveled to Springfield with John Dill Robertson to block the transfer. The two men induced Thomas Curran of the Appropriations Committee to suppress the bill. All of this happened so quickly within the one-week special session that President Kinley had no time to rally University supporters.
During the course of this prolonged impasse, concocted solely to protect Noble's patronage base, other Research and Educational Hospital units came into jeopardy, just as Kinley had feared. In 1928 a concerted effort arose to persuade Public Welfare to construct a permanent home for the Institute for Juvenile Research near the University of Chicago. (The Institute for Juvenile Research was initially housed in one of the early Research and Educational Hospitals, and Illinois medical faculty had already begun studies utilizing its patients.) Kinley fought this proposal on the grounds that state funds should not be used for a building on the campus of a private institution. But in order to persuade Rodney Brandon, the new Director of Public Welfare, to retain the Institute for Juvenile Research at its Illinois site, Kinley was forced to sacrifice his hope for a prompt, full transfer of all the Hospitals to the University.
Brandon felt that Public Welfare was too closely tied to the work of the Institute for Juvenile Research to surrender its control to the University. In general, however, Brandon was far more cooperative than any of his predecessors back to Charles Thorne, who had mapped out the original agreement with President James in 1919. Although unwilling to yield full control to the University, Brandon agreed to Kinley's request for a modified agreement giving the University greater voice in hospital management.
