Department Publications
Department History (1931—1942)
 |
Introduction 1858-1912 1913-1930 1931-1942 1943-1958 1959-1968 1969-1970 1971-1985 1986-2008 |
In 1931 the legislature enacted a law providing for joint control of the Research and Educational Hospitals. The language of this modified agreement of 1931 entirely omitted the Illinois Charitable Eye and Ear Infirmary, listing as constituent units only the following: the "University Clinical Institute (the General Hospital)," the "out patient department of the University," the "Institute for Juvenile Research," the "Illinois Surgical Institute for Children," and the "Psychiatric Institute." But the University did not give up its hopes for the Infirmary. In June 1935, in his remarks at the Tenth Anniversary of the opening of the Research and educational Hospitals, David J. Davis, Dean of the College of Medicine, predicted that the Infirmary would ultimately find a permanent home within the growing west side medical center campus.
 |
Harry Gradle |
The changed political climate of the thirties gave good reason for optimism. In 1932 Henry Homer won election for Governor by a larger margin than Franklin Delano Roosevelt's for the Presidency. Homer thus became the first Democratic Governor of Illinois since 1917 and only the third since the Civil War. As a Democrat—and an idealist with a reputation for efficient administration—Homer was not so reliant on Chicago patronage as his less statesmanlike predecessor. Early in Homer's administration, Anton Cermak replaced "Big Bill" Thompson as Mayor, and— most auspicious for the University—in 1933 William Lincoln Noble's duplicitous Trusteeship came to an end. Political circumstances were right for reclaiming the Infirmary, if the new Governor could only overcome the stupefying economic problems of the thirties.
With the introduction of a three percent sales tax and a new tax on utilities (the Illinois Supreme Count had declared unconstitutional a legislative attempt to initiate an income tax), and with strict economies in other areas, Homer managed to increase welfare and educational budgets without stinting on support of the unemployed in Illinois. (These numbered some 1.5 million in 1933, at the nadir of the Depression, at a time when the federal government was pouring as much money into Illinois as it was into Pennsylvania and New York combined.)
Homer, determined to bring the Infirmary up to public and professional expectations, made its reform one of his first priorities. To fill the post of Chief of Staff, which Noble had so long abused as a patronage base at the service of Mayor Thompson and Governor Small, Homer chose Harry Gradle. A dynamic, highly educated ophthalmologist with great administrative skill, Gradle had organized the instructional courses of the American Academy of Ophthalmology and Otolaryngology in 1921. In that same year he joined the faculty at Illinois, serving until 1927. From 1929 to 1943, he was Professor of Ophthalmology at Northwestern (where his father, Henry, author of the first English-language presentation of Koch's germ theory, had been the first Head of Ophthalmology in 1897).
Between 1933 and 1945, Harry Gradle transformed the Illinois Eye and Ear Infirmary. His impact was so great that one Infirmary historian has compared the significance of his appointment as Chief of Staff in 1933 with that of the founding in 1858. A wise and forceful organizer—and a first-rate clinician and educator in the bargain—Gradle recruited a strong attending staff of the foremost available ophthalmologists and otolaryngologists. He completely separated the two disciplines, establishing research and educational programs within each department under the direction of recognized leaders from the Illinois faculty (Peter Kronfeld in ophthalmology; Joseph Beck in otolaryngology).
Gradle improved clinical care by establishing a number of specialty clinics. The first of these, inaugurated in 1934, were five down-state clinics devoted to trachoma, a major cause of blindness long endemic in the seventeen counties of southern Illinois. At the turn of the century, E. V. L. Brown had surveyed and mapped trachoma incidence in every Illinois county, later establishing what has been called the State's first trachoma clinic (in Mount Vernon in 1920). The statute creating the Department of Public welfare in 1917 had specified the treatment of trachoma as one of its charges, but treatment efforts based in the northern part of the State had utterly failed. ("The cost is excessive and patients are not contented to remain so far from home until treatment has been completed," said a contemporary account in the Illinois Health Messenger of June 1, 1934.)
Since trachoma patients would not remain in Chicago, Gradle arranged to bring Chicago doctors to the most heavily infected areas. Governor Homer made special funds available to the Department of Public Welfare, the State Department of Public Health and the Illinois Society for the Prevention of Blindness, and, in 1934, a summer program of treatment for "indigent victims of trachoma in southern Illinois" began, with treatment centers to be conducted by Infirmary physicians in the lower counties. Free bus service provided by the Department of Public Welfare carried patients from 114 towns and villages to and from the five clinical centers. In the first five years of operation, as these centers cared for over 3,500 trachoma cases, the disease began to show signs of diminishing for the first time in the State's history. (By 1954 it was possible to reduce services from four days weekly to only two, at Vienna and Eldorado. In 1965, when Governor Otto Kerner closed what had become known as the ''Governor Homer Trachoma Clinics," Peter Kronfeld spoke of a ''happy ending to this department's participation in the treatment and final eradication of trachoma.")
Another product of Harry Gradle's Infirmary re-organization was one of the first glaucoma clinics in the United States (1939). This administrative innovation advanced Peter Kronfeld's particular research interests and contributed to his eventual recognition as one of the world's leading investigators of this condition. At last the Infirmary was beginning to serve the purpose for which it was ideally suited, a purpose long neglected for the sake of politics: large numbers of patients, receiving first-class care, and at the same time furnishing opportunities for the thoughtful observation and investigation that lead to greater understanding of the disease process itself—and often to improved care and ultimate prevention as well.
By 1940 Harry Gradle had equipped the Infirmary with an enormous staff of bright, energetic professionals: six attendings, nine associates, eighteen "adjunct, " fourteen " extramural ophthalmologists," six eye residents and six eye interns. This team handled some 100,000 patients yearly, 5,000 of them as inpatients in the Infirmary's 200 beds. An orthoptic department with two technicians averaged a caseload of sixteen per day. It is to this period that Edward Collier has dated the rise of the ''spirit of the Illinois Eye and Ear Infirmary,'' a "unique sense of loyalty and esprit de corps" among graduates of a residency program led by such teachers as Harry Gradle, William Hughes, James McDonald, Peter Kronfeld and Georgiana Dvorak-Theobald.
Joseph Haas recalls a fine example of this élan from the early forties, when he was an Infirmary resident in Ophthalmology. At that time the Administrator of non-academic affairs was a political appointee who had won his Infirmary position as a consolation prize, after losing the Republican nomination for Cook County Coroner. To strengthen his political standing, he provided his important friends with cards for Infirmary admission, initialing the corner to signal the residents to give the holders VIP treatment, while ordinary patients waited.
The residents agreed among themselves to put the charts belonging to those with marked cards at the bottom of the pile, placing them last for examination. The Administrator retaliated. He could not reduce the residents' salary (because they had none), but he began allowing them only one daily meal instead of three; he discontinued their phone privileges; and he put eight cots in a single room for all eight who lived on the grounds.
In response, Haas and a fellow resident organized a strike. Leaving one of their number at the Infirmary to attend urgent cases, the others met at the Adams Tavern, at Adams and Halsted, where they called in reporters from the Tribune. This "restored the amenities" (as William Hughes re-tells the story) and the strike came to an end.
It was one of Harry Gradle's greatest administrative achievements to re-open the question of the Infirmary's status and the possibility of moving it into the midst of what were then called the Chicago Professional Colleges. The College of Medicine had never ceased discussing this prospect, bringing it up again and again with successive Directors of Public Welfare. Especially in the late thirties, besieged as it was by hundreds of thousands of patients unable to pay for medical care, the University desperately needed to free space occupied by Ophthalmology and Otolaryngology in the overcrowded Dispensary and General Hospital. As an additional argument for University acquisition of the Infirmary, Dean Davis noted a dearth of teaching beds in the Department of Surgery for patients with hare-lip and cleft palate.
For many years Illinois faculty had dominated the staffing of the Infirmary. Despite the absence of any formal or legal ties whatever, the Research and Educational Hospitals Laboratory performed tests for the Infirmary as freely as it did for the Illinois Neuropsychiatric Institute, the University Health Service, and "other related sources" outside the Hospital. Radiology faculty from the College of Medicine read all x-rays taken at the Infirmary. Yet, despite this high degree of functional integration, the Infirmary was excluded from the legislation which ultimately transferred control of the other Research and Educational Hospital units to the University in 1941.
In 1940, at Harry Gradle's request, the Trustees authorized the introduction of a bill to restore the Infirmary to its status as one of the Research and Educational Hospitals projected in the original 1919 agreement. At the same time, reportedly at Gradle's instigation, the Institute of Medicine of Chicago conducted a survey of Infirmary operations. Based on the University's actual contributions to day-to-day running of the Infirmary, the Institute recommended that the Department of Public Welfare share Infirmary management with the University.
Once the 62nd General Assembly had enacted this recommendation into law (making the Infirmary the first unit of the Hospitals without the label "Institute"), the Trustees (in May 1942) authorized the President to negotiate terms with the Director of Public Welfare. In July 1943 the University and the Department signed an agreement providing for joint operation, a document filled with precise, detailed specifications that reflect the two decades of bad faith that had intervened since 1919. For the next 22 years, the Infirmary—although scarcely "conveniently located"—served as the University's primary clinical facility for Ophthalmology and Otolaryngology. Aged and creaking as it neared the age of 100, the old building at Adams and Peoria Streets nonetheless continued to serve.