Monday, May 20, 2019

Miss Charlton, Miss Noyes, Dr. Osler and the Founding of the Medical Library Association

Miss Charlton, Miss Noyes, Dr. Osler and
 the Founding of the Medical Library Association
A Presentation to the 2019 American Osler Society Conference

In 1896, Dr. William Osler was elected president of the Medical & Chirurgical Faculty, and as he often did, he came in like a whirlwind. A building, which was slated to be the long-term home of the Faculty, was purchased. A new library was opened with much fanfare. The Book & Journal Club was established, and everyone clamored to join. All looked rosy on the surface.

But the Faculty’s library had actually fallen on hard times after the Civil War, Maryland being a border state, and was struggling to recover. The collection had moved several times, becoming less and less organized. There was no librarian for much of this time, and physicians could “buy” a key to access the library. There was room for a library in the new building, but the outdated collection of books assembled over the past six decades was mostly in boxes, and the newly-hired librarian wasn’t up to the job of bringing order to the collection.

Dr. Osler quickly raised funds to create a cozy and fraternal reading room, where physicians could gather and talk about books. His next mission was to find a librarian who could manage both the collection of books and the membership of the Faculty.

After consulting the president of Baltimore’s Enoch Pratt Free Library, Dr. Osler hired a young librarian, Miss Marcia Crocker Noyes. Less than two weeks after her interview with Dr. Osler, she went from living with her sister and being the head of circulation  at the Pratt library, to living at the Faculty’s building and becoming its sole employee.

While her background was in the nascent field of library studies, she had absolutely no medical experience. But that was something which Dr. Osler thought could be easily remedied. She made herself invaluable to the physicians at the Faculty and was at their beck and call, literally 24-hours a day.

As part of her job – and much of it was “other duties as specified” – she made herself available to other medical societies to assist them in creating their medical libraries, and began a system of exchanging duplicate books.
Among her early projects was culling the Faculty’s collection of books, keeping only the most current, and ones which hadn’t been damaged during the numerous moves.

Additionally, the card catalogue, which was outdated in myriad ways, was thrown out, and a new classification system of indexing and cataloging the books was established. As an aside, we still have the complete card catalogue, including cards written in Miss Noyes’s “library hand”, the standard for librarians before typewriters became popular.

While Miss Noyes was learning her craft at the Faculty, Miss Margaret Charlton, the Librarian of the Medical Department at McGill University, suggested an association of medical librarians. Although the American Library Association already existed, she noted that, “their problems are not our problems.”

The inaugural meeting took place in Philadelphia in May of 1898 with four physicians and four librarians, including Miss Charlton. Although Dr. Osler could not attend, he was supportive of the efforts, and paid for Miss Noyes and Miss Elizabeth Thies, the librarian from Johns Hopkins, to attend the meeting.

Miss Noyes and Miss Charlton would go on to excel in their field as librarians overseeing large collections, Miss Charlton at McGill and then Toronto, and Miss Noyes at the Faculty. Miss Thies left Johns Hopkins in 1899 to become the private librarian of Dr. Howard Kelly, one of the “big four” at Johns Hopkins. However, she was a charter member of the Medical Library Association and was elected to an honorary membership in 1948.

Among the earliest objectives of the MLA were: exchanging library duplicates; securing the libraries of retired or deceased physicians; distributing journals of various medical societies; and searching auction sales for antiquarian books.

From the first meetings, it was established that the organization was to be of and for medical libraries, rather than for librarians. The two main projects of the early MLA were a publication and the book exchange. Dr. Osler and Miss Noyes were integral to both in the MLA’s formative years.

Over its first decade and a half, the Bulletin (which we will use as an encompassing term for the MLA’s publications) was published in fits and starts. It was slated to be a quarterly publication, but that didn’t always happen.

The first publication was called Medical Libraries, published from 1898 to 1902, with the ambitious tagline from Oliver Wendell Holmes, “Libraries are the standing armies of civilization.” It was followed by the Bulletin of the Association of Medical Librarians, which only lasted a year. Miss Noyes, along with Dr. Henry Hurd of Johns Hopkins and Mr. John Brownne of New York, edited the publication.

Up next was the Medical Library and Historical Journal, which lasted from 1903 to 1907. These volumes were filled with original articles and tips for caring for a library, including hints on dealing with broken bindings, bugs, dust and mis-filed books.

Finally, came the Aesculapian, which lasted three volumes. Publications ceased for the next four years.

In 1911, the publication was revitalized, and became The Bulletin of the Medical Library Association. This continued to be its name until 2001, when it was renamed The Journal of the Medical Library Association.

The Bulletin moved into the Faculty’s building and Miss Noyes, and her close friend, Dr. John Ruhräh became the editors. The first volume of the new Bulletin contained a history of the Association, basically bringing everyone up to date on what had happened over the past few years. She continued as editor, with various collaborators, until 1926.

While the Exchange and the Bulletin were suffering a tumultuous first decade, the organization managed to have annual meetings, the first two in Philadelphia, then Atlantic City, Baltimore, Chicago, Boston, St. Louis and others. It was at the 1901 meeting that Dr. Osler was elected as President of the organization. He stepped down in 1904, most likely due to his incredible non-stop schedule of teaching, writing and travelling, but perhaps due to the idea of an upcoming possible appointment as Regius Professor at Oxford.

The Exchange was the other original mandate of the organization. Dr. Osler was a huge bibliophile and was exceedingly generous in giving libraries the rare books and journals that he found in his travels. He wanted every library to be great.

During its first year, the Exchange was in Philadelphia. It then moved to Baltimore where Miss Noyes oversaw it, helped by a part-time employee, from 1900 to 1904. To give you an idea of the numbers involved in the Exchange, in 1901, 2,443 books were distributed, and 2,126 books were received. Even today with computers and spreadsheets, this would be a daunting job!

Dr. Osler had established the Book & Journal Club, and it was one of the Faculty’s most popular clubs. Of course, Dr. Osler had an ulterior motive in establishing this club – if physicians knew about the Faculty’s library, they would be more likely to support by donating their book collections to it and perhaps to the MLA’s Exchange.

To give you a quick idea of the quality of the Book & Journal Club, at one meeting, Dr. Harvey Cushing shared a notable collection of the works of Vesalius, partly from his own library, and partly from the libraries of Dr. Howard Kelly and Dr. Osler. This included three copies of the first edition of De Humani Corporis Fabrica from 1543, as well as others rare volumes on anatomy.

When the Faculty celebrated its centennial anniversary in 1899, it was an occasion for gifts of rare books and fine portraits to be given to the Faculty, often with a slight push from Dr. Osler. And if there were duplicate volumes, all the better!

During the four years the Exchange moved away from Baltimore, the MLA realized exactly how much Miss Noyes did to keep it up and running in an orderly fashion. It was also during that period that Dr. Osler was President of the MLA and realized how important it was to keep the Exchange as THE integral part of the MLA. While the Bulletin was not being published, the Exchange was the glue holding the organization together.

By 1909, the Faculty had built its own building, and space for the Exchange was included in the plans. Dr. Osler had moved to Oxford in 1905 and Dr. John Ruhräh became the head of the Faculty’s Library Committee and was also active in the MLA as Treasurer. Dr. Ruhräh and Miss Noyes jointly edited the Bulletin from 1911 until 1926.

In some ways, Dr. Ruhräh took over where Dr. Osler left off. Both Miss Noyes and Dr. Ruhräh had a deep admiration of Dr. Osler, and remained friends with him until his death, 100 years ago this coming December. Dr. Ruhräh had attended Dr. Osler’s open clinics while he was in medical school (not at Hopkins).

The three seemed to have a similar sense of humor, and notes still exist of them teasing each other. Dr. Osler sent Miss Noyes bouquets for her birthday, even though it wasn’t her birthday. Dr. Ruhräh wrote a prescription to Miss Noyes on New Years’ Eve for a year filled with happiness and joy. Warm letters were sent back and forth across the Atlantic. The affection between these friends is apparent all these years later.

As he was dying, Dr. Ruhräh wrote his recollections of his years as a student of Dr. Osler’s. They also shared a mutual love of books – the rarer the better. Several years ago, we discovered the unpublished manuscript, dusted it off and published it. Dr. Ruhräh’s personal anecdotes cement the memories of Dr. Osler’s years in Baltimore.

In the decade and a half after the Bulletin and the Exchange moved to Baltimore, both continued to grow and prosper. Miss Noyes eventually hired a second assistant to help with the Exchange, and things carried on until eventually, it all just became too much.

But by 1926, the strain on the resources and staff at the Faculty became overwhelming, as they were essentially not paid to run the Exchange. It was difficult for member libraries to understand that just because they wanted a volume, it wasn’t always available, despite the huge number of books flowing in and out of the Exchange. This was a source of frustration to Miss Noyes and she writes about it in the Bulletin as she is stepping down from running the Exchange.

In the 20’s and 30’s, Miss Noyes was the Executive Secretary of the Faculty, and lived and worked on the premises. She was also the Faculty’s Librarian, on call 24/7. For part of that time, she was the editor of the Bulletin and was managing the Exchange, which was receiving and distributing more than 20,000 volumes a year.

She worked with medical societies across the country to help them establish their libraries, and was an active member of the MLA.

In 1934, she became the first woman, and the first person with a non-medical background, to become President of the MLA. She finally incorporated the organization after almost 40 years, and constantly travelled to visit member libraries across the country. And now, she was ready to slow down a bit.

Miss Noyes remained an active member of the MLA and attended conferences and meetings. Letters between Miss Noyes and Dr. William “Billy” Francis, Osler’s nephew and the head of the Osler Library at McGill, indicates that sometimes they were happy with the MLA and sometimes it really irritated them and they didn’t agree with the way it was being managed.

Miss Noyes died in 1946, 50 years after she had first arrived at the Faculty. Her funeral was held in Osler Hall, named for her dear friend. More than 60 physicians whom she’d served acted as the pall-bearers.

Former Faculty President and friend, Dr. Albert Chatard wrote this in her obituary in the MLA Bulletin:
Miss Noyes created a created a reality of the hopes and dreams Dr. Osler formulated while he was at Hopkins… On this foundation, she worked constantly, before and after he left Baltimore, as his understudy to create an atmosphere both effective and genial, so that people would like to come to the building… and would feel that interesting and important things were going on under its roof.

On a related note, last week was the Annual Conference of the MLA and the Marcia C. Noyes Award which recognizes a career that has resulted in lasting and outstanding contributions to medical librarianship, was given to MedChi’s friend, MJ Tooey. She is the Executive Director of the Health Sciences and Human Services Library at the University of Maryland in Baltimore.

We continued the tradition of giving flowers, started by Dr. Osler, and presented a bouquet in Miss Noyes’s memory, with all of our love.

Presentation by Meg Fairfax Fielding
2019 American Osler Society Conference
Montreal, Quebec, Canada
May 13-15, 2019

Tuesday, May 7, 2019

2019 Noyes Award Winner: MJ Tooey

The 2019 Marcia C. Noyes Award, given by the Medical Library Association, has a special meaning this year, both professionally to our organization and personally to me, your blog author. 

Not only is it the 100th Anniversary of the death of MLA founder, Sir William Osler, MD, but the winner of the award is MedChi friend, MJ Tooey, AVP Academic Affairs, and Executive Director of the Health Sciences & Human Services Library at the University of Maryland, Baltimore. 
MJ has been more than kind in assisting MedChi and the Center for a Healthy Maryland on more than one occasion.
She participated as a guest lecturer a few years ago when we presented a talk on three aspects of Marcia Noyes's life - the academic, the ethereal and the artistic. 

The links between MedChi go back more than 200 years, when the Medical & Chirurgical Faculty of Maryland founded the first medical school in Maryland. Marcia Noyes, MedChi's librarian for 50 years, was instrumental, along with Dr. Osler, in founding the Medical Library Association, about which I will be lecturing at McGill University next week.* The Noyes Award was established in 1947, just after Marcia's death, and is only awarded to exceptional librarians, not annually.

There are many accounts of the physicians at MedChi, or the Faculty, as it was known then, giving bouquets of flowers to Marcia. About five years ago, we decided to revive the tradition and give the winner of the Noyes Award a bouquet of flowers, with Marcia's approval!

The Noyes Award is being given to MJ Tooey this week, pulling together some of the strands of the history of several organizations where both Sir William Osler, MD, and his favorite librarian, Miss Marcia C. Noyes, were both intimately involved. (The actual awards ceremony is at the finale of the conference, but the winner gets the flowers at the opening breakfast so they can enjoy them throughout the conference week.)
Like Marcia, MJ is exemplary in her field and is such a deserving recipient of the Marcia C. Noyes Award. From all of us at MedChi, our warmest congratulations go to our friend, MJ Tooey. 

*Look for my presentation about Marcia, Osler and the founding of the MLA on this blog in a few weeks.

Thursday, May 2, 2019

2019 Hunt History of Maryland Medicine Lecture

The Center for a Healthy Maryland is pleased to announce that this year’s speaker for the Thomas E. Hunt, Jr., MD History of Maryland Medicine will be Dean Paul Rothman, MD, Chief of the Medical Faculty at Johns Hopkins Medical System.
In this centennial anniversary of Sir William’s death, Dean Rothman’s lecture will discuss how Osler’s influence has spanned the century, with original ideas from the late 1800’s coming full circle and being used in the practice of medicine today.
As Dean and CEO, Dr. Rothman oversees both the School of Medicine and the Johns Hopkins Health, which encompasses six hospitals, a self-funded health plan and hundreds of community physicians.
This year’s lecture will take place on Thursday, June 6, 2019 in MedChi’s Historic Osler Hall. The evening will begin with a reception at 6:00 and the lecture at 6:30 p.m. RSVP HERE by June 1, 2019. 

Wednesday, April 10, 2019

Harford County’s Early Influence on Medicine in Maryland

I gave this presentation to the Historical Society of Harford County on the early history of medicine in the County. 

Harford County’s Early Influence on Medicine in Maryland
In the 1770’s, there were no controls over the practice of medicine. Charlatans and phony practitioners abounded.  A group of physicians called for some control over the practice of medicine and even minimal standards to be set. Physicians convened, and ideas were set, but nothing happened.
Over the next two decades, more meetings were held, and physicians in a number of counties came together to talk about medicine and share their knowledge. Among the counties where physicians met, was Harford County. In the late 1700’s, Dr. John Archer, his sons and pupils gathered to form a society known as the “Harford Medical Society.”
In January of 1799, physicians from each of Maryland’s counties, plus Baltimore City, assembled at the beginning of the Maryland General Assembly’s annual session. A proclamation was read to the legislature and the bill signed into being.
On January 20, 1799, the Medical & Chirurgical Faculty of Maryland was established to prevent quackery and pretenders to the medical arts. (As an aside, Chirurgical comes from the Latin word chirurgery, which was the ancient word for surgery. All surgeons are physicians, but not all physicians are surgeons.)
Among the Faculty’s 100 founders, four were from Harford County: Dr. John Archer, and Thomas Archer, as well as Thomas H. Birckhead, and Elijah Davis. Thomas Archer (1768-1821) was one of John Archer’s six sons.  Today, our focus is on John Archer, who personified medicine in early Harford County.  

John Archer (1741-1810) was born in Churchville, and was the only one of five siblings who survived childhood. He was educated at Nottingham Academy and Princeton College. After graduation, he briefly considered opening a grammar school in Baltimore, but instead attended Princeton’s School of Theology, after which he became a Presbyterian minister. Although he mastered the prayers and the order of service, he did not find theology satisfying, and his first sermon was a serious bomb, so he began medical school.  
Archer, one in a class of ten students, studied medicine with Professor John Morgan at the College of Medicine in Philadelphia, which later became the University of Pennsylvania. Archer graduated in 1768, the first person in the New World to receive a medical degree. There was some contention as to who would be the first, but by virtue of his last name, Archer was it. 

There was a dispute as to whether Archer actually received a medical degree, as there was really no such thing at the time. During the first years of the College of Medicine, there were two degrees awarded. First was a MB or Medical Bachelor, and three years later an MD was awarded. However, Archer never applied for the second degree, and officially, only a very few actually received the MD degree. The rule was discontinued in 1792.   
In those days, physicians still relied on what we now call “folk medicine.” Among Archer’s papers are notations prescribing juice of several millipedes, and other physicians at that time were suggesting a goat’s blood julep, powdered bees and viper’s flesh, all washed down with frog-spawn water. I guess that proved that what didn’t kill you, would cure you.

In 1769, Archer returned to Harford County to begin his medical practice, which continued for 40 years, with only two interruptions: The American Revolution and his service in the US Congress.
When the Revolutionary War broke out, Archer was already a seasoned physician, and he and former classmates created the “Medical Corps of the American Revolution.” He attained the rank of Major and was commended by General Washington upon leaving military service.
Between 1779 and 1800, he trained more than 50 students at “Medical Hall”, a substantial stone building on 450 acres which Archer had built.   There were between six and twelve students at a time, and while it was not a formal medical school, students were trained through a “preceptorship.” Medically, a preceptor is a practicing physician who gives personal instruction, training, and supervision to a medical student or young physician. This was the way most medical students learned their craft until the mid-1800’s when medical schools became more common.  

Until they had achieved a certain level of understanding of medicine, they were assigned the more routine cases, while Dr. Archer took the complicated ones, which kept him amply busy.
A story has it, that when a stranger asked Mrs. Archer if the doctor lived at Medical Hall, she responded, “He has his laundry done here.” So it is rather incredible that over the years, Archer and his wife had nine or ten children, six of whom, all boys, survived. Of the six, five chose to enter the field of medicine, the other became a lawyer.
In addition to Dr. Archer’s lectures, friends from his Philadelphia days coming through the area, stopped to lecture the students. These included notables including Dr. John Morgan, who was Dr. Archer’s mentor; Dr. Benjamin Rush, who was a classmate at Princeton; and Benjamin Franklin who talked about his recollections of the French medical system.

Older students accompanied him on his rounds and helped compound the medicines he prescribed. Younger students stayed behind at Medical Hall, studied their medical books and attended meetings of the Harford County Medical Society which was in its infancy.  

The Medical Hall alumni formed an association which pre-dated MedChi, but some of whose members became founders of MedChi. The alumni met to present original papers and share ideas.  
Medical Hall also pre-dates the founding of Maryland’s first medical school, which was established by the Medical & Chirurgical Faculty in 1807. It eventually became the University of Maryland, School of Medicine and is partially the reason we were long known as “The Faculty.”
As if teaching young students and practicing medicine in the Mid-Atlantic states wasn’t enough, Archer also served in the US Congress for two terms. Contemporary accounts talk about him being pulled from a legislative session to care for a local child or assist at a difficult birth, as obstetrical issues and childhood croup were his specialties.
It is said that Archer’s interest in obstetrics began in Philadelphia when he witnessed what might have been the birth of the first “Siamese” or conjoined twins in America.
Archer was a leader in promoting vaccines, which had been around since 1798 and widely used during the later colonial period. What was unusual was that Dr. Archer was a leader in promoting vaccines, especially smallpox, for slaves, more as an economic protection rather than a medical one. Sick slaves could not work.
Archer seemed to be quite a character and he did not suffer fools gladly. In his biographical sketch in the Annals of Maryland Medicine, he is described as having: 
“A mind of the combative order, never courting, yet never declining controversy. His sarcasm, when roused, is said to have been withering. In his portraits, he is remarkably stern. His heart is exceedingly kind and he was ever prompt to relieve the distressed…”
We have a portrait of Archer at MedChi, and we often wonder whether he was as scary as he looked, or if the painter was just not very talented.  His son mentions commissioning a painting, and we think the portrait we have might be the one mentioned. 

In 1808, Archer had a stroke, and was also suffering from rheumatism. In preparation for his death, he granted freedom to his slaves and left a prophecy that abolition of slavery would be coming, despite his understanding that the economy of the South was dependent on it.
Archer had a second stroke in 1810, which lead to his death a few weeks later. At 69 years old, he’d lived a long and full life, and left a lasting legacy.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
As I mentioned, John Archer had six sons, five of whom were physicians. We already learned a bit about Thomas Archer.
Robert Harris Archer was born in 1775. He was a pupil of his father, and then practiced in Baltimore and as physician at the City Hospital. In 1799, he was a surgeon in the 27th Regiment of the Maryland Militia. He moved to Lancaster County for several years, and then to Cecil County until 1819. In addition to his medical practice, Robert served as a member of the legislature for four years, on the Governor’s Council for the next four years, and as a Judge in Orphans’ Court for ten years, until his death in 1857.
John Archer, Jr. was born at Medical Hall in 1777. He also was taught by his father, but eventually received his MD from the University of Pennsylvania. He served as a physician in the Maryland Militia during the War of 1812. He died in Baltimore in 1830.
James Archer was born in Harford County in 1779, presumably also at Medical Hall. He studied with his father, and also at Penn. He practiced in Harford County until 1810, when he moved to Mississippi, where he died in 1815.
The youngest son, George Washington Archer, also studied at Medical Hall, but sadly, he died while he was a student.
Stevenson Archer, the son who became a lawyer, didn’t do too badly for himself, becoming the Chief Justice of Maryland, and a member of Congress. In 1817, he was appointed by President James Madison as the Judge of the Mississippi Territory, which also gave him gubernatorial powers.
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The other Harford County founders were Thomas Archer, Thomas Birckhead and Elijah Davis.
Thomas Archer (1768-1821) was the oldest of Archer’s surviving sons, and was one his father’s pupils at Medical Hall. In 1802, Thomas Archer commissioned the portrait which we have of his father, which was reputed to be a very fine likeness of him, which worries us! Sadly, Thomas was an invalid for many years. It was said of him, “No human being could lay a wrong at his door.”
Thomas Birckhead was probably born in Harford County, although no records remain which give his birthplace or birthdate. He lived in an estate near the Magnolia Station of the Philadelphia, Wilmington and Baltimore Railroad. His son, Samuel Birckhead, son-in-law, James Reardon, and grandson, Lennox Birckhead, were physicians. In addition to being a physician, he served as a trustee of Harford County’s first school. The date of his death is unknown, but it was thought to be sometime in late 1829 or early 1830.
Elijah Davis (1760-1829) was born in Chester County, PA, and attended medical lectures at the University of Pennsylvania, as did his brother. He was taken prisoner at the Battle of Long Island in 1776 and taken to England on a prison ship where was imprisoned for two years. He went to Paris to study medicine, came back to the States, but returned to Paris to finish his medical degree. In 1786, he came back to Harford County for good. Davis was a member of the Maryland House of Delegates and State Senate for four terms. He was an honorary member of the Medical Society of Baltimore. His son, Septimus Davis, was also a physician.

There are several other late 18th century physicians from Harford County that I thought I’d share.  
Richard Nun Allen was born in Harford County in 1796. He received his MD, plus a gold medal, from the University of Maryland in 1817. He practiced medicine in the county until his death at Savage Factory, Harford County in 1833.
Amos Corbin was born near “The Rocks” in Harford County in 1784. He attended the College of Medicine in Maryland (later the University of Maryland) in 1812, and then became a Surgeon’s Mate in the 39th Regiment of the Maryland Militia during the War of 1812 (which took place in 1814). In addition to being a physician at the Baltimore City Almshouse, he was a member of the Baltimore City Council. He died in Baltimore in 1866.
While Thomas Emerson Bond, Jr. is later than others in this group, he is worth including. He was born in Harford County in 1813 and attended Baltimore College, and then the University of Maryland. He practiced in Baltimore for about 15 years and then founded the Baltimore College of Dental Surgery in 1839. This was the first dental college in the Western Hemisphere and it endures today as the UM School of Dentistry. Bond was also a Professor of Special Pathology and Therapeutics at the Dental School. When Bond retired, he moved back to Harford County to begin writing. Among his books were several treatises on Dental Medicine and Science. In addition, he was the editor of the Baltimore Christian Advocate and the Episcopal Methodist, as well as being a preacher at the Methodist Episcopal Church. He died in 1872.
Skipworth H. Coale was born at Deer Creek, Harford County in 1787. He attended the University of Maryland where he graduated in 1816. He married the daughter of Samuel Chase, a signer of the Declaration of Independence and Supreme Court Justice. Among his accomplishments was the invention of an apparatus for fractured clavicles in 1816. His son, also named Skipworth, also attended the University of Maryland. The father died in 1848.
Jacob Hall was born in 1747. Although there is no information about his education, we know that he became a surgeon in the 3rd New Hampshire Regiment, and was present at “battles against the Indians.” There is mention of Hall reading a paper before the College of Physicians in Philadelphia in 1791, entitled “Cases of Jaundice Cured by Electricity.” He died in Harford County in 1812.
Josias Carvil Hall was born in Harford County in 1746, and received his MB at the College of Medicine in 1769. He signed the Harford County Declaration of Independence in 1775 and as a Colonel he commanded the 2nd Battalion of the Maryland Flying Camp.  He was a delegate to Congress in 1785, a member of the Governor’s Council in 1786, a Lieutenant-Colonel in the 9th Infantry until 1800. He died in 1814.
Richard Wilmot Hall, who was born in Harford County in 1785. He also studied medicine at the University of Pennsylvania, and then came to Baltimore where he was a professor of Obstetrics. He served as a Surgeon to the 51st Regiment of the Maryland Militia during the War of 1812. He was the author of “Memoirs of Military Surgery” a book in two volumes. He died in Baltimore in 1847.

• Maryland Medical Journal, December 1990. William H.M. Finney, MD. “John Archer: First Medical Graduate in the New World.”
• The Medical Annals of Maryland, 1799-1899. Eugene Cordell, MD
• Johns Hopkins Hospital Bulletin, 1898
• Johns Hopkins Hospital Bulletin, September 1899. “Recollections of one of Archer’s descendants.”
• Philadelphia Inquirer, January 8, 1956. “Archer’s Notebook found after 191 years.”

Monday, March 11, 2019

University of Maryland Celebrates 100 Years of Admitting Women

Empowered to Practice: Maryland Celebrates 100 Years of Admitting Women

By Christianna McCausland

Prior to 1918, women had made progress into the medical world. The first woman to graduate from medical school in the United States—the first modern woman doctor of medicine, in fact—was Elizabeth Blackwell. She matriculated at Geneva Medical College (now Hobart) in 1849, graduating first in her class. Despite her accomplishments, she consistently found herself shutout of hospital posts. Reflecting on her life she stated, “A blank wall of social and professional antagonism faces the woman physician that forms a situation of singular and painful loneliness, leaving her without support, respect or professional counsel.”

Blackwell had to forge her own path. She opened her own dispensary, the New York Infirmary for Women and Children, and opened the Woman’s Medical College there in 1868. In her article, “The Entry of Women into Medicine in America: Education and Obstacles 1847-1910,” Meryl S. Justin explains that all-women medical colleges like Blackwell’s flourished in the mid-to-late 19th century.

The Women’s Medical College of Baltimore opened its doors in 1882 and during its 28-year history graduated 116 physicians. Justin states that female physicians were particularly successful in western states where the desperate need for doctors overrode any gender bias.

By 1900, there were 7,387 female practitioners. Then, women’s colleges began to shutter their doors. Much of the blame likely lies in the release of The Flexner Report, an exhaustive study of medical education published in 1910 by Abraham Flexner and underwritten by The Carnegie Foundation. According to “The Flexner Report—100 Years Later” published in The Yale Journal of Biology and Medicine, while the report created the academic model still used today, it also caused approximately one-third of American medical schools to close.

In the report Flexner noted that there were an increasing number of co-educational schools available to women and yet there was a decrease in the number of women attendees. He theorized that women clearly were just not that interested in going to medical school: “Now that women are freely admitted to the medical profession, it is clear that they show a decreasing inclination to enter it. More schools in all sections are open to them; fewer attend and fewer graduate…their enrolment should have augmented, if there is any strong demand for women physicians or any strong ungratified desire on the part of women to enter the profession. One or the other of these conditions is lacking, perhaps both.”

The Flexner Report explained that it wasn’t financially worthwhile to fund women’s medical colleges, as those few women who were interested in school could attend co-educational schools.

Flexner neglected to consider that the decrease in female enrollment was due to the bias women faced when applying to coeducational institutions, and in the classroom should they be admitted. Even if they made it to graduation, a new set of challenges awaited. Like Blackwell, most women physicians were blocked from observing in clinics or training as interns and barred from admission to medical societies.
Flexner did seem to understand this when he noted that if the women’s colleges were to close, “interne [sic] privileges must be granted to women graduates on the same terms as to men.” Many women’s colleges, including Baltimore’s, went out of business. It’s not surprising that with nowhere to go to school, this era saw a marked drop in the number of female doctors. Things began to change after the turn of the century. A new wave of feminism, evidenced by suffrage, coalesced with women’s increasing involvement in social justice movements, particularly those having to do with the health of women and children. Medical societies began opening to women; in 1915 the American Medical Association admitted its first females.

At Maryland several factors contributed to the decision to accept women. There was a shortage of physicians due to World War I and it was increasingly seen as inappropriate that a medical school accepting an appropriation from the state did not consider female candidates. In addition, women had been attending the schools of dentistry and pharmacy for many years, with exceptional results.

The first woman to successfully take advantage of the medical school’s new policy was Theresa Ora Snaith. Snaith grew up in the bustling manufacturing town of Weston, West Virginia, the daughter of a well-to-do well-driller. Snaith transferred to Maryland from the Women’s Medical College in Philadelphia and became its first female graduate in 1923. After graduation she was a successful pediatrician in Weston until her death at age 61. The auxiliary at Stonewall Jackson Memorial Hospital in West Virginia is named in her honor.

One can only speculate what academic life was like for these pioneering women, though Snaith’s entry in the university yearbook gives an indication of the scrutiny female medical students experienced. “I am sure we all agree,” it states, “that she has not detracted from the prestige of our Alma Mater.”

In the 1920s women accounted for one percent of the student population. By the 40s that number had risen to just 5 percent. Yet women were making their mark on the profession. Eva F. Dodge, ’25, for example, became Maryland’s first rotating intern and resident in obstetrics and gynecology. During her five-decade long career she was a teacher, physician and public health administrator. In 1967 she became the first woman to receive Medical Alumni Association Honor Award and Gold Key. Ruth W. Baldwin, ’43D, co-discovered the causes of congenital cerebromacular degeneration and established the seizure unit at Maryland in the 1950s.

Martha E. Stauffer, ’60, grew up in a family of physicians. Her father’s Hagerstown practice was on the first floor of the home where she grew up. She remembers going through his office wastebasket as a young child, fascinated to read the old drug circulars. When she opted for medical school after attending Vassar, her family was supportive but her initial interviews at Maryland made it very clear the environment she was entering.

“I met with a surgeon first and he said, “I don’t know why I’m wasting my time interviewing you. Medical school is no place for a woman.” That was my first introduction,” she recalls. “He said women don’t go into medicine, they ought to be home taking care of the family.”

Unsurprising, that surgeon did not support her admission, but the other two interviewers, a researcher and an internist, did not share the prejudice of the first. Stauffer entered the school in 1956, one of three women in a class of 98 people, and graduated four years later. She explains that it is in her nature to ignore nonsense, a quality that served her well when there were off-color comments about female genitalia in anatomy classes, or when someone mentioned that she was taking a spot at the school from a more deserving man.

“I looked at my goal—to be an MD—and decided to stay focused on my goal, to do the best I could, to work as hard as I could, keep my grades up, and not ruffle any feathers,” she states. “I let all the comments rub off.”

She did, however, raise concerns over the accommodations for women on call during their junior and senior year clinical rotations. Men were provided a twin bedroom; if a woman was on call they were sent to a basketball court-sized room with approximately 20 cots lined up for every single woman on call in every specialty.

“There was one telephone that hung by the door, so you wanted to make sure you didn’t take the bed by the door because you’d be answering the phone for everyone in the room all night,” she recalls. “Looking back now it was just outrageous, but it’s just an illustration of how the focus had not yet been given to women’s comfort and health. It’s an example of the barriers that faced women at that time.”

By the time Stauffer left, there were plans to improve female on call accommodations. Stauffer’s father was an internist and she thought she would follow his footsteps. But she also loved pathology and endocrinology. At Maryland she found great professors and mentors and did two sequential summer fellowships in endocrinology. The chief of endocrinology, Tom Connor, ’46, became a mentor. He encouraged her to write up her research on a young patient with oxalosis and submit it to the student essay contest at The New England Journal of Medicine. The essay won in 1960.

Stauffer remembers that Harlan Ferminger, MD, head of the department of pathology, inspired students to think about pathology in new ways. She also recalls her Saturday morning rounds with Jacob Finesinger, MD, chief of psychiatry, who taught her how to effectively speak with patients. Theodore Woodward, ’38, chief of the department of medicine, she recalls as being a master of small group teaching. After graduation from medical school, Stauffer completed residencies in internal medicine, anatomic pathology, laboratory medicine and nuclear medicine and became board certified in each of these specialties. She then spent two years doing research on metabolic disorders of bone, such as osteoporosis, which she continued until her retirement. Today she’s a retired professor of pathology at the Dartmouth Hitchcock Medical Center in New Hampshire and retired chief of pathology and laboratory services at the Veteran Administration Hospital in Vermont.

During her career she states, “I never noticed any prejudices against me as a woman, however I did notice, and I think it is still the case today, that even if you did good work you were much less likely to be promoted up the academic ranks than if you were a man.” “I’ve had a very gratifying career and enjoyed medicine,” she continues, “I feel grateful to those who have helped along the way and I attribute a lot to the University of Maryland.”

Bella F. Schimmel, ’52, began at Maryland four years earlier. She was one of five females, though two left during the first semester. Like Stauffer she remembers there being plenty of supporters of women at the school and some detractors. Like Stauffer, she found the detractors were more often professors, not students, and that their reasoning was that women were “taking” spots from men who would do more with their degree than a woman ever could.

“There were some people who felt this was no place for a woman, that you were taking a man’s place and that a woman would not devote her life to medicine as a man would,” she states. “It was frustrating to hear but, “I belong here” was always my answer.”

Like Stauffer, Schimmel has proved the naysayers wrong, making medicine her life’s work. Born and raised near Druid Hill Park in Baltimore City, Schimmel studied zoology at University of Michigan. Though she considered lab work or working with animals, “I decided medicine could offer me a wide range of career possibilities, be it research or teaching or clinical work,” she states. “However, I had no notion that I could get into medical school and carry out the intense requirements necessary.”

Schimmel remembers that growing up, doctors were afforded a special status, that they were respected members of the community. She wanted that, too. In addition, she wanted to work with people and medicine offered many ways to do so.
Schimmel was interested in pediatrics at Maryland. She recalls Milton Sachs, MD, as being a mentor and great listener at the school. After graduation she took a pediatric residency position at UCLA and worked as an intern at Los Angeles County General Hospital. She also worked overseas doing pediatrics in Germany with the U.S. Army. Through her work she began to see how connected child health was to the health of the family, particularly the mother. She switched her specialty to psychiatry, studying three years in adult psychiatry and two years in child psychiatry. She’s also trained in psychoanalysis. She’s taught at UCLA most of her life and worked in, and led, children’s clinics. Now 90-years-old she still sees some patients in clinics and in her private practice. She also provides horticulture therapy to special education classes in California schools. She raised four children and has four grandchildren.

“The School was gracious enough to admit me and I have always been grateful for that,” Schimmel states. “It enabled me to have a career and gave me my life’s work.”

Despite women’s obvious commitment to the field of medicine, their desire to be physicians, and the need for women in the medical field, enrollment at Maryland as with all U.S. schools, remained scant through the 20th century. That changed with a new wave of feminism in the 1970s and particularly with the passage of Title IX in 1972. After Title IX, which prohibits discrimination based on sex in any education program or activity receiving Federal financial assistance, women’s acceptances at medical schools exploded.

At Maryland, the percentage of women jumped from 10 percent in the 1970s to 40 percent in the 1980s. In 1996 the school graduated its first predominantly female class, and the attendance of women has hovered above 50 percent virtually every year since.

With growing equality at medical school, women began to reach the upper echelons of achievement once reserved for their male counterparts. Catherine N. Smoot-Haselnus, ’85, became the first female president of the Maryland State Medical Society in 2002 and Willarda V. Edwards, ’77, succeeded her, becoming the first female African American president of the society in 2004.

In 2017, the Association of American Medical Colleges (AAMC) announced that for the first time there were more women enrolled in medical school than men. However, AAMC research also shows that that even as the bench of qualified women gets deeper, their representation in positions of authority is not commensurate. 

According to the AAMC’s 2013–14 The State of Women in Academic Medicine, women make up a little more than one third (38%) of full-time academic medicine faculty and the percentage of permanent women department chairs (15%) and deans (16%) at U.S. medical schools remains low. As Maryland celebrates its 100th year accepting women, it is positioned to take the next great step toward parity: to graduate a new generation of female physicians who will not only be empowered to practice, but to lead.

Permission to reprint was granted by Medical Alumni Association of the University of Maryland, Inc.

Monday, February 11, 2019

Dinner and a Show: Cirque Goes Hollywood

Please Join us for Dinner at MedChi’s Historic Osler Hall
and the "Cirque Goes Hollywood" Concert at the Meyerhoff Symphony Hall,
Featuring Jack Everly, Conductor
Troupe Vertigo acrobats.

Tickets are $100 per person, and include dinner, the concert and 
a tax-deductible contribution to the Center for a Healthy Maryland.
Current medical students and residents are free, but reservations are required. 

Please click here to purchase tickets or make a reservation.

Saturday, April 6, 2019

5:15 p.m.
Tour of MedChi's Historic Building

6:00 p.m.
Dinner in Historic Osler HallMedChi, 1211 Cathedral Street

7:30 p.m.
"Cirque Goes Hollywood" Concert 
Baltimore Symphony Orchestra
Meyerhoff Symphony Hall, 1212 Cathedral Street

For more information, please click here