The 2022 Hunt Lecture: Medicine and Mount Vernon

The Annual Thomas E. Hunt, Jr. MD History of Medicine Lecture, Presented by Jamie Hunt, son of Dr. Thomas Hunt. 

Thanks to Meg Fairfax Fielding, Director of Development at The Center for a Healthy Maryland, who encouraged me to put together this talk, which is being given for the first time tonight. Meg chose the wonderful image you see here.

It’s from the 1870s when Baltimore was around 150 years old and Mount Vernon was about 40. To the left of the Washington Monument, the first phase of the Peabody Institute has been completed; to the right, work has not yet begun on what would become the Garrett-Jacobs Mansion. Further to the right, on the corner of Cathedral and Monument Streets, the mansion of B&O railroad president John Work Garrett has not yet been demolished for an apartment building that’s now a hotel. And the parks were still grassy expanses surrounded by iron fencing.

The focus of this talk, of course, is “Medicine and Mount Vernon.” On this topic, there is much to say. I could easily spend our time discussing the accomplishments of MedChi, which has had its headquarters in Mount Vernon since 1909, when it celebrated its 110th anniversary of its founding. It would be fun—to me, anyway—to spend the next 30 or 40 minutes reading selections from MedChi’s 65,000 volume library, perhaps joined by long-time librarian and resident ghost Marcia Crocker Noyes. 

So, let me drill down a bit on where I’m going with this.

Winston Churchill, the first prime minister in the long and remarkable reign of the late Queen Elizabeth II, gave a speech to a meeting of the House of Lords in October 1943, urging that the House of Commons, heavily damaged by bombs two and a half years before, be rebuilt exactly as it was. “We shape our buildings,” he told the gathering. “Thereafter they shape us.” Anyone who’s watched the proceedings in Parliament knows exactly what he meant. Vigorous—and occasionally visceral—debate on the issues of the day is an integral part of British democracy. The House of Commons—a surprisingly intimate space—is configured to encourage just that. 

And so it is with medicine and Mount Vernon. Both came of age in the late 19th and early 20th centuries. Medical professionals played critical roles in the neighborhood's development from its beginnings as a country estate to the civic and cultural center it is today. And the neighborhood—intimate, cosmopolitan, centrally-located and ringed by hospitals and railroad stations—became a fertile ground for world-class medical innovation.

This talk will comprise a series of six vignettes giving a broad outline of that history and focusing on some key figures. My one regret is that, to keep this to a reasonable length, many outstanding people will go unmentioned, and others will be mentioned only briefly. Many stories had to be left on the cutting room floor, so to speak.

 

The most interesting neighborhood in the world

Every doctor is a historian because every patient has a history. Every tool in the historian’s toolbox—records, personal and third-person testimony, observation and inference—are in the doctor’s black bag as well. Indeed, some of the greatest historians have been physicians, going all the way back to Luke of Antioch in the first century, author of two books of the Bible, and Ibn Abi Usaybi’aa of Damascus in the 13th century. His account of his contemporaries and the physicians who preceded them is still relevant and read today.

My father, Thomas Edward Hunt, Jr., an orthopedic surgeon and historian for the Baltimore City Medical Society and Med Chi, died at age 90 five years ago this coming Christmas Eve, having outlived two wives and a close companion.

He and his five children, grandchildren, great-grandchildren, step-children, brother, sisters, in-laws, and countless friends and associates were blessed that, while his body became weaker as he grew older, his mind didn’t, and he was a lively story teller up to the end.

His stories were usually funny and upbeat and often tied to some historical theme, but on one occasion a few years before he died, he and I were talking and he got unusually somber. He said, “I’m sorry I didn’t spend more time with you when you were younger.” Honestly, I had to bite my tongue because I the first thing I thought—but didn’t say— was, “Dad, I think you might have repressed some memories.” I did a lot things we’d all like to forget.

Dad did, in fact, spend a good amount of time with me, but it wasn’t the usual father-son, let’s throw the football, let’s go fishing, let’s stay up and drink beer until dawn type of thing. Instead, on Saturday mornings I’d hop in his old Volkswagen Bug and we’d drive around town visiting his patients in the dozen or so hospitals where he had privileges. Every trip was a guided tour of the city. He loved Baltimore stories and those about Mount Vernon most of all. The first apartment he and my mother, Gene Maley Hunt, lived in was on Madison Street and his offices—first in the Latrobe Building then the Medical Arts Building—were a block to the north on Read.

It was in Mount Vernon that I was first introduced to the founders of the Johns Hopkins Medical School:

Sir William Osler in medicine, William Stewart Halsted in surgery, William Henry Welch in pathology, and Howard Atwood Kelly in obstetrics and gynecology—captured together in the famous painting by John Singer Sargent entitled “The Four Doctors.”

Driving up Charles past Franklin Street, Dad would point to where Osler’s mansion once stood in the shadow of the Basilica, and the stories flowed. Osler, hailed as the “Father of Modern Medicine,” was a practical joker, married a direct descendant of Paul Revere, lost his only son in the British Army in WWI. Further up Charles at Madison was the University Club, where bachelor Welch, first on the faculty, would stay into the wee hours, alarming friends who worried he’d be mugged when he finally left, or might not show up on time the next day.

Around the corner was the apartment of the Sage of Baltimore, H.L. Mencken, who mocked Kelly’s evangelical Christianity even as he acknowledged that, among surgeons, there were few better than he. And then there was the brilliant taskmaster Halstead, who fell in love with and married a nurse, just as my father did. The story goes that he had gloves developed and introduced for the first time into surgery. Not to prevent the spread of germs—germ theory still wasn’t widely accepted yet—but to protect his wife’s hands from chemicals in the operating room.

And, of course we went to Mount Vernon’s cultural fixtures. At the heart of it all was the 178-foot-tall Washington Monument, first architectural monument to the father of our country, which has a cameo in chapter 35 of Moby Dick: “Great Washington stands aloft on his mainmast in Baltimore …” Around it was the beautiful, sculpture-studded 19th century setting of Mount Vernon Place, where a plaque on a stunning church marks the site where Francis Scott Key died, two blocks from where the original Star-Spangled Banner manuscript resides at the Maryland Historical Society, as it was known then. 

We went to Peabody’s magnificent library and to see the elaborately decorated unicorn’s horn (it was really from a narwhal) at the Walters. And there was Mass at the Basilica, the nation’s first cathedral, right across from the central Pratt Library, where the Maryland Room remains my second-most favorite place in the world and the source of most of the information in this talk. Beacon Hill in Boston is beautiful; Bloomsbury in London is lovely; Montparnasse in Paris is magnificent, but Mount Vernon is the most interesting neighborhood in the world.

 

A fighter and a lover

When he writes an obituary, Jacques Kelly of the Baltimore Sun has a knack for “telling” details that give a vivid insight into a person’s character.

When Dr. Bill Howard died at age 81 in 2016 after a storied career, Kelly recalled him saying, “I personally have had every sports injury known to man.” This included 11 broken noses plus a broken ankle and big toe, four concussions, two torn up knees, and a lost tooth.

Not surprising, really. He’s shown here in the uniform of the Baltimore Rugby Club, which he helped found in 1960 and for which he played for 28 years. A colleague from Union Memorial, where he was medical director and pioneer in sports medicine, noted drily: “that association afforded him considerable experience in sports injuries, mostly his own.” Being near the old Memorial Stadium—then home of the Orioles and the Colts—helped, too.

Another telling detail: Bill was a direct descendant—great-great-great-great grandson— of Peggy Chew and John Eager Howard: the “first couple” of Mount Vernon.

The two raised nine children at their 300-acre estate, Howard’s Park, and their home, Belvedere, which sat just north of what’s now the intersection of Calvert and Eager Streets. 

That happy marriage was made possible by the timely interventions of two doctors. Before Howard was a lover, he was a fighter. Around the time the Declaration of Independence was being signed, he raised a company and headed to New York City, where the British had General Washington on the run. It seems likely that, while marching north, John met Peggy for the first time at the Chew’s summer estate in Germantown outside Philadelphia. He would have been 24 and she 16 and any meeting would have been brief as he pressed on toward war. A little over a year later, in October 1777, he was back at the house, this time with the American army fighting British soldiers who’d taken it over.

Four years later, at Eutaw Springs, South Carolina, the by-then much-honored warrior was hit with a musket ball that fractured his left collar bone and caromed, exiting next to his shoulder blade. Though bleeding heavily, he refused to leave the field. Credit Dr. Richard Pandell for treating him under heavy fire and likely saving his life.  

Then, his friend Dr. Thomas Cradock took Howard into his house northwest of Baltimore for a year, overseeing his convalescence and – even more important – handling his correspondence with Peggy. Learning that her most ardent suitor, a British major, was hanged as a spy a year earlier, Howard took his shot and won her heart. They married in 1787 and moved to Belvidere not long after. Meanwhile, in 1799, Dr. Cradock became one of the incorporators of MedChi.  

By 1815, as you can see on this wonderful interactive map produced by local scholars and computer savants, the rough outline of the future Mount Vernon (named, of course, for Washington’s Virginia estate) is evident.

Belvedere – from the Latin for “beautiful view” is at 1. Then as now, the jail is at 2. The city’s almshouse and farm, where the UMMC Midtown campus is today, is at 3. The foundation of the lofty Washington Monument—citizens paid for it but didn’t want it near their houses—is to the south at 4. Further on, the Basilica is under construction. Peggy and John had many distinguished descendants, including Bill and his uncle, Dr. John Eager Howard, chief of medicine at Union Memorial, an award-winning endocrinologist, and a leading investigator into, as he put it, “bones, stones, and groans.” Anyone who’s had kidney stones will understand completely.

 

“Save me from destruction”

Since 1995, the University of Maryland School of Medicine, Baltimore VA Medical Center, and the Medical Alumni Association have produced an annual conference called “The Historical CPC”, Clinicopathologic Conference.

In these sessions, scholars review all available evidence to assess the cause of death of famous people from the past. They have concluded that Beethoven had syphilis, Florence Nightingale had bipolar disorder, the Roman emperor Claudius was poisoned by a mushroom, and Edgar Allan Poe died of rabies rather than, as many have concluded, of alcohol or drug abuse.

As many of you know, Poe died in Baltimore on October 7, 1849, at Washington Medical College (later Church Home and Hospital) on Broadway, several days after being found delirious in a gutter on Lombard Street …  just north of what is now Little Italy. Not long after, he was buried next to Westminster Hall at Fayette and Greene Streets. Ravens’ stadium—named for his poem— looms large to the south. I think even Poe groaned at last Sunday’s choke finish.

If Baltimore is the place where Poe died, it’s also the place where—exactly 16 years earlier to the day—a doctor and two other prominent citizens gave his literary and love lives a critical intervention.

In 1833, Dr. James H. Miller, an orator at Med Chi and a faculty member and later president (coincidentally) of Washington Medical College, had been named attending physician of the Almshouse. Founded before the Revolution and funded by levies on tobacco (sounds familiar), the almshouse and its attached farm served the city’s indigent, aged, disabled and mentally ill. For a doctor, it was an education all to itself. He wrote, “That it possesses the choicest facilities for a school of practical medicine is unquestionable. We have here every form of disease, from the most ephemerally acute to the most protractedly chronic. We see it in every age from infancy to old age …”

Dr. Miller was also actively engaged in the cultural life of the city and so gathered with John Pendleton Kennedy, a lawyer and writer, at the home of John H.B. Latrobe, son of the architect of the Basilica, across the street from that domed landmark on the night of October 7. They were charged with judging a literary contest for which first prize was the then-munificent amount of $50. Poring through the manuscripts, they were struck by Poe’s vivid, riveting prose and gave the top prize to the then-largely unknown author who was living with his aunt and cousin on the western edge of town. It was, quite literally, a life-saver. Just months earlier Poe had written his estranged father-in-law in Richmond, begging him to “save me from destruction” but no money to the poverty-stricken author was forthcoming.

Kennedy served as a patron for Poe and, nearly two years later, lined up an editorial job for him in Richmond. The steady income enabled the 26-year-old, deeply enamored with his cousin, Virginia Clemm, 13, to get married. Aunt Maria Clemm joined the couple in their travels from Richmond to Philadelphia to New York, and Poe went on to make his indelible mark on American letters.

 

Milieu matters

On May 24, 1930, Dr. Thomas S. Cullen, age 61, of 20 E. Eager Street – a highly respected Hopkins gynecologist and one-time protégé of the great Dr. Howard Atwood Kelly, born to a minister and his wife in rural Canada but as great a lover of Baltimore and Maryland as one could hope to find – bought ad space in three Chestertown newspapers to publish an open letter to the town’s citizens.

“You have a lovely town,” he wrote. “A wonderful river, fine college and, best of all, a charming group of people, but you have no sewage disposal plant and dump your sewerage into your best asset – your river. How do you think a yachtsman who anchors in your river is impressed?”  Perhaps anticipating that some might not care about the opinions of this hypothetical yachtsman, he brought the point closer to home: “…worst of all, he sees small boys catching crabs and fish near the sewer.” That was not a hypothetical. Some of Chestertown’s residents were indignant and made their feelings known to the state’s board of health, on which Cullen was a new member. But the doctor had the data on his side. And a nearly lifelong personal and culinary interest.

When he was six and still living north of the border, his mother received a shipment of canned oysters prominently labeled “Baltimore.”

He absolutely loved them and, starting when he came to Baltimore to study at Hopkins, he took a keen interest in the body of water they came from. Over the years, he took many steamship trips to serve at a hospital in Cambridge. Any free time he had there and anywhere he was on the bay, he investigated the water quality. Over the years, it grew worse and worse. Increasingly, oyster beds had to be closed because oysters, of course, are filter feeders.

Undaunted by the agitation, Cullen pressed his case for sewage plants throughout the bay. He couldn’t do it himself, but he had a gift for bringing people together and Mount Vernon was ground zero for doing it. Milieu matters, and the neighborhood had a remarkable one – men *and* women, artists, authors, actors, bonvivants, clergy, entrepreneurs, musicians, philanthropists, politicians, raconteurs, scientists and, of course, medical professionals.

He knew most of them and had no problem talking to any of them. When he wanted the wonderfully talented anatomical illustrator Max Brödel on the Hopkins faculty, he persuaded Henry Walters first to fund the position and later to endow it. When he determined that the job as city’s commissioner of health was rendered less effective by being used as a political plum, he successfully made the case to boss Sonny Mahon to extract it from the grasp of his fellow pols. And, convinced of the need to treat sewage before it got into the bay, he held a dinner party at the Maryland Club for sixty civic leaders from the towns and cities surrounding the bay to get them on board.

So far, so good. But how to pay for it? In an odd twist, the Great Depression and Franklin Roosevelt’s election in 1932 opened a possibility. Cullen wasn’t fully persuaded about the effectiveness of what he called the “make work schemes” the new administration was proposing. But he saw an opportunity in it to help the bay, so he went to Washington to make his case. Successfully, as it turns out. Sewerage plants were built and the bay’s water quality improved. The ever-boyish oyster fan from Canada was named chairman of the Chesapeake Bay Authority, a federal body charged with cleaning up the bay, and he couldn’t have been happier.

 

On an equal basis

One of my mother’s favorite sayings was, “God writes straight with crooked lines.” Her own life was an example. She was a talented writer and, if I’m remembering the story correctly, she had her heart set on pursuing that in college, possibly as a journalist. But her family couldn’t afford it, so she went to Mercy Nursing School, then on Calvert Street, instead. She made friends there she kept all her life, met my father, and they raised their five kids in a pretty nice house in north Baltimore. We drove her crazy but she seemed pretty happy with how things turned out. Most of the time.

At any rate, we can all thank God, or fate, or providence, or the deity of your choice, that after completing her MD degree at Hopkins in 1927, Dr. Helen B. Taussig wasn’t able to specialize in Internal Medicine as she wanted to after completing a cardiology fellowship.

At the time, there was only one position for women, and it was taken. So, she decided to specialize in the then very new field of pediatric cardiology.

At the time, there was little that could be done for infants and small children with congenital heart defects. As chief of the pediatric department of Hopkins, she took a particular interest in infants with a heart defect that resulted in insufficient oxygenated blood circulating through their bodies, known as blue baby syndrome. Collaborating with Hopkins chief of surgery Alfred Blalock and his talented lab assistant Vivien Thomas, she helped created the Blalock-Thomas-Taussig shut, which dramatically improved blood flow. According to the New York Times, by the time she died, her work had save the lives of tens of thousands of babies.

So, how did this Cambridge, Massachusetts born woman who became the first elected head of the American Heart Association, wind up in Baltimore? Harvard Medical School wouldn’t grant degrees to women at the time, but Hopkins would.

And for that, we thank Elizabeth Garrett. She was Baltimore and Ohio Railroad president John Work Garrett’s fourth child and only girl. She had great financial acumen and was invaluable to him in helping him manage his affairs. She met many of the great figures of the second half of the 19th century, including George Peabody, who amassed a fortune as a financier in London and was set on philanthropic works in both the UK and America.

Had she been a man, she likely would have taken over as head of the railroad when her father died in 1884. Instead, she gave a special focus to improving the lives of women: the next year, she helped found the Bryn Mawr School to provide an education equal or greater to that boys received. In the early 1890s, Hopkins’ trustees decided to open a school of medicine. The economy was poor and fundraising wasn’t going well, so Elizabeth was approached for a gift. She promised to get them to their goal on the condition that (1) the standards for admission were rigorous and (2)  that women would be admitted “on an equal basis” with men. Initial resistance gave way to acquiescence, and the rest is history.

Of course, even once women were admitted, it wasn’t smooth sailing for them. Male faculty could be less than welcoming, and that could be grinding, especially for free spirits like Gertrude Stein. At Radcliffe, William James called her his “most brilliant woman student” but at Hopkins, where she matriculated in 1897, she was depressed by what she regarded as a paternalistic culture. Add to that a growing infatuation with a woman who was already in a relationship with another woman, and Stein ultimately left without finishing her degree. She went Paris with her brother, Leo, in 1902 and formed a bond with Alice B. Toklas, whose alleged “autobiography” was one of her best-selling works.

In a happy turn for Baltimore, though, the relationships she formed with artists such as Matisse and Picasso helped lead to acquisitions by two of the friends she’d made while in the city, sisters Dr. Claribel and Etta Cone. They decorated their apartment in the Marlboro just west of Mount Vernon with their extraordinary collection, which ultimately was left to the Baltimore Museum of Art.

 

 

One night with Venus

William Safire, who for many years wrote “On Language” for the New York Times, highlighted the word “fruitcake” in one column. “In the sense of ‘crazy,’” Safire wrote, “it was thrust forcefully into the language by the gangster Jake (Greasy Thumb) Guzik in 1939, when his longtime mob boss, Alphonse Capone, was released from Alcatraz Penitentiary. Asked if the deranged Capone would reassume control of the Chicago mob, Guzik replied sadly, ‘Al is nuttier than a fruitcake.’”

Crude, but unfortunately accurate. The 40-year-old’s seven-year hitch in prison meant the syphilis he may have acquired 20 years earlier in a Chicago bordello wasn’t properly treated and brain damage was well along.

In 1940, he came to Baltimore to visit Dr. Joseph Earle Moore, who was highly regarded for his work on venereal disease as well as an early advocate for penicillin, which wasn’t widely adopted until 1942.

Prior to then, mercury was a common treatment – hence the expression, “One night with Venus, A life with Mercury – and had its own deleterious effects. Moore and a psychiatrist concluded Capone had the mentality of a 12-year old at that point. After a few weeks of treatment at Union Memorial – to which his family gave weeping cherry trees in thanks – Capone moved to Florida.

Moore kept his office in the Medical Arts Building, built at Cathedral and Read Streets in 1927. It was the heart of a neighborhood that by that time had become a hub for medical professionals. 

Not long after, the Latrobe Building to the east on Read Street was converted from apartments to offices, serving as a sort of annex to the Medical Arts Building.

Elsewhere in the neighborhood, specialists set up in the older mansions. 4 East Madison was home to the nation’s first orthopedic practice, formed in 1907 by Dr. William Baer. The founding director of orthopedics at Johns Hopkins, he trained many surgeons who rose to great prominence and did leading research on spinal problems and hip arthroplasty.

Around the corner, 14 W. Mount Vernon Place was once the residence of William Marburg, an important Hopkins supporter.  In time, it became offices for a number of prominent ophthalmologists—most recently, until the mid-1990s, Dr. Charles Iliff and his sons.

Nicknamed "Wilmer West” for its occupants’ connections to Hopkins’ Wilmer Eye Institute, the building was host to the world famous inventor of the subspeciality of neuro-ophthalmology, Frank Walsh;  Robert Welch, who discovered and invented the terms "sea fans" for the peripheral retinal findings in sickle cell disease; and Richard Hoover , who helped folks with visual disabilities suffered in WWII, and trained patients  in the  use of the white cane, now known as the Hoover cane. 

Dr. Jensen, who was also at 14 West, recalled that patients loved to come to the building, a grand space with beautiful woodwork and fittings. Over time, though, parking, access, the challenges of putting new technology in older spaces, and other issues marked the end of the golden age of medicine in Mount Vernon. It all made sense, of course, but something grand and dignified was lost.

To borrow a line architectural historian Vincent Scully used about the old classically designed Penn Station in New York City before it was demolished and replaced: “Once, we entered the city like gods…”

Thank you!

From Meg: To finish the lecture, and as a personal note, I am including a passage from Dr. Thomas Cullen's book, in which he describes Mount Vernon on a snowy evening. 

Charles Street in certain lights can revert. The sky clears after a storm, the day thins and recedes. Along Charles Street, Baltimore is again the Baltimore Tom Cullen knew in youth; the town whose portrait is engraved in old prints, withdrawing in mannerly perspective before the eye of the beholder, accepting with happy serenity of the well-proportioned the homage of regard. It was so, coming to Eager Street on a remembered evening. 

New snow on the sills and cornices laid soft-edged accents below and above the ordered rows of lighted windows. The west was blue-green over the gas lamps of the climbing cross streets, the east pale with reflected brightness. Against it on the far hilltop a dome showed - small and dark beyond the balustrade of Mount Vernon Place and the lines of lights falling away and lifting again - the lanterned dome of Johns Hopkins. Tom Cullen broke a silence that was long for him.

"I love this old town," he said.