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.
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.
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.
