Johns Hopkins

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The staff organization was also unusual. Each service (i.e., surgical, medical, pathological, obstetrical) was to be supervised by one man, who would have sole responsibility for what happened on that service. He would also, upon the opening of the medical school, be responsible for the teaching of his specialty. Osler’s radical proposal was that each department head have under him a resident assistant, that is, a medical-school graduate who had completed his internship and would have complete authority when his chief was not about. The system proved invaluable, filling the gaping hole between inexperienced intern and busy professor (or, as it is now, practicing physician), and has been in general use ever since.

 

And the hospital was doing business. During that first year there were so many visitors to the dispensary (up to two hundred a day) that a charge of ten cents a patient was instituted—for those who could pay. Unfortunately there were no sinks equipped with running water in the wards, so after an operation the doctor had to scrub in a portable wooden washstand filled by pitchers, and when he couldn’t get an orderly to empty it right away, the dirty water often overflowed onto the floor.

Meanwhile the hospital staff began to get impatient for the medical school to open. After all, the university had been open since 1876, and those undergraduates studying this new course called premed were being turned away to rival medical schools.

The problem, a very common one, was financial. It seemed that Johns Hopkins had left his country retreat and all his Baltimore & Ohio stock to the university, and all his bank stock and the remaining real estate to the hospital. The country retreat had had to be sold to the city as a park; and a terrible situation had arisen with the B&O stock: it had plunged disastrously in value, to the point where no dividend was paid between 1888 and 1891. The trustees could not invade the principal and began to worry lest Harvard and the University of Pennsylvania succeed in wooing Osler and Welch away before the medical school even opened. The situation was complicated by the fact that since the medical school was technically and legally a part of the university and not the hospital, none of the latter’s funds could be used for it.

Into this bleak and unhappy dilemma stepped Martha Carey Thomas, a trustee’s daughter and an English professor at Bryn Mawr College, and her friend Mary Garrett, daughter of the head of the B&O , who saw a way to advance the cause of women in medicine. They offered to form a national Women’s Fund for the Higher Medical Education of Women to raise money for the school—on condition that the admission requirements for women be the same as for men. The trustees, knowing they were in a tight corner, grudgingly agreed, but only if the ladies could raise the seemingly impossible sum of $500,000.

Welch, the newly appointed dean, and President Gilman were against it from the start. Welch indicated much later that his hesitancy sprang from a distaste at having to explain “indelicate things” to ladies. Although Osler, Kelly, and others were anxious to get the agreement settled and sent in a supporting letter, Welch’s signature was conspicuously absent.

By 1892 the faculty of the nonexistent school was growing restive. Osler was sorely tempted to return to McGill, which was dangling a $1,000,000 chair before his nose; and Harvard was still after Welch. The Women’s Fund was nowhere near its goal, having raised less than $200,000. But Miss Garrett, an early feminist and a woman of considerable personal wealth, was not to be thwarted. She would put up the remaining $306,977 but now tacked on even more stringent demands: not only were women to be admitted on an equal footing, but all candidates would have to have an A.B. degree or its equivalent, a reading proficiency in French and German, and knowledge of chemistry and biology as well as Latin, mathematics, and physics. And there was to be a four-, instead of a three-, year curriculum. These were by far the toughest admission standards ever contemplated for any medical school in the country. Osler, on hearing the latest proposal, commented to Welch: “We are lucky to get in as professors, for I am sure that neither you nor I could ever get in as students.”

The administrators of Hopkins had, they said, eventually planned to gradually introduce more rigid standards for admission, but certainly not before the school even got off the ground. In fact, Welch later recalled that he had set down these idealistic terms years before in a letter to Gilman not long after arriving in Baltimore. He surmised that Miss Garrett had gotten hold of the letter through her lawyer, a member of the board of trustees. But, he declared, “It is one thing to build an educational castle in the air at your library table, and another to face its actual appearance under the existing circumstances.”

The trustees knew that they were trapped. First they tentatively agreed but haggled over Miss Garrett’s stipulation that women be admitted “on the same terms” as men. Why not just substitute “equivalent” or “equal” for the word “same”? they asked. Miss Garrett stubbornly refused and in exasperation made it a further condition that all the funds revert back to her or her estate should there be a violation of her wishes. On December 24, 1892, the trustees finally gave in.