The Hospital for the Ruptured and Crippled Eugene H. Pool, Fourth Surgeon-in-Chief 1933–1935 Followed by Philip D. Wilson, Fifth Surgeon-in-Chief 1935
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In 1933, for the second time in the history of the Hospital for the Ruptured and Crippled (R & C), a general surgeon, Eugene Hillhouse Pool, MD, was appointed Surgeon-in-Chief by the Board of Managers of the New York Society for the Relief of the Ruptured and Crippled. R & C (whose name was changed to the Hospital for Special Surgery in 1940), then the oldest orthopaedic hospital in the country, was losing ground as the leading orthopaedic center in the nation. The R & C Board charged Dr. Pool with the task of recruiting the nation’s best orthopaedic surgeon to become the next Surgeon-in-Chief. Phillip D. Wilson, MD, from the Massachusetts General Hospital in Boston and the Harvard Medical School was selected and agreed to accept this challenge. He joined the staff of the Hospital for the Ruptured and Crippled in the spring of 1934 as Director of Surgery and replaced Dr. Pool as Surgeon-in-Chief the next year. It was the time of the Great Depression, which added a heavy financial toll to the daily operations of the hospital. With a clear and courageous vision, Dr. Wilson reorganized the hospital, its staff responsibilities, professional education and care of patients. He established orthopaedic fellowships to support young orthopaedic surgeons interested in conducting research and assisted them with the initiation of their new practices. Recognizing that the treatment of crippling conditions and hernia were becoming separate specialties, one of his first decisions was to restructure the Hernia Department to become the General Surgery Department. His World War I experiences in Europe helped develop his expertise in the fields of fractures, war trauma and amputations, providing a broad foundation in musculoskeletal diseases that was to be beneficial to him in his future role as the leader of R & C.
KeywordsEugene H. PoolVirgil P. GibneyWilliam Bradley ColeyHospital for the Ruptured and Crippled (R & C)New York HospitalHospital for Special Surgery (HSS)Philip D. WilsonFranklin D. RooseveltFiorella H. LaGuardiaRobert MosesRobert B. OsgoodMemorial HospitalPhilip D. Wilson, JrBradley L. ColeyBradley L. Coley, JrHelen Coley NautsFenwick Beekman
In 1933, for the second time in the 70-year history of the Hospital for the Ruptured and Crippled (R & C), a general surgeon became Surgeon-in-Chief. Eugene Hillhouse Pool, MD (1874–1949) was appointed the fourth Surgeon-in-Chief by the Board of Managers of the New York Society for the Relief of the Ruptured and Crippled. A distinguished nationally known surgeon, Pool had been Director of the Second Surgical Service of the New York Hospital and Professor of Surgery at Cornell University Medical College.
As the oldest orthopaedic hospital in the country, R & C became a leading institution in orthopaedics from its founding in 1863. This reputation grew even more with the introduction of surgery in 1888 by its second Surgeon-in-chief, Virgil P. Gibney, MD (1847–1927). It was further supported by an additional staff appointment, Dr. Royal Whitman (1857–1946), a highly respected and qualified orthopaedic surgeon. Gibney, with his administrative abilities, foresight and caring for patients, complemented Whitman who was a skilled surgeon, writer and teacher, although less endowed with communicative skills. In spite of this leadership, the reputation of the hospital started to show signs of decline in the first quarter of the century. As the surgical techniques for treatment of hernia made significant advancement, the historical relationship between the treatment of rupture and crippling conditions became outdated, although the bracemaker still remained to provide for both conditions. Declining ties of the professional staff with the hospital and within the hospital were further strained by the looming financial crisis in the country. In 1929, the hospital’s status suffered when at age 72, Whitman resigned. Dr. William B. Coley, MD (1862–1936), the third Surgeon-in-Chief, was not an orthopaedic surgeon, and this added to the hospital’s declining status in the orthopaedic world . Eventually Coley, suffering from poor health, resigned from the office of Surgeon-in-Chief in 1933.
The Board of Managers realized it needed help from the academic medical community. It was urgent to appoint temporarily, a prominent surgeon to the office of surgeon-in-chief to reestablish R & C as a leader in orthopaedics. The Board persuaded Dr. Eugene Pool to accept this position on an interim basis.
For his first year in office, Pool critically observed the state of the hospital, its staff, its treatment of patients, teaching, education and research, and formulated a plan for the changes needed.
Since receiving the honor of being appointed Surgeon-in-Chief…, I have been an observer rather than a worker, and have studied basic problems rather than details. In this connection one is impressed by the extremely doubtful nature, which a private, unattached hospital faces. Medicine and surgery have progressed so much during the three decades of the present century that the purely clinical institution finds itself handicapped in comparison with teaching and scientific centers as a result of lack of stimulus of scientific thought and the lack of laboratory facilities. The solution is an allegiance or affiliation with a university whereby the clinical workers may have access to and the use of the laboratory facilities of the more highly developed institution and contacts with and the advice of the highly trained minds. Such an affiliation for the Hospital for Ruptured and Crippled is much to be desired.
The Hospital for Ruptured and Crippled was in the early days the leading orthopaedic centre of the Country. It has not retained this position. We should therefore plan to regain it.
If the institution is to develop on the lines suggested, a conspicuous leader should be chosen and placed in charge of the activities of the institution and all efforts should be centered upon the development of orthopaedic surgery and regaining the position of the institution, which it held under those great leaders Gibney, Bull, Whitman and Coley.
The interests of the institution are superior to those of the individual and every one should feel that any sacrifice should be made to further its interests.
He summarized that “The main weakness seemed to be a considerable number of attending surgeons, none of whom devoted a large part of their time to the Institution, with the result that there was no head and little research work and teaching” . The Board received this report on February 8, 1934 and immediately took action to seek out the best possible orthopaedic surgeon to fill this office.
Eugene H. Pool was born June 3, 1874 in New York City. Pool graduated from St. Paul’s School in Concord, New Hampshire and received his A.B. from Harvard College in 1895. He was accepted to the College of Physicians and Surgeons of Columbia University and was awarded his MD in 1899. During his surgical internship at New York Hospital (1900–1901), Pool was influenced by one of his mentors, Dr. William T. Bull (1849–1909) who later invited him to join his practice. Bull, having a large surgical practice, was one of the master surgeons of his time. He had been appointed to the staff of the New York Hospital in 1883 and was a colleague and partner of both Dr Coley and Dr. Gibney [3, 4].
Dr. Pool maintained a close association in practice with Dr. Bull for 7 years, while rising through the ranks of the faculty of the College of Physicians and Surgeons, finally becoming Professor of Clinical Surgery in 1915. Likewise, his staff appointments at the New York Hospital rose to a senior level. He became an Attending Surgeon in 1932 when the New York Hospital moved uptown to join the Cornell-New York Hospital Medical Center. He was appointed Clinical Professor of Surgery at the Cornell University Medical School and Senior Attending Surgeon at the New York Hospital.
…Dr. Pool was an extraordinarily able man. Endowed with a fine mind, he developed it to the highest degree. He was wise in counsel, discerning in judgment, unfailing in leadership, with a limitless capacity for work. …He had vision, was a straight thinker and was able to crystallize his thoughts….He had a keen sense of kindly humor. He had a love of people and boundless kindness toward people. That is why his patients believed in him, trusted him implicitly and never forgot him .
Many R & C surgeons were drawn into service during World War I. Despite the fact that Woodrow Wilson won reelection as President of the United States in 1916 using the phrase “he kept us out of the war” the country increasingly began to side with Britain and France and other countries fighting Germany. The sinking of the British passenger ship Lusitania by a German submarine in 1915 resulted in the deaths of 128 Americans and provided the spark that ignited America against the Germans. Finally, Wilson asked Congress for a declaration of war on April 6, 1917. We were little prepared for war with only 370,000 men under arms. By the end of World War I, that number had swelled to 4.8 million. Of those mobilized, America’s losses were 48,000 killed in battle and 56,000 lost to disease. Compared to the rest of the countries, these figures were trivial. Germany had 1.8 million dead; Russia, 1.7 million; France, 1.4 million; Austria-Hungary 1.2 million and Britain, 908,000. In addition to those killed, there were millions wounded. Of over two million British troops wounded, there were 240,000 amputees .
In February 1934, Dr. Pool as Surgeon-in-Chief gave his first report for the year 1933 to the Board of Managers of the New York Society for the Ruptured and Crippled. The message had clear goals to find the best orthopaedic surgeon for the office of surgeon-in-chief, affiliate with a university, and expand the laboratories, research and education facilities. Additionally, it was vital to promote the interests of the hospital rather than emphasize an individual practitioner, a concept that has continued to challenge the academic medical world, even in our present times .
How could a reasonable financial arrangement be reached between the individual physician/surgeon and a hospital where such a close symbiotic relationship was advantageous? In the 1930s, most physicians and surgeons practiced independently trying to make a living at the time of a great depression without concern for the health of their hospital. The key is that both the individual physician and institution need to be successful as well as players on the same team. Our current hospital, Hospital for Special Surgery, has attained that goal being named no. 1 in Orthopaedics in our country in 2007 . The formula may be very complex and difficult to achieve, but the end results need to be a mutual respect benefiting both parties. Many academic institutions and staff even today have not been able to formulate the winning combination to make this all work.
Dr Pool’s search ended with the appointment of Philip D. Wilson, MD, of Boston, a nationally known leader in orthopaedics, to fill the office of the Surgeon-in-Chief. At age 48, he resigned as the Chief of the Fracture Service at Massachusetts General Hospital and from the faculty of Harvard Medical College. Dr. Wilson came on the R & C staff in May 1934 as Director of Orthopaedic Surgery while Pool retained the title of Surgeon-in-Chief. An affiliation was made with the College of Physicians and Surgeons of Columbia University, and Dr. Wilson was given a university appointment as Clinical Professor of Orthopaedic Surgery .
Dr. Pool’s honors
New York Surgical Society—President, 1923–1925
Society of Clinical Surgery—President, 1927–1929
New York Academy of Medicine—President, 1935–1936
American Surgical Association—President, 1936
Pool resigned from the New York Hospital on April 7, 1947 and died on April 9, 1949. He had been divorced from his first wife, Esther Hoppin Pool in 1930 with whom he had two sons, Dr. J. Lawrence Pool and Beckman Pool2. His second wife, Kitty Lanier Harriman Pool, died in 1936 while his third wife Frances Saltonstall Pool survived him.
…A man who habitually shunned the spotlight…he left a shining example for doctors, present and future.
Just like the many changes occurring during the early third decade at the Hospital for the Ruptured, our nation was being challenged like it never had been before by the Great Depression. The economic depression took its toll on the hospital operations, its staff, and particularly the physicians. Beginning with the devastating crash of the stock market on October 28–29, 1929, our country did not begin to show any recovery until the mid-1930’s after Franklin D. Roosevelt had been inaugurated as the 31st president of the United States. Much of the country had blamed the previous Republican President Herbert Hoover for the depression, although its roots went further back into the administration of Calvin Coolidge. Hoover’s big mistake was that he kept reassuring our country that things were going to get better if they all had a little patience.
FDR’s new deal programs in the first 100 days
New deal programs
Tennessee Valley Authority Act (TVA)
Civilian Conservation Corps (CCC)
Works Projects Administration (WPA)
Emergency Banking Act
Homeowners Loan Act
Federal Emergency Relief Act
Agricultural Adjustment Act (AAA)
Civil Works Administration (CWA)
In 1935 President Roosevelt introduced and encouraged Congress to pass the Social Security Act, the sweeping federal unemployment insurance and pension provision systems paid for by employers and their employees.
New York City, with Wall Street at the eye of the storm, was experiencing troubled times, the like of which had never been seen before. The crash brought not only financial collapse with wages and rents tumbling and long breadlines but a significant increase in crime. There was a wave of gang warfare, murder, gambling, bribery and corruption in politics with links between the underworld and the police .
After spending seven terms in the House of Representatives as a Congressman from then Italian East Harlem, Republican Fiorella H. LaGuardia, ran on an anti-corruption Fusion ticket as well as a nominee on the American Labor Party. He won a difficult election and served as mayor from 1934 to 1945.
Born in 1882 in the Bronx, Fiorella Enrico LaGuardia changed his middle name to Henry and affectionately was known by his constituents as the little flower, the Italian translation of his first name. Raised as an Episcopalian, LaGuardia’s non-practicing Catholic father was from Cerignola in Apulia, a southeast region of Italy, and his Jewish mother from Trieste, Italy.
LaGuardia was a fighter who aggressively pursued organized crime figures. The first thing he did when elected mayor was to order the chief of police to arrest the mobster Lucky Luciano. LaGuardia supported Roosevelt and his New Deal program and instituted a number of changes that helped address many issues created by the depression in the city. Loved and trusted by his constituents, he was such a liberal Republican that he originally had difficulty enlisting party support.
One of his first appointments was that of Robert Moses (1888–1981) as Commissioner of the New York City Department of Parks, a position Moses held until 1961. Robert Moses, a 1909 graduate of Yale, had entered college just before his 17th birthday. After Yale, he applied at Oxford University where he was accepted and matriculated in Wadham College. There, conservatism prevailed, a political philosophy that would stay with Moses most of his life. Moses, who was unsuccessful in seeking the nomination for Mayor became the 1934 Republican nominee for Governor of New York State but lost the election to Herbert Lehman. He went on to build New York City like no one else in history 3.
Creations and influences of Robert Moses in the five boroughs
Creations and influences
Cross Bronx Expressway
Henry Hudson Parkway
Grand Central Parkway
Northern State Parkway
Southern State parkway
Jones Beach State Park
Jacob Riis Park
New York Coliseum
The department of orthopaedic surgery Staff in 1937 as recorded in the 74th annual report of the board
Senior Consulting Surgeon And Surgeon-In-Chief Emeritus
EUGENE H. POOL, M.D.
PHILIP D. WILSON, M.D
DEPARTMENT OF ORTHOPAEDIC SURGERY
Attending Orthopaedic Surgeons
RICHMOND STEPHENS, M.D.
EARL E. VAN DERWERKER, M.D.
Associate Orthopaedic Surgeons
PAUL C. COLONNA, M.D.
LEWIS CLARK WAGNER, M.D.
Assistant Orthopaedic Surgeons
FRANCIS CARR, M.D.
PETER C. RIZZO, M.D.
T. CAMPBELL THOMPSON, M.D.
Executive Assistant To Surgeon-in-Chief
ERNEST EDGAR MYERS, M.D.
Senior Research Fellow
JOHN R. COBB, M.D.
Gibney Research Fellow
Junior Research Fellows
J. NEILL GARBER, M.D.
(Completed January 1, 1938)
ARTHUR A. THIBODEAU, M.D.
(Completed January 1, 1938)
ARTHUR EYRE-BROOK, F.R.C.S.
In Charge Of Plaster Room
EDWARD LEROY BARNETT, M.D.
Orthopaedic Surgeons To Out-patient Department
DAVID I. HORWICH, M.D.
ROBERT L. PATTERSON, Jr., M.D.
Assistant Orthopaedic Surgeons To Out-patient Department
WILLIAM FRIEDER, M.D.
FRANCIS J. FADDEN, Jr., M.D.
J. THEODORE GEIGER, M.D.
The hernia department now reorganized into the department of general surgery under Dr. Carl Burdick
DEPARTMENT OF GENERAL SURGERY
Chief of Service
CARL G. BURDICK, M.D.
FENWICK BEEKMAN, M.D.
DAVID GILLESPIE, M.D.
RODERICK V. GRACE, M.D.
BRADLEY L. COLEY, M.D.
WALTER F. JONES, M.D.
VINCENT HURLEY, M.D.
ROLAND L. MAIER, M.D.
JOSEPH SHAEFFER, M.D.
VANSEL S. JOHNSON, M.D.
NORMAN L. HIGINBOTHAM, M.D.
JOHN E. SULLIVAN, M.D.
YOLANDE H. HUBER, M.D.
W. ROSS McCARTY, M.D.
DEPARTMENT OF MEDICINE AND PEDIATRICS
Chief Of Service
CARLISLE S. BOYD, M.D.
Associate Attending Physicians
R. GARFIELD SNYDER, M.D.
FRANK G. PETTENGILL, M.D.
Assistant Attending Physician
CORNELIUS H. TRAEGER, M.D.
Physician To Out-patient Department
JOSEPH ALEXANDER, M.D.
LE MOYNE C. KELLY, M.D.
Assistant Physicians to Out-patient Department
FRANK ROSSOMONDO, M.D.
J W. FORSTER, M.D.
LILLIAN HELLSTROM, M.D.
Clinical Assistant To Out-patient Department
WILLARD H. SQUIRES, M.D.
Pediatricians To Out-patient Department
RICHARD SCHORR, M.D.
FRANK H. ORR, M.D.
Assistant Pediatrician To Out-patient Department
WILLIAM WHELLER, Jr., M.D.
An instructor at Cornell Medical College and two other medical schools, Coley won the Legion of Merit during World War II when he served in the Philippines as a surgical consultant to the Eighth Service Command. After the war, he was a founder of Amputees Alliance, a self-help society for amputees4.
Bradley L. Coley was married to Phyllis Macdonnell and had three sons, Dr. William B. Coley, II, Dr. Geoffrey M. Coley and Bradley L. Coley, Jr. whose nickname was “Pete”5. (Coley BL Jr, personal communication, 2008). Bradley L. Coley died in 1960 at the age of 68 years old.
When the United States entered the war in April 1917, he was commissioned a Captain in the Medical Corps and was sent overseas as a battalion medical officer assigned to the British Expeditionary Force. Later transferred to N.3, Australian, Casualty Clearing Station, he was reunited with Dr. Robert Osgood, who was organizing the orthopaedic service for the American Expeditionary Force. He had Wilson detached from the British and sent him for advanced war surgery to study amputation centers and management of amputations in London, Paris and Italy. After reassignment at Base Hospital no. 9 near Châteauroux (Fig. 1) where Dr. Eugene Pool had been assigned, Wilson received his promotion to Major and was assigned to the AEF as orthopaedic consultant in amputations. He returned to America in February 1919 to assume the position of Chief of the Amputation Service at the Walter Reed General Hospital until his honorable discharge in July 1919.
A few months later he was invited to join the practice of Dr. Joel E. Goldthwait and Dr. Robert B. Osgood in Boston and was appointed to the staff of Massachusetts General Hospital (MGH) and to the Harvard Medical School as Instructor in Orthopaedic Surgery. Eventually in 1929, Dr. Wilson was deeply disappointed when he was passed over for Chief of Orthopaedics at Massachusetts General Hospital in favor of Dr. Marius Smith-Peterson. However, Wilson served as Chief of the Fracture Service at the MGH and wrote the section on amputations in Nelson’s Loose-Leaf Living Surgery. In collaboration with Mr. William A Cochrane, F.R.C.S., Edin. Wilson authored the textbook, Fractures and Dislocations . In 1933, while still practicing in Boston, he became one of the founders of the American Academy of Orthopaedic Surgeons serving as its President in 1934.
While on his first tour in France in 1915, Dr. Wilson met a 28-year-old French nurse’s aid at the American Ambulance in Neuilly and soon became engaged and then married in July 1916. Germaine Parfouru-Porel was the daughter of a famous actress. Her mother was also a successful producer and served as the head of the Odéon, the second state theater in Paris. Although Germaine Porel (the name was shortened by her father) was bilingual, she grew up in a home where her parents only spoke French. After returning to the United States, Dr. and Mrs. Wilson eventually raised three children: Paul Wilson, Philip D. Wilson, Jr.6, and Marianne Wilson Finkel.
Specialty clinics and chief of the clinic
Clinic and chief of the clinic
Scoliosis Clinic—John Cobb, MD
Clubfoot Clinic/Plaster Room—Leroy Barnett, MD
Cerebral Spastic Clinic—Robert Lee Patterson, Jr., MD
Back Pain Clinic—Ernest E. Myers, MD
Arthritis Clinic—R. Garfield Snyder, MD
Obesity Clinic—Frank G. Pettingill, MD
Bone Tumor Clinic—William B. Coley, MD/Bradley L. Coley, MD
Resident education was very important, originally established at the hospital by Virgil Gibney in 1887. The length of training for the eight orthopaedic residents was lengthened from 18 months to 2 years. General surgical residents trained for 1 year, and there was a medical resident for one year.
The annual Surgeon-in–Chief pro tempora was inaugurated with Dr. George Bennett, Professor of Orthopaedic Surgery at Johns Hopkins Medical school, as the first to occupy that role.
Opened in 1935, the new Medical Library had comfortable chairs, cases to house books and journals and a secretary to assist with preparing bibliographies. It replaced a small area in the physicians’ Staff Room where some books and periodicals were collected but often disappeared before residents had a chance to read them.
The X-ray Department showed steady growth, and for the first time, had a full time radiologist on staff. Dr. Raymond W. Lewis was appointed Director of the X-Ray Department in June 1938.
The hospital suffered a major loss with the death of its administrator, Joseph D. Flick, on December 14, 1937. Having been appointed in 1917, Mr. Flick, at age 66, served 21 years under Dr. Gibney and the next three surgeons-in-chief who were most indebted for his devoted assistance. Overseeing a number of expansions of the building during periods of crisis and change, he was succeeded by Edward A. B. Willmer, a civil and mechanical engineer from Labrador .
Dr. Beekman served as the first hospital Chairman of the Library Committee and was past President of the New York Historical Society in 1947. A member of the family for whom Beekman Street was named, he was a founding member of the Board of Surgery and the American Board of Plastic Surgery and had been Clinical Professor of Surgery at New York University Medical College. We are truly indebted to Dr. Beekman for preserving such a wonderful source of history of the oldest orthopaedic hospital in this country7 .
A celebrated veteran of the Spanish–American and Philippine Wars, Major General John “Black Jack” Pershing led the American Expeditionary Force (AEF) which other Allied Commanders tried to push into a subordinate role in troop replacement.
J. Lawrence Pool, MD (1906–2004) having interned in medicine at New York Hospital eventually was appointed Professor and Chairman of the Department of Neurological Surgery, Columbia University in 1949, retiring in 1972. He and his brother Beckman were the amateur squash champions of the world and together wrote more than 13 books on the subject.
Those interested in learning more about Robert Moses are encouraged to read Robert A. Caro’s critical but masterful 1,246-page biography of Moses, The Powerbroker.
As a result of World War II, there were over 15,000 amputees, while in World I, there were over 2,600 major amputees .
I am most indebted to “Pete” Coley for his generous time and assistance in providing me with many original documents, photos, reprints, anecdotes and other materials from his family collections. His recall of the history of the lives of his grandfather Dr. William Bradley Coley, his father Dr. Bradley L. Coley and his aunt Helen Coley Nauts enriched my appreciation of the Coley contributions to orthopaedics and cancer in the first half of the 20th century. The name William B. Coley, lives on as a periodic symposium and an annual award honoring him. The William B. Coley Award is given each year to an accomplished scientist in the field of cancer immunology at the annual dinner of the Cancer Research Institute in New York, founded by Helen Coley Nauts in 1953.
Philip D. Wilson Jr. eventually would become Surgeon-in-Chief of the Hospital for Special Surgery in 1972.
Beekman’s detailed history of Ruptured and Crippled from its origin in 1863 until 1939 gave me an important source of information for that 75-year period. I plan to continue collecting the hospital history for the years 1939 until the last decade of the 20th Century.