Harvard Public Health Review, 75th Anniversary Issue, Vol. I, 1939-1953

War and

ESPiTE PRESIDENT RoosEVELT's New Deal policies, America's H decade-long economic depression has left nearly 40 percent of ^ ^ ^ families below the federal poverty line. T^e Grapes o/ Wrat^, John Steinbeck's 1939 novel describing the struggles of migrant workers in Depression-era America, is an overnight bestseller.

Only 2.0 years after the carnage of the Somme, Europe once again plummets toward war. World War II claims some 55 million lives and launches the atomic age. It also serves as a proving ground for public health methods, as preventive medicine and disease control programs slash mortality rates from disease among U.S. troops.

Hundreds of Harvard School of Public Health graduates and faculty contribute to this triumph, both on the homefront through warrelated research and training, and on the battlegrounds of Europe and the South Pacific.

In 1946 the School gains administrative independence within Harvard University. Over the coming decade, the School will be at the center of a mid-century renaissance in the health sciences, as new methods are developed to quell disease and extend and improve life.

Trenches

1939 Faculty in the Division of Industrial Hygiene assist in

Rockefeller Institute's

the rescue of crew of the U.S. Navy submarine Jqua/us,

Rene Dubos, who will

which has foundered in 200-foot-deep waters off

later briefly join the

Portsmouth, New Hampshire.

School's faculty, isolates first broad-spectrum antibiotics.

HE OUTBREAK of W o r l d W a r

II marked a turning point for both the field of public health and the Harvard School of Public Health. The all-out mobilization for war, coupled with a concerted effort to control the infectious diseases that had ravaged armies in wars past, catapulted public health professionals to a new level of prominence and importance. To much acclaim, they rose to the occasion.

Yet the war years were trying times for the School, sapping it both of students and faculty. The steady climb in enrollment during the first two decades of the School's existence suddenly reversed itself, and by 1942. the number of students had dropped to an all-time low. Only 1 1 students were awarded degrees at the 1 9 4 3 commencement, down from 48 just two years earlier. American students were so scarce that school officials toyed with the idea of allowing foreign students to write their final exams in their native languages.

J

6 MO

e x c e p t ^fop^c^/ %/cers...

Abraham Perley '39

professor of pediatrics and child health, was released from the Department of Child Hygiene to study the impact of food shortages on French children for a Rockefeller Foundation health commission. He later returned under the auspices of the American Red Cross to establish a program to care for the malnourished children and was captured and interned by the Nazis and didn't return to the School until March 1 9 4 4 .

agawst m/ect;oMS A'sease awowg fA'e troops.

Other faculty who left for warrelated duties included Edward W. Moore, a chemist in the Department of Sanitary Engineering, who was assigned to a project for the British Army; Fredrick J. Stare, chair of the new Department of Nutrition; Elliott S.A. Robinson, director of the Division of Biologic Laboratories; and Arthur P. Long, the division's assistant director. The shortage of faculty severely strained the School's educational programs. In EonnJers; Hart^zrJ Sc/wo/ o/ fM&^c .S'c^oo/, Jean Curran, the School's first historian, reports that by 1943 the School's child hygiene department was so depleted of faculty that a student, Stuart Stevenson, taught courses the

The School also was losing faculty at an alarming rate. Epidemiology Department Chair John Everett Gordon was given a leave of absence in 1 9 4 0 to set up a communicable disease program for the British War Office (see article page 49). Gordon took with him John R. Mote, a young assistant professor in the department.

A year later Harold Coe Stuart,

TAe 3c^?oo/'s /acM/ty a w j g r a d a t e s were

OT! t%7e /ro?!t

jMnwg WorM War N

as t^e 7Mz/;'tary wage^ a preewptwe i*aft/e

Or

HSPH enrotlment reaches 95 (47 degree candidates,

The insecticidal

46 special students, and 2 certificate candidates). By

properties of DDT are

1943, however, enrollment will be cut in half.

discovered.

last four months of the school year.

Two alumni, Vlado Getting, D.RH.'4o, and Helen Roberts, M.P.H.'44, were recruited to shore up the epidemiology department.

According to Curran, the strain of keeping the School running during the war contributed to the retirement of Dean Cecil Kent Drinker and the subsequent appointment of Edward Godfrey Huber.

Formerly the province of social reformers, public health—particularly as it pertained to sanitation and control of infectious diseases— became a matter of military necessity during World War II. Military bases and facilities, springing into existence virtually overnight, needed clean water supplies and proper sewage disposal. Memories of the heavy toll the 1 9 1 8 influenza epidemic had taken on civilians and soldiers at the close of World War I was still fresh in people's minds. Venereal disease was a centuries-old problem for armies made up primarily of young men. The health of civilian populations, especially refugees, was also a concern, partly for humanitarian

44 ^ H ^ H

reasons and partly for fear that epidemics that started in the general population could spread to soldiers.

During the war, Harvard and other schools of public health were pressed into service as ad hoc public health training grounds for military personnel. In 1 9 4 5 , for example, the School was asked to give 63 N a v y and Army officers a rough-and-ready, two-month course in disease preven-

tion and public health. The School's Department of Sanitary Engineering churned out sanitary engineers at a record rate through a specialized Army Training Program, which consisted of two, 12-week terms. In the November 1 9 4 4 edition of the HartwJ HeaM? AJM^MZ jBMHe^M, Gordon Fair, head of the department, wrote that some 60 men had passed through this program in

the first year. The School also moved to bolster its instruction in venereal disease control, hiring Walter Clarke, executive director of the American Social Hygiene Association, to teach courses.

Of course, the School was very much tied to the war effort through one of its prominent graduates and future deans, Brigadier General James Stevens Simmons, s . D / 3 9 (see article page $5). As head of the Preventive Medicine Service of the Army's Office of the Surgeon General, Simmons was the top public health official in the armed services. A strong advocate for building up the ranks of the military's health specialists, Simmons would boast of having trained 30,000 officers and enlisted men in various public health specialties by mid-1944.

The lead article in the very first edition of the School's A/Mww/ BM/Zetzw in M a y 1 9 4 4 was written by Simmons and was confidently titled, "Preventive Medicine: The Key to Victory and World Recovery." The same issue of the Bulletin also lists six alumni and one faculty member as working for Simmons in the Preventive Medicine Service.

The armed services had a voracious appetite for people with public health training. The first issue of the BMf&fw boasted of the School having 1 1 5 alumni in the Army, 2.7 in the Navy, two in the Coast Guard, 3 5 in the U.S. Public Health Service, and 2 in

SoM/ers parage w HarMrJ

1940 Epidemiology Department Chair John Gordon granted

Hans Zinsser, legendary head of the Department of

a leave of absence to organize the Harvard-Red Cross

Bacteriology whose work spurred vaccines for typhus

Field Hospital Unit in Great Britain. He will not return

and Rocky Mountain spotted fever, dies of leukemia.

to the School until after the war.

non-military service abroad. By the end of the war, the School's tally showed a total of 3 3 3 in either military or government service, 1 6 5 from the School of Public Health and 168 from the Department of Sanitary Engineering. Four alumni—Arthur Washburn '37; Huron L. Vaughan '38; James H. Stephens '38; and Leonid S. Snegireff —were awarded Bronze Stars.

Five others—Paul Russell '2.9; Francis Carroll '39; Virgil Cornell '39; Granville Larimore '42; and Gaylord Anderson '42—were awarded Legion of Merit Awards. Professor John Gordon would, among a passel of other honors, receive the Army's Distinguished Service Medal.

Y THE TIME the first issue of the A/M7MW; was published in M a y 1944, World War II was nearing its close.

D-Day was a month away, and the Germans would be pushed out of France and Belgium by September. In the Pacific, it would be another eight months before U.S. Marines would win the pivotal battle on the tiny island of Iwo Jima.

Assistant Professor Harold Coe Stuart joins The

The School retroactively

U.S. adult per capita

Rockefeller Health Commission in southern France to

awards 33 master of

consumption of

study the nutritional and health needs of children in

public health degrees

cigarettes reaches

the war-torn region.

to holders of the

1,976, an almost

certificate of public

40-fold increase since

health.

1900.

Yet the pages of these early issues of the BMffetw provide a glimpse into the wartime experiences of HSPH alumni. Bits and pieces of news and personal observations are scattered throughout the alumni notes. Full letters, some of them quite long and detailed, were published under the

heading "News from the Front."

Together, they create a picture, albeit impressionistic and fragmented, of what World War II was like for a handful of Harvard-trained public health professionals.

Much of what the School's graduates in uniform did during the war involved basic sanitation—making sure that the troops and military bases had clean water, disease-free food, and proper sewage disposal.

Infectious disease control was also often part of the sanitation assignment.

Bernard Blum's experience at Oak Ridge, Tennessee, is a prime example.

When Oak Ridge was chosen as the place to manufacture the fuel for the

"We ^ ^

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Jack Pratt '40 atomic bombs it went from being an obscure, sleepy village of 19,000 to a bustling town of 78,000. Blum '38, was put in charge of keeping the inhabitants of the secret"atomic city" healthy. "The town was seething with construction. The mud was unbelievable," Blum wrote in a remembrance published in the BM/L?f;'M in November 1 9 4 5 . "It was obvious that environmental sanitation was a major job which deserved the highest priority."

J.A. Logan sounded incredibly busy when he wrote to Gordon Fair from Brazil: "We have completed three hospitals and have a considerable number of health centers in various stages of completion; the privy program is going full blast, and promises to be the biggest thing of its kind in the world. We are just getting started with our water supplies, our malaria control program, while operating, still needs more orientation."

Writing to Professor Fair from New Guinea, Jack Pratt '40 said "Our biggest bugaboo to health is fungus infection, which sooner or later seems to hit practically all of the men."

A lieutenant with the Twelth Naval

1941 Japanese planes attack U.S. naval base at Pearl Harbor. The United States enters World War II.

Construction Regiment, Pratt would later write from the Philippines of surviving an attack by the Japanese air force. "We had a merry-go-round of alerts, raids, strafings, paratroop landings, fleet actions and other amenities of war.. .Things have settled down now. We are out of the mud and improving facilities. A shower, a cold drink and a change to dry clothing constitute the acme of desire.

Nearly everything else is tolerable with these things."

As Pratt's experience illustrates, a degree in public health did not immunize one from combat. Michael Doyle '37, in the midst of his fourth campaign, felt "as though his profession were that of arms rather than sanitary engineering," said a note in the May 1944 BM^e^'w. "His work has been of all kinds, from assault to heavy construction and has included water supply and sewage disposal."

"Personally, I have been very fortunate," reported Abraham Perley '39 in the November 1944 BM^^M. "Although I've been in actual combat, I have no scars, physical or mental, except perhaps those of tropical ulcers, which now and then have a tendency

to break down. Thus far, even malaria has spared me. And if I am lucky, I may even get home soon on 'Rotation.' After more than two years overseas, home and family should feel to me mightily good."

The same issue of the BMjfe^M soberly reports that three alumni in the service had been killed: Paul Seaman '42, a lieutenant in the Air Force; Howard Shaw '38, an infantry captain; and Francis Vetch, Jr., '40 a lieutenant in the Air Force. Vetch's death struck a chord with a fellow alumni: "Francis was a good friend of all his classmates and was looked upon as a leader and a good student by all of us," wrote a classmate, Loren R. Heiple. "The loss of men of his caliber is a tragic price for the greed of war."

Not every death was in the line of duty. The reports that in November 1944, Fridgeir Olason, who had just earned his doctorate in public health, was killed along with his wife and three children when the passenger ship that was taking them home to Iceland was sunk by a German submarine.

^

^

LONG WITH TRAUMA AND

^ ^ ^ ^ tragedy, the war also pro^ T ^ H L vided some alumni with opportunities for new experiences. In a captivating letter from Egypt, Stuart Stevenson '44, a member of the field staff of The Rockefeller Foundation, describes an elaborate meal at the end of Ramadan: "The Pasha in his beautiful white silk robes broke the fast first by taking a glass of apricot juice, then every one began drinking water and all sorts of fruit juices.

Then we had a feast which lasted three hours with about 1 5 courses. After that a reception was held at the local officials' club. As we walked in the band began to play and we were led to a special head table. It was on the lawn, with hundreds present, with

colored electric lights hanging from the palm trees like dates."

J.A. Logan in Brazil observed: "The Grande Hotel is still doing business on the strand and the sidewalk cafe in front is still crowded with Americans drinking gin-tonicas and Brazilians drinking suarana. I have been staying here since I arrived and the place hasn't lost its novelty yet..."

The exigencies of war also gave rise to moments of lightheadedness that occasionally show through in the BMHe^M's letters and notes. The November 1944 alumni notes record that Nicholas Leone '41 spent 1 0 days on a boat in the English Channel.

"He is getting some interesting shots with his movie camera," the notes say, "and plans to entitle the him,

'From a Bath to a Meai in a Hetmet.'"

Granviile Larimore, chief of venerea! disease education for the Army's Surgeon Genera! Office, begins his tetter "Greetings from Holiywood," and he tetls how he is in the middle of cutting, dubbing, and editing a venereal disease prevention movie called "Pick-Up." (It is a fair bet that the take-home message from "PickUp" was don't!)

Loyalty to the School and the bonhomie among classmates also are abundantly evident in the BM/fetw's wartime letters and notes. Fairly typical is Arthur Washburn's ' 3 7 , letter, published in May 1944. "Major Charles Gill and Lt. Col. Shields of our class are in this area and I get to see them once in awhile. We are going to have a get together one of these times soon and drink a toast to all of you and to the School." ^

N ADDITION To the carnage ] caused by bullets, bombs, and ) death camps, World War II unleashed a wave of refugees that numbered in the millions. A large contingent of HSPH alumni were involved in refugee health programs through the United Nations Relief and Rehabilitation Administration (uNRRA), one of the predecessors to the World Health Organization.

Female graduates of the School seemed to have played an especially important role in UNRRA. Ruth

Cecil Drinker, Constantin Yaglou, and Leslie Silverman

The newly organized Department of Public Health

begin studies that lead to development of basic

Practice introduces a course in public speaking and

design criteria for gas masks for the U.S. Army Chemi-

"radio technique" to help prepare future health

cal Corps.

officers in clear and effective presentation.

47 ^ ^ o\

48 ^ ^ ^

Parmelee, a 1942. graduate, w a s one of just two UNRRA w o r k e r s assigned to an 8,ooo-person refugee c a m p in w h a t w a s then called Palestine. Without adequate staff, equipment, or supplies, Parmelee w a s facing a public health disaster w h e n she came to the c a m p in J a n u a r y 1 9 4 4 . I n an article for the BM/Zefw she described h o w the refugees were "alive w i t h lice."

Scabies—a mite-borne infection— w a s prevalent a n d t y p h o i d cases h a d occurred " b u t there w a s not a hypodermic syringe in the c a m p for giving i n o c u l a t i o n s . . . . " Epidemics of measles and w h o o p i n g cough broke out before a proper quarantine area could be established. Eventually, by her account, Parmelee persuaded British officials a n d others to provide supplies and staff, a n d the situation w a s brought under control.

M a r g a r e t Varley '44, wrote several letters to the BM/Jefw about her experiences in Greece. Initially she seems daunted. I n a letter published in M a y '4$ she wrote that she was in a "queer position—the only A m e r i c a n w o m e n in northern Greece at the present time. It w a s thrilling at first, but at this point I crave feminine society." But in a tetter published six months later, Varley has clearly hit stride a n d the sense of pride she has in her achievements is infectious, even 50 years later:

ever have a semblance of community again." T h e Institute of H y g i e n e , where A n w a s assistant director, MO w a s " b u r n e d a n d blasted," said A n in his letter, published in N o v e m b e r 1943Jozef Lubczynski, a 192.5 graduate of the M a r g a r e t Varley '44 S c h o o l and a doctor in the Polish A r m y , wrote f r o m L o n d o n : " F o r two months, I was alone with "Before the w a r we lived a quiet life. m y G r e e k g i r l s — n o medical officer. I D u r i n g G e r m a n occupation at the w a s the health division, w i t h typhus, time of the fall of Warsaw, m y wife diphtheria and meningitis very prevaw a s forced to a b a n d o n the city. O u r lent. I set up a medical warehouse, home w a s burned and property lost. w i t h drug and m i l k distribution and M y wife is living in some rural supplied food, drugs a n d improvised district outside the city. I have no supplies to eight hospitals. I w o r k e d news f r o m her."

15 hours a day a n d no Sundays off for two months. I w a s o n the road a Perhaps the most poignant letter great deal of the time (in a truck, no w a s written by K a r e l U r b a n e k , a jeeps). It was pioneer w o r k . But even1 9 2 4 graduate of the School, o n his tually I got a medical officer, a sanireturn to his native C z e c h o s l o v a k i a . tary engineer, t w o Y a n k e e nurse U r b a n e k provides few details because, assistants a n d two Greek W a r Relief as he wrote, " m y experiences gained medical teams. It's a fine set-up." during the past years are not pleasant, 'Tor

77%OM%?S.,

A s the w a r w i n d s d o w n , the BMj/efw's a l u m n i notes began to fill up w i t h news about medals being awarded and plans for after discharge.

But the wartime accounts of some foreign a l u m n i in war-ravaged countries also started to trickle in.

T h e stories are grim, the anguish concealed by a thin layer of propriety.

T h o m a s A n '39, writes about the ruination in M a n i l a and h o w "it w i l l take quite some time before it w i l l

so that I do not like even to recollect them

Responding to war-time stringencies, Dean Cecil

Harold Coe Stuart

Cecil Drinker resigns as dean. Edward G. Huber,

Drinker calls for a School-wide survey of possible waste

captured by German

D.P.H.'25 (left), head of the Department of Public

in the use of steam, electricity, and refrigeration.

army in France and

Health Administration, appointed acting dean.

" T h e reality is namely worse than one can describe, and the facts are too repugnant to be believable for anyone w h o did not live them through.

O n the other h a n d , " he continued, "the recollections of m y H a r v a r d days belong to the most joyous events of m y life."

Peter Wehrwein

1942

interned at BadenBaden for 16 months.

71he HarvardRed Cross F/e/d Hosp/fa/(/n/t ^ ^ ^eM^fmg m w y

^ M O ^ e M ^ 7 r e w e w ^ e r e J ^o c o t t e r Mp^ m my W^eM ^

w m p p m g

w y

^e// ^ r o ^ e /oose.

John Everett Gordon, director of the Harvard-Red Cross Field Hospital Unit December 3 , 1 9 4 1 .

F

IFTEEN MINUTES a f t e r

arriving in London in August 1940, Professor John E. Gordon was caught in his first bomb-

ing raid. As director of the American Red Cross-Harvard Field Hospital Unit, Gordon had gone to aid the British Ministry of Health in its efforts to keep the beleaguered royal forces free of disease as they faced the advancing Nazi army. With barely enough time to feel the English mist on his face, Gordon experienced firsthand the destruction of war. When some of the shock had worn off, he walked through the rubble created by the blast to the first-aid station, where his head wound was treated and he was given a cup of tea to calm him.

Gordon recovered from his harrowing introduction to war. A mere seven months laterâ&#x20AC;&#x201D;Gordon would eventually spend six years aiding the war effortâ&#x20AC;&#x201D;he calmly

Re^ Cross MMrses f^e /yosp^f, 0^67266? ?M .SepfeTM^er J <741

Fredrick J. Stare joins

Ernest E.Tyzzer retires

HSPH tuition rises to

the School as assistant

from faculty and is

$400 a year.

professor and chair of

succeeded by Rene

the newly created

Dubos of the

Department of Nutrition.

Rockefeller Institute.

50

^ X

reported that "the progress of the war has been most uneventful. There has scarcely been a respectable air raid in London for weeks "He had, however, gotten quite his fill of the English mist and rain at that point: "All of the members of the unit are looking for raincoats," he wrote.

The American Red Cross-Harvard Field Hospital Unit grew out of a series of meetings called by Harvard University President James B. Conant at the outbreak of war in 1 9 3 9 .

Harvard Medical School Dean Sidney Burwell, Gordon, and Charles Wilder, professor of preventive medicine and epidemiology, and other faculty came together to discuss how to help Britain in her greatest time of need.

In a letter to the British Ministry of Health, President Conant offered the university's medical and public health services to Great Britain. For the School, which was already depleted by war-related efforts, this was a big sacrifice. Gordon had only two years previously accepted a position at the School as professor of preventive medicine and epidemiology and was heading the Department of Epidemiology. The British Ministry of Health "gratefully accepted the] gencroujH offer" and "cordially i n v i l g d f ^ ^ ^ H Dr. Gordon to England. He was uniquely qualified to accept.

Gordon earned a PH.nnRrnrgYTH from the University of Chicago and an M.D. from Rush Medical College i ^ H 192.5. His experience with commuTR** cable diseases began immediately, with his going first to the Chicago Municipal Contagious Disease

Hospital followed by service as medical director of the Herman Keefer Hospital for Contagious Diseases in Detroit. Gordon's experience tracking epidemics began even earlier. After having just graduated from college, where he studied bacteriology and epidemiology, he went into World War I army camps to track influenza and meningitis epidemics. Afterwards, while on an assignment from The Rockefeller Foundation, he embarked on a three-year stint to study scarlet fever epidemics in Romania. He earned a reputation as an intrepid shoe-leather epidemiologist by swabbing the throats of all the children in the village where he was working each week, comprehensively tracking the course of the disease.

While in Romania, recovering from a bout of influenza, he received a letter asking him to join the School.

The missive almost went undelivered because his secretary, believing that "nothing of importance" was in that day's mail, had decided not to deliver it to him.

Gordon's seemingly life-long quest for adventure was well captured by student who wrote about him after lis death: "It used to be surprising Avho knew only his sedate demeanor in Boston to learn that, when in a new held situation, he /ith boyish enthusiasm." ie approached the rigors of war with the same enthusiasm: "I am having the time of my life," he wrote in a letter to colleague Sidney Burwell.

"Rarely have I had so many intriguing problems, such a diversity of experience, and such satisfactorily complete days."

1943 As chief of preventive medicine services in the office of the U.S. Surgeon General, Brigadier General James Stevens Simmons, S.D.'39, completes 40,000-mile, around-the-world tour of military public health facilities.

g

^ ^ ^ ^ ^

^^^ ^^^

O R D O N ' S ARRIVAL in

England in the spring of 1 9 4 0 coincided with the beginning of

the Battle of Britain, in which royal forces fought against Hitler's encroaching army. Poland had fallen the year before. Belgium and Holland had just been cut off from their allies, and France had acquiesced after the Nazis marched unopposed down the Champs Elysees. The British Isles stood alone to absorb the full force of the Luftwaffe's bombing machines. After nearly four months of bombing, with both Germany and England suffering heavy losses to their air forces and an enormous toll in English civilian casualties, Hitler postponed the assault on England "until further notice" and turned his attention toward Egypt.

The Americans' presence couldn't have been more timely or welcome.

When newly inaugurated Prime Minister Winston Churchill declared that "the British Empire and the United States will have to be somewhat mixed up together in some of their affairs for mutual and general advantage," he was referring to the battlefield. Yet with more and more people displaced by the bombing and crammed into air raid shelters, conditions for disease were ubiquitous. Gordon's team of epidemicfighting forces, which included John Mote, then an assistant professor in epidemiology, were prepared to face their opposition. Among their first responsibilities was to inspect air raid shelters; expecting the worst, they surprisingly found nothing.

GorJoM n g ^ renews

R e J Cross sta/jf.

" W h y no major outbreaks of communicable disease have occurred under shelter conditions is, of course, just as stimulating a problem as the attempt to find the cause of an existing outbreak," Gordon wrote in a communique back to the states about the held unit's progress.

September 2.1, 1 9 4 1 , was the official opening of the American Red Cross-Harvard Field Hospital Unit centered in the southern village of Salisbury, Wiltshire. It was a village under transformation as its tiny streets teemed over with R.A.F and army officers, and new enterprises like Woolworth's settled in beside old bookstores and bootmakers. The 404-foot spiral of the 13th-century

Cathedral "could be seen for miles around," wrote Gordon, and a very English restaurant called the Haunch of Venison served delicious food in a dining room with sagging floors up a "narrow winding stairway."

Gordon's collaboration with the American Red Cross built on a relationship Harvard and the relief organization had initiated during World War I. For the World War II effort, the American Red Cross provided financial backing and arranged for the construction of the Harvard Field Hospital. The 2.2. buildings that made up the hospital and laboratory were constructed from prefabricated units made in the United States, purchased and shipped overseas by

the Red Cross. The 100-bed facility was staffed by 85 Americans: 65 nurses, 1 0 epidemiologists, and 1 0 lab technicians. It was quite an operation, and it received a great deal of attention. " M o s t every important news agency in Britain has reported on the Unit and sent photographers to the site in order to make a pictured record of the Hospital," read a line in a monthly newsletter Gordon wrote to send back to the States about the Unit's progress. Notices appeared in the M^Mc^aster GtMrJMM, the EowJoM T/wes, PzrtMre Posf, the L<3Mcet, and over the radio. The lads from the United States were even featured in a Paramount News Reel.

Due to war-time

To improve American eating habits, U.S. Department

demands on personnel,

of Agriculture issues a pamphlet that introduces

oniy11degreesare

concept of basic seven food groups.

conferred at H5PH commencement.

Despite being in the middle of a war zone, the English held fast to their sense of hospitality and extended a long, gracious arm to the Americans.

Evoking a scene from the musical O/wey; in which even orphans know proper British cordialness, Gordon quotes an expression he heard frequently: "We want you to consider yourself a member of the family here." It was a sentiment echoed by Sir Wilson Jameson, chief medical officer of the British Ministry of Health, when he wrote: "The staff of the Unit have come to be regarded not as a group of workers from America but more as part of the general public health staff of the country."

Gordon and the Unit's objective was "to conserve military manpower through the application of appropriate disease preventive measures."

The plan was that the Harvard Field Hospital would not only treat patients,

but, in conjunction with its attached laboratory, would also be a center for research into communicable diseases.

Obviously both sides of the Atlantic would profit by this arrangement: England gained a needed adjunct to her incredibly drained medical resources, and research in preventive medicine being done at the School would be enhanced by the information gained. A mobile unit, which Gordon referred to as a "freelance" unit, was organized to respond to sudden outbreaks of typhus, influenza and other epidemics wherever they struck.

The freelancers soon got their chance to go to work with an outbreak of paratyphoid fever in Bristol, which had been heavily bombed and whose local hospital was stressed beyond its capabilities. Gordon's mobile team responded immediately to the problem and, as Sir Wilson

Jameson wrote in a letter to Burwell, the situation was "brought rapidly under control." Gordon's mobile team also responded to outbreaks of jaundice in Northern Ireland and other areas; several cases of trichinosis in northern England; mumps and meningitis in London and Wales; and typhoid fever in Devonshire. " I could go on multiplying instances of the manner in which this excellent unit is rendering us invaluable help," Jameson wrote to Burwell.

Surveying the health of the civilian population was just one of the Unit's major objectives. In the same way a reconnaissance team attached to an army unit surveys a future battlefield for lurking hazards, Gordon organized his own units to search for signs of communicable disease in advance of troops moving into an area. "The health of a command is influenced strongly by the environment in which

Gordon fWg^ f/?e ^eM ^ospzta/s 22

1944 First issue of the

University-wide com-

While traveling to Mexico under the auspices of The

Hart/arcf PuN/c Hea/f/?

mittee appointed by

Rockefeller Foundation, nutrition department Chair

/S/u/nn/ Bu//ef/n pub-

Harvard President

Fred Stare's plane crashes. After providing emergency

lished. Vlado Getting,

Coriant recommends

care to the victims, Stare and others walk away from

D.P.H.'40, is editor.

independence for the

the crash site, return to the airport, and take the next

School of Public Health.

plane to Mexico City.

it Ends itself," wrote Gordon. Disease among civilians whether hostile or friendly, will cross over to infect troops w h o come into the area. History gives credence to Gordon's concern.

a Punjab summer to studies of diarrhea in the Arctic reflected his pioneering spirit."

Indeed until the 2.0th century, infectious diseases took a greater toll during war than did opposing armies.

"During the American Revolution, the War of 1812., the Mexican War, and the Civil War, our armies were weakened by infectious diseases, and at times the mortality from this cause alone was appalling," wrote James Stevens Simmons, s.o.'39, dean of the School of

And then nothing happened. N o major epidemic threatened the Allied forces. In fact, according to statistics Gordon compiled after the war, if battle-related mortality is excluded, World War II was the first conflict in which accidental trauma, such as vehicular accidents, drowning, falls, athletic

Public Health from 1 9 4 6 to 1 9 5 4 , in the M a y 1 9 4 4 issue of the H ^ r t w J PM&^'c A/M7M7M The threat of influenza especially created uneasy fidgeting among the soldiers, and not without good reason. The great flu epidemic of 1 9 1 8 , sparked in part by World War I, killed nearly 40 million people worldwide and troops fighting the war paid their tremendous dues to this lethal virus as outbreaks among the allied forces took a heavy toll.

Yet the allies' health was in experienced hands. Gordon prepared his Unit for anything, but that was to be expected from a man about whom a former student was once said: "His pride in being able to move easily from held work in the i2.o°F heat of

Russian-born U.S. biochemist Selman Waksman

illnesses, and general sanitation. He warned against drinking locally produced milk, which might be a vector for tuberculosis and other bacteria.

Unit members inspected mess halls to ensure that food was clean and rations adequate.

The standard operating procedure included instructions for how to prepare for and prevent everything from respiratory diseases such as scarlet fever, diphtheria, and tuberculosis to insect-borne diseasesâ&#x20AC;&#x201D; malaria being the most feared, particularly among troops returning from the East. Gordon was particularly attentive to nutrition, digestive

The D-Day landing in

isolates streptomycin, an antibiotic (a term he coined)

Normandy, France, by

which will later be used to treat tuberculosis, typhoid,

Allied forces is a

and pneumonia.

turning point in the war against Nazi Germany.

injuries, and even suicides replaced non-battle-related disease as a major cause of death.

Soon after the United States entered the war, Major-General Dwight D. Eisenhower was sent to London as Commander of the American forces in the European theater. In July, British and American troops joined together to launch Operation Torch, and the American Red CrossHarvard Field Hospital was incorporated into the U.S. Army. On July 7, Gordon was commissioned in the U.S. Army as chief of the Division of Preventive Medicine, USAFBI (United States of America Forces of the British Isles). In the early summer of 1 9 4 3 , plans were drawn up for an assault on the west coast and an invasion of France.

Troops began arriving from throughout the European theater to prepare for the upcoming invasion.

Malaria, " a disease of such rarity in Great Britain," said Gordon, "as to be almost a curiosity," became the most important health problem as troops, as he wrote, "seeded with this infection" came from Africa and Italy, particularly Sicily. Also, an outbreak of influenza required much attention but caused no deaths.

The two major health problems that confronted the Unit among the Allied forces were trench foot, which while not a communicable disease was certainly preventable, and venereal disease. The latter absorbed considerable attention and resources, and it appears, taxed the Unit's patience: "the control of venereal disease, which even in those early days of American occupation, gave evidence of being all the problem that had been anticipated," wrote Gordon.

It was a problem throughout the war.

From February 1944 onward, all attention focused on the upcoming invasion of Normandy. In March, all ground and air force units were vaccinated against typhoid, smallpox, typhus fever, and tetanus, and proper sanitation was stressed in lectures as a personal responsibility of every troop member—"no more, no less," wrote Gordon. Field unit officers under Gordon's command inspected

troops' food and water and instructed them on insect and louse control, waste disposal, and general hygiene.

After the Normandy invasion, the Unit's Division of Preventive Medicine, under Gordon's direction, was relocated to northern France in order to be closer to the conflict, eventually establishing headquarters in Paris. As the war raged on, Gordon reported that civilian public health—especially typhus control—once again took precedence. On March 2.1, 1 9 4 5 , General Patton's Third Army swept through Germany on its way to Berlin, marking the beginning of the end of the war in Europe. But the war's end did not bring an end to Gordon's efforts. "Overshadowing all else were the health problems of the millions of displaced persons wandering over Europe," Gordon wrote in a subsequent history of preventive medicine in the European theater.

After a brief stint in the Pacific theater of operations, Gordon returned to the School, civilian life, and the teaching of preventive medicine in 1946. But his war years continued to influence his work for the remainder of his very long career.

the British and the Americans.

According to a U.S. Army history, Pre^eMtwe MeJzcwe ??z WorM Wi^r 77."The Anglo-American coalition in World War II, one of the closest and most effective in the history of wars, served as a solid basis from which the successful public health activity of Civil Affairs and Military Government grew from its early beginnings in 1940 to the end of the war in 1 9 4 5 . " V-E day was a shared victory for British and American forces; that these fighting men were relatively free of disease was a tribute to Gordon, Harvard, and the British Ministry of Health. Some years later, while working in the Middle East as a consultant to the World Health Organization, Gordon would draw on his wartime experiences and look to public health as a unifying language that all nations, regardless of political differences could speak: "We may not be able to agree on bombs but thank God we can all agree on better control of typhus."

Terri L. Rutter

Beyond circumventing major disease outbreaks, the American Red Cross-Harvard Field Hospital Unit proved the efficacy of public health, particularly in times of war, and helped strengthen the alliance between

1945 Rockefeller Foundation approves additional grant

President Franklin

of $1,000,000 over 10 years to support the School's

Roosevelt suffers a fatal

transition to an independent Harvard faculty.

stroke and is succeeded

by Vice President Harry S. Truman.

Donald Hornig witnesses the first successful atomic bomb test at Los Alamos, New Mexico. Hornig, who helped develop the bomb's triggering device, will later chair the School's Department of Environmental Health.

Dean, 1946-1954

ROWING UP IN rural North Carolina, *

on the cusp of the twentieth century, James Stevens Simmons played the usual

.

boyhood gamesâ&#x20AC;&#x201D;climbing trees, pretending to be a soldier or doctor, and

diagnosing the ailments of his friends. When his playmates tired of the games, Steve, as he was called, would collect butterflies and other specimens for his growing natural history museum.

Years later, as chief of preventive medicine in the office of the U.S. Surgeon General during World War II, Brigadier General Simmons would successfully merge the roles of physician, soldier, and scientist that his childhood games foreshadowed. In an extraordinary 30-year career, Simmons traveled around the world, moving from the field to the laboratory to the hospital; studying malaria, dengue, and other tropical scourges; and developing a preventive medicine program that safeguarded the health of the more than $ million men and women who served the United States in World War II. Along the way, he earned four Health in 1939) and a trophy case full of honors and decorations, including the U.S. Army's Distinguished Service Medal; the Sedgwick Memorial Medal, the American Public Health Association's highest honor; and the Walter Reed Medal of the American Society of Tropical Medicine.

Following his success in World War II Simmons returned to Boston to lead the newly independent Harvard School of Public Health, serving as dean from 1 9 4 6 - 1 9 5 4 .

James Stevens Simmons

i

contribute to the security of man's position as an intelligent, peaceful, and civilized animal."

Gregarious and energetic, Simmons could often be found sitting in on classes and chatting with students in the hall. The general with the piercing eyes who drew salutes on the battlefield was known to his HSPH colleagues as "Steve." As one former colleague later said, "Steve Simmons made you feel as though the gleam in that eye was meant expressly and intimately for you."

Deaw AfMwoTM wee^s

s^M^ew^s

Taking over from Acting Dean Edward G. Huber, D.p.H.'z^ Simmons inherited an institution depleted by the war. Graduates and faculty members had left in large numbers to serve their country on the battlefields of Europe and the South Pacific. Many who remained focused their work and research on the public health aspects of the war.

Simmons faced the daunting task of rebuilding a faculty that had fallen to 1 0 full-time and 3 part-time members and a student body that had shrunk to fewer than 50 students each year.

The School's financial resources, diminished by the crash of the stock market in 1 9 2 9 , were further stretched by the renovation of the School's new home in the former

1946

HarMr^ Sc^ooJ

Hea/^,

Huntington Hospital. There was an immediate need to broaden the School's base of financial support. ^""""S

IMMONS APPROACHED t h e

School's administration with the same determination and g elan with which he had worked to protect America's fighting forces. His introductory talk to the class of 1 9 4 7 , (85 members strong) had the forceful ring of a general's pre-battle address to his troops: "[EJveryone respects the integrity of the unselfish men and women of every nation who are devoting their lives to the humane profession of public health.

I congratulate you on your decision to join this important profession at the present critical time, for never in the history of the world has public health had such an opportunity to

In 1949, Simmons presented to the President of Harvard and the Board of Overseers a comprehensive 10-year plan for growth that addressed the School's financial needs. The plan called for an active fund-raising effort to be driven by faculty and volunteers, which would focus on increasing the School's endowment and raising funds for current use.

Simmons was particularly adept at winning endowment support from America's rapidly growing foundation community. He also began a more active outreach program to the School's alumni, meeting annually with the Alumni Association to report on the progress and achievements of the School, encourage alumni involvement, and request their support (he was the first dean to seek financial support from alumni).

Simmons' 10-year plan included elevating tropical public health from the status of a division within the Department of Epidemiology to a department in its own right. (The Department of Tropical Medicine

The School of Public Health becomes independent

John Crayton Snyder is appointed to head the new

Faculty unanimously

of Harvard Medical School with an annual operating

Department of Public Health Bacteriology. James L.

approves the addition

budget of $285,000. Brigadier General James Stevens

Whittenberger joins physiology faculty, beginning

of the degrees of

Simmons is named dean.

34-year career at Harvard.

master and doctor of science.

had been incorporated into the medicai schooi when the two faculties split in 1946.) Simmons' service in the armed forces—particularly in the Philippines and the Panama Canal Zone—had sparked a life-long interest in malaria, yellow fever, dengue fever, and other tropical public health scourges. While earning his degree from the School, Simmons worked with George Cheever Shattuck, clinical professor of tropical medicine, who would become a lifelong friend and colleague; and Simmons' doctoral thesis on malaria control was based on research he had completed while stationed in the Panama Canal Zone in 1 9 3 5 and 1 9 3 6 . As dean, Simmons would work with Shattuck to rally the friends, colleagues, and former students of tropical medicine pioneer Richard Pearson Strong and establish an endowed memorial fund in support of a professorship to honor Strong—the first named professorship at the School.

Beyond his administrative duties, Simmons, who perhaps better than any other public health leader of his era knew the national value of a healthy citizenry, used his reputation and position to push for an expanded national commitment to train public health professionals. Ironically, after the great public health advances that had been spurred on by the two World Wars, the nation found itself unable to fill many public health positions at the local, state, or federal level. Studies estimated that the nation's public health training programs would have to produce

2,300 graduates annually from 1 9 5 0 until i 9 6 0 to meet these needs—a figure far beyond the capacity of the nation's nine accredited schools of public health. ^

^

hp %<}

—

UST AS W E U N I T E D a

H ^

few years ago," wrote Simmons in 1 9 5 3 , "to

meet the health hazards H of war, we can and must unite to meet the hazards of peace. We must build up the nation's health in order to ensure its future strength and security, and we must work for an improvement of world health in the hope of ensuring a lasting world peace."

Simmons became an outspoken advocate for governmental support of public health education, addressing Congress on the national need for trained public health professionals on several occasions. "We who are responsible for the future of American public health must recognize this challenge, initiate sound plans to meet the national need for training, and see that training is properly financed," he said in 1 9 5 1 . In his three terms as president of the Association of Schools of Public Health Simmons also called upon the nation's 76 schools of medicine to place increased emphasis on preventive medicine, which he believed was the best way to keep the American public strong, diminish the effects of the diseases of old age, and control escalating health-care costs, which had already begun to trouble many.

academic institutions in Asia that would permit collaborative research and faculty exchanges. Unfortunately, Simmons did not live to see this dream realized. In the summer of 1 9 5 4 , while returning with his wife, Blanche, from a visit to North Carolina to see their daughter and new grandson, Simmons suffered a fatal heart attack at age 64.

When the faculty and students gathered to begin the 1 9 5 4 - 1 9 5 5 academic year, the Honorable Robert F. Bradford, chairman of the Visiting Committee, summed up the importance of Simmons' leadership in shaping the School's future: "Steve Simmons needs no epitaph. He left this School a rare and rich legacy.

He left a living portrait, not of a man alone, but of an institution, a tradition, and an ideal."

A fitting memorial for a man who worked so hard to secure the School's future, the James Stevens Simmons Professorship, held first by Simmons' friend and colleague James L. Whittenberger and today by John B. Little, was established at the School in 1 9 5 7 as a result of a fund-raising effort spearheaded by Simmons' long-time friend and colleague, Shattuck.

Marceita J. Bernard

Simmons also hoped to create what he described as a "bridge of health" between the School and

Gordon Fair, Gordon McKay Professor and head of

Communicable Disease Center (CDC) is established

the Department of Sanitary Engineering at the School,

as a field station of the U.S. Public Health Service in

is appointed dean of Harvard's School of Engineering.

the Atlanta, Georgia, offices of the defunct Office of Malaria Control in War Areas.

HH^H

REDRtCK J . STARE w a s

changing planes at New York's LaGuardia airport, en route from St. Louis to Boston, when he heard the news. The Japanese air force had just bombed the U.S. naval base at Pearl Harbor, precipitating America's entry mto World War II. Stare, a recent medical school graduate with a PH.D. in biochemistry, continued on to Boston, where he was scheduled to meet with Cecil Kent Drinker, dean of the Harvard School of Public Health, and A. Baird Hastings, head of the Department of Biochemistry at Harvard Medical School, to discuss starting a Department of Nutrition at Harvard. (At the time, the two schools shared administrations, and nutrition courses for both medical and public health students were taught through Baird's department.)

First m Food Fredrick J. Stare and the Department of Nutrition

1947 School introduces a series of 24 "Saturday Morning

Professor Emerita Alice Hamilton becomes the first

Health Forums." Speakers the first year include Dean

woman to receive the Lasker Award from the Albert

Simmons, Martha May Eliot, Alice Hamilton, Ross

and Mary Lasker Foundation for her contributions to

McFarland, Red Cross Chairman Basil O'Connor, and

the prevention of occupational disease.

Johns Hopkins luminary Abel Wolman. The collected lectures will later be published as P u M c Mea/f/; Wor/d Today.

f/w

Six months later, Stare was back at Harvard as

Harvard, and it would have a great impact on the direc-

assistant professor of nutrition and chair of the fledgling

tion the department would take during his 34 years as its

Department of Nutritionâ&#x20AC;&#x201D;the first such department in a

chair.

medical or public health school in the world. Under Stare's leadership, the department quickly emerged as a leading

The United States' entry into World War II would prove to be a boon for scientific research, as the Depart-

center of research into the myriad ways nutrition affects

ment of Defense generously subsidized research to aid the

health, uncovering vital clues about the links between

Allied effort. Stare and his departmental colleagues won

cholesterol and atherosclerosis, clarifying the health benefits

grants to study parenteral nutrition and how nutritional

and hazards of proteins and fats, shaping understanding

status affects malaria. These grants, along with funding

of a well-balanced diet, and spearheading the campaign to

from The Rockefeller Foundation, helped jump-start the

teach schoolchildren the value of good nutritional habits.

nascent department's research program. After the war,

Stare himself would become a resounding, oft-quoted, and sometimes controversial public voice on issues of food and diet.

Stare's close ties to the ^ r ^ T H E

BASIC

y o U R ^ ^

ENRICHED ORWIOLE MEAT. FOUOW. FtSH, EGGS. LEGUMES GRAIN BREAD. HOUR. CEREALS. AND PW^O

food industry would prove invaluable in acquiring new funds to sustain the burgeoning department's growth. An

Ironically, the man picked to head this enter-

adept fund-raiser, Stare

prise says he had never even

cultivated contacts with

heard of Harvard until he

executives in the food industry, who welcomed

got to college. A selfdescribed "simple country boy from the Midwest," Stare was born and raised

the opportunity to fund

PRUIT5. INCLUDING CITRUS; VEGETABLES. INCLUDING GREEN LEAITANDYELMW

research that would lend insight into food and nutrients. Within two

in Wisconsin, the nation's dairy capital. His father was

decades, Stare's depart-

president of a major canning

ment moved from bor-

company, with strong busi-

rowed space in the medical

ness ties throughout the

school to its own building

food industry. He earned his

on Huntington Avenue. By

PH.D. from the University of Wisconsin's School of

^ W F C T Y O U R H E M n ^ PROTECTIVE tXPRS,

1 9 7 0 , the department included 1 8 0 professional and support staff, with five

Agriculture, birthplace of the country's earliest research on nutritional elements and

departmental endowment funds and an annual budget of

health in animals. Experiments conducted on calves at

$4 million.

Wisconsin in the early 1900s revealed that essential elements in foods contributed to growth and development. One of the investigators on these studies, E.V. McCollum, went on to discover vitamins A and B. Stare's foundation in food and nutrition had been well laid by the time he arrived at

"Fred was an empire builder," says former colleague Mark Hegsted, one of the department's original members.

A biochemist, Hegsted had followed Stare to Harvard from Wisconsin; he would go on to publish over 400 papers, many of them dealing with protein, responses to malnutrition,

At the request of the governor of New York, the

Ross McFarland joins

India gains

nutrition department begins state-wide nutrition

the School's Department

independence from

survey looking at the impact of rising food prices and

of Industrial Hygiene.

Great Britain.

possible food shortages.

and the effects of calcium intake on osteoporosis.

As World War II wound to a close, Stare, Hegsted, and their departmental colleagues turned their attention to two nutritional issues of growing public concern: obesity and coronary artery disease. The department's challenge was great, for just as its cholesterol and obesity studies were taking off, the suspected culprits in these diseases were gaining a foothold in the American diet. Fueled by the postwar economic boom, eating out became a favorite American pastime, and the foods consumed were far from the nutritionist's guide to healthful eating. Beginning in the late 1 9 4 0 ' s , McDonald's restaurants and Baskin-Robbins ice cream stands began popping up around the

country, heralding the dawn of the fast-food franchise. Food companies also began filling supermarket shelves with prepared and processed foods, such as canned meats and fatand sugar-loaded snacks.

The department's shift toward the dietary underpinnings of disease marked a transition from what Hegsted calls the "golden age of nutrition"â&#x20AC;&#x201D;the period during the 1 9 1 0 s and 1 9 2 0 s when chemists throughout the United States and Europe rushed to discover the essential vitamins and minerals that staved off disease, such as Vitamin C for scurvy, thiamin for beriberi, and niacin for pellagra. In the postwar era, for largely unexplained reasons, deficiency diseases all but disappeared in the United States and

Europe, and many academics wondered if nutrition studies had dried up. It was a wary time for nutritionists, says Hegsted.

"I've always wondered if our department had been delayed four or five years, whether Harvard would have accepted it," he says.

But even as deficiency diseases disappeared, the perils of the nation's growing indulgence in fats and sweets were becoming increasingly clear. By 1 9 5 0 , the U.S. mortality rate from heart disease, already the leading cause of death, had passed 300 per 100,000-â&#x20AC;&#x201D;nearly twice the 1 9 2 0 death rate. For American men, the heart disease death rate was over 400 per 1 0 0 , 0 0 0 . But the causes of coronary artery disease remained largely a

gM J Co//MgMg m 1940^.

ResMrc^? on <2MZ?7M/s proM'JeJ c/MM

?!Mtne7!f5.

1948 The Stirling County Study, the first large-scale study of the impact of social factors on mental health, begins under the direction of Alexander Leighton.

Leighton will later chair the Department of Behavioral Sciences.

United Nations establishes World Health Organization headquartered in Geneva, Switzerland, and the U.N. General Assembly adopts the Universal Declaration of Human Rights.

medical mystery. (President Franklin Delano Roosevelt's physicians, for example, expressed surprise when he dropped dead of a stroke in 1 9 4 5 , despite Roosevelt's long history of dangerously high blood pressure.)

A breakthrough came in 1 9 5 3 , with publication of University of Minnesota physiologist Ancel Keys' landmark study showing a correlation between heart disease rates and diets high in animal fat. The study launched a wave of research into the metabolism of fat and the role of blood lipids in the development of atherosclerosis. Between 1 9 5 3 and 1 9 7 0 , department researchers published more than 400 original studies and scholarly reviews on obesity and the relationship between atherosclerosis and cardiovascular disease. The research ranged from metabolic experiments using animals, such as the 1 9 3 9 article, "Mucopolysaccarides and experimental atherosclerosis in rabbits," to a cohort study published in 1 9 6 6 by Hegsted and others that showed the definitive link between dietary fat and serum cholesterol levels.

Stare also recruited faculty whose skills reflected this new focus, including cardiologist Bernard Lown (see sidebar page 64) and Yaletrained physiologist Jean Mayer.

Mayer, who joined in 1 9 5 0 , would spearhead research into clinical aspects of obesity and the physiologic effects of food regulation during the

!

next quarter century. He would go on to serve as special consultant in nutrition to President Richard Nixon and chair of the White House Conference on Food, Nutrition, and Health in 1969. He left the department in 1 9 7 6 to become president of Tufts University.

H ^H^^

a similar column, called "Food for Thought."

In 1 9 5 5 , in an attempt to make the government's io-year-old national nutrition guidelines more accessible and easier to adhere to, Stare's group compressed the government's Basic Seven food groups into the Basic Four. The following year, these guidelines were adopted by the U.S. Department of Agriculture (usDA).

The nutrition department's Basic Four depicted a shield of four quadrants of equal size, each containing a different food group. "Protect your health with protective foods," reads the legend under the Basic Four shield. It proposed daily consumption of two or more servings of meat, two servings of fruits and vegetables, four or more servings of grains, and two or more servings of dairy foods.

Thick fog of air pollution kills 22 and hospitalizes

The Framingham Heart

thousands in small, western Pennsylvania city of

Study, the first large-

Donora, a high-profile event signaling dire health

scale longitudinal

consequences of dirty air.

study of cardiovascular

^ ^ ^ ^

ESEARCH, ALTHOUGH THE

mainstay of the department, was only part of the nutrition story. From the ^ outset, Stare also sought to get the word out that, as he once put it, "good nutrition means good food, consumed in variety and in such quantities as to make its maximum contribution to health and well being." Beginning in 1 9 4 5 , Stare wrote a twice-weekly syndicated newspaper column, "Food and Your Health," that provided practical nutritional information for the general public. Mayer later penned

disease, begins.

62 ^ ^ ^ y

The Basic Four wouid be the standard dietary guideline for the next 20 years, guiding the eating habits of two generations of Americans. But as eating habits and nutritional knowledge evolved, new dietary prescriptions were advanced.

In 1 9 7 6 , the Basic Four was replaced by the federal Dietary Guidelines for Americans, and more recently the guidelines gave way to the uSDA's modified food pyramid. In each instance, department faculty or graduates played a role, extending the department's history of trying to provide clear nutritional advice to the public based on the best current knowledge.

In the 1 9 7 0 s , Hegsted and department graduate Chris Hitt, M.H.s.'7$, helped map out the Dietary Guidelines for Americans, Hegsted as a member of the USDA and Hitt serving on the Senate Select Committee on Nutrition and Human Needs. The guidelines, with its recommendations to reduce meat consumption and increase intake of fruits and vegetables, would turn out to be, in Hitt's words, " a radical departure" from the Basic Four. The guidelines in turn provided a framework for the usDA's current modified food pyramid, which presents grains, fruits, and vegetables as the "base" of a healthy diet and tapers upward to foods that should be eaten infrequently, such as fats and sweets. Two years ago, Walter C. Willett, Stare's successor as department chair, unveiled his Mediterranean Diet pyramid, a modification of the USDA's

pyramid that proposed further reductions in consumption of some foods, especially red meat.

Stare also shaped American eating habits in more subtle, behind-thescenes ways. That we have an alternative to skim and whole milk is because Stare suggested to a milk company executive to add more protein to skim milk, resulting in the creation of 1 percent milk. And Stare claims that the basic recipe for the ultimate dieter's breakfast, Special K cereal, was written on a piece of scrap paper during a meeting with the president of the Kellogg Company. ^ ^ ^

TARE'S OUTSPOKENNESS

^L ^^^^ ^

and no-nonsense views on nutrition brought him headto-head with many alternative diet proponents, or what he called "food faddists"—a term first used in 192.2. by the University of Wisconsin's McCullom to describe vegetarians. Stare's battle with food faddists began in 1 9 5 9 , when he was sued by the Boston Nutrition Society for libel. That case would mark the beginning of Stare's confrontation with those who would profess to have found the next "miracle food," and he continues to be frustrated by the specious quest for the perfect food or diet.

"There's still a bunch of nonsense in food fads," says Stare today.

Because of his high public profile, he regularly received—and responded to—queries from concerned individuals. A collection of this " f a n mail," published in 1 9 8 2 under the title,

1949 Dean Simmons is

School introduces courses in "Human Ecology"

Donald L.Augustine is

awarded the Legion of

and "The Public Health Aspects of Atomic Energy."

appointed head of the

Honor by the French

The latter attracts a larger class than any other

Department of Tropical

government.

subject offered.

Public Health.

Dear Dr. ^Mre; ^^OMM J Eaf?, runs the gamut from hopeful inquiries about foods that may cause or alleviate gout, arthritis, memory loss, diverticulitis, and cancer to outright attacks on Stare's nutritional views.

"Dear Dr. Stare," began one irate letter. " Y o u r statements regarding foods are disturbing and appalling to me Don't you realize that man is a fruit eater...not constructed to eat flesh foods?" A letter signed by "an enraged housewife" decried the hazards of "hot dogs, sugared cereals, and colas" and admonished Stare to "tell the truth about good healthful foods."

With characteristic candor and good humor, Stare answered his correspondents and critics, always proffering a moderate, commonsense approach to eating. In response to a question about the food value of Scotch whiskey, Stare concluded, "Remember, food (including drink) is meant to be enjoyed, not feared, overconsumed, or misunderstood."

As an antidote to " f o o d faddism" and nutritional quackery, Stare counseled sound nutrition education in the nation's elementary, secondary, and, especially, medical schools. " O f all the environmental factors affecting health in present-day civilization in this country, none is more important than nutrition. Yet in most medical schools, organized instruction in nutrition is sadly neglected, despite 'lip service' to the contrary," wrote Stare in a 1948 article stressing the importance of training future physicians in public health nutrition.

And in a 1 9 8 6 in article titled "Nutrition Education in America: From Day One" Stare wrote: "We are a nation of nutritionally naive consumers, currently wasting billions of dollars each year on diet fads and nutrition nonsense. The only means for overcoming our wide-scale nutritional ignorance is by developing and conducting a comprehensive nutrition education program."

investigators who are doing some form of research in nutrition throughout the School of Public Health, the medical school, faculty of arts and sciences, and affiliated hospitals of Harvard.

H N THE 3 0 YEARS THAT STARE

] led the Department of Nutrition, ] the contours of the nation's ] nutritional landscape changed ) dramatically. When Stare arrived at Harvard, there were 2.5 to 30 known essential human nutrients; today, there are 45 to 50. The understanding of the relationship between dietary and serum cholesterol has improved dramatically.

By the mid-1970s, when Stare retired, mortality from heart disease was in the midst of a long decline from its mid-century peak. On the other hand, despite a half century of education and information about the perils of overindulgence, Americans continue to get fatter. In 1942., when Stare arrived at Harvard, under 1 $ percent of Americans were obese.

Today, over 33 percent of the nation tips the scales at zo percent or more over their ideal weight, the clinical definition of obesity.

Mar^ HegsfeJ, owe o / ^ e ong;?M/ % recew? ?MM?c Hea/^ Ro%7?& progr%7M. "It's the sad story of nutrition," says Hegsted. "There are more fat people now than there ever were."

"People eat because eating is a pleasure of life," says Stare. "There's not much interest in nutrition."

Obesity is just one of the many areas of research brought together under an umbrella program established by Stare in 1 9 8 4 called the Harvard Human Nutrition Program, H2.NP. Stare, in retirement, was looking for a way to strengthen the teaching of nutrition throughout Harvard. Today, under the direction of Clifford Lo, the program is working to link together the 100-plus

The department's long tradition of national leadership in nutrition research is carried forward by Willett, the Fredrick John Stare Professor of Nutrition and Epidemiology. Like his faculty namesake, Willett is a smalltown Midwesterner who is unafraid of speaking his mind on food issues.

Willett recently decried the introduction of olestra, the fat substitute recently made available to the makers of snack foods; his research exposed margarine's harmful side effects; and he has also touted the benefits of olive oil and other staples of a Mediterranean diet.

It was this kind of strong public advocacy that Stare had in mind in 1962. when he addressed the annual meeting of the Harvard Medical Alumni Association: "I have always felt that professors in our schools of medicine and public health, and other leaders in the health professions, are falling down on the job if they don't speak out clearly and emphatically on health quackery and nonsense, be it food faddism, antifluoridation, propaganda, or 'cancer cures.'"

Terri L. Rutter

Reviving Current Some of the most unlikely research to emerge from the Department of Nutrition, but which would have significant impact in clinical treatment of heart disease, was conducted by a young cardiologist named Bernard Lown and his group of researchers. Because the department was doing so much work on atherosclerosis, Stare determined that they should bring on board "an honest-to-goodness cardiologist." After he had been recommended several times by colleagues, including Paul Dudley White, the legendary heart physician at Massachusetts General Hospital, Lown was brought on board in 1958.

At the time, Lown was primarily interested in sudden cardiac death.

"I knew nothing about nutrition," he says. But Stare's group was interested in cardiac disease, and so was Lown.

Pro/essor Ewer/tMy Be7'7MrJ Low?!

"The way Fred ran the show, it was the ultimate Protestant reformation. Every believer or communicator operated in his or her own unique way," says Lown about his unlikely but ultimately compatible presence in the department. "There was no sense of this is what the

department was doing, so this is what everybody should be doing. It was free-flowing." Lown does admit, however, to speaking a very different language than the department's biochemists.

Lown had been looking for support for his idea to apply electric current directly to the stilled heart, literally jump-starting it back to life.

But because he had no engineering knowledge, he kept being turned down. "I didn't know AC from DC," he says.

Finally, Lown talked to Stare, who listened. "He said don't worry about it; do the work," says Lown. To develop the idea, Stare supported the Lown group with $100,000 per yearâ&#x20AC;&#x201D;at that time "an enormous amount of money." And what Lown developed would forever change the treatment of cardiac arrest.

In 1958, a patient of Lown suffered from a recurrent arrhythmia. Lown had resuscitated the patient several times using drugs; finally though, the poor man was dying, and Lown had run out of resources. Desperate for a solution, Lown thought about the work of Paul Zoll, a cardiologist at the Beth Israel Hospital who had shown some success eliciting a heartbeat from a heart attack victim by applying alternating current directly to the heart. Believing he had nothing left to lose, Lown took Zoll's idea and applied alternating current to the man's heart. It worked. "The fellow reverted miraculously," says Lown. "From a dying person, here was a live person, ready to go."

Lown later learned, however, that alternating current was actually very injurious and potentially lethal to the heart, so he began looking for a safer way to use electricity to correct rhythm disruptions in the heart.

"That was a real challenge," says Lown, "to develop a device that could do this that was absolutely safe." He met the challenge with the development of the DC defibrillator, which started a "revolution" in cardiac care.

Use of the defibrillator is now part of routine care for the emergency treatment of myocardial infarctions.

However improbable the end result of Lown's research, even more surprising was the actual laboratory in which it was designed. "Elegant research doesn't need elegant space," says Lown. "Elegant ideas result in elegant research."

Although plans for a new building had been approved, new space wouldn't be ready for occupation for another four years, in 1962. So, Stare gave Lown a room behind an "ancient" Coke machine in the old Huntington Hospital to set up his lab. "Well, the room behind the Coke machine was the old rat room," says Lown. Before any work could begin, he and his colleagues had to remove the rat cages. Then they built a loft to add an additional layer of space. Once the lab was up and running, it operated on three levels: people working in the loft, on ground level, and one person lying on the floor to do an experiment.

"It looked bizarre," says Lown, "but, it worked."

1950 Marvarcf PtAb//<r MeaM] /t/umn/ Bu//ef/n introduces "Pappy Says...," a column written by faculty member Hugo Muench, whose humorous, mildly irreverent observations on public health and the School will appear regularly for the next four years.

Hugh LeaveH /\n

/nnovat/ve

t e a c h e r - a d m /n /stra t o r c/eve/op5 a mu/t/d/sc/p//'ned a p p r o a c h to pub/zc hea/t/i pract/ce ^

N JANUARY 1 9 3 7 , rain swelled the Ohio River along ! its Kentucky edge to breaking point. Finally the

Public Health. Leavell succeeded the late Edward Godfrey Huber, D.P.H.'z^, who had chaired the department since

! southern bank yielded, and water Hooded into the

1 9 3 8 , when it was still the Department of Public Health

) streets of Kentucky's largest city, Louisville. Civil

Administration. The department's redesignation in 1940

and government personnel from the U.S. Public Health

coincided with a broadening in the scope of instruction

Service, Army Medical Corps, and Navy, along with Red

that corresponded to new realities in public health.

Cross nurses and doctors from around the country

"Our department has the great responsibility of

descended on the city to restore order and help dry it out.

dealing with the application of what is taught in other

Food and clothing were delivered by airplane, and over

departments of the School," wrote Leavell in 1 9 5 1 in

2.00,000 people received typhoid vaccines in an effort

the H a r t w J

to prevent an epidemic in the outbreak-ripe conditions.

Hea/f^? A/M77in? BM/Zetw.

In his teaching, Leavell was influenced by the

Coordination of all the players in this enormous

emerging field of "social medicine," which held that the

rescue project fell to Louisville's public health director,

social environment was as essential to keeping a person

Hugh Rodman Leavell. A local boy made good, Leavell

well, or rehabilitating a sick individual, as was physical

had been in private practice in Louisville since graduating

health. Leavell proposed that integrating the social sciences

from Harvard Medical School in 1 9 3 0 . He also chaired

into public health would expand and enhance the benefits

the Department of Public Health at the University of

of the physical and biological sciences. This attention to

Louisville and acted as the city's part-time public health

what in today's age of holistic medicine is called "attend-

director, presiding over a successful campaign to wipe

ing to the whole person," permeated all aspects of

out diphtheria. (In 1 9 3 3 , Louisville experienced the fourth

Leavell's work.

highest death rate in the country from diphtheria.)

Leavell's hands-on experience would prove invalu-

Using as his guide the definition of health developed by the World Health Organization in 1946â&#x20AC;&#x201D;a state of

able when he returned to Harvard in 1946 as head of the

"complete physical, mental, and social well being"â&#x20AC;&#x201D;

Department of Public Health Practice at the School of

Leavell incorporated a team concept for public health

In a letter to President Harry S.Truman, Dean

School sponsors the first annual Industrial Tropical

Simmons urges passage of a bill for federal aid to

Health Conference, attended by representatives of

medical and public health schools that the House

American Cyanamid, Coca Cola, Firestone Tire and

Commerce Committee has tabled.

Rubber, United Fruit, and other leading international companies.

practice. He drew his faculty from a variety of disciplines, each concerned with a different aspect of a person's well-being: Elizabeth Prince Rice was a social worker in the Department of Maternal and Child Health who taught a course on social work in health agencies; Margaret Varley, M.P.H.'44, taught a course on public health nursing; and James Dunning addressed dental public health practice. The department even offered a course in veterinary public health practice taught by Raymond Fagan.

In the classroom, Leavell employed a variety of nontraditional teaching techniques that were ahead of their time, including the casebased method; field teaching studies in partnership with community agencies; problem-solving focused on real life issues and programs; and vigorous student participation in all aspects of curriculum development, program planning, and implementation. In cooperation with the Departments of Biostatistics, Maternal and Child Health, and Tropical Public Health, Leavell created joint courses to augment his department's offerings.

"What an innovative, inspiring, imaginative and stimulating teacher he was, always ready to try the untested," wrote his former students upon his death in 1 9 7 6 .

Leavell also incorporated the development of sound administration methods into his multi-leveled approach. His own administrative skills were called "a precious attribute fundamentally grounded on

an unusual grasp of human relationships," in the citation for the Lemuel Shattuck Award, which he received in 1 9 6 1 from the Massachusetts Public Health Association. It was one of two prestigious awards with which he would be honored; he also accepted the Elisabeth Severance Prentiss Award in 1963 for outstanding achievements in the field of public health.

In 1948, Leavell's ideas were given a real-life laboratory with the establishment of the Wellesley Human Relations Service. Soon after the end of World War II, veterans around the country settled into government subsidized housing communities called Victory Villages.

One of these was situated on the outskirts of Wellesley, an affluent, predominantly white, Protestant suburb of Boston. The veterans, who were an ethnically and culturally diverse group, required a range of health services, and the town's leaders, seeking to avoid a clash of cultures, approached Leavell for help in coordinating their care.

Leavell had recently recruited psychiatrist Erich Lindemann from the Massachusetts General Hospital to direct the department's mental health programs. As director of outpatient psychiatric services at Mass General, Lindemann had been studying how physical illness affects mental health, specifically the psychology of burn victims from the 1942.

Cocoanut Grove fire in Boston.

and the school systems and medical practitioners. The center served as a field site and research laboratory for the School's students, while also providing mental health services to city residents. Today, the Wellesley Human Relations Service is still in existence, although its research and teaching components were phased out as federal funding was stopped.

The Service now operates entirely as an independent clinical practice.

Leavell's broad-based approach to public health "embraced all relevant disciplines, all levels of practice and all parts of the world," wrote his former students. Leavell traveled throughout Asia, India, and Central and South America, surveying public health measures being applied in these regions, believing that both host and visitor would benefit from mutual learning and understanding.

Upon his retirement in 1 9 6 3 , Leavell returned to India on a Ford Foundation fellowship to serve as a consultant and adviser to the director of the Indian Government's Institute of Public Health Administration and Education in New Delhi.

"He was a man of vision," wrote Dean John Crayton Snyder about Leavell upon his retirement. " M a n y men are endowed with unique talents in special fields of interest, but few have applied their abilities to such a wide range of activities."

Terri L. Rutter

At the Wellesley Human Relations Service, Leavell and Lindemann coordinated the efforts of community organizations, such as the churches

1950 Physiologist Jean Mayer, who will pioneer under-

Communist forces

British epidemiologists

standing of regulation of food intake and metabolic

from North Korea

Richard Doll and

obesity, joins the Department of Nutrition.

^ g s

invade South Korea,

Bradford Hill show first

trig!)

precipitating the

evidence of link

Korean War.

between lung cancer and smoking.

Ftying High

Ross McFariand and the Birth of Aerospace Medicine A

MONG THE HUNDREDS OF THOUSANDS

of documents in the iate

Ross Armstrong McFarland's archives, encompassing journal reprints, jL

j L . copies of talks and speeches, notes, and correspondence, is one slip

of paper that speaks voiumes about McFarland's piace in aviation history.

It is a teiegram from this century's most famous female aviator, Amelia Earhart, dated March 3, 1 9 3 7 , four months before her plane disappeared, that reads: "On contemplated world Right am wondering if there is anything I can check of possible value your (sic) research work

"

"Dear Miss Earhart," responded McFariand, then a member of the Harvard Fatigue Laboratory. " I am of the opinion...that if you are going to be taking many long hops that you would find oxygen of considerable value in reserving your strength and in keeping fit

It could also be used in emergency

situations and for headaches or when you feel exhausted due to prolonged flights."

U.S. life expectancy at

Infant mortality rate is

birth is 68.2 years, an

29.2 out of 1,000 live

increase of about 20

births, half the 1931

years since 1900.

rate.

Emily quickly learned his

McFarland's informed opinions, particularly on the effects of

arcane language of altitude and cabin

attitude change and oxygen depriva-

pressure. Soon after their marriage,

tion on pilot performance, helped

she fainted during a Right. The crew

breathe life into the burgeoning field

was ready to administer oxygen, but

of aviation medicine. Long before

Ross intervened, saying it was

frequent-flyer miles and low-budget

incorrect cabin pressure that caused

airlines made air travel for most

her to faint. This incident prompted

people as commonplace as breakfast

the McFarland's preHight visits to the

cereal, McFarland was working to

pilot. "And now," says Emily, " I

make the airplane environment

always ask what the cabin pressure is."

healthy and safe for everyone, from

After earning his PH.D. in

the cockpit to the rear of the cabin.

psychology from Harvard, McFarland spent a year at Trinity College in

"He was a pioneer on the level

England, where he conducted his Rrst

of Orville Wright," says Daniel Spoor, M.p.H.'66, one of McFarland's

studies on how human behavior was

students, who collectively became

affected by lack of oxygen and other

known as "Ross's boys." Spoor

environmental changes, using as his

would go on to direct the recovery

Abator

subjects pilots from the Royal Air

missions of Apollo 7 and 8 and, later,

McFar/ana!'s many /?yer /WeMcfs a w J coffeagMes.

the astronaut clinic and lunar lab of

Ear^art was among

Apollo 1 1 .

Born in 1 9 0 1 in Missouri, McFarland would come

Force. After leaving Trinity in 192.9, McFarland did some postgraduate

study at Columbia University in the Department of Psychology at the College of Physicians and Surgeons.

of age just as the modern age of aviation was taking Right.

There, he investigated the ways in which the central

He was two years old when the Wright brothers made

nervous system is dependent upon a normal supply of

their historic flight across the dunes of Kitty Hawk, North

oxygen, glucose, and organic elements.

Carolina. And he was completing his PH.D. in psychology

His research led to the development of "nomograms"

at Harvard when another aviation pioneer, Charles

from which the combined effects of altitude and other

Lindbergh, accomplished the Rrst non-stop solo transat-

variables such as carbon monoxide levels could be pre-

lantic Right in 192.7. McFarland would later become

cisely estimated and predicted. These Rndings led to

friends with Lindbergh, as he would with hundreds of

regulations for the use of oxygen by pilots in civil aviation

pilots throughout his career.

and by military pilots during night combat.

"He loved to Hy," says Emily McFarland, M.p.H.'56,

As aviation technology advanced, it quickly reached

of her late husband. "We always went into the cockpit to

a point where the capabilities of aircraft exceeded the

talk to the pilot."

physical limitations of the men who Rew. As he would later

Ross and Emily married in 1 9 5 0 when he was 49

write in the paper, "Human Problems Associated with

years old. It was his Rrst marriage, her second, her Rrst

High-Speed and High-Altitude Flight": "Altitudes so high

husband having died a year earlier. Emily says she hesi-

that human life is no longer possible may now be reached

tated about marrying such a long-time bachelor, but she

within a few minutes, and the full range of tolerable

adds with a smile, "Ross was very convincing."

temperature is met within a single Right."

1951 At the government's urging, the School stages a

Dean Simmons under-

CDC establishes the

World population

six-week training program for 50 U.S. Public Health

takes seven-week

Epidemic Intelligence

surpasses 2.5 billion.

Service officers who will be sent to Southeast Asia to

inspection tour of

Service.

fight malaria, trachoma, and other diseases that

Japan and Korea for

threaten the region'spolitical stability.

the Office of the U.S. Surgeon General.

Such rapid altitude changes, McFarland discovered,

for legibility at extremes of speed and studied the size of

cause a drop in the avaiiabie oxygen to the pilot. When

gauges to determine whether they could be used easily.

this happens, the pilot behaves as if intoxicated: his

He recognized that the eye's ability to adjust from light

attention fluctuates, his calculations become unreliable,

to dark conditionsâ&#x20AC;&#x201D;a characteristic he called the "dark

and his judgment becomes faulty. He may become fa-

adaptation"â&#x20AC;&#x201D;was impaired by lack of oxygen, which

tigued, or experience sleepiness, headache, and breathless-

might disrupt a pilot's ability to read his instruments.

ness, all of which ultimately affect his ability to fly,

He also stressed the need for an emergency supply of

increasing the chances of failure or accident.

oxygen in the cockpit to enable a pilot to survive sudden

Armed with his research on the effects of anoxia,

drops in cabin pressure. In fact, McFarland's studies on

along with a broader interest in the relationship between

cabin pressure are responsible for the familiar warning

man and machine, McFarland delved head first into trying

now made at the beginning of every commercial passenger

to understand the reasons for pilot error and the relation-

flight: "In the unlikely event of a drop in cabin pressure,

ship between pilot physiology and the physical demands of

please..."

flight. Over his nearly 40-year career, McFarland produced numerous studies, articles, and lectures showing that pilot error could be reduced if the plane was better adapted to the pilot and the pilot was better suited to the job. He

CFARLAND BEGAN STUDYING t h e e f f e c t s of

! ^

/ H

altitude changes in 193 5, as a member of the

J L V -HL International High Altitude Expedition to the

advocated for converging the knowledge and perspectives

Chilean Andes. Hiking along this South American range,

of engineers, physicians, psychologists, physiologists, and

with peaks reaching over 2.1,500 feet, McFarland and his

anthropologists to address the problems of airline safety.

colleagues studied the effects of altitude change on each

In the process, he revolutionized the held of aviation and

other and on the Andean people living in the mountains.

helped create a new held of study that he called "human

(This expedition also sparked McFarland's lifelong love of

factors" research, which attempted to understand the

mountaineering.)

relationship between people and the machines they

Two years later, McFarland joined the Harvard Fatigue Laboratory based at Harvard Business School, which was investigating how people functioned under different

operate in the belief that by adapting machines to human limitations one can improve an individual's performance.

"One of the most important ways of improving flight safety and combat efficiency is to design equipment in terms of human capability," he wrote in his classic textbook, HM77MM Factors

TrdiTMporf^z'oM. "Unless

aircraft are designed around the characteristics of airmen, it is hardly fair to attribute so many accidents to human failure as is usually the case."

"He laid out the basic human factors in civil aviation," says Stanley Mohler, a former colleague of McFarland who is now the director of the only civil aviation residency medical program in the world at Wright State University in Dayton, Ohio.

To this end, McFarland looked at the size and illumination of the print on airplane instrument panels

1952 T h o m a s R . A . Davis, class of 1953, sets sail in his

HSPH tuition rises to

48-foot ketch M/rufromNewZealand en route to

$770 a year. The class

Boston. Davis's wife, Lydia; sons, John and Timothy;

of 1952 numbers 121,

and two cats will accompany him on the 11,000-mile

42 of whom are

voyage.

women.

I

occupational situations and work stresses. Research on the health of industrial workers conducted at the lab included studies on fatigue and work efficiency among Mississippi sharecroppers, examinations of the physiological changes that occur under temperature extremes in the workplace, and the sources of energy and heat dissipation in muscle tissue in steel mill workers. McFarland and his Fatigue Lab associates produced 61 reports on topics ranging from pilot response to anoxia to sensory and motor responses during acclimatization to the health effects of prolonged exposure to high altitudes.

In 1937â&#x20AC;&#x201D;the year Amelia Earhart's plane was lost over the Pacific Ocean and Soviet aviator V.P. Chkalov flew non-stop over the North Poleâ&#x20AC;&#x201D;Pan American Airlines hired McFarland as a consultant to study pilot fatigue on long flights by its new fleet of Flying

Clipper Ships. At Pan American, McFarland established the Health Security Program, which eventually grew into a full-fledged medical program for pilots. The program laid the foundation for commercial pilot fitness and established a more comprehensive examination for pilot selection.

"He was the first scientist to study pilot fatigue," says Mohler.

In 1940, at the request of the U.S. Navy, McFarland initiated, with Ashton Graybiel, the 1,000 Aviators Study, which resulted in the development of better tests for the selection of fighter pilots. During World War II, McFarland continued his studies on military pilots as a civilian operations analyst with the 1 3 th Air Force in the Solomon Island Campaign. In 1946, he published HM??MM Factors w At'r Transport Dest'gw, one of the first textbooks on the new

discipline of human factors, which would evolve into the modern field of ergonomics.

In 1 9 4 7 , McFarland joined the Harvard School of Public Health as a member of the Department of Industrial Hygiene, where he expanded his research to include highway transportation safety. He also applied his concepts of human factors to the design of automobiles and 18-wheel trucks. Six years later, the Advisory Board for Medical Specialties and the Council on Medical Education and Hospitals of the American Medical Association authorized certification of properly qualified specialists in aviation medicine. McFarland's time had finally arrived. In the 1 9 5 4 - 1 9 5 5 academic year, the School began offering a series of seminars to students enrolled for the master of public health or master of industrial

AstrowgMt G/eww prepared /or f^e ceMtn'/Mge t e s t .

Gradates o/ Mcfar/an^'s prograw were

se/ect;wg awj test/wg t/?e /i'rst seven wen ^nown

as t^e MercMry AstroTMMts.

U.S. polio epidemic strikes 50,000 people, killing

Four-day smog in

John D. Rockefeller, Jr.,

3,300. Jonas Salk begins testing a vaccine using

London leaves 4,703

founds The Population

tissue culture methods developed four years earlier

people dead, three-

Council.

at Harvard.

times the city's usual mortality rate.

health degrees wishing to obtain credit toward certihcation in the field of aviation medicine.

"W" N 1 9 5 7 , T H E D A N I E L A N D

Florence Guggenheim J L Foundation gave the School $2.50,000 to establish the HarvardGuggenheim Center for Aviation Health and Safety. (While the Guggenheims are known primarily for their philanthropy in arts and literature, funding aerospace studies was not so out of line for them. In 192.6, the first liquid-fuel rocket was launched by physicist Robert H. Goddard, and five years later, his research was financed by Harry Guggenheim.) McFariand, who was then associate professor of industrial hygiene, was named technical director of the center, and in 1 9 6 2 , he was named the Daniel and Florence Guggenheim Professor of Aerospace Health and Safety.

The year after the center was opened, the first U.S.-built commercial jet, the Boeing 707, went into service, marking the beginning of the commercial jet age. By the end of 1 9 5 9 , 63 percent of passengers crossing the Atlantic flew rather than taking an ocean liner. In an article for the P ^ M c H ^ M ? A/M7W7M PzJ/e^M, McFariand wrote that the center would unify the basic research in a growing jet age, while serving as a clearing house for technical information on aviation health and safety.

By the time the center was established, 37 flight surgeons from the U.S. military and the Royal Canadian Air Force had already completed advanced training in aerospace

medicine through McFarland's seminars. Almost zoo more of "Ross's boys" would follow before McFarland's retirement in 1972..

"He was very much the gentleman professor," says Clarence Jernigan, M . P . H . ' 6 6 , the only physician sent by N A S A to attend McFarland's course.

"He had genuine interest in each of us as individuals," concurs Royce Moser, Jr., M . p . H . ' 6 $ . Moser describes the practice of aerospace medicine he learned from McFariand as finely tuned primary care and preventive medicine with special attention to problems affecting the flier: "You're looking for subtle things. For example, a simple faint in the average person may not be something to worry about. But in a pilot, it's cause for an extensive evaluation. " A flier has several million dollars invested in him, particularly those who fly military aircraft," Moser continues. "You can't afford to miss something that jeopardizes that investment."

McFarland's wealth of knowledge on the physiologic limitations of fliers also earned him a role in the burgeoning space race. Following the infamous explosion in 1967 during the launch test of the first manned Apollo flight—the three astronauts on board were killed—McFariand began consulting for N A S A . McFariand "laid the groundwork for understanding altitude physiology, which is important for spacecraft environment control systems," says Jernigan.

Upon finishing McFarland's program, Jernigan returned to N A S A with what he had learned about the human physiological parameters of

nitrogen tolerance—nitrogen, when added to oxygen, reduces its flammability—to redesign the launch atmosphere for the post-fire space system.

McFarland's investigative hand reached to subjects affecting the entire field of flight. He studied the safety of the passenger cabin environment, including the possibilities for the spread of infectious agents. He was interested in the hazards experienced by crop-dusting flyers. Another area that McFariand was interested in was natural aging, specifically how aging affected the pilot's ability to fly.

In the military, an old pilot is in his late forties or early fifties, says Cpt. John Baggett, director of the Special Studies Section of the Air Force. By then, a pilot has usually made rank and isn't flying anymore. Yet in the civilian world, the Federal Aviation Administration has set the flight ceiling at age 60. McFariand was interested in a person's physiological age over his chronological age.

"In the case of all productive workers, the important variable to consider is not chronological but rather functional age or the ability to perform required duties efficiently and safely," McFariand wrote in his last paper—an analysis of the employment of older workers.

McFariand retired from the faculty of public health in 1972.. He died four years later.

Many of Ross's boys have gone on to impressive careers, a couple even making their way into contemporary pop culture. Among them was Charles (Chuck) Berry, M . P . H . ' $ 6 , medical director of N A S A

1953 HSPH Department of Nutrition is featured in the first

J. Howard Mueller, head of the Department of

Nathan Marsh Pusey

broadcast of 77)6 fncf/ess fronf/er, a new NBC radio

Bacteriology, dies. His research helped make possible

succeeds James Bryant

improved immunizing toxoids for diphtheria and

Conant as President of

tetanus.

Harvard University.

program hosted by actor Raymond Massey.

71 ^ ? ^

I

from the time the first astronauts were chosen in the [ate 1 9 5 0 s to 1975s when the U.S. spaceship Apollo docked with the u.s.s.R.'s Soyuz. He also trained Kenneth Cooper, M.p.H.'6i, famous as the father of aerobics.

Royce Mose?; Jr.,

M.P.H.'6j, awj C^MC^ Berry, M.p.H.'j6, Ew;7y McFar/awJ, M.p.H.'j6,at tbe groMwJ-brea^mg cere?7!07!y/brt%7e Ross A. McFar/awJ

MemorM/ Laboratory tbe Department 0/EwMr07!77!e7!ta/ Hea/tb 1992.

What McFarland's former students recall most warmly about their time at the School are the many dinner parties and luncheons that the McFarlands frequently hosted at their home on Mt. Auburn Street in Cambridge. The McFarlands were generous hosts, and Emily brought together the boys in Ross's program with their wide and eclectic circle of friends.

In the summertime, Emity, who is a past president of the Cambridge Plant and Garden Club, tended lovingly to her luscious Engtish country garden at McFarland's summer home in Dublin, N e w Hampshire. A grand estate, the house boasts 12. bathrooms, an expansive lawn, and a dreamy view of the take.

Walking through the neat rows of ferns during a recent visit (the home is now owned by an acquaintance of Emily's, but she is always welcome), Emity points out her favorite flowers.

She directs a visitor to peer inside the windows of a smalt cottage at the edge of the garden. "We used to call this 'Ross's tavern,'" she says.

Occasionally, Ross's boys would excuse themselves from the gracious mixed company and sherry in the garden during the couple's annual summer picnic and retreat into the tavern.

Scientists James Watson and Francis Crick describe the double-helical structure of DNA.

The enthusiasm "Ross's boys" displayed for their studies had a great impact on Emily, and she eventually decided to pursue a degree in public health for herself. She says that while Ross was initially reticent about the idea, his students were more encouraging, eventually winning him over.

In 1 9 5 6 , Emily graduated with an M . p . H . in Health Education and Community Organization. Emily was an early member of the Foundation for Child Development, which was founded by Eleanor Roosevelt.

What has kept Emily's place in the hearts and minds of Ross's boys were her graduation gifts: Emily wrote individual poems for each of them, accompanied by an iltustration of a 19th century hot air balloon. (Emily has had several of her poems published in various publications and

Physiologist Ancel Keys shows the correlation between coronary heart disease and diets high in animal fats.

newspapers.) In 1 9 9 2 , Ross's boys memorialized their mentor by establishing the Ross A. McFarland Memorial Laboratory in the Department of Environmental Health.

Emily pauses in her stroll through the garden and crosses her arms.

She is a tall woman; in pictures of her and Ross together she is nearly as tall as he. She glances quietly at the flowers, and beyond at the wide body of water. " R o s s gave everything he had to the School," she says. "His research and his work were his life."

Terri L. Rutter