A Vision of Hope: The 200-Year History of the New York Eye and Ear Infirmary 1820-2020

small specialty-focused hospital with a mission to serve the poor and afflicted citizens of

Laurie Levin is a Harvard

Manhattan with vision and hearing loss. Two centuries later, their dream has evolved into

University/UCLA-trained

one of the world’s leading centers for ophthalmology (EYE) and otolaryngology (ENT).

anthropologist and author who

Nevertheless, the same vision, mission, and values of its founders, Edward Delafield, MD,

specializes in non-fiction books

and John Kearny Rodgers, MD, still permeate the entire institution.

and institutional histories.

Dr. James C. Tsai

www.laurielevin.net

President, New York Eye and Ear Infirmary of Mount Sinai from the Foreword

1820

a V i s ion of

The esprit de corps of the NEW YORK EYE AND EAR INFIRMARY is legendary, based on vibrant fellowship, shared pride, and a deep sense of belonging. To be sure, bonds such these are rarely found on any standard job description. But ask insiders, especially those who have been there awhile, and they easily spell out what makes NYEE unique.

H ope

“The Infirmary has always been characterized by camaraderie and collegiality that you don’t find in other hospitals and academic departments.

Ever since I started here as a resident in 1989, the rapport between physicians, nurses and staff has always made this a wonderful place to work, teach, and care for patients.”

9.281”

Dr. Paul Sidoti Professor and Site Chair for the Department of Ophthalmology “In a nutshell, the Infirmary’s mission gets into your blood: groundbreaking research and teaching excellence, which translates into superb patient care, all make me extremely proud to be part of its 200-year history.”

THIS BOOK ... honors the thousands of men and women of the Infirmary over the past 200 years who have dedicated their lives to repair and enhance the lives of so many grateful

L AU R I E L E V I N

ISBN 978-0-578-61431-1 ISBN 978-0-578-61431-1

volume of stories and facts, highlighting our first 200 years.

ScD (Hon), FACS, FASRS, CRA Surgeon Director and Retinal Service Chief, New York Eye and Ear Infirmary of Mount Sinai

Larry Zempel, Zempelworks.com

12.312 .125

9 780578 614311

Victoria Toro 45-year staffer in the Infirmary’s Social Work Department

Printed in USA

from the Introduction

3.875

2020

T H E 20 0 -Y E A R H I S TO RY O F T H E 1820 -2020

Dr. Richard B. Rosen Book and cover design by

“NYEE touches peoples’ lives every day, in the best ways possible—but it’s really a two-way street. My patients have impacted my life, put everything into perspective and taught me the true meaning of resilience.”

N E W YO R K E Y E A N D E A R I N F I R M A RY

90000>

patients. In the spring of 2020, we look forward to sharing this lusciously illustrated family

Arthur Tortorelli Technical Director at the Jorge N. Buxton, MD, Microsurgical Education Center since 1977

.75

12.312

3.875 .125

9.281”

NYEE 200

TWO HUNDRED YEARS AGO, two visionary physicians dared to dream—founding a

ABOUT THE AUTHOR

1820

2020

a V i s ion of

H ope

1820

2020

a V i s ion of

H ope

T H E 20 0 -Y E A R H I S TO RY O F T H E

N E W YO R K E Y E A N D E A R I N F I R M A RY 1820 –2020

L AU R I E L E V I N

The NYEE South Building at 13th Street and 2nd Avenue, North Building behind.

iv

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

A VISION OF HOPE The 200-Year History of the New York Eye and Ear Infirmary 1820–2020

by Laurie Levin Foreword by Dr. James C. Tsai; Introduction by Dr. Richard B. Rosen Copyright © 2020 New York Eye and Ear Infirmary of Mount Sinai 310 East 14th Street • New York, New York 10003 www.nyee.edu ISBN 978-0-578-61431-1 Printed and bound in USA. First printing, September 2020 Published by New York Eye and Ear Infirmary of Mount Sinai Design by Larry Zempel, Zempelworks, Los Angeles Photo credits: All photos are from the NYEE/Mount Sinai archives except where noted.

NYEE 200: A VISION OF HOPE

Contents

1820–2020

Foreword by Dr.James Tsai

vii

Introduction by Dr.Richard Rosen

viii

1 2 3 4 5

1820–1864 SO WIDE A FIELD OF USEFULNESS

1

1865–1905 AS NEW YORK GROWS, SO MUST ITS CHARITIES

33

1906–1945 THEIR SPIRIT LIVES WITH US FOR EVERMORE

59

1946–1985 REACHING FOR MORE

97

1986–2020 A VISION OF HOPE

131

Epilogue: COVID Courage

176

APPENDIXES

179

A. Timeline

B. Presidents and Chairs of the NYEE Board of Directors 1821–2012

190

C. NYEE Administrative Leadership 1958–2020

191

D. Mount Sinai Health System Leadership 2020

192

Notes

197

Acknowledgments

214

v

vi

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Dedication We dedicate this book to the generations of New York Eye and Ear Infirmary clinicians, researchers, and educators whose compassion, imagination, and dedication over the last 200 years have helped transform the lives of multitudes.

NYEE 200: A VISION OF HOPE

Foreword

1820–2020

TWO HUNDRED YEARS AGO, two visionary physicians dared to dream—founding a small specialty-focused hospital with a mission to serve the poor and afflicted citizens of Manhattan with vision and hearing loss. Two centuries later, their dream has evolved into one of the world’s leading centers for ophthalmology (EYE) and otolaryngology (ENT). Nevertheless, the same vision, mission, and values of its founders, Dr. Edward Delafield and Dr. John Kearny Rodgers, still permeate the entire institution.

The New York Eye and Ear Infirmary of Mount Sinai (NYEE) has always been a special place for the caring of those in need, with a dedicated cadre of talented physicians, scientists, nurse, staff, and trainees providing its patients with the highest level of quality compassionate care. While our record of successful outcomes and scientific and technological breakthroughs has been recognized globally, on the eve of our 2020 bicentennial, we remain as committed as ever to building upon this hospital’s rich history and tradition. Our ongoing integration and collaboration with Mount Sinai Health System—a world-leading health care enterprise with $8 billion a year in revenue and more than 7,200 physicians—will ensure that we continue as a premier medical center for surgical specialty clinical care, innovative research, and medical education.

Dr. James C. Tsai

As we envision our next century of growth and achievement, a critical resource will be the cutting-edge

President, New York Eye and Ear Infirmary of Mount Sinai

research capabilities of our affiliated medical school, the Icahn School of Medicine at Mount Sinai. Our Mount Sinai/NYEE Eye and Vision Research Institute will leverage one of the world’s largest biobank repositories at

Delafield-Rodgers Professor and Chair, Department of Ophthalmology

the Icahn School, as well as its leading-edge Brain, Genomic Technology, Global Health, Molecular Imaging,

Icahn School of Medicine at Mount Sinai Mount Sinai Health System

intelligence, and gene transfer therapy to move the field of medical science forward. Furthermore, as we enter

and Stem Cell Institutes. We will continue to translate technologies such as adaptive optics, artificial our third century of clinical excellence, we will become the first institution in the United States to introduce a robotic microsurgical intervention system for complex ophthalmic surgery.

I feel honored and privileged to introduce you to the extraordinary history and legacy of this exceptional specialty hospital.

vii

viii

New York Eye and Ear Infirmary

Introduction

NYEE 200: A VISION OF HOPE

WHEN I FIRST CAME to the New York Eye and Ear Infirmary in 1984 as a medical student, a second-year resident, Dr. Scott Spector, regaled me with stories of the infirmary past, how the legendary architect Stanford White supposedly helped design the South Building, how Francis Ford Coppola and his crew took over a ward on the fourth floor of the infirmary’s South Building to shoot the hospital interiors for The Godfather, and how the founding hospital president was a signer of the U.S. Constitution. It was not until a few years later, when our new department chair, Dr. Joseph Walsh, returned from his fellowship-turned-chairmanship at Montefiore Medical Center/Albert Einstein College of Medicine to take the helm, that I began to learn the great legacy of the infirmary and its place in American ophthalmology.

Dr. Walsh was an enthusiastic student of history, incessantly scavenging for scraps of our past and cobbling them into an ever-expanding compilation of lost anecdotes. He collected and identified classes of bygone residents, dove into old collections of photographs, and perused ancient Board of Trustees reports. He formalized the department annual reports, creating them on his desktop computer, and initially assembling them in Duo-Tang folders printed at the sixth floor print shop. Slowly, I was seduced into the richness of this

Dr. Richard B. Rosen

ScD(Hon), FACS, FASRS, FARVO, CRA The Belinda B. and Gerald G. Pierce Distinguished Professor of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai Deputy Chair for Clinical Affairs, Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Chief, Retina Service, Mount Sinai Health System Vice Chair and Director of Ophthalmology Research, New York Eye and Ear Infirmary of Mount Sinai Surgeon Director, New York Eye and Ear Infirmary of Mount Sinai President, New York Eye and Ear Infirmary Ophthalmology Associates, PC Honorary Professor of Applied Optics, School of Physical Sciences University of Kent, Canterbury, UK

dusty trove of documents and references from days past.

Given my own previous career in photography, I was inspired to illustrate his reports with photos from our embryonic Advanced Retinal Imaging Center, Dr. Robert Ritch’s Ocular Imaging Center, and Dr. Steven McCormick’s invigorated Pathology Laboratory. The reports slowly expanded into published volumes with striking color images. From time to time, alumni, staff members, and even patients would contribute photos and memorabilia, further stoking the flames of nostalgia and reverence for the rich traditions built by our forebears. Oral histories from the likes of Drs. Seymour Fradin, Thomas Muldoon, Richard S. Koplin, and others, as well as contributions from our development and external affairs directors, Ann Brancato and Jean Thomas, helped fill in the many gaps from the nearly 200 years since the founders’ initial dream.

Our infancy was marked by a modest beginning and an adolescent period of rapid growth, which featured frequent moves to new homes as we outgrew our digs every few years, before finally planting ourselves firmly on Second Avenue at 13th Street. From this point on, we began to acquire the trappings of an adult organization with sustained expansion as we hustled to keep up with a growing following of New Yorkers who recognized the gem in their midst.

NYEE 200: A VISION OF HOPE

1820–2020

Within a few years, many of our physicians also began to export our brand of expertise and helped pass it on to new institutions and departments of ophthalmology locally, nationally, and internationally, sharing the culture of caring and curing that they had learned here. New advances in anesthesia, surgical techniques, and clinical expertise to enhance patient care, and academic associations such as the American Ophthalmological Society, the New York Ophthalmological Society, and later, ARVO and the Pan American Ophthalmology Association, were pioneered by our faculty. Quietly, we remained steadfast to our mission of service as the first and ultimately last freestanding eye institute in the country.

With the approach of our bicentennial, Dr. Walsh encouraged me to assemble a historical scrapbook of our place in American history. Further emboldened by some fellow history aficionados, including Drs. Jay M. Galst, Stanley B. Burns, and James G. Ravin, I serendipitously stumbled upon Laurie Levin, an author-anthropologist and chronicler of institutional histories, and her creative partner, Larry Zempel, graphic artist extraordinaire, who agreed to help me compose and assemble a modern history and family album of the infirmary.

Sadly, Dr. Walsh passed away in 2017, never seeing the fruition of our shared aspiration. To honor his vision and inspiration, I have dedicated the book to his memory, for his mentorship and friendship, and for exemplifying the ideals of compassionate care, boundless curiosity, and leadership. This book also honors the thousands of men and women of the infirmary over the past 200 years who have dedicated their lives to repair and enhance the lives of so many grateful patients. We look forward to sharing this lusciously illustrated family volume of stories and facts, highlighting our first 200 years.

In memory of

Dr. Joseph B. Walsh

FACS, FRCOphth 1940–2017

Chairman, Department of Ophthalmology 1988-2013

ix

So wide a field of usefulness

“

It was here [at the London Dispensary for Curing Diseases of the Ear and Eye] that Dr. Rodgers, Dr. Edward Reynolds,

of Boston, and the writer of these pages first learned their own ignorance of these diseases, and seized the opportunity of studying a subject which opened to them

1

so wide a field of usefulness.” 1 — Dr. Edward Delafield

1820 –1864

WIKIMEDIA COMMONS

1 So wide a field of usefulness 1820 –1864

1818

The year was 1818 and two young medical men, Dr. Edward Delafield, age 22, and Dr. John Kearny Rodgers, age 23, stepped onto the New York Harbor dock after an arduous transatlantic crossing from Great Britain. Happy to be home, the arrivals were poised to begin the next phase of their medical careers.2 Two years prior, following their graduations from the New York College of Physicians and Surgeons, Delafield and Rodgers had been eager to deepen their professional understanding and sailed to London with the express intention of matriculating at the Guy’s and St.

A

Thomas’ Hospital, one of Europe’s most prestigious centers of medical knowledge.

THE FUTURE COMING INTO VIEW

s Delafield’s and Rodgers’s carriages zigzagged their way through New York’s bustling thoroughfares to their respective homes, much looked and smelled familiar. New York’s population was approaching 124,000 and the city was already becoming a “great and growing capital,” eclipsing, some said, Boston and Philadelphia. 3 Horse-drawn wagons, carriages, and pushcarts competed for the right-of-way in the unpaved and often-muddy streets. A medley

of buildings—some shabby, wooden, and fire-prone, others of stately, solid masonry—met the eye, depending on the route. Commerce ruled and the thrum of business kept the docks, factories, shopkeepers, and workers buzzing. Civic-minded citizens, religious reformers, and upper-class philanthropists, men and women alike, sought to temper the city’s mercantile reputation with cultural activities, practical and social improvements,

Preceding spread: ships in New York Harbor, circa 1818.

Opposite: the New York Harbor wharf, circa 1818.

and goodwill. The numbers of newspapers, booksellers, bustling reading rooms, refined eateries, theaters, parks, and literary societies were expanding at a bewildering rate, as were organizations promoting religious and moral reforms, women’s rights, charitable giving, and medical and scientific progress. 4

3

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

A belief that change for the better was possible drove their energetic endeavors. But so did the darker realities of New York City life. Absent a municipal sewage system, the fetid stench of human and animal waste hung in the dusty, ash-polluted air. Decaying carcasses of dogs and cats often remained by the roadside for days or weeks, with no dependable trash collection to remove them. Rats ran largely unchecked. Less obvious at first glance were rising ethnic and racial tensions, rousing abolitionist meetings, persistent labor strikes, abhorrent working conditions, rampant social displacement, soaring crime rates, and abject destitution. 5 Ever-lurking, too, were the grave threats of epidemics, disease, and infection.

were left to seek help where they could find it, often in an almshouse. Organized efforts for the public good

A belief that change for the better was possible drove their energetic endeavors.”

targeted the health and well-being of the poor, such as the Relief of Poor Widows with Small Children, the New York House of Refuge, and the Humane Society, to name three of many. But these, as well as other stopgap measures, did little to staunch the appalling lack of institutional health care. The New York Dispensary, founded by concerned members of the city’s Medical Society in 1791, was perpetually inundated by the needy, as was the New York Hospital. Originally founded in 1770, New York Hospital had been shuttered by fire soon thereafter and remained closed until 1791, when the institution was designated as “the public hospital” and mandated to care for the “respectable poor.” Roughly 25 years later, it was there that Delafield and Rodgers had received much of their early doctoring experience. 6, 7 (continued on page 10)

Right: a sooty back street in New York, circa 1820.

Opposite: the New York Hospital, also circa 1820.

NYEE resided in the building to the left.

ALAMY

“

At the time, most affluent New Yorkers in poor health received treatment and surgery at home. The indigent

M U S EU M O F T H E C I T Y O F N E W YO R K

1. SO WIDE A FIELD OF USEFULNESS 1865–1905

5

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

D R . E DWA R D D E L A F I E L D 1 7 9 4 - 1 8 75

I

NSIGNIA FORTUNA PARIA, translated from Latin into

Commodore Stephen Decatur’s call for volunteers and,

six children. All were ultimately claimed in their youth

English, means: “The rewards of effort are equal to

along with three of his brothers, joined “The Iron Grays”

by the same disease, including their eldest son, Edward

good fortune.” If this motto, inscribed on the Delafield

in defense of city and country. Soon after, he served

Henry Delafield, who at the age of 23 had just graduat-

heraldic crest dating from the Norman Crusades, was

as a surgeon’s mate and, until March 1, 1815, as a sur-

ed from the College of Physicians and Surgeons, like his

destined to inspire, then Edward Delafield most certain-

geon in the New York Militia’s Sea Fencibles, under

father. Despite this almost unimaginable sorrow, Delafield

ly fulfilled its purpose. Born in New York City on May 7,

Major James T. Leonard. With

1794, to Anne (née Halette) and John Delafield, Edward

peace restored and this in-

was one of a family of 14 children. Scarcely a decade be-

valuable

fore, in 1783, John Delafield, then a 35-year-old mer-

his belt, Edward returned to

chant, had arrived in New York from the British Isles on

complete his Doctor of Med-

the ship Vigilant. In his trusted possession was news of

icine degree at the College of Physicians and Surgeons

married again, in 1838, to Julia Floyd, the granddaughter

the peace treaty between the United States and Britain

of New York and interned for a year as house physician

of William Floyd, a signer of the Declaration of Indepen-

and an official copy of the treaty that marked America’s

at New York Hospital.

dence. The couple had five children, one of whom, Dr.

experience

under

INSIGNI A FORT UNA

independence. A scant four years later, by 1787, he had

The newly minted Dr. Delafield’s next decision

joined with others to found the Mutual Insurance Compa-

would change his life forever, and shape the futures of

ny, the first post-revolution enterprise to extend fire-risk

generations of patients to come. In the summer of 1816,

i,ii

coverage to New Yorkers.

he joined Dr. John Kearny Rodgers, a class-

By the time Edward was born, the

mate from the College of Physicians and Sur-

Delafields were counted among New York’s

geons and future lifetime collaborator, at

burgeoning elite—including the Jays, Gra-

London’s Guy’s and St. Thomas’s Hospital.

cies, Macombs, Lawrences, and Varicks—

It was there that Delafield and Rodgers were

who occupied the stately Federal-style

exposed to medical training that hadn’t yet

mansions that lined lower Broadway, near

reached America’s distant shores. After their

Whitehall, Beaver, and lower Greenwich

British advisers urged them to matriculate at

Streets. The Hamiltons, Morrises, and Hoff-

the London Dispensary for Curing Diseases

mans lived nearby. In keeping with his famiiii

Francis Delafield, graduated from Yale and the College of

of the Eye and Ear, the first hospital in the

ly’s social standing, Edward received a first-rate educa-

world devoted to the treatment of eye disease, the two

tion, first at New York’s Union Hall Academy and then at

colleagues quickly recognized the glaring gaps in their

Yale University, graduating with a Bachelor of Arts de-

knowledge and set their minds to absorbing as much

gree in 1812. Having decided to pursue medicine, he en-

about the embryonic science of ophthalmology as pos-

rolled in the College of Physicians and Surgeons and

sible. After Delafield briefly extended his studies in Par-

apprenticed to Dr. Samuel Borrowe, a highly esteemed

is, the two young doctors returned to New York in 1818

New York physician.

primed to translate their newfound insights into action.

But Delafield’s medical training took an unex-

But none of Delafield’s career ambitions or single-

pected turn following the British Navy’s blatant viola-

minded efforts prevented him from enjoying a personal

tions of U.S. maritime rights and Congress’ declara-

life. In 1821, he married Eleanor Langdon Elwyn, a grand-

tion of what was to become the War of 1812 against the

daughter of John Langdon, a U.S. senator and governor

United Kingdom. With the British blockade of New York

of New Hampshire. Before her untimely death from “gal-

harbor in 1814, the young medical student answered

loping consumption” in 1835 at the age of 35, she bore WIKIMEDIA COMMONS

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

Physicians and Surgeons, went on to study general med-

guests enjoyed the family’s refined hospitality. Some,

icine in Paris and ophthalmology in Vienna during the

no doubt, attended the daily family prayers, which were

Civil War, and became a prominent New York surgeon in

compulsory for family members and servants alike.

his own right.

By the autumn of 1874, Delafield’s final, enfee-

Before and after these devastating person-

bled days were spent under the watchful eye and helping

al losses, Delafield pursued an

hands of Hugh Reiley, his devoted friend and coachman

impressive

PA R I A

of

distin-

of 25 years. Delafield died that winter, on February 13,

paths.

Short-

1875. Mourners filled the soaring nave of New York City’s

ly after the founding of the New

Trinity Church, not only to pay their respects to him but to

guished

number

career

York Eye Infirmary, he joined his

also honor his two brothers, Joseph and Henry Delafield:

former mentor, Borrowe, in private practice. Busy as

All three had died within days of each other. Of the many

he already was, Delafield was appointed Professor of

eulogies, Revered Sullivan H. Weston, the chaplain and

Obstetrics and Diseases of Women and Children at the

a trustee of the College of Physicians and Surgeons,

College of Physicians and Surgeons in 1826 and Attend-

evoked Delafield’s towering, if somewhat intimidating,

ing Physician at New York Hospital in

character as “…eminent-

1834. This indefatigable service contin-

ly scholarly, with cultivat-

ued with his election to the post of Trust-

ed literary tastes; his lan-

ee of the College of Physicians and Sur-

guage was at once chaste,

geons in 1839, then as the institution’s

select, and forcible. He

vice-president from 1855 to 1858, and

was a great favorite with

finally as its president for the next 17 years until his death. Concurrently, in 1842, he gathered a group of respected physicians at his stately city home at 1 East 17th Street and established the New York Society for the Relief of Widows and Orphans of Medical Men. As president of the Society, Delafield presided over a meeting in late 1846 during which its members discussed creating the New York Academy of Medicine. Shortly thereafter, on January 6, 1847, the Academy was formally established, with Delafield among its founding fellows. If this breakneck pace wasn’t enough, Delafield was one of the founders and the first presiOpposite: the Delfield Crest. Left: Charterhouse Square, 1819. Above: Dr. Edward Delafield, circa 1820. Right: Delafield in his 60s.

dent of the American Ophthalmological Society in 1864.

As a trustee on the Roosevelt Hospital’s Board of Directors, now Mount Sinai West, he was elected its first president in 1869. As such, he stood at the side of President Ulysses S. Grant and other esteemed dignitaries at the Roosevelt Hospital’s cornerstone-laying ceremony.

In his later years, Delafield and his wife Julia often frequented Felsenhof, the family’s mid-Victorian summer home in Darien, Connecticut. Set on 165 acres overlooking Scott’s Cove, “the house had an English air about it,” according to the infirmary’s Dr. Bernard Samuels, who was one of Delafield’s biographers. It contained many iv

elegantly appointed rooms, connected by a wide hallway with six shallow semicircular alcoves, each containing a marble bust of Delafield’s most esteemed colleagues. An enormous, manicured English garden and well-tended kitchen garden, as well as outbuildings and a carriage house that stabled the family’s fine trotters, graced the property. Over the years, rounds of distinguished

his students. While affable to his intimate associates, he was at the same time dignified and reserved in his general manners….No one who knew him ever thought of taking a liberty with him—his stately manner would at once rebuke any undue familiarity.” v But it was an obituary that best summed up the great man’s inestimable contributions: Delafield’s innovative ideas and unflagging purpose “…[were] so incorporated in the works of the day that it would be difficult to give him all the credit justly his due.” vi Delafield is buried alongside his second wife, Julia, who died in 1879, in the family mausoleum in Green-wood Cemetery, in Brooklyn, New York.

7

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

DR. JOHN KEARNY RODGERS 1 79 3 -1 8 5 1

W

hereas Delafield was born into a mercantile

became a demonstrator of anatomy. In 1815, Rodgers

Physicians and Surgeons as Dr. Post’s Demonstrator of

family of great wealth and social position,

had already been appointed house surgeon to New York

Anatomy. He held that post for four years until his bur-

Dr. John Kearny Rodgers’s roots were equal-

Hospital, where he met Delafield, an assistant house

geoning practice, cofounding of the fledgling infirmary

ly distinguished, albeit of more modest origins. Born of

physician. “It was here,” Delafield later wrote of his close

with Delafield, and appointment as a vascular surgeon

Scottish ancestry on October 18, 1793, Rodgers was

friend and colleague, “that, living together and labouring

at New York Hospital in 1822 obliged him to resign.

the grandson of the Reverend John Rodgers, pastor

together in a common cause, a friendship begun as stu-

By 1823, Rodgers’s reputation had spread be-

of the Wall Street Presbyterian Church, and the eldest

dents under the same master, was cemented by a bond

yond the confines of the United States and he was called

son of Dr. John R.B. Rodgers, an attending physician at

which death alone dissolved.”

New York Hospital, and Susannah R. Kearny. In 1808, at age 15, Rodgers entered Princeton University to read the clas-

“The world shall see, sir!”

sics, a line of study at which he seemingly failed to shine. Upon his graduation in 1811,

As was customary for young surgeons who could

as the story goes, Princeton’s president, Samuel Stan-

afford making a medical pilgrimage back to the “mother

hope Smith, directly expressed his doubts that Rodgers

country,” Rodgers set sail for London in 1816 with the ex-

would ever make his mark in the world. To which the

press purpose of deepening his professional training un-

high-minded, unflappable Rodgers countered, “The

der the tutelage of England’s most eminent medical men-

world shall see, sir!” i

tors of the day. Edward Delafield was to do the same six

Following Princeton, Rodgers earned a Doctor of

months later. Along with 400 other eager pupils, the two

Medicine degree at New York College of Physicians and

crowded into Guy’s and St. Thomas’ Hospital’s overflow-

Surgeons in 1816. Under the mentorship of Dr. Wright

ing lecture halls to hear the “giants” of medicine, includ-

Post, a prominent figure in New York’s medical estab-

ing Sir Astley Cooper, who had encouraged Saunders to

lishment, Rodgers, a gifted anatomist and surgeon, soon

establish the London Dispensary for Curing Diseases of the Eye and Ear some years before.

By “walking the Dispensary wards,” the two young doctors were immersed in the teaching and innovative practices that ultimately ignited their aspirations for what might be possible back home. Before leaving London in 1818, Rodgers passed his examination and received a license from the Royal College of Surgeons. Eager to expand his professional knowledge even further, he spent the spring and summer months studying in Paris, and then he and Delafield briefly toured the Continent—presumably for enjoyment—before returning to New York together in October of the same year. Immediately upon his November

Dr. Wright Post, circa 1820.

return, Rodgers resumed lecturing at the College of WIKIMEDIA COMMONS

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

to Curaçao, West Indies, by the island’s rear admiral and

cases and procedures of his day. Considered one of

governor to perform an operation. Too appealing to turn

New York’s most foremost surgeons, he was the first

down, Rodgers took leave of his stateside duties for sev-

to use ether anesthetic for the drainage of a perirectal

eral months. In what might be described as ophthalmol-

abscess in 1846 and the first to ligate the innominate

ogy’s first international goodwill mission, he performed

artery in 1848. No less important was his notable bed-

scores of “severe” operations on poor and rich patients

side manner, described best by Delafield, who wrote:

alike in two converted rooms of a fort located near Wil-

“…[His] kind and considerate manner, that gentle but cheerful address, that so evident heartfelt interest in the well-doing of his patients which…made him so universally beloved by all who fell under his professional care.” Considered peerless, he was known and respected for his immersive commitment to all these qualities. As such, Rodgers was asked to be a consulting surgeon to the New York Lying-In Asylum, the Institution for the Blind, and the Emigrants’ Hospital. He also enjoyed an honorary membership of the New York Pathological Society and served as president of the New York County Medical Society and vice-president of the Academy of Medicine.

Sadly, his brilliant career was cut short after a month long illness, variously described by disagreeing lemstad, the capital city. Upon Rodgers’s departure, the governor issued a formal letter of gratitude published in the island’s Dutch and English newspapers. Later that fall, back in New York, Rodgers married Mary Ridgely Nicholson, with whom he had six children: two sons and four daughters. After Mary and one of his daughters died of tuberculosis, he married Emily Hosack, daughter of Dr. David Hosack, New York’s most distinguished physician at the time, in 1847. Two more daughters were born from this union.

Over the arc of his professional life, Rodgers never ceased to refine his technical skills, employ new approaches, and push the boundaries of successful surgical outcomes by tackling the most challenging

Left: the Charter House Hospital.

Above: Dr. John Kearny Rodgers, circa 1820.

physicians as liver inflammation, peritonitis, and “inflammation of the veins of the portal system.” Rodgers died on November 10, 1851, at the age of 58. Most certainly, Rodgers’s many achievements and values—the foresight that drove the cofounding of the New York Eye Infirmary, the courage to innovate path-blazing skills, and a deep, abiding concern for his patients— were “equaled by few and enviable by all.”

9

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

(continued from page 4) By 1818, when Delafield and Rodgers returned to New York, the city’s medical landscape was also beginning to change. In addition to the New York Hospital, Bellevue Hospital, dedicated in 1816, was the city’s only other major medical facility, if one of last resort, for those deemed “dangerous or morally reprehensible.” 8 But during this era of successive epidemics, many impoverished patients of good character ended up there, too, in part

“

because New York Hospital began turning patients away to reduce overcrowding and mortality rates. As the

...here was an open field in which they might work, an almost untrodden path in which they might walk...”

only alternative, Bellevue’s patient population soared at a frightening rate, its wards overflowing with patients who were disproportionately chronically, contagiously, or terminally ill.

Grim as these conditions were, it is unlikely they were top of mind for Delafield or Rodgers, who arrived home filled with optimism and ambitious plans. Their two-year tenure at Guy’s and St. Thomas’ Hospital and, almost more importantly, at the London Dispensary for Curing Diseases of the Ear and Eye, had exposed significant gaps in their New York College of Physicians and Surgeons training. 9 The College’s shortcomings were attributable to several reasons. Even in the best of times, the flow of advancing medical and scientific ideas from Europe to America was glacial. The Napoleonic Wars and the War of 1812 both disrupted whatever trickle there was. Moreover, the College trained generalists; subspecialties were yet to be recognized or formally practiced.

However, that the College’s curriculum failed to include any instruction related to eye anatomy, pathology, or therapeutics was hardly unusual. With little or no training or experience, most surgeons tended to shy away from highly technical and risky ocular procedures, given their high rates of infection and low rates of success.10 Consequently, the treatment of eye ailments routinely fell to “oculists,” who were untrained, unlicensed lay practitioners touting cures utilizing “certain mechanical appliances” or “prescribing patent medicines of their own making.” 11 Even Delafield, in one of his later speeches, called attention to a celebrated quack who

WIKIME

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“…pretended to possess the secret of ‘drawing off the effete and turbid humors of the eyes of old people and replacing them with fresh and youthful fluids.’” 12 For Delafield and Rodgers, the London Dispensary for Curing Diseases of the Ear and Eye was the ideal incubator for nurturing new ideas, clinical experiences, and inspiration. Not a day was wasted under the tutelage of Sir William Lawrence, Dr. Benjamin Travers, Dr. John Richard Farre, and Sir Astley Cooper.

Delafield later recalled, referring to himself and Rodgers in the third person, “The thought flashed upon them that here was an open field in which they might work, an almost untrodden path in which they might walk, and in the ardor of youth, they devoted themselves to this new branch of knowledge.” 13 

Ad for a patent medicine of the time, “For All Complaints of the Eyes.”

1. SO WIDE A FIELD OF USEFULNESS

Why, Delafield and Rodgers asked, must these formerly industrious patients fall through the cracks?”

1818

PURSUING A

C O M PA S S I O N AT E M I S S I O N

B

M U S EU M O F T H E C I T Y O F N E W YO R K

“

11

1865–1905

ack on their home turf, Delafield and Rodgers conducted a groundbreaking survey to assess where and from whom “feeble” New Yorkers suffering from eye diseases received care. The results were hardly surprising.14 Because the New York Hospital routinely turned away those seeking care for blindness or

other eye pathologies, they found that Bellevue became the default option for warehousing not just criminals and “paupers,” but also a significant number of the “useful class” whose vision deficits rendered them unfit to work.

Formerly, many had been productive men and women of meager means who simply could not afford competent medical advice and were too prideful or independent to apply for aid from a hospital or dispensary. Why, Delafield and Rodgers asked, must these formerly industrious patients fall through the cracks? (continued on page 14)

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

M O O R F I E L D S E Y E H O S P I TA L London “Out of compassion for the pitiful state of many soldiers returning from the Egyptian campaign afflicted with military ophthalmoplegia and trachoma infections…” i — Dr. John Cunningham Saunders (1773-1810), founder of Moorfields Eye Hospital

mounting war deaths, and far from

status as an ongoing, comprehensive hos-

the bloody frontlines, another un-

pital dedicated to ophthalmology. As one of

foreseen enemy was lurking. Entire

the first regularly trained surgeons in Brit-

regiments on both sides contracted

ain to set up a practice committed exclusive-

what was then called Egyptian oph-

ly to diseases of the eye and ear, Saunders

thalmia or Ophthalmia militaris, a dis-

served as the Dispensary’s director until his

ease that was never clearly identified. Contemporary ex-

untimely death at age 37 in 1810. During his brief but sig-

perts suggest not one, but possibly several afflictions,

nificant career, he developed early techniques to deal

including trachoma, gonorrhea, Haemophilus aegypti-

with soft, opaque lenses through needling and was one

cus, or some hybrid of the three. Whatever the precise

of the first English physicians to use belladonna to fa-

etiology, thousands of soldiers were stricken and waves

cilitate cataract surgery. His book, A Treatise on Some

of homebound expeditionary troops returned either blind

Practical Points Relating to the Diseases of the Eye

or nearly so, often infecting their families with the same

(1811), was edited posthumously by his colleague Farre

debilitating outcome.

and published by the Governors of the Hospital, both to

ii

Prior to this rampaging ocular infection, epidem-

aid his widow and inform ophthalmologists who followed

ic in its proportions, Europe’s medical establishment had

after his death. Among them were two young, untested

given barely a nod to the study of eye diseases, save for

physicians from New York, Delafield and Rodgers, who

a handful of forward-thinking German physicians. The

took Saunders’s legacy a step further by introducing

treatment of eye diseases lay in the shadowy dominion

modern ophthalmology into the New World and estab-

of “oculists” who were little more than quacks, snake-oil

lishing America’s first specialty hospital: the New York

peddlers, and charlatans with literally no background in

Eye Infirmary.

ocular physiology, let alone effective solutions. But with civilian outbreaks growing and public health alarms rising, respectable British and French physicians began to take note. Whereas the French were unconvinced the disease was contagious, British medical men believed otherwise and responded by establishing the Royal Infirmary for the Diseases of the Eye on Cork Street in 1804,

WIKIMEDIA COMMONS

W

hat

do

the

Napoleonic

wars,

a

young

English surgeon, and the New York Eye and Ear Infirmary have in common? More than

one would think.

In 1803, 17 years before the New York Eye and Ear Infirmary’s founding, Britain, ending an uneasy truce, declared war on France in a long-overdue response to Napoleon’s 1798 Egyptian Campaign and his imperialistic designs on British colonies and the rest of Western Europe. Apart from the ensuing military confrontations and

“under the patronage of the majesties and of the royal family for the relief of the poor and supported by voluntary contributions.” iii With the crisis in full swing, Dr. John Cunningham Saunders, mentee of the influential London surgeon Sir

W EL LC O M E

12

Astley Cooper and a demonstrator of anatomy at Guy’s and St. Thomas’s Hospital, cofounded, with Dr. John Richard Farre, the London Dispensary for Curing Diseases of the Eye and Ear at 40 Charterhouse Square, West Smithfield, in 1805.iv Shortly thereafter, Saunders converted the dispensary to a charitable trust to protect its

Left: Napoleon at the Battle of the Pyramids,

by Baron Antoine Jean Gros, 1810.

Top: the Moorfields crest.

Above: Dr.John Cunningham Saunders.

1. SO WIDE A FIELD OF USEFULNESS

13

1865–1905

pital. Despite the elegant imprimatur, the institution continued to be widely known as Moorfields.

By the end of the 19th century, Moorfields moved yet again into a newly constructed hospital building, its cornerstone laid by the Prince of Wales.

Enhancements such as air conditionD ES M O N D/M O O R F I EL D S

ing and central heating in the outpatient department, electric lighting, an operW EL LC O M E

ating theater designed to minimize infection, and an X-ray department contributed to dramatic improvements in surgical outcomes. Even so, the instiWithin two decades, Saunders’s Dispensary out-

tution struggled financially and might have closed were

grew its original location. In 1822, a new building was

it not for a financial infusion from the Prince of Wales’s

to form Moorfields, Westminster, and Central Eye Hos-

constructed in Lower Moorfields, where land was more

Hospital Fund during the early 1900s. Subsequent fun-

pital, which is referred to in shorthand as Moorfields to

affordable, and the charity was renamed the London

draising supported new building construction and, in

this day.

Ophthalmic Infirmary. A decade and a half later, in 1837,

1947, the Royal London Ophthalmic Hospital, the Royal

Consolidated by Britain’s National Health Service

the infirmary received a Royal Charter from Queen Victo-

Westminster Hospital (founded in 1816), and the Central

the following year, the combined hospitals, under the

ria and was renamed the Royal London Ophthalmic Hos-

London Ophthalmic Hospital (founded in 1843) merged

leadership of physician and professor Dr. Barrie Jones, became a world-renowned ophthalmological center for clinical research, subspecialty clinics, microsurgery, and postgraduate education. The institution’s reputation only grew with the introduction of the retinal diagnostic service by Dr. Alan Bird, and the novel use of fluorescein dye later that decade. The inauguration and success of Moorfields’ primary-care clinic in 1986 proved to be the basis of an ambulatory care model that, by 2006, informed the majority of its services. Two years later, Moorfields opened the world’s largest children’s eye center, with an overseas satellite located in Dubai. More recently, in 2009, the institution became a founding member of UCL Partners, one of Britain’s first academic health science centers, and won accreditation as an academic health

W EL LC O M E

science network in 2013.v Above left: the London Ophthalmic Infirmary, circa 1822.

Left: Moorfields Eye Hospital today, built in 1947.

Above: Desmond Children’s Eye Centre of Moorfield, today.

14

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

(continued from page 11) Based on these results, Delafield and Rodgers proposed a threefold opportunity. Establishing a medical organization devoted exclusively to treating the poor with eye ailments, they proposed, would “serve the interests of humanity.” Doing so, they reasoned, also might enable more of the afflicted to return to work, thereby reducing their dependency on public support. And not least, an ophthalmic clinic would provide a venue where inquisitive surgeons could learn new techniques and treatments related to eye diseases, as well as provide a collection point for much-needed data on the emerging field of ophthalmology.15 Compelling as these benefits sounded to the two young surgeons, neither the New York City authorities nor the medical profession warmed to their proposition. Undeterred, Delafield and Rodgers decided to take matters into their own hands and prove the worthiness of their ideas, pledging that before soliciting public assistance a second

Above: City Hotel, 1831.

Right: Guy’s Hospital, circa 1799.

WIKIMEDIA COMMONS

NYPL

time, they would start a fledgling clinic and expand their private medical practices to fund their dream.16 

1. SO WIDE A FIELD OF USEFULNESS

A FIRST HOME

P

1865–1905

ublic notices were circulated citywide announcing the August 14, 1820, opening of the New York Eye Infirmary, located at 45 Chatham Square, now Park Row, diagonally across from City Hall. That the first permanent eye hospital in the Western Hemisphere began in a two-room rented suite on the second floor

of an unassuming brick house is hard to imagine. 17 Yet modest though the clinic was, the founders’ intentions

stated on the handbill were anything but: “The primary object in establishing the New York Eye Infirmary was to contribute toward the relief of the poor who, by a diseased state of one of the most important organs of the human body, are deprived of the means of gaining a livelihood.”

As the story goes, the first officially registered patient was a young man suffering with a fistula of the lacrimal sac who, for undisclosed reasons, disappeared before he could be treated.18,19 Not the auspicious beginning Delafield and Rodgers had hoped for. But from that patient forward, word of the infirmary’s free care and medicines spread quickly. Within a short time, an ever-increasing surge of needy patients began to pass through the infirmary’s doors every Monday, Wednesday, and Friday from 12–1 pm. So many prospective patients visited that the building’s landlord was soon recruited to become the clinic’s superintendent, in charge

1820

of keeping order in the cramped waiting area. The only trained surgeons on the staff, Delafield and Rodgers, saw patients back-to-back, prescribing treatments compounded by a handful of medical students enlisted from the College of Physicians and Surgeons who were trained in the apothecary arts. By the end of the clinic’s first seven months, even with this skeleton crew and restricted hours, 436 patients had been treated. Among them were three patients, “born blind,” possibly with congenital cataracts, whose sight had been restored by what may have been the first successful cases of cataract needling in America.20 Yet as gratifying as the infirmary’s success was, it was also financially worrisome. Clearly, the swelling demand for services was outstripping the clinic’s resources and draining the founders’ pocketbooks. Securing outside funding was the logical solution. At the urging of Drs. Samuel Borrowe and Wright Post, Delafield and Rodgers’s respective mentors, a public meeting was convened to pursue the idea on March 9, 1821, in a free assembly room donated by the City Hotel, “long remembered for the excellence and variety of its wine cellar.” 21 Among the many prominent attendees were Dr. David Hosack; Philip Hone, soon to become the “gentleman mayor of New York”; and Benjamin Strong, president of the New York Sugar Refining Company and one of the founders of the first Bank for Savings in New York. A committee to draw up a set of institutional bylaws was formed, anchored by Colonel William Few, a cosigner of the U.S. Constitution, founder of the University of Georgia, and Delafield’s commander in the Georgia State Militia during the Revolutionary War. By April 21,

Above: the second-floor suite at 45 Chatham Square, the first home of the New York Eye and Ear Infirmary.

1821, the Board of Directors, known as “The Society of the New York Eye Infirmary,” was established. Two hundred members signed on and elected Colonel Few its first president.

15

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

According to the Society’s bylaws, an individual could become a Governor for Life by donating at least $40, which entitled him to free treatment for two patients at any time, for life.22 The same privileges applied to an annual subscription of $5.00, but only for as long as the contribution fee was paid.23 An annual subscription of $3.00 allowed a donor free treatment for one patient at any one time.24 A strict set of rules governing the Society and the comportment of its staff and officers was put into place, with its two surgeons and two consulting surgeons, as well as its officers, held to the highest standards of behavior. Should an individual or his duties prove unfit, formal consequences were to be imposed. With the Society established, the charity was officially incorporated as The New York Eye Infirmary by the New York State Legislature on March 22, 1822. Even though the enterprise had been treating patients with diseases of the ear, recorded as “anomalous diseases,” since its inception, it was known as the New York Eye Infirmary for the next 42 years, until the name was officially changed to The New York Eye and Ear Infirmary (NYEE) in 1864.25, 26 

ON THE MOVE

I

nitially, the Society’s funding efforts provided the struggling institution a measure of relief and, with it, some means to expand to larger quarters. By 1822, the infirmary had relocated to Murray Street, across from Columbia College, on the corner of Broadway. A full-time apothecary was brought on staff to inventory and

maintain all of the infirmary’s surgical instruments, but only with the surgeons’ direction. Additionally, he took charge of bleeding, cupping, and applying leeches. The Chatham Square superintendent was replaced by a porter to oversee patients in “the anteroom during the hours of prescription, remaining with and arranging them for treatment in the order in which they came.”27

Although slightly larger than the former location, the space was still inadequate to accommodate the everincreasing patient load. Lacking beds, chagrined surgeons were left no other option but to immediately discharge patients, even those who had undergone the most serious operations. Knowing full well that many patients lived in deplorable, overcrowded lodgings or on the streets, in conditions that severely compromised their full recovery, surgeons were convinced that offering patients beds would make all the difference in their recovery. The infirmary’s leadership petitioned the Corporation of the City of New York and the governors of the New York Hospital to make offsite rooms available. An appeal to the New York Dispensary to join forces was also submitted. Each effort was fruitless.

Above: notes of the March 9, 1820 meeting of the NYEE Board of Surgeons.

Left: Colonel William Few, first president of the Society of the New York Eye and Ear Infirmary, 1821.

With every passing month, the infirmary’s funding deficits mounted. Appeals were made in places of worship and some clergy, including Grace Church’s Rev. J. M. Wainwright, also an infirmary board member, made direct requests to their congregations for contributions. The infirmary went so far as to hire a person to encourage solicitations, ignoring criticism from some quarters that benevolence fostered idleness. Countering this belief,

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

The NYEE Official Seal “Since the world began it was not Delafield forcefully responded, “A large proportion of our population consists of industrious tradesmen and

heard that any man opened the

mechanics, or females with very small incomes and various other individuals whose means are just adequate to

eyes of one that was born blind…”

their support while in health and who have it not in their power to bear the expense of obtaining good advice

— King James Bible: John 9:32

when afflicted with diseases threatening the impairment of sight.” 28 Financial matters worsened when yellow fever, then known as “epidemic fever,” swept over New York City again in 1822, forcing the infirmary to close for three months, the first and only time in its 200-year history.

Besides this intermittent threat, New York state was also grappling with widespread and “violent ophthamalia” [conjunctivitis], which had wreaked partial or total blindness on untold numbers across its northern and western counties for years. Inspired by the New York Hospital’s successful petition for funds to build a hospital for the insane several years earlier, the infirmary’s Board of Directors approached the New York State Legislature with an eminently fiscally sound argument: If treated early, ophthamalia was curable and, in the long run, the fewer blind people, the fewer the demands on the state’s coffers. Finally convinced, the legislature passed an Act of Relief on April 1, 1824, which initially granted the infirmary $1,000 annually to build an appropriate building. It also stipulated that “at least one medical student from each county of the state should be admitted free of charge to witness the

I

n early 1824, when John Delafield, Jr., New York Eye and Ear Infirmary Treasurer and one of Edward Delafield’s

brothers, was instructed by his fellow board members to oversee the creation of a seal for the organization and he willing-

practice and surgery”

ly obliged. Ideally, they had agreed, not

therein.29 Subsequent,

only should the image represent the infir-

but sometimes irregular, renewals undergirded

mary’s pious and religious underpinnings, but also telegraph its humanitarian mission to restore sight to the sightless. Less

the growing charity for

than seven months later, on July 2, 1824,

years to come. 

John Delafield unveiled the New York Eye and Ear Infirmary’s official seal to great effect. The seal depicts an iconic moment from the New Testament when, to the astonishment of those gathered around them, the Great Physician miraculously heals a man “born blind.” Everything the infirmary sought to stand for. Many in the growing ophthalmological circles agreed.

NYPL

So much so, that the seal was adopted by Collection of clothing in New York “for the fever-sticken,” circa 1822.

the American Ophthalmological Society in 1864, the same year Edward Delafield, one of the organization’s founders, was named as the first President.

17

18

New York Eye and Ear Infirmary

M O R E S PAC I O U S Q UA R T E R S

NYEE 200: A VISION OF HOPE

S

oon thereafter, the infirmary’s leadership signed a lease for $500 per annum with the governors of the New York Hospital to rent a portion of the Marine Hospital, a former lunatic asylum located at 139 Duane Street. Compared to the Chatham and Murray facilities, the new space, in the Bloomingdale district, was

palatial. The two-story quarters, surrounded by a yard, contained a kitchen and a large room for the clinic on the first floor, with a six-bed ward on the second dedicated to the recuperation of “indoor patients.” A superintendent oversaw the day-to-day operations and patients continued to be seen according to strict stated hours, three times a week. If funds were available, indigent patients were boarded free, whereas those with the ability to pay, about 35 percent of those admitted, were charged $2.50 per week-long stay.30

This change in policy reflected the infirmary’s growing reputation and the increasing volume of cases, including a mounting percentage of out-of-county patients. One such case was a Mr. Anson Spooner from Niagara County, who, blinded as a “consequence of the bursting of a cannon in some public rejoicings,”

Above: New York Hospital, 1852 map.

Right: the Marine Hospital, the structure on the left, home to NYEE in the early 1820s.

M U S EU M O F T H E C I T Y O F N E W YO R K

NYPL

underwent two operations—one for a cataract, the other for an artificial pupil—which “succeeded in restoring

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

him to sight sufficiently perfect to read large type.” 31 Out-of-state paying patients also sought care with more frequency. In 1825 alone, the infirmary’s surgeons treated cases from New Jersey, Massachusetts, Maine, Connecticut, Vermont, Pennsylvania, North Carolina, and Ohio.32 There was also an uptick in the number of sufferers with ear ailments and the infirmary officially added a “new branch” with the appointment of its first aurist in 1823. The 1824 Annual Report prominently recorded that “one deaf and dumb child has applied and been under treatment for several months. The prospects of success in her case are most flattering and indeed to a certain extent already realized. She can already hear and understand many words spoken in a tone but little above the usual one and has learned to speak in the same proportion.”

1826 IN SEARCH OF A PERMANENT HOME

At long last, indigent New Yorkers of “good character” could now turn to the infirmary and other specialized institutions as an alternative to Bellevue. And by doing so, they were alleviating some of the pressure on public hospitals’ overcrowded facilities.33 But the infirmary’s contributions to the greater good did not stop there. From the onset, Delafield and Rodgers, often referred to as the “Fathers of American Ophthalmology,” had envisioned more: “The surgeons believe that they had in view at the establishment of this charity, not less important than the relief given to the afflicted, it daily fulfills. They allude to the diffusion on the subject of diseases of the eye, by instructing medical students in this very important branch of their profession.” 34 Only three years later, in 1823, the college announced that one of the surgeons, presumably Delafield, was scheduled to present the first-ever series of lectures concerning diseases of the eye delivered in America during its winter session. By then, the number of medical students trained on-site had grown from the original 15 in 1820 to 37. Delafield’s lectures soon became a permanent part of the college’s offerings. “Surgeons now have the satisfaction to announce,” Delafield affirmed with satisfaction, “that the anticipations of public benefit derived from the infirmary in the instruction of medical students in this branch of surgery, have been realized…” 35 

D

espite the advantages of the infirmary’s 139 Duane Street location, the leadership was actively looking for larger quarters by 1826, spurred by the leap in favorable outcomes due to in-house postoperative care. Following two brief relocations, at 459 Broadway in 1827 and 96 Elm Street in 1834, another

building, at 45-47 Howard Street, was leased in 1840.36 That same year, the Otology Service was officially added, although one source pegs the date as 1823, another as 1864.37, 38 Apart from these details, little is documented about this period: No descriptions of the locales or amenities are extant, nor are in-depth explanations of the board’s motivations, save for a key entry in the 1844 Annual Report, which states: “…efforts are now being made for the raising of funds to erect a plan and substantial building.” 39 In the 24 years since its founding, 20,565 patients had been served by the infirmary and, based on these demonstrable merits, there was no turning back:

19

20

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

the time had come for the infirmary to find a permanent home. The 97 Mercer Street property, described as an “ordinary dwelling house” located between Spring and Prince Streets, owned by the New York Life and Trust Company, proved to be the best prospect.40 As it stood, the “prescribing apartments [measured] twenty-four

“

square feet,” a marked improvement on the Howard Street facility.41 The Mercer Street property fell short of the infirmary’s ultimate aspirations, yet it represented a reasonable stopgap move. Not only because the site

How could an institution that returned the afflicted to productive lives and enhanced the public good by training up-and-coming surgeons…go unsupported?”

was accessible from even the most distant parts of the city via major stage routes, but also because the $7,000 selling price was comparatively affordable.42 This outlay, plus an additional $1,500 in solicitations to build modest accommodations for indoor patients behind the existing three-story building, were sufficient to meet the infirmary’s needs, at least for the short-term.

If other details about the Mercer Street location are lacking, such as its specific layout, dimensions, amenities, numbers of patient beds, and staffing, one conclusion is obvious. Evident from the infirmary’s first year on Mercer Street in 1845 until its last, 11 years later in 1856, was that with the charity’s sterling reputation was spreading. More and more medical students, beyond those matriculating at the College of Physicians and Surgeons, sought admission to the infirmary’s teaching program. According to an 1847 account, 150 “pupils and graduates of Medicine from this [New York] and other states have visited our city for the purpose of profiting by the extensive facilities…” 43 Moreover, while the charity’s increased capacity was definitely a positive, the higher patient census was, predictably enough, straining its already tight financial resources.

However meager, unreliable funding support from the New York State Legislature and New York City only exacerbated chronic shortfalls. And now, there was a mortgage to pay.

Belt-tightening measures were put into effect. So much so that in 1848, indigent patients who were unable to provide for themselves and required free beds were being turned away. Three years later and to the infirmary’s credit, even with “in house indigent cases scaled back, the total number of free-care patients treated since its 1820 founding stood at an impressive 51,580.44 It was a delicate balancing act, but by 1852, thanks to “rigid economy” and “enlarged liberality,” the charity’s debt was paid off.45 Once debt-free, the leadership actively pursued ways to realize their longer-term plans for a larger permanent home. At every opportunity, they sought funding from the New York State Legislature, stating and restating the infirmary’s well-established benefits: How could an institution that returned the afflicted to productive lives and enhanced the public good by training up-and-coming surgeons in diseases of the eye go unsupported, they argued? And if these benefits didn’t suffice, they continued, was it not prudent to support the infirmary’s vision-saving interventions, which effectively reduced the financial and custodial load borne by other “noble charities,” such as the state-funded New York Institution of the Blind?

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

REVOLUTIONARY INSIGHTS

RE OF CONG

SS

F

modation and Refraction. Then, in 1857, came the

throughout the 19th

electrifying news of von Graefe’s iridectomy opera-

c e n t u r y, t h e N e w

tion in the surgical treatment of glaucoma. Not since

York Eye and Ear Infirmary

Daviel’s operation for cataracts, a century earlier,

functioned as a major hub

had any surgical procedure in ophthalmology so cap-

and aggregator through

tured the fancy and acclamation of the practitioners

which state-of-the-art ad-

the world over. Americans training abroad and phy-

vances, technologies, and

sician immigrants from European upheavals, includ-

teachings in ophthalmolo-

ing the Revolution of 1848, brought these discoveries

gy were put into practice by

to America and gave further impetus for the estab-

the medical establishment

lishment of ophthalmology as a separate entity. Drs.

and disseminated throughout the United States. No set

Cornelius Agnew and Henry D. Noyes, two infirmary

of innovations demonstrates this more clearly than the

graduates having studied under von Graefe, Donders,

1851 introduction of Helmholtz’s ophthalmoscope and

and Bowman, returned home to find the infirmary in

the cascade of groundbreaking contributions that fol-

its new permanent home, a grandiose building on

lowed. How this happened is eloquently explained by Dr.

Second Avenue and 13th Street. Reveling in these

Gerald Kara, the New York Eye and Ear Infirmary’s dis-

spacious quarters, they instituted lectures and dem-

tinguished physician and historian, in his article “One

onstrations of the new knowledge and instrumenta-

Hundred Years of Ophthalmology.” i

tion they had acquired in Europe.”

“…[In] 1851, came the

LIBRARY

announcement from Heidelberg of the invention which From the New-York Daily Times, February 27, 1854.

“

rom its beginning and

revolutionized ophthalmology, the ophthalmoscope of Helmholtz. The wondrous details of the fundus, once surmised, could now be actually visualized. Developments

The Eye and Ear Infirmary...has been doing a most praiseworthy work for now these 33 years.”

took place in rapid succession. In 1856, Jager, in Vienna, published his Atlas of Diseases of the Fundus. In the same year, Donders published Anomalies of Accom-

Above: Hermann von Helmholtz in 1848. Right: the Helmholtz Ophthalmoscope

21

22

New York Eye and Ear Infirmary

1856

NYEE 200: A VISION OF HOPE

Despite these compelling rhetorical questions and favorable endorsements from influential newspapers such as the New-York Daily Times, the infirmary’s petitions fell mostly on deaf ears. An 1854 appeal to the New York State Legislature for $20,000, with the infirmary’s pledge to tap outside sources, failed. A second, made the following year, won only partial state backing: a $10,000 grant only if the infirmary’s leadership could raise $20,000 in private funds.46 Recognizing a final best offer when they saw one, the leadership accepted the award. In short order, five benefactors stepped forward with half of the matching sum and a flurry of contributions thereafter exceeded the balance.47 Frustrated by the government’s fickle support, Delafield redoubled his private fundraising efforts to cover the project’s projected requirements and liabilities, “confident that the New York Eye and Ear Infirmary will become independent of state and city funding, wholly from the beneficence of living donors and legacies.” 48 

“A B U I L D I N G M O S T ELEGANT AND CONSPICUOUS”

F

or the majority of New Yorkers, April 25, 1856, may have seemed like a typical spring day—mild weather, blue skies, flowers abloom—but for many of the celebrants gathered on the northeast corner of 13th Street at Second Avenue, at the New York Eye and Ear Infirmary’s dedication of its new building, the day was the flowering of a different sort and the culmination of 36 years of persistence and commitment. Designed by the architects Mettam and Burke, the “chaste” edifice was built in the “modern Italian style of architecture” and promised “to be quite an ornament to that part of the avenue.” 49 But to the infirmary’s eight-member surgeon staff and stalwart leadership, the four-story brownstone represented much, much more: the capacity and resources to treat even greater numbers of the afflicted.50 The infirmary’s outpatient department occupied the ground floor, along with an operating theater modeled after the one in St. Mark’s Hospital, Dublin. A lecture room, without a gallery, was large enough to seat 120 students. The upper three floors offered ample room for enough beds to accommodate 40 to 50 patients. The building was heated by two hot-air furnaces, supplemented by 20 stoves throughout; one was situated in the operating room. But even

CONGRESS LIBRARY OF

with these improvements, many limitations remained. When the water pipes weren’t frozen, running water was available only on the first and second floors. Whatever water was required for the floors above was carried by hand. Patients had access to one bathtub, several water closets, and compost toilets, otherwise known as “earth closets,” for the women.51

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

Delafield, at 62 years old, stood on the dais, his audience poised to receive his long-awaited commemorative address. After a long reprise of the charity’s early years, he added the following sobering observations: “The erection of this building is so far a guarantee that the New York Eye Infirmary is permanently established. But it possesses little else; and until it is endowed with a fund sufficient to yield an annual income adequate to its support, its usefulness must be crippled and contracted. That this fund will be provided, its directors feel confident, and will not rest in their efforts until it is obtained. It is, indeed, a source of some mortification to them that although our infirmary was the first established in America, and in its wealthiest and most important city, two others which arose in consequence of its erection, have succeed in obtaining endowments far beyond ours.” 52 Delafield’s remarks regarding Boston’s Massachusetts Charitable Eye and Ear Infirmary, established in 1824 by Dr. Edward Reynolds, a fellow student at the London Eye Infirmary and personal friend, and Philadelphia’s Wills Eye Hospital, founded in 1832, were hardly veiled. It may even be likely that he intended to spike the appeal for philanthropy with a splash of guilt among in his respectful listeners. Despite the potential sting of Delafield’s words, he ended his speech on an up note, reasserting his belief that the New York Eye and Ear Infirmary would continue to lead in its noble mission to serve the poor and nurture. “In this country, a new spirit of inquiry has been excited,” Delafield began, “that is beginning to be considered an essential part of every accomplished surgeon’s education, to be acquainted with the nature and modes of treatment of the Diseases of the Eye.” 53 And lead the infirmary did. During the first year of occupancy in the 13th Street brownstone, service hours were expanded: Eye patients were seen every day of the week and ear patients three days a week, with clinical instruction by surgeons.54 Week after week, local patients as well as others from far and wide filled the reception room to overflowing. One such case, invoked as “superhuman” in the 1857 Annual Report, involved, “…a man totally blind, accompanied by his wife, [who] applied at the infirmary for treatment, and on inquiry it was ascertained that this couple, having heard of the New York Eye Infirmary and being unable to pay their passage by public conveyance, had traveled on foot to this city, a distance of over two hundred miles, his wife leading her blind consort by the hand, in hope of having his sight once more restored.” 55 (continued on page 26) The permanent home: a hand-tinted page from the 1856 NYEE Annual Report.

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24

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

DR. CORNELIUS AGNEW 18 30 -18 8 8

O

ver the course of his 58-year life, Dr. Cornelius

medical education under the preceptorship of several of

In 1864, Agnew resigned his post at the now-re-

Rea Agnew was considered one of New York’s

Europe’s most preeminent physicians: Sir William Wilde

named New York Eye and Ear Infirmary to devote more

most celebrated surgeons, ophthalmologists,

in Dublin, deviser of Wilde’s incision for mastoid abscess;

time to the Commission and, when his tenure was com-

and otolaryngologists of the 19th century, and earned the

Drs. William Bowman and George Critchette in London;

plete, he became the chief organizer of the School of

distinction early on. Born in the city on August 8, 1830,

and Drs. Frédéric Jules Sichel and Louis-Auguste Des-

Mines of Columbia College. That same year, he and sev-

to William and Elizabeth Thompson Agnew, descendants

marres , ophthalmologists at the Ricord and Valpeau clin-

eral New York Eye and Ear Infirmary surgeons founded

of Huguenot, Irish, and Scottish immigrants who came

ics in France. Returning to New York in late 1855, Agnew

the New York Ophthalmological Society. Originally lim-

to the New World during the 18th cen-

set up practice as a general prac-

ited to 44 participants, it stands as the oldest ophthal-

tury to seek religious freedom, young

titioner and resumed his position

mological society in the United States. Two years later,

Cornelius grew up in privileged cir-

with the New York Eye Infirma-

in 1866, Agnew founded the Clinic for the Diseases of

cumstances. His paternal grandfather

ry. A year later, he married Mary

the Eye and Ear at the New York College of Physicians

had immigrated to the United States

Nash, the daughter of Lora Nash,

and Surgeons. In 1868, he and 25 prominent Brook-

in 1786, settling first in Philadelphia,

a New York merchant, and to-

then New York, where he became in-

gether they had eight chil-

volved in the shipping and commission

dren, seven daughters and

business. In turn, William, Cornelius’s

one son.

“A Surgeon of a Lion’s Heart,

father, became a successful merchant

Slight of build, of me-

in his own right. Both William and Eliz-

dium height and dark-com-

abeth were strict Presbyterians and

plexioned, the young sur-

raised their Cornelius as a “highly mor-

geon already had the makings

al boy, conscientious youth, and strict-

of a leader. His “gently dignified

ly religious man.”

manner…rendered him attractive

ii

Cornelius Agnew entered Co-

to all, and fascinating to many…

lumbia College when he was 15 and

[E]ven in conversation [he] had a

graduated four years later, in 1849,

way of smiling softly from time to

with a Bachelor of Arts degree. Drawn

time, as if a pleasant undercurrent of thought were playing beneath

to medicine, he studied under New York Eye Infirmary surgeon and esteemed cofounder

the more immediate matter.” iii His sterling reputation as

Rodgers, who also served as a New York Hospital sur-

a physician and a gentleman soon won him the appoint-

geon and professor of anatomy at the New York College

ment of surgeon general of the State of New York. Shortly

of Physicians and Surgeons. Three years later, in 1852,

after the American Civil War began, Agnew was appoint-

Agnew earned his medical degree from the New York Col-

ed medical director of the New York Volunteer Hospital,

lege of Physicians and Surgeons, with a special interest

treating wounded soldiers from the Union Army. In tan-

in diseases of the eye and ear. The next year, he served

dem, he took on an active role in the newly established

as house surgeon at the New York Hospital; briefly prac-

United States Sanitary Commission in 1861, which en-

ticed medicine in Houghton, Michigan; and returned to

listed thousands of volunteers; established, staffed, and

the New York Eye Infirmary in 1855 to accept an appoint-

supplied field hospitals; and operated soldiers’ homes,

ment as surgeon. Soon thereafter, possibly at the urging

lodges, and rest houses for traveling or disabled Union

of Rodgers, his mentor, Agnew decided to broaden his

soldiers.

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

lynites led by S.B. Chittenden, eager to form a philan-

Agnew’s contributions to the field of ophthalmolo-

thropic clinic, established the Brooklyn Eye and Ear Hos-

gy were prodigious and his scientific writings extensive.

pital. iv Scarcely a year later, in 1869, Agnew met with

These included professional journal articles on medical

six of his fellow Union League Club members to estab-

ethics, otology, and surgery on the extraocular muscles,

lish the Manhattan Eye, Ear, and Throat Hospital. That

as well as many other topics. In 1871, he invented a new

same year he was elected to the Clinical Professorship

incision for draining the lacrimal sac made through the

of Diseases of the Eye and Ear at the College of Physi-

conjunctiva between the caruncle and the inner commis-

cians and Surgeons, a position he held until his death on

sure of the eyelids.vii Later, he developed a groundbreak-

April 18, 1888.v

ing operation for divergent strabismus, the details of

Agnew’s

professional

activities,

public

which he published in “A Method of Operating for Diver-

ser-

vice, religious voluntary positions, and memberships

gent Squint” in the Transactions of the American Oph-

seemed to know no bounds. He offered his time and ex-

thalmological Society in 1886. His “operation for thickened capsule” was also considered highly innovative in its day.

the Eagle’s Eye and the Lady’s Hand”

Fidelity, duty, and incessant labor guided Agnew throughout his life. In a laudatory eulogy delivered by Dr. T. Gaillard Thomas before the overflowing room of

LIBRARY OF CONGRESS

Agnew’s bereft New York Academy of Medicine colpertise to dozens of organizations, becoming, for example, trustee of the School of Mines of Columbia College; secretary of the first Sanitary Reform Association; governor of the Woman’s Hospital; Regent of the State Hospital for the Insane at Poughkeepsie; president of the Medical Society of the State of New York; director of the New York Tract Society; director of the Young Men’s Christian Association; elder in the Fifth Avenue Presbyterian Church; trustee and chairman of the board of the Presbyterian Church of Palisades; and indian commissioner, appointed by United States President Chester A. Arthur, all this while maintaining one of the largest and most lucrative private practices in New York City.vi

Above: Dr. Cornelius Agnew. Left: the 1855 executive committee of the U.S. Sanitary Commission; Dr. William Holme Van Buren, George Templeton Strong, Rev. Dr. Henry Whitney Bellows (Commission President), Dr. Cornelius R. Agnew and Prof. Wolcott Gibbs (from left).

leagues: “As we view his labors now, after he is at rest, we cannot but feel surprise that any man could have consented to endure them; that anyone could have felt his duty to have given himself up to the public weal and the good of his fellow man. Fortunate is it for the world that such good men are occasionally met with; not only for the good which they directly accomplish, but also for the beautiful and forcible examples which they offer for the imitation of others.” viii

25

26

“

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

(continued from page 23)

…and until it is endowed with a fund sufficient to yield an annual income adequate to its support, its usefulness must be crippled and contracted.”

But the infirmary’s improving, free-care policy had its limits. Whereas there was, as of 1860, a full-time house surgeon training in both ophthalmology and otology, and room to treat the surging number of indigent outpatients, budgetary constraints continued to exclude them from extended stays. Only patients able to afford the raised $3.50 a week boarding costs were eligible. 56 Even so, in the first year of the 13th Street location, 156 paying patients received care, exceeding any previous year in the charity’s history.

Responding to the “surgeons’ painful duty of turning from their doors all those who have not the means of providing for themselves while undergoing the treatment necessary for their relief,” the board of directors set up a “permanent fund,” which, by 1863, totaled $25,290, including a $10,000 “noble legacy” by Dr. Jacob Hansen.57, 58

1860

Unfortunately, there were no simple answers and none to suggest that generosity alone could disarm the escalating need. Far more powerful forces were at work, reshaping the city and the republic. Between 1850 and 1860, the foreign-born percentage of the United States nearly doubled and many settled in New York City.59 By

A stereoscopic view of the infirmary, circa 1860.

ROBERT N. DENNIS COLLECTION

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

27

Dr. William Thomas Green Morton and Ether

New York City’s population had increased eightfold, reaching approximately 813,669, according to the 1860 Census. And not surprisingly, as the most populous city in the United States, the number of indigent and dispossessed rose accordingly.60 A large percentage of these newcomers lived in rat-infested, overcrowded tenements without running water or indoor plumbing, ideal breeding grounds for disease,

W EL LC O M E

contagion, and especially eye ailments.61

DID YOU KNOW that the 1862 landmark decision in the

“William Thomas Green Morton v. The New York Eye Infirmary” patent infringement case opened up the utilization of general anesthesia for the entire medical profession?i In 1846, Dr. William Thomas Green Morton became the first medical practitioner to publicly demonstrate the use of inhaled ether before rapt onlookers in a crowded operating theater of Massachusetts General Hospital. Recognizing ether’s potential commercial value and claiming to be its “discoverer,” he sought to secure a patent for the anesthetic under the name letheon. But the truth was the soporific had been employed informally and discussed in medical circles for years. Most notably, Dr. Charles Thomas Jackson, who took vigorous exception to Morton, pointed out he had introduced Morton to the vapor’s painkilling potential long before.

As more physicians and medical institutions began to use inhaled ether, Morton retaliated by launching a spate of lawsuits claiming patent infringement. Not surprisingly, Morton’s actions were widely rebuked by the medical community as a violation of the profession’s humane intent and scientific spirit and he was ultimately censured by the American Medical Association. But it was his legal action brought against the New York Eye Infirmary in 1862 before the Circuit Court of the United States for the Southern District of New York that proved to be the

turning point. In a landmark decision, Circuit Court Judge Shipman found “…that the subject matter, under consideration, was not patentable…” thereby effectively declaring that “letheon” was no more than “ether in disguise,” freeing the medical profession to employ ether without prejudice. ii,iii The Honorable Judge Samuel Nelson of the United S t ate s S u p r e m e C o u r t subsequently concurred with Shipman’s decision. iv Yet despite the New York Eye Infirmary’s favorable verdict, Morton spent the remainder of his short life (1819-1868) relentlessly applying for a series of related patents and filing legal actions against scores of individuals and hospitals, alleging they had usurped his proprietary claims.

That Morton failed to prevail in even a single case stands as a win for the medical profession and patients forevermore.

Left: a painting of Morton administering ether at Massachusets General Hospital, 1846.

Above right: a replica of the inhaler he used.

W EL LC O M E

1860, four decades after the infirmary’s founding,

...“letheon” was no more than “ether in disguise”...

28

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

More than ever before, the immigrants hailed from diverse nations, resulting in an uneasy clash of cultures, ethnicities, values, political affiliations, and opinions, largely along class and race lines.62 Competition for jobs, plummeting wages, and chronic strikes only fanned the pervasive discontent.

As the Civil War (1861-1865) dragged on, dwindling voluntary enlistment and mounting deserter rates gave way to the National Conscription Act, which called upon 24,000 men to be drafted from New York City alone.63 These simmering tensions, combined with unbridled resentment toward those who could buy their way out of the Union’s seemingly insatiable recruiting demands, was too explosive to contain. All this came to a head with the New York Draft Riots, four days in 1863 during which tens of thousands of rampaging rioters, men and women alike, filled the streets of lower Manhattan, leaving death and destruction in their wake.64 Yet throughout this roiling period, the New York Eye and Ear Infirmary stood firm to its mission; it managed to treat 6,272 eye and 933 ear patients between 1863 and 1864.65 With weary prospects of peace and the Union’s reunification on the horizon, the charity intensified its resolve. And, looking ahead to the future, no one could

WIKIMEDIA COMMONS

deny there was much healing to do. 

1864

Left: a depiction of the Draft Riots in 1863 from an unidentified periodical.

Opposite: The Metropolitan Fair Buildings on Union Square, 1864.

NYPL

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

29

30

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

D R . DAV I D K E A R N Y M C D O N O G H 1821 -1893 “That there exists in the Breast of the White Man an inveterate hatred against the Black Man; and the very name of Negro—the very thought that he is endeavoring to raise himself above the groveling elements of Brutality— draws that hatred to a focus which radiated that nefarious past, called Prejudice…” i

could purchase their freedom on an installment plan with

he joined approximately 80 recently arrived former slaves

one non-negotiable proviso: “It is your freedom in Libe-

from the McDonogh plantation. But David McDonogh re-

ria that I contract you,” John McDonogh stated unapolo-

mained behind and, shortly thereafter, informed his for-

getically, “for I would never consent to give freedom to a

mer master of his intention to study medicine, contract

single individual among you to remain on the same soil

or no contract. Fed up and infuriated, John McDonogh

with the white man.” Two of

cut his ties to David, but

John McDonogh’s slaves, Da-

left Senator Lowrie to ex-

iii

vid and Washington, showed particular promise. And, in

— Dr. David Kearny McDonogh, 1844

1838, John McDonogh made

hese passionate, impenitent words eloquently

send the pair to Lafayette Col-

capture the lifelong struggle of Dr. David Kearny

lege in Easton, Pennsylvania,

McDonogh, America’s first African American oph-

a “free state,” ostensibly to

thalmologist. He was born in New Orleans in 1821, the

prepare them for their future

“property” of John McDonogh, one of Louisiana’s richest

missionary work in Liberia.

T

an extraordinary decision to

Rising above brutality: America’s first African American ophthalmologist

ercise his own judgment as to whether to support David through to graduation.

Which, Senator Lowrie apparently did.

Despite the daunting challenge, David McDonogh

became

Lafay-

ette College’s first African

and largest landowners. As a trader and owner of more

John McDonogh con-

than 500 enslaved people, John McDonogh became in-

vinced Senator Walter Lowrie,

volved in the American Colonization Society (ASC) in

his friend and a strong anti-

1825, an organization comprised of Abolitionists and

slavery activist from Missouri, to act as the legal guard-

was roundly rejected by them all, until he made contact

slave owners who generally shared the widely held opin-

ian to the two “ex-slaves” while matriculating. David Mc-

with the New York Eye and Ear Infirmary’s cofounder

ion that integrating emancipated Blacks into white Amer-

Donogh, who, like Washington, adopted his owner’s

Rodgers, possibly through the intercession of Senator

ica was untenable. Founded in 1816 by Robert Finlay, a

surname, was the more academically inclined. He was

Lowrie. In New York, under Rodgers’s mentorship, the

New Jersey Presbyterian minister, the ASC advocated

only 19 when he began his first term at Lafayette, where

aspiring physician attended classes, but was never of-

the return of freed slaves to Africa as an alternative and

he faced yet another rude awakening: As a former slave

ficially enrolled in Columbia’s College of Physicians and

was involved in estab-

and by virtue of his color, he was forced to take classes

Surgeons from 1844 to 1847. Tragically, upon gradua-

lishing a founding colo-

and meals apart from his classmates. Although deeply

tion, the college refused to award him a diploma. Never-

ny in Liberia­­—ideas John

aggrieved, he strategically smothered his anger. Even if

theless, with Rodgers’s continuing support, McDonogh

McDonogh came to em-

he were a “free man” in Pennsylvania, his former master

served on the New York Eye and Ear Infirmary’s staff as

brace.

had only to alert mercenary slave catchers and the as-

a specialist in diseases of the eye for 11 years and on

piring student could be rounded up and sent back to the

New York Hospital’s for two, where he earned the re-

McDonogh plantation in chains.

spect of New York’s medical establishment, which nev-

Over time, the Louisiana planter took the

American graduate in 1844.

He applied to several New York medical schools, and

ACS’s repatriation plan a

In the shadow of this terrifying threat, David Mc-

er failed to regard him as a full-fledged medical doctor.

step further by allowing

Donogh persisted. While in his junior year in 1841, he

When Rodgers died in 1850, McDonogh took “Kearny”

some of his slaves to be-

became interested in medicine and sought John Mc-

as his middle name, to honor the man who had opened

come literate and crafting

Donogh’s permission to apprentice himself to Hugh H.

doors when all others had been shut.

a scheme whereby they

Abernathy, an Easton doctor. McDonogh begrudgingly

During this time, McDonogh began a private prac-

agreed to the request. Washington McDonogh left Lafay-

tice on Sullivan Street in Greenwich Village and joined

ette College for Liberia before graduation in 1842, where

with Frederick Douglass in abolitionist and worker’s

Louisiana planter John McDonogh, circa 1845.

1. SO WIDE A FIELD OF USEFULNESS

1865–1905

rights causes. He married Elizabeth Van Wagner, had

National Medical Fellowship awards held in Harlem, New

three children, and settled in Newark, New Jersey. In

York, the scholarship is dedicated to increasing the num-

1875, he was awarded a medical degree from the Eclec-

ber of underrepresented African American and Latinx

tic Medical College of New York, where he also became

physicians in ophthalmology/ENT programs.vii Another result of Koplin and Shaw’s mission to re-

his Newark home and was buried at Woodlawn Cemetery

store McDonogh’s rightful place in medical history came

in Bronx, New York.iv Five years following his death and

in early 2017, after they approached the Columbia Uni-

in honor of his achievements, the McDonough [sic] Me-

versity’s Vagelos College of Physicians and Surgeons,

morial Hospital was opened on West 41st Street, offering

previously the New York College of Physicians and Sur-

medical education and clinical care to men and women

geons, proposing that McDonogh be awarded the med-

of all races. It hired staff and admitted patients regard-

ical degree he had been denied in 1847. The institution

charter to train black women as nurses.v Regrettably, the hospital survived for less than a decade. A second McDonough [sic] Hospital was proposed in the early part of the 20th century, but after a spectator-packed kickoff ceremony on Fifth Avenue, was never built.

But that is hardly the end of McDonogh’s story.

“My interest in Dr. David K. McDonogh began as an innocent inquiry about an ophthalmologist who was a freed slave and who graduated from Lafayette College, which was also my alma mater,” said Dr. Richard Koplin.vi In N AT I O N A L M E D I C A L F E L L O W S H I P S

agreed and, as part of its May 2018 commencement exercises, Patricia Worthy, McDonogh’s great-great-granddaughter, accepted the posthumous medical degree on his behalf. In a separate but related expression of remediation, the Vagelos College of Physicians and Surgeons’ $1 million David McDonogh Memorial Scholarship was established, funded by Diana and Roy Vagelos.viii All measures of justice, long overdue.

2008, Koplin and Diane Windham Shaw, director of special collections & college archives, Skillman Library, Lafayette College, joined forces to breathe life back into McDonogh’s forgotten biography. Koplin and Shaw’s research sparked the creation of the McDonogh Society of Lafayette College and the National Medical Fellowship’s Dr. David Kearny McDonogh Scholarship in Ophthalmology/ENT, the latter spearheaded by Daniel Laroche, MD (Founding Committee Chair), Karen Allison, MD, Ann Arthur-Andrew, MD, Nneka Brooks, MD, Jacqueline Busingye, MD, Benjeil Edghill, MD, Rondai Evans, MD, Chaneve Jeanniton, MD, John Mitchell, MD, and Dwayne Rollins, MD. Inaugurated on November 2, 2016, at the Above: A tribute to Dr. David K. McDonogh by Anthony Smith, MD. Left (left to right): NMF Ophthalmology/ENT Committee members Melynda Barnes, MD, Tamiesha Frempong, MD, Giselle Lynch (Dr. David Kearny McDonogh Scholarship 2018 recipient), Jacqueline Busingye, MD, Daniel Laroche, MD, Karen Allison, MD, John Mitchell, MD, Nneka Brooks, MD, Benjeil Edghill, MD. In photo but not visible: Ann Arthur-Andrew, MD, and Chaneve Jeanniton, MD. Right: Dr. McDonogh’s grave marker, Woodlawn Cemetery, Bronx, NY.

WIKIMEDIA COMMONS

less of race and was the first medical institution with a

N AT I O N A L M E D I C A L F E L L O W S H I P S

a faculty member. In 1893, at age 72, McDonogh died in

31

“As New York grows, so must its charities” — Dr. Edward Delafield

1865 –1905

NYPL

2 “As New York grows, 1865 –1905

so must its charities”

The devastating aftermath of the American Civil War and the April 14, 1865,

1865

assassination of President Abraham Lincoln left the Union, Northerners and Southerners alike, reeling. To be sure, New York City was distant from the front lines, but neither distance nor the flush of war profiteering could blunt the human consequences of such a deeply divisive conflict.1 Few of the city’s families remained untouched and death was in the air. Funeral processions were commonplace and it was not unusual to see returned soldiers and deserters, physically and mentally maimed on the brutal battlefields, standing stock still on the sidewalks as mourners filed past. Of the war’s estimated 750,000 dead, 46,524 were from New York State.2, 3 According to one authoritative source, during the three-day battle of Gettysburg “…more than three thousand Union troops were killed and another fifteen thousand wounded—many from New York.” 4 In the weeks that followed, “…Bellevue would

H

receive 618 men…all badly injured.”

THE MEDICAL F O R T U N E S O F WA R

orrific eyewitness accounts of the dying and wounded crammed into the early Civil War field hospitals were surpassed only by descriptions of the carnage on the killing grounds. Crude medical practices, compounded by the lack of medical supplies and the absence of even the most rudimentary sanitation, condemned thousands of wounded battlefield survivors to their

Currier & Ives print of Lincoln’s funeral cortege turning up Broadway past Union Square, April 25, 1865.

deaths. Yet ironically enough, these intolerable conditions and staggering mortality rates gave

rise to medical advances that might otherwise have taken decades. Under unimaginable duress, military and

36

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Dr. Edward Curtis and the Death of Lincoln medical practitioners were forced to innovate and improvise new therapies, technologies, and practices to improve their patients’ odds. The anesthesia inhaler, facial reconstruction, the wider use of prostheses, and ambulanceto-emergency-room systems were among them.

Game-changing practices also gained traction during the war, especially those advocated by Florence Nightingale, who addressed a gathering of Union Army leaders in Washington, DC, about reducing mortality rates through better ventilation and basic sanitation procedures in operating

WIKIIMEDIA COMMONS

D I D YO U K N OW t h a t U n i t e d States Army Surgeon Dr. Edward Curtis assisted Army Surgeon Dr. Joseph Janvier Woodward in President Abraham Lincoln’s White House autopsy on April 15, 1865? In a letter to his mother, Curtis captured Surgeon General Joseph K. Barnes’s poignant observation “…that the President showed most wonderful tenacity of life, and, had not his wound been necessarily mortal, might have survived an injury to which most men would succumb…” i At the time, Curtis was already credited with having developed a microtome for cutting tissue sections for microscopic examination and having taken the first photos of microscopic sections. After resigning his commission in 1870, he became a clinical assistant at the New York Eye and Ear Infirmary, a microscopist at the Manhattan Eye and Ear Infirmary, and a lecturer, then Professor of Materia Medica and Therapeutics, at the New York College of Physicians and Surgeons.

rooms and hospital sick bays.5 Her innovative approach and teachings were likely to have impressed Surgeon General William Hammond, a Union Army physician credited with designing the first pavilion-style battlefield hospitals, which incorporated many of Nightingale’s innovations.6 Above: a Florence Nightingale “Mortality Pie Chart” that helped revolutionize statistical analysis. Below: Nightingale’s innovations were incorporated into Union Army hospitals.

M AT T H E W B R A D Y V I A W I K I I M E D I A C O M M O N S

G E T T Y/ I S T O C K P H O T O

“...the President showed most wonderful tenacity of life...”

Lincoln’s deathbed.

JACOB RI I S VIA WI KI I M ED IA COM MON S

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

1865–1905

None of these advances were lost on the New York Eye and Ear Infirmary’s surgeons and leadership who, according to an entry in the infirmary’s 1866 Annual Report, lost no time implementing these salubrious changes. “The great wars of the last few years, with their attendant number of sick and wounded men,” the entry began, “have given hygiene and ventilation a prominence before unknown. Influenced by these considerations, the Surgeons have thought that more uniform success in treatment could be secured by the improvements now being put into effect.” 7 Enthusiastic, too, was their endorsement of offering ophthalmological prostheses as a way of returning patients to productive lives. “A surgeon must sometimes remove an eye [as a] consequence of some disease,” the entry continued, and “…to remedy this deformity thus caused, the insertion of an artificial eye, not to gratify the patient’s vanity, but because such a deformity is a very serious hindrance to obtaining employment.” 8 The surgeon’s enthusiasm also extended to the “scientific and rational use of spectacles” for those “…engaged in the finer mechanic arts and in sewing [whose eyes]… are unable to bear the constant effort [and who]…are obliged to either give up their employment or if they persist, severe and dangerous inflammation may ensue.” 9 Equally as emphatic was the surgeons’ push to create more free in-house patient beds. According to their straightforward reasoning, “the sight of many more people could be saved under the shelter and care of the infirmary, but returning them to their homes would have disastrous consequences, therefore they are

A New York tenement of the time, a Jacob Riis photo.

“

turned away.” 11 To finance the proposal, the board invited “any person giving the sum of $4,000 [to] found a permanent, free bed for the lifetime of the donor and be occupied by such patients as the donor designates.

After his death, the bed will remain free for the use of poor patients and will bear the name of the donor inscribed upon it.” 12

The New York Eye and Ear Infirmary stands forth as not only a relief but a preventative of pauperism.”10

As facilities for in-house patients incrementally expanded, so did the infirmary’s medical expertise and place “as a special school of clinical instruction.” In 1873, the Nose and Throat Department was added, and within eight months, between April 1 and December 31, 1873, 138 patients had been treated and 28 operations performed under its auspices.13 These enhanced services not only offered physician trainees firsthand experience in this emerging subfield, but also buttressed the infirmary’s guiding philosophy that broader clinical opportunities, courses of lectures, and publications in medical journals would benefit “…the whole community…throughout the country…thus endowed with knowledge by which they may confer sight, not upon the poor only, but bring the same boon to the affluent.” 14

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

A Tale of Toil and Appreciation DID YOU KNOW

that throughout its 200-year history, the New York Eye and Ear Infirmary has earned the support of all classes of New Yorkers, not only the well-heeled? As this story from the infirmary’s 1870 Annual Report reveals, giving from the heart knows no distinction and finds its way to the worthy along infinite paths. It begins: “…An old Irish woman who had earned a hard living by peddling stockings and small wares…[who] after thirty or forty years of toil had saved a few thousand dollars—she was unmarried—and besides remembering her few relatives, she wished in her will to make some bequests for charitable purposes. Though ignorant, she was a shrewd woman and, in consulting with the gentleman whom she desired to be her executor, she freely discussed the claims of the several objects of charity with which she was acquainted, and among others she mentioned this infirmary. ‘Put them down for a hundred dollars,’ she said.

‘They took good care of Johnny when he had a bad eye.’ Several years before, this boy who was her nephew had been a patient of the institution and the rough but kind-hearted woman wanted to make a return for the attention which she fully appreciated. The old woman died soon thereafter, and the money has been paid to the Treasurer.”i

“They took good care of Johnny when he had a bad eye.”

With the growing volume and diversity of cases now being treated at the infirmary came more rigorous attention to record-keeping. For the first time in its nearly 55-year history, the infirmary’s surgeons began to chart detailed accounts of their cases, a practice long in place in European medical circles. 15 Leading the way were Drs. Richard H. Derby, who documented 31 cataract extractions, and George W. Lefferts and Horatio Bridge of the Nose and Throat Department.16 Other infirmary surgeons quickly followed suit. Daily logs of both clinic and indoor patients tracking each patient’s age, sex, overall condition, diagnosis, intervention, anesthetic, prescriptions, and treatment outcome soon became standard, providing uniform records as well as a rich source of clinical data for the infirmary’s research and teachingminded medical staff. 17 By 1874, the infirmary’s branching services were attracting upward of 195,000 patients annually, 10,000 of whom were new patients.18 Yet, despite the laudatory efforts of the infirmary staff who “well fulfilled their duties…,” the daily attendance in the outpatient department presented “…a most striking illustration of distress and calamity.” 19 Genuinely needy patients, as well as individuals of means who feigned poverty so as to take unfair advantage, clamored for free care. But how might the overwhelmed infirmary staff determine who had a legitimate claim and who didn’t? After all, receiving and providing free care was, in great part, based on good faith and trust on both sides. Pushed to draw the line somewhere, somehow, the infirmary posted stern warnings on the clinic’s walls to put potential freeloaders on notice.20 Little more could be done, short of

JACOB RI I S VIA WI KI M ED IA COM MON S

demanding written proof of income where none existed. 

Mulberry Street (hand-tinted), circa 1880.

Above: patient summary from NYEE Annual Report, 1895.

Right: a word of warning.

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

NOT A MOMENT TOO SOON

1877

I

1865–1905

n 1877, the infirmary received its largest donation to date: a $30,000 bequest from Mrs. John C. Green, in memory of her husband, John Cleve Green.21, 22 With this most generous gift, the infirmary’s board voted to purchase a lot and an existing building on Second Avenue, adjacent to the original infirmary site, and

earmarked the remaining amount to renovate the latter and connect both buildings upon completion. A resolution was unanimously adopted to name the new building the Green Pavilion and acquire a portrait of the benefactor to hang in the “salon,” alongside the infirmary’s other esteemed patrons and leaders.23

Green’s lead gift led to a flurry of additional donations, all of which were news items at time, including $250 from William H. Vanderbilt that qualified him as a life member; $50 from James Brown, earmarked for “spectacles” for the indigent; $500 from W.F. Cary, a director of the infirmary for many years; two legacy gifts, $2,500 and $5,000, from life member Washington B. Vermilya and Dr. Edward Delafield, respectively; and $2,669 from the City of New York.24 When the Green Pavilion opened in 1878, it represented more than just a well-appointed building, but an even more forward-looking commitment to improved patient outcomes. With the addition of no-fee indoor beds, more patients could now benefit from the infirmary’s surgeons’ insistence that supervised postoperative care was a necessity, not a luxury. Acknowledging this, the board sought ways to develop more free beds without incurring debt or dipping into the infirmary’s permanent endowment. Simultaneously, they were faced with a similar challenge related to the climbing deficits associated with the Dispensary’s distribution of free medicines. However, in this case a possible, partial solution was within reach. After weighing the alternatives, the leadership decided to impose a 10 cent voluntary per-prescription fee, subject to each treating physician’s discretion. Much to everyone’s surprise, once the charge was implemented, many patients “cheerfully rendered” the token payment as a way of giving back to the charity that had given them so much.25 Of the 13,947 “free prescriptions” distributed that year alone, 6,422, or nearly half, generated a much-valued $642.20.26 Not much by today’s standards, to be sure. But back then, every penny was welcomed. 

One of the Dispensary waiting rooms, circa 1880.

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New York Eye and Ear Infirmary

K E E P I N G PAC E WITH PROGRESS

NYEE 200: A VISION OF HOPE

D

uring the first part of the 1880s, the infirmary continued to make low-key changes but seemed to be catching its breath, taking its measure, and regrouping. Rooms newly occupied by the Aural Department in the Green Pavilion were finally “appropriately and properly furnished.” Quietly and

systematically, the Board of Surgeons devised a rigorous scheme of coursework for the School of Instruction for Diseases of the Ear, Eye, and Throat “in place of the desultory and hitherto prevailing [one].” 27 Several hygienic upgrades, noteworthy for their modest scale, were carried out, including the purchase of an Ericson motor and double boiler so that “…water was carried upstairs in iron pipes to the fourth story of the main building and bath accommodations thus afforded there.” 28 In addition, water closets were trapped and ventilated and hallways and wards were painted.

1880 An outpatient eye exam/ treatment room, circa 1880.

40

But it wasn’t long before the Board of Surgeons began clamoring for better facilities. In 1884, arguing on their behalf, Derby presented a compelling case for making an investment in more space. Surgeons and their assistants, Derby began, were forced to perform procedures in full view of other patients, “often to the distress of timorous women and anxious, terrified children.” 29 Their “wish list” included larger, more comfortable patient waiting areas, separate from those in which clinical examinations and treatments were conducted, and a separate room of “large size, removed from noise and bustle, for the determinations of refraction and accommoda-

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

1865–1905

Dr. Francis Delafield 1841-1915 tion, the fitting of glasses, and the estimation of the field of vision.” Also pressing, in the surgeons’ view, was access to a small room, convenient to the clinical rooms, for performing minor operations that did not require anesthesia. More imperative still was a special accommodation for contagious diseases, amounting to a quarantine ward entirely separate from where operative cases were received. In short, the infirmary’s aging facilities, including the Green Pavilion that had opened scarcely 5 years before, were deemed inadequate.

Nevertheless, good news was forthcoming. In light of the upswing in the national and metropolitan economies, the board loosened their conservative purse strings to address the most insistent of the surgeons’ requests: a quarantine ward.30 During that same 1884 winter, a special provision was passed to allow for the lease of a small, one-story building on 13th Street for the express purpose of caring for contagious cases. This dedicated ward was immediately occupied by seven patients diagnosed with purulent ophthalmia, for periods of two to six weeks. The following July and August, “through the kindness of an unnamed board member, a tent was erected in the infirmary yard for even more patients suffering from chronic inflammation.” 31 At best, these measures were stopgap and everyone knew it. The surgeons’ patience was wearing thin and, in 1886, Dr. Henry D. Noyes, the infirmary’s executive surgeon since 1875, formally restated the staff’s message in unvarnished terms. “We beg leave to submit to the Directors…an urgent call for the erection of a new building,” he began. “We must have dark rooms for the ophthalmoscope, special rooms for examining for spectacles…

Each surgical service should have a complete set of rooms for doing all its work and caring for all its patients entirely apart from every other surgical service…[By doing so,] this work will be done more rapidly and better, the patients will be less crowded, and will not be exposed to the gaze of the waiting throng or offended by the spectacle of others’ miseries.” 32 Otherwise, how could the surgeons be expected to keep up with medicine’s fast-clip advances and offer quality care if the infirmary failed to provide them with the tools and environment to do so?

By way of one critical example, one need only consider the revolutionizing introduction of Carl Koller’s local anesthetic and its immediate impact on the astounding increase in the number and positive outcomes of eye

DID YOU KNOW that Dr. Francis Delafield (1841-1915), was a son of Dr. Edward Delafield and a prominent New York physician in his own right?

Like his father, Delafield graduated from the College of Physicians and Surgeons and then studied abroad in Paris, Berlin, and London.i Upon his return to the United States in 1865, he took up the position of surgeon at the New York Eye and Ear Infirmary and served as physician and pathologist at the Roosevelt Hospital. Later, he became associated with Bellevue Hospital, and held the Chair of Pathology at the College of Physicians and Surgeons, where he mentored Dr. William Welch, the founder of Johns Hopkins Medical School, and Dr. William Steward Halstead, the father of modern surgery, who created Johns Hopkins Medical School’s first academic department of surgery. Delafield was active in the New York County Medical Society, the New York Academy of Medicine, and the Pathological Society, and was elected the first president of the Association of American Physicians in 1886.

He published widely on the subject of renal pathology and his extensive contributions are considered classics in the field.

surgeries. But an additional factor that played into the surgeons’ pressing demands: competition. Several newer clinics—the New York Ophthalmic Hospital (1852), the Brooklyn Eye and Ear Hospital (1868), the Manhattan Eye, Ear, and Throat Hospital (1869), the Herman Knapp Memorial Hospital (1868), and the newly established Harlem Eye and Ear Infirmary (1881)—were far “better equipped and supplied with every appliance” than the

...a prominent New York physician in his own right.

infirmary, and drawing more and more patients into their orbit.33 Granted, the infirmary’s leadership had done their best to keep it abreast, but its significant lack of finances had held its potential to do more in check. The way things stood, either the infirmary would bet on the future or be left behind. 

Above: Dr. Francis Delafield. Below: admission to a Delafield course at the College of Physicians and Surgeons, Columbia College.

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

JOHN CLEVE GREEN 1 8 0 0 -1 8 75 ships bound for China and South America’s far-flung ports. At age 33, Green joined the house of Russell & Co. in Canton, China, where he set about building his vast wealth, augmented in part by his timely purchase of U.S. railroad investments. Upon his return to New York, he served for many years as the director of the Bank of Commerce and was a prominent member of the New York Chamber of Commerce.

In 1839, John Cleve Green married Sarah Helen Griswold, his first employer’s daughter, with whom he had three children. None survived into adulthood.

P R I N C E T O N U N I V E R S I T Y/ W I K I M E D I A C O M M O N S

42

The couple lived in an elegant townhouse in New York’s Washington Square and owned a sprawling country house on Staten Island.

WIKIMEDIA COMMONS

W

hen, in 1877, Mrs. John C. Green, born Sarah Helen Griswold and an heiress in her own

Never a man to take a predictable path...

right, made a bequest of $30,000 to the New

York Eye and Ear Infirmary in memory of her husband, John Cleve Green, the gift was the largest the chari-

Over the course of their lives and after their

ty had ever received. i,ii,iii But however generous, the

deaths, John Cleve Green and Sarah Helen Griswold

gift was relatively restrained, given the Greens’ most

Green bequeathed millions to scores of institutions and

elevated standing in New York society. At the time of

philanthropies, in addition to the New York Eye and Ear

his death in 1875, John Cleve Green had amassed a

Infirmary. Beneficiaries included, but were not limited to,

breathtaking fortune, valued at $7 million, close to

Princeton University, then known as the College of New

$156 million in today’s terms. Quite an achievement, in

Jersey, and Princeton Theological Seminary, New York

light of his background as one of nine children raised

University, New York’s Deaf and Dumb Asylum, and the

by modest Lawrenceville, New Jersey, farmers.

Home for the Ruptured and Crippled.

Never a man to take a predictable path, John Cleve Green, when the time came to attend college, chose instead to sign on as a lowly clerk at the China trading house of N.L. & G. Griswold, tea, textile, and opium merchants located on New York City’s South

Above left: the N.L.& G. Griswold clipper ship Challenge, on which Green served as supercargo. Left: the J.C. Green School of Science, Princeton University. Above: John Cleve Green, by Daniel Huntington, 1870.

Street. Shortly after demonstrating a precocious talent for foreign trade, he was promoted to supercargo in charge of freight and sales on a number of clipper P R I N C E T O N U N I V E R S I T Y/ W I K I M E D I A C O M M O N S

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

1865–1905

D R . H E N RY D. N OY E S 18 32-1900 “His broadly conservative mind made him a sound counsellor, and his rare qualities of skill, sound judgment, and insight, and perfect honesty and truthfulness made him a man to be trusted in the fullest sense of the word.” i — Dr. C. S. Bull

D

resignation in 1898. Dur-

sional organizations and societies, including the New

ing the final two years of

York Academy of Medicine, the New York County Med-

his life, Noyes served as a

ical Society, New York State Medical Society, the Amer-

consulting surgeon. From

ican Medical Association, and the Medical Library Jour-

1868 until 1892, he held a

nal Association.

professorship in Ophthal-

Whether delivering lectures to appreciative au-

mology and Otology at the

diences, performing surgery in the operating room, at-

r. Henry D. Noyes, considered one of the most

Bellevue Hospital Medical

tending to suffering patients, or tending to his duties as

eminent, forward-looking ophthalmologists in the

College, as well as a pro-

a long-serving member of the infirmary’s Board of Di-

history of American ophthalmology, distinguished

fessorship of Ophthalmol-

rectors, Noyes was widely acknowledged for his 41-year

himself early in his career. Born in 1832 and educated

ogy from 1868 until his

dedication to the New York Eye and Ear Infirmary. “He

in New York City, he later attended New York Universi-

death in 1900.

gave to its management his best thought, knowledge,

ty where he earned a Bachelor of Arts degree in 1851

Over this same pe-

and experience, and no labor was ever too great, no

and, by 1854, a Master of Arts. Having decided to pur-

riod, Noyes’s reputation grew. He was the first to pho-

time too valuable, to devote to its interests,” one admirer

sue a career in medicine, Noyes was accepted at the New

tograph an image of the retina in a live subject (a rabbit).

wrote. “If the success of any charitable institution is ever

York College of Physicians and Surgeons and earned a

A matchless clinician who was “rarely at a loss in an op-

due to the labors of one man, the New York Eye and Ear

degree in Medicine in 1855. Upon graduation, he spent

erative procedure,” Noyes was a “graceful and forcible

Infirmary today owes its success to the love and devo-

three years on the resident staff of the New York Hospi-

speaker” with a style that was “both finished and terse,”

tion of Dr. Noyes.”vii

tal before taking a year’s leave, accompanied by his col-

and whose “contributions [to ophthalmic literature] were

ii

league Dr. Cornelius R. Agnew, to hone their training in the most prestigious centers of medicine in England, France, and Germany.

“…no labor was ever too great, no time too valuable…”

The two young surgeons returned to New York

always of the best.”iv From his first scientific publication

in 1859, just prior to the American Civil War. Noyes es-

titled “Sclerotico-Choroiditis Posterior” in 1860, Noyes

tablished a practice in New York City and was invited to

authored no fewer than 100 articles in a wide range of

serve at the New York Eye and Ear Infirmary as an assis-

prestigious journals, based on his original research and

tant ophthalmic surgeon, as was Agnew, that same year.

lectures delivered at professional gatherings throughout

Both were eager to share their newly acquired knowl-

his career.v His groundbreaking Textbook on the Diseas-

edge and the most current practices in ophthalmolo-

es of the Eye, first published in 1888, has been reissued

gy with their less-traveled contemporaries and men-

numerous times and occupied an esteemed place in oph-

tors.iii Among their demonstrations was the proper use

thalmic literature for more than a century.vi

of the newly introduced ophthalmoscope, a particularly

Noyes’s active involvement and leadership in the

cumbersome instrument, mastered under the legendary

American Ophthalmological Society spanned his profes-

guidance of Drs. Graefe, Donders, and Bowman, known

sional career. He was one of the organization’s founders

then as “the triumvirate of ophthalmology.” In 1864, Noy-

in 1864 and served as its secretary from its inception un-

es was named an ophthalmic surgeon and, in 1875, was

til 1874. From 1878 until 1884, Noyes was the society’s

appointed the infirmary’s executive surgeon until his

president. He was also a member of many other profes-

Noyes died on November 12, 1900, at age 69 in Mount Washington, Massachusetts.

Above: Dr. Henry D. Noyes. Below: Dr. Noyes examining a patient at NYEE, circa 1885.

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

D R . CAR L KOLLE R 1 8 5 7- 1 9 4 4

A

c ro s s t h e a g e s

world began in the mid-1800s with the introduction of

That day marked the dawn of a medical revo-

and the globe,

ether and chloroform, which helped spare surgical pa-

lution. Within two weeks, Dr. Hermann Knapp, found-

humans have

tients the agony associated with invasive procedures,

er of New York’s Ophthalmic and Aural Institute, lo-

employed a wide range

except for those who underwent delicate eye proce-

cated at 44-46 East 12th Street, had employed the

of c r e at i ve r e m e d i e s

dures. The general narcotic-induced anesthetics rou-

technique.v No doubt, the surgeons at the New York Eye

to blunt the pain asso-

tinely triggered vomiting, retching, and general rest-

and Ear Infirmary nearby were not far behind. In 1885,

ciated with everything

lessness, which posed a “grave danger to the operated

Koller arrived in New York to demonstrate his ground-

f ro m to ot h a c h e s a n d

eye,” so eye surgeons often performed surgeries with-

breaking advance to his eager American colleagues.

childbirth to surgeries

out anesthesia. ii That is until Dr. Carl Koller, a young in-

Three years later, in 1888, he immigrated to the United

of all descriptions and

tern, house surgeon, and aspiring ophthalmologist on

States, became a citizen, and joined the

severity. i This ancient

staff at the Allgemeine Krankenhaus in Vienna, ush-

New York Eye and Ear Infirmary Staff. In

k n ow l e d g e, w hi c h in -

ered in the modern era of local anesthesia.

1890, he became a member of the Mount

cludes deliriant herbs,

Sinai Hospital staff and served as the

Initially, the inspi-

acupuncture, carotid compression, alcohol, opium,

ration for Koller’s break-

Chief of Ophthalmology for many years.vi

cannabis, cocaine, and scores of other substances,

through came from his

Among his many awards, Koller received

is the source of many pharmaceutical drugs in use to-

friend and colleague, a cer-

the American Ophthalmological Society’s

day. The era of modern anesthesiology in the Western

tain Sigmund Freud, who

first Lucien Howe Medal in 1922.

was exploring the use of cocaine as a remedy to break a colleague’s morphine addiction. During the summer of 1884, the future psychoanalyst

convinced

Koller

to partake in the alkaloid to further his investigations into the drug’s effects on muscular strength.iii Heretofore, Koller’s quest for a local anesthetic for eye surgery had been confined to solutions derived from chloral hydrate, bromide, and morphine. But after experiencing cocaine’s tissue-numbing

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44

That day marked the dawn of a medical revolution.

properties firsthand, an idea took shape. Koller’s first experiments with a cocaine solution administered into the eyes of frogs and guinea pigs confirmed that only a few drops were necessary to dilate the pupil and eliminate troublesome, involuntary reflex motions. From there, Koller quickly moved to trials on himself, then on a few colleagues, followed by a handful of patient volunteers.iv

By September 15, 1884, Koller was poised to present his findings to the Congress of the German Ophthalmological Society of Heidelberg.

Above left: Dr.Koller as a young man in Vienna. In January 1885, an anti-Semitic insult resulted in a duel between Koller and another medical student. Koller won the saber fight, wounding his opponent, but injured his own future in Vienna. Center: Dr. Sigmund Freud. Above right: the Lucien Howe medal.

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

HIGH AIMS

R

1865–1905

isk-averse as the leadership was, they devised a cautious expansion plan, the staged details of which were announced at the 1889 annual board meeting by Benjamin H. Field, the head of the Building Committee. To keep the infirmary “front rank,” a house and lot were purchased adjoining the

infirmary’s existing location on Second Avenue It was then decided that the wisest course of action given all the financial considerations was to “…leave intact and rent the most northerly house on Second Avenue, to tear down the house known as the Green Pavilion and the house of 13th Street, then to alter over the original infirmary building and to erect a new building on the vacant lot and the land at present occupied by the houses to be torn

1884

down.” 34 “When sufficient money is raised,” Field continued, “the original infirmary building and the remaining house on Second Avenue can be torn down and rebuilt and thus have a complete building suitable for our work.” 35 Convinced this gradual rollout met the infirmary’s best interests, the board agreed it was “better to go ahead and make our contacts, feeling confident that it will be much easier to obtain subscriptions for the balance when the public see we are really doing something and it would be better to even encroach on our permanent fund than to remain in our permanent condition.” 36 It was a chancy and uncharacteristic move, but one the leadership was willing to take.

On March 15, 1890, the infirmary inaugurated its next expansion with a cornerstone ceremony, punctuated by great relief and brightened expectations. The festivities began with remarks by former New York Mayor Abram S. Hewitt, one of the institution’s honorary governors, and a prayer offered by Rt. Rev. Henry Potter, seventh Bishop of the Episcopal Diocese of New York. These gentlemen were followed by John Harsen Rhoades, Esq., president of the Board of Directors, who mapped out the infirmary’s “high aims” and what achieving them would require: “We have determined upon the expenditure of $125,000, of which $75,000 has been

“

raised—nearly one-half of which has been subscribed by our own Board of Directors—[that] we must have an $50,000 additional; and we ought to have at least $250,000 in all to add to our present resources, and to give

We beg leave to submit to the Directors…an urgent call for the erection of a new building....”

us a revenue sufficient to meet our yearly expenses and prevent a deficit.” 37, 38 Dr. Henry D. Noyes echoed Rhoades’s appeal with the lofty reminder that philanthropy “…in a particular sense, blesses him who gives and him who takes.” 39 No doubt, Noyes’s message was meant to stir not only the infirmary’s larger donors, such as J. Pierpont Morgan, Cornelius Vanderbilt, Adrian Iselin, and Miss Caroline Phelps Stokes—all of whom had given generously in the past—but also to inspire a fresh base of potential benefactors.

In 1890, with the help of generous sponsors, “a model building for the Charity” was begun, allegedly based on Stanford White’s “overall” design, although no definitive documentation of his participation is available and this attribution is, most likely, mistaken.40, 41 By 1891, three floors were being added to the original

45

46

New York Eye and Ear Infirmary

1893

NYEE 200: A VISION OF HOPE

brownstone, creating space for the Departments of Throat and Ear’s new reception and prescribing rooms, as well as facilities that would triple the treatment areas dedicated to diseases of the eye.42 The laboratory was newly fitted with suitable tables, cases, sterilizing compartments, microscopes, microtomes, and apparatus for bacteriological investigations and photo-micrography—“more varied equipment…than any in Europe”— all of which promised to boost the infirmary’s ability to offer normal and pathological histology as well as bacteriology instruction.43, 44 All was to coincide with the infirmary’s new status as a New York State chartered School of Ophthalmology and Otolaryngology, conferred the previous year. 45, 46 Near-term plans were also taking shape. Underway were the nucleus of a museum—intended to furnish students with the opportunity, when advisable, to conduct experimentation on animals—and a greatly enlarged library, thanks to the acquisition and donation of Professor Nagel of Tubingen’s private medical library, consisting of 414 volumes and 4,000 pamphlets, by Mr. William C. Schermerhorn.47, 48 Despite optimistic projections, the cost of these enhancements was ultimately unsustainable. Distressingly, during this period, neither receipts nor support from the charitable public was sufficient to cover running expenses or avoid a swelling deficit. Troubled by the overruns and determined to weather the financial storm, the board explained their next actions this way: “We owe our permanent fund $32,563.07…[and] have been forced to confine our expense below what is properly necessary for the best care of our patients.” 50, 51 In plain terms, trimming expenses translated into turning patients away. But as the belt-tightening went into effect, the infirmary received a generous behest that would ironically complicate matters even further: a “princely gift” of $80,000, from the estate of Dr. Abram Du Bois, the renowned eye surgeon who had trained under Rodgers and joined the infirmary staff in 1843. Du Bois’s beneficence, earmarked to build a pavilion dedicated to the treatment of eye patients, presented the board with a dilemma: How to honor Du Bois’s largesse and expressed wishes without further overextending the infirmary’s finances? Lacking a behind-the-scenes account, one can only imagine the lively debates that filled the board room and ultimately emboldened them to take their next leap of faith.

By 1893, the architectural plans for the infirmary’s further expansion, clearly attributed to architect R.W. Gibson in the signed drawings included in that year’s Annual Report, had been approved and the existing buildings on the corner of Second Avenue and 13th Streets demolished so that the Abram Du Bois Pavilion and an additional, as yet unnamed, pavilion would stand in their place, “uniform in design with the Hospital Building on 13th Street.” 52, 53, 54, 55, 56 The hope was that another large donor, seeking to take advantage of the naming opportunity, would step forward and that Du Bois’ $80,000 bequest, used in the construction, could

The first edition of New York Eye and Ear Infirmary Reports, published in January 1893, represented a collection of authoritative articles authored by the infirmary’s Surgeons.49

be restored to the Endowment Fund.57 A year later, the new five-story building, “lighted by electricity, with an elevator, affording ample accommodations for the House staff [as well as servants and nurses]…rooms on each

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

1865–1905

of two stories for private patients…and a well-lighted operating theater for the Ophthalmology Department, Pathology Laboratory, and Library…stands on the site of our old building.” 58 The “well arranged” Du Bois

“

Pavilion was made up of two wards of 10 beds each, located on the second and third stories. Two fifth-floor wards were dedicated to the treatment of blinding contagious eye diseases until a separate pavilion could be

...a new five-story building ‘lighted by electricity, with an elevator...and a well-lighted operating theater’”

constructed.59 Understandably, the opening of the gleaming new facilities inspired even more requests for specialized instruments, apparatus, and equipment. By way of an example, the upgraded operating rooms, now used conjointly with the Ear Department, enabled surgeons to perform procedures on the auricle, drumhead, mastoid cells, and cranial cavity for brain abscesses. 60 That was the good news. But insofar as there were no adjacent postsurgical wards, patients had to be transported to the adjoining building on Second Avenue at considerable risk. Moreover, and embarrassingly,

1896

some visiting surgeons were obliged to bring their own instruments. 61 The Pathology Department was also in need of state-of-the-art equipment to keep up with surgical advances, including “two more microscopes and a microtome suitable for cutting larger sections than is possible to cut with the instrument now in the lab.” And the Physical Laboratory sought to acquire “…optical benches, color-tops, photometers, organ pipes, standard tuning forks, lamps, photographic and projecting apparatus…” to augment their physiological optics and acoustics capabilities. 62 On top of all these appeals, the Throat Department petitioned the board to “install a tile floor in the operating room to replace the asphalt floor being both unsightly and inappropriate.” 63 Were it not for the leadership’s dogged determination to find solutions, the infirmary might have collapsed under its own success. Until another major donor stepped up, the board needed to devise an interim strategy to staunch the infirmary’s financial hemorrhaging. To that end, a Century Fund was established, consisting of at least 100 subscribers at $100 per year for a period of time not to exceed five years, with the hope that as endowments grew, the annual subscription would diminish on a pro rata basis per person. 64 Not enough to bail the infirmary out of its “extremity,” but something.

Just then came a reprieve. In 1896, as if on cue, the infirmary received two highly significant contributions that would have major consequences for its near future. The first was yet another gift from the Du Bois family— children William A., Matthew B., and Katherine Du Bois gave $75,000 in memory of their mother, Catherine Brinckerhoff Du Bois, to the Endowment Fund to sustain the Du Bois Pavilion. The second donation, of $51,000 to memorialize James N. Platt, came from his family—Mrs. Evelina C. Bliss, Miss Ida E. Bliss, and Mrs. J. Adele Stafford—to build a pavilion for the long-requested quarantine ward for patients suffering from contagious eye

R.W. Gibson, architect of the 1893 infirmary expansion. (Wikimedia Commons)

diseases. Were things looking up? Yes…and no. 

47

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1893 Expansion: Third Floor Plan

NYEE 200: A VISION OF HOPE

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

1893 Expansion: 13th Street Elevation

1865–1905

49

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

A TEMPLE OF HOPE AND HELP

“

I

n the closing years of the 19th century, the aggregate number of patients who had sought the charity’s care was approaching 1 million since the hospi-

tal had opened. Day after day, the infirmary’s reception rooms filled to overflowing, as they had since its found-

…Like a kindly light it has led the afflicted poor out of the valley of darkness. It has lent the ear of sympathy to those in the soundless pit of deafening silence, and in restoring the hapless breadwinner to work and thus preventing pauperism, it has illustrated the efficiency, excellency, and reasonableness of charity,…

In the whole history of the infirmary, not a penny was ever known to have touched the hand of a surgeon or assistant surgeon.” 65

1900 Above right: the completed NYEE building, from the 1894 Annual Report.

ing in 1820. Portrayed in the popular press as a “temple of hope and help…that ‘slumbers not, nor sleeps,’” the infirmary’s reputation as protector and guardian of community health remained undiminished and incontrovertible. But whereas the infirmary’s original mission persisted unchanged, its reach, capabilities, and expertise had evolved far beyond any of Delafield’s and Rodgers’s most ambitious dreams. No number of endowed pavilions, well-lit operating rooms, up-to-date equipment, or skilled staff seemed to make a dent. Escalating costs or none, there was no other way but forward.

The board floated various ideas to ease the infirmary’s mounting cash flow problems. One was to generate a “handsome income” by creating more private rooms for prosperous patients who were increasingly pressing the “privilege of admission.” 66 Another was to launch a vigorous, targeted fundraising campaign blanketing the broader public. In an ongoing series of well-placed notices in several widely read daily newspapers, the board’s straightforward solicitation read: “…The directors now desire to thus publicly call the attention of those interested in the charities of New York to the pressing needs of this institution in hope that careful investigation will lead to a generous response to the appeal now made.” 67 The response was lukewarm. But just when hopes were faltering, a “friend of the institution” donated $30,000 toward the infirmary’s endowment, followed by a $16,000 subscription from “…those directly represented in the work,” most likely the infirmary’s surgeons.68 This combined windfall proved sufficient to underwrite staff increases, which soon grew to 31 surgeons, 56 assistant surgeons, and 12 house staff.69 It also ensured that the construction of the long-awaited quarantine Platt Pavilion could move forward. In the early summer of 1900, the house adjacent to the infirmary on 13th Street was demolished and construction began. Immediately upon opening in 1901, the facility’s private and public wards filled to capacity, partly because of a steady stream of patient referrals from Bellevue, New York, Mount Sinai, New York Post-Graduate, and Manhattan Hospitals, and partly because the Pavilion was so “admirable.” 70 By every measure, the new facility was impressive: separate furnished wards for men and women, with five beds each as well as

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

“

1865–1905

51

THE INFIRMARY’S FREE CLINIC Gentlemen, we need additional facilities and we need them at present. Not next year nor two years hence, but now!” three cribs for babies, two comfortable rooms with open fireplaces for private patients, and plumbing arranged so that “water can be drawn at any time by a mechanism beneath the basin and controlled by the

foot.” 71

A crematory to burn all the infectious

dressings was also provided for.

However, this significant investment most certainly left the other infirmary services wanting, if not somewhat envious. In his report to the Board of Directors, Derby, by then the infirmary’s Executive Surgeon, took a firm stand on behalf of the Ear Department staff for improved operative facilities, especially for the growing number of intracranial procedures that were “commensurate with the magnitude and gravity of work which daily claimed [their] attention.” 72 “Gentlemen,” Derby implored, “we need additional facilities and we need them at present. Not next year nor two years hence, but now!” 73 The pressure was on. His urgent petition would be answered by a $75,000 gift from Mr. Schermerhorn, which funded the 1903 opening of the 34-bed Schermerhorn Pavilion, dedicated to the diseases of the ear. 74

P

atients of all ages, occupations, and states of

lums…dim-eyed women who put off buying glasses in

distress flocked to the infirmary’s free clinic.

order to keep shoes on their children; wrecks of man-

Among them, in the words of an impassioned

hood with whiskey-boiled and tobacco-burnt eyeballs;

but unnamed newspaper journalist writing for The Eve-

pretty girls and sweet-mannered boys with fearful sou-

ning World in 1894, were “…the college graduate, with

venirs of the fevers that plague childhood; victims of

his foolish head full of learning and no sight in his ill-

street accidents, of railroad and steamship disasters

used eyes; the little watchmaker girl, the corset-steel

of cruelty, of abuse, or fatality, from all over the city,

cutter, the stone-cutter, the machinist, and the button-

from every State in the Union, from every country on

maker with a piece of metal or stone lodged in the del-

the continent, from every nation on the surface of the

icate membrane; the lusty engineer, with a drop of

earth…” i

crude oil under the cornea…the babe not a week in the world, the yellow little cigarette-maker, saturated with the fumes that no moth can touch; the bloodless seamstresses, emaciated art students, the poor little children from the crowded tenements and crowded asy-

“... from the crowded tenements and crowded asylums...”

The Women’s Ear Ward, Schermerhorn Pavilion.

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WIKIMEDIA COMMONS

DID YOU KNOW that for all the advances in ophthalmology by the end of the 19th century, many traditional practices, home remedies, and deleterious drugs were still in widespread use?i,ii A peek into an ophthalmologist’s little black bag might reveal collyrium eyewashes, variously made of chinaberry, redroot, or eyebright (euphrasia officinalis) and other botanicals. Apothecaries compounded a range of eye preparations using mercury in several forms, including mercury bichloride, silver nitrate, zinc sulfate, zinc oxide, copper sulfate, alum, lead subacetate, tincture of iodine, sodium borate, camphor, and opium. And physicians soothed their patients’ postoperative trauma and inflammation using warm and cold compresses and poultices, some made from slippery elm or sassafras pith, along with the strategic placement of blood-sucking leeches, preferably of the Norwegian variety.

G E T T Y/ I S T O C K P H O T O

A Peek into 19th Century Pharmacopia

Top: a period illustration of Euphrasia officinalis. Above left: a leech.

Above: a 19th century apothecary kit.

The Platt Pavilion under construction, 1900.

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

“

ON THE BRINK

Ever-swelling outlays to meet the demands for maintenance, new employees, and wage increases spelled trouble ahead.”

1903

M

1865–1905

ost certainly the infirmary had achieved milestone after milestone, but at what cost? For some years, contrary to the leadership’s longstanding no-debt policy, the charity had been carrying a deficit, accruing at the annual rate of between $4,000 and $5,000. If this burden didn’t keep leadership up

at night, nerves frayed and brows furrowed as revenues fell behind receipts and interest rates on the charity’s investment securities evaporated, cutting deep into the disposable gains routinely used to cover general running expenses. Unlike the Du Bois Pavilion, which could draw off the Endowment Fund for emergencies, the new Platt Pavilion could not count on permanent reserves to buffer soaring overhead expenses. Ever-swelling outlays to meet the demands for maintenance, new employees, and wage increases spelled trouble ahead.75

What may have been the first inkling of problems to come was the nurse boycott, reported in the March 3, 1903, edition of The Evening World. The walkout began with six young nurses protesting the hiring of a new head nurse who, they maintained, was unqualified to issue orders pertaining to the treatment of eye and ear ailments.76 After their demand that the position be filled by someone promoted from within their ranks was rejected, the strikers “tore up the patients’ charts, disarranged the glasses and bottles, and in other ways interrupted the work of the hospital,” leaving 57 patients unattended. Six new nurses were hastily recruited from Boston and Montreal, along with Derby’s warning that none of the young strikers would be rehired as long as he was in charge.77 While Derby solved this problem with dispatch, the clinic’s chronic duress was not as easily resolved. In addition to sputtering receipts, the monies generated from private benefactors, on-again, off-again state and local government contributions, and a portion of inside-patient fees were inadequate to underwrite free care for the 40,000 to 50,000 new patients now being seen annually. With inflation on the rise, the burden was too great and, reluctantly, the board approved a clinic fee of 25 cents per visit. This charge remained unchanged for the next 50 years, remarkably enough.78 At the

GRE OF GON

SS

same time, inpatient ward rates, which had increased incrementally over the years, were raised to $7.50

LIBRARY

a week, but only if the patient could afford it; $15 a week for semi-private accommodations; and $25 a week for well-appointed private rooms.79

From The Evening World, March 3, 1903.

A private room in the Schermerhorn Pavilion, circa 1903.

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New York Eye and Ear Infirmary

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1904

None of these measures were enough and the infirmary’s spiraling financial crisis broke publicly in the early months of 1904, with headlines in three New York dailies reading “Deficit Faces Eye and Ear Infirmary, “Noted Hospital’s Plight,” and, shockingly, “Platt Eye Pavilion Closes.” 80, 81, 82 Reports confirmed the infirmary’s $22,000 deficit was snowballing at a rate of $2,000 monthly, due largely to precipitously low annual revenues, which had dropped to $55,000, far short of the necessary $75,000 required to meet expenses. 83 With no other viable alternative and unwilling to further erode the charity’s $300,000 investment principal, the board made the wrenching decision to close the Platt Pavilion. Should the infirmary be unable to raise between $20,000 and $25,000 by May 1, they warned, all indoor wards would be closed, including the Schermerhorn Pavilion.

Only five or six beds in the endowed Du Bois Pavilion, of 25 total, would still be available. More dire still, that amount was only a short-term fix. The board’s grim forecast was that the charity needed a staggering $500,000 to shore up the existing $300,000 Endowment Fund, to ensure the infirmary would be self-supporting. “Unless we can get that,” the infirmary’s Superintendent Dr. A.H. Harrington lamented, “we will have to remain practically idle.” 84

Prospects of the impending closures prompted impassioned pleas from all quarters. Harrington pointedly

“

challenged New York’s Health Commissioner Thomas Darlington when he asked, “Where shall patients suffering from contagious ophthalmia go?” 85 The infirmary’s surgeons weighed in, declaring that shuttering

...is New York ‘rich enough to afford the sacrifice of even one among its finest human interest institutions?’”

the Platt Pavilion would be nothing less than a “public calamity.” 86 Even the local press took direct aim at the privileged few, posing the sarcastic question: is New York “…rich enough to afford the sacrifice of even one among its finest human interest institutions?” Driving the point home, the same writer implored, “If all the millionaires of Greater New York had to live in a single street, that thoroughfare…would have to be more than twenty miles long. And it might be forty.” 87 By the end of March 1904, a disheartened Harrington stated, “…I don’t think the people generally have responded as they ought.” 88 Still, no one gave up. Donations trickled in from poor East Siders who gave what they could, and others in slightly better circumstances offered gifts of $5 and $10. But the greater part of the emergency $20,000 raised during that period came from the infirmary trustees themselves, such as longtime board members John L. Riker and Adrian Iselin. Generous sums, to be sure, but $5,000 short of the $25,000 needed to run the hospital until the end of the fiscal year. By May, and with considerable relief, the board announced that their short-term $25,000 goal had been met and the infirmary would stay open until September 30, 1904. But the Platt Pavilion would remain closed. To consider the crisis fixed was folly, they cautioned. Unless an additional $80,000 was raised to cover the hospital’s running expenses, the infirmary’s fate would be sealed.

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

1865–1905

55

Miss Viola Allen

suffering from contagious ophthalmia go?”

OF GONG RES LIBRARY

Left: articles from The Evening World and The Sun, February and March 1904. Above right: an operating room. Right: a Platt Pavilion ward for contagious diseases of the eye.

WIKIMEDIA COMMONS

“...vivacious and charming as ever.”

Above: Viola Allen.

Left: The Theatre magazine cover featuring the actress as Viola in Twelfth Night.

WIKIMEDIA COMMONS

ruary 14, 1904, mere moments after Miss Viola Allen’s closing bows for her per formance in Shakespeare’s Twelfth Night at New York’s Knickerbocker Theater, the thespian was rushed to the New York Eye and Ear Infirmar y for an emergency mastoidectomy? i Unbeknownst to her adoring public, Allen had undergone an ear operation by a Boston ear specialist scarcely three weeks prior, only to realize that night that something was still drastically wrong. In the spirit of “the show must go on,” the stalwart stage and silent film star pushed through the excruciating pain, right up to her hasty exit. According to Dr. E.B. Dench, the New York Eye and Ear Infirmary surgeon who conducted the last-minute procedure, had the actress waited another 24 hours, the putrefying abscess might have destroyed the bone, invaded her brain, and threatened her life. Consummate professional that she was, Miss Allen faced the dangerous operation as “vivacious and charming as ever.” To the delight of her ardent fans, some weeks later the news was she had made a full recovery and would soon be returning to the stage.

Where shall patients

S

“

DID YOU KNOW that on Feb-

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Helen Keller at the Schermerhorn Pavilion DID YOU KNOW

that the May 11, 1903, dedication of the Schermerhorn Pavilion was a day many philanthropically minded New Yorkers would never forget?i At 4 pm, shortly after the infirmary’s foyer filled to overflowing and the invitees settled into their seats surrounding the improvised, flower-festooned stage, a lovely young woman wearing a white organdy gown and a wide-brimmed picture hat was led to a chair on the dais. She was the keynote speaker, none other than Miss Helen Keller, the “deaf and blind prodigy” who was soon to graduate cum laude from Radcliffe College. The day’s program began with a series of speeches by Dr. Gorham Bacon, Dr. H. Hay Schiefflin, and Bishop Henry Codman Potter on behalf of the infirmary, and Drs. David A. Greer and William Reed Huntington from St.

“In order to be happy, we must each live in the common life of all.”

The infirmary was almost as busy as ever. The halls and reception rooms were crowded, the wards full, the operating rooms abuzz with 37,606 new patients, 12,509 outdoor patients, and 2,102 indoor patients, providing a total of 23,596 days of hospital care.89

Bartholomew’s and Grace Churches, respectively. As each speaker delivered their remarks, Miss Keller’s teacher, Miss Anne Sullivan, interpreted their words by finger-spelling onto Miss Keller’s lips or into her hand. When it was time for Miss Keller to address her rapt audience, she was guided to the podium and, with great poise and dignity, spoke: “In spite of the hard words that are spoken against this great city, I find here a wide human sympathy. Everyone is imbued with it; we feel it everywhere. Surely there would be no need for eloquent appeals in behalf of the New York Eye and Ear Infirmary if you could look into the darkness which the blind see and listen to the stillness which the deaf hear. There is no greater deprivation than blindness; no sharper anguish than deafness. I know these limitations as you cannot know them, yet I have not known the suffering which this institution is meant to alleviate. My own difficulties are vastly increased because I cannot see or hear. How must they be redoubled when one has seen and heard for many years, and has been engaged in pursuits that require all the faculties, and then suffers this unutterable loss!

WIKIMEDIA COMMONS

By 1905, there was reason to be guardedly optimistic.

“In order to be happy, we must each live in the common life of all. We must enjoy with the joy of others. We must feel their sorrows. All that we have, all that we know, all that we have discovered, we must bestow, at least in part, for the universal good. This institution has become your sacred burden. Look on it, lift it, bear it proudly. It is your part and privilege to hold up the hands of the physicians here who are fellow workmen together with God.”

Helen Keller (left) in 1899 with lifelong companion and teacher Anne Sullivan.

Austerity measures had shrunk the annual deficit to $1,677.64, a sum notably smaller than in previous years.90 The city had agreed to underwrite the care of certain dependent cases with a $2,095.66 supplement. A $20,000 lump-sum donation had somewhat plumped up the Endowment Fund and assorted benefactors had rallied to support running expenses. Cash flow was improving. Although the Platt Pavilion was still closed and the infirmary was still turning away ophthalmia cases, hopes rose for a partial reopening by the coming year. Yet absent a major endowment gift, much would depend on whether $10,000 could be raised through donations to cover the following year’s operating costs. Eager to rebuild the confidence of their donor base, the board stated: “[After] a careful watch of internal economies and an increase in actual earnings, we can assure the friends of the infirmary and the public that we are using our utmost endeavors to secure and preserve a credible financial showing.” 91 And, the board added almost contritely, “[going forward]…we shall take these steps cautiously and any further expansion will depend on our actual earnings.” 92

2. AS N EW YORK GROWS, SO M UST ITS CHARITIES

“

[going forward] we shall take these steps cautiously and any further expansion will depend on our actual earnings.”

1905

1865–1905

Despite lessons learned, it had been a close call. However, viewed through a wider-angle economic lens, the infirmary’s resilience and recovery were nothing less than remarkable. Long before the shorter financial downturns associated with the panics of 1901 and 1903, the demise of several large American enterprises during the panic of 1893 had triggered a domino-like meltdown of stocks, banks, and loan, trust, and mortgage companies that rippled through the country’s economic health for nearly a decade.93, 94 Apart from weak intermittent financial rallies, securities and investments seesawed along with plunging employment rates and wages, which, in turn, escalated labor disputes and energized union recruitment. Throughout this period, the city’s vagrancy and crime rates shot up. Socialists and unionists opened soup kitchens and organized “hunger demonstrations.” 95 Municipal and charitable enterprises were pushed beyond their capacities, undercut, in some quarters, by the persistent sentiment that aid only encouraged dependency among the desperate.96 After all, those who occupied society’s most vulnerable sectors were expected to make the best of it, were they not?

Demoralizing as this period had been, an uneven but steady recovery was underway by the early 20th century. New York City, now including Queens, Staten Island, the Bronx, and Brooklyn, totaled 300 square miles and a population of more than 3 million: the largest city in the United States and one of the largest in the world, second only to London.

Unprecedented consolidation fueled the resurgence: merging municipalities, boundary-straddling public works— subways, bridges, railways, water tunnels, and electrification projects—the forging of companies and industries into massive corporations, and construction of the first skyscrapers, towering symbols that would

Construction of the Flatiron Building, one of New York’s first skyscrapers, was completed in 1902.

enshrine New York City as the “Capital of the World.” 97  WIKIMEDIA COMMONS

57

“Their spirit lives with us for evermore”

“

…[We] are about to start on our second

century with the same confidence and hope

that strengthened and heartened the founders

and our predecessors in offices, that we would carry on to the end in alleviating and curing the troubles incidental to those all-important senses—sight and hearing.”

— Infirmary Board President John J. Riker, 1920

1906 –1945

T H E N E W YO R K T I M ES

WIKIMEDIA COMMONS

3 “Their spirit lives with us 1906 –1945

for evermore”

1906

By the opening years of the 20th century, the newly consolidated City of New York was home to approximately 3.4 million residents, a large percentage of whom were immigrants who hailed from all corners of the globe.1 A massive number came from Southern and Eastern Europe, with significant, but smaller, groups arriving from Northern Europe, the Middle East and East Asia, the Caribbean, and Central and South America, as well as U.S.-born rural blacks and whites. Most came to the United States and its cities in search of a better life. Those who settled in New York City often did so in tight-knit neighborhoods. As a whole, they formed a living tapestry of language, cultures, skills, and ethnicities that would not only transform the labor force and politics, but also shape public health policy and the social service institutions they relied upon.

U N C E R TA I N T Y AND THEN SOME

F

resh on the heels of earlier financial downturns, the panics of 1906 and 1907 led to a persistent and deepening economic inequality, especially among the newcomers.2 Critics pointed to the “evils” of unfettered competition and laissez-faire capitalism and called for better antitrust enforcement and financial regulation in the name of a “moral economy.” 3 Local reformers chipped away at Tammany Hall’s corrupt stranglehold on New York City’s civic life by advocating the

formation of more accountable, independent umbrella agencies to oversee and manage public health, law

Preceding spread: Manhattan panorama, 1906.

Opposite: immigrants at Ellis Island, circa 1910.

enforcement, housing, welfare, and schools to better protect the collective good.4 Mirroring this general movement, medicine also was inching toward broader, coordinated regulation. The American Medical

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Association (AMA) sought to alert the general public to the dangers of quacks and spurious patent medicines by initiating wide-reaching health campaigns, and pushed for tighter credentialing standards to weed out undertrained physicians and shady medical schools.5,6,7

“

In light of the prevailing zeitgeist, it was no coincidence that the infirmary’s leadership engaged Dr.

Your outpatient waiting rooms and work rooms are distinctly overcrowded...and the confusion and congestion in your waiting halls...was very great.”

Cobb Farrar, superintendent of the Massachusetts Eye and Ear Infirmary and surgeon of outpatients at Massachusetts General Hospital in Boston, to conduct a comprehensive assessment of the organization’s health in 1902. Not only did Farrar’s first-person 40-page account, titled “Report on the Management of the New York Eye and Ear Infirmary,” guide the infirmary’s growth for years, it also outlined hiring practices and advocated reining in rampant waste to reconfigure the infirmary’s physical layout and beyond. Read from today’s vantage, his piercingly specific observations provide an unvarnished view of the institution’s inner workings at the turn of the 20th century.8 In one example, Farrar urged employing a professional auditor and “a medical superintendent who is trained in medical or surgical practice or the practice of eye and ear diseases who is young and with executive ability and enthusiasm…but not recruited from within to avoid criticism, favoritism or jealousy.” 9 Eager to pass on best practices, he offered to mentor the new hire at Massachusetts Eye and Ear. In another example, he strongly suggested tighter controls over the “complex and heterogeneous system of the attending staff [insofar as] too many men have services at once, too many men make ward visits at the same time and have an equal right to the operating room at the same time, [so as] to eliminate the high demand…upon the services of your nurses and attendants.” 10 After evaluating the infirmary’s nursing policies, Farrar encouraged the leadership to follow Massachusetts Eye and Ear’s lead by establishing a similar postgraduate nurse training program to enhance patient success rates and eliminate the expense of “untrained nurses who are more often like assistants to staff members, anticipating their every move and procedure.” 11 These nurses, he noted, are “merely upper-class servants and not women who are trained to the profession.” 12 Among Farrar’s most pointed observations were those related to the condition and running of the outpatient clinic. “Your outpatient waiting rooms and work rooms are distinctly overcrowded,” he wrote, “and the confusion and congestion in your waiting halls, as I saw them, was very great. The atmosphere…becomes excessively foul in a very few minutes because of the class of patients and the large numbers drawn from such a class. It would be desirable to shut your stairways by tightly closing the doors and also your elevator wells

Graduating Class, 1908, eye residents.

with a view to prevent, so far as possible, this excessively contaminated air which must carry disease germs

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1906–1945

from rising to the ward floors above.” 13 Installing a turnstile, he advised, might moderate the physical flow of patients in the short run, but implementing more rigorous screening by establishing “a bureau of inquiry staffed by competent staff to determine the fitness of patients who apply for treatment and turning away all such patients in regard to whom a reasonable doubt arose” was key to a longer-range solution.14 Farrar, in keeping with the prejudicial class distinctions of the day, then proceeded to make a case for attracting more revenue-producing patients by creating a separate entrance and “dignified and comfortable reception rooms for private patients and their friends.”

By all rights, the total sum of Farrar’s top-to-bottom critique was daunting, especially given “the [infirmary’s]

1907

decreasing purchasing power of gift and fixed income with increased pressure for larger means.” 15 Even so, the leadership committed to implementing many of Farrar’s recommendations, toggling between immediate demands and long-range upgrades. By 1907, with the partial reopening of the Platt Pavilion for the treatment of trachoma cases and the resumed use of the Throat Ward for the care of adenoid and tonsil cases, the number of patient beds grew to 131. And the staff was larger than ever: 18 visiting surgeons, 37 assistant surgeons, 32 clinical assistants, and 6 house surgeons, supported by 93 officers and employees.16 (continued on page 66)

CROWDED WAITING ROOM

The dispensary reception hall, circa 1910.

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NYEE 200: A VISION OF HOPE

OPHTHALMIC NURSING “THE IDEAL NURSE…should have a love of work, sacrifice, and humanity.…Her value will depend much more upon personal qualities and her conduct than her knowledge of anatomy and materia medica. The demand for her service will also depend largely upon her personal appearance, attractive manner, and cheerful spirit. She should be properly attired in correct uniform with no rustling silk skirts, scent of perfumery, or glitter of jewelry.”i — Dr. Lewis G. Griffin, The Ophthalmic Nurse, 1920

clearly attributable to a “higher standard of nursing in ev-

n 1845, three years after the New York Eye and Ear In-

[one] would necessarily expend for retraining of the ser-

I

firmary moved to Mercer Street, the name Matron Gertrude Green appears for the first time in the institution’s

annual reports. Those under her charge were probably women servants hired to maintain the indoor wards and to tend to less fortunate patients who, unlike the more affluent, could not retain their own private attendants for the duration of their stay. Apart from instruction in the basics of caregiving, few, if any, of Green’s staff would have been formally educated. At the time, formal nursing proii

grams in the United States were unheard of, apart from earlier efforts to train midwives, one by New York Hospital’s Dr. Valentine Seaman in 1798 and another by Philadelphia’s Dr. Joseph Warrington a few years later. It wasn’t until 1872 that Dr. Maria Zakrzewska established America’s first institution-based nursing school, at Boston’s New England Hospital for Women and Children. New York’s Bellevue Hospital followed suit

WIKIMEDIA COMMONS

in 1873.

During this period, the infirmary was staffed by only two permanent

Dr. Maria Zakrzewska, circa 1875.

“nurses” who assisted the surgeons during operations

ing to Mary E. McCready, nursing superintendent at the

and, along with an unspecified number of untrained at-

time, “[The postgraduate nurse training program] will be

tendants, cared for as many as 75 ward patients at any

of great benefit for it will enable us to have the very best

one time.iii,iv As institution-based nursing programs be-

nurses for less money than would be paid to permanent

gan to graduate certified candidates, their value became

nurses and we will be able to do with 10 permanent nurs-

increasingly obvious. By 1896, the Massachusetts Eye

es and 15 postgraduate nurses at $10 a month, thereby

and Ear Infirmary nurse training program was in place

less expensive and up to a better standard.”viii However,

and reaping demonstrable benefits. Most notably, the

a critical piece that would attract even more applicants

better outcomes for patients attended by nurses were ery way for a very much smaller amount of money than

...a love of work, sacrifice,

vices on an equal number of untrained nurses, who, after

was still out of financial reach: the construction of a res-

all, would always be merely upper-class servants and not

idential facility for the new trainees, a standard practice

women who are trained to a profession.”

at the time. Until the money could be raised, the nurses

v

The New York Eye and Ear Infirmary’s leadership

would be housed in three sections of the infirmary, with

took notice. By 1899, pointing to the “success of the op-

one of the sleeping rooms converted into a nurses’ parlor.

eration already underway in Boston” and the “handsome

No one was particularly satisfied with the scattershot ar-

profit” generated by creating more private rooms staffed

rangement, but everyone made do.

by competent nurses, the infirmary’s leadership endorsed

Enter the Nursing Comfort Committee, a subcom-

the creation of the New York Eye and Ear Infirmary Post-

mittee of the Ladies’ Visiting Committee, soon to be re-

graduate Training School for Nurses, with the intention

named the Woman’s Aux-

of constructing a suitable residence for them.

A nurs-

iliary Board and then, in

ing superintendent and matron, hired a year later, quick-

1929, the New York Eye

ly staffed the infirmary with 19 qualified nurses who held

and Ear Infirmary Auxilia-

diplomas from a general hospital training school. Post-

ry, whose mission it was

graduate trainees were offered a weekly lecture course,

to beautify the parlor so

delivered by the infirmary’s visiting surgeons, house sur-

that “our nurses should

geons, and the nursing superintendent. After “faithful-

be given entire free -

ly” attending the course for four months and passing an

dom from the sights and

end-of-term examination, the trainees were awarded a

sounds during the time

New York Eye and Ear Infirmary postgraduate diploma.

when they are relieved of

vi

On the eve of the opening of the Platt Pavilion in 1901, six

their duties.”ix And beau-

student nurses were enrolled, with the goal of enlarging

tif y they did. Over the

the infirmary’s nursing staff to 25 and providing “nursing

next several years and

care at a higher level than ever before.”vii

with “ the comfort and

Plus, there was another advantage: Nurses ea-

happiness of the nurs -

ger to gain specialized credentialing were willing to ac-

es” uppermost in mind,

cept lower wages to advance their knowledge. Accord-

the committee rented a

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

piano, stocked the nurses’ library with 270 books, pur-

portion of the hospital building that had been ear-

chased a much-welcomed bathtub, and raised “sum-

marked for ward patients (and generating revenue) was

mer money to provide [them] with fruit and vegetables

converted to nurses’ rooms instead.xiii

and other small delicacies.” Arrangements were also

If plans for a new residence stalled, the sense of

made “…by which the nurses [could] buy their aprons at

urgency persisted. In the words of the leadership, the

a small outlay to themselves” or sew their own on a sec-

Nurses’ Home was “a necessity in order that the 42 hard-

ond sewing machine, donated by the Singer Manufac-

worked and faithful women may be properly housed and

turing Company.xi

the better the home comforts that surrounds, the better

x

1906–1945

the class of nurse.”xiv In 1911, a special appeal was made

and humanity...

“to the wealthy Hebrews of the city as over 60% of the [infirmary’s] beneficiaries are Hebrews.”xv But this effort also failed to raise adequate support. With the United

Generous as these amenities were, the “burning

States’ 1917 entry into World War I, the resulting nursing

question of…providing a Nurses’ Home of sufficient ca-

shortages, and the temporary suspension of the infirma-

pacity to the nursing department” continued to bedev-

ry’s Postgraduate Training School for Nurses, the project

il the infirmary’s leadership well into the first decade

was shelved. But as soon as peace was declared in 1918

of the 20th century.xii True, the broader and capricious

and the school reopened in 1921, the Nurses’ Home was

economic climate had stymied their original plans, but

back on the table, if only because recruiting efforts were

the nursing staff’s patience was wearing thin. Press-

faltering for lack of appropriate quarters.

ing forward, in 1908, the board restated its resolve to

Despite the board’s decision to postpone other

build a residential facility on land it already owned.

building projects in favor of the pressing need, nothing

Doing so would require

happened until 1927, when it was announced that “the

raising $110,000, plus

erection of the new building to house the Nurses’ Home

a

mainte-

and other additional hospital facilities will, in all proba-

nance fund, a hard les-

bility, start the coming year.”xvi,xvii But 1928 came and

son learned from the

went with nary a shovel of dirt turned. Then, almost out

temporary

of

of nowhere, all hopes were dashed on Black Thursday,

the Platt Pavilion some

October 24, 1929, the first day of the catastrophic stock

years prior. Following a

market panic that quickly brought the nation to its eco-

lackluster philanthrop-

nomic knees.

sufficient

closure

ic response, the house

Shortly thereafter, the board issued a restrained

occupied by the infir-

statement that read: “Work on the new building to house

mary’s

super-

the Nurses’ Home and additional facilities has been un-

intendent at 224 Sec-

avoidably delayed but it is very much hoped that during

ond Avenue was briefly

the coming year a definite plan can be adopted and work

considered as an alter-

on these much-needed improvements started.”xviii Their

native,

ultimately

call for “some good friends [who] will come to our aid

vetoed for lack of ad-

with funds for the erection of the new buildings which are

equate space. A small

greatly needed” rings achingly optimistic.xix

former

but

Yet, remarkably enough, between 1933 and 1934, with the Depression in full swing and no end in sight, the leadership opted for a stopgap solution to relieve the nurses’ overcrowded accommodations scattered throughout the hospital. In place of a new building, two infirmary-owned houses, located at 310 and 312 East 14th Street, were renovated and refurnished as living quarters at “considerable expense…[but] greatly relieved the former congestion of the nurses’ quarters.”xx This “most excellent housing,” along with shrinking the nursing shifts to nine hours, yielded immediate benefits.xxi That “the health of the nursing group has been good with small loss of nursing service due to illness” only served to confirm that the money had been well spent.xxii Further discussion of the new building was put on indefinite hold, but for the time being the infirmary’s nurses were wellhoused, a “pleasant and comfortable” buffer against the lean and troubled years ahead.

Left: the David M. Look Roof Garden for Nurses, 1909.

Above: nurses in 1893.

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New York Eye and Ear Infirmary

1911 “

…incremental but significant upgrades…”

NYEE 200: A VISION OF HOPE

(continued from page 63) Over the next several years, incremental but significant upgrades were made to the infirmary’s infrastructure. An antiquated ice machine was scrapped for an “ice box,” the entire building was rewired to comply with Fire Department regulations, modern telephones were installed from top to bottom, and a backup battery storage system was purchased to stabilize an iffy power supply. Nonnegotiable expenditures, such as the $2,000 outlay to alter the infirmary’s building to conform to the city’s plan to widen Second Avenue and a $14,000 expenditure to replace the infirmary’s aging plumbing system, did not stand in the way of purchasing up-to-date X-ray equipment which, in 1907 alone, “skiagraph[ed]…

4t h

AV E

NU

E

E1

ND

308

SE

CO

North Building (existing)

ST

ninety-eight patients, forty-eight of which showed RE

ET

foreign bodies.”17 During the same period, the infirmary reconfigured its space to accommodate an additional clinic room for the dispensary’s ear patients

310

and a new children’s ward, and to expand the Platt Pavilion. These improvements pushed some but not all 312

314

of Farrar’s other ambitious recommendations onto the back burner. By 1911, private patients accessed the infirmary via their own separate entrance, received treatment in a dedicated operating room, and recuperated in well-appointed rooms on the fourth floor remodeled for their exclusive use, all in the hopes that “the

South Building (existing)

increase of revenue will materially help towards the care and treatment of the poor.” 18 But typically, no sooner than a maintenance repair had been addressed, a ward expanded, or a private room spruced up, that the next set of “urgent” items bobbed to the top of the list: newer technical equipment, better-

E1

3t

hS

designed operating rooms, improvements to the dispensary, more administrative hires to vet and manage freeTR

EE

T

care patients, and the pressing need for a Nurses’ Home. Clearly, it was time to bite the bullet. Workarounds, making do, and interim fixes had kept the infirmary on track for years, but only a major expansion would give the institution room to breathe more efficiently and competitively. To that end, three contiguous lots at 310, 312, and 314 East 14th Street, adjacent to the existing infirmary property, were acquired. The final

Above: parcel map of the expanded NYEE site, 1916, showing today’s existing buildings.

Above right: the private patient entrance to the DuBois Pavilion, 1910.

parcel, located at 308 and purchased in 1916, created a plot measuring 80 feet x 100 feet, upon which “the new infirmary building may be erected.” 19

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1906–1945

One for the Road—to Hell!

DID YOU KNOW that in 1910, infirmary physicians working in the dispensary reported an unusual spike in the number of male patients who were blinded overnight?i Thanks to Dr. Emil Gruening, director of the infirmary and the first physician in the country to call attention to methyl alcohol poisoning, all 16 were promptly diagnosed but, sadly, none were reported to have regained their sight.ii The culprit: “white whiskey” or “Weisse Schnapps,” as it was called on New York’s Lower East Side at the time. Peddled in quantities as small as a dram (approximately 1/8 of an ounce), one shot of the home-brewed liquor could cause instant, permanent blindness, and sometimes death. In one account, “a man, who having been drinking for a week, sent his wife out one day to buy ten cents worth of whiskey at the southeast corner of Avenue B and 6th Street. Soon after drinking this ‘white whiskey’ the patient went blind and then died.”iii Fearing a wider public health crisis, Dr. E.L. Meierhof, another infirmary physician, alerted the New York City Health Department. Department Commissioner Dr. Ernst J. Lederle launched a full investigation and tracked down a total of 30 victims during the same period. Within days, a warrant was issued for two saloonkeepers, one on Avenue D and the other at two Rivington Street establishments. But no street vendors were cited, suggesting they may have vanished into thin air.

Clockwise from top left: the first X-ray room, 1905; the Pathology Department, 1915; the upgraded X-ray room, 1915; the Platt Pavilion contagious eye disease ward, 1916.

In another striking decision, and one that would prove indispensable in light of unforeseen future events, the infirmary established a Social Service Department in 1915, first headed by Florence M. Campbell, who resigned after a year to be married. She was replaced by her sister, Helen E. Campbell, also a social service worker, and one assistant. The department’s mandate was to prevent patients from regressing or becoming chronic and its

Wood (methyl) alcohol —complete with antidote instructions.

efforts were nothing less than groundbreaking and ambitious. According to Helen Campbell’s account in the infirmary’s 1916 Annual Report, her duties encompassed a wide range of services: from arranging home followup or securing settlement nurses to carry out treatment to seeing that patients returned to clinic at stated

...blinded overnight.

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

A Jefferson Descendant DID YOU KNOW

intervals. Activities such as providing medical supplies to patients who couldn’t pay, helping other agencies

WIKIMEDIA COMMONS

that one of the New York Eye and Ear Infirmary’s leading ophthalmologists was a great-great-grandson of Thomas Jefferson? Dr. Francis Wayles Shine, born in Orlando, Florida, in 1874, was the son of Captain Thomas J. Shine of the Confederate Army and Mrs. Virginia Eppes Shine, a Jefferson great-granddaughter. After earning a degree in medicine from the University of Virginia in 1898 and practicing briefly in Boston, Shine studied in Berlin and Vienna.

Upon his return to the United States, he completed his aural internship at the infirmary in 1904 and his ophthalmological internship in 1906. Following his training, Shine remained at the hospital, where he became an assistant ophthalmological surgeon in 1907, an assistant aural surgeon in 1908, an attending surgeon in 1917, and an executive surgeon in 1929. In 1939, he was appointed a consulting ophthalmic surgeon and served on the infirmary’s Board of Directors until his death in 1941.

Above: Dr. Francis Wayles Shine, 1950.

Left: Thomas Jefferson, circa 1787.

obtain necessary treatment for patients, and finding family assistance if a parent was hospitalized were also under the social service workers’ purview. They even assisted patients in finding employment, arranged dental appointments, paid for glasses and artificial eyes when needed, and referred blind patients to the Blind Association to learn industrial work.

What the new Social Service Department may have lacked in staff and resources, it more than made up for in know-how, networking, and ingenuity. Impressively, in 1916 alone, Helen Campbell and her assistant saw and advised 1,754 patients in their office; sent 95 children or adults to the countryside to convalesce; distributed 742 pairs of free glasses and 18 artificial eyes; sent 17 patients to other institutions, including Batavia Institute for the Blind, St. Roses Home for Incurable Cancer, Dyker Heights Home for Blind Babies, and Ray Brook Sanitarium, through Bellevue Hospital; and provided Christmas dinners for 25 needy patients. 20 Theirs was a comprehensive approach, limited only by dollars and cents and the lack of staff to make even more happen.  The Social Service Department, circa 1930.

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

69

1906–1945

HELPING HANDS

I

n the infirmary’s 1917 Annual Report, Helen E. Campbell, head of the Social Service Department, featured a summary of a postoperative follow-up visit that pro-

vides a glimpse of the medical and social challenges impoverished patients faced on a daily basis. Mabel G., a 14-year-old girl, had just been discharged from the infirmary after undergoing a cataract operation. The infirmary’s social worker climbed the dark tenement stairs to the family’s squalid two-room flat, only to find “…five small children. The mother had gone out to her office, leaving Mabel to do the house work. The father is a drunkard and at present not living with the famifor mother’s consent to send her [Mabel] to the country, which, later she gave readily. Furnished with clothes and rubbers and today she is to go to Chappaqua. i The

Ladies Auxiliary donated $25 to Mabel G.’s recovery.”ii How Mabel G. fared once she returned from Chappaqua is left unstated. But what can be said is that the infirmary’s stalwart Ladies Auxiliary and social workers did what they could to improve Mabel G.’s chances for recovery, as well as those of thousands of others caught in the vise of poverty and hopelessness.

The Ladies Auxiliary donated $25 to Mabel G.’s recovery.

Above: a New York tenement, circa 1917.

Below: children in the Look Sun Parlor, and the DuBois Childrens’ Eye Ward.

JACOB RI I S VIA WI KI M ED IA COM MON S

ly. Mabel needs convalescent care. Left word, asking

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LIBRARY OF CONGRESS

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

“OVER THERE”

W

1906–1945

ith the Great Conflict already raging in Europe, America experienced a boom, fed by a surge of patriotism following Congress’s formal declaration of war against Germany on April 6, 1917. As it turned out, gearing up for the distant battlefields would require sacrifices at home and “carrying

on” would pose substantial challenges. For one, the costs of medical supplies and some drugs escalated precipitously, in one case by 2,000 percent.21 For another, the infirmary was left shorthanded after a significant

number of employees, directors, interns, and nurses “joined the colors.” This included 28 physicians and surgeons who, “answering the call of their country,” enlisted or were drafted in 1917. 22 The board backed the effort, stoically stating, “While we miss them, the work goes on as usual.” 23 Other staff members signed up as volunteers under the banner of the Red Cross. Pressure on those who remained behind increased when, at the request of the United States War Department, a group of infirmary physicians were asked to form a special Medical Advisory Board to examine nearly 1,500 prospective recruits sent to the infirmary from draft boards across the city.24 Alarmingly, however, as the war effort escalated, the infirmary’s general running expenses, including food and energy costs, rose. Coal became scarce and expensive, although, according to an entry in the 1918 Annual Report, neither patients nor staff “suffered…inconvenience from the extreme cold weather.” 25 Painstaking efficiencies were put into effect to offset what turned out to be a $20,000, or 20 percent, increase in the infirmary’s overall operating budget in 1918. Although cost-cutting had shaved the deficit that year to “a wonderfully good showing” of $7,000, and even with the architectural drawings completed, plans to launch a $1 LIBRARY OF CONGRESS

million campaign to construct a new building were scuttled until further notice.26 In the pinch, some board members had opened their pocketbooks yet again to cover immediate repairs and equipment upgrades: Board President Lispenard Stewart purchased “battleship linoleum for two rooms and one ward” and Treasurer Lewis Iselin equipped the sterilizing room with all-new sterilizers. Funds were patched together to replace instruments and chairs in the dispensary, renew a part of the smokestack in the engine room, hire a file clerk to organize clinical histories, and install new plumbing on the sixth floor, “adding to the comfort of employees.” And money was found to purchase a “lungmotor…an apparatus which, when required for use, is needed in a hurry.” 27, 28 Along with other donations amounting to $20,667.10, a bequest of $1,000, and the $15,000 sale of the 121 Mercer Street property purchased in 1856, the infirmary’s 1918 books closed with $190.75 in the black. 29 That razor-slim margin spelled trouble.

In the shadow of war profiteering and financial rebound, the number of those who had fallen on hard times Above: The Breath of the Hun by W.A. Rogers, circa 1918.

Opposite: World War I field hospital.

continued to rise, adding considerably to the dispensary’s caseload. Even so, the leadership held firm on the limits of free care, based on the long-standing policy that the “Board of Directors intend that the infirmary

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

AN ENDLESS CHAIN LETTER

I

n 1916, Elisabeth Whitman, the head nurse at the New

American War Relief. Despite the earnest young nurs-

York Eye and Ear Infirmary, was approached by S.V.

es’ well-intentioned insubordination, neither the United

Clarke, a nurse employed elsewhere, and her friend,

States Post Office nor the New York Police Department

Winifred Lipscombe, who had an idea. The latter two

pressed charges against them, concluding that “the work

were struck by the news that Allied European hospitals

was for a good cause and that everybody connected with

were running low on anesthetics and valiant soldiers

it was worthy of respect and confidence.”

were suffering unnecessary pain as a result.i With the

purest of intentions, they decided to craft an “endless chain letter” to help rectify the shortage and, over Whitman’s objections, used her name and the infirmary’s address to add “stability” to the appeal. It read: Owing to the scarcity of anesthetics, operations

“Do not fail or the chain will be broken.”

which give untold agony are performed without their aid.

To mitigate the suffering, we make an appeal to everyone to give 25 cents to purchase chloroform to use in the “Hospitals of the Allies.” Please make four copies of this letter and send them to your friends, using the next highest number than this on each letter. Do not fail or the chain will be broken. Send 25 cents to Miss Elisabeth Whitman, Eye and Ear Hospital, Thirteenth Street and Second Avenue, New York City, New York.

Within days, letters containing quarters, pennies, and dimes were flooding the infirmary. Only then did the infirmary’s leadership become aware of the scheme and its endorsement was hardly forthcoming. But it was already too late: There was no way of putting a stop to more than 50,000 openhearted responses and the bushels of coins arriving daily. Whitman’s only alternative was to keep a meticulous account of the more than $5,000 in contributions, which she dutifully turned over to various organizations, including the British War Relief, the Red Cross, the Junior War Relief, the Needlework Guild, and the British-

Ernest Hemingway (at left) recovering from his wounds at an Italian hospital, 1917.

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72

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

“

1906–1945

shall not do its charitable work with borrowed money and therefore hope its friends will continue their support and enable them to carry on the good work.” 30 But “friends” were harder and harder to come by. As public

The Board of Directors intend that the infirmary shall not do its charitable work with borrowed money and therefore hope its friends will continue their support and enable them to carry on the good work.”

donations dwindled, nationwide appeals to assist the war effort, such as giving to Liberty Bond and Red Cross drives, surpassed all else. The choice was stark: Either cut back on free care or support it by chipping away at endowments and/or invested funds, risking bankruptcy. Such was the bind that many charitable institutions faced, including the New York Eye and Ear Infirmary.

In 1919, facing a citywide crisis, the New York Eye and Ear Infirmary banded together with 45 other voluntary, nonprofit general hospitals, special hospitals, and chronic convalescent facilities and tapped the nonsectarian United Hospital Fund to lead a $3 million appeal that would cover their aggregate deficits and be disbursed accordingly. 31 Membership in the fund was open to any hospital in Manhattan or the Bronx that was duly incorporated, had had at least 35 ward beds for the previous three years, and had provided no less than 5,000 days of free service during the same period. Above all else, there was strength in unity, or so everyone hoped. 

“THEIR SPIRIT LIVES WITH US FOR EVERMORE”

1919

A

fter these war-drenched years, America was primed to celebrate the November 11, 1918, armistice and eager to usher in what were later called “The Roaring Twenties.” By most popular accounts, these fizzy, exuberant times were saturated in daring and dash. Women won the right to vote, the Jazz Age

bloomed, and many reveled in a general uncorseting of morals and lifestyles. But darker forces were at work: Not everyone was guzzling bootlegged liquor in defiance of the newly ratified 18th Amendment, commonly known as Prohibition. Politically, an undercurrent of divisive sentiments—Catholic vs. Protestant, rural vs. urban, nativist vs. immigrant—was gaining traction. Nowhere were all these competing attitudes and contradictions more glaring than in New York City. By 1920, the city’s population had swelled to 5,620,048, of which approximately 40 percent were either first-generation immigrants or their children. For most of these New Yorkers, the postArmistice prosperity was as distant as their ancestral homes. 32, 33 Sobering as these statistics were, others

expressed restrained optimism. Among them was infirmary Board President John J. Riker, who, in the 1920 Annual Report, stated, “The New York Eye and Ear Infirmary with this year has completed its 100th fiscal year. We passed our century mark without any deterioration of our morale [and] have been generously and thoughtfully treated by our many and constant friends. [We] are about to start on our second century with the same confidence and hope that strengthened and heartened the founders and our predecessors in offices, that we would carry on to the end in alleviating and curing the troubles incidental to those all-important senses— sight and hearing.” 34 Words to inspire.

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

The Spanish Flu Epidemic of 1918 DID YOU KNOW

that the 1918 influenza pandemic— also known as the Spanish Flu—killed at least 50 million people worldwide, including approximately 675,000 who lived in the United States? i,ii Experts suggest that World War I’s massive troop movements and overcrowded barracks fueled the lethal contagion. Although the first outbreak in the United States has been traced to the spring of 1918 in scattered military camps and East Coast cities, the official news of the epidemic was kept under wraps for fear of undermining public support for the Great War. But after a second, virulent wave struck down hundreds at Boston’s Camp Devins and a nearby naval facility in September 1918, the alarming truth was uncontainable. From then on, the affliction spread like wildfire. By October, more than

100,000 Americans had succumbed. Following a brief lull, a third, slightly less grave wave of infection flared from early 1919 through the spring until the summer, when it finally subsided.

With anti-flu vaccines yet to be developed, doctors and public health officials had no other choice but to recommend first-line interventions: quarantine, good personal hygiene, and closures of public spaces. Some cities passed ordinances mandating face masks be worn on the street; others, like New York City, threatened to fine or jail anyone who failed to cover their mouths while coughing.

W I K I M ED I A C O M M O N S ( B OT H I M AG ES )

New York City… threatened to fine or jail anyone who failed to cover their mouths while coughing.

Above left: transporting flu victims.

Left: a vast improvised hospital during the epidemic, 1918.

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

“

...this always means a crowded clinic with distress and wretchedness on every hand.”

1921

1906–1945

Yet the word from the Social Service Department painted a more realistic picture. “A long period of unemployment seems facing us,” the entry stated, “and this always means a crowded clinic with distress and wretchedness on every hand. Food and warm clothing for little children must be provided and follow-up work among the newly discharged patients will probably be doubled.” 35 Because no one in need of an operation or glasses was turned away, the social workers were called upon to conduct an overwhelming number of investigations, the results of which were turned over to the registrar for free or partial-pay treatment. With only two trained social workers and an average of 570 office visits a day, a request was made for two more hires to help alleviate the crushing backlog and “increase the value of the infirmary to the community.” 36 Based on merits alone, the request was completely reasonable. But adding paid staff exceeded the infirmary’s budget. Instead, members of the Auxiliary’s Social Service Committee, largely composed of women of privilege who were seeking meaningful outlets for their abilities, filled the gap. These volunteers spent hours in the cramped Social Service Department’s office, vetting prospective candidates for free treatment and managing mounds of paperwork. Beyond the daily grind, they tapped their well-cultivated social contacts to forge alliances with other helping agencies, organizations, and potential benefactors. So indispensable and able was their service that the volunteers assumed full charge of the Social Service Department and the infirmary’s staff social workers in 1925.

The Social Service Department was not the only branch of the infirmary to experience explosive growth.

Pathology and Radiology Department records for 1921 tell the same story. 37 Tallies from the Pathology Department indicated that 9,749 items were processed, representing a 10 percent rise over the previous year, and that “lab methods are becoming more complicated and exacting and the time required to handle a given number of items” was increasing. Even after an assistant pathologist had been brought on board, the workload was still

The new NYEE Pathology Department, circa 1925.

overwhelming. Radiological services jumped as well over the same period to 2,958, more than 65 percent, owing, in part, to more “…exams of the nasal accessory sinuses in hope of determining the cause of obscure diseases of the eye.” Improvements were made to the building here and there, when possible, and on an as-needed basis.

But the area that chronically resisted a quick fix was the infirmary’s acute shortage of qualified nurses.

Although American Red Cross nurse volunteers filled in and “greatly relieved the pressure of work for the regular staff,” the leadership believed the answer lay in reviving the infirmary’s Postgraduate Nursing program, which had been suspended during the war. 38 Still, a major impediment stood in the way. Attracting the best candidates turned on the very thing the infirmary lacked and considered most urgent: a proper Nurses’ Home. This vexing problem moved closer to a solution in 1925 when the board disclosed, “We have saved during the past few years by various means a sum that lacks only about $200,000 of an amount sufficient

75

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

A Little Help May Be Far-Reaching

WIKIMEDIA COMMONS)

DID YOU KNOW

that Mrs. W. Emlen Roosevelt, chair of the New York Eye and Ear Infirmary Women’s Auxiliary and wife of the prominent New York banker William Emlen Roosevelt, first cousin once removed of President Theodore Roosevelt, penned an ardent plea in support of the infirmary, which was published in The New York Times? i

“With an average daily clinic of 689 wretched people, the Social Service Department of the New York Eye and Ear Infirmary, Second Avenue and Thirteenth Street, is struggling to find employment for the deaf and blind. Most of the men have been given work, but the wages are low. Compensation at the Light House, for instance, is only $8 per week, which will barely pay for a room and food. They need clothing; clean clothes often lead to a better job and always put fresh courage into the hearts of these handicapped people. If your readers could see the struggle these men make to be self-supporting, we feel sure they would be moved to help by sending old clothing to the Social Service Department of the infirmary, or one may telephone Stuyvesant 0851 and it will be called for. A little help may be far-reaching.”

— Mrs. W. Emlen Roosevelt, in The New York Times, April 24, 1923

to enable us to erect the absolutely necessary additions to our plant, on land already owned by us. We have not a mortgage of any description, have never made a drive, and do not intend to, so the only solution would seem to be that a friend or friends interested in our good work will help us in the early future.” 39 Two years later, in 1927, the infirmary announced that “the erection of the new building to house the Nurses’ Home and other additional facilities will, in all probability, start the coming year.” 40 But by 1928, another seemingly far more ambitious plan was in the works. Calling on “a friend or friends” for support had bloomed into a broader public appeal, with the formerly modest $200,000 funding goal revised upward to $2 million for “more wards, more clinics, more private rooms and a Nurses’ Home.” 41 The campaign fell short of its funding goals and the construction’s start date was postponed.

Eye operating room, 1920s.

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1906–1945

The Ties That Bind This twist of fate proved paradoxically advantageous. For scarcely a year later, on October 24, 1929, Wall Street’s stock market began its decline, triggering the Great Depression and the worst financial meltdown in United States history. Within a few short weeks, all bets were off, and not just temporarily. While no one in their wildest dreams could have imagined the eviscerating future, neither were they ready to succumb to their darkest fears. Putting the infirmary’s best face forward, Board President Dexter Blagden tentatively announced: “Work on the new building to house the Nurses’ Home and additional facilities has been unavoidably delayed, but it is very much hoped that during the coming year a definite plan can be adopted, and work on these much-needed improvements started.” 42 

1929

W I K I M ED I A C O M M O N S ( B OT H I M AG ES )

“

Work on the new building to house the Nurses’ Home and additional facilities has been unavoidably delayed…”

LIBRA

CONG RY OF

D I D YO U K N OW that on December 21, 1925, the Matilda Ziegler Matinee for the Blind hosted a special performance of “The Enemy” at the Times Square Theater for an audience of 1,200 blind theatergoers from the New York Eye and Ear Infirmary, the Home for the Destitute Blind, the Catholic Center for the Blind, the Jewish Guild for the Blind, and the Hospital for the Blind on Welfare Island? i Seated in the stage boxes were guests Helen Keller and Katherine McGirr, the deaf and blind daughter of the editor of the Matilda Ziegler Magazine for the Blind. The magazine, published in Braille from 1907 to 2014, was a monthly circular of general-interest articles sent through the mail free of charge by special provision of the United States Congress to every blind and vision-impaired person in the United States and Canada who could read Braille. The publication was the brainchild and devotion of the heiress Electa Matilda Ziegler, the mother of a blind son and the widow of the industrialist and Arctic expedition financier William Ziegler.ii

RESS

Above: Electa Matild Ziegler.

Left: her magazine for the Blind, published in Braille.

77

78

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

THE GIFT OF GIVING

W

hat better way to spend a Sunday afternoon than dispensing “kindly ministrations” to those infirmary patients in need of “cheering their

despondency?”i So believed the infirmary’s Committee of Ladies, formally organized in 1896 and first chaired by Mrs. George Hoffman. And what better way to enliven and uplift than through song? On Sundays, bandaged, recuperating patients gathered together to sing simple and familiar hymns, often led by Mrs. McEwen, an accomplished vocalist, accompanied by Mrs. Lander on piano. So encouraging was the response that the committee soon broadened its efforts to include reading to patients at their bedsides, sending flowers to brighten the wards, and distributing toys to the children. But why stop there when there when the need was so great and there was so much to accomplish?

By 1900, the Ladies Visiting Committee, as the or-

ganization was then called, was dropping in on recovering patients every morning, between the hours of 10 am

The Dispensary Waiting Hall, Christmas Eve 1917.

and noon. During the dreary winter months and especially around the holiday season, the ladies concentrated

ment Committee, which “experimented with jackets for

eling to the infirmary’s supplies and ensured the closets

their efforts on spreading cheer and delight. On Christ-

the men in the wards to wear over their pajamas” and rou-

were regularly inspected “to find order and cleanliness.” iv

mas Day, they made sure that a small evergreen, “pretti-

tinely collected and contributed a “goodly supply of in-

And the Entertainment Committee made sure Thanks-

ly decorated and with gifts for the children and fruit and

fant wear,” gingham dresses, “outing-flannel children’s

giving treats and assorted Christmas Day gifts were de-

flowers and candy for the adults, was carried through all

wrappers, and nurses’ aprons and bibs.” Or they could

livered to the right place at the right time so that “each

the wards.” Two years later, the work of the Women’s

join the Linen Committee, which had “the sewing room

child received a cornucopia or a toy, each adult a hand-

Auxiliary Board, as the Ladies Visiting Committee was

changed to sunnier quarters and the closets reconstruct-

kerchief prettily boxed, and everyone in the household

renamed, had split into subcommittees, each assigned to

ed” and stocked with new linens that were both “useful

was remembered with an orange.” v

specific tasks to upgrade the infirmary’s operations with

and ornamental.” iii Also available were the Nurses Com-

For the better part of the next two decades, the

practical as well as humanizing touches.

ii

fort and the Housekeeping Committees, whose members

Women’s Auxiliary Board was largely limited to the do-

Oversight was provided by the Executive and Fi-

took charge of providing such items as extra flower box-

mestic sphere within the infirmary’s confines. But in the

nance Committees. Members could sign up for the Gar-

es, two bathtubs, two dozen doilies, tray covers, and tow-

1920s, with formation of the infirmary’s Social Service Department, the eager members of the Auxiliary’s So-

“...each child received a cornucopia or a toy, each adult a handkerchief prettily boxed, and everyone...an orange.”

cial Service Committee took the opportunity to broaden their role by assisting the social workers in administrative and outreach tasks. Not only did auxiliary members lend a hand in taking and verifying patient financial applications—they would ultimately take over the department’s administration in 1925—they also ambitiously expanded the role of recuperative aftercare for hundreds of

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

needy patients, children, and adults.vi,vii The fundraising

department requests, such as that made by Audiolo-

events they promoted and underwrote allowed scores of

gy for the acquisition of a $50,000 Brain Stem Evoked

pediatric patients to be dispatched to fresh-air camps

Response instrument, the very latest technology that

for weeks-long stays to promote their recovery; mothers

measured a patient’s neurosensory disorders for visu-

with children were offered tickets for “a day’s sail away

al, neural, and auditory responses. x

eration with the Lighthouse for the Blind, also conducted hearing and vision screenings for prekindergarten through first graders, alerting school staffers to visual and hearing problems in the classroom. That the auxiliary maintained and managed all the money funneled

from the terrific [summer] heat,” up the Hudson River to

through its organization, Liebowitz believed, was one key

Indian Point and Bear Mountain.

to its success.

Lamentably, Liebowitz recalled, as the “old guard”

the members of the Women’s Auxiliary worked shoulder

retired, interest flagged and the next two auxiliary pres-

to shoulder with the Social Service Department’s staff to

idents served only a single term each. Despite their best

offer solace and solutions to patients under the crushing

efforts, the organization’s membership dwindled. Yet the

weight of need, desperation, and uncertainty. And when

vibrant legacy of the auxiliary endures. Across the many

the auxiliary women weren’t behind their desks or on the

decades and successive name changes—the Committee

working skills, and copious personal resources to further the infirmary’s good works. Whether they were hosting a 1935 Savoy Plaza fashion show modeled by that season’s “debutante-manikins” or

WIKIMEDIA COMMONS

Over the course of the Depression and World War II,

wards, they harnessed their elite social standing, net-

selling tickets to the 1943 St.

K TIMES N E W YO R

1906–1945

of Ladies, the Ladies Visiting Committee, the Women’s Auxiliary Board, the Women’s Association, or the Auxiliary of the New York Eye and Ear Infirmary—auxilians have been bound and unified through a singular calling: to give and reach out to those in need of help and healing. Looking back, the organization’s spirit of generosity

Timothy’s League’s National

During the 1980s and 1990s, Margaret Loeb

and warmth not only burnished the infirmary’s reputation,

Theater Party’s debut of Sid-

Kempner, a longtime member of the Board of Direc-

but also touched the lives of thousands—all for the better.

ney Kingsley’s play “The Pa-

tors and an ardent infirmary supporter, championed the

triot,” the Women’s Auxiliary

Auxiliary like few others.xi Inspired by Kempner’s devo-

always stood at the ready to

tion to the institution and their close friendship, Presi-

connect, support, and serve

dent Susan Liebowitz, whose tenure extended from 1984

the New York Eye and Ear

to 1992, breathed new life into the organization and its

Infirmary. viii,ix

Fund for Special Services and Special Department Re-

Documentation is scarce

quests.xii Most notably, Liebowitz revived the Spring Gala

regarding the auxiliary’s

in 1987, popular evenings such as Tap Dancing with hon-

activities after World War II,

oree Kitty Carlisle, cocktail parties in fellow auxilians’

but when NYEE President Gordon Braislin announced

homes, private museum tours, special luncheons, con-

plans to build a staff residence in 1969, the Women’s

tacts with United Nations volunteers, and theater events

Association (formerly the Women’s Auxiliary) was the

such as the “Legs Diamond” Grand Theater Benefit. Re-

first to step up, with a $19,000 lead gift, followed by

freshed, infirmary members supported a series of oppor-

a flurry of supporting events, including the 1971 Bicy-

tunity outreach programs, such as the training of autistic

cle Bash. The organization also sponsored a series of

and disadvantaged public high-school students for rota-

Career Days, aimed at introducing deaf and blind high-

tions through several of the infirmary’s nonmedical de-

school students to potential employment in the medi-

partments, and provided money to underwrite scores of

cal field. During the following decade, auxiliary activi-

special request projects, including a pediatric playroom

ty waned. But it still managed to contribute to specific

and a special private patient room. Members, in coop-

Left: debs for NYEE, 1940.

Center: Margaret Loeb Kempner.

Below: the NYEE Alumni Association Spring Dinner at the Biltmore Hotel, April 1961.

79

New York Eye and Ear Infirmary

W E R E H A P P Y D AY S R E A L LY H E R E A G A I N ?

NYEE 200: A VISION OF HOPE

I

n 1930, moviegoers across the United States crowded into darkened theaters to see the spirit-lifting film Chasing Rainbows. Many left humming “Happy Days Are Here Again,” its snappy theme song, which was to become a wildly popular anthem of hope as the Great Depression deepened. Despite a smattering of initial

forecasts predicting a rosier future, the sweeping downturn quickly took on bottomless proportions, most graphically on the streets of New York City. Whereas hobos, itinerant workers, and grifters had always been a part of the public landscape, confined largely to the Bowery and Skid Row, now everyday folk—lower- and middle-class men, women, and children—were out of work and homeless. Everywhere one turned, the makeshift shanties, soup kitchens, flophouses, and shelters were inescapable. According to one account, by early 1931, “70,000 breadline meals were served each day, at seventy-nine locations.” 43 Three years later, in 1934, New York City Mayor Fiorello LaGuardia stated that more than 400,000 families were dependent on public relief programs.44 Pummeled by poverty and deplorable health conditions, countless numbers turned to private and locally supported municipal clinics for relief. Although New York City’s Health Department had improved over the first decades of the new century, it, like other municipal social service organizations, was underequipped to deal with the multitudes who were down on their luck. The number of despairing and destitute who poured into the dispensary was staggering: patient visits leaped from 155,539 in 1930 to 181,347 in 1931 and need-based interviews surged 63 percent over the same interval.45, 46 Unexpected and “unusual” requests for emergency

relief prompted the auxiliary to cancel its annual Christmas party in favor of providing emergency relief for a broader base of patients, who received clothing, bedding, furniture, and Astor and Salvation Army food baskets. Milk was secured for 28 families through Mrs. Randolph Hearst’s Free Milk Funds. A blood transfusion was supplied to one patient and three months’ worth of Red Cross tuberculosis care was covered for another.47 To be sure, these gifts were lifesaving for the fortunate recipients, but poignantly inadequate in light of the thousands at a loss for basics. With the dispensary’s resources taxed beyond bursting, revenues from hospital

EDIA

COMM

ONS

admissions and extended private patient stays fell precipitously with “the hard times, as people hesitate to go

WIKIM

80

to the hospital until absolutely necessary.”48 Predictably, the infirmary was only one of thousands of hospitals locally and nationwide that were under duress. In 1933, officials of New York’s United Hospital Fund published an impassioned public appeal to help shore up the aggregated $4.5 million annual deficit of its 56 affiliated voluntary hospitals, of which the New York Eye and Ear Infirmary was one. 49 Never in the fund’s history had its members “been faced with a task so momentous nor a financial situation so acute.” 50 None of these institutions shared in federal, state, or city relief funds, yet they were required to treat “public charges” at less than cost, under the city’s rulings. It was truly

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1906–1945

a double bind, considering how many people were destitute, unemployed, or skidding into abject poverty. “We are still facing the conditions of unemployment discouragement,” Blagden commented somberly, “and a general letdown that is bound to have its reaction after a long and continued depression.” 51 The Depression ground on, descending to more menacing depths. Expectations of a quick turnaround tumbled along with future plans. With no end in sight, the infirmary’s leadership imposed additional salary cuts and strict “efficiencies” institutionwide. Each competing cost, each line item, from incidental to major, was weighed with great deliberation. Tellingly, the infirmary’s determined staff met these austerity measures with resourcefulness that kept the infirmary abuzz, belt tightening or no. Two examples from the Pathology Department illustrate this spirit. When, in 1932, Dr. Bernard Samuels’s Eno Laboratory holdings increased by 356 specimens, he opened its doors to eight “externs” from across the country who, “through service, [were] able to repay in a measure for the time and pain spent in their training,” under the seasoned guidance

1933

WIKIMEDIA COMMONS

Above: a bread line in Chicago, 1932.

Below: the Eikonometer in use, 1934.

of the infirmary’s Dr. Edgar B. Burchell and Helen Meyer. 52 Building on the infirmary’s widely renowned repository of more than 60,000 microscopic slides, Samuels also initiated an innovative lecture series entitled “Histopathology of the Eye,” attracting house staff as well as drawing specialists from Brooklyn Eye and Ear Hospital; Manhattan Eye, Ear, Nose, and Throat Hospital; Lenox Hill Hospital; Bellevue Hospital; Mount Sinai Hospital; and Presbyterian Hospital. Adding to this, 92 courses and practicums sponsored by the infirmary’s School of Ophthalmology and Otology and a Board of Surgeons’ evening lecture series were offered during the same year, invigorating the infirmary’s corridors, laboratory, and lecture rooms with the lively exchange of ideas and possibilities.

Depression or no Depression, the New York Eye and Ear Infirmary refused to stand still. In 1933, Dr. Conrad Berens opened the Orthoptics Clinic and, in 1934, breaking more new ground, the Executive Committee recommended that the board establish “Nose and Throat Department at a cost, including the re-equipping of the Ear Department, not to exceed $10,000 and to be as much less as Dr. Ruppe and Dr. Saunders agree.” 53 Dermatology and Bronchoscopic clinics were also set up and a dentist, Dr. Kenneth F. Chase, began seeing patients in a room set aside for dispensary and ward patients. The Aniseikonia Department, equipped with New York City’s first eikonometer, and the Department of Motor Anomalies clinics opened the same year. By 1935, Berens had established a School of Orthoptics in the Eye Department, the first of its kind in the United States dedicated to training physicians to evaluate and treat problems of the eye muscles and double vision.54 An Allergy Clinic was added to the infirmary’s roster of services in 1936, followed by a Photographic Department in 1938. Intent on incorporating technical photography into the infirmary’s diagnostic tool kit, the Board of Surgeons hired Dorothy Delano, the department’s first full-time technician, in charge of creating images

81

82

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

NYEE INQUIRING MINDS Dr. John Martin Wheeler

Dr. F. Phinizy Calhoun

Dr. John Martin Wheeler, the noted oculoplastic and or-

Dr. Phinizy Calhoun was born in 1879 to parents whose

bital surgeon, earned his Doctor of Medicine in 1905 and

families were among the first settlers of Georgia.vi His

Masters of Science degree in 1906 from the University of

grandfather, Dr. Ferdinand Phinizy, was a founder of

Vermont, where he also taught anatomy until 1907. But he

the Atlanta Medical College (later, the Emory School of

discovered his true calling at the New York Eye and Ear

Medicine) and his father, Dr. Abner W. Calhoun, was the

Infirmary, when, as an ophthalmological intern, he was

first eye-and-ear specialist in the southeastern United

singled out for his innovative mind and meticulous surgi-

States. vii F. Phinizy Calhoun graduated from the Univer-

cal dexterity.

1879-1938

1879-1965

In 1908, Wheeler joined the private prac-

sity of Georgia in 1900, attended Harvard for a year, and

tice of Dr. D.W. Hunter and refined a less risky surgical al-

then earned a medical degree at the Atlanta Medical Col-

ternative to a technique developed by his mentor that first gained widespread attention

lege of Physicians and Surgeons in 1904. After interning at Grady Memorial Hospital in

in the British Journal of Ophthalmology. In effect, Wheeler represented the next gener-

Atlanta, he traveled north, to the New York Eye and Ear Infirmary, to complete his resi-

ation in the long line of gifted NYEE surgeons, descending from Rodgers who “taught

dency training in ophthalmology in 1908. He then went on to postgraduate study in Vi-

Noyes, who paved the way for Weeks in plastic surgery…” iii Weeks, in turn, drafted

enna. Upon his return to the United States, he joined his father’s Atlanta ophthalmol-

Wheeler as his assistant surgeon, then senior assistant surgeon, until Wheeler became

ogy practice. After his father died in 1910, Calhoun assumed his father’s chair as head

an attending surgeon in 1919.

of Emory University’s Department of Ophthalmology from 1910 to 1937 and his position

i,ii

As a member of the medical corps in World War I, Wheeler had cared for blind-

as chief at Grady Hospital and Wesley Memorial Hospital, now Emory University Hos-

ed and disfigured veterans and was drawn to the field of plastic surgery, a specialty

pital. He established a lectureship at the University of Georgia in honor of his grandfa-

to which he contributed many landmark papers upon his return to civilian practice. Al-

ther, and his family created and endowed the medical library as a memorial to his father.

though his devotion to the New York Eye and Ear Infirmary took many forms and con-

Among his many professional affiliations, Calhoun served as the president of the newly

tinued throughout his entire life, he was also a visiting surgeon in charge of the oph-

founded Association for Research in Vision and Ophthalmology in 1929 and president

thalmic service at Bellevue Hospital from 1925 to 1928, after which he became the first

of the American Ophthalmological Society in 1941.

director of the Edward S. Harkness Eye Institute at Columbia University’s Department of Ophthalmology in 1932.iv,v His much-publicized treatment of the King of Siam in 1931 earned him the Order of the Cross of Siam and instant “celebrity doctor” status in the United States. Despite the fame, however, Wheeler chose to reduce his private practice to spend more time teaching postgraduates. Ironically, he is said to have diagnosed himself with ocular melanoma based on a shadow he noticed while playing on the golf course which, when confirmed, ultimately necessitated the removal of his left eye. Nevertheless, over the next three years, he continued to serve as the director of the Institute of Ophthalmology, as well as a consultant to nearly a dozen other hospitals in the New York and New Jersey area until the time of his death in 1938.

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1906–1945

Dr. Harvey James Howard

Dr. Conrad Berens

American-born Dr. Harvey James Howard, a descendent

Dr. Conrad Berens, the son of a well-known Philadel-

of the Duke of Norfolk, was as famous for his adventurous

phia ophthalmologist of the same name, was a world-

life as he was for his contributions to ophthalmology.viii

renowned ophthalmologist in his own right. Berens grad-

After he graduated from the University of Pennsylvania

uated with a degree in medicine from the University of

with a medical degree in 1908, he became a resident at

Pennsylvania in 1911, where he interned in medicine and

the New York Eye and Ear Infirmary from 1909 to 1910

surgery for two years.xi In 1913, he took his residency as

and was then recruited to head the Ophthalmology De-

a house surgeon at the New York Eye and Ear Infirmary,

partment at the University Medical School, Canton Chris-

graduated in the class of 1915, and continued to be as-

tian College, in Canton, China. When he returned to the

sociated with the institution throughout his professional

United States five years later, he won a Rockefeller Foundation Scholarship and attend-

life. In addition to consulting for 10 other hospitals in the New York area, he became a

ed Harvard University, where he studied ophthalmologic pathology, specializing in con-

lecturer in the New York Eye and Ear Infirmary’s School of Ophthalmology and Otology,

genital abnormalities of the eye.ix During World War I, he served as a captain in the Unit-

professor of Clinical Ophthalmology in the New York University Postgraduate Medical

ed States Army, where he codeveloped the Howard-Dolman stereoacuity test, used to

School, and, finally, advisory attending surgeon, consulting pathologist, and consultant

evaluate potential military aviators. When he completed his duty, he returned to China in

to the New York Eye and Ear Infirmary’s Research Department, which he established. In

1917 to head the Department of Ophthalmology at Union Medical College in Peking (now

1933, Berens opened the infirmary’s first Orthoptic Clinic. Two years later, in 1935, he

Beijing), where he organized the first teaching program. It was during this period that

and orthoptists Elizabeth K. Stark and Ethel Mueser also established the first School of

Howard, who was fluent in Chinese, attended Pu Yi, the boy emperor residing in the For-

Orthoptics in the United States.

1880-1956

1889-1963

bidden City, who is also known as the Last Emperor. After a yearlong sabbatical (1923 to

His abiding connection to military service began as a First Lieutenant in the U.S.

1924) as a University of Vienna Fellow, he returned to Peking, only to be kidnapped with

Army Medical Corps during World War I. Following his return to civilian life, he became

his 11-year-old son by Manchurian bandits. Held for a $100,000 ransom, Howard and his

one of the founders of the Research Laboratories for Aviation, later to become the

son “escaped” after 10 weeks, allegedly because he was fluent in Chinese and had suc-

School of Aviation Medicine. During World War II, he served as a national civilian con-

cessfully treated his captors’ minor ailments. Details of this harrowing ordeal were viv-

sultant to the Air Surgeon and, later, to the U.S. Air Force Surgeon-General. Berens

idly captured in the wildly popular book Ten Weeks With Chinese Bandits, published in

also poured his seemingly inexhaustible energy into the founding of the Association

1926. After that, Howard was offered an appointment as Washington University School

for Research in Vision and Ophthalmology and the Pan-American Association of Oph-

of Medicine’s first chair of the Department of Ophthalmology and he and his family head-

thalmology, of which he became the first secretary and second president, from 1950 to

ed back to the United States in 1927. By 1934, Howard had resettled in St. Louis and

1952. He also co-established the New York University Bellevue Medical School’s first

launched a private practice. From 1931 to 1948, he served as the medical director for the

successful graduate courses in ophthalmology. He also held scores of prominent roles

Missouri Commission for the Blind.

in the field’s most prestigious organizations, foundations, councils, committee, associ-

x

ations, and societies, including vice-president (1927) and president (1949) of the American Academy of Ophthalmology and Otolaryngology and president of the American Ophthalmological Society (1953). In addition, he was a prolific contributor to the field, as the editor of The Eye and Its Diseases (1936) and coauthor of six other well-known textbooks.

83

84

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

INQUIRING MINDS, continued Dr. Algernon B. Reese

Dr. Bernard Samuels

Dr. Algernon B. Reese was born in Charlotte, North Car-

Dr. Bernard Samuels was born in Front Royal, Virginia,

olina, the grandson of a Virginia physician and son of a

in 1879 and traced his distinguished roots from pre-Rev-

pharmacist father and mother from a prominent North

olutionary ancestors through his grandfather, who be-

Carolina family.xii In 1921, Reese was awarded a degree in

came a member of Congress and a Justice of the Su-

medicine from Harvard University and, in the same year

preme Court of Appeals of Virginia.xiii As a young man,

and again in 1925, served as extern at the Allgemeines

he was educated at Randolph-Macon Academy, spent a

Krankenhaus, a prestigious hospital in Vienna. In be-

year at the University of Virginia, and earned his med-

tween, he spent two years in general surgery at New York

ical degree in 1907 from Jefferson Medical College in

City’s Roosevelt Hospital and was a pathology resident

Philadelphia. After an internship at St. Mary’s Hospital in

at the Massachusetts Eye and Ear Infirmary. He took a second pathology residency

Pueblo, Colorado, he studied in Vienna under the legendary Fuchs. During World War I,

the New York Eye and Ear Infirmary and was a member of the Class of 1925. Reese en-

he was stationed in France, where he served as a major in the United States Army.

tered private practice at this time and, after also serving on the staff of Cornell Univer-

Upon his return to the United States, he became associated with noted New York eye

sity Medical College, he became an attending ophthalmologist and clinical professor at

surgeon (and Algernon Reese’s uncle) Robert G. Reese. Samuels joined the New York

the Vanderbilt Clinic and Presbyterian Hospital and Columbia University’s Institute of

Eye and Ear Infirmary staff as a pathologist in 1919, became an attending surgeon in

Ophthalmology. There, he organized the Department of Ocular Pathology, now known

1930, and remained on the staff until his resignation in 1946. His decades-long com-

as the Algernon Reese Pathology Laboratory.

mitment to developing the infirmary’s superb Eno Laboratory earned him and the fa-

1896-1981

1879-1959

Over the course of his long career, Reese made significant scientific contribu-

cility worldwide recognition. Closer to home and early on, he unrelentingly lobbied the

tions to the field of ocular oncology, most notably related to the recognition, classifi-

infirmary’s Board of Directors and Board of Surgeons to formulate plans for a new infir-

cation, diagnosis, and treatment of retinoblastoma, as well as research into retrolental

mary, but he did not live to see the fruits of his labors, as the new North Building did not

fibroplasia and classifications of ocular melanomas. He authored more than 200 sci-

open until 1968. Nevertheless, “the seeds were well-planted,” according to his friend

entific papers and numerous textbook chapters and is best known for his book Tumors

and colleague Dr. Gerald B. Kara.xiv

of the Eye, published in 1951, 1962, and 1976. In addition to his service on many com-

Prior to and throughout his association with the infirmary, Samuels also held po-

mittees, he served as the president of the American Academy of Ophthalmology and

sitions at Cornell University Medical College, first as a clinical instructor in 1914, then

Otolaryngology (1954-1955), president of the American Ophthalmology Society (1960),

assistant professor in 1922, and as a full professor in 1927 until his retirement in 1942.

and president of the American Board of Ophthalmology. In recognition of a lifetime of

In addition to consulting for several other New York area hospitals, he also was an at-

contributions, he received many honors and awards, including the Howe Medal from the

tending surgeon at New York Hospital from 1932 to 1942. Samuels was a prolific lec-

American Ophthalmological Society (1950), the Proctor Award of the Association for

turer, author, and contributor to the scientific literature in both ophthalmology and pa-

Research (1958), and the Prize Medal from the American Medical Association (1961).

thology, beginning with his first article, “Epipapillary Tissues” (1931), to his last, titled “Cataract Complicating Glaucoma” (1946). He founded the Institute of Ophthalmology of the Americas and was also a history buff, known for meticulous accounts of the early development of the New York Eye and Ear Infirmary and the in-depth profile of one of its founders, Dr. Edward Delafield. In addition to a long list of professional societies and associations to which he belonged and participated, Samuels devoted time to the American Ophthalmological Society (AOS) beginning in 1926, when he became a member.

He was the editor of the organization’s Transactions from 1932 to 1942, the society’s president in 1949, and recipient of its Howe’s Medal in 1956, and regularly represented the AOS as a delegate to the International Council of Ophthalmology, starting in 1951.

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1906–1945

for “the increasing number of plastic operations done by the Eye Department…and penetrating the opaque corneas to prognosticate possible results in corneal transplants.” 55 The images were so useful that by 1939,

“

Delano was routinely filming “many moving pictures of operations [of] unusual cases.” 56 Funds also were found for the Social Service Department to up its staff from three to eight. One full-time

No budgetary stone

social worker was assigned to the eye clinics; one to the ear clinics; one covered all of the specialty clinics—

was left unturned.”

medical, diabetic, dermatology, neurology, dental, radium, and bronchoscopy; two worked the wards; and three served as administrative assistants.57 Yet even with more hires, how the social workers managed is a wonder.

In 1938, the department’s caseload exceeded the previous year’s intake by 12,809, and that increase nearly doubled to 28,400 in 1939.58, 59 Hopes were that the newly created Admitting Office, outfitted with an up-todate card system to track case histories, purchased at a cost of $2,200 per year, would be money well spent to manage the seemingly endless crush of applicants.60 No budgetary stone was left unturned. Behind the scenes, the Housekeeping Department’s critical services were reorganized with a particularly sharp eye trained on economy and efficiency. 61 The laundry staff was

1938

trimmed to include “a laundry man and a male helper…[which] has brought about smoothness and dispatch.”

The Linen Room that tailor-made and maintained all the supplies for the operating rooms, laboratories, kitchen, and wards—as well as “the sash curtains throughout the hospital”—became the sole responsibility of two full-time seamstresses, with the occasional assistance of an assistant housekeeper. The Dietary Department’s old coal stove was replaced with a modern gas range and baking unit, streamlining the preparation of 250 meals daily based on three distinct menus—one for the staff and private patients, another for the nurses and semiprivate patients, and a third for the ward patients and “the help.” 62 Targeting food costs, the kitchen installed an “electrified” ice box, “aiding considerably in the storage of perishable foods.” 63 Other efforts to bring the hospital’s budget more in line with expenditures included “raising the semiprivate rates from $4.00 to $4.50 and clinic charges for return visits from 25 cents to 50 cents.” 64 And the money from the sale of the infirmary’s property at 113 Norfolk Street in 1937 was added to the coffers. 65, 66 All of these proceeds were welcome. But much would have gone unfulfilled were it not for the infirmary’s circle of longtime benefactors, individuals and staff alike, who saved the day. The generosity of the School of Ophthalmology and Otology funded the addition and equipping of a new operating room. A $1,000 gift from Dr. John Elmer Weeks made it possible to convert a portion of the sixth floor into a library and a large lecture room, close to the museum and newly established surgeons’ lounge. The “John E. Weeks Lecture Hall” or “Great Hall,” as it was known, soon became the infirmary’s educational epicenter. Between Board of Directors

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A DVA N C I N G O P H T H A L M O L O GY I N T H E A M E R I C A S was formed to support and expand the PAAO’s mis-

and Board of Surgeons meetings, ongoing seminars,

sion, which includes prevention of blindness through

practicums, and courses, and a newly inaugurated

the promotion of medical science, education, and training through, among many activities, grants, loans, and fellowship programs; residency training programs; vis-

given at the Manhattan Eye and Ear Hospital and

iting professor programs; and basic science and clinical

the Presbyterian Eye Institute, the Great Hall was

courses. Today, the PAAO, through its 26 affiliated na-

regularly filled to overflowing. 67

tional societies, represents more than 25,000 ophthal-

I

n 1939, World War II erupted in Europe, forcing the cancellation of that year’s International Congress of Ophthalmology. Drs. Harry S. Gradle of Chicago and Mo-

acyr E. Alvaro of São Paulo, approached the Council of the American Academy of Ophthalmology and Otolaryngology with an idea. Given the shrinking and increasingly risky opportunities for collegial exchange, the time was ripe, they proposed, to form an international forum based in the Western Hemisphere to promote the exchange of the rapidly advancing scientific views and information in

evening lecture series that merged with the ones

mologists worldwide collaborating with a wide network

Strained as pocketbooks were, adding comforting

of partner societies, nongovernmental organizations,

touches to humanize the hospital experience did

and individual members to further its aims. It is recog-

not fall completely by the wayside. Each gesture

nized by the International Council of Ophthalmology as the representative body of ophthalmology in the Amer-

of kindness made a difference. Thanks to the

icas, Spain, and Portugal. In the words of Dr. Fernando

“liberality” of Mrs. John W. Cutler, every infirmary

Arevalo, PAAO’s current president, “The goal is to cre-

ward received radios. Mrs. Lyman Delano and Mrs.

ate the opportunities for our young ophthalmologists to

Samuel Riker Jr. stocked the fiction library, reserved

become our future! And that future is great if we keep building and supporting our Pan-American community!”

these fields. The council enthusiastically embraced the

for private patients. And the fifth and sixth floor roofs were landscaped and furnished, compliments of Mrs. George Emlen Roosevelt as a memorial to

plan and set up a committee chaired by Gradle, Alvaro,

her aunt, Leila Roosevelt Reeve-Merritt. When the

and the New York Eye and Ear Infirmary’s Dr. Conrad Be-

adult wards were entirely refitted with modern

rens. They coordinated the first Pan American Congress of Ophthalmology, held at the Hotel Cleveland, in Cleve-

hospital beds, those designated for the semiprivate

land, in October 1940, following the annual meeting of

and private rooms were all donated, as were the sets

the American Academy of Ophthalmology and Otolaryn-

of new cribs, tables, and chairs that freshened the

gology. First-time attendees included 240 ophthalmolo-

Children’s Ward. 

gists from the United States and 25 from Latin America, most of whom traveled by ship for 12 to 20 days to reach the Atlantic seaboard, then boarded a train for the more than half a day it took to reach Cleveland.

Twins in the Children’s Eye Ward, circa 1935.

Distances, it turned out, were far from the only hurdle. Long before simultaneous translations were available, language barriers complicated matters even further. However, solutions were forthcoming, and no sooner had the Pan American Association of Ophthalmology (PAAO) come into being than its professional and scientific reach became unstoppable. In 1959, the Pan American Ophthalmological Foundation (PAOF)

PA A O

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1906–1945

DR. EDGAR B. BURCHELL 1872-1960

T

he distinguished and unlikely career of Dr. Edgar

Burchell enlisted and became an orderly to Dr.

Brower Burchell, renowned New York Eye and Ear

Walter E. Lambert, the infirmary’s Ophthalmic Chief, af-

Infirmary bacteriologist and serologist, evolved

ter the declaration of the Spanish-American War in 1898.

under the most unusual of circumstances.i,ii Born in 1872

When he returned from Cuba, he set his sights on learn-

into a poor family on New York City’s Lower East Side,

ing bacteriology, and through Dr. Robert G. Reese was

Burchell was forced to leave grammar school to help

sent to Vienna, where he mastered the preparation of

support his mother after his father, a carpenter, died.

specimens of the eye, temporal bone, and accessory si-

He first worked as an apprentice to a jeweler and then,

nuses in the famous laboratory of Drs. Maximilian Salz-

at age 16, was hired as a porter in the infirmary’s busy

mann and Ernst Fuchs. Back at the infirmary, Burchell

Eno Laboratory, cleaning test tubes and other equipment

became a technical resource for and instructor to the in-

for $17 a month. Unbeknownst to his employers, Burchell

firmary’s doctors. When King Prajadhipok of Siam came

was a keen observer with a voracious appetite for self-

to the United States for an eye operation, Dr. John M.

education. Left alone after hours to clean up the laborato-

Wheeler recommended that Burchell serve as a con-

ry, he began to practice the experiments he had seen and

sulting pathologist on the case. Burchell also assist-

even salvaged an old copy of Gray’s Anatomy, from which

ed Weeks in isolating the Koch-Weeks bacillus and Dr.

he quietly learned about the eye, ear, nose, and throat.

George Sloan Dixon in the X-ray localization of foreign

How Burchell’s hidden abilities came to the attention of

bodies of the globe. Burchell is credited with conduct-

Dr. John E. Weeks is undocumented, but his talents were

ing early experiments with snake venom in ophthalmolo-

such that he was soon promoted to laboratory assistant.

gy, joined the esteemed pathologist Dr. Bernard Samuels on lecture tours worldwide, and was one of the original instructors of bacteriology at the New York University Medical School.

A Passion for Pathology

In 1934, Burchell was awarded an honorary Doctor of Science degree from Roanoke College in Salem, Virginia. Henceforth, he was referred to as “Doctor,” despite his lack of a high school, college or medical degree.

Over the course of his 60-year career at the infirmary, he achieved great prominence and professional respect throughout the United States and abroad. In 1944, at age 73, Burchell was formally made the first Honorary Member of the American Academy of Ophthalmology and Otolaryngology and the first to be so designated withWIKIMEDIA

out an MD degree. Burchell died in 1960, but the physical legacy of his life’s work—500 impeccable preparations of the temporal bone and accessory sinuses, the

COMMONS

basis of the infirmary’s Temporal Bone Laboratory, and more than 100,000 meticulously stained sections of the human eye—remain sterling examples of one man’s remarkable pursuit of advancing scientific knowledge.iii

Above: Dr. Edgar B. Burchell.

Below: Burchell with his assistants, circa 1940.

Left: A first edition of Gray’s Anatomy.

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NYEE 200: A VISION OF HOPE

WIKIMEDIA COMMONS

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1941

A PIVOT POINT

B

1906–1945

y the end of the decade, hostilities were heating up across Europe with the Nazi invasion of Poland in September 1939 and the declaration of war against Germany by France and Great Britain a few days later. In the United States,

newsreel clips of bloody battles such as the siege of Warsaw, the Saar offensive, and the Japanese-Chinese conflict flashed across movie house screens. Unsettling as these images were, Americans remained more worried about the Depression; their struggles to feed and care for their families were far more immediate and life-threatening.

Although President Franklin Delano Roosevelt’s Works Progress Administration (WPA) had made gains since its 1935 start, much remained to be done. The agency had steadily secured jobs and subsistence wages for millions of the unskilled unemployed—primarily men, but some women and youth—largely through federally financed national public building programs. 68 Notwithstanding the

recession of 1937 to 1938, the nation was gradually getting back on its feet.

Whatever the looming global threats to peace, the danger still seemed an ocean away, kept at bay by the prevailing winds of isolationism. But not for long. The fall of France to Germany’s Nazi armies in June 1940 was a grim harbinger of invasions to come. 69 Within months, the United States Congress passed the Selective Training and Service Act, requiring all men ages 21 to 45 to register for the draft, and qualifying infirmary nurses and doctors began joining up. And then came December 7, 1941, and the Japanese surprise attack on Pearl Harbor, followed by the United States’ declaration of war against Japan the next day, which only

WIKIMEDIA COMMONS

accelerated staff shortages. On December 10, 1941, the infirmary’s Executive Board issued the following recommendation to the Board of Directors: “In view of the fact that war is taking, and probably will continue to take, a great many of our younger doctors, the matter of changing the By-Laws to allow the Board of Directors at their discretion to extend the period of service of any surgeons beyond the present age limit, during the time of an emergency was discussed, and it was decided to ask the Board of Directors for such a change in the By-Laws.” 70, 71 Determined to preserve the infirmary’s high standard of care, those who remained put in longer hours with no extra pay. Everyone pulled together. After all, there was a war to win.

Defense spending for military preparedness poured into the U.S. economy, all but eliminating unemployment in many areas of the country. Production of wartime provisions and arms, as well as consumer goods, shifted into high gear as shipyards and airplane factories sprang up seemingly overnight. Whereas 17.2 percent of the nation’s workforce had been unemployed in 1939, less than 9 percent were without jobs by 1941. 72 Yet,

Opposite: the battleship Arizona in flames, December 7, 1941.

regardless of the turnaround, many were still stuck in the Depression’s demoralizing grip. 73 Contrary to assumptions, New York City’s recovery lagged and “unemployment actually increased…even as it evaporated elsewhere.” 74 As a result, the infirmary was busier than ever and running at close to full capacity.

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NYEE 200: A VISION OF HOPE

DR. JOHN ELMER WEEKS 1853 -1949 “Dr. Weeks was a man of singular determination and in-

Weeks came to the N ew

dustry, and an unusually dexterous operator, with sound

York Eye and Ear Infirmary in 1890

in 1920 and five years later moved to

judgement; his quiet self-assurance and an infinite ca-

as “curator and pathologist” and

Portland, Oregon, where his close as-

Weeks left the infirmary staff

pacity for work made him the successful practitioner

established an up-to-date labora-

sociation with Dr. Kenneth C. Swan

that he was during his 38 years that he practiced in New

tory in the infirmary’s new building

helped to shape the founding of the

York.”

i

in 1894. Later that year, he invit-

University of Oregon Medical School’s

ed Dr. George A. Dixon, also a pa-

Ophthalmology

thologist, to become his coworker,

became the Casey Institute of the Or-

and together they created the in-

egon Health and Sciences University

iii

— Dr. Arnold Knapp

Dr. John E. Weeks’s long career in ophthalmology began when he graduated from the University of Michigan with a medical degree in 1881.ii After a year of general practice in Pennsylvania and New York, he became an intern at New York’s Work Hospital in 1882 and then a resident at the New York Emigrant Hospital in 1883. Following this residency, Weeks received intensive training in ophthalmology under Dr. Herman Knapp at the New York Ophthalmic and Aural Institute, first attending the Outpatient Department, then as a resident from 1884

Department

(which

firmary’s first X-ray department, in

in 1944). Weeks’s financial contribu-

a small room on the fifth floor, ad-

tions were instrumental in establish-

jacent to their laboratory. In 1904,

ing a library, auditorium, and binocu-

using

technolo-

lar vision clinic there. He also funded

gy, the two physicians developed

a scholarship to support ophthalmolo-

early

imaging

“Wherever the competition is the keenest.”

to 1886, and finally as an assistant surgeon from 1887 to 1889. Working in the Institute’s laboratory, he codiscovered the Koch-Weeks bacillus, the organism responsible for contagious epidemic conjunctivitis, commonly known as “pink eye.” His tenure at the Institute coincided with two other positions: one as chief of New York University Medical College’s Department of Ophthalmology clinic from 1886 to 1889 and a second at the College of Physicians and Surgeons from 1888 to 1890. In 1890, Weeks

joined

Bellevue

Hospital Medical College, first as a lecturer of Ophthalmology, then as professor of the same in 1900; 21 years later, he was named Professor Emeritus. From 1901 to 1921 he was head of the New York University Medical College’s Department of Ophthalmology.

a technique to detect foreign bodies in a patient’s eye.

gy research at the University of Michigan Medical School,

In that year alone, they performed 198 X-ray examina-

his alma mater. In acknowledgement of his many contri-

tions and 11 radium treatments. Later, Dixon refined the

butions, Weeks received an honorary Doctor of Science

accuracy of this procedure, which became known as the

degree from the University of Michigan Medical School

Weeks & Dixon method of roentgenologic localization of

and a Doctor of Laws degree from New York University

intraocular foreign bodies.

Weeks’ textbook, A Treatise on the Diseases of the Eye (1910), is well respected to this day, as are his

and the Bellevue Hospital Medical College. He was also elected Honorary Professor of Ophthalmology at the University of Oregon Medical School.

numerous clinical and operative contributions, including

Weeks died in La Jolla, California, in 1949, many

a method of restoration of the orbital socket, to a wide

years and miles distant from his birthplace of Paines-

range of ophthalmological journals.iv As a leader in his

ville, Ohio. His extraordinary passion for ophthalmolo-

field, Weeks maintained numerous and distinguished

gy was captured by his colleague Knapp, who fondly re-

professional affiliations and offices. Among them: he

called, “When asked, after [Weeks] had retired, where he

served as chairman of the Section of Ophthalmology of

would advise a young ophthalmologist to settle, he re-

the New York Academy of Medicine in 1902, chairman

plied, ‘Wherever the competition is the keenest.’” v

of the Section of Ophthalmology of the American Medical Association in 1905, and president of the American Ophthalmological Society in 1921. He held active memberships in scores of national and international societies as well.

Left: Contemporary illustrations of the Koch-Weeks bacillus, circa 1889.

Above: Dr John E. Weeks, circa 1935.

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

1906–1945

With all plans for construction deferred until future notice, other options began to look more appealing.

“

Starting in 1939, the board and the New York Postgraduate Hospital, the precursor of the New York University Medical Center, had opened preliminary discussions regarding an affiliation and the attractive possibility that

…the managing Board of the institution is determined to carry on the work of the infirmary during the war…”

the two institutions might jointly construct a new building.75 But time was a-wasting, with no firm agreement in hand. In 1940, the board proposed a creative workaround to expand capacity and possibly generate as much as $15,000 per year in revenue.76 This called for renovating two houses, one located at 308 East 14th Street and the other on Second Avenue, as house staff residences, and converting their former rooms on the second and third floors of the infirmary building to semiprivate accommodations for inpatients. Meanwhile, affiliation discussions proceeded, going so far as to convene a meeting with infirmary surgeons, assistant surgeons, attending surgeons, and assistant attending surgeons to discuss the matter further.77 As Europe’s cauldron of war churned, the infirmary made its own preparations with a heightened sense of

1942

alert. The infirmary’s Board of Directors President Robert M. Youngs stated reassuringly, “Although the present emergency has accentuated the difficulties of all voluntary hospitals, the New York Eye and Ear Infirmary takes great pride. Difficulties occasioned by the shortage of professional staff, personnel changes among the employees, rationing restrictions, and continuing increase in operating costs, the managing board of the institution is determined to carry on the work of the infirmary during the war, maintaining its high standard and preparing to meet any emergency demands which may develop.” 78 This included the implementation of an emergency blackout routine that blocked all visible light from the street and the setting up of a first-floor emergency room staffed “with four residents and a full complement of nurses in attendance to take care of all eventualities.” 79 A Volunteer Department was established, drawing largely on a group of women, many of whom worked regular jobs and were also involved with actively soliciting funds for the United Hospital Fund Drive and the infirmary’s Victory Loan Drive. These commitments aside, they gave up whatever leisure time remained to them so as to free the infirmary’s overworked graduate nurses for more critical duties. The first 14 volunteers served mainly on the wards and a unit of nine Red Cross nurses’ aides were assigned to the hospital’s operating rooms, donating a total of 1,914 and 2,258 hours, respectively, in 1942 alone.80 By the end of 1945, that number had increased to 7,309.81 As pressures of the war mounted, so did the numbers of wounded who required specialized medical interventions. With the express purpose of sharing and refining their expertise, the infirmary deepened its existing ties with Columbia University’s College of Physicians and Surgeons. Six years earlier, in 1938, the infirmary’s School of Ophthalmology and Otology, established in 1890, had joined forces with the College

91

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NYEE 200: A VISION OF HOPE

in an agreement to allow the infirmary’s residents to take basic science courses at Columbia-Presbyterian Hospital. By so doing, they became eligible to receive a degree from Columbia University and a diploma from the New York Eye and Ear Infirmary. But the exigencies of World War II had wrought severe staff shortages and a pragmatic assessment of resources for both institutions. In June 1943, with 132 of the infirmary’s staff physicians enlisted in the armed forces, Youngs announced that the board had “decided that medical teaching controlled by the standards of a large university medical school could develop more effective training programs to cope with war casualties and expansion of research.” 82, 83 Berens was named Clinical Professor of Ophthalmology and executive director of the department and Dr. J. Morrisset Smith was given a similar title in the field of Otorhinolaryngology.84 With the war in full swing, the infirmary’s Social Service Department reported a noticeable decline in requests for rate reductions for medical care and tests, a metric that possibly signaled better financial prospects ahead.

At the same time, however, social workers, in cooperation with the Army Emergency Relief and the New WIKIMEDIA COMMONS

York chapter of the American Red Cross, were busy planning for the medical and social needs of discharged servicemen, disabled veterans, and their relatives. Recognizing the anticipated number of returning soldiers and the importance of aftercare, Helen D. Paine, the chairman of the Volunteer Department, weighed in as well: “As more nurses return to the hospital, the need for volunteers in the wards may gradually lessen, but all the faithful workers are standing by as long as they are needed. Our post-war plans are to continue with a vigorous and planned volunteer department…as there will always be a need for such workers, because of the extra work these departments incur due to post-war problems of unemployment and readjustments to peace time life.” 85 Handling the current and future needs of the varied patient population prompted the Executive Committee to authorize the Board of Directors to spend up to $60,000 to construct a new Bronchoscopic and Audiometer Building in the courtyard of the infirmary’s existing building to house the X-ray Department, Bronchoscope Department, and the Department of Research for treatment of hearing defects.86 In April 1944, this figure was revised upward to $78,000 to include a second sound room and additional equipment, plus special soundproofing to eliminate the vibrations from the subway, which was scarcely 90 feet distant.87 A few months later, the leadership voted to purchase a $15,000 custom-built biplanar fluoroscope for roentgenological studies to detect foreign bodies, a diagnostic tool “not duplicated in this country” at the time.88, 89 At the time, no member of the infirmary’s staff had returned to active practice from the armed forces. In fact, several additional members had been “called to the colors.” 90 But gradually, by the end of 1945, more and more Above: a field surgery dugout in Belgium, circa 1944.

residents who had served returned with a renewed interest in specializing in ophthalmology.91

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

93

1906–1945

WIKIMEDIA COMMONS

In response, the infirmary’s teaching program shifted its curriculum from its emphasis on treating battlefield casualties to one oriented toward peacetime practices and preparing upcoming ophthalmologists to assume leadership positions in the field.92 Then, at long last, after so much suffering, destruction, and sacrifice, World War II ended with the Allied defeat of the Axis powers in Europe and Asia on V-E and V-J days, May 8, 1945, and September 2, 1945, respectively. Peace brought a return to normalcy and the promise of a brighter future.

The infirmary had weathered the uncertainties of the Depression followed by the devastation of a global war, guided by the steadfast devotion of its committed leadership, physicians, nurses, staff, and volunteers. In the last year of World War II, despite personnel shortages and related privations, the hospital had logged 34,065 dispensary visits and treated 112,874 patients in its numerous specialty clinics.93 And as more doctors were

Above: a field eye hospital, Europe, circa 1944.

Right: a field hospital in Normandy, 1944.

WIKIMEDIA COMMONS

discharged from military service, the long waiting lists for treatment reduced dramatically.

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

The “New York at War” Parade DID YOU KNOW

that members of the New York Eye and Ear Infirmary’s Social Service Department staff joined the Social Service Section of the “New York at War” parade on June 12, 1942? Organized by New York Mayor Fiorello H. La Guardia, the 500,000participant, 300-float show of support for World War II was part military parade and part civilian homefront procession. An estimated 2,500,000 fervent spectators thronging the streets cheered them on, all the way up Fifth Avenue, from Washington Square Park to 79th Street. But by all accounts, not every patriot was welcome. Over vigorous objections by the American Civil Liberties Union, GermanAmerican, Japanese-American, and ItalianAmerican groups were formally banned and sidelined out of prejudice.

Service Flags and Gold Stars AND DID YOU KNOW

Top: 1944 Air Raid Instructions poster.

Below: a WWII Service Flag with three stars, one of them gold. The infirmary’s flag (now lost) had 132 stars, with one gold, by 1943.

that the New York Eye and Ear Infirmary displayed a “service flag” honoring those among its staff and Board who had been drafted during World War II? i By 1943, the infirmary service flag contained 132 stars, including a gold star in remembrance of “a brilliant young physician, Dr. J. Grant MacKenzie, who was killed in a bomber crash while doing important research work in Otology.” ii A second gold star was designated in 1945 to commemorate the death of Lt. Cmdr. Sheldon E. Prentice, a board member, lost in action in the Pacific in March 1945. iii Unfortunately, a complete list of others from the infirmary who served or sacrificed their lives does not survive.

W I KI M ED IA CO M M O N S ( ALL I M AG ES)

94

3. THEIR SPIRIT LIVES WITH US FOR EVERMORE

“

95

1906–1945

The time had finally come to weigh the pros and cons of rebuilding on the infirmary’s 90-year-old site or expanding afresh in another location. Reinvigorated by the prospects of peacetime research advances and

We are hopeful that our course has now been charted for the future and that we can look forward to greater accomplishments in our work.”

medical innovations that lay ahead, the leadership took a decisive step, one that had been under discussion in some form or another since 1939.94 On February 27, 1946, the infirmary’s board voted to affiliate with the New York University-Bellevue Medical Center in the construction of its projected University Center on the East Side Drive from 30th Street to 34th Street. 95 A campaign was launched to raise $15 million, New York University’s share, while the city would be responsible for $22 million to rebuild the existing Bellevue Hospital area.96 Under the plan, the infirmary would occupy one section of the university buildings and would continue its work in the fields of Ophthalmology and Otolaryngology as a separate entity. No mention was made regarding

Alfred Eisenstaedt’s iconic photo: Times Square on V-J Day, August 15, 1945.

president, summing up the infirmary’s collective expectations in unadorned terms, stated, “We are hopeful that our course has now been charted for the future and that we can look forward to greater accomplishments in our work.” 97 And so the New York Eye and Ear Infirmary took its next step to secure and further its long tradition of resilience and excellence. 

A L F R E D E I S E N S TA E D T V I A W I K I M E D I A C O M M O N S

1945

a monetary contribution by the infirmary, apart from offering its specialty expertise. Youngs, the board

Reaching for more

“

No institution ever stands still. In any

institution, as needs arise, they must be met or else that institution slips into low gear.” 1 — Gordon S. Braislin President, New York Eye and Ear Infirmary

4 1946 –1985

The final 1962 design of NYEE’s North Building, Rogers, Butler & Burgun, Architects.

WIKIMEDIA COMMONS

4 Reaching for more 1946 –1985

With peace declared, the nation basked in an era of prosperity unlike any before.

Stratospheric growth rates fueled the nation’s sense of optimism. So much was on the ascent: Employment soared, along with job benefits, as did college enrollment, thanks

1946

to the GI Bill. Factory production, especially in the automobile industry, jumped to alltime highs and, as the Cold War escalated, defense spending poured into the economy.

There was a suburban boom, a housing boom, and a baby boom, too. The exuberance was tempered only by recent memories of the dehumanizing and destructive power of the Second World War and a creeping Red-scare campaign that would soon grip the country. On balance, though, the zeitgeist was hopeful and many looked to New York City as the “global capital,” poised to symbolize a better future. With the onrush of domestic and international corporations scrambling to establish beachheads in Manhattan and the construction of the newly founded United Nations overlooking

P

Turtle Bay, much appeared promising.

A WORLD OF POSSIBILITIES

United Nations Secretariat Building, 1947.

Designed in the “international style” by a board of architects led by Wallace Harrison, Le Corbusier, and Oscar Niemeyer.

ostwar-era health care was also transforming. 2, 3 Over time and due to a complex interplay of factors—the advent of private health insurance in the 1930s, the proliferation of employersponsored health plans in the 1940s and 1950s, the passage of Medicare in 1965—the utilization of medical resources began to climb. Accelerating scientific and technological innovations expanded the effectiveness, cost, and practice of medicine. Seminal breakthroughs included

the discovery of DNA, the development of effective vaccines and antibiotics, the introduction of more precise diagnostic imaging tools, and the use of life-saving surgical interventions like cardiac pacemakers and

10 0

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

kidney transplants. Financial support flowed to basic science research across a variety of fields, thanks to the partnership between the U.S. government and universities and institutes. 4 The National Science Foundation (NSF) was created in 1950. Shortly thereafter, the National Institutes of Health’s National Institute of Neurological Disease and Blindness (NINDB) was formed, from which the National Eye Institute (NEI) evolved in 1968.5 The New York Eye and Ear Infirmary stood poised to take advantage of this emerging trend based on its long tradition of research, starting from the infirmary’s publication of the first issue of New York Eye and Ear Infirmary Reports in 1883 and continuing with the 1926 creation of the Department of Research under Dr. Conrad Berens. Although the department was temporarily deactivated during World War II for financial reasons, many of its investigators pursued their studies independently, without its aegis. In 1951, when activity in the Department of Research formally resumed, 32 separate research projects were underway, involving 50 participants from the infirmary’s attending staff, residents, technical experts, and graduates.6, 7 Yet, investigative zeal or none, if the infirmary aspired to become a preeminent player in the increasingly

G E T T Y/ I S T O C K P H O T O ( B O T H I M A G E S )

An aerial view of Levittown, on Long Island, New York, and a home interior, 1950s.

competitive world of medical research and patient care, something would have to be done about its aging physical plant and infrastructure. 

4. REACHING FOR MORE

TA K I N G S T O C K

1949

I

1946–1985

n his May 4, 1949, Special Report of the President, infirmary President General

Ephraim F. Jeffe made a case for the institution’s changing role and laid out various options: “The functions of a highly specialized hospital such as ours transcends any local limitation of definition.

That is why I think the service rendered by the infirmary is a contribution to the welfare of the people of this entire country as well as to the surrounding areas.

Fullest consideration has been given to numerous alternatives such as improving the present structure, remaining in the present location and rebuilding, acquiring new land elsewhere and constructing a new building, affiliating or consolidating with another suitable hospital or medical center, if feasible.” 8 Around the same time, there was the tempting possibility of constructing a building on land

adjacent to and owned by Roosevelt Hospital. A merger with Manhattan Eye, Ear, Nose, and Throat Hospital was also discussed, and inquiries were made as to how the infirmary might figure into NYU’s future plans. Even the sale of the infirmary’s 13th and 14th Street properties was again on the table.

With the exception of the infirmary entering into a teaching affiliation with NYU-Bellevue Medical Center in 1949, each of these explorations and overtures were ultimately passed over or deferred. Each alternative was stymied by a familiar refrain: general funds for construction were “extremely limited” and construction costs were at “prohibitive peaks.” The board, therefore, decided that the best action was no action, with the proviso that the existing infirmary building be kept in proper repair. Many months and board meetings later, a decision as to whether the hospital building was to be abandoned or remain in operation indefinitely was still pending.

Then, in 1953, the leadership engaged the consultancy of Neergard, Agnew, Craig, and Westerman to conduct a comprehensive, systematic study of the infirmary’s aging physical plant. Upon completion, the report endorsed an extensive rehabilitation effort from top to bottom, inside and out. And so, after extensive consideration, it was decided the infirmary would stay put. At least for the foreseeable future.

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In Living Color DID YOU KNOW

that the infirmar y took the world stage in living color in September 1954, at the X V I I I nter national C on gress of Ophthalmology and the American Academy of Ophthalmology and Otolaryngology? i One of the most popular and instructive features of the Congress was the presentation of a surgical program telecast directly from the infirmary’s Eye Operating Rooms to the Empire Room of the Waldorf-Astoria Hotel via color television. Sponsored by Smith, Kline & French Laboratories in cooperation with the infirmary, this marvel of broadcast technology required weeks of preparation by the Committee on Television, headed by the infirmary’s Drs. Brittain F. Payne and J. Gordon Cole. The first two days of televised surgery were devoted to otolaryngology, followed by the broadcast of 30 major eye operations, performed primarily by infirmary staff and magnified to a size approximately 4 feet by 3 feet—modest by contemporary standards, but monumental in 1954. In total, an estimated 1,500 physicians and surgeons worldwide viewed these demonstrations over the course of five successive afternoon sessions. By all accounts, the “ratings” were great.

Over the next several years, repairs and construction to the infirmary’s historic building were ceaseless. If one hallway or another wasn’t being painted, then an aging smokestack was due to be replaced. A conductive floor covering was installed in the eye and ear operating rooms to eliminate the risk of static electricity causing an explosion, and the male ear ward on the third floor was reconfigured into two four-bed, semiprivate rooms to meet increased demand.9 Changes to the two boilers in the engine room, one fired by oil and the other by coal, were being evaluated; the laundry department received a new, long-overdue “mangler, two new wash wheels, and one new extractor.” 10 The sterilizing room in the Eye Suite was completely rehabilitated and central suction was installed in all the rooms in the Ear Operating Suite, eliminating the need for free-standing, bulky units.11 No sooner was one problem addressed than another arose, tackled by workmen of all stripes, fixing one thing or another.

Meanwhile, with an eye toward capturing more government, foundation, and private support, the infirmary’s physician-scientists advanced their investigations into such areas as uveitis and glaucoma, aided by grants garnered from the Snyder Ophthalmic Foundation, the Ophthalmological Foundation, the Alfred P. Sloan Foundation, and the New York Community Trust. Limited only by the lack of research space, the board voted to convert the ground floor of the adjacent, infirmary-owned, five-story brownstone at 314 East 14th Street into a small but modern laboratory as a stopgap measure, until an estimated $50,000 could be raised to establish a first-rate facility. 12 Soon thereafter, in 1954, funds became available and the brownstone was completely gutted to create the new Research Laboratories, complete with elevator, central air-conditioning, and a large, dry basement where much of the experimental apparatus, including an electron microscope, could be housed.

When completed, the building consolidated an Isotope Laboratory; a Biochemistry Laboratory; a Bacteriology, Virology, and Tissue Culture Laboratory; an Animal Room and Animal Operating Room; a Photographic Room; a library; and a conference room, all under one roof. By 1957, the facility was up and running with 25 research projects underway, including those which had received a license from the Atomic Energy Commission to possess various radioactive isotopes such as P32, C-14, and tritium, followed, a few months later, with a certification for P33 for human use.13 Next door, every infirmary floor was abuzz with activity, with close to 200 physicians and surgeons on the active attending and resident staffs, along with 40 registered nurses, 16 practical nurses, 34 aides, and 9 orderlies, as well as employees in the dietetics, laundry, social service, accounting, public relations, and other support departments. 14 Over the course of this period, the infirmary staff ceaselessly and, finally, successfully lobbied the board to make new, state-of-the-art ophthalmology and otolaryngology services and treatments available. For example: the Maxillo-Facial Plastic Clinic, a relatively new branch of Otolaryngology, began

4. REACHING FOR MORE

1946–1985

seeing patients (1951); the Department of Ophthalmology successfully introduced the use of homologous peritoneum for the replacement of deficient conjunctiva and a new procedure for treating detachment of the retina by means of meridional lamellar scleral resections (1954); and a Retina Service (1957) and the Cornea and Glaucoma Services (1958) were formed. By the late 1950s, the Department of Pleoptics was taking the lead as the first of its kind in the country and the largest of its kind in the Western hemisphere. 15 With infirmary departments and specialty clinics proliferating at a startling rate, square footage was at a premium and it was not uncommon for one group of practitioners to surrender space to another. One switch contributed to patient overcrowding, when the Ear Department relinquished one of its much-frequented clinic rooms so the accounting department could relocate from the back of the main floor in the Platt Pavilion to the front of the building, next to the cashier’s cage, to accommodate larger but more efficient accounting machines. Another swap called upon the Audiology Department to make way for the Department of Electrophysiology’s “valuable” addition of electroretinography, building on Berens’s early clinical use of the technology at the infirmary in 1951, by transferring one of its fifth-floor quiet rooms to a converted workshop in the courtyard building.16,17 In a three-way exchange, the admitting office moved into the space previously occupied by the optical shop, which, in turn, took over the Social Service Department’s offices after the latter moved to the The new NYEE Research Laboratory, 1954.

area that had housed the Eye Department’s Clinic 5. These ongoing displacements, aptly described as “borrowing from Peter to pay Paul,” were not only disruptive, but hardly sustainable in the longer run.18 By 1958, with pressure mounting, infirmary President Alexis C. Coudert asked Dr. J. Swift Hanley, infirmary director and chairman of the Board of Surgeons, to conduct an independent survey of the hospital from a professional and physical standpoint, taking into account all the completed and scheduled recommendations suggested by the Neergard Report.19 Upon critical inspection, Hanley stated that “every portion of the property was immaculate and the maintenance remarkable for the age of the buildings,” and given the “cheerful attitude of all the nurses and staff, it was evident that a high morale exists.” 20 Yet, even if the equipment and expertise were the finest, “rightly or wrongly,” one observer concluded, “the physical plant is bound to be viewed by many as a reflection of the hospital itself…[and] the lack of a modern building must cause a loss of business to the hospital.” 21 In Hanley’s colorful words, the infirmary made him “think of a good man in old clothes and shoes, but the clothes are pressed and the shoes are shined and he is presentable. We have an old plant in good condition but we have reached a point where we can no longer carry on successfully in operation of patient care. Every time an improvement is made in one department another department is deprived of space. There is one and only one solution to the problem and that is a new building.” 22

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ROOM T O B R E AT H E

1958

R

ealistically, however, the “one and only solution” was light-years away. The leadership’s first step was to make an assessment as to whether the infirmary’s current location was suitable and, if so, to determine if a sufficient amount of property surrounding the hospital’s established footprint could

be acquired to build a larger, modern facility. According to an analysis submitted by Gordon S. Braislin, then president of Braislin, Porter & Wheelock, Inc. and future infirmary president, the answer to both questions was yes. 23 He argued that while New York City’s northward expansion had pushed older portions of the city into decline, midtown Manhattan was enjoying a renewal as old tenement blocks were torn down. New office buildings had sprung up along Third Avenue following the demolition of the elevated subway lines. A spate of apartment buildings was also under construction, particularly from the East 20s up into the 60s and 70s, along Second and Third Avenues. It was only a matter of time, he underscored, before the immediate area surrounding the infirmary would become more desirable, too. As for a reliable patient base, Braislin noted that the densely populated Stuyvesant Town and Peter Cooper Village residential complexes, as well as several city- and statefinanced housing projects, were nearby, and that a number of hospitals located in the infirmary’s general area, including the New York Infirmary Hospital, Beth Israel Hospital, Manhattan General Hospital, and Columbus Hospital, were highly utilized.

In Braislin’s opinion, all of these factors favored the infirmary remaining in its current location, subject to the acquisition of more land while property values were still low. The goal: to acquire a plot large enough so that the “hospital would embrace the entire blockfront of Second Avenue from East 13th Street to East 14th Streets to the present depth.” 24 This required purchasing and consolidating five separate parcels owned by four individuals, which would allow for the construction of a new hospital building on the 14th Street corner without

“

disrupting patient care in the existing facility. Then, contingent on sufficient funding, the balance of the changes to the old hospital could be completed after the hospital operations had moved into the new structure.

The pigeons would be clucking on the window sills outside and there was a flyswatter hanging from a nail on the wall in case a fly got inside….Flat-out, we told him ‘We need a new building!’”

Without mincing words, Braislin concluded: “I believe the hospital is at a crossroads: the great amount of new building in the city has made the old buildings seem even older, and I feel that the decision to rebuild or not may well decide whether the hospital will go ahead in the future or whether it will fall behind. If the hospital has been able to make the financial strides which have taken place in the last several years with its present old buildings, it seems to me that with a properly modern plant its future should be assured.” 25 

4. REACHING FOR MORE

GOOD FORTUNE FAVO R S T H E B O L D

T

1946–1985

he new decade began with the good news that 1959 and 1960 had been two of the infirmary’s most successful years in its history, with 96,550 clinic visits and 7,071 inpatients, for a total of 44,479 days of bed care.26 Coudert was proud to point out that the institution had added to its stature as a specialty

hospital by integrating the three functions of research, medical education, and patient care, while still preserving the hospital’s motto that “in all considerations and policy decisions, ‘the patient comes first.’” 27 That the infirmary was routinely filled to capacity, Coudert continued, had not undercut its “traditional reputation as a friendly, family-type institution in which each patient is known as an individual and not as a number, as is the case in so many of the larger institutions.” 28 This integrated approach became the centerpiece of the hospital’s expansion and redevelopment plan, led by Braislin, the infirmary’s next president. 29 And not a moment too soon, according to Dr. Seymour Fradin’s humorous but vivid example. “The standards for operating rooms were changing,” he recalled, “and ours at the infirmary were old and simply inadequate.

Like no air conditioning. So in the summer we’d open the windows. The pigeons would be clucking on the window sills outside and there was a flyswatter hanging from a nail on the wall in case a fly got inside. A group of us attendings met with Coronel Martin, the infirmary’s head administrator and then with President Braislin.

Flat-out, we told him ‘We need a new building!’” 30 Their voices led a chorus of many. Prior to Braislin’s preliminary announcement of the New Building Fund in November 1962, the board had “quietly and quickly accumulated more than $600,000 in cash and pledges from the ‘infirmary family’ and a few close friends for initial working capital.” 31 With the exception of two small parcels, the infirmary had acquired the adjacent

property, sufficient to extend its footprint between 13th and 14th Streets on Second Avenue, and had obtained the approval of the Hospital Council of Greater New York. The design services of Rogers, Butler & Burgun, Architects, were retained to draw plans and specifications for the new inpatient and ancillary facilities to be joined at the lower floors with the infirmary’s existing building.32 The board worked swiftly and efficiently, setting their sights on reaching the $7,500,000 campaign goal and completing the project by the infirmary’s 150th anniversary in 1970. By 1964, the New Building Fund had amassed more than $2,649,000, more than a third of the way to its target.33 To accelerate the effort, the leadership reached out and received support from such corporations as Consolidated Edison; New York Telephone Company; Socony Mobil Oil Company, Inc.; Standard Brands, Inc.; and several unidentified leading foundations.34 During the same period, the infirmary opened discussions with Beth Israel Hospital, two blocks away, with the idea of forming a working agreement whereby the two hospitals would make all their facilities available to both institutions’ paGordon S. Braislin’s 1958 typewritten plan for acquisition of five parcels for the NYEE expansion.

tients, so as to maximize the use of their staff and facilities and reduce overall costs.35, 36 The agreement included the infirmary’s long-standing stipulation that the corporate independence of both institutions be ensured.

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This commitment to the future infused the infirmary with optimism and energy, synergizing clinical and laboratory research, patient care services, and medical education. The new Biochemistry Department developed a broad program of biochemical studies with emphasis on the relationship between cataract formation and protein metabolism, cataract formation in diabetes, and an investigation of various radioactive materials with the property of localizing eye tumors.37 Researchers in the Department of Electrophysiology studied the effects of radiation on eye tissue as well as other classified topics as part of the United States Air Force’s nascent space program.38 A group of infirmary physician-scientists geared up to explore inner ear problems subjected to radioisotope techniques, funded by a National Institutes of Health grant. And another team of infirmary investigators launched a multiyear study of the effects of lasers on ocular structure and function, sponsored by the John H. Hartford Foundation.39

1962

As had always been the case, more patients were being seen and treated with each passing year. But by the early 1960s, more patients were covered by private or employer-based health insurance. Reimbursements for patient care improved, thanks to the Associated Hospital Service of New York’s more favorable cost formula and the New York City Department of Welfare’s increases for welfare recipients.40 These factors contributed to the infirmary’s sound fiscal health, which, in turn, stimulated even more specialized services. The summary recorded in the infirmary’s 1961-1963 Triennial Report offers a partial but revealing perspective on the hospital’s burgeoning activity as seen through the lens of the Department of Otolaryngology. 41 Over the span of three years, of the 80,786 visits to the Otolaryngology clinics, 8,039 patients had been admitted with ear, nose, or throat problems, of whom 7,650 had undergone surgical procedures. All cases requiring special laryngeal and bronchial consultations and treatment were seen in the Department of Bronchoesophagology and Laryngeal Surgery, known throughout the city and the country for highly sophisticated, top-notch care. The Head and Neck service also routinely received referrals from other hospital services for tumors and disorders of the thyroid gland, benign and malignant tumors of the skin of the head and neck, oral cavity and paranasal sinuses, and congenital anomalies of the head and neck. This sheer volume of cases spoke to the infirmary’s glowing reputation as well as to the wealth of diversified clinical material available to residents in training.

By mid-decade, approximately 5 percent of eye, ear, nose, and throat specialists in the country had received their postgraduate training at the New York Eye and Ear Infirmary. They were practicing in 35 of the nation’s 50 states, with 31 alumni practicing abroad. 42 The infirmary’s reputation for superlative teaching and training attracted an average of 20 applicants for each of the available 10 slots to its three-year postgraduate programs, with the proviso that only the highestranking graduates of a medical college who had completed a full year of hospital internship need apply. 43 Courses in the basic sciences were given in the New York University Postgraduate Medical School, while clinical instruction and didactic lectures were offered at the infirmary by its Chief Surgeons, who were also members of NYUMC’s Clinical Faculty. (continued on page 110)

4. REACHING FOR MORE

GORDON S. BRAISLIN 1901 -1990

M

1946–1985

President of NYEE, 1961-1976

uch in life depends on

ny, Gordon S. Braislin, Inc., of which he

causes, of which only

timing and the same can

was president. That entity merged into

a handful are men-

be said for institutions.

Braislin, Porter & Baldwin, Inc. in 1942,

tioned here. From 1961

So when Gordon S. Braislin be-

and ultimately became Braislin, Porter &

to 1977, he was a trust-

came president of the New York

Wheelock, Inc., also a real estate com-

ee of Roosevelt Hospi-

Eye and Ear Infirmary in 1961, the

pany, where he served as president un-

tal and served on the

timing couldn’t have been more

til 1965. The same year, he also became

Board of Directors of

perfect.i,ii Given his broad fi-

chairman and chief executive officer of

the Brooklyn Eye and

nancial experience and person-

the Dime Savings Bank of Brooklyn, lat-

Ear

al charisma, Braislin was, inar-

er known as the Dime Savings Bank of

to 1961), the Com-

guably, the right man at the right

New York, from which he retired in 1976.

munity Blood Coun-

time. His 15-year tenure ushered

He went on to serve as director and

cil of G r e a t e r N e w

in an extraordinary era during

chairman of the Savings Bank Life Insur-

Yo r k (1963 to 1976),

ance Fund and a director of the Savings

and the Downtown Brooklyn Development Asso-

which the infirmary realized the redevelopment and revitalization it had sought for decades. Braislin’s humanitarian instincts and financial and

Bank Trust Company.

ciation (1965 to 1975). He was a founding member of the New York Blood Center, as well as a director

York Eye and Ear Infirmary,

of the American Bible Society and a Trustee of the

Braislin gave of his time to a

Brooklyn Institute of Arts and Science.

wide range of New York’s largest influential institutions and

civic commitments, benefitted the infirmary just when it needed it most. As Dr. Gerald B. Kara, executive surgeon director of Ophthalmology and infirmary historian, noted, “aided by Dr. J. Swift Hanley, Chairman of the Board of Surgeons, and Col. Charles E. Martin, the ablest administrator in the infirmary’s long history…the planning, construction and completion of [the North] building was achieved mainly through the unceasing and tireless effort of Gordon Braislin…worthy occupant of the position once held by William Few.”iii Braislin was born in Brooklyn in 1901, the son of William C. and Alice Cameron Braislin. After graduating from Cornell University with a Bachelor of Arts degree in 1923, he joined New York Investors Inc., beginning in the mortgage and real-estate departments. Within a relatively short period of time, Braislin was named president of two of the company’s real-estate subsidiaries.

By 1938, he had launched his own real-estate compa-

(1956

In addition to serving as president of the New

...the right man at the right time. real-estate expertise, honed by years of professional and

Hospital

Below: Gordon S. Braislin at the groundbreaking ceremony for the soon-to-be North Building.

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NYEE 200: A VISION OF HOPE

PL ANS FOR TH E NORTH BU I LD I NG , 1962 Rodgers, Butler & Burgun, Architects

4. REACHING FOR MORE

1946-1985

Left: the architects’ first design of the planned building (the final design is on pages 96-97).

Above: renderings of a central nursing station and a patient reception area.

109

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NYEE 200: A VISION OF HOPE

The Holdouts (continued from page 106)

DID YOU KNOW

that NYEE’s new North Building had to be designed and erected around two small parcels on the southeast corner of 14th Street and Second Avenue after the owners of the White Tower Restaurant and a store selling professional uniforms refused to sell the properties to the infirmary?i One of the “holdouts” was the site of optical store OPTYX until 2019.

Gordon Braislin at the North Building Gala, 1967.

On November 16, 1967, the infirmary hosted a gala opening for its new North Building on 14th Street. Eight hundred staff members, employees, and benefactors toured its gleaming interiors and state-of-the-art equipment.44 In contrast to the old hospital, with only 175 beds and eight operating suites, the spacious nine-floor North Building had 214 beds, 10 operating suites, ample space to accommodate six clinics, and extended space for laboratories. It was truly a decades-long dream

R O B E R T F R A N K V I A G E T T Y/ I S T O C K P H O T O

come true. So sleek and up-to-the-minute was the North Building’s interior design that its modern, midcentury decorating scheme was featured in a three-page story in the March 1969 issue of Interiors magazine. “Our new modern facilities will permit us to offer the best available care to both our private patients and to the 100,000 clinic patients who each year come to us for us from all parts of the world as well as from the New York area,” President Braislin told the assembled crowd.45 Patient and community outreach also expanded with public events, such as the free Glaucoma Detection Testing Program, cosponsored by the infirmary and the Lions Club. Between the hundreds of posters in local shop windows, four days of announcements on local TV news, and pamphleteering by members of Epiphany Girl Scout Junior Troop 3-360, more than 400 Peter Cooper Village and Stuyvesant Town residents were screened on a beautiful New York spring Sunday; 40 received results that prompted referrals for further study to either their own ophthalmologist or a hospital of their choice. 46 The event was so successful that it grew into the ever-larger Detection Day for Eye and Ear Disorders over the next decade, drawing hundreds of residents from the East Side as well as from New York’s five boroughs who were eager to receive preventive information and screening for glaucoma, vision defects, ear problems, and hearing loss. These and other GOOGLE STREET VIEW

service opportunities were enhanced by the formation of a Volunteer Committee, a summer Junior Volunteer Program, and a special Career Day for blind and deaf middle- and high-school students organized to promote and encourage these youth to consider health care-related positions following their graduation.

The mortar on the North Building’s white and dark-green brick facade was barely set when, in the summer of 1969, President Braislin proposed the next ambitious project. In his speech commemorating the first group of Top: a Robert Frank shot of customers at the White Tower, 1947.

Above: that corner in 2019.

graduating senior residents who had spent the last year of their three-year training period in the infirmary’s North Building, he spoke of the need for a staff residence building. “No institution ever stands still,” Braislin said. “In any institution, as needs arise, they must be met or else that institution slips into low gear.” 47 As in so many times in the past, among the first to step up to the fundraising challenge was the Women’s Association, whose treasurer, Mrs. Hunter H. Romaine, presented Braislin with a $19,000 gift honoring Mrs. Aurora Klimek, director of Nursing Services, on the spot.48 With this welcome gesture of largesse, the project was on its way. 

I NTER IO RS M AG A ZI N E ARC H IVES

4. REACHING FOR MORE

Above: completed waiting area and nurses’ station, 1969.

Right: the completed North Building. Note the White Tower restaurant on the corner of 14th Street and Second Avenue.

1946–1985

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NYEE INQUIRING MINDS Dr. Louis J. Girard 1919-2010

Born in Spokane, Washington, in 1919, Dr. Louis J. Girard moved with his family to Houston in 1932 after his father, Henry Girard, was invited to direct and conduct the first Houston Grand Opera.i As an undergraduate at Rice University, Girard was drawn to the sciences. He graduated in 1941 and, much later, was named a Distinguished Alumnus. He then went on to earn his medical degree at the University of Texas Medical Branch in Galveston in 1944. Like many in his generation, Girard served in the U.S. Army Medical Corps during World War II. He was stationed at Fort Belvoir’s Regional Station Hospital, where he was appointed the chief of Eye, Ear, Nose, and Throat Service. After the war, he completed his ophthalmology residency at the New York Eye and Ear Infirmary and was awarded a fellowship in ophthalmic surgery under the mentorship of the internationally known Dr. Conrad Berens. Having earned recognition as a Distinguished NYEE Alumnus, Girard was recruited by Baylor College of Medicine to help build its Department of Ophthalmology and, in 1957, at age 38, was promoted to Professor and Chairman, becoming the youngest full professor of ophthalmology in the United States at the time and the first full-time academic ophthalmologist in the Southwest. Girard left these posts to begin private practice in 1970, but remained clinical professor at Baylor until he retired at age 79, in 1998. One of his most famous patients was President Lyndon B. Johnson.

Girard’s field-transforming contributions to ophthalmology are many. In 1949, he conducted the first clinical investigation of corneal contact lenses; five years later, in 1954, he was the first ophthalmologist to perform and document corneoscleral transplantation. Girard codesigned the first small, thin contact lens in 1958 and, over the course of his distinguished career, introduced numerous ophthalmic surgical techniques and invented 25 surgical instruments, most notably the Girard Ultrasonic Fragmentor for intraocular surgery and the Girard Keratoprosthesis, a plastic cornea. Among his scores of professional affiliations was the Pan American Association of Ophthalmologists (PAAO), where he devoted his energies to developing comprehensive courses on the new types of contact lenses and keratoplasty. He published the first book on corneal contact lenses with Joseph W. Soper and Whitney G. Sampson, authored 11 books and 404 scientific articles, and produced 73 scientific films. In addition to establishing the Southwest’s first eye bank, now the Lion’s Eye Bank, and the region’s first Institute of Ophthalmology, now the Cullen Eye Institute, he also established the first ophthalmic tissue-culture laboratory in the world.

Dr. Jorge N. Buxton 1921-1999

Dr. Jorge N. Buxton, the New York Eye and Ear Infirmary distinguished corneal surgeon, was born in Argentina in 1921. He graduated from Argentina’s Champagnat, St. George’s College, earned his medical degree at the National University of Buenos Aires Medical School and completed his internship at Ramos Mejia Hospital.ii Soon after he imigrated to New York with his wife, Amalia, in 1947, he began an internship at St. Clare’s Hospital. He completed the New York University Medical School’s basic science course in ophthalmology and took his residency in ophthalmology at both the Newark Eye and Ear Infirmary and the New York Eye and Ear Infirmary. It was during this time, from 1955 to 1957, that he became an associate of Drs. Berens, Britain F. Payne, and Ramon Castroviejo.

In 1958, he headed up the infirmary’s new Cornea Service.iii After serving in the U.S. Air Force in Wiesbaden, Germany, and attaining the rank of major, he returned to New York City. In 1963, he was appointed surgeon-director and the first director of the Cornea Service at the New York Eye and Ear Infirmary. Later, he was named Executive Surgeon and Chair of the Medical Board. Having enjoyed a successful Park Avenue practice for many years, he made a decision to relocate his office to the New York Eye and Ear Infirmary in 1975, where he was the first doctor to rent private office space. Over the course of his career, Buxton served as clinical professor of ophthalmology at the University of Medicine and Dentistry of New Jersey, the State University of New York at Stony Brook, and New York Medical College. He also served as a consultant in ophthalmology to a number of hospitals in New York and to the U.S. Food and Drug Administration, as well as director of eye banks in New York, New Jersey, and Buenos Aires, and of Tissue Banks International.

In addition to membership in several national and international societies, Buxton received numerous awards, including the Honor and Senior Honor Awards from the American Academy of Ophthalmology, an award from the Order of St. John, and a citation by the U.S. Food and Drug Administration. Notably, he was named a Distinguished Alumnus of the New York Eye and Ear Infirmary and delivered several named lectures, including the Kevin Touhy Lecture (1975), the Arturo Grullon Memorial Lecture (1976), the Sylvio de Abreu Fialho Memoria (1978), and the 11th Conrad Berens Lecture (1979).

Buxton’s distinguished legacy lives on in the New York Eye and Ear Infirmary’s Jorge N. Buxton, MD, Microsurgical Educational Center, which opened in 2004.

4. REACHING FOR MORE

1946-1985

Dr. Virginia L. Lubkin

Dr. Morton L. Rosenthal

There are few better terms to describe Dr. Virginia L.

As a “physician, surgeon, teacher, musician, sailor and

Lubkin than “trailblazer.” After graduating from New York

champion of the underdog,” Dr. Morton L. Rosenthal in-

University in 1933 with a Bachelor of Science degree

spired the respect and admiration of others throughout

summa cum laude, she entered Columbia University’s

his life.vi,vii He belongs to a three-generational family of

College of Physicians and Surgeons and earned a Doctor

ophthalmologists, beginning with his father, Benjamin C.

of Medicine in 1937.iv As a young woman in a world dom-

Rosenthal, followed by his brothers, J. Robert Rosenthal

inated by her male counterparts, she interned at Harlem

and Gerald C. Rosenthal, and daughter Jeanne L. Rosen-

Hospital from 1938 to 1940 and took her place as an as-

thal, currently a senior attending surgeon and associate

sistant resident in neurology at Montefiore Hospital in 1940, an assistant resident in

director of the Retina Center at the New York Eye and Ear Infirmary.viii Morton L. Rosen-

general pathology (1940-1941), and a fellow in ophthalmology (1941-1942). During this

thal began his medical career after earning his MD degree at SUNY Downstate College

time, Lubkin was also an assistant resident graduate in basic science at P & S Oph-

of Medicine in 1952 and interning at the Maimonides Hospital of Brooklyn from 1952-

thalmology Harkness Eye Institute (1941-1942). Following this training, she complet-

1953. In 1954, he completed the Harvard Course in Basic Sciences in Ophthalmology

ed a residency in ophthalmology at Kings County Hospital, Brooklyn (1942-1943), and

and took a six-month preceptorship in ocular pathology at Howe Laboratory under Dr.

Mount Sinai Hospital, New York City (1943-1944), where she eventually became an at-

Parker Heath at the Massachusetts Eye and Ear Infirmary (MEEI).

1914-2004

tending ophthalmologist and associate clinical professor emerita at Mount Sinai School of Medicine.

1926-2002

From 1954 to 1956, Rosenthal was a resident at the New York Eye and Ear Infirmary and then a fellow from 1956-1957 under MEEI’s Dr. Charles Schepens, the father

Believed to be one of the first female ophthalmologists in the United States, Lub-

of modern retinal surgery. In 1957, Rosenthal founded the Retina Service at the New

kin joined the New York Eye and Ear Infirmary in 1945 to become a senior attending

York Eye and Ear Infirmary—the first of its kind in New York City—and introduced tech-

ophthalmic surgeon, blending her passion for clinical practice, research, and teaching.v

niques of indirect ophthalmoscopy and fundus drawing for visualizing the retinal pe-

As the co-creator of NYEE’s first bioengineering laboratory and director of the infirma-

riphery, ushering in a new era in modern retinal surgery. In 1966, Rosenthal and Fradin

ry’s Aborn Center for Eye Research in 1978—renamed the Aborn-Lubkin Eye Research

coauthored a seminal article still used in retinal exams today, featuring Fradin’s illustra-

Laboratory after her 2004 death—Lubkin was known for her ability to “think outside the

tions, entitled “The Technique of Binocular Indirect Ophthalmoscopy.”

box” and made innovative contributions in areas ranging from the fields of ophthalmic

Rosenthal, who so generously gave of his time and expertise to many profes-

plastic surgery to piezoelectric aspects of ocular tissue to dyslexia. She created the

sional organizations, left his indelible mark on the New York Eye and Ear Infirmary.

first graduate course in oculoplastics and a biyearly symposium in the development of

For more than 30 years, he served the institution in various capacities, including sur-

dyslexia at Mount Sinai School of Medicine, as well as educator courses in psychoso-

geon director of the Department of Ophthalmology, chairman of the Medical Board,

matic ophthalmology at the American Academy of Ophthalmology. Over her long ca-

and member of the Board of Directors, and spent

reer, Lubkin garnered renown and lectured to ophthalmologists and a wide range of

countless hours as a teacher and mentor to in-

other health professionals in some 35 countries, from Asia to the Middle East to South

numerable residents and fellows. Those who had

America and beyond.

the great good fortune to have known and worked

In 1982, along with other members of the New York Eye and Ear Infirmary team—

with Rosenthal agree: He was a man of “endless

Dr. Richard Koplin, Morton Gersten, and Dr. Dennis Gormley—Lubkin contributed to the

curiosity, boundless intellect, passion, courage,

invention of corneal topography and the first corneal topographic mapper, known com-

humor, and vision.”

mercially as the Computed Anatomy’s TMS-1, leading the way to precision corneal vision correction. In addition to scores of memberships in professional associations and societies, Lubkin won the Senior Honor Award from the American Academy of Ophthalmology in 1989 and was named a diplomate of the American Board of Ophthalmology.

Three generations of Rosenthal doctors, left to right: Benjamin C. Rosenthal (1895-1984), J. Robert Rosenthal (1931-2016), Morton L. Rosenthal (1926-2002), Jeanne L. Rosenthal (1954-), Gerald C. Rosenthal (1935-1990).

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

NYEE INQUIRING MINDS, continued

Dr. Seymour Fradin

next step was to apply to Johns Hopkins School of Medicine, Department of Art as Ap-

b. 1926

plied to Medicine, where he was accepted. Three years later, in 1953, he graduated with

According to Dr. Seymour Fradin’s own account, the idea

a certificate of completion. Shortly thereafter, he landed his first job as a medical artist

of becoming an ophthalmologist was planted totally by chance when he was 13 years old. “Morton Rosenthal and I were friends at the same public school and I was invited for dinner, where he introduced me to his father, Dr. Benjamin Rosenthal, an ophthalmologist,” Fradin recalled.

ix,x

“I

asked Dr. Rosenthal, ‘Where do you work?’ and he began to tell me about the New York Eye and Ear Infirmary. That’s where it all started.” But not right away. In 1943, after graduating from high school at the age of 17, Fradin was accepted into an aeronautical engineering program at Georgia Tech and given a deferment. A year later, after the Allies invaded Europe in 1944, the young engineering student was immediately drafted, assigned to the U.S. Army Air Corps, and ultimately joined the 344th Bomb Group in Munich.

After Fradin’s discharge in 1946 and return to New York, he took advantage of the G.I. Bill and enrolled in Brooklyn College, majoring in Biology. But he also found time to attend art classes at the Brooklyn Museum of Art in the afternoons. Fradin’s

Left and above: Fradin drawings of indirect ophthalmoscopy techniques.

Right: paintings of a retina, above, and a retinal tear and laser repair, below.

Far right: Fradin with his sketch pad.

at the University of California, San Francisco, in the Department of Medical Illustration of the School of Medicine—an experience that convinced him medicine was his true interest. In 1954, he was accepted to the State University of New York Downstate Medical Center College of Medicine, where he graduated with a medical degree in 1958. After his Lenox Hill Hospital internship, Fradin began his residency at the New York Eye and Ear Infirmary (1959-1962). Upon completing his residency, he became the third fellow of the new Retina Service, founded by his boyhood friend Rosenthal. From 1963 to 1968, Fradin served as the associate director of the Retina Service. From 1970-1996, in addition to running a private retinal practice on Park Avenue, he volunteered his time teaching in infirmary’s Retina Service. During this time, he collaborated with Dr. Richard Rosen to develop the first digital ophthalmoscopy simulation, entitled “Techniques of Indirect Ophthalmoscopy and Fundus Drawing,” which became a component of the American Academy of Ophthalmology’s ONE Network, a global platform for ophthalmic education. Fradin retired in 1997, but has continued to serve at the infirmary as a retinal consultant, teaching first-year residents and fellows in diagnostic retinal techniques—a passion that he actively pursues to this day.

4. REACHING FOR MORE

Dr. Thomas O. Muldoon

1946-1985

Although Muldoon was also on the staff

b. 1936

of St. Luke’s Hospital, he found his profession-

If ever a physician was considered to embody the high-

al home at the infirmary, inspired by his col-

est standards of clinician, educator, and administrator by peers and students, it is Dr. Thomas O. Muldoon. Born in Niagara Falls, New York, in 1936, he began by studying history and earning his Bachelor of Arts in 1958 and a Doctor of Medicine degree in 1962, both at the University of

Rochester.xi,xii

After a yearlong medical-surgical in-

ternship at St. Luke’s Hospital Center from 1962 to 1963, he found his interests leaning toward general surgery. But then, Muldoon was drafted into the United States Navy Reserve Medical Corps as a lieutenant, only to return to St. Luke’s for his surgical residency from 1965 to 1966. By that time, he had ruled out several subspecialties, including ob-gyn, until a friend, Dr. James Newton, an attending physician at the infirmary, suggested he consider ophthalmology and invited him to interview for one of the infirmary’s six residency slots in 1966. Muldoon was selected as the seventh, and he completed his residency in ophthalmology in 1969. Following this training, he received a one-year fellowship (1969 to 1970) in vitreoretinal diseases and surgery at the New York Eye and Ear Infirmary under the preceptorship of Rosenthal and Fradin. He then joined Newton’s practice from 1970 to 1975.

leagues’ singular mission and comradery. And it is there that Muldoon has devoted his energies and talent over the last five decades. He was an early and vigorous champion of vitrectomy and is known as one of the leading vitreoretinal surgeons in the world. And due to his uncompromising standards of excellence and unflagging leadership as the New York Eye and Ear Infirmary’s Surgeon Director of the Retina-Vitreous Service, the Bendheim Family Retina Center has attained international and national renown. He was also one of the guiding forces behind the formation of the New York Eye and Ear Infirmary Ophthalmology Associates Professional Corporation, which continues to fortify the infirmary’s commitment to quality teaching, patient care, and research.

That Muldoon is a superb clinician and mentor is widely acknowledged. In 2004, he was recognized as the New York Eye and Ear Infirmary John Kearny Rodgers Physician of the Year and was awarded Alumnus of the Year by the Infirmary Alumni Association. His numerous teaching appointments and awards underscore Muldoon’s unwavering commitment to training the next generation of ophthalmologists. His board memberships include the American Board of Ophthalmology, American College of Surgeons, State Board for Professional Medical Conduct of New York State, and numerous positions on the New York Eye and Ear Infirmary’s Board of Directors. In addition, he is a member of the American Medical Association, American Academy of Ophthalmology, New York Academy of Medicine, Pan-American Association of Ophthalmology, New York State Medical Society, American Society for Retinal Surgeons (formerly the Vitreous Society), Fluorescein Angiography Society of Greater New York and Glaucoma Foundation, and he has served as President of the New York Society of Clinical Ophthalmology, Staff Society of the New York Eye and Ear Infirmary, and Ophthalmic Laser Surgical Society.

Left: Muldoon at the opening of the Bendheim Family Retina Center, 2003.

Above right: Muldoon with residents in training.

Right: a portrait of Muldoon in his element.

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New York Eye and Ear Infirmary

THE INFIRMARY IN TRANSITION

NYEE 200: A VISION OF HOPE

N

ew York City’s precipitous economic decline in the 1970s was only one very visible example of how the sweeping forces of deindustrialization, “white flight,” and a national recession were tipping the financial scales. 49 Deserving or not, New York City had come to symbolize the moral, political, and economic

consequences of a progressive agenda gone wrong. Over the course of the decade, 600,000 jobs had evaporated and, reversing all historical precedents, the city’s population fell by well over 800,000, a 10 percent decline. 50, 51

Saddled with huge debt and an enfeebled revenue base, its infrastructure and wide-ranging public services crumbled. Support for education, the police and fire departments, parks, and city maintenance plummeted.

Crime and arson rates soared, as did “white flight.” Large swaths of the city resembled abandoned war zones, with streets and buildings reduced to shambles. Threatened with bankruptcy, the city averted a meltdown through a complicated patchwork of bond issues and severe cutbacks, not least of which was scaled-back support of public-sector programs related to education and health care.

Even so, a vibrant core of infirmary supporters was not about to let the New York Eye and Ear Infirmary “slip into low gear” or let the institution’s commitment to community service falter. Hardly, if the calendar of fundraising events was any indication. From annual theater parties followed by a festive buffet at Sardi’s to a kids-only Rockefeller Center ice-skating morning sponsored by Tiffany’s, not a season passed without

1970

an infirmary benefit on the social schedule. Nary a year went by when infirmary employees failed to pledge thousands of dollars to the United Fund of Greater New York. Nor would any of the infirmary’s most loyal supporters have missed the gala 150-year Sesquicentennial Ball, held on Thursday, May 7, 1970, at which 600 elegantly attired guests gathered in the candlelit grand ballroom of the Biltmore Hotel, seated at tables decorated with centerpieces of salmon-colored geraniums and gold-and-white balloons aloft.52 Among them were Walter N. Pharr and T. Townsend Burden Jr., cochairs, and Mayor and Mrs. John V. Lindsay, Mr. and Mrs. Gordon S. Braislin, and Mr. and Mrs. Charles J. Nourse, who served as honorary chairs. It was a night to remember.

A year later, on the evening of May 18, 1971, the infirmary’s Women’s Association sponsored their first Bicycle Bash, in tandem with the city’s kickoff of the Spring Bicycle Season in Central Park, to raise the $500,000 still lacking for the much-needed nurses’

Above: an image of urban decay in the city, 1970s.

Right: NYEE supporters at a Bicyle Bash dinner, 1970s.

residence.53

4. REACHING FOR MORE

DR. ARAN SAFIR 1926 -2007

B

1946–1985

Inventor of the Electronic Retinoscope and Co-inventor of Iris Identification

orn in New York City in 1926, Aran Safir

scope in use at the time. Seek-

tion that the pattern of every iris is stable and unique

had the first inkling that he might be in-

ing to develop a prototype,

to each individual. iii The two inventors filed their pat-

terested in optics in high school, when

Safir won the support of the

ent in 1985, describing the idea of illuminating the eye

photography—both the art and technology be-

NYEE Research Committee,

to obtain an image of the iris, then verifying a match

hind it—caught his attention. But it would be de-

which awarded him $500. With

by comparing it to a previously stored image. Their in-

cades before he invented the ophthalmetron, the

“about six feet of bench space

novation launched the

first electronic refraction device.i,ii At age 18, af-

in someone else’s laborato-

evolving field of bio-

ter a year of studying engineering at Cornell Uni-

ry” and a borrowed double-

metric identification in

versity, Safir entered the U.S. Navy in 1944 and,

beam oscilloscope, he set to

use worldwide today.

based on an aptitude test, trained as an electron-

work. On the suggestion of the

Safir’s many ac-

ic technician. Following war’s end, he remained in

NYEE chief administrator, the

ademic appointments

the military for an additional year, working on air-

young inventor teamed up with

included instructor and

craft radio and radar systems. Once discharged,

a patent attorney who was also

p r of e s s o r p o s i t i o n s

an electrical engineer. The

at the Albert Einstein

ical student majoring in English and was accepted into

two built a working model cobbled together from sur-

College of Medicine,

New York University Medical School in 1950. There, he

plus parts purchased at the outdoor Canal Street hard-

Mount Sinai School of

soon discovered “the magic of the eye as an optical in-

ware stalls and a telescope made from the leftover mail-

Medicine, and the Bio-

strument.”

ing tube that had held Safir’s medical school diploma.

medical Sciences Graduate School at the City Univer-

he enrolled in New York University as a premed-

With an NYU postgraduate course in ophthalmol-

The idea of dynamic scanning to measure an op-

sity of New York, as well as director of the Mount Sinai

ogy under his belt, Safir became a resident at the New

tical system had never been patented before, and it took

Institute of Computer Science. He was an associate at-

York Eye and Ear Infirmary from 1956 to 1959, where

several rejections, a hearing, and six years from the ap-

tending surgeon at the New York Eye and Ear Infirma-

he conceived of and drew plans for a photoelectric de-

plication’s submission in 1958 to its granting in 1964.

ry (1959 to 1964) and an associate attending ophthal-

vice that he believed would improve upon the retino-

Bausch & Lomb licensed Safir’s patent that same year,

mologist at Mount Sinai Medical Center (1964 to 1980).

“The magic of the eye as an optical instrument” but for one reason or another, took eight years to man-

In addition to memberships in scores of professional so-

ufacture an instrument. By then, another company had

cieties, Safir was the recipient of many awards, such as

launched its own version and Safir’s Bausch & Lomb ret-

NYEE’s Alfred Huidenkoper Bond Memorial Award for

inoscope never attained a significant market share. “I

Excellence in Research (1959), the Gerard B. Lambert

made very little money from this invention,” Safir later

Award (1975), and the Award of Merit from the American

wrote. “If I were to reckon my income from it in dollars

Academy of Ophthalmology and Otolaryngology (1976).

earned per hours spent, I would have been far better off

In 2013, he was posthumously inducted into the National

to have spent my time practicing ophthalmology!”

Inventors Hall of Fame.

Even so, Safir’s scientific innovations did not end with the electronic retinoscope. In the 1980s, he collaborated with Leonard Flom to develop a highly accurate iris identification system based on the observa-

Left: Dr. Peter Frampton using a retinoscope.

Above: an iris identification scan.

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

DR. CHARLES D. KELMAN 1930-2004

H

Designer of the Phaco-Emulsifier for Cataract Surgery

ow does a young

working independently with the support of private grants,

tional Congress on Cataract and Refractive Surgery in

man growing up with

designed the phaco-emulsifier, an ultrasonic instrument

Montreal and was President of the American Society of

dreams of becoming

that emulsifies the nucleus of the eye’s lens to remove

Cataract and Refractive Surgery (ASCRS) from 1995-

a musician end up on the

cataracts.v,vi By 1967, Kelman was poised to transform

1997. His many other notable distinctions include the Ar-

world stage as the father of

ophthalmic surgery with the publication of his article ti-

thur J. Bedell Memorial Lecturer at the Wills Eye Hospi-

phaco-emulsification

and

tled “Phaco-emulsification and Aspiration—A New Tech-

tal, where the eponymous Charles D. Kelman Laboratory

a pioneer in using cr yo -

nique for Cataract Removal: A Preliminary Report,” in the

and Library are located; the American Academy of Oph-

extraction for intracapsu-

American Journal of Ophthalmology.vii After encounter-

thalmology’s Laureate Recognition Award for his

lar cataract extraction?i,ii,iii

ing considerable initial resistance, phacoemulsification

invention of phacoemulsification and the cryo-

Ophthalmologist Charles D.

drew increasing attention and Kelman conducted training

probe; and a place in the National Inventors

Kelman lived that remark-

courses in the technique to interested ophthalmologists

Hall of Fame in 2004. Kelman also received

able story. Born in Brooklyn,

outside the university department setting, another frame-

the Lasker Award, the nation’s highest

New York, in 1930, his earliest aspirations were musical.

breaking Kelman innovation.

award for medical science, posthumously.x

He was a talented jazz saxophonist and eager to perform

In effect, Kelman’s pioneering achievement rev-

professionally by his teens, but his parents told him he

olutionized cataract surgery like no other before it. Not

tional renown, and valued esteem of his peers,

could become anything he wished, as long as he became

only did his new procedure reduce the risk of complica-

the other “Charlie” Kelman—avid golfer, helicopter pi-

a doctor first.iv And so he did. After graduating from Bos-

tions and postoperative pain, it also transformed an ex-

lot, accomplished musician, composer, showman, and

ton’s Tufts University with a Bachelor of Science degree

tended hospital stay into a short outpatient procedure.

Broadway producer—thrived. A documentary, produced

in 1950, he received his medical degree from the Univer-

But Kelman didn’t stop there. He went on to design an in-

by New York metro area public television station WLIW21,

sity of Geneva in Switzerland in 1956, followed by an in-

traocular lens that could be inserted through a standard

titled “Through My Eyes: The Charlie Kelman Story,” high-

ternship at Kings County Hospital in Brooklyn. Kelman

phaco incision so as to maintain the benefits of small-

lighted the uphill battles in his long struggle to legitimize

then completed his ophthalmology residency at Wills Eye

incision surgery. He also invented and

Hospital in Philadelphia from 1956 to 1960, whereupon

patented numerous ophthalmic instru-

he entered private practice and became a member of the

ments and the phakic and aphakic intra-

attending staffs of the Manhattan Eye, Ear, and Throat

ocular lenses. Additionally, his contributions influenced

Hospital and the New York Eye and Ear Infirmary.

The young surgeon never abandoned his enduring

Along with the highest honors, interna-

The jazz of ophthalmology

the practice of plastic surgery as well as advances in other fields of medicine, such as neurosurgery.viii

phaco-emulsification. The homage features clips of Kelman’s nightclub act as he riffs on his jazz sax, performing “I’ve Gotta Be Me” and “Give Into That Secret Dream In-

passion for the sax, but chose to turn his improvisation-

Millions of patients worldwide have benefited from

side You.” What better theme songs

al talents toward creating new methods to facilitate cat-

the contributions of his ever-inventive mind. As a leading

for a man whose unstoppable drive,

aract surgery. Early in his career,

innovator in the field of ophthalmology, Kelman received

quicksilver humor, and irrepressible

Kelman’s use of cryosurgery for

numerous awards, including the American Academy of

passion contributed equal parts to

intracapsular cataract extraction

Ophthalmology Achievement Award (1970), the Ridley

his life work as a gifted and game-

and the invention of the cryo-

Medal from the International Congress of Ophthalmol-

changing ophthalmologist?xi

probe led to innovations relat-

ogy (1990), and the “Inventor of the Year Award” from

ed to small-incision cataract ex-

the New York Patent, Trademark, and Copyright Law As-

traction and the development of

sociation (1992).ix In 1992, Kelman received the pres-

phaco-emulsification.

Between

tigious National Medal of Technology and Innovation

1962 and 1963, Kelman, inspired

from President George H.W. Bush. In 1994, Kelman was

by dentists’ ultrasonic tools and

named “Ophthalmologist of the Century” at the Interna-

Itae eaquaectet ut aliam, volorum Left: Kelman demonstrating et quam quam, sinciat estrum the Phaco-Emulsifier. doluptibea corunte cullumquos Above right: the National Medal nobis cum esequia nisimin velectem of Technology and Innovation. faccaborem volorem osantur?

Right: Kelman a solo.

Solum takes estio tet

4. REACHING FOR MORE

1974

1946–1985

Through these and other savvy fundraising efforts, construction began on the $5 million Staff Residence Building in the fall of 1973 and was completed by the spring of 1974. Located at 321 East 13th Street between First and Second Avenues, the 14-story, 123-apartment building (complete with a 25-car parking garage) offered reasonably priced rentals for infirmary staff members as well as any other qualified hospital employees in the city. 54 In light of the uncertain economic and social climate, that the infirmary had successfully added two major and entirely modern edifices to its campus and rehabilitated its original site, all within seven years, was nothing less than remarkable.

Keeping the philanthropic flame alive contributed significantly to the infirmary’s ability to navigate through this era of turbulence and transition, as did scrupulously monitored reserves built from prior donations and its expertly managed plant. Yet even with the specter of deficit spending looming, the infirmary’s menu of services and capacities continued to grow, bolstering revenues. One example was the 1972 expansion of the infirmary’s Temporal Bone Dissection Laboratory. Established in 1958, it was the first of its kind on the East Coast and, as of 2004, is known as the Jorge N. Buxton, MD, Microsurgical Education Center.55 A second was the 1974 creation of the Retinal Diagnostic Center, with the assistance of a grant from the Dana Foundation; it would eventually evolve into the state-of-the-art Bendheim Family Retina Center, opened in 2003. Clinics were also established for neuropathology, uveitis and low vision.56 Another initiative was the formation of the Department of Plastic and Reconstructive Surgery at the end of the decade.57, 58 According to Dr. Donald Wood-Smith, he was approached by his good friend and colleague Dr. Byron Smith, chairman of the infirmary’s Surgical Committee, who believed that the public’s rising interest in aesthetic and reconstructive plastic surgery might be a financial boon for the hospital.59 Following this conversation, NYEE’s Medical Board’s Search Committee and administration asked WoodSmith to chair the Plastic Surgery Department.

Wood-Smith accepted, but with one proviso: that the fourth floor of empty beds be converted into an outpatient operating facility. It was an excellent recommendation.

Left: the NYEE Staff Residence Building, 1974.

Right: Phacoemulsification wet lab at the Jorge N. Buxton, MD, Microsurgical Education Center at NYEE taught by faculty and voluntary physicians.

119

120

“

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Meanwhile, the economics of health care were rapidly shifting. On top of a steady and swift uptick in labor costs, inflationary pressures, and serious restrictions in Medicare, Medicaid, and Blue Cross reimbursements,

Grave decisions face the infirmary...”

the explosion of malpractice insurance costs beginning in the mid-1970s had proven to be the undoing of many independent physician-practitioners and large health care organizations across the country. Implications for the infirmary were likewise threatening. “Malpractice insurance costs alone would have increased more than 13 times the amount paid at the beginning of the four-year period ending in 1977,” counseled infirmary President Guy G. Rutherfurd, who had succeeded Braislin in 1977. “But rather than yield to inflationary premiums,” he continued, “the infirmary initiated its own self-insurance fund for malpractice.” 60 However, the imperative to pool resources and reduce ever-spiraling maintenance costs grew only more immediate and magnified the infirmary’s need to broaden its network of shared services and collaboration with other New York hospitals. The hospital forged affiliations with the State University Health Science Center at Stony Brook and the Veterans Administration Hospital at Northport and reaffirmed those relationships already in place with Lenox Hill Hospital, New York University-Bellevue, Roosevelt Hospital, and the New York Infirmary. But would these efficiencies save the day? Some thought not. Dr. Gerald B. Kara strongly urged caution. “There is no doubt that the face and character of the infirmary will undergo changes in the near future,” he stated. 61 “The institution which, in solo fashion, has served the public so faithfully for over a century and a half will have to yield some degree of

Guy G. Rutherfurd, president of NYEE, 1977-1980.

1977

autonomy and individuality in any proposed merger.…Grave decisions face the infirmary; these decisions will determine the future course and destiny of our hospital. We are confident that, in whatever form, the infirmary will continue as a center for specialty care in New York.”

While conditions slowly changed by the late 1970s, the infirmary’s leadership remained firmly focused on the hospital’s long-term survival. And for good reason: Three of five of New York City’s eye, ear, nose, and throat hospitals had failed to survive this stormy era: 62 The Harlem Eye and Ear Hospital, which had closed, sold its assets, paid its debts, and distributed the remaining funds equally to the New York Eye and Ear Infirmary and Manhattan Eye, Ear, Nose, and Throat Hospital; the Bronx Eye and Ear Hospital, when faced with similar problems, merged with Bronx-Lebanon Hospital, which was itself exploring other merger possibilities at the time; and Brooklyn Eye and Ear, which closed after declaring bankruptcy in 1976. Although the infirmary was serving a portion of these institutions’ former patients, a significant percentage of the city’s population continued to flee to the suburbs, where ophthalmology and otolaryngology services were developing at an unprecedented rate.

4. REACHING FOR MORE

Career Days DID YOU KNOW

that in 1969, the Women’s Association of the New York Eye and Ear Infirmary launched Career Days, a pilot project aimed at encouraging highschool students with disabilities to consider health care careers? i The idea was initiated by the United Hospital Fund in 1965 and included all 59 member hospitals. NYEE was one of the first institutions to organize an event, inviting participants—24 students from Charles Evans Hughes High School and 24 ninth graders from Junior High School 47—to tour the infirmary on two different days. Mrs. Dorothy Dean, a blind medical stenographer from Long Island Jewish Hospital, addressed the Charles Evans Hughes students. Mr. Robert Clynes, a young man deaf since birth, explained his training and work experience to Junior High School 47 students. Brimming with hope, the animated groups crowded around the infirmary staff, who demonstrated specially adapted typewriters and telephone switchboards. Their message: You have a place here. You can do it. Let’s learn from each other.

The Sesquicentennial Ball AND DID YOU KNOW

that the 1970 Sesquicentennial Ball’s coveted raffle prizes did not disappoint?

After an evening of dining and dancing to the strains of the Meyer Davis Orchestra, a great hush descended over the Biltmore’s Grand Ballroom the moment the drawing of chances began. i Among the delighted recipients were Mr. Clifton Bertholf, Director of the Optical Department and an infirmary staff member since 1941, holder of the lucky ticket for a Grace Line Caribbean cruise for two. Miss Karen Miller, daughter of Board member Mr. Charles H. Miller, became the giddy new owner of a Sony portable color television, donated

by Gimbel’s, and Mr. Dale Blue, secretary to Mrs. Aleatha Tibbs Rapoport, director of the Orthoptics Department, won a dinner for two at the 21 Club—and was instantly “being pursued by all of the young ladies!”

1946–1985

The Bicycle Bash AND DID YOU KNOW

that the infirmary’s first Bicycle Bash, held on May 18, 1971, to benefit the construction of the Residents Building, was part of the kickoff of the City’s Spring Bicycle Season in Central Park? i Speaking at the ribbon-cutting ceremony, NYEE’s President Gordon S. Braislin joined Mayor John V. Lindsay at one of the Central Park South park entrances, where 200 bicycles, compliments of Tavern on the Green, awaited the infirmary’s guests. The event, organized by cochairs Don and Tess Durgin, members of NYEE’s Board of Directors, and a bevy of corporate sponsors, including the Colgate-Palmolive company and the First National City Bank, was designed to delight. The NYEE cyclists were greeted by a small combo from the Skitch Henderson Orchestra (taking a break from Johnny Carson’s late-night show), outfitted in period attire aboard two hansom cabs.

Playing a nonstop medley of 1890s tunes, these turn-ofthe-century pied pipers led the peloton across the park to the Tavern, decorated with early 19th-century bicycles, whose natural wicker hampers were filled to overflowing with yellow and white daisies. What better way to cool down from a “grueling workout” than with cocktails and dinner, followed by dancing to Henderson’s full orchestra and a balance-defying unicycle act by Jack, the Bicycle Clown?

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

The NY Telephone Co. Fire

NYEE’s Eye and Ear Kids in the ’70s

DID YOU KNOW

that in the wee hours of February 27, 1975, a fire broke out at the New York Telephone Company switching station at 13th Street and Second Avenue, just south of the New York Eye and Ear Infirmary? i,ii For 15 terrifying hours, clouds of acrid smoke billowed from the building as 500 firemen, many wearing face masks and carrying yellow tanks of compressed air on their backs, struggled to extinguish the stubborn blaze. A 300-block area in Manhattan lost telephone service and nearby residents rushed outside their apartments in nightclothes, huddled in tight knots against the freezing night wind, desperate for updates.

Cut off from routine lines of communication, officials from the New York Eye and Ear Infirmary immediately set up direct contact with fire officials on the ground.

Overcome by smoke, infirmary staff canceled all surgeries and supervised a partial evacuation of the hospital, asking on-the-scene radio reporters to broadcast live reports to advise patients’ friends and relatives as the situation evolved. By midmorning, the infirmary’s lobby was filled with families and homeward-bound patients.

Those who weren’t well enough to be discharged were transferred by ambulance to other hospitals, and outpatient clinics and surgeries were canceled for the day.

Although the infirmary was back to functioning normally within 24 hours, it would take weeks before telephone service was restored to the area.

N E W YO R K T I M ES A R C H I V ES

122

If a picture is worth a thousand words, this page is worth seven thousand— equivalent of a very happy short story.

4. REACHING FOR MORE

1946–1985

The Godfather at NYEE As it was, the infirmary struggled to maintain high occupancy rates, owing to the very nature of the specialty.63

This was soon exacerbated by several factors. For one, inpatient hospital stays withered, triggering

stunning financial consequences, as outpatient surgeries and the use of surgicenters ascended. For another, shrinking state government and insurers’ reimbursements all but mandating shorter hospital stays failed to meet most hospitals’ actual operating costs. For a third, emerging government policies designed to curtail spiraling health costs and enhance efficiency were also clearly aimed at encouraging regionalization and the concentration of medical facilities. When it came down to the infirmary, all these factors combined shaped one

DID YOU KNOW

that in the early 1970s, Francis Ford Coppola and his film crew took over a hospital room on the fourth floor of the infirmary’s South Building to shoot the hospital interiors for The Godfather? The scene features Mafia don Vito Corleone, played by Marlon Brando, in bed, recovering from gunshot wounds after an attempted mob hit. Michael Corleone, his son, played by Al Pacino, is by his side, on guard, in case another assassin attempts to breach Corleone’s security to finish the job.

urgent question: Could NYEE, devoted solely to the specialties of ophthalmology and otolaryngology, generate enough inpatient volume and income to survive over the long term?

In response, the board entertained a proposed merger with New York University (NYU), which owned and operated the New York University Medical Center, consisting of University Hospital and the Institute of Rehabilitation Medicine.64 Cooperation and bonhomie between the two institutions was long-standing. NYU’s medical school and its training programs had benefited from its teaching affiliations with the infirmary’s highly specialized staff. This advantage would only strengthen with a merger. And estimates showed the merger might increase the infirmary’s inpatient volume as much as 10 percent.65 It was also suggested that, given the prevailing trend toward university-based graduate medical education, NYU’s research capacities would fill a void in the infirmary’s existing programs and buttress its standing as a tertiary teaching center.66 As stipulated, the infirmary would become a division of the New York University Medical Center and all eye, ear, nose, and throat work of the Medical Center would be based at the infirmary, to the extent practicable.

However, there were several possible deal-breakers. According to documents, the “surviving corporation” would be the University, governed by the NYU Medical Center Board of Trustees.67 Although the infirmary’s Board of Directors “would cease to exist,” a number of its members would be appointed to the NYU Medical Center Board. Likewise, the infirmary’s Medical Board would be “dissolved,” with all members of the professional staff ranked as attending or associate attending joining the NYU Medical Center Board. Despite these hurdles, by mid-1978 the NYU merger had won the approval of the infirmary’s Board and life members, Over the next six months, however, it became clear that the younger staff harbored doubts about the proposed advantages. With time passing, President Rutherfurd pressed his case: “If we don’t merge, we face serious problems. Doctors are not lined up waiting to rent space in the hospital, our census continues to drop, our expenses cannot be met with patient income.…As we continue to lose money, we will have to start terminating employees. Some of the fears of our staff are founded.” 69, 70 That said, in an attempt to reassure, he added,

PA R A M O U N T P I C T U R E S

but “further assent,” by whom was unspecified in the Biennial Report, was “still necessary for ratification.” 68

123

124

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Alaska or Bust DID YOU KNOW

that in the summer of 1970, infirmary Otology fellow Dr. Dominador Almeda returned to New York after nine months in Sitka, southeast Alaska, as the only otologist in a 35,000-square-mile area and one of only four such specialists in all of the state?i As the recipient of the infirmary’s Alaska Fellowship, a three-year otology research project sponsored by the infirmary and an anonymous grant, in conjunction with the United States Public Health Department and the Alaska Crippled Children’s Association, Almeda provided care to 700 high school students who came from all over Alaska. He also routinely flew in a single-prop plane with a bush pilot to five isolated outposts where residents rarely saw a doctor, much less an otology specialist. On one dramatic occasion, a famous Tlingit elder and totem pole carver who had been deaf since 1940 was brought to Almeda for treatment. Astonishingly, the condition was operable, and news of the man’s improved hearing brought the young doctor more cases than he could possibly treat. As it was, over the course of his stay, Almeda performed 250 surgical procedures. But every now and then, the otologist-sportsman stole away into the Alaskan wilderness, where, he reported, the deer hunting and fishing were exceptional.

“No staff members will lose their status at the infirmary, New York University will not sell our plant and move the operation elsewhere, the OR schedule will continue as is, and members of the staff will have an ample opportunity to book patients.”71 In a response dated April 1979, the infirmary’s Affiliation Committee submitted a position letter that delineated 12 provisos for discussion and clarification, presumably forming the basis for another round of negotiations.72 Lacking archival documentation, it is impossible to speculate what was decided between then and March 1980. But the exercise became moot on Thursday, March 27, 1980, when discussion of the entire matter came to a screeching halt. That morning, President Rutherfurd had received a telephone call from Dr. Ivan Bennett, New York University’s acting president, informing him that the NYU Medical Center’s executive committee was withdrawing the merger option, citing “many difficulties which prevented the University from making the merger commitment at this time.” 73 Euphemisms aside, it was no secret that NYU, like many medical institutions, was itself facing a major financial crisis and had been forced to sell off its Bronx campus.74 The long-sought deal was dead.

Without hesitation, President Rutherfurd appointed a special committee of the board, medical staff, and administration to review the future course of the infirmary. Only months later, an affiliation proposal with the New York Medical College (NYMC), headquartered in the Westchester County suburb of Valhalla approximately 13 miles north of New York City, was on the table.75 Under its terms, the infirmary and NYMC would maintain their independent corporate status; infirmary staff members would be appointed to the NYMC faculty, and vice versa. The plan also called for the infirmary to expand its teaching program, develop a comprehensive laboratory, and improve care and services to NYMC’s community. Both institutions would cooperate to develop medical education and allied health programs, as well as form a joint review committee with equal representation to guide joint policies. Numerous stipulations governed the appointment of key leadership, administrative, and medical positions, including the election by the infirmary of a representative of the medical school to its Board of Directors.

By 1980, the health-care environment was as changeable as ever. On the federal and state level, the slow recovery from the disabling combination of inflation, increasingly high interest rates, and soaring unemployment and energy costs continued to directly impact health-care policy. Even as the recessionary wave ebbed, medical institutions were forced to find a balance between a system geared toward expansion and tightening regulations that constricted spending. At the time, there was much discussion about how

A Tlingit totem pole, Sitka, Alaska.

reimbursements might be in some way be associated with medical schools. In this respect, an affiliation

4. REACHING FOR MORE

“

N Y E E A F F I L I AT E S W I T H N E W YO R K M E D I C A L C O L L E G E

N

ew York Medical

ties merged to become New York Medical College, Flow-

College (NYMC)

er and Fifth Avenue Hospitals in 1938.

wa s founded in

New York Medical College relocated to Valhalla,

1860 by a group of civic-

New York, in 1972, at the invitation of Westchester Coun-

minded leaders led by the

ty government and Westchester Medical Center, which,

esteemed poet and own-

upon its completion in 1977, became a major clinical af-

er of the New York Eve-

filiate of the college. The following year, the college affil-

ning Post, William Cullen

iated with the Archdiocese of New York. Eventually, the

Bryant. i The institution

College’s Flower-Fifth Avenue Hospital in New York City

first opened its doors near Union Square, on the corner of 20th Street and Third Avenue, during the Civil War. In 1869, the school formally adopted the

was converted to a long-term residential care and shortterm rehabilitation facility and was renamed the Terence Cardinal Cooke Health Care Cen-

name New York Homeopathic Medical Col-

ter, a clinical affiliate of the college to the

lege, which was changed in 1887 to New York

present day. The college eventually short-

Homeopathic Medical College and Hospital.

ened its name to New York Medical Col-

In 1889, the College built the Flower

lege in 1974. A century and a half after its

Free Surgical Hospital, located at York Ave-

founding, the Archdiocese of New York

nue and 63rd Street, named in honor of Con-

NYU, like many medical instititutions, was facing a major financial crisis....The long-sought deal was dead.”

125

gressman Roswell P. Flower, who later became governor of New York. The college officially changed

and Touro College and University System, a 30-campus network of private higher education institutions under Jewish auspices and head-

its name to New York Homeopathic Medical College and

quartered in Manhattan, reached an agreement in which

Flower Hospital in 1908. By 1935, the college’s outpa-

Touro replaced the Archdiocese as NYMC’s sponsor. The

tients were being treated uptown at the Fifth Avenue

new alliance was celebrated in a ceremony held in New

Hospital at Fifth Avenue and 106th Street; the two enti-

York City’s Bryant Park on May 25, 2011.

Above: The New York Homeopathic Hospital Medical College, 1860. Right: New York Medical College today.

N E W YO R K M ED I CA L C O L L EG E ( A L L I M AG ES )

1980

1946–1985

126

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

PUSHING THE ENVELOPE: C O R N E A L M A P P I N G A N D T H E A B O R N L A B O R AT O R Y

I

t was a fortuitous meet-

measured the length of the human eye prior to the pro-

ing of the minds when

cedure using soundwaves. “With an accurate measure-

Mar tin Gersten, an in-

ment of the eye’s length,” Koplin explained, “mathemat-

ventor and autodidact pro-

ical equations were developed to define the accurate

ficient in many areas of

power of the implantable lens once the cloudy lens was

continued generosity, the division was renamed the

computing and engineer-

removed.”ii The device was commercialized by Surgical

Aborn Laboratory Center in 1988. (It was renamed the

ing, and Co-Director Dr.

Design in 1981 and subsequently sold to Alcon. In early

Aborn-Lubkin Eye Research Laboratory after Lubkin’s

Richard Koplin of the infir-

1982, they were approached by Dr. Dennis Gormley with

death in 2004.) By the late 1980s, the development of

mary’s Cataract Division,

the idea to topographically map the cornea. By this time,

the corneal topography technology was proceeding,

started the infirmary’s Bio-

Lubkin had joined the Bioengineering Division with fund-

largely underwritten by 10 physicians interested in the

engineering and Computer

ing from the Aborn Foundation. A few years earlier, in

initiative. The group, with the help of Professor Richard

Science Division, tucked

1978, Louis Aborn, a prominent New Yorker, had come to

Mammone, an applied mathematician from Rutgers Uni-

away in an unused space

Lubkin, reporting persistent pain in his left eye after hav-

versity, commercialized the first computerized corneal

on the fourth floor of the

ing consulted a string of other ophthalmologists whose

mapping system. By then, Koplin and his team, includ-

infirmary’s

South

Build-

“I barely knew a bit from a byte”

ing in 1979.i Back then, “I barely knew a bit from a byte,” Koplin admitted. But of one thing he was certain: The future of medicine belonged to technology. And so began the groundwork for what is now widely known as corneal topography technology.

Koplin and Gersten’s first innovation was in the field of ultrasound biometrics. In response to the new and growing requirements of visual outcomes related to cataract surgery, they invented a device that accurately

answers amounted to little more than changing his eye-

ing Dr. Evan L. Silvi, were ready to branch out in other re-

glass prescription. Realizing this was no ordinary refrac-

search directions, most significantly in developing a way

tive problem, Lubkin ordered a battery of tests and made

to measure the compatibility of intraocular lens implant

a diagnosis “of a perilous condition that must be caught

and the curvature of the eye following cataract surgery,

in time and urgently treated lest it result in blindness.”iii

assess damage to the optic nerve, and determine suit-

That Lubkin had gotten to the bottom of the problem and

ability of surgery or laser treatment for glaucoma.iv They

proceeded with treatment did not go unnoticed. By way

were also ready to hire more engineers and move into a

of thanks, Aborn and his wife donated $75,000 through

larger lab off-site to accommodate increasingly sophis-

their Aborn Foundation to establish a laboratory that

ticated equipment. To do so, they gathered a group of

supported, among other efforts, Lubkin’s lifelong all-en-

investors, split from the Aborn Laboratory, and founded

compassing passion to modernize the Eikonometer, an instrument first acquired by the infirmary in 1934 for determining the degree of aniseikonia.

Computed Anatomy, a private company. Their pioneering efforts led to the invention of the corneal mapper, the device known commercially as TMS-1, leading the way to precision corneal vision correction that

Lubkin approached Koplin, direc-

is still widely in use today.

tor of the nascent computer lab, with the Aborn donation, hoping to combine forces. The physician-scientists won additional funding from foundation grants and private individuals, most notably the Aborn family. In honor of their

Above left: Dr. Richard Koplin.

Above right: corneal maps.

Far left: at the Aborn Lab, circa 1988 (from left), Dr Dennis Gormley, Dr Richard Koplin, Martin Gersten, Dr. Evan Silvi, Dr Virginia Lubkin.

Left: the YMS-1 corneal mapper.

4. REACHING FOR MORE

1946–1985

Spreading the Word

on the Airwaves between the infirmary and the NYMC could be mutually beneficial: The infirmary would be able to extend its network, thereby improving its patient census, and NYMC would be able to add prestigious infirmary physicians to their rosters. To be sure, reimbursements were an important factor, but hardly the most important one.

Wedded as the infirmary was to its hard-earned autonomy as a specialty hospital, the affiliation had been structured to preserve its institutional independence. At the official public signing of the affiliation in September, Rutherfurd emphasized cooperation. “Together,” he stated, “we will continue to achieve our commitment to maintain the highest-quality patient care with an active teaching program and seek access to funding for research opportunities.” 76 Dr. Michael Wood Dunn, acting dean-chairman of the Department of Ophthalmology at New York Medical College and the first person to be appointed chairman of the Department of Ophthalmology at the New York Eye and Ear Infirmary, then spoke, highlighting the live-and-let-live nature of the relationship. “The position of preeminence as a specialty hospital that the New York Eye and Ear Infirmary has held for the past 160 years is key to the future of this institution,” he confirmed.77 Although the NYEE/NYMC affiliation represented another turning point in the infirmary’s evolution, other further-reaching transformations were on the way. The pace at which outpatient procedures and ambulatory care was spreading was unprecedented, as was the rise of specialties in every field of medicine. These factors alone were reshaping the practice, organization, and costs associated with every aspect of health care delivery.78 Persistent, too, was the problem of ever-shrinking reimbursement and the general trend toward corporatized, centralized planning, budgeting, and personnel decisions that would most certainly challenge traditional institutional and physician autonomy.79 Closer to home, other matters, such as repurposing the physical layout of the infirmary’s existing buildings to accommodate the surge in outpatient care, protecting its long teaching tradition, and fundamentally restructuring its voluntary physicians’ financial stake in the

1985

institution, would up the institutional ante and, once again, prime the infirmary for its next incarnation. 

DID YOU KNOW that in the early 1980s, New York Eye and Ear Infirmary doctors started appearing regularly on a wide range of television and radio programs, speaking about the infirmary’s latest advances in ophthalmology and otolaryngology?i Dr. Richard Koplin, medical director of Biomedical Engineering and Computer Science Division, chatted with health and science editor Earl Ubell of WCBS-TV’s evening news about the use of intraocular implant lenses following cataract surgery. Dr. Virginia Lubkin discussed ophthalmic plastic surgery and aired a short film on WORTV’s “Midday.” Dr. Richard J. MacKool, after performing a groundbreaking microsurgery on a 5-week-old infant, presided over a widely covered press briefing that aired on WNBC-TV “News 4 New York,” WABC-TV “Eyewitness News,” and WPIX-TV “Action News.” And Dr. K. Buol Heslin, Dr. MacKool’s cosurgeon, appeared on an NBC-TV network production of “Hour Magazine,” filmed on location at the New York Eye and Ear Infirmary. Truly, reality TV at its best.

127

128

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

T H E B E N D H E I M F A M I LY R E T I N A C E N T E R

W

hen Dr. Morton L.

a full-time fellowship on the Retinal Service

Rosenthal foun-

will be offered.” With ever greater percent-

non photocoagulation. The facility was unri-

d e d N e w Yo r k

ages of Rosenthal’s patients benefiting from

valed in New York City, positioned to provide

iv

fundus photography, and argon laser and xe-

the most sophisticated diagnostic and treat-

City’s first retina service at

his modern techniques, he was soon operat-

the infirmary in 1957, it is

ing on as many as 12 cases a day, all day long,

unlikely he could have ever

twice a week. Word of these innovative surgical

imagined that his pioneer-

techniques was attracting even more residents keen to

diseases, retinal tumors, and numerous other eye disor-

ing work would blossom into

learn them. So much so that by 1960, Rosenthal had be-

ders, all leading causes of blindness in the United States.ix

a world-renowned retina

come the Director of Fellowships in Retinal Surgery and

Upon Rosenthal’s re -

center. After completing his

after 1968, along with his colleague and boyhood friend

tirement in 1995, Muldoon be-

ophthalmology fellowship

Dr. Seymour Fradin oversaw a prestigious program ap-

came chief and the director of

at the Massachusetts Eye and Ear Infirmary under the

proved by the AMA and Retinal Society, typically training

the Retina Service and expand-

famous retina specialist Dr. Charles Schepens, Rosen-

12 host residents for 12 to 18 months each.v

ed his efforts to develop the cen-

i

ment procedures for complications due to diabetes, retinal detachment, vascular diseases, arterial

thal returned to the New York Eye and Ear Infirmary brim-

By 1969, fluorescein angiography was introduced

ter and incorporate the emerg-

ming with fresh ideas about how to improve retina sur-

as a new diagnostic tool for retinal vascular disease,

ing state-of-the-art diagnostic

gery. Few believed that the general surgeons’ prevailing

through the generosity of a patient of Dr. James Newton,

equipment. By 1999, the cen-

20 percent success rate could be bettered. For the most

a recent graduate of the retina fellowship who joined the

ter was equipped to offer digi-

part, his enthusiasm for setting up a separate special-

NYEE Retina Service. While the retina clinic remained in

tal fluorescein and indocyanine

ty service was met with resistance. According to Rosen-

a small suite on the first floor of the general eye clinic,

green angiography, 3-D ultraso-

thal’s daughter, Dr. Jeanne L. Rosenthal, senior attend-

patients had to be sent upstairs to the Photography De-

nography, and optical coherence

ing surgeon and associate director of the New York Eye

partment, where John Goller, the chief photographer, per-

tomography.x Argon, krypton, dye, diode, and YAG lasers

and Ear Infirmary Retina Center, “All six chiefs were very

formed the fluorescein angiograms. Dr. Thomas O. Mul-

were being routinely employed, as well as advances in

negative. But after a lot of cajoling and arguing, the only

doon, an upcoming graduate of the retina fellowship

the repair of complicated retinal detachments, long-act-

way they permitted Dad to do anything was if it were all

under Rosenthal and Fradin, who had since joined Newton

ing gases, silicone oil, heavy liquids, wide-angle surgical

under Dr. Berliner, who was a senior attending surgeon.

in practice, had an idea to use the South Building’s recent-

viewing systems, and endoscopy. State-of-the art vitre-

No one wanted to give him space so the Retina Service

ly vacated fifth floor operating rooms as a home for retinal

ous surgeries and procedures to address macular holes

basically started in a closet in the basement—the old flu-

testing. “I went to Jerry McCoy, the hospital administrator

and submacular pathology were routinely being per-

oroscopy room.”ii

at the time, and suggested we set up the Retina Diagnos-

formed. A rapid expansion of imaging and therapeutic

It was decided that by “pooling

tic Center there,” Muldoon recalled.vi “McCoy pointed to a

research initiatives were implemented under the direc-

all retinal detachment cases and ro-

large painting in his office and told me ‘Retina is the size

tion of Dr. Richard Rosen, a recent graduate of the reti-

tating the residents through the ser-

of a postage stamp to the infirmary…cataract surgery and

na fellowship under the tutelage of Muldoon and Dr. Jo-

vice on a three-month basis, the res-

ENT is our real business.’” After much persuasion, Mul-

seph Walsh. Studies of macular pigment density, retinal

ident staff [would] receive a more

doon persuaded McCoy to pay for the renovations and the

vascular blood flow, 3D ultrasonographic tumor volume

thorough training and the patients

newly consolidated Retinal Diagnostic Center opened on

measurements, and scanning laser ophthalmoscope mi-

improved.”iii By 1958, the naysayers

the fifth floor. Upon completion, the center was hailed as

croperimetry (SLO-MP) were added, and clinical trials of

were becoming the minority when it

offering “the best possible patient care with the newest

photodynamic laser therapy for age-related wet macular

was reported that “the newly formed

equipment and the latest in medical technology available

degeneration were just beginning.

Retinal Service has been working out

in the field.”

well and perhaps the thing of great-

tion grant, its capabilities now included electroretinog-

est interest is the fact that next year

raphy (ERG), ultrasonography, fluorescein angiography,

vii,viii

With the assistance of a Dana FoundaAbove left: Dr. Morton L. Rosenthal. Above center: a fundus image.

Above right: Dr. Thomas O. Muldoon. Left: Dr. Charles Schepens.

4. REACHING FOR MORE

1946-1985

At the technical heart of these achievements were the center’s advanced diagnostic modalities, including digital and scanning laser fluorescein angiography and indocyanine green angiography, wide-angle fundus imaging, three-dimensional ultrasound, and high-resolution optical coherent tomography (OCT), the equivalent of an MRI scan of the eye. These were networked to allow instant access of results throughout the institution using an innovative picture archiving and communication system (PACS). Equally as cutting-edge were the center’s complete treatment toolkit including diode, yttrium-alu-

As a direct result of many of these initiatives, the

minum-garnet (YAG) photodynamic laser therapy, trans-

transformation of ophthalmic imaging is well underway a

pupillary thermotherapy, and micropulse lasers, as well

decade later, as fluorescein angiography—the standard

Given the growing success of the Retina Service

as cryotherapy. By 2006, the newly dedicated Bend-

of care for diagnosing retinal vascular disease since its

with Muldoon at the helm, he was able to persuade the in-

heim Family Retina Center was the largest of its kind in

introduction in 1961—is giving way to OCT angiography,

firmary board of directors to construct a completely ren-

the New York area, with more than 40,000 annual pa-

which provides visualization of the retinal and the cho-

ovated Retina Center that would occupy the entire eighth

tient visits.xiii Thanks to a nearly $2 million gift through

roidal capillary networks at a much finer level of resolu-

floor of the North Building, in space formerly occupied

the Bendheim’s Family Foundation and Leon Lowen-

tion noninvasively.xv Moreover, because OCT angiogra-

by ENT inpatients. The $5 million, 9,600-square-foot fa-

stein Foundation, infirmary physician-scientists, working

phy does not require the administration of intravenous

...If that’s not a dream come true, what is?

dyes, it can be conducted more quickly, with no discomfort to patients. With the founding of the Advanced Retinal Imaging Laboratory, this and technologies targeting cellular-level pathology are now being used for a grow-

cility opened on March 24, 2003, and was considered

with other researchers from all over the world, were de-

ing number of high-value research and clinical applica-

a showcase for its award-winning innovative ergonomic

veloping high-resolution prototype imaging tools based

tions and studies of previously undetectable parts of the

space design, staff- and patient-friendly environs, effi-

on new forms of OCT, metabolic studies of retinal blood

eye. The next generation of ophthalmologists is now be-

cient patient throughput, and presentation. Perhaps as

flow, and multifunctional instruments that combined

ing trained on these NYEE state-of-the-art systems so

noteworthy as the center’s design was its impact on ex-

scanning laser imaging with microperimetry for assess-

that they will be able to take advantage of the new vis-

panded retinal care, with dedicated full-time retina fel-

ing visual function and structural correlations.xiv

tas available to tomorrow’s retinal clinician. Rosen, who

lows to complement the attending and resident staff and

is now chief of Retinal Services and director of Ophthal-

a full suite of advanced diagnostic technology to provide

mic Research, believes, “This technology is helping cli-

for a blossoming population of retina patients. With the

nicians to identify retinal disease progression early and

new Retina Center’s opening, the annual growth of the

perhaps prevent patients from ever reaching more ad-

clinic population jumped 25 percent, with patient visits

vanced stages of retinal degeneration.”xvi And if that’s

increasing dramatically from 12,400 in 1999 to 35,641 in

not a dream come true, what is?

2004. xi Over that same period, the number of ERGs performed grew from 65 to 509, angiograms from 3,000 to 4,757, and laser treatments from 3,025 to 5,969. And the cure rate for retinal detachments soared, to more than 92 percent by 2005.xii

Above left: entrance to the center today.

Above right: an OCT angiography readout.

Left: Dr. Richard Rosen and members of the Bendheim family at the Center’s opening.

129

A vision of hope

“

What makes New York Eye and Ear Infirmary so special is

the shared feeling and mindset of everyone who works here that it is an honor and privilege to be part of a hospital that

has made history through the centuries—the 19th, 20th, and now the 21st. It is our responsibility to protect and preserve the NYEE legacy, but also to innovate and transform NYEE so that for centuries to come, patients, trainees, the community, and our own physicians and staff will benefit from such a precious and enduring resource.”

— Dr. James C. Tsai, President, New York Eye and Ear Infirmary of Mount Sinai, Delafield-Rodgers Professor and System Chair of Ophthalmology, Mount Sinai Health System.

Image: Slice of a central retina section showing all layers (ONL, INL, GCL). Red indicates rod photoreceptors, located in outer nuclear layer (ONL). Green indicates Müller glial cells, whose cell bodies are located in inner nuclear layer (INL), and their branches across all three layers. Dark blue indicates the nucleus of all cells in three layers (GCL).

1986 –2020

5 A vision of hope 1986 –2020

1986

Following the recession of 1981-1982, some sectors of the national and local New York economy basked in the heady exuberance of yet another Wall Street boom.1 A wave of gentrification, most notably in lower Manhattan, gave rise to new businesses and an influx of young, upscale residents who snapped up rundown buildings for renovation. Some viewed the revitalization as an opportunity to put a fresh face on crumbling neighborhoods; others as the end of their cherished bohemian enclaves.2 What persisted, despite the recovery, were the city’s homeless and murder rates, the latter of which held steady until a 25 percent drop in 1992.3 But neither steep rents and inflated property values nor the grim crime statistics discouraged newcomers from settling in the New York metropolitan area. Between 1980 and 2005, the general population increased by 1.2 million, a significant number of whom were immigrants. As a group, these arrivals were more ethnically, racially, and culturally diverse than ever before, and they were reshaping the city anew.4,5

REVISING E X P E C TAT I O N S

Opposite: Erin Walsh, MD, and NYEE pediatric ophthalmology fellow Phillip Tenzel, MD, perform a cover test for ocular misalignment.

T

he infirmary, a prominent local landmark for more than a century and a half, joined a broad network of neighborhood associations and organizations by bringing its voice to the 14th StreetUnion Square Local Corporation and advocating for area improvements on behalf of its patients, employees, physicians, and neighbors alike.6 Embracing the philosophy that healthier people translate into healthier communities, the hospital redoubled its outreach efforts and launched the

“Sights and Sounds” speakers bureau to educate the broader public about eye and ear disorders, the importance of preventive care, and its wide range of services and free screenings.

134

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

The Eye Trauma Center

WIKIMEDIA COMMONS

DID

YOU

KNOW

t h at o n J a n u a r y 9, 1986, New York City’s Mayor Ed Koch ina u g u r a t e d t h e i n f i rmary’s New York Eye Trauma Center ? Cutting the ceremonial ribbon with a gold-plated s c a l p e l , h e b o a s te d , “[I’m] the only 61-year-old mayor in the country who can read without glasses.”i The center was founded by Dr. Richard Koplin, who directed it for the next 20 years, and was dedicated to treating sight-threatening injuries occurring daily throughout the tristate area. The center was affiliated with the National Eye Trauma System and the National Eye Trauma Registry. Among the celebration’s guests was the former NYEE patient Hector Oliveras of Ridgewood, Queens, who nearly lost his eye to a July 4 firecracker. With his sight restored, Oliveras presented the mayor with a corned beef sandwich from the Second Avenue Deli to replace the two Manny’s Moonachie Cheese Steaks Koch had lost in his bet with Harold Washington, the mayor of Chicago, waged on a highly contested Bears vs. Giants football game. ii Today, the New York Eye and Ear Infirmary of Mount Sinai is a national eye trauma center and the only service in the New York City metropolitan region with expertise in treating patients with ocular trauma. iii The Ocular Trauma Service is an integrated multispecialty service with more than 25 board-certified surgeons representing NYEE’s Anterior Segment, Retina, and Oculoplastic Services. Coverage is 24/7, with a triage officer represented by the senior house staff. Patients are referred from the New York region, as well as from around the United States, for primary and secondary repair of complex ocular injuries.

Meanwhile, the infirmary’s leadership was prescribing another kind of comprehensive health assessment: a thorough self-reexamination of certain terms initially set out in the infirmary-New York Medical College affiliation relating to self-governance. Insofar as both institutions valued their respective autonomy, the alliance was tacitly defined as “live and let live.” Yet, in areas where the two entities intersected, not all was seamless. Part of the official 1980 affiliation agreement had designated Dr. Michael Wood Dunn, from the New York Medical College, as chief of the infirmary’s Department of Ophthalmology—an appointment that was met on the infirmary side with resistance from the onset, which only grew. In 1988, NYEE’s leadership was ready to confront this thorny issue head-on, determined to recruit a candidate from within the infirmary “family.” To that end, three of the hospital’s senior physicians—Drs. Thomas O. Muldoon, Robert C. Della Rocca, and Joseph B. Walsh—held an informal strategy meeting to discuss the infirmary’s long-range future and, more specifically, who should take the helm.

Muldoon and Della Rocca had an idea. According to Walsh, “It was therefore with some surprise that I was approached on January 15, 1988, during a Saturday morning breakfast at the Larchmont Yacht Club, by Dr. Muldoon and Dr. Della Rocca (my fellow classmate and friend), about becoming, on a ‘temporary’ basis, the Chair of Ophthalmology at NYEE/NYMC [sic].…Their charge, as recorded by Bob on a legal pad as bullet points: Leadership, Respect, Teaching, Image and Quality, Contacts—National and International—Research and NYMC relationship.” 7 Once the “nominee” had agreed to take on the position, the infirmary’s medical board convened a meeting with the New York Medical College’s leadership at which the board insisted upon replacing Dunn with one of its own. The infirmary prevailed and on March 1, 1988, Walsh officially assumed his “temporary” duties as Professor and Acting Chair of Ophthalmology, soon to become Professor and Chair of Ophthalmology—a position he would hold for the next 25 years.8 In 1989, scarcely a year into Walsh’s tenure, the infirmary reported bottom-line profits of $286,000, due, in part, to cost cutting and its new affiliation with Beth Israel Medical Center. 9, 10 The slim margin made it clear that it would take more than austerity measures and active outreach to increase utilization. But the hope was that time and demographics just might be on the infirmary’s side. The first wave of Baby Boomers would be turning 65 by the end of the decade. If forecasts were correct, the “forever young” Boomers would soon be dealing with age-related conditions—hearing loss, cataracts, glaucoma, complications from diabetes—as well an increasingly popular demand for plastic surgery: prime candidates for the infirmary’s specialty services. NYEE’s leadership asked, “Would the infirmary be ready?”

The $4 million Center Campaign was launched to renovate the infirmary’s 5th floor Ambulatory Care Center in

Top: Mayor Ed Koch. Above: the Second Avenue Deli corned beef sandwich.

the North Building. By 1991, of the 120,000 people treated in the infirmary’s Ophthalmology and Otolaryngology Outpatient Care Centers, only 17,000 had been admitted for surgery.11,12 Shortly after the new Ambulatory Center opened, the infirmary’s leadership signed a lease/buyout option on the Manufacturers Hanover Bank building

5. A VISION OF HOPE

1986–2020

135

Bebop Heaven

“

across 14th Street at 230 Second Avenue. This location would become home to the comprehensive Vision Correction Center once the technological advance of excimer

The first wave of Baby Boomers...

Would the infirmary be ready?”

1991

laser was approved.13 During a period when most other hospitals were cutting back, the infirmary had solidified its position as a preeminent specialty care center, operating with greater efficiency and within a balanced budget.14 And, most importantly, adding new patient care programs and services all the while.

Behind the scenes, long-needed organizational changes were also well underway.15 In February 1991, Walsh and his colleagues convened what is informally referred to as “The Shelter Island Retreat,” all-day meetings over the course of a weekend that took place at Muldoon’s and Della Rocca’s summer homes. According to Walsh,

D I D YO U K N OW

that world-renowned jazz trumpeter “Dizzy” Gillespie and the wo r l d - r e n ow n e d i nve nto r of phacoemulsification and jazz lover/performer Dr. Charles Kelman didn’t meet on the stage, but at the New York Eye and Ear Infirmary, when the latter performed successful cataract surgery on the former?i Some would say it was a match made in bebop heaven.

those in attendance in addition to himself were Paul Kessler, NYEE president; Elaine Berg, executive vice president; Rafaela Almodovar, departmental administrator; Mora Comerford, director of nursing; Margaret Stanton, director of ambulatory care service; Della Rocca, Muldoon, and Dr. Alan Weseley, surgeon directors; Dr. Mark Speaker, residency director; and Drs. David Glaser and Paul Sidoti, residents.16 Among several identified problems, those critically tied to keeping the infirmary clinics functioning smoothly included inconsistent attending staffing, inadequate oversite of the clinics, the lack of central control of staffing and monitoring of pa-

“Homage to Hippocrates,” mural-size painting mounted in the North Building lobby.

tient care, and the need for a better structure for resident education. These issues pointed to the need for a long-range plan to overhaul the institution’s traditional voluntary organization.17 The transition would involve reorganizing from a horizontally structured institute with six surgeon ophthalmology directors and six surgeon otology directors to one with vertically integrated clinical services, headed by fulltime associate directors who would function as core teaching faculty. It was a model more akin to a university structure, divided into general and subspecialties, such as glaucoma, retina, ocular motility, cornea, plastics, neuro, and so on.18,19,20, 21 Also under serious consideration were strategies to create a “cadre of dedicated, highquality attending instructors, assuming the responsibility for clinic care, resident education, and research…designed as to be financially neutral and independent of the hospital.”22 A range of financial structures was considered, ultimately leading to formation of the New York Eye and Ear Infirmary Ophthalmology Associates, PC, in September 1992. 

From top: Dizzy Gillespie and trumpet; Dr. Charles Kelman and sax; doctor and patient at NYEE.

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NYEE 200: A VISION OF HOPE

D R . J O S E P H B R E N N E N WA L S H , FAC S , F R C O p ht h 1940-2017 “In a lifetime you can help but a finite number

responsibilities grew, his involvement with the infirmary decreased—if only temporarily.

of patients, but by sharing your knowledge

In 1986, while Walsh was acting chair of Ophthal-

and experience with students, your impact

mology at Montefiore and acting editor of the journal

increases logarithmically.” i

Ophthalmology, he opted to take a part-time sabbatical from his duties and asked Muldoon to be his preceptor in

— Dr. Joseph B. Walsh, FACS, FRCOphth

E

retinal surgery. Recognizing Walsh’s gifts, Muldoon welcomed him into his private practice. A year later, in 1987,

ver inspiring, ever committed to the greater good,

with his Montefiore commitments fulfilled, Walsh joined

and ever revered by his family, friends, and col-

the infirmary/New York Medical College teaching staff.

leagues, Dr. Joseph B. Walsh, distinguished reti-

In 1988, and much to Walsh’s surprise, Muldoon and Dr.

nal specialist, educator, and humanitarian, died August

Robert C. Della Rocca approached him with a proposi-

25, 2017, at the age of 76. He served as professor and

tion: Would he consider becoming the infirmary’s inter-

chair of the New York Eye and Ear Infirmary of Mount Si-

im chair of Ophthalmology? Walsh accepted the “tem-

nai’s Department of Ophthalmology for 25 years, and

porary” post on March 1, 1988, and served continuously until his retirement 25 years later. “Little did I know when

helped to reinvigorate its reputation as one of the top ophthalmology institutes in the country, before retiring

gy as a career specialty and he decided to apply for oph-

as chair in 2013.

thalmology residencies nearby. But the Vietnam War in-

But Walsh’s enduring association and devotion to

tervened.ii In 1968, following the Tet Offensive, Walsh

the infirmary actually began decades before. Upon re-

was abruptly transferred to Vietnam and was unable to

ceiving his bachelor’s and medical degrees from George-

make his scheduled interview at the New York Eye and

town University in 1966, Walsh became a medical res-

Ear Infirmary. To his great relief, he was accepted into the

ident at Boston City Hospital/Boston University Health

program on his merits alone.

Service while on a United States Air Force assignment

According to Walsh, the infirmary’s training pre-

on the East Coast. There, his fellow intern and friend Dr.

pared him well for his subsequent retinal fellowship with

Richard Mackool suggested Walsh explore ophthalmolo-

his legendary mentors Drs. George Wise and Paul Henkind, as well as his academic career at Montefiore Medical Center/Albert Einstein College of Medicine (AECOM) where he served as director of residency training, director of the retina service, and vice-chair and associate professor of Ophthalmology. During his first few years at Montefiore, NYEE’s Dr. Thomas Muldoon invited him to run the infirmary Retina Service’s Thursday night Fluorescein Conferences, which were always followed by dinner at the popular Sparks Steak House on 16th Street. Walsh also helped organize and run the infirmary’s Ophthalmology Board Review Course, the first of its kind in the country, as well as the infirmary’s Annual Spring Alumni Meeting. But, as his Montefiore/AECOM

I entered the New York Eye and Ear Infirmary in July Far left: Walsh and his residents’ graduating class, 1988.

Below: with a patient. Opposite: Walsh at his desk, circa 2000.

Far right: at the opening of the NYEE Retina Center, 2003.

5. A VISION OF HOPE

1986–2020

1970,” he recalled, “what the relationship between this

Under Walsh’s leadership, the infirmary grew to

the institution he served so selflessly extended far be-

august institution and myself was to unfold over the next

become one of the world’s top eye institutions. But,

yond his position and title. He often described the in-

40-plus years.”iii

as always, he was quick to attribute its success to

firmary in personal terms and proudly stated, “Several

Walsh was an acclaimed expert in retina medicine

“many, many, individuals, including the Board of Direc-

years ago, over 44 multigenerational infirmary physi-

and surgery whose research and clinical findings were

tors, Administration, Nursing, Support Services, and

cian families were identified…and this multi-genera-

widely published in peer-reviewed journals and text-

Philanthropy,” adding, “the most vital component has

tional support is found also in infirmary departments

books.iv Committed to humanitarian work, he was knight-

been the attendings, residents, and fellows.” v Known

throughout the institution. I am honored to be a part

ed by the British Order of St. John for providing quality

and beloved as a tireless teacher and advocate for the

of this extraordinary committed family.” vi Those of us

ophthalmic care to underserved populations at St. John’s

infirmary’s residents, he poured his vast energy into

at the New York Eye and Ear Infirmary who were priv-

Eye Hospital in Jerusalem and received the New York

mentoring and inspiring generations of ophthalmolo-

ileged to know Dr. Walsh and touched by his encour-

State Ophthalmology Society’s Hobie Award. He also

gists, always encouraging them to follow their dreams

agement, guidance, and gentle humor might respect-

served as president of the New York Society for Clinical

and strive for excellence. Walsh’s deep attachment to

fully disagree: in truth, the honor was all ours.

Ophthalmology and was honored as the Society’s 45th Mark J. Schoenberg Memorial Lecturer. In 2009, he was named as the first recipient of the infirmary’s Belinda Bingham Pierce and Gerald G. Pierce, MD, Distinguished Chair of Ophthalmology.

He poured his vast energy into mentoring and inspiring generations of ophthalmologists.

137

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

L I G H T-Y E A R S A H E A D

L I G H T-Y E A R S AHEAD

1995

I

n 1995, the infirmary celebrated its 175th year with spirited optimism. And deservedly so: the institution was ranked as one of the top specialty care centers for ophthalmology and otolaryngology in the nation by U.S. News & World Report.23 With more than 145,000 outpatient visits that year, the Department of Ophthalmology

could proudly take credit for being the most comprehensive and highly utilized eye care center in the region, meeting the specialized needs of patients across all ages and eye disorders. 24 A stream of pioneering techniques, services, and clinical trials set the infirmary apart. Researchers at the infirmary were at the forefront of developing new techniques for laser treatment of retinal diseases, incorporation of silicone oil and fluorocarbons, and wide-angle viewing and endoscopic vitrectomy for improving the success rate of retina detachment surgery.

The Glaucoma Center was making extensive use of laser technology for treatment and diagnostics, computerized optic nerve analysis, visual field-testing equipment, the first clinical high-resolution ultrasound biomicroscope in the United States, and one of the first prototype optical coherence tomography (OCT) systems in the world. The Department of Pediatric Ophthalmology and Ocular Motility was employing advanced diagnostic and therapeutic approaches that involved the use of botulism toxin, innovative orthoptic modalities, and complex surgical procedures to treat ocular disease in children and visual motor problems in patients of all ages.

Infirmary surgeons associated with the Plastic and Reconstructive Surgery Department were exploring the use of various plastic materials and patients’ own cartilage to construct an absent outer ear, for example, for the treatment of a condition called microtia.25 A unique microvascular surgical procedure to transfer tissue to

repair or reattach missing digits was also being performed, as well as a wide array of the latest techniques for elective plastic surgery: endoscopic face-lifts, no-incision eyelid blepharoplasty, and liposuction for reshaping body contours. On the research and innovation front, the infirmary was paving the way to the future. To name only a few: basic cell biology studies were underway, leading to a better understanding of uveal melanoma conducted in the world’s only lab able to sustain and study these cells in vitro, as well as investigations into correcting nearsightedness and farsightedness without making a surgical incision and the development of corneal topography, permitting surgeons to use the experimental picosecond laser to remold corneal tissue for vision correction. A multifaceted telemedicine program incorporating telediagnosis and education for both patients and physicians, locally and around the world, was also introduced.26

Doctor and patient in the Plastic and Reconstructive Surgery Department.



5. A VISION OF HOPE

THE DEVELOPMENT OF THE NYEE OPHTHALMOLOGY ASSOCIATES

T

raditionally, voluntary or not-for-profit hospitals

Recognizing that these time-honored traditions

were organized for charitable purposes and com-

needed to adapt to 20th century exigencies to survive,

munity benefit. Physicians gave of their time to

several senior members of the infirmary’s staff initiat-

attend charity patients who might otherwise go with-

ed the idea of forming the New York Eye and Ear Infir-

out care and, in exchange, the hospital provided private

mary Ophthalmology Associates, a professional corpo-

practitioners access to facilities, equipment, and staff

ration (PC). According to Dr. Thomas O. Muldoon, who

that they could not provide for themselves in their offic-

spearheaded the effort, “Voluntary attendings have a

es. Voluntary hospitals also functioned as “hubs” of med-

lot of talent and contribute to the educational program

ical expertise, a fixed location where senior colleagues

and the success of a hospital. So they should be active

could pool their knowledge as well as mentor advanced

participants and not left behind. If a hospital or medical

medical students while treating eligible patients in a free

school has only salaried employees, they may not feel

or low-cost clinical setting. For decades, this win-win-

the same deep loyalty as those who have a vested in-

win arrangement worked. “Voluntary call systems,” as

terest in strengthening the long-standing values of the

one source described them, “reflected the abundance of

institution.” ii The goal of forming the associates, a legal

the past, and being a good citizen and taking a call as

entity separate and distinct from the infirmary, was to

part of your obligation to the community.” i But following

provide greater continuity between the infirmary’s teach-

World War II, the economics and models of health care

ing physicians and its residents, and to optimize quality

delivery began to change.

patient care.iii Not only did it aim to establish a system,

By the 1980s, a complex convergence of factors,

based on an equitable formula, that would compensate

including advancing and expensive medical technolo-

the infirmary’s voluntary staff for their instruction in the

gies, physician specialization, ascendancy of managed

clinic and the operating room, but also to contribute dis-

care, increasing federal regulation, the rise of ambula-

cretionary funding to enhance teaching and research

tory care, and decreasing reimbursements, was squeez-

programs.

ing the voluntary model to the breaking point. Increas-

Upon winning support from all the stakeholders,

ingly, physicians were bypassing voluntary hospitals and

the New York Eye and Ear Infirmary Ophthalmology As-

choosing, instead, to invest their expertise in medical or-

sociates, PC was formed in September 1992. Revitalizing

ganizations in which they had a proprietary interest. In

results were immediately forthcoming. As quickly as a

an attempt to stay competitive, many voluntary hospi-

year later, Chairman Walsh noted a marked improvement

tals began to grant high-profile, prestigious individuals

in the quality and extent of coverage in both the Gen-

staff privileges that carried no obligation to serve the un-

eral and Subspecialty Clinics.iv And in 1995, the asso-

derserved or teach. Both trends upended long-held val-

ciates had contributed in excess of $840,000 to the in-

ues and practices in medical institutions across the Unit-

firmary for teaching and research—an amount that soon

ed States, including the infirmary. The pressing question

reached into the millions of dollars with every successive

became: Was there a way to attract the most talent-

year.v Coming up on three decades later, the New York

ed practitioners—those who are often drawn to private

Eye and Ear Infirmary Ophthalmology Associates, con-

practice—to teach and train the next generation of phy-

tinues to maintain a strong financial position and occupy

sicians?

an integral role in protecting and nurturing the infirmary’s venerable tradition of medical education that began 200 years ago.

1986–2020

The Cochlear Implant Program of Mount Sinai DID YOU KNOW that in 1992, Alex Carrasco, a bright and lively 10-year-old from Brooklyn, was the New York Eye and Ear Infirmary’s first recipient of a cochlear implant? i Born without hearing deficits, Alex developed early language skills and grammar, but then became deaf as a result of a bone disorder, osteogenesis imperfecta, which gradually immobilized his inner ear. But thanks to his memory of hearing, Alex was an excellent candidate for a stateof-the-art 22-channel device. More than a “super hearing aid,” the early cochlear implant amplified sound and had a speech processor that coded the vibrations into electrical impulses carried by an implanted electrode to the auditory nerve. Alex underwent this delicate five-hour operation conducted by Dr. Christopher J. Linstrom, a nationally recognized otologic surgeon and director of Otolaryngology Resident Education at the infirmary. Over the course of the next three months, under the guidance of the infirmary’s communication sciences team and a representative from Cochlear Corporation, the manufacturer of the device, Alex learned to decode and translate these electrical messages into recognizable language. Today, more than 150 cochlear implant procedures are performed annually at the New York Eye and Ear Infirmary at Mount Sinai’s Ear Institute.

Dr. Christopher Linstrom and assistant with Alex Carrasco and family members.

139

14 0

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

SEEING THINGS STRAIGHT The Orthoptics Service at NYEE glass prism bars. These were superseded by innovative plastic prism bars introduced by the infirmary’s Dr. Con-

nicians were providing orthoptic services to more than

rad Berens in 1939.v But it was Elizabeth K. Stark who

4,000 patients annually in its Orthoptic Department, also

took the practice of orthoptics in the United States to

referred to as the Orthoptic and Perimetric Department.xi

the next level. Having worked and collaborated with Dr.

Under the guidance of infirmary doctors Bruno S. Priest-

LeGrand Hardy and Berens in the strabismus clinic, she

ley, Abraham Schlossman, and J.M Shier, residents ac-

honed her expertise by traveling abroad to train at Mad-

tively participated in orthoptic workups that included

dox’s Orthoptic Clinic. After Stark returned from London,

fusion evaluation on the major amblyoscope.xii With pa-

she helped found the first orthoptic clinic at the Fifth Av-

tient volume increasing annually, two new troposcopes

enue Hospital with Hardy in 1932.

A year later, Berens

were purchased in 1955, financed by the sale of many

followed suit and opened an orthoptic clinic at the infir-

unused and outmoded instruments.xiii In 1960, Priestly in-

vi,vii

S

ince the 1930s, the Orthoptics Service at the New

York Eye and Ear Infirmary has helped countless patients enjoy a better quality of life through the

diagnosis and nonsurgical management of disorders of eye movement and binocular vision.i The study of orthoptics traces its early origins back to the writings of Dr. Emil

Javal, a French ophthalmologist who, in 1893, initiated

By the 1950’s, NYEE’s certified orthoptic tech-

mary where, in 1935, he also established, with orthop-

troduced the practice of pleoptics for the treatment of

tists Stark and Ethel Mueser, the first School of Orthop-

amblyopia, which became its own separate Department

tics in the United States.viii,ix Shortly thereafter, growing

for a brief period of time.xiv,xv By the end of the 1960s the

interest in the field prompted the 1938 formation of the

infirmary’s Orthoptic and Pleoptic Service, then part of

American Orthoptic Council, which organized the first

the Department of Ocular Motor Anomalies, had expand-

invitation-only written and oral practical certification ex-

ed greatly in space and staff, reporting approximately

ams for orthoptic technicians in the United States, held

25,000 patient visits in 1968—the largest such service in

in March 1939 at the infirmary.x

the United States.xvi

the use of the stereoscope and exercises to treat strabismus.ii By the turn of the century, Dr. Ernest Edmund Maddox, an English surgeon and ophthalmologist with an interest in abnormal binocular vision, began to invent devices to treat the condition.iii So busy was his practice that he trained his eldest daughter, Mary Maddox, in his methods. And it was she who went on to pioneer the field of orthoptics and establish the first Orthoptic Clinic at London’s Royal Westminster Ophthalmic Hospital in 1928.iv However, ophthalmologists in the United States were less receptive to the discipline. Among the few early adherents who did recognize the importance of ocular motility and prism exercises was the infirmary’s Dr. Henry D. Noyes, who, in collaboration with Dr. George M. Gould, devised the first

“Every patient is unique and fascinating—

5. A VISION OF HOPE

1986–2020

Orthoptists have long partnered with ophthalmol-

Pediatric Ophthalmology Department embraces a multi-

ogists to provide evaluation of and vision screening pri-

dimensional and multimodal approach, leveraging the or-

marily for children with binocular vision and eye move-

thoptists’ extensive clinical experience and highly tuned

ment problems, such as strabismus and amblyopia. But

observational skills to detect visual signs and cues, even

the recent growth of pediatric ophthalmology as a spe-

in nonverbal infants. “Through regular monitoring of chil-

cialty has extended their practice to include pediatric

dren with ophthalmic issues, such as amblyopia and bin-

glaucoma and cataract disease. With pediatricians de-

ocular problems,” Shippman adds, “we are able to pro-

tecting vision problems and strabismus in younger pa-

vide better treatment and possibly prevent some types

tients, more preverbal children are being referred to pedi-

of vision loss.”

atric ophthalmologists for diagnosis. Sara Shippman, CO,

Another recent change has been the number of

who graduated from the infirmary’s School of Orthoptics

adults receiving orthoptic evaluation and treatment. Peo-

in 1967, became the director of Pediatric Ophthalmolo-

ple are living longer and orthoptists are increasingly called

gy/Orthoptics in 1971, and has seen these changes first-

upon to help patients with age-related disorders, such as

hand. “Before pediatric ophthalmology opened here in

cataracts, diabetic eye disease, age-related macular de-

1963, we were mostly working with older children who

generation, systemic or neurological vision disorders, and

were six, seven, or eight years old,” she recalled.xvii But

low vision. Employing early detection and regular moni-

then give them specific options to help them deal with

now staff orthoptists can begin interventions earlier, be-

toring, orthoptists can help patients with these condi-

the problem.” xix

fore the children’s developing brains have accommodat-

tions avoid progression and vision loss.

Shippman’s

Today, while the infirmary’s Orthoptic Department

ed to their visual disparities. Therefore, the infirmary’s

practical philosophy speaks to the infirmary’s humanis-

is no longer freestanding and the School of Orthoptics

each is a new chapter.”

xviii

tic and individualized approach: “Every patient is unique

was discontinued in 2006, four staff orthoptists still run

and fascinating; each is a new chapter. Our aim is to un-

one of the largest clinical programs in the country, un-

derstand our patient’s problem, whether a child or adult,

der the umbrella of NYEE’s Pediatric Ophthalmology/Or-

describe the problem to the parent or the patient, and

thoptics/Adult Strabismus Service, and treating more than 5,800 patients per year.xx With access to the latest imaging and vision diagnostics and their partnership with ophthalmologists throughout the Mount Sinai Health System, NYEE’s orthoptists are ideally positioned to provide highly individualized evaluations of and specialized treatment to patients of all ages with vision disorders. xxi

Opposite above: Sara Shippman, CO, with a patient.

Cross spread below: Artwork from pediatric patients.

Above: Sara Shippman with a parent.

141

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

NYEE’s Ocular Tissue Culture Laboratory

MANAGING MANAGED CARE

DID YOU KNOW

that in 1990, Dr. Dan-Ning Hu established the NYEE Tissue Culture Laboratory and developed the first successful methodology for isolation, culture and study of human iris pigment epithelial cells (1992), human uveal melanocytes (1993), and conjunctival melanocytes (1997) in collaboration with Dr. Steven A. McCormick, Chief of Pathology.

In 1995, the Tissue Culture Laboratory was renamed the Tissue Culture Center by Infirmary President Joseph Corcoran, and, in recognition of his achievements, Hu was appointed Research Professor of Ophthalmology at New York Medical College. This lab also established various in vitro models for studying the functions and roles of uveal melanocytes and retinal pigment epithelial cells in ocular physiology and pathology. In collaboration with Dr. Richard Rosen and others, Hu demonstrated that a deficiency of melatonin is associated with and may have a causal effect on age-related macular degeneration. They also found that zeaxanthin, a native component of macular pigment, has potent anti-VEGF activity and can inhibit the growth and metastasis of uveal melanoma. Hu and Rosen have continued their studies, with promising results in their search for antidotes to mitigate the onset of hydroxychloroquine retinopathy.

Following NYEE’s 2013 merger with Mount Sinai Health System, the Laboratory was relocated in 2017 from its original Infirmary location to the medical school campus to improve access to additional laboratory facilities.

F

1999 As cultured in the NYEE Tissue Culture Laboratory in the 1990s: Above: human iris pigment epithelial cells; Left: human uveal melanocytes.

orward momentum or none, managed care and federal programs continued to bear down not just on the infirmary, but health care institutions and physicians across the nation, simultaneously ratcheting up demands and slashing funding and reimbursements. By 1996, the region’s newly powerful health

maintenance organizations (HMOs) controlled the health care of approximately 6 million New Yorkers, triggering a spate of huge hospital mergers, aiming to consolidate their bargaining positions and negotiate better reimbursements. 27 Doing so held the prospect of reducing expenses by sharing such backend functions as purchasing, maintenance, billing, legal, and marketing. In mid-June of that year, Mount Sinai and New York University Medical Centers announced they would merge. Two weeks later Beth Israel and Long Island College Hospital declared likewise. Soon after, New York Hospital and Presbyterian Hospital detailed plans to unite, forming a care network that would control roughly 16 percent of Manhattan’s hospital-patient market and one of the largest not-for-profit health care systems in the nation. 28

The rapid and voracious nature of this shift presented a menacing threat to the infirmary’s very existence.

Lacking access to managed care contracts, the infirmary—the last specialty hospital in New York City to remain independent after this wave of mergers—saw its clinic visits, largely composed of Medicaid patients, drop from 98,000 annually in 1993 to 84,000 in 1998. 29 During January and February of 1999 alone, new patient visits declined by 10 percent, compared to the same period the previous year. 30 Such drastic erosion was unsustainable both in terms of solvency and the infirmary’s residency program. Chairman Walsh explained the situation in straightforward terms in a detailed letter to his infirmary colleagues dated March 25, 1999: “The Departmental Executive’s first choice would be as each of you, to hold the banner high and claim our historical place in the sun but this route is fraught with risk. All projections of a standalone course lead to a continuing weakening institution and the likely demise of the infirmary as we know it and as it was given, in trust, to us.” 31, 32 If securing managed care contracts must be the infirmary’s lifeline, few choices remained but to participate as part of a network or health services management organization. A decision was made to proceed accordingly, bearing in mind that the least restrictive of these arrangements would be a partnership that allowed for an independent infirmary, budget, board of directors, and professional staff.

Previously, the infirmary’s Executive Committee had weighed an alliance with New York University, which, by 1998, was clearing the final hurdles to merge with Mount Sinai Medical Center. 33, 34 But following extensive due diligence, the infirmary’s leadership determined that joining with Continuum Health Partners was the preferable option. NYEE announced its decision in June 1999 and upon signing the agreement with Continuum, the 103-bed infirmary became part of a health care network that also included Beth Israel, St. Luke’s-Roosevelt, and Long Island College Hospital, totaling 3,108 beds and an annual operating budget of

5. A VISION OF HOPE

1986–2020

C O N T I N U U M H E A LT H PA R T N E R S , I N C .

C

ontinuum Health Partners’s history begins with

Like many metropolitan hospitals in the late 1970s,

the merger between St. Luke’s-Roosevelt Hospi-

St. Luke’s and Roosevelt Hospitals were suffering from a

Hospital Center in Brooklyn; it also created an outpatient center on Union Square.iv

tal Center and Beth Israel Medical Center in 1997,

plummeting patient census and a surfeit of empty beds.

Signaling a major shift for all parties involved, the

whose separate but esteemed reputations had earned

Their merger in 1979 created St. Luke’s-Roosevelt Hos-

1997 merger of Beth Israel and St. Luke’s-Roosevelt under

them both respect.i St. Luke’s Hospital, founded in 1858

pital Center, with the hope that the consolidation would

the umbrella of Continuum Health Partners, Inc., a hold-

by William August Muhlenberg, pastor of the Episcopa-

shore up their troubled financial standings by eliminating

ing company, involved redistributing board seats, reas-

lian Church of the Holy Communion, opened on Fifth Av-

duplicated services and reducing personnel and capaci-

signing the management of joint finances, integrating 13

enue between 54th and 55th

administrative functions,

Streets, then in 1896 moved

and downsizing physician

into a newly constructed building on 113th Street. ii In 1953, St. Luke’s merged with

These were the very lifelines NYEE needed —or so its leadership believed.

nearby Women’s Hospital, becoming St. Luke’s Hospital Center and a teaching hospital for Columbia University’s

staff. HealthWorks, a purchasing subsidiary, was formed to provision mem-

ber hospitals.v What didn’t change were the hospital’s

College of Physicians and Surgeons. Roosevelt Hospital

ty. However, by the 1990s, following the completion of an

teaching affiliations: Beth Israel retained its primary affil-

was established in 1871 with a founding gift from James

ambitious $500 million expansion—the largest hospital

iation with the Albert Einstein College of Medicine, a unit

Henry Roosevelt, a wealthy New Yorker and distant cous-

development project in the United States at the time—St.

of Yeshiva University, and St. Luke’s-Roosevelt main-

in of two presidents, who had died in 1863. Located on

Luke’s-Roosevelt was drowning in unsustainable losses

tained its ties to Columbia University’s College of Phy-

the block bordered by West 58th and 59th Streets and

and the institution sought to create a stabilizing alliance

sicians and Surgeons. From the start, however, the alli-

Ninth and Tenth Avenues, it, too, expanded with the con-

with Beth Israel Medical Center, known for its success-

ance began experiencing financial difficulties, accruing

struction of the nine-story Ward Building in 1923 and the

ful management.

millions of dollars in operating losses on both sides in its

nine-story Tower Building in 1953.

Beth Israel Medical Center’s long and venerable

history also began in the 19th century.iii In 1890, a founding group of 40 Orthodox Jews incorporated the Beth Is-

first year alone. Even so, Continuum joined with Long Island College Hospital in 1998 and added the New York Eye and Ear Infirmary to its portfolio in 1999.

rael Hospital, a dispensary on Manhattan’s Lower East

But as serious as the prognostications were, the

Side. A year later, Beth Israel had outgrown this modest

New York Eye and Ear Infirmary was betting on an up-

storefront and moved into a leased building large enough

side. With the insurance industry threatening to shut out

to form a 20-bed hospital, administered in strict accor-

independent specialty facilities in favor of managed care

dance with Orthodox Jewish religious practices. After

contracting with large one-stop-shopping health care

many decades and several moves, the hospital relocated

systems, joining Continuum Health Partners offered the

to a new 13-story, 500-bed facility adjacent to Stuyves-

infirmary access to its existing 48,000 Health Insurance

ant Square at East 16th Street in 1929. In 1964, Beth Is-

Plan subscribers as well as the possibility of a place at

rael acquired Manhattan General Hospital across the

the insurance contracting table for future managed care

street and changed its name to Beth Israel Medical Cen-

contracts. These were the very lifelines NYEE needed—

ter in 1965. By the 1990s, the institution began a sprawl-

or so its leadership believed.

ing, multisite expansion, purchasing Doctors Hospital on the Upper East Side, then DOCS Physicians, a suburban network of primary-care clinics, and Kings Highway

143

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

DARKNESS VISIBLE The World Trade Center, 9/11/01

O

n Tuesday, September 11, 2001, New Yorkers awoke to a glorious morning bathed in clear, blue skies. It was business as usual in the city.

At the infirmary, patients were arriving for their early appointments and the hospital staff was busy checking paperwork and filling examination rooms, like any routine day. That is, until 8:46 am, when American Airlines Flight 11 flew into the North Tower of the World Trade Center, followed shortly thereafter by United Airlines Flight 175 hitting the South Tower—a catastrophe that would transform lower Manhattan and the world forever. News of the attack reached the infirmary within minutes, and NYEE activated its disaster plan. The Ear, Nose, and Throat

WIKIMEDIA COMMONS

144

Clinic was closed and transformed into a fully bedded triage area. Its staff, gloved, gowned, and masked, stood ready to back up nearby Beth Israel Medical Center and other tertiary care hospitals.i All quickly became shadow and ash. The first 9/11 patient to arrive at the infirmary was a dazed woman, covered in fine gray dust from head to toe, who had somehow walked uptown from Ground Zero.ii As the horror of the day unfolded, fewer survivors than expected sought help. But more than 75 first responders—police officers, firefighters, and paramedics—overcome with smoke in-

“It was not the downtown we knew… it was a war zone.” dent at the time.iii “It was not the downtown we knew…

The group, composed of key staff at all four partner hos-

ritations were treated and released. Unwilling to desert

it was a war zone.” infirmary triage teams were sched-

pitals, was divided into 12 subcommittees, each ad-

those who remained on duty, many immediately returned

uled in six-hour shifts around the clock and provided care

dressing different aspects of disaster preparedness.

to the disaster site. Heroes, each one.

to hundreds of rescue workers. Three days later, the Na-

Contingency plans were put into place to cover commu-

At the request of the city’s Office of Emergen-

tional Guard took command and the last infirmary team

nications, pharmacy supply management, and other ar-

cy Management, the infirmary established rescue work-

left Stuyvesant High School at noon on Friday, Septem-

eas vulnerable to breakdown in the event of an emergen-

er centers at four different locations one block from the

ber 14. Throughout the crisis, team members maintained

cy or terrorist attack. Staffwide trainings and education

disaster area: Independence School, the Century 21 de-

cell phone communication with the NYEE command sta-

were implemented involving simulations of a “bioterror-

partment store, Stuyvesant High School, and Burger

tion and distributed ophthalmic medical supplies from the

ism” event, detailed drills, and decontamination tents

King. “We left the infirmary in the sunlight, but as we ap-

infirmary’s stock, later refreshed with supplies from phar-

erected in the infirmary parking lot—all in the solemn

proached the 10-block perimeter of the World Trade Cen-

maceutical companies, volunteer health projects, and pri-

hope that none of these preparedness protocols would

ter, the sun disappeared behind a heavy, gray cloud…

vate concerns from across the state and the nation.

be necessary ever again.

halation, corneal abrasions, conjunctivitis, and other ir-

inches of dust covered the streets, buildings, every leaf

During the two weeks following 9/11, the infirma-

on the trees and blanketed the incinerated abandoned

ry joined with its Continuum partners to form a Nuclear,

vehicles,” stated Dr. Aimi Mosney, a senior NYEE resi-

Biological, and Chemical Preparedness Planning Group.iv

The aftermath of the 9/11 attack on the World Trade center.

5. A VISION OF HOPE

1986–2020

$1.6 billion.35 Robert G. Newman, Continuum’s president, stated, “At a time when too many hospitals want to be all things to all people, I think it says a lot when institutions can recognize their relative strengths.” 36 Moreover, he continued, the intention of the consolidation was not, referring to the infirmary, “to close or gobble up a specialty hospital and have it lose its identity.” 37 The plan called for Continuum to designate the infirmary as its Center of Excellence for ophthalmological care, thereby providing the hospital a source of networkwide managed care contract patients as well as a diversity of cases. But would the infirmary/ Continuum alliance deliver? Only time would tell.

NO EASY SOLUTIONS

2001

A



s industrywide assessments of large-scale health systems became available, one conclusion was clear: Not all health care mergers are created equal. In general, efficiencies were realized across the board; however, successes were uneven with respect to integrating clinical services and physician

staffs. In many instances, attempts to meld personnel and services too quickly met with greater resistance than anticipated.38 By contrast, in other arrangements, the emphasis was less on integration and more on coexistence.

Such was the case in the infirmary’s alliance with Continuum Health Partners. “They left us alone” is how many infirmary doctors describe the Continuum merger in retrospect.39 But not entirely. Since 1988, the infirmary

and Beth Israel had engaged in cooperative agreements, such as in the Voice Lab and Vestibular Rehabilitation Service, located at the infirmary since 1993.40 Now the number of collaborations and interdependencies grew.

The infirmary began relying on Beth Israel’s blood bank and radiation therapy services. And there were joint efforts with Beth Israel’s Hyman-Newman Institute for Neurology and Neurosurgery. 41 The infirmary’s resident education programs also deepened its ties to Beth Israel and St. Luke’s-Roosevelt and, prompted in part by a greater need for distance learning and archived presentations, added webcasting capabilities to its Internet presence. 42 Then, in the summer of 2001, three years into the Continuum merger, Beth Israel Medical Center suffered another catastrophic cash-flow problem, echoing its 1997 $2.2 million loss.43 On the verge of hitting rock bottom and with its bonds downgraded to “junk status,” Beth Israel’s Board of Trustees saved the day by raising $15 million in contributions.44 Some observers believed Continuum might be able to regain its financial footing by restructuring its debt and merging more of its departments, whereas others were less optimistic.45 While not grappling with the same challenges as an acute-care facility like Beth Israel, the infirmary had its own obligations to meet. Long regarded as the “safety net” for the ailing elderly and poor, the institution drew patients from a wide geographical area. In 2002, for example, 25 percent of the infirmary’s patients came from the Lower East Side and Manhattan service area, 41 percent from Brooklyn, 17 percent from Queens, and 13

145

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

An Eye for an Eye DID YOU KNOW that the

New York Eye and Ear Infirmary and Eye Bank held the first colloquium of its kind on the future of organ, tissue, and eye transplantation and donation in 2005?i The conference, titled “Eye on the Future,” featured 30 speakers who addressed the cultural, ethical, legal, and medical issues related to anatomical donation. One of the three cochairs who organized the meetings was Dr. Wing Chu, a cornea surgeon affiliated with NYEE and the medical director of the Eye Bank.

percent from the Bronx; a significant percentage of them were Medicaid or Medicare recipients, self-payers, or uninsured, which translated into reduced reimbursements or none at all.46 As a consequence, that same year the infirmary carried over $7 million in uncompensated care, comprised of more than $3 million in charity care and nearly $4 million in uncollectable debts. 47 Another $320,999 was expended on community service activities.48 The seesawing patient census did not help either. Although the infirmary was treating a larger percentage of HMO patients with every passing year, overall ambulatory care visits and new patient visits dipped 7 percent in 2003. 49 This low point was followed by an uptick in 2004, only to decline again by 2006.50 Judging from the statistics, the only constant was volatility. Even so, the infirmary’s leadership, under the able and steady presidency of Joseph P. Corcoran, made a point to improve its future prospects by seeding new strengths and advancing those already established. In 2000, Dr. Donald Wood-Smith, chair of the Plastic

A More Natural Approach

Surgery Department, created the Postgraduate Aesthetic Surgery Training Program, which attracted a

AND DID YOU KNOW

rates of other Manhattan hospitals. 51 A new Retina Center, conceived and realized under Muldoon’s direction,

that in 2008, the New York Eye and Ear Infirmary surgeons Robert Allen, Joshua Levine, and David Greenspun—a trio of the world’s leading breast reconstructive surgeons—traveled to Tel Aviv to hold a weeklong seminar with their Ichilov Hospital colleagues to introduce their newly developed microsurgery technique for women undergoing mastectomies?i,ii In effect,

and...

the pioneering procedure would chart the course to the future.

Unlike older methods of breast reconstruction based on permanent implants inserted under the chest muscles, the innovative perforator breast flap surgery utilizes the patient’s own skin and tissue, taken from her abdomen and buttocks. Without interfering with the muscle, the flap is transplanted to the mastectomy site to replace the removed skin and tissue and tailored to be as symmetrical with the remaining breast as possible.

Today, at NYEE’s New York Center for the Advancement of Breast Reconstruction, state-of-the-art muscle-sparing and implant-free microsurgical breast reconstruction options are available to women of every body type. For those who are candidates, a breast created from living tissue that looks and feels more natural is a healing alternative in itself.

heretofore untapped pool of patients seeking quality aesthetic surgery at costs significantly below the going opened in 2003, and was followed by the inauguration of the Jorge N. Buxton, MD, Microsurgery Education Center in 2004. And in 2005, NYEE’s Breast Service, composed of three pioneering surgeons, Drs. Robert Allen, David Greenspun, and Joshua Levine, began offering mastectomy patients a breakthrough surgical alternative using their own tissue rather than the traditional synthetic implants for breast reconstruction.

Demand for this more natural approach grew to such an extent that two of the infirmary’s operating rooms were upgraded and dedicated to their advanced microvascular technique. 52 Meanwhile, the infirmary received additional recognition from the United States Eye Injury Registry as the Eye Trauma Center for New York City.

During this same period, the Oculoplastic and Orbital Surgical Service, guided by Della Rocca, was implementing plans to enhance Web-based teaching to international sites and institutions and to enlarge the clinic footprint to develop clinical information and the availability of imaging procedures. 53 “Starting with Drs. John Wheeler, Wendell Hughes, and Byron Smith through Drs. J. Gordon Cole and John Simonton, the infirmary has been known as the ‘Mecca’ for international and national ophthalmologists for decades and ‘the place’ where patients with the most difficult and complex ophthalmic plastic and reconstructive surgery continue to come,” Della Rocca, now system chief of Oculoplastic Reconstructive Surgery at the Mount Sinai Health System, recalled. 54 “Under Walsh’s leadership, everyone was encouraged to be involved. “We were always asking, ‘Can we do this better?’ or ‘How do we make this better?’ That’s the way we kept the infirmary’s greatness moving forward.” Consonant with this spirit, Dr. Seymour Fradin, Dr. Richard Rosen, and other physician-leaders spearheaded a proposal to construct a 10-story, 60,000-square-foot Research Institute on

5. A VISION OF HOPE

1986–2020

The Chodosh Award the site of the infirmary’s parking lot. “[The infirmary’s] favorable situation may be only temporary unless we make the necessary decisions to expand our clinical and research base,” Fradin explained. 55 “In the face of continued increase in patient volume and new and advanced methodology and research,” he argued, actualizing this project “is our ultimate and permanent legacy and responsibility.” Although the proposal failed to gain traction, it was undeniably prescient.

Several milestones signaled renewed momentum during 2007 and 2008. Not only was the infirmary maintaining a balanced budget in a challenging health care environment characterized by declining reimbursements and increasing regulatory requirements, but it had also begun to expand its network of outpatient facilities and physician satellite offices on the Upper East Side and in Chinatown, Flushing, Brighton Beach, and Westchester.56 The hospital was also attracting new benefactors. In 2006, the Leon Lowenstein Foundation gifted the Bendheim Family Retina Center $1.5 million, earmarked to support NYEE physician-scientists in their quest to develop new technologies for noninvasive imaging to better diagnose and treat retinal disease.57 And a record-breaking $600,000 was raised at the hospital’s 2007 “Thanks for Giving” ball, honoring distinguished Board Member Susan Liebowitz and esteemed physician Dr. Richard Kabakow.

That same year, benefactors Shelley and Steven Einhorn’s $2 million donation established the infirmary’s first endowed chair—the Shelley and Steven Einhorn Distinguished Chair of Ophthalmology.58 Its first recipient was Dr. Robert Ritch, professor and chief of the infirmary’s Glaucoma Services, surgeon director and director of International Training, and the Recipient of the 2007 American Academy of Ophthalmology’s Lifetime Achievement Honor Award.59 Three years later, the Einhorns gave the infirmary a second major gift:

DID YOU KNOW that in 1999 the New York Eye and Ear Infirmary established the Paul L. Chodosh, MD, Professorship in Otolaryngology to honor Dr. Paul L. Chodosh, a consummate clinician whose commitment to medicine embraced the critical role of education and inspiring mentorship? So, too, are his dedication to providing the best otolaryngological patient care, achievements in interdisciplinary inquiry, and surgical innovations being celebrated in the recent creation of the Paul L. Chodosh, MD, Teaching Scholar Award by NYEE and the Chodosh Family. The Chodosh Award, as the professorship is now called, is bestowed once every three years to a full-time Otolaryngology faculty member for being an exceptional educator in the field of Otolaryngology by our institution’s own residents and fellows. With an endowment currently valued at approximately $700,000, the awardee receives $100,000 over that same period. The inaugural Chodosh Award awardee is Dr. Maura K. Cosetti, Associate Professor, Otolaryngology and Neurosurgery, Icahn School of Medicine at Mount Sinai, and director, Otology/Neurotology, Mount Sinai Downtown. Dr. Cosetti’s delivery of the prestigious Paul L. Chodosh, MD, Lecture at the formal award reception promises to be the first of many more to come.

$1 million to found the Shelley and Steven Einhorn Clinical Research Center, envisioned as a platform from which the infirmary would mount groundbreaking clinical research into the causes and treatment of glaucoma, a condition that can strike without warning and cause irreversible eye damage.

“Since the opening of the Einhorn Center on March 18, 2010, our group, alone and in collaboration with others, has produced over 350 peer-reviewed published manuscripts and about 450 conference presentations.

Among the Center’s many achievements is the establishment of a world-renowned ophthalmic imaging center focusing on adaptive optics, OCT angiography, diabetic retinopathy, and high-resolution OCT imaging of the retinal structures involved in glaucoma and correlation of damage to these with visual fields and their progression,” Ritch stated.60 “Through a more recent $1 million grant from the Safra Family Foundation, in collaboration with Mount Sinai, we discovered the first cellular mechanism for any glaucoma, showing that exfoliation syndrome, the most common recognizable cause of open-angle glaucoma worldwide, is a disease

Dr. Muara K. Cosetti with a patient.

147

148

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Project Chernobyl DID YOU KNOW that in 2006, members of the New York Eye

of autophagy, such that the cell is unable to recycle misfolded waste protein aggregates. Since 1984, the

and Ear Infirmary’s Otolaryngology Department organized an international conference at the United Nations titled “Living With Radiation: Diagnosis and Treatment of Thyroid Cancer After the 1986 Chernobyl Nuclear Accident”? i,ii

Glaucoma Foundation Think Tank has focused annually on this disease, leading to rapidly increasing genetic and biochemical studies and significantly increasing the number of researchers globally. Our hope is to make this a preventable or even reversible disease.” 61 A selective glimpse of the infirmary’s other clinical and research activity during this period was likewise impressive. Consider the 2008 opening of the Ear Institute, a comprehensive clinical center located a few blocks north on Second Avenue, dedicated solely to the diagnosis and treatment of ear disorders. Or the collaborative efforts between ENT surgeons and NYEE’s Department of Radiology, using CT, MRI, and PET/ CT imaging, who were endoscopically removing tumors located deep in the nasal passage and skull base. 62, 63 Then there was the infirmary’s Head, Neck, and Ophthalmic Cancer Registry—the only one in the United States. The infirmary’s high volume and diverse clinical armamentarium also attracted more than 100 clinical trials, largely related to ocular tumors, glaucoma, and retinal imaging and diseases, including groundbreaking

With an estimated 100,000 immigrants from the affected region settling in the New York metropolitan area alone, this population was at high risk for radiation-induced thyroid cancer. Although the disease typically appears in adults approximately 20 years after exposure, early detection and screening can potentially optimize its management. By bringing together the world’s leading authorities on the subject in such a high-profile venue, infirmary physicians were determined to alert and inform colleagues nationwide whose patients might be among the Chernobyl survivors. In 2009, their commitment evolved into the infirmary’s Project Chernobyl and the Thyroid Disease Center.

work supported by National Institutes of Health/National Eye Institute grants. Additionally, infirmary physicians were a part of the prestigious National Eye Institute Pediatric Eye Disease Investigative Group for amblyopia treatment studies. An array of other trials in the areas of uveitis, macular degeneration, corneal and external disease, and vision correction was underway as well. 64 In 2009, Dr. Gerald Pierce, an infirmary alumnus, and his wife, Belinda, established the infirmary’s second endowed chair—the Belinda Bingham Pierce and Gerald G. Pierce, MD, Distinguished Chair of Ophthalmology at the New York Eye and Ear Infirmary in honor of his friend and mentor, Chairman Joseph B. Walsh, MD—and designated Walsh as its first recipient.

Just shy of a decade after joining Continuum, the infirmary continued to make impressive strides as Chairman Walsh pursued the institution’s teaching charter with vigor and NYEE’s academic standing climbed higher than ever. The hospital’s medical faculty directed highly competitive training programs in ophthalmology, otolaryngology, and plastic and reconstructive surgery. Of the roughly 450 residency applicants from top medical schools across the country, only seven individuals were selected annually, with classes of 20 residents and fellows graduating each year. 65, 66 The hospital was staffed by almost 700 full-time employees, including

Above: the 2006 UN “Living With Radiation” conference.

Right: the Chernobyl power plant in 2006 before the construction of the sarcophagus containment structure.

WIKIMEDIA COMMONS

100 in nursing positions, and approximately 631 community and full-time medical and dental professionals who were providing care for nearly 128,000 ambulatory visits and 22,000 ambulatory operating room procedures annually. 67 Concurrently, the number of certified infirmary beds had contracted to 69, fewer than in previous decades but adequate to accommodate the roughly 1,200 patients annually who were admitted as inpatients for complex surgical procedures that required hospital stays, now averaging a mere 2.2 days. 68, 69

DID YOU KNOW

In 2012, consistent with its past record of national recognition, the infirmary was once again named one of “America’s Best Hospitals,” as well as one of the top specialty hospitals in the New York metropolitan area

by U.S. News & World Report.70 That year’s Annual Report documented continued growth across all core specialties and the volume of surgeries, including laser procedures, numbered 31,132. Had Superstorm Sandy not wreaked havoc throughout Manhattan and the surrounding region that year, it is likely the 2012 totals would have surpassed 2011’s 31,544.71 As it was, the infirmary’s clinics were as busy as ever, logging 126,202 outpatient visits and drawing patients from diverse communities across the five boroughs.

Investing in its primary facilities, the infirmary opened a Perioperative Care Unit, finalized plans for the major renovation of the 9th floor Pediatrics Unit, continued to lay the groundwork for opening two new operating rooms in 2013, and upgraded the 7th floor. Many more enhancements, including the installation of state-of-the-art ophthalmology ceiling-mounted microscopes in all 12 ophthalmology operating rooms, were put into place. All the while, NYEE’s research activities were intensifying. To mention only two: a Clinical Research Consortium, in conjunction with Bausch & Lomb, was established to encourage bench-to-bedside research by infirmary ophthalmologists, and a generous gift of the David Marrus Family Foundation funded the creation of the Adaptive Optics Imaging Lab in collaboration with the Eye Institute of the Medical College of Wisconsin.72 Also, as of 2012, the infirmary’s larger financial outlook was much improved, with a 59 percent increase in revenues over the four previous years and $18 million in cash flow, maximized reimbursements, and a reduction of outstanding receivables.73 Several community satellite plans were in development, including joint ventures to open ambulatory surgery centers in the Bronx, Manhattan, and two others in Brooklyn and Queens, as well as four new NYEE physician satellite offices in Bay Ridge, the Upper 

149

Susan Liebowitz

Manhattan suffered a widespread power outage during Superstorm Sandy, 2012.

West Side, Bayside, and Astoria the following year.74

1986–2020

WIKIMEDIA COMMONS

2012

5. A VISION OF HOPE

(continued on page 159)

that Susan Liebowitz’s service contributions to the New York Eye and Ear Infirmary are inestimable?i A tally of the time and energy she has poured into chairing numerous charity and public relations events and the hundreds of thousands of dollars she helped raise in support of NYEE stand without peer. Her involvement with the hospital began when, in 1968, she married Dr. Solomon Liebowitz, an alumnus of the infirmary who played an important role as president of the infirmary’s Alumni Association during the 1990s. After raising two daughters and earning her real estate license in 1983, Mrs. Liebowitz brought her fundraising acumen to the Auxiliary of the New York Eye and Ear Infirmary, serving as president from 1984 to 1992. She was also a member of the United Hospital Fund Committee of Voluntary Initiatives from 1987 until 2002.

In 1992, Liebowitz was invited to join the infirmary’s Board of Directors, later held the position of board liaison on the infirmary Quality Care Council and, beginning in 2001, was a charter member of the Board of Directors of the Continuum Quality Care Board. She retired from both boards in 2002. Having championed the infirmary’s cause for decades, Susan Liebowitz was named Margaret Loeb Kempner Humanitarian Award Honoree for community service at the 2007 “Thanks for Giving” Ball—a fitting homage to her life of tireless, determined devotion and open heart.

At a fundraiser circa 1990: celebrity Kitty Carlisle, NYEE President Paul R. Kessler, NYEE Auxiliary President Susan Liebowitz (right).

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

PRACTICE MAKES PERFECT The Jorge N. Buxton, MD, Microsurgical Education Center

A

ny

surgeon

will

11-station Temporal Bone Laboratory designed by Jack

confirm that mas-

Urban on the South Building’s 5th floor.vi At the time, Ur-

tering the tactile

ban had designed only one other laboratory of its kind in

feel and three-dimensional

the world: the House Otology Group in Los Angeles. NY-

anatomy of any kind of sur-

EE’s Temporal Bone Laboratory flourished under the di-

gery requires hours and

rection of Dr. Emmett E. Campbell, otologist and NYEE

hours of focused practice

alumnus, whose courses attracted more than 1,800 resi-

long before operating on a

dents and attending physicians, and drew students from

real patient. What could be

as far away as Australia, Egypt, Great Britain, Japan, In-

better than to acquire the

dia, Iran, Ireland, and the Philippines. In 1995, the lab’s

necessary hands-on expe-

directorship passed to Dr. Christopher J. Linstrom. He,

rience through simulations in a laboratory designed ex-

along with Arthur Tortorelli, the technical director of

pressly for that purpose? Go no further than the New

the facility since 1977, carried on the practice of offer-

York Eye and Ear Infirmary’s Jorge N. Buxton, MD, Micro-

ing highly sought-after temporal bone dissection cours-

surgical Education Center—a premier facility that bridg-

es. From 2003-2008, Dr. Joseph Arigo led the facility.

es the gap between academic medicine and the operat-

He initiated extensive hands-on dissection programs in

ing room.i,ii,iii,iv

temporal bone surgery, alongside Dr. Stimson Schantz,

The center is built on NYEE’s tradition of intensive

who coordinated head and neck anatomy courses; Dr.

microsurgical training. In the early 20th century, Dr. Ed-

Steven Schaefer, who oversaw training in sinus surgery;

gar Burchell took that tradition a step further when he

and Dr. George Alexiades and Linstrom, who shared

single-handedly assembled a world-famous collection of

their skull-base surgery expertise.

WIKIMEDIA COMMONS

150

more than 500 meticulously dissected temporal bones

In 2002, recognizing the need to incorporate ac-

and accessory sinuses that came to be the basis of study

celerating technological advances in microsurgery, a

for generations of surgeons to come. His groundbreak-

team of otolaryngologists, ophthalmologists, engineers,

ing investigations of the seventh facial nerve and its re-

and architects, led by ENT and eye residency program di-

lationship to potential disfigurement inform surgeons to

rectors Linstrom and Dr. Richard Rosen, worked for more

performed under

this day. Burchell’s foundational efforts led to the 1958

than a year to develop the lab’s next redesign. When it

creation of the New York Eye and Ear Infirmary’s first of-

was time to name the center, sentiment was strong to

magnification, with delicate

ficial Temporal Bone Laboratory, located on the 7th floor

honor Buxton, NYEE’s first chief of Cornea Service in

of the South Building, which consisted of one teaching

1963 and a champion of modern microsurgery. His son,

station equipped with hammers and chisels and plaster

Dr. Douglas F. Buxton, FACS, surgeon director at New

lived for passing on this

molds to anchor the temporal bone.v Several years later,

York Eye and Ear Infirmary of Mount Sinai and clinical

a second station was installed to accommodate a micro-

professor of Ophthalmology at the Icahn School of Med-

new world of techniques

scope and a drill system.

icine at Mount Sinai, recalls, “Early on, my father rec-

The laboratory’s next expansion took place in

ognized the future of technology-driven medicine and

1972, after Dr. Young Bin Choo, the illustrious oto-

he actively adopted and introduced major microsurgi-

laryngologist and NYEE alumnus, successfully se-

cal advances, such as the first ophthalmic microscope

cured an $85,000 Daniel and Florence Guggenheim

and 10-0 nylon suturing into his NYEE opthalmology

Foundation grant to construct a new, state-of-the-art,

practice.” vii “He was passionate about excelling in proce-

“He was passionate about excelling in procedures

microscopic instruments and materials. And he also

and concepts to other Above left: Dr. Jorge N. Buxton.

Above right: Illustrations of the temporal bone. Above: Dr. Douglas F. Buxton.

doctors.”

— Douglas F. Buxton, MD, speaking of his father, Jorge N. Buxton, MD

5. A VISION OF HOPE

dures performed under magnification, with delicate mi-

As the hub for “hands-on” training, the center rou-

croscopic instruments and materials. And he also lived

tinely offers a range of courses for ophthalmologists that

for passing on this new world of techniques and con-

include corneal transplantation, nonlaser glaucoma sur-

cepts to other doctors.” Thanks to the fundraising efforts

gery, strabismus surgery, retina surgery, and suturing

of Buxton along with the whole infirmary family, $1.2 mil-

and incision techniques. Otolaryngology residents also

lion in donations was raised from the Alcon Laboratories,

use the center to practice essential microsurgical tech-

Inc., the Charles and Mildred Schumacher Foundation,

niques for surgeries routinely conducted in extremely re-

Experimentation, innovation, and excellence

1986–2020

Determined to perpetuate the legacy of his father’s passion for surgical innovation and teaching, Buxton created the Jorge N. Buxton, MD, Microsurgical Education foundation in 2010. Under his executive directorship, the foundation continues to support the Jorge N. Buxton, MD, Microsurgical Education Center by helping maintain and continually upgrade its surgical training facilities. Aligned with NYEE’s mission to provide the best clinical training for physicians as a means of promoting the best care for its patients, the foundation is dedicated to fostering ophthalmic and otolaryngeal microsurgical teaching in an environment that promotes experimen-

the Ambrose Monell Foundation, and many supportive

stricted operative areas located deep within the temporal

tation, innovation, and excellence. Through sponsorship

physicians and friends.

bone of the head, involving sensitive bones and delicate

of educational programs and visiting faculty, as well as

In 2004, the completely renovated, state-of-the-

tissues responsible for hearing and balance, and the na-

international observers and researchers, the foundation

art Jorge N. Buxton, MD, Microsurgical Education Cen-

sal sinuses. Additionally, reconstructive and aesthetic

occupies a vital role in support of the New York Eye and

ter opened and quickly became the centerpiece for

surgeons access the center’s resources to practice the

Ear Infirmary’s mission as the institution enters its third

the infirmary’s laboratory surgical education. Current-

newest laser skin resurfacing methods and to train in an

century of medical training and service.

ly, the center comprises 16 stations complete with mi-

array of endoscopic techniques that have been intro-

croscopes and integrated assistant/teaching scopes

duced over the last decade.

designed to flexibly accommodate temporal bone surgery, ophthalmic surgery, head and neck dissection, sinus surgery, and plastic surgery. A demonstrator’s station equipped with a high-resolution camera displayed on multiple large flat-screen monitors throughout the lab allows instructors leading wet lab sessions to perform live demonstrations while residents work at their own station. The lab was also designed so that manufacturers are able to install the newest surgical systems for state-of-the-art training in phacoemulsification for cataract surgery and vitrectomy for retinal surgery. In 2006, a virtual reality EyeSi Surgical Simulator was added to help residents experience simulated surgery for handeye-foot coordination development before transitioning to the operating room. On the immediate horizon is the highly anticipated acquisition of the Preceyes Surgical System, an advanced robotic device that facilitates submicroscopic retinal and glaucoma surgeries on the delicate microanatomy of the eye.

The Jorge N. Buxton, MD, Microsurgical Education Center today.

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NYEE INQUIRING MINDS Dr. Robert C. Della Rocca 1941–

Oculoplastic surgeon Dr. Robert C. Della Rocca has long been regaled by his students, residents, fellows, and associates with many loving epithets: “The Fixer,” “The Raven,” and often, most appropriately, “The Boss.”i Known for his kind heart, generous spirit, and the “ability to size up situations from an aerial perspective,” he has served as the Infirmary family’s guiding light for decades, starting with his days as Chief Resident when he and Dr. Joseph Walsh struggled to provide academic leadership to a largely clinical program, and continuing through his recruitment of Walsh as Chair to restructure the Department of Ophthalmology and relaunch its international prominence.ii During his tenure as NYEE Medical Board President, he helped join the economically isolated Infirmary to Continuum Health Partners in 1999—a decision that ultimately paved the way for the Infirmary’s current standing as the center of ophthalmology excellence in the Icahn School of Medicine at Mount Sinai.

Della Rocca’s distinguished medical career began with his graduation from Creighton University Medical School in 1967. After serving in Vietnam as a Captain in the U.S. Army and earning a Bronze Star and Army Commendation Medal, he became a resident in ophthalmology at NYEE from 1970 to 1973, serving as Chief Resident in his senior year. He then pursued two fellowships in oculoplastic and orbital surgery: the first under Dr. Byron Smith at the Manhattan Eye, Ear, & Throat Hospital, followed by a second under Dr. Orkan G. Stasior at Albany Medical Center. Shortly thereafter, in 1974, he began organizing courses at the American Academy of Ophthalmology. Della Rocca then returned to the Infirmary and remained to burnish the Service’s reputation even brighter. A year later, Della Rocca opened his own oculoplastic surgery practice at the Infirmary, teaching residents and offering courses related to trauma and eyelid reconstruction at the Postgraduate Institute and the American Academy of Ophthalmology. From 1982 to 2019 Della Rocca served as NYEE’s Chief of Oculoplastic, Reconstructive and Orbital Surgery, as well as the Chairman of the Department of Ophthalmology at Mount Sinai St. Luke’s (now Mount Sinai Morningside) from 2001 to 2019. In 2017, he was appointed Chief of Oculoplastic, Orbital and Reconstructive Surgery for the Mount Sinai Health System. In addition, he has been a professor of Clinical Ophthalmology at New York Medical College and Albert Einstein Medical College.

Della Rocca’s diverse private practice has focused upon repair and reconstruction of congenital and traumatic problems in both pediatric and adult patients, including eyelid and adnexal disease tumors, tear duct abnormalities, eyelid position abnormalities, orbital trauma and fractures, tear duct disease, orbital diseases, orbital tumors, and inflammation and treatment of thyroid-related disease. With a reputation for successfully tackling the most challenging cases, combined with his ability to share his scientific and medical insights, he has mentored more than 35 national fellows and 85 international fellows from 26 countries. iii In recognition of decades of remarkable service, Della Rocca received NYEE’s John Kearny Rogers Physician of the Year Award in 2001, the American Academy of Ophthalmology’s

Humanitarian Award in 2003 and, in the same year, the New York State Ophthalmologic Society’s Hobie Award in Recognition of a Lifetime Commitment to the Progress of Ophthalmology and Patients around the World. With more than 50 publications, including five oculoplastic textbooks and numerous peer-reviewed journal articles, he has been frequently invited to speak at national and international conferences and meetings. Widely known for his humanitarian work and international volunteerism, Della Rocca has led group medical missions to 15 countries over the past three decades. He is also a founder and past Medical Director of the Volunteer Health Program, as well as Annual Visiting Consultant, Surgeon, and Board Member for the Institute for Latin American Concern.

Dr. Robert Ritch 1942–

Dr. Robert Ritch holds the Shelley and Steven Einhorn Distinguished Chair in Ophthalmology and is Emeritus Surgeon Director and Chief of Glaucoma and Professor of Ophthalmology at New York Eye and Ear Infirmary of Mount Sinai. In addition to developing a classification of angle-closure and its underlying mechanisms, he has been a prolific innovator of medical, laser, and surgical glaucoma treatments and researcher into exfoliation syndrome, pigment dispersion syndrome, and normal-tension glaucoma, largely unappreciated

conditions at the time.

In 1978, while still a fellow, Ritch performed New York’s first laser iridotomy and initiated the first AAO course on laser treatment of glaucoma. In 1983, he joined the NYEE faculty and, over the next two years, grew its glaucoma service from 4-6 patients a week to 300. During this time, he established the world’s first patient glaucoma support group, later known as the World Glaucoma Patient Association. In 1985, Ritch founded The Glaucoma Foundation, attracting researchers from many fields into glaucoma research. That same year, he organized the first Bangkok Ophthalmology Symposium, during which the first laser peripheral iridioplasty—a procedure he developed—in Asia was performed.

To advance NYEE’s glaucoma capacities, Ritch created New York’s first Glaucoma Laser Center and acquired the first Nd:YAG laser and the first ultrasound biomicroscope in the United States. The Infirmary was also the nation’s first to acquire the automated perimeter (Octopus 201R), optic nerve analyzer (Rodenstock), and commercial OCT, forming the basis of one of the world’s major ocular imaging centers. After establishing a NYEE fellowship program and making top fellows associates, he developed the largest glaucoma subspecialty group in the Northeast. He has trained more than 160 clinical and research fellows, and began an international program that has hosted over 120 ICO fellows and 150 observers from more than 50 countries. He also helped modernize ophthalmology residency programs in Southeast Asia and other countries, giving rise to Asian, Brazilian, Thai, and International Ritch Fellows Societies.

5. A VISION OF HOPE

Ritch co-founded the Ophthalmic Laser Surgical Society, the Lindberg Society, and the first World Glaucoma Day. He served on the Board of Trustees and as Vice President of the Association for Research in Vision and Ophthalmology (ARVO), served on the Board of Directors of the International Council of Ophthalmology (ICO), and was elected to Academia Ophthalmologica Internationalis, a group whose membership is limited to 85 individuals worldwide. Ritch has produced nine textbooks and over 2,000 medical and scientific papers, book chapters, and conference abstracts. He has delivered over 750 lectures, including more than 50 named lectures, and served on numerous medical and scientific advisory, editorial, and organizational boards. In addition to over 60 national and international awards and medals, Ritch has also received several Lifetime Achievement awards and medals, including the Joanne Angle ARVO Service Award, the HRH Prince Abdulaziz Al-Saud Prevention of Blindness Award, and the Bietti Medal, one of seven top medals conferred by the ICO.

Dr. Richard J. Mackool 1944–

Dr. Richard Mackool, an internationally recognized expert on microsurgery of the eye, has performed more than 70,000 microsurgical procedures, specializing in lens implants, small incision, no-stitch cataract surgery, glaucoma microsurgery, laser vision correction, corneal transplants and vitreous microsurgery.iv He is the founder and Director of the Mackool Eye Institute and Laser Center in Queens, New York’s first ophthalmic ambulatory surgery center, established in 1983, and is revered as a dedicated educator of hundreds of ophthalmologists worldwide. One of his closest peers was Dr. Joseph B. Walsh, an internal medicine resident whom he met in Boston where the two were in training. At the time, Mackool introduced Walsh to the idea of pursuing ophthalmology as a career and, a few years later, they entered their NYEE residencies as classmates. Walsh became NYEE’s Chief of Ophthalmology in 1988.

Mackool’s lifelong fascination with engineering began at age 14 when he and his father took a 1953 Ford apart and put it back together.v After graduating from Boston University School of Medicine in 1968 with an MD degree, he served his internship at the Los Angeles County/USC Medical Center from 1968-1970, followed by an NYEE residency in ophthalmology in 1973. As a resident, he carried a small red notebook in his jacket into which he journaled ideas and insights. Noted for challenging his surgical residents by asking whether they wanted to approach a surgery “their way” or the “right way,” he was soon dubbed “Magic” for his remarkable surgical prowess. Upon graduation, Mackool became the director of resident training and completed a corneal fellowship with Jorge Buxton, MD. By the late 1970s, with his corneal and vitreoretinal private practice thriving, he collaborated with Anton Banko, a mechanical engineer who co-designed the first phaco instrument with Dr. Charles Kelman, and Dr. Buol Heslin, one of Mackool’s former residents, to create the Mackool/Heslin Ocusystem, introduced in 1980.

1986–2020

As an inventor of computerized microsurgical instruments and techniques for cataract removal, nearsightedness, and astigmatism, Mackool has published two textbooks and over 400 scientific papers, and has been granted more than 50 patents. He co-designed the acrylic intraocular lens (IOL), and was the first surgeon to implant an acrylic IOL in April 1990. Mackool is professor of ophthalmic surgery at the New York Eye and Ear Infirmary of Mount Sinai and New York University Medical Center. He has lectured throughout the United States and internationally, and eye surgeons from every continent in the world have traveled to New York to attend his courses. His educational video series, Mackool Online CME, has been viewed by many thousands of surgeons since 2011. In 2019, Mackool introduced the first 3D online medical videos, “Mackool Online 3D CME.” These videos and 3D viewing systems are available to every U.S. ophthalmology training program through medical education grants.

He has been a Fellow of the American Academy of Ophthalmology since 1975 and holds memberships in a dozen other medical and scientific societies. Most recently, in 2011, he became a Founding Member of the American College of Ophthalmic Surgery. In 2013, Mackool received the American Society of Cataract and Refractive Surgery’s Innovator of the Year Award.

Dr. Mark Kupersmith 1951–

Got a neuro-op emergency patient? Call Kupersmith—anytime, day or night! That’s the mantra NYEE residents and attendings have been chanting for more than 40 years. As Director of Neuro-Ophthalmology at NYEE and now Chief of Neuro-Ophthalmology at the Mount Sinai Health System, Dr. Mark J. Kupersmith continues to live up to his reputation, making himself available on short notice to help NYEE’s medical staff manage the many sight- and life-threatening emergencies that pass through the Infirmary’s doors. And no wonder.

He collaborates with a highly skilled team of neurologists, neurosurgeons, neuroradiologists, and ophthalmologists who, together, address disorders of the optic nerve, which connects the eye to the areas of the brain that process vision, eye movements, lids and pupils. vi With access to one of the leading imaging labs in the country, his team not only manages and diagnoses complex systemic and neurologic disorders, but also conducts original research and directs the Neuro-Ophthalmology research network, with NYEE serving as a leading clinical trial site to test cutting-edge treatments.

Kupersmith received his BS and MD degree in five years from Northwestern University Medical School in 1974 and completed a residency in Neurology and Ophthalmology at New York University (NYU) Medical Center from 1974-1980. During this time, Dr. Seymour Fradin, one of his NYU professors, suggested he come to NYEE to establish the Neuro-Ophthalmology Service and, in 1981, Kupersmith did just that. He devoted the first part of his career towards understanding the electrophysiology of human vision, in normal and

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NYEE 200: A VISION OF HOPE

NYEE INQUIRING MINDS, continued

disease states. Later, he became interested in clinical trials as well as imaging using MRI and optical imaging for optic neuritis, papilledema, and non-arteritic anterior ischemic optic neuropathy. In 2005, following his role in planning and conducting the National Eye Institute Optic Neuritis Treatment Trial, Kupersmith, along with a national team, created the Neuro-Ophthalmology Research Disease Investigator Consortium (NORDIC), which he currently directs.

Throughout his career, Kupersmith has been committed to training the next generation of ophthalmologists and neuro-ophthalmologists. From 1989-2005, he held the position of Professor of Neurology and Ophthalmology at NYU School of Medicine and from 20052014, he was a Professor of Neurology and Ophthalmology at Albert Einstein School of Medicine. Currently, Kupersmith is Professor of Ophthalmology, Neurology, and Neurosurgery at the Icahn School of Medicine at Mount Sinai, Director of Neuro-Ophthalmology, and Surgeon Director at the Infirmary. He is a fellow of the American Neurological Association, North American Neuro-Ophthalmology Society, American Academy of Neurology, American Academy of Ophthalmology, and the Association for Research in Vision and Ophthalmology.

Kupersmith’s research has contributed to the field of neuro-ophthalmology for decades. His work has addressed the understanding and management of too many disorders to list. He has authored and co-authored more than 200 peer-reviewed publications, as well as a book, Neurovascular Neuro-Ophthalmology.vii Among the many recognitions he has received was the North American Neuro-Ophthalmology Distinguished Service Award in 2009, and he was honored as the American Academy of Ophthalmology Hoyt Lecturer in 2014.

Dr. Paul T. Finger 1955–

“In search of excellence in ophthalmic oncology” is how Dr. Paul T. Finger encapsulates the scope of his distinguished medical career. As Founding Director of the NYEE Ocular Tumor Service, Finger has assembled and works with multispecialty teams of highly trained ophthalmologists, ophthalmic pathologists, oculoplastic surgeons, and imaging experts to provide excellent care for patients with a wide range of benign or cancerous eye conditions such as intraocular melanoma, hemangiomas, melanocytomas, lymphomas, and retinoblastomas, as well as tumors of the conjunctiva, iris, orbital, and adnexa. As Finger says, “I treat anything that grows in and around the eye.”

Finger completed his Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy Fellowship under Samuel Packer, MD, Chairman of Ophthalmology, North Shore University Hospital-Cornell, and in 1989 joined NYEE to become the Founding Director of the Ocular Tumor Service where he initiated the “Collaborative Ocular Melanoma Study,” NYEE’s first National Institutes of Health grant. In 1998, he founded The New York Eye Cancer Center and The Eye Cancer Foundation. These three venues have attracted hundreds of residents and fellows from the United States and around the world. In 2002, Finger was promot-

ed to Clinical Professor of Ophthalmology at New York University School of Medicine and he continues to maintain attending surgeon privileges at NYEE, Manhattan Eye, Ear & Throat Hospital (MEETH), and Mount Sinai Beth Israel.

Finger’s contributions to ocular oncology began in 1980 when he invented the first miniature microwave dish to heat intraocular tumors. Since then, he has pioneered many new methods of diagnosis and treatment. Examples include the first use of topical chemotherapy eye drops (mitomycin and interferon) for patients with conjunctival melanoma and the invention of “Finger’s Aspiration-Cutter Biopsy Technique,” which requires a tiny, selfsealing, corneal incision. He holds 35 patents, trademarks, and inventions, such as antiVEGF drugs that suppress radiation vasculopathy; “Think of Sunglasses as Sunblock for your Eyes” ®; and palladium-103 plaque radiation therapy for choroidal melanoma. With the use of these and other innovations, fewer than 5 percent of Finger’s choroidal melanoma patients must have their eye removed and over 80 percent retain close to their preoperative visual acuity.

Because of this, Finger is widely considered a leader in the field with national and international presentations, more than 280 peer-reviewed publications, and 36 collaborative ocular melanoma study publications, 3 books, 51 book chapters, and multiple editorial board memberships. As Chair of the American Joint Committee on Cancer-Ophthalmic Oncology Task Force, Finger has made AJCC-UICC TNM staging widely used around the world.

In 2019, Finger was named a Life Fellow of the American Academy of Ophthalmology (AAO). His numerous memberships in other professional societies and associations include The Retina Society, the International Society of Ophthalmic Oncology and Pathology and the American Society for Therapeutic Radiation Oncology (ASTRO). As a resident physician in 1984, Finger was chosen as the recipient of The New York Academy Medicine’s William Hoppin Award. Three prestigious awards from the American Academy of Ophthalmology followed in 2001, 2007, and 2009. In 2012, he received the Robert M. Ellsworth Award from Cornell University College of Medicine. Two years later, in 2014, he was given the Tulane Medical School Alumni Achievement Award. Most recently, in 2019, Tulane Medical School established the Paul T. Finger, MD Endowed Lectureship in his honor.

Dr. Paul A. Sidoti 1962–

Dr. Paul Albert Sidoti—admired for his calm, reassuring demeanor, wise counsel beyond his years, and as a meticulous surgeon and clinician—has been a pillar of the NYEE program since the earliest days of his residency. He is respected internationally as an authority on glaucoma and serves as Chief of the Glaucoma Service for the Mount Sinai Health System, Chair of Ophthalmology for NYEE, and Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai.

5. A VISION OF HOPE

After graduating summa cum laude from Princeton University with an AB in Biology in 1984, he earned a medical degree from the Albert Einstein College of Medicine in New York in 1988. Following his internship in internal medicine at New York Hospital, Cornell University Medical Center, he completed his residency in Ophthalmology at NYEE (1989-1992), where he was Chief Resident (1991-1992). He then went on to specialty training in glaucoma at the Doheny Eye Institute/University of Southern California School of Medicine. Upon returning to NYEE in 1994 as a specialist in the management of pediatric and adult glaucoma and the Medical Director of the Outpatient Eye Clinics, he introduced many new concepts into the Ophthalmology training program.

Sidoti is active in many local and national professional organizations, including the American Academy of Ophthalmology, the American College of Surgeons, the American Glaucoma Society, and the Association for Research in Vision and Ophthalmology. He has served as an oral board examiner for the American Board of Ophthalmology and has also been the recipient of numerous awards and honors including the Infirmary’s John S. Hermann, M.D. Memorial Award for Excellence in Teaching (1996), the Glaucoma Foundation’s Medical Service Award (1996), and The American Academy of Ophthalmology Senior Achievement Award (2017). In 2016, he was inducted into the prestigious Doheny Society of Scholars in recognition for his contributions to academic ophthalmology as an alumnus of the Doheny Eye Institute.

Recognized by his NYEE and Mount Sinai Health System colleagues for excellence in teaching and physician communication, Sidoti has also been named as one of New York Magazine’s Top Doctors and New York Metro Area’s Top Doctors numerous times over the past 20 years.

Sidoti’s research interests are focused on the treatment of and surgical intervention for glaucoma, notably glaucoma tube shunt surgery. Not only did he introduce and popularize successful glaucoma implant surgery using the Baerveldt Implant among the Infirmary staff, following his fellowship training with Dr. George Baerveldt he also helped spearhead the introduction and adoption of the Trabectome™ for MIGS (minimally invasive glaucoma surgery). With more than 100 contributions to the medical literature, he is considered a leading expert in the medical and surgical manageTHE TRABECTOMETM ment of adult and pe1. Handpiece tip clearing diatric glaucoma. As a aqueous humor blockage member of the Board of 2. Handpiece parts 3. The device Directors of the Lavelle Fund for the Blind, Inc., he is widely regarded as a strong advocate for the assistance of the visually impaired and low-vision training at NYEE as well.

1986–2020

Dr. Ronald C. Gentile 1965–

In the earliest days of Dr. Ronald C. Gentile’s career, he was known for his unrelenting thirst for knowledge and enthusiasm, sometimes losing track of time studying his patients’ retina with a three-mirrored lens and the indirect ophthalmoscope.

So it is hardly surprising that he subsequently devoted his clinical practice to all aspects of retina disease and surgery. It is the same exuberance about the medical mysteries of retinal pathophysiology and his explorations into new techniques for surgical repair that has led to his deservedly high regard by the ophthalmology community at large. Currently, Gentile serves as NYEE’s Co-Director of the Ocular Trauma Service (posterior segment) and Surgeon Director, and is Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai. He is also an attending surgeon at NYU Langone Health-NYU Winthrop University Hospital on Long Island. Since 2016, he has served as President of Gentile Retina, an independent clinical practice within NYEE. Gentile earned his MD degree, summa cum laude, in June 1991 from SUNY Health Science Center at Brooklyn (Downstate Medical Center), took an internship in Internal Medicine at Columbia Presbyterian Medical Center, and then joined the residency at New York Eye and Ear Infirmary in 1992, eventually serving as Chief Resident. Following his residency, he did a fellowship in Ophthalmic Pathology (1995-1996) under Dr. Steven A. McCormick and then trained in Vitreoretinal Diseases and Surgery (1996-1998) at Kresge Eye Institute under Drs. Gary W. Abrams, the late James E. Puklin, and Dean Eliott.

As an expert in diabetic eye disease, retinal vascular disorders, macular diseases, ultrasonography, retinal detachments, and ocular trauma, Gentile has repeatedly joined the ranks of the Best Doctors in New York (Castle Connolly Medical Ltd.) and New York Super Doctors®. In addition to clinical practice, surgery, and teaching, he has been an active investigator in clinical vision research and has participated as principal investigator in a number of studies of breakthrough therapies. His contributions have included new understandings of macular hole development, surgical management of silicone oil, and new approaches to repair of optic nerve pits. He has published more than 100 journal articles and has served as a reviewer for several highly regarded scientific journals.

Gentile holds memberships in numerous national and local professional organizations such as the American Society of Retina Specialists, the Macula Society, and the New York Ophthalmological Society. He is past Chairman of the New York Academy of Medicine, Ophthalmology Section. In 2016, he was honored with the Richard T. Troutman, MD, Award in Ophthalmology, received the American Academy of Ophthalmology’s Achievement Award in 2013, and was given the American Society of Retina Specialists (ASRS) Honor Award in 2007. As a founding member of Operation Restore Sight (ORS), a humanitarian organization associated with Dooley Intermed International, he has helped lead international eye care missions to train local eye care physicians in underserved communities throughout Africa, Asia, and Latin America.

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WHERE OCULOPLASTIC SURGERY BEGAN Oculoplastics, Orbital and Reconstructive Surgery

A

The Erhardt Eyelid Clamp, developed at NYEE.

New

Wheeler’s most renowned student was Dr. Wendell

NYEE and the Manhattan Eye, Ear & Throat Hospital

York Eye and Ear

L. Hughes. After receiving his training in ophthalmology

where he started the oculoplastic surgery clinic, Smith

Infirmary’s

many

at Bellevue Hospital (1923-1925), Hughes studied oculo-

served in the military in World War II, which also informed

extraordinary accomplish-

plastic surgery with Wheeler and joined his NYEE Service.

his prodigious publications and honed his wide-ranging

ments is the distinction

Following Wheeler’s departure, Hughes spent three years

contributions, including the use of dermatome in oph-

of being the birthplace of

on the Service under Weeks. In 1939, Hughes became the

thalmic plastic surgery, definition of the mechanisms of

modern ophthalmic plas-

Surgeon Director of NYEE’s Hughes Clinic, all the while

blow-out fractures of the orbit, and description of der-

tic and reconstructive sur-

becoming a national figure in oculoplastic surgery. Along

mis-fat grafting following enucleation.

gery. The specialty began

with Wheeler, he was asked to be a founding member of

with one of the Infirmary’s

the American Board of General Plastic Surgery.

mong

the

Hughes also trained Dr. J. Gordon Cole, who became clinic chief after Smith’s departure. After Hughes

death,

resigned as NYEE Surgeon Director in 1951, Cole was ap-

er, widely considered to be

Hughes continued to teach ocu-

pointed Chief of Oculoplastic Surgery and, in 1953, Sur-

the founder of modern ophthalmic plastic surgery, who

loplastic surgery at the American

geon Director. Cole’s technique of excising eyelid tumors

is revered for his many innovations such as on-lid halv-

Academy of Ophthalmology and

with histologic control and his American Ophthalmologi-

ing technique for eyelid repair, cicatricial ectropion re-

Otolaryngology’s annual meet-

cal Society thesis on reconstructive surgery of the ocular

pair, grafting techniques, flaps, socket reconstruction,

ings. He is best known for the

adnexa were highly influential, along with his Postgrad-

exophthalmos, and orbicularis transplantation.i Follow-

“Hughes flap,” a tarsoconjuncti-

uate Institute course collaborations with Hughes, Smith,

ing his appointment as NYEE’s Surgeon Director in 1919,

val flap, replacing “like with like,”

Dr. John Simonton, and Dr. Orkan G. Stasior.

Wheeler initiated in-house courses surveying his ground-

used for lower eyelid reconstruction. Hughes published

Simonton trained as a general surgeon and oph-

breaking techniques as well as at the American Academy

the details of his technique in Reconstructive Surgery of

thalmologist at Lenox Hill Hospital. After developing an

of Ophthalmology—the only oculoplastic surgery instruc-

the Eyelids, the most comprehensive book on the sub-

interest in oculoplastic surgery in the Navy, he studied

tion offered at the time (see his profile, p. 82).

own, Dr. John M. Wheel-

Upon

Wheeler’s

ject at the time. A modified version of this flap contin-

under Dr. Brittain Payne, Hughes, Smith and Cole at the

Wheeler vigorously shaped the emerging field

ues to be the procedure of choice to this day. In 1951,

Infirmary. Beginning in 1955, Simonton taught orbital

through his mentorship of many prominent physicians,

Hughes resigned as Surgeon Director but remained on

anatomy and surgery at the American Academy of Oph-

several of whom went on to make their own significant

the NYEE staff as a consultant. The American Society of

thalmology and Otolaryngology’s annual meetings, and

contributions. Among them: Dr. Algernon B. Reese, a

Ophthalmic Plastic and Reconstructive Surgery’s Wen-

at the Postgraduate Institute. He was appointed NYEE’s

former NYEE resident who established the orbital tumor

dell Hughes Lecture honors his formidable legacy.

Surgeon Director in 1963 and, upon Cole’s retirement in

service at Columbia University’s Institute of Ophthalmol-

Of all of Hughes’ acolytes, Dr. Byron Smith be-

1975, became Chief of Oculoplastic Surgery. Well-known

ogy (see his profile, p. 84); Dr. Isadore Goldstein, known

came the most prominent. Smith began his NYEE resi-

for his publications on dacryocystorhinostomy, orbital

for his work on the recession of the levator muscle for ex-

dency in 1937, later to become the Chief of the Hughes

anatomy, and tumors, he was invited to share his exper-

ophthalmic goiter; and Dr. Webb Weeks, NYEE’s Surgeon

Service Clinic. Although professionally anchored to

tise on the subject of ptosis surgery at the 1977 Amer-

Director from 1930-1940. Although Wheeler resigned as Surgeon Director in 1928 to become a professor of ophthalmology at Columbia University where he established the Eye Institute, he remained a consultant and advisory surgeon director to the Infirmary until his death in 1938.

Above left: Dr. John M. Wheeler.

Above: Dr. Wendell L. Hughes.

Left: The Hughes Flap procedure, using upper eyelid tissue to reconstruct the lower eyelid.

Right: Pre- and post-operative images of (L)blepharoplasty (eyelid lift); (R) enucleation (eye removal). Photos courtesy of ASOPERS.

5. A VISION OF HOPE

1986–2020

Left: The Oculoplastic Service in 1986: Front row left to right: Drs. Robert C. Della Rocca, John T. Simonton, Byron Smith, Virginia L. Lubkin. Standing left to right: Drs. Philip J. Silver­stone (fellow), Janet L. Roen, Joel Kopelman, Donald A. Macdonald, Perry F. Garber, Stephen L. Bosniak, Arie Liebeskind (radiologist). Not Present: Edward N. Bedrossian, Richard Angrist. (Photo by J. Goeller.)

Dr. Harsha S. Reddy was named Direc-

Below left: Dr. Robert C. Della Rocca.

Dr. James Orcutt. He joined the Infir-

Above right: Dr. Harsha S. Reddy; below right: Dr Reddy in the operating room.

tor of NYEE’s Oculoplastic Service in 2019. Reddy trained at Harvard Medical School and the Doheny Eye Institute prior to completing his fellowship at the University of Washington with mary in 2011, where his career thrived under Della Rocca’s mentorship. As Director, Reddy has strengthened the Service’s collaborations with NYEE’s

ican Society of Ophthalmic Plastic and Reconstructive

vice’s reputation even brighter. A year later, Della Roc-

Otolaryngology and Ocular Oncology Services and, ever

Surgery meeting as the Wendell L. Hughes Lecturer. At

ca opened his own oculoplastic surgery practice at the

leading with the newest technology and curricula, he

this time, under Simonton’s leadership and in collabora-

Infirmary, teaching residents and offering courses relat-

continues to advance the Infirmary’s long tradition of re-

tion with Smith, New York City’s first formal combined oc-

ed to trauma and eyelid reconstruction at the Postgradu-

search and educational excellence. All while furthering

uloplastic fellowship was approved by the American So-

ate Institute and the American Academy of Ophthalmol-

Della Rocca’s indelible legacy of volunteering overseas,

ciety of Ophthalmic Plastic and Reconstructive Surgery.

ogy. Upon Simonton’s retirement, Della Rocca became

creating educational materials for ORBIS International,

Chief of Oculoplastics at the Infirmary in 1982 (see his

and training oculoplastic surgeons worldwide.

As an incubator for the newest ideas in oculoplastic surgery, the Infirmary has always been the training

profile, p. 152).

ground for other world-renowned oculoplastic surgeons,

In 2017, Della Rocca was appointed Chief of Oc-

including Dr. Joseph C. Hill, the first physician in Cana-

uloplastic, Orbital and Reconstructive Surgery at Mount

da trained to perform oculoplastic surgery, and Drs. Sta-

Sinai Health System. Under his accomplished guidance,

sior, Charles S. Maris, Alvin H. Brackup, Harold Kirshner,

the Infirmary’s Oculoplastic, Orbital and Reconstructive

Hampson Sisler, and Virginia L. Lubkin (see her profile, p.

Service has consistently advanced its standing as a cen-

113) , several of whom continued to teach the specialty

ter of excellence. It comprises top specialists with ex-

at the Infirmary and greatly contributed to the American

tensive experience treating a range of conditions relat-

Academy of Ophthalmology.

ed to the eyelids, eye socket, tear duct system, and face,

But one of NYEE’s most celebrated oculoplastic

ranging from medically corrective to cosmetic surgery or

surgeons, Dr. Robert C. Del-

a combination. The Service is also recognized worldwide

la Rocca, actually received his

for managing the most challenging cases such as those

specialty training elsewhere.

involving orbital trauma and complex tumors—a capa-

Although he took his residency

bility that is enhanced by its access to the full range of

in ophthalmology at NYEE from

NYEE’s ear, nose and throat specialists and Mount Sinai

1970-1972 and was then Chief

Health System’s distinguished oncology, endocrinology,

Notes

Resident from 1972-1973, he

and other clinical departments and divisions. As such, it

i. Garber, Perry, MD, FACS and John T. Simonton, MD, FACS. The New York Eye and Ear Infirmary Oculoplastic Surgery: Where it all began.

Adv, Opthal. Plastic & Reconstruct. Surgery, Vol. 5, pp. 283-3(Å), 1986.

This sidebar is based on and draws almost exclusively from this article.

pursued two fellowships in oc-

is a pre-eminent leader in the field and, throughout Del-

uloplastic and orbital surgery, first under Smith at the

la Rocca’s tenure alone, a renowned referral source and

Manhattan Eye, Ear, & Throat Hospital and then under

training center for more than 35 national fellows and 85

Stasior at Albany Medical Center. Della Rocca then re-

international fellows from 26 countries.ii

turned to the Infirmary and remained to burnish the Ser-

Following Della Rocca’s appointment as Chief,

ii. https://www.nyee.edu/files/MSHealth/Assets/HS/Newsroom/ SpecialtyReports/2018/Ophthalmology/Ophthalmology-SpecialtyReport.pdf

157

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

THE OPENING BELL The NYEE Ear Institute

O

n February 15, 2008, the New York

neurotologists,

audiologists,

speech-lan-

Stock Exchange invited D. Mc-

guage pathologists, early intervention spe-

Williams Kessler, president of the

cialists, social workers, and trained ed-

New York Eye and Ear Infirmary, to ring its

ucators with expertise in evaluating and

opening bell to herald the start of Low Vi-

supporting children with hearing loss and

sion Awareness Month and the opening of

their families. As the first and largest otolo-

the New York Eye and Ear Infirmary Ear In-

gy center in New York City, the institute also

stitute, a consolidation of NYEE’s Cochle-

holds the distinction of being the largest cen-

ar Implant Center with Beth Israel Medi-

ter-based provider of early intervention ser-

cal Center’s Cochlear Implant Center and

vices, as well as the only practice on the East

Hearing and Learning Center.i Joining him

Coast with a multidisciplinary team dedicat-

on the elevated podium were Dr. Simon Pa-

ed to the treatment of microtia and atresia.

risier, founder of the Children’s Hearing In-

Other services such as pediatric and adult

stitute and NYEE Drs. Ronald A. Hoffman,

hearing aid dispensaries, cochlear implants,

professor and clinical director of the new-

hearing habilitation, vestibular diagnostic audiology, and vestibular rehabilitation are also

ly formed Ear Institute; Steven D. Schaefer, professor and chairman of Otolaryngology; and Joseph

of Neurosurgery, Icahn School of Medicine at Mount Si-

available. By bringing together and collaborating with such

B. Walsh, professor and chairman of Ophthalmology. The

nai; chair of Otolaryngology, New York Eye and Ear Infir-

a diverse group of outstanding researchers and specialists

honor—one usually reserved for the titans of industry, heads of state, and celebrities—signaled an auspicious beginning. Ten days lat-

“We listen so kids can hear.”

Ear Institute offers patients integrated, individualized, and innovative care that is not only compassionate and caring, but life-changing.

er, during the Ear Institute’s official ribboncutting ceremony at its new 380 Second Avenue loca-

mary of Mount Sinai and Mount Sinai Beth Israel; chief of

tion, Manhattan Borough President Scott Stringer pre-

Otology-Neurotology at the Mount Sinai Health System;

sented President Kessler with a New York City Procla-

and director of the Mount Sinai Health System’s Audiol-

mation declaring February 25 New York Eye and Ear In-

ogy, Hearing, and Balance Center and its Ear Institute.v,vi

firmary Ear Institute Day. Two seminal contributions had

“We are actively engaged in a range of investigations

made the consolidation possible. The first, a gift of more

such as exploring the relationship between cognitive

than $1 million, raised during the Children’s Hearing In-

disorders and hearing loss. We are also one of the few

stitute’s 2006 “We Listen So Kids Can Hear” benefit gala

otology centers researching cochlear implants, along

at Lincoln Center; the second, a $100,000 donation by

with the cognitive and balance problems associated with

Robert E. and Susan Klein to establish the Susan Klein

unilateral hearing loss.”

ii

Family Center for Educational Outreach at the Beth Israel/New York Eye and Ear Cochlear Implant Center.

from across the Mount Sinai Health System, the

iii,iv

The Ear Institute at New York Eye and Ear Infirmary of Mount Sinai sets itself apart from other institu-

Today, there are even more reasons to ring bells

tions by bringing together under one roof a highly spe-

about the Ear Institute at New York Eye and Ear Infirma-

cialized and comprehensive multidisciplinary team of

ry of Mount Sinai, as it is now known. “This is an exciting

professionals dedicated solely to caring for patients of

time at the Ear Institute,” says Dr. George B. Wanna, pro-

all ages with hearing and balance problems. The insti-

fessor of Otolaryngology-Head and Neck Surgery, and

tute’s skilled team includes otolaryngologists, otologist-

Above: NYEE President D. McWilliams Kessler and NYEE doctors and administrators at the NYSE opening bell, February 15, 2008.

Below: a happy patient of the Ear Institute.

5. A VISION OF HOPE

159

1986–2020

YET ANOTHER CRITICAL CROSSROADS

2012

F

GOOGLE EARTH

???

rom the broadest perspective, macro-trends in health care foretold the destiny of Continuum Health Partners, Inc. Diminishing reimbursements, an accelerating movement from inpatient to ambulatory care, and the increasing reliance on expensive infrastructure capabilities, technologies, and procedures

continued to reshape health care economics nationwide. The infirmary’s positive metrics notwithstanding, the costs of maintaining the 812-bed Beth Israel Medical Center, the combined 711-bed St. Luke’s-Roosevelt Hospital Center, and, by then, the 32-bed NYEE were taking their collective toll.75, 76 Absent the resources to upgrade its

aging facilities, Continuum’s finances continued to falter.77 With few viable alternatives, the company’s leadership began to explore a merger with NYU Langone Medical Center in 2011.78 This dialogue culminated in a June 2012 announcement that the two entities had agreed to move forward, outlined in a nonbinding memorandum of understanding, subject to final confirmation on both sides.79 Mount Sinai Medical Center, meanwhile, saw the proposed merger as a strategic threat, and also saw that acquiring Continuum’s extensive lower Manhattan properties, including a 275,000-square-foot facility at Union Square, Beth Israel Medical Center at First Avenue and 16th Street, as well as NYEE’s holdings, was a strategic opportunity it could not afford to miss.80 Shortly after the Continuum/NYU announcement, some members of the Continuum leadership who were dissatisfied with the direction of the plans opened a dialogue with Mount Sinai, prompting NYU to withdraw from the negotiations soon thereafter. 81 In July 2013, the boards of Mount Sinai Medical Center and Continuum Health Partners signed an agreement that created The Mount Sinai Health System (MSHS), one of the country’s largest nonprofit networks, extending from Manhattan to Brooklyn to Queens.82



160

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

T H E M O U N T S I N A I H E A LT H S Y S T E M 1852– Present “The Mount Sinai Health System’s goal is to provide the highest-quality care and the most innovative therapy to the broadest group of people across all of our hospitals and ambulatory sites. The complete integration of our Health System with the Icahn School of Medicine gives us the ability to bring the latest science and innovative thinking derived from a great faculty directly to the patient and the bedside.” i — Dr. Kenneth L. Davis, President and Chief Executive Officer, Mount

O

Sinai Health System n January 15, 1852, nine representatives from several of New York’s Hebrew charitable organizations convened to create a Jewish hospital

that would serve the needs of their growing community. Like the founders of so many other historic Jewish hospitals, they were motivated by both lofty and practical factors: the ancient Jewish traditions of bikur

cholim, the moral imperative to care for the indigent sick, and tzedakah, or charity, the ethical and religious obligation to do what is just and right, as well as countering widespread anti-Semitic hospital admission and hiring practices.ii,iii,iv Philanthropist Sampson Simson, who became the first president of the institution’s Board of Directors, led the effort by donating land located at West 28th Street between Seventh and Eighth Avenues, a part of the city that was then largely rural, and providing ongoing financial support critical to its early survival. The organization’s leadership also initiated a vigorous fund-

raising campaign to finance the construction of a building, assisted soon thereafter by a $20,000 bequest from the prominent philanthropist Judah Touro. In the fall of 1853, the founders held a formal groundbreaking for the Jews’ Hospital in the City of New York, as Mount Sinai was then called, and construction began. The completed 45-bed facility was dedicated on May 17, 1855, with a commemorative religious ceremony, and opened to patients on June 5.

During the Civil War, the hospital’s modest ward capacity expanded to care for the soaring numbers of wounded Union soldiers. By then, the desire to expand

of Nursing (1923), and the creation of a small laborato-

and relocate the hospital was mounting. These ambi-

ry facility.v By the early 20th century, increased patient

tious plans required more state support, prompting the

demand and the hospital’s growing technical capacities

leadership to adopt a nonsectarian admissions policy

necessitated that it expand once again, establishing its

and to petition the State Legislature in 1866 to change

third and current home on Fifth Avenue at 100th Street.

the chartered name of the institution to the more inclu-

Dedicated on March 15, 1904, the 10-pavilion, 456-bed

sive Mount Sinai Hospital. Two years later, on October 5,

facility, built at a cost of $1.35 million, inspired the ap-

1868, the directors signed a 99-year lease with the city

pellation “This House of Noble Deeds,” with its three-

for a property on Lexington Avenue between 66th and

fold mission of “benevolence, science, and education.” vi

67th Streets for the sum of $1.00. Fundraising for a new

With new room to breathe, patient services and clinical

building began immediately. The new Mount Sinai Hos-

departments expanded and flourished, including the De-

pital was dedicated on May 29, 1872. Enlarged to 120

partment of Social Work (1906), a Social Service Auxil-

beds at a cost of $335,000, and lit by gas fixtures in the

iary, the Department of Physical Therapy (1911), and the

absence of electricity, the building and more open sur-

Department of Neurosurgery (1932). In 1909, the Eye

roundings were a welcome relief from the hospital’s

and Ear Department split, creating separate Ophthalmol-

former, now industry-choked, location.

According to This House of Noble

ogy and Otology departments. Additional specialty services were added as time went on. Its state-of-the-art re-

Deeds: The Mount Sinai Hospital, 1852-

search facilities and commitment to medical education

2002, a comprehensive history of Mount Si-

also gave rise to scores of medical investigations along

nai Hospital authored by Arthur H. Aufses,

with the launch of the Journal of The Mount Sinai Hos-

Jr. and Barbara J. Niss, it was during this

pital in 1934.

period that the institution as we know it today began to take shape. Among the accomplishments were the formation of the Out-patient Department (1875), creation of a Medical Board (1872), formation of House Staff (1872), the founding of the Mount Sinai Training School for Nurses (1881), later renamed The Mount Sinai Hospital School

Far left: Dr Kenneth L. Davis.

Left: Sampson Simson, circa 1850.

Above: a Mount Sinai banner showing the hospital buildings,circa 1874.

5. A VISION OF HOPE

The

t wo

world

tutes, ISMMS holds the distinction of being 4th in the

wars created increased

United States among medical schools for overall research

demands for medical

funding per principal investigators.x Having received

ex p e r t i s e

throughout

$393.8 million in National Institutes of Health (NIH) fund-

the United States and

ing in 2019, it ranks 12th among medical schools in the

The Mount Sinai Hos -

United States for NIH funding. The school, growing from

pital’s staff rose to the

a strong hospital, has always nurtured a culture of inno-

call. During World War I,

vation that includes ensuring that Mount Sinai research

20 physicians, 2 den-

discoveries are turned into new diagnostics and treat-

tists, 50 nurses, and

ments for patients. Through Mount Sinai Innovation Part-

53 enlisted men, many

ners, the commercialization arm of the Icahn School of

from the Mount Si-

Medicine and the Health System, Mount Sinai research-

nai staf f, formed The

ers file for hundreds of patents each year, and the school

Mount Sinai World War I

has spun out a number of successful startup companies.

Unit, Base Hospital #3 in France.vii Over the course of

The Mount Sinai Health System is New York City’s

World War II, nearly 900 Mount Sinai physicians, nurs-

largest integrated health care delivery network, and The

es, staff members, and trustees served in various war-

Mount Sinai Hospital is ranked 14th in the nation by U.S.

time capacities. On the home front, the hospital also

News & World Report’s “Honor Roll” of top hospitals and

trained Red Cross aides in an effort to address the

in the top 20 nationally in eight medical specialties, ac-

nursing shortage in the United States. With the rise

cording to the 2019-2020 “Best Hospitals” guidebook.

of Nazi Jewish persecution, The Mount Sinai Hospital

The system is structured around eight hospital campus-

cooperated with the National Committee for the Re-

es—Mount Sinai Beth Israel, Mount Sinai Brooklyn, The

settlement of Foreign Physicians and assisted a large

Mount Sinai Hospital, Mount Sinai Queens, Mount Si-

number of émigré physicians with a new start.

nai Morningside, Mount Sinai South Nassau, Mount Si-

The end of World War II in 1945 ushered in a peri-

1986–2020

nai West, and the New York Eye and Ear Infirmary of

od of growth for the hospital and, by the late 1950s, The

Mount Sinai, totaling 3,815 beds—and the Icahn School

Mount Sinai Hospital initiated plans to establish its own

of Medicine at Mount Sinai. Its vast geographic footprint

medical school. Chartered in 1963, Mount Sinai School

includes more than 7,200 primary and specialty care

of Medicine was the first nonuniversity medical school

physicians and 13 freestanding joint venture ambula-

to be established in 50 years.xiii Opening in 1968, it was

tory centers throughout the five boroughs of New York

envisioned as a university of the health sciences. During

City, Westchester, and Long Island. Mount Sinai physi-

the early 1980s, Mount Sinai’s Trustees launched an ini-

cians can be found in more than 410 ambulatory prac-

tiative to rebuild the hospital that culminated in the ded-

tice locations. The Health System employs more than

ication of the new I.M. Pei-designed Guggenheim Pavil-

42,000 people and, in 2018, received over 4 million inpa-

ion in 1992.ix In 2013, the Mount Sinai School of Medicine

tient, outpatient, and Emergency Department visits com-

was renamed the Icahn School of Medicine at Mount Si-

bined. With its extraordinary array of resources for state-

nai (ISMMS). With a faculty (full-time and voluntary) that

of-the-art care, the Mount Sinai Health System is poised

currently numbers more than 6,500 and spans 34 aca-

to identify, respond to, and provide compassionate care

demic departments and 39 clinical and research insti-

to the growing and diverse population it serves.

MOUNT SINAI HEALTH SYSTEM

161

162

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

ENVISIONING OUR FUTURE

T

he process of integrating Continuum’s five hospital campuses with Mount Sinai’s two began immediately and still continues at this writing. One part that directly involves NYEE is the transformation of Mount Sinai’s operations below 34th Street, replacing much of the nearly 100-year-old aging and outmoded Mount

Sinai Beth Israel infrastructure and creating a revolutionary network of greatly expanded primary, specialty, urgent, behavioral, and outpatient surgery services that seek to address the health care needs of today and the

future. Dr. Jeremy Boal, executive vice president and chief clinical officer of Mount Sinai Health System and president of Mount Sinai Downtown, says: “The change is a massive move from predominantly inpatient care to other

“

locations of care, ambulatory, home-based, office-based, and virtual care, while still maintaining an inpatient platform that meets our community’s needs. It is also a big shift from a focus on treatment of disease to one that also

Slowly but surely, the infirmary is becoming more holistic.”

encompasses prevention and wellness; from episodic care to continuity of care.” 83 The project includes the construction of a state-of-the-art acute-care hospital on the site formerly occupied by NYEE’s Residents’ Building. Equipped with comprehensive critical care and 24/7 emergency capabilities as well as a larger ambulatory surgery center, the new hospital will provide the surrounding community with an array of care options tailored to the needs of modern medicine. Not only will NYEE physicians be able to perform more complex surgical procedures that are limited by its current resources, but these changes will also help ensure the

2014

infirmary’s continuing fiscal health.84 Moreover, NYEE patients will benefit from Mount Sinai Health System’s vast referral network, top-ranked physicians in every field, and comprehensive care resources. Conversely, patients throughout the Mount Sinai network will have seamless access to the infirmary’s highly respected Ophthalmology Department, ranked 12th in the nation, according to the 2019-2020 U.S. News & World Report “Best Hospitals” Guidebook. 85, 86 Although the completion of the new hospital is some years off, the consolidation of services has already begun. At present, two of the infirmary’s microsurgical suites are in use for Mount Sinai’s Center for Transgender Medicine and Surgery patients, and the Mount Sinai Integrative Sleep Center moved its downtown sleep lab to the 7th floor of the infirmary in 2018.87, 88 As an integral part of the Mount Sinai Health System, the renamed New York Eye and Ear Infirmary of Mount Sinai began its transformation with the 2013 retirement of Dr. Joseph B. Walsh, chair of the Ophthalmology Department. In September 2014, Dr. James C. Tsai was recruited as the inaugural Delafield-Rodgers Professor and System Chair of Ophthalmology and president of New York Eye and Ear Infirmary of Mount Sinai. Tsai’s expressed goal is to maximize “the synergies between [the Mount Sinai Health System and the New York Eye and Ear Infirmary of Mount Sinai] to create even more exceptional clinical care for our unparalleled number and breadth of patients, expand our state-of-the-art technology for disease characterization, and share our academic expertise in virtually every eye disease.” 89 Within this unprecedented framework, NYEE’s leadership has begun to restructure the institution’s organizational and operating systems. One sweeping change has been in the way information is dis-

5. A VISION OF HOPE

1986–2020

163

NYEE’s Eye Stroke Protocol seminated. In the past, most departmental decisions were managed independently by each department chief and their direct reports. And major decisions were brought to the attention and resolved during medical board meetings with the hospital administration, scheduled once a month.90 While this process was deliberate and thoughtful, the recent changes are bridging communication barriers and are better adapted to the fast-paced demands of the current health environment.91 Slowly but surely, the infirmary is becoming more holistic.92 “Our approach is to get everyone working together, focused on patient safety and experience, and use performance improvement methodologies to advance operational efficiency—what is going on inside the hospital—not only on growth,” Christopher T. Spina, senior vice president and chief operating officer, noted.93 “Care is delivered in a multidisciplinary manner which requires tremendous teamwork, transparency, and respect,” Spina continued. “Our management team has adopted a collaborative model of shared purpose, inclusion, and evidence-based decision making. Our physicians provide extremely valuable insight and are key partners in our success.” One of the strategies to open the lines of communication is a daily 8:15 am “morning huddle,” in which all the major departmental leaders hear and share information about important is-

DID YOU KNOW

that when 27-year-old Elodie Ontala entered NYEE’s walk-in clinic on a fall morning in 2018 and described a gray blurry cloud blocking her vision in her only good eye, the infirmary ophthalmologists on duty shifted into high gear?i After an emergent fluorescein angiogram failed to reveal a suspected arterial occlusion, an optical coherence tomography test pinpointed a pattern of paracentral acute middle maculopathy (PAMM), a far rarer form of retinal capillary ischemia. In lay terms, Ontala’s diagnosis translated into an “eye stroke,” which can cause a permanent, devastating loss of vision that is as urgent an emergency as a stroke in other parts of the brain. Fortunately, Ontala was in the right place: The infirmary is one of the few major medical centers in the country that has an Eye Stroke Protocol. Developed 10 years ago by Dr. Richard Rosen, director of Retina Service and Ophthalmic Research at NYEE, in collaboration with Dr. Mark Kuper-

sues affecting the entire hospital. Another is the introduction of the Team STEPPS Program (strategies and tools to enhance performance and patient safety).94 Open to all physicians, nurses, managers, and nonclinical service teams, the training aims to help each member understand his or her role, contributions, and demands, so that as a whole they can better adapt to change, improve patient safety, and deliver exceptional care. A third is frequent Town Hall Meetings, forums open to all employees that inform and solicit feedback on a wide range of issues and concerns.95 NYEE’s teaching program is also in transition. While its two-century-old mission to train the next generation of leaders in ophthalmology and otolaryngology is unwavering, changes are afoot. Drawing on the two institutions’ common and unique strengths, and under the umbrella of the Icahn School of Medicine at Mount Sinai, the unified Department of Ophthalmology offers unparalleled service and learning opportunities for residents and fellows. With a large and diversified volume of patients across the Mount Sinai Health System and a core full-time faculty teaching faculty composed of more than 150 full-time and voluntary physicians whose aca-

Top: initial SLO and OCT images show “eye stroke” maculopathy and VA of 20/200.

Above: three months after treatment, color fundus and OCT images show repair and VA of 20/20.

Right: angiogram shows a catheter entering the ophthalmic artery carrying medication.

smith, then director of Neuro-Ophthalmology and Mount Sinai Health System’s nationally recognized Department of Neurosurgery, it currently stands as the best option for saving the sight of patients presenting with central retinal occlusion.

Ontala was immediately transferred from NYEE to Mount Sinai West, where Dr. Christopher Kellner and his team of neuroradiologists, on duty 24/7 for stroke-related emergencies, waited in an operating room prepped to administer intra-arterial tissue plasminogen activator, or tPA. There they threaded a catheter through Ontala’s femoral artery, from her groin past her heart and carotid artery to the ophthalmic artery in her brain, and released the clot-dissolving medication. Following the procedure, Ontala’s vision in her treated eye steadily improved—from 20/200 after her first week of recovery to a remarkable 20/20 and crystal clear results only three months later.

164

New York Eye and Ear Infirmary

2020

NYEE 200: A VISION OF HOPE

demic expertise encompasses virtually every known eye disease, the infirmary has long held the reputation as one of the world’s leading specialty hospitals and a leader in premiere graduate medical education programs. The U.S. News & World Report 2019-2020 “Best Hospital” Survey ranked NYEE as the #1 Ophthalmology hospital in New York City and No. 12 among the top Ophthalmology Departments in the United States. Echoing this, the 2019-2020 Doximity Residency Survey named NYEE’s Ophthalmology Residency Program No. 1 in New York City and No. 20 in the nation.

As such, NYEE is leveraging its integration with The Mount Sinai Hospital (MSH) to create not just the largest ACGME accredited program—growing to 30 residents over the next few years—but one of the most advanced, thanks to a challenging curriculum and microsurgical laboratory offering state-of-the-art simulation training.

“Everything will be in alignment with the principles we’ve used to develop and guide the program, but our residents will now have the opportunity to also see patients in a variety of other Mount Sinai Health System settings, including The Mount Sinai Hospital, the James J. Peters VA Medical Center (Bronx), and NYC Health + Hospitals/ Elmhurst (Queens), Dr. Paul A. Sidoti, professor and site chair of Ophthalmology at New York Eye and Ear Infirmary of Mount Sinai, explained. 96 Doing so will help physicians-in-training sharpen their knowledge and surgical/clinical skills through a vast range of ocular trauma cases, diverse pathologies, age groups, and instructors

“

who include some of the most skilled and knowledgeable specialists and subspecialists in the field of ophthalmology.97 “Combining the resources and faculties of two major teaching centers brings us to a new level of excellence

The resultant increase in patient and surgical volume and the greater diversity of both patients and practice settings will truly enhance the quality of resident education...”

in terms of what we can provide our residents and fellows,” Dr. Douglas Fredrick, deputy chair for education in the Department of Ophthalmology and the system chief for Pediatric Ophthalmology said. “Because trainees are exposed to a diverse and challenging range of patients across four distinct health care settings,” Fredrick continued, “they get the kind of clinical and operating room experience few other programs across the country are able to offer.” 98 The infirmary will remain the main and busiest site and the principles used to guide the development of this unified program will align with those that have long characterized NYEE’s graduate medical education.99 In keeping with this tradition, NYEE and MSH’s two residencies were officially merged in the fall of 2019 and 10 residents were matched for an integrated 4-year residency. A unique addition to the residency training program is a joint internship that will begin in July 2020. Prior to starting their three-year residency, trainees will be enrolled in a one-year internship at Mount Sinai Beth Israel’s Internal Medicine program that will include nine months of general medicine and three months of ophthalmology training. “Those three months in ophthalmology will give trainees a significant head start when they begin their residency,” Dr. Harsha S. Reddy, the new director of Residency training at NYEE, elaborated.100 “They’ll be better prepared to transition not only to patient care, but also to meaningful research projects.”

5. A VISION OF HOPE

1986–2020

The Ocular Stem Cell Program at the Icahn School of Medicine at Mount Sinai The merger offers a spectrum of reciprocal opportunities and a source of a growing number of investigative alliances that draw on and complement the strengths of physician-scientists from both institutions. Dr. Louis R. Pasquale, site chair in the Department of Ophthalmology, heads the effort to integrate NYEE into the cutting-edge interdisciplinary clinical and translational research of the Icahn School of Medicine at Mount Sinai.101 Energized by the Icahn School of Medicine’s wellspring of research funding, assets, and resources, these collaborative efforts promise to elevate the infirmary’s current position as a global leader in vision and hearing specialty

DID YOU KNOW that in 2018, scientists at the Mount

Sinai/NYEE Eye and Vision Research Institute demonstrated how gene transfer holds the possibility of rebuilding damaged retinas and restoring visual function in people diagnosed with macular degeneration, retinitis pigmentosa, and, potentially, glaucoma through retinal regeneration? i Dr. Bo Chen, associate professor of Ophthalmology and director of the Ocular Stem Cell Program at the Icahn School of Medicine at Mount Sinai, is actively advancing this approach in his laboratory with help from a $2 million gift from the McGraw Family Foundation. Recently recruited from Yale University, Chen has successfully demonstrated the ability of damaged mammalian retinas to self-repair using gene therapy. With this advance, the potential for humans to regain lost retinal function is closer than ever.

Postdoctoral fellows Xinzheng Guo, PhD, and Ye Xie, PhD, with Bo Chen, PhD, examining bacterial colonies.

services even higher. According to President Tsai, “Through an ongoing integration, the Ophthalmology Department has identified several priority areas for translational research, including ocular stem cell/regenerative biology, glaucoma and neuroscience, ocular imaging and functional correlation, vitreoretinal therapeutics, ophthalmic surgical robotics, artificial intelligence, and genetics/genomics of the eye.” 102 Examples of some of these initiatives include the New York Eye and Ear Infirmary’s Ophthalmic Innovation and Technology Program, the Advanced Retinal Imaging Laboratory, and the Mount Sinai/NYEE Eye and Vision Research Institute. Centralizing and sharing resources galvanizes surgeons, clinicians, and researchers as they develop advanced diagnostic and therapeutic strategies. By extending their reach to colleagues and patients throughout the nation and the world, these innovations and translational solutions offer wellness benefits to us all.103, 104 

Above: Bo Chen, PhD, examining a retinal slice at a cellular level.

Above right: a mouse subject being tested for optomotor response (OMR) and visual function.

Right: a macro view of retinal stem cells in process of division.

165

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New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

DR. JAMES C. TSAI 2014 – Present

W

hen Dr. James C. Tsai was recruited to lead the New York Eye and Ear Infirmary and integrate it with Mount Sinai’s academic department in September 2014, he was well prepared to accept the challenge.i A magna cum laude

graduate and trustee emeritus of Amherst College, Tsai earned his medical degree from Stanford University School of Medicine and his MBA from Vanderbilt University. He then completed his residency in ophthalmology at the Doheny Eye Institute and re-

ceived his glaucoma fellowship training at the Bascom Palmer Eye Institute, University of Miami Health System, and the legendary Moorfields Eye Hospital and London’s Institute of Ophthalmology. Prior to joining Mount Sinai, Tsai served as the inaugural Robert R. Young Professor and Chair of Ophthalmology and Visual Science at Yale University School of Medicine and chief of Ophthalmology at Yale-New Haven Hospital. Before this appointment, he directed the glaucoma division at the Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons.

Tsai is an elected member of the American Ophthalmological Society, and elected fellow of the New York Academy of Medicine and chair of its Ophthalmology Sec-

Secretariat Awards, Fight for Sight’s Physician-Scientist and Visionary Awards, and

tion. He is currently serving as chair of the Glaucoma Subcommittee of the National

Doheny Eye Institute’s Distinguished Alumnus and Society of Scholars Medallion

Eye Health Education Program Planning Committee of the National Institutes of Health

Awards. In Tsai’s multiple roles as president of the New York Eye and Ear Infirmary,

(NIH), and president-elect of the International Joint Commission on Allied Health Per-

the inaugural Delafield-Rodgers Professor, and system chair of Ophthalmology, Icahn

sonnel in Ophthalmology. As an internationally recognized physician-scientist and ex-

School of Medicine at Mount Sinai, he now leads the nation’s oldest specialty hospital

perienced health care administrator, he has received numerous awards and honors, in-

which has, over the years, been repeatedly nationally ranked by U.S. News & World Re-

cluding the American Academy of Ophthalmology’s (AAO) Senior Achievement and

port among the best hospitals for ophthalmology.

“The merger of the nationally ranked Department of Ophthalmology at New York Eye and Ear Infirmary of Mount Sinai with the storied Department of Ophthalmology of The Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai presents an exciting opportunity to advance eye care throughout the New York Metropolitan area, nationally, and internationally.”

— Dr. James C. Tsai, President, New York Eye and Ear Infirmary of Mount Sinai, Delafield-Rodgers Professor, and System Chair of Ophthalmology, Mount Sinai Health System

5. A VISION OF HOPE

N E W YO R K E Y E A N D E A R I N F I R M A RY O F M O U NT S I NA I Satellite and Affiliate Locations

MAP IN PROGRESS

1986–2020

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AHEAD OF THE CURVE NYEE’s Ophthalmic Innovation and Technology Program “The whole objective of our Program is to convert translational research into products, and that requires innovation: an ecosystem of people, partnership, industry, clinicians, and engineers of new technology.” i –Dr. Tsontcho (Sean) Ianchulev Director of the Ophthalmic Innovation and Technology Program

T

hink of the New York Eye Infirmary of Mount Sinai’s (NYEE) Ophthalmic Innovation and Technology Program as an incubator, laboratory, and launching

pad for the next generation of micro-interventional ophthalmological devices—all rolled into one.ii A kind of synergistic force field attracting thinkers and doers from inside and outside the NYEE and Mount Sinai Health System (MSHS) who are passionate about developing new therapies, technologies, and diagnostic modalities.

As the inventor of three U.S. Food and Drug Ad-

benefit patients

ministration-approved devices—the miLOOP™, the first

a n d s o c i et y— c o m e s

micro-interventional cataract fragmentation device for

in. “As an Executive-in-Res-

non-thermal cataract surgery; intraoperative aberrome-

idence, Sean Ianchulev, MD, MPH,

try, which has eclipsed the 50-year standard for intra-

is an integral member of our team, help-

ocular lens power determination; and CyPass™, the first

ing to advance technology in Mount Sinai for

non-trabecular micro-stent for glaucoma — Ianchulev

the benefit of patients,” says Erik Lium, PhD, Execu-

knows of what he speaks. iii And more innovations are on

tive Vice President of Mount Sinai Innovation Partners.

the way. “The Program is creating a place where the best

“Dr. Ianchulev’s work as a clinician, inventor, and entre-

and the brightest ideas are not just taken out for a spin,”

preneur, along with the faculty and clinicians at NYEE’s

Ianchulev adds, “but are actually brought to life.”v

Ophthalmic Innovation and Technology Program, are

That is where Mount Sinai Innovation Partners— MSHS’s technology commercialization office, which en-

bringing next-generation technologies to the healthcare marketplace.”

sures that Mount Sinai discoveries and innovations are

The infirmary is home to the Ophthalmic Innova-

translated into health care products and services that

tion and Technology Program as well as residents and

“Everything is out there for us to discover

Far left: Dr Ianchulev. Top: the miLOOP device. Above sequence: the miLOOP segmenting a patient lens with severe cataracts. Left and above: Dr. Kira Manusis using miLOOP to break up a cataract.

5. A VISION OF HOPE

students in training to become the next generation of excellent clinicians at the front line of innovation. “The infirmary has always been small and light on our feet, so we can pivot quickly,” observes Dr. Richard Rosen, a driving force behind one of the Program’s first collaborative ventures: Preceyes Surgical System, a robotic, intraocular microsurgical system. Currently, there are only three Preceyes Surgical Systems in the world, one of which is scheduled to arrive at the infirmary’s Jorge N. Buxton, MD, Microsurgical Education Center by early 2020. “Like many new promising tools, first we go into the lab where we’ll be training residents and students, understanding what Preceyes is capable of doing and its parameters. Then we target what we want to use it for,” Rosen continues.vi “After several months, we will know

1986–2020

what we need and be able to go back to the partner company and say ‘We need to do it this way.’ Once it reaches the point of when it extends the range of the expert surgeon—that’s when we move into the clinical sphere.”

Ianchulev believes that the “eureka” moment no longer belongs to a single individual but is based on wide-ranging collaboration and cross-pollination. His is a “holistic” approach that unites the strengths of the infirmary and the MSHS, draws on the “spill over” of ideas across disciplines that may be relevant to ophthalmology, advances clinical and translational research, structures funding, structures technology transfer, and creates a robust liaison process.vii “You have to have people who recognize the application, not just have the ideas… people who have a great desire to roll up their sleeves

and we want it to happen here”

and get to work—together,” he enthuses.viii “Everything is out there for us to discover and we want it to happen here, at New York Eye and Ear.” Above: Dr. Ianchulev training resident Dr. Duaa Sharfi in the use of the miLOOP. Left series: Preceyes surgical tools enable (left to right) subretinal injections; retinal staining, ERM peeling, and vein cannulation.

Below far left: the Preceyes Surgical System in use. Below left: Dr. Ronald Gentile performing emergency surgery to repair a maculaoff retinal detachment (note lasers). Below: a macular hole before and after surgery.

PREC E Y ES ( TH IS & ABOVE FOU R)

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EXPLORING THE UNIVERSE WITHIN The Advanced Retinal Imaging Laboratory at NYEE “Developing and refining nextgeneration imaging tools gives us a constructive pathway forward to explore and attempt to understand the underlying mechanisms of complex eye diseases. It complements the therapeutic efforts of our researchers and clinicians on the biologic frontiers of cell and gene therapy by helping to visualize the living cellular features of those conditions.” i

ful tool used to enhance resolution and compensate for

–Dr. Richard Rosen Director of Retina Service and Ophthalmic Research, NYEE

oration with the Medical College of Wisconsin and Stan-

hen NASA’s astronomers and engineers first

School of Medicine at Mount Sinai, in the David E. Mar-

W

harnessed the power of adaptive optics to explore the outer reaches of our cosmos in the

1990s, they probably had little inkling that decades lat-

er the same technology would help ophthalmologists visualize the equally breathtaking internal universe of the human retina in an effort to unlock the molecular mystery driving retinal diseases. Adaptive optics is a power-

optical distortions, irrespective of the application.ii In the

case of the inter-galactic objects, adaptive optics helps overcome distortion caused by atmospheric turbulence; in ocular imaging on a cellular level, it works to compensate for distortions in the light reflected from the eye using a special mirror that “adapts” to the changes in those distortions.

NYEE is one of a handful of sites in the country using adaptive optics scanning laser ophthalmoscopy (AOSLO) and is part of a translational research collabford University. Software enhancements to this transformative technology, developed by Dr. Yuen Ping Toco Chui, Associate Professor of Ophthalmology at the Icahn rus Adaptive Optics Imaging Laboratory within The Shelley and Steven Einhorn Clinical Research Center of New

Top left: Fundus image of diabetic retina and an OCT map revealing capillary loss. Above: AO/OCT angiography perfusion density mapping of diabetic retinopathy. Below left: Dr. Rosen at work.

York Eye and Ear Infirmary of Mount Sinai, are optimizing its diagnostic potential. “The software we’ve developed,” Chui explains, “provides an algorithmic analysis of the imaging data to help clinicians determine if a patient is likely to have early diabetic retinopathy, glaucoma, or perhaps other neurological disease.” Chui’s software has also boosted the utility of optical coherence tomography angiography (OCTA), a new noninvasive way to view retinal blood flow patterns. By facilitating more sensitive mapping of the earliest changes in various retinal layers and their blood supply, and using motion contrast analy-

Across spread (nine images): OCTA volume-renderings of retinal neovascularization in a patient with proliferating diabetic retinopathy (PDR). Colors indicate layers of retinal vascular scans.

Ophthalmology and Neuroscience at the Icahn School

sis of red blood cell movement, physicians now have the

of Medicine at Mount Sinai, states.iii “And that’s open-

ability to recognize these diseases prior to many irrevers-

ing up to us a new world of research using previously un-

ible changes.

explored ocular tissue.” Smith has been a pioneer in the

NYEE’s multimodal advanced imaging capabili-

use of hyperspectral autofluorescence imaging for the

ties are also uncovering clues to the biologic footprint

eye, using techniques developed by scientists to exam-

of macular degeneration. “With their increasingly higher

ine the surface of the Earth from space and more recent-

resolutions, these technologies are allowing us to more

ly adapted to the field of medicine. With this technology,

accurately measure the circulation and thickness of the

Smith and his team have been able to find an association

layers of the retina,” Dr. R. Theodore Smith, Director of

between geographic atrophy, the advanced dry form of

Biomolecular Retinal Imaging at NYEE and Professor of

age-related macular degeneration (AMD), and renal im-

5. A VISION OF HOPE

1986–2020

pairment in people with AMD. In another study, his team leveraged OCT and OCTA to explore the finest details of the choroidal capillaries and found that individuals with coronary artery disease have thinner macular choroids.

This finding may eventually prove useful as an early biomarker for the disease, as well as for identifying patients at risk for outer retinal disease.

Like the vast cosmos, the universe within is finally yielding answers to many of the probing questions that have long seemed beyond our reach. How do we explain the miracle of vision? And what are the sources of and treatments for devastating blindness? And Rosen is ready to find out: “These tools are giving us the wings to fly to a whole different universe of what is possible.”iv

“...the wings to fly to a whole different universe”

Above: OCTA vascular scans series continues.

Below: Justin Migacz, PhD, in the David E. Marrus Adaptive Optics Imaging Laboratory at NYEE.

Top: Imaging techniques applied to solar eclipse retinopathy.

Above: OCTA vascular scans series continues.

Below: OCTA volume-rendering of retinal hemangioblastomas.

Top: Dr. Rosen with trainees at the NYEE Retinal Imaging Lab. Above: image of retinal hyperspectral drusen. Below: OCTA volume-rendering of retinal neovascularization in a PDR patient.

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PAS S I N G I T F O RWA R D The Ophthalmology Residency Program “…when, in 1820, the infirmary was established…[it] aimed not only to be a public charity, but a school of surgery in two of its most important branches. Accordingly, its doors have been open to students of medicine from the first day of its foundation; and hundreds of medical men now practicing in every part of our continent, have learned from seeing here numerous cases of disease, and hearing their nature discussed and explained by the surgeons, to recognize such cases in their own practice and treat them with success.”i —Dr. Edward Delafield, April 25, 1856

...one of the premier

talks and were “pronounced capable of practicing this

Dr. Paul A. Sidoti, professor and site chair of Ophthal-

special branch of medicine in the circles to which they

mology at the New York Eye and Ear Infirmary of Mount

would return.”iii The following year, in 1824, the infirma-

Sinai, observes: “This means that the residents and fel-

ry welcomed others in compliance with a provision in the

lows working in our hospital clinics are exposed to a tre-

New York Legislature’s 1824 Act of Relief that stipulat-

mendously diverse patient population with a wide variety

ed “at least one medical scholar from each county of the

of ophthalmic conditions. The breadth of experience and

state should be admitted to witness the practice and sur-

high surgical volume that this affords has made the infir-

gery at the infirmary at all times, free of charge, provided

mary one of the premier training programs in the world.”vi

he first presented a certificate from the president of his

Added to NYEE’s enormous clinical breadth and

county medical society.”

iv

depth are the translational research and educational ini-

More than 100 years later, when the infirmary’s

tiatives within the Department of Ophthalmology at the

Dr. Bernard Samuels wrote, “One lives in the knowledge

Icahn School of Medicine at Mount Sinai. “This natural

gained from others,” he wasn’t simply expressing an ele-

synergy,” according to Dr. James Tsai, president of New

gant idea, but echoing Delafield’s philosophy upon which

York Eye and Ear Infirmary of Mount Sinai and System

the infirmary’s premier clinical and surgical residency

chair of Ophthalmology for the Mount Sinai Health Sys-

training programs are based.v NYEE’s current standing

tem, “is extending the infirmary’s longstanding reputa-

n the winter of 1823, Dr. Edward Delafield delivered a

as a top-ranked program nationally and internationally

tion for clinical excellence to innovating and developing

lecture series on the diseases of the eye at the infirma-

can be attributed to the efforts of another of the institu-

groundbreaking approaches that treat complex, blinding

ry, which, most likely, represented the first systematic

tion’s great leaders: Dr. Joseph Walsh, chairman of the

eye diseases.” vii,viii

I

effort to teach ophthalmology in the United States. De-

Department of Ophthalmology (1988-2013), who cham-

NYEE’s rigorous three-year ACGME-accredited

signed to coincide with succeeding winter sessions of the

pioned and elevated the critical role of teaching like no

Ophthalmology Residency Program is designed to at-

College of Physicians and Surgeons, the didactic course

other before him. “Our reputation for clinical excellence,

tract a diverse group of individuals who are committed

offered the college’s students instruction on a topic that

history, location, and walk-in clinic not only draws peo-

to developing a deep understanding of ophthalmic dis-

the majority of doctors were largely unschooled in. In

ple from Manhattan but also from all of the New York City

ease, patient care, and vision research.xi Seven first-year

that first year alone, 37 students attended Delafield’s

boroughs and the entire New York metropolitan region,”

residents enter the program annually in July, for a total

1910 Graduates of the Program

1933

1969

ii

5. A VISION OF HOPE

1986–2020

training programs in the world

1973

The Resident Graduate’s Chair.

of 21 residents. In addition, NYEE has enjoyed a vari-

for presentation of their scientif-

Along with didactic and clinical instruction, NYEE’s

able number of highly sought-after departmental fellow-

ic work at local, regional, and na-

faculty also pass along intangible, but no less foundation-

ships in retina, glaucoma, uveitis, pediatric ophthalmol-

tional meetings.

al, values that have long characterized the infirmary’s staff

ogy, ophthalmic plastic, and reconstructive surgery, and

Although the NYEE Oph-

and physicians: the importance of the human connection. Dr.

cornea, external disease and refractive surgery. The Pro-

thalmology Residency Program

Claude Douge, assistant clinical professor of Otolaryngology,

gram offers the full breadth of medical and surgical train-

has expanded to include oth-

who first came to the infirmary as a resident in 1974, states:

ing in ophthalmology, including experience in all oph-

er Mount Sinai Health System venues, the infirmary will

“What I always tell my residents and fellows is that there is no

thalmic subspecialties: comprehensive ophthalmology;

remain the primary site for this program. Currently, resi-

other place in the world where you can get so many different

contact lens; cornea and external disease; glaucoma;

dents and fellows see approximately 80,000 patients per

kinds of cases like NYEE. But if you don’t care, you cannot

neuro-ophthalmology; ocular oncology; ophthalmic plas-

year in the busy NYEE clinics, where they are given full

treat well. If you don’t listen and ask the right questions, your

tic, orbital, and reconstructive surgery; pediatric ophthal-

responsibility for the patients they care for under the su-

patient will immediately pick up that you aren’t interested and

mology; refraction; refractive surgery; retina; and uveitis.

pervision of NYEE’s dedicated faculty. Of the more than

won’t give you the answers you need to help them. When you

The program’s surgical training is equally compre-

400 ophthalmologists on staff at NYEE in 2019, 70 per-

have the right to tell somebody, ‘I’m going to put you on the

hensive and includes hands-on experience with corneal

cent of the 130 members of the New York Eye and Ear

operating table and I’m going to put you to sleep and you may

transplantation; complex and pediatric cataracts; eyelid

Infirmary Ophthalmology Associates are voluntary phy-

not wake up,’ that’s no joke. There must be trust, compas-

and orbital reconstruction; femtosecond laser cataract

sicians who participate, in some way, in the training pro-

sion, and empathy.”xii

surgery; glaucoma surgery; keratoprosthesis; LASIK/

gram under its auspices.x “There is no requirement for

At NYEE, the “knowledge gained from others” not only

PRK; ocular surface and orbital tumor resection; pars

members of the voluntary medical staff at NYEE to teach

includes the practice of medicine, but also the art of medi-

plans vitrectomy; plaque radiation therapy; strabismus

in our clinics and operating rooms or to take calls, so we

cine. By every measure, the Residency Program inspires and

surgery; and trauma surgery. The residents, fellows, and

are fortunate to have a large cadre of faculty who are mo-

prepares young ophthalmologists to become the next gener-

faculty at NYEE also staff the busy inpatient and emer-

tivated by a genuine interest in working with and instruct-

ation of leaders in patient care, education, global health, and

gency department consultation service at Mount Sinai

ing our physician trainees,” Sidoti explained. “Some of

vision research. No doubt, it all would make Delafield very

Beth Israel. In addition to their clinical activities, all res-

our physicians have been involved with resident edu-

proud.

idents and fellows are offered dedicated research time

cation at NYEE for over 20 years because they love to

and funding to facilitate scholarly endeavors and allow

teach and want to be here.”

xi

1989

2010

173

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NYEE 200: A VISION OF HOPE

“What good thing remains to do?”

O

nly a handful of medical institutions have earned and maintained as much respect as the New York Eye and Ear Infirmary over such a long arc of time—since its founding in 1820 to its incorporation as a Center of

Excellence for the Mount Sinai Health System nearly 200 years later. To celebrate the infirmary’s bicentennial anniversary is to celebrate its venerable heritage as a champion of the underserved and for its excellence, quality patient care, and spirit of innovation. The commemoration also marks an opportunity to honor all the men and women whose ingenuity, commitment, and countless acts of caring have made what the infirmary stands for today. And it is an occasion to thank the millions of patients and their families who have placed their trust in the infirmary’s mission to heal and restore the gifts of sight and sound. Generations upon generations of people have walked through the infirmary’s welcoming doors and each of them holds a fragment of its collective, enduring purpose. But if only one person’s words can stand in for their testimonials, then consider those of the Honorable George William Curtis, the renowned 19th century author and civil reformer. In his March 15, 1890, speech at the infirmary’s commemorative laying of the cornerstone and time capsule into the foundation of what would become its renovated building at the corner of 13th Street and SecondAvenue, Curtis posed timeless questions that continue to inspire as the New York Eye and Ear Infirmary of Mount Sinai embarks upon its third century: “…Are we content that the future shall say that in this golden day, New York had higher buildings and dirtier streets, more splendid shops and more squalid slums, richer men and poorer government, more brag and less public spirit, than any other great city? Or shall it say the city in which this box was sealed was a city in which no man was at ease while another man suffered; in which every resource of the utmost human skill was at free service of every man’s necessity; a city in which the question was not ‘Am I my

Above: a drawing of the NYEE building, Second Avenue elevation with planned addition, 1893.

Opposite: The NYEE South Building at 13th Street and Second Avenue, 2020.

brother’s keeper,’ but ‘What good thing remains to do?’” 105

5. A VISION OF HOPE

1986–2020

175

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New York Eye and Ear Infirmary

2020 “

NYEE 200: A VISION OF HOPE

Epilogue:

WITH THE ADVENT OF THE COVID-19 PANDEMIC, the year 2020 unwound like

COVID Courage

of Mount Sinai’s (NYEE) Bicentennial Anniversary took on even deeper meaning as

New York City earned the dubious distinction of being the nation’s hottest ‘hot zone.’”

no other. What began as a commemoration of the New York Eye and Ear Infirmary we heroically pursued, in extraordinary circumstances, our unshakable mission to deliver quality care to those who entrust us with their most precious senses.

Within weeks of the disease’s initial outbreak in Wuhan, China, infections and deaths exploded across Asia, Europe, and the Middle East. The disease spread quickly to the United States, concentrated, at first, in Washington, California and New York. In no time, New York City earned the dubious distinction of being the nation’s hottest “hot zone.” Infections climbed exponentially and patients poured into the region’s medical clinics, ambulatory care centers, emergency rooms, and hospitals, overwhelming our limited medical resources, but not our historic tenacity and resilience.

Working with the New York State Department of Health and the U.S. Centers for Disease Control and Prevention, Mount Sinai Health System (MSHS) responded rapidly to implement strategies and best practices system-wide to keep our patients and staff safe. All of them evolved as our knowledge and experience grew. Non-urgent elective surgeries and procedures were temporarily postponed to preserve scarce resources and supplies, increase staffing availability, and maximize bed capacity. Urgent ophthalmic conditions such as retinal detachment, uncontrolled glaucoma, vitreous hemorrhage, optic neuropathy, orbital trauma, infectious keratitis, and otolaryngologic emergencies continued to be prioritized and addressed with surgery, laser treatments, and intravitreal injections.

Telemedicine became a key tool in our ability to render timely care and maintain the safety of our staff and facilities. A tele-ophthalmology triage system, developed in concert with the clinical informatics team and faculty, transformed NYEE’s walk-in clinic to a virtual one. Patients with urgent and emergent eye care needs were able to schedule phone and/or video visits with our providers to discuss their condition, arrange for an in-person examination if necessary, and facilitate prescription of indicated medication. Similar services were expanded to the outpatient practices of both Ophthalmology and ENT as well. Teleconferencing allowed our residents, fellows, attendings, and staff to remain in constant communication and continue to participate Above: Front page of the New York Times, March 27, 2020.

Left: ICU on the 6th Floor of The Mount Sinai Hospital. Team leaders of the COVID-19 Biobank Research Study, in the Department of Genetics and Genomic Sciences, picking up blood samples and providing nurses with empty test tubes.

EPILOGUE: COVID COURAGE

1820–2020

in lectures, microsurgical courses, and Grand Rounds from the safety of their homes and offices. Special interactive online programs for ophthalmic technicians covering a wide range of topics, including glaucoma management, double vision, intraocular lens selection, and others, were introduced to take advantage of open gaps due to modified patient scheduling.

Many of our physicians and staff stepped forward to aid in the crises and were temporarily redeployed to areas of critical need within the larger health care system. While those on NYEE’s front line ensured the availability of emergency/urgent care, ENT services, and surgery, more than 100 staff members—nurses, anesthesiologists, CRNAs, residents, ENT specialists, and ophthalmologists—provided invaluable assistance daily at Mount Sinai Beth Israel, Mount Sinai West, Mount Sinai Brooklyn, Elmhurst Hospital Center, and The Mount Sinai Hospital in the emergency departments, Covid medical floors, and ICUs. NYEE clinicians, trainees and scientists remained hopeful and defiant in the face of the social upheaval that the Covid-19 pandemic brought, applying the most current big data and global communication tools along with our in-the-trenches clinical observations that have long been embedded in NYEE’s DNA. Our 200-year commitment to our community and familial inter-responsibility will ensure that our enterprise prevails for the sake of the city and the people we cherish.

At the time of this April 2020 writing, even as the pandemic raged on, we were detecting a ray of light at the end of this dark tunnel. Encouraging reductions in infectivity rates and hospitalizations, more discharges, and the availability of testing were all signs that our efforts were succeeding. Sustained by the selfless and courageous sacrifices of our NYEE physicians and staff, we will prevail. But, regrettably, before this battle is won, some will have tragically lost their lives to this plague. Despite these heart-wrenching hardships and losses, we have fearlessly carried on keeping our institutional promise to put our patients first.

With great pride, respect, and gratitude,

Top to bottom: Nicole Simons, MA, a Team Leader of the COVID-19 Biobank Research Study, in the Department of Genetics and Genomic Sciences, presenting the study to a nurse huddle at The Mount Sinai Hospital; an NYEE ophthalmologist consults via telemedicine; NYEE Dr. Jonathan Ascher meets with anesthesiologists. Right: COVID-19 screening in the NYEE lobby.

James C. Tsai, MD President, New York Eye and Ear Infirmary of Mount Sinai

177

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Appendixes

NYEE 200: A VISION OF HOPE

A. Timeline

179

B. Presidents and Chairs of the NYEE Board of Directors 1821–2012

190

C. NYEE Administrative Leadership 1958–2020

191

D. Mount Sinai Health System Leadership 2020

192

Notes

197

Acknowledgments

214

APPENDIXES

1820–2020

A. Timeline Chapter 1 1805–1864 1805 Dr. John Cunningham Saunders establishes the world’s first public eye hospital, first known as the London Dispensary for Curing Diseases of the Eye and Ear, to treat the veterans of the Napoleonic Wars in Egypt returning with infectious conjunctivitis and the victims of the epidemic that ensued. The institution will become the Royal London Ophthalmic Hospital and, eventually, Moorfields Eye Hospital.

Saunders pioneers successful pediatric cataract surgery.

1816 Dr. Rene Laennec invents the stethoscope.

Drs. Edward Delafield and John Kearny Rodgers, recent graduates of the College of Physicians and Surgeons, leave for England to continue their education. They are introduced to lectures at the London Ophthalmic Hospital.

1818 Dr. James Blundell performs the first successful transfusion of human blood.

1820 Delafield and Rodgers open the New York Eye Infirmary, the first specialty eye clinic in the Western Hemisphere, on August 14, at 45 Chatham Square in New York City.

Infirmary surgeons perform the first successful congenital cataract surgeries in the U.S., restoring vision to three pediatric patients.

1821 The Society of the New York Eye Infirmary, a formal charity, is created with bylaws modeled after the U.S. Constitution at the suggestion of the Infirmary’s first president, Col. William Few, one of the Constitution’s signers.

1822 The first New York Eye Infirmary Annual Report is published in the New York American newspaper.

The Report documents that in little more than a year, 1,120 persons afflicted with diseases of the eye had come forward for relief, 801 of whom were deemed cured.

On March 22, the New York State Legislature formally recognizes the incorporation of the New York Eye Infirmary. As such, ophthalmology becomes the first specialty to be recognized by the medical profession and the legislature.

Following the success of the New York Eye Infirmary, Dr. Edward Reynolds, a classmate of Rodgers and Delafield, founds the Massachusetts Charitable Eye and Ear Infirmary.

1826 Dr. Louis Braille invents an alphabet of raised dots to aid the blind.

1827 Dr. John Isaac Hawkins invents trifocal lenses.

The New York Eye Infirmary relocates to its fourth home, at 459 Broadway.

The New York Eye Infirmary relocates to its second home, on Murray Street.

1833

New York City’s yellow fever epidemic forces the Infirmary to shutter its doors for three months.

1834

1823 The New York Eye Infirmary adds its first “aurist” to its staff.

Rodgers travels to Curaçao, West Indies, at the request of the island’s rear admiral governor to perform surgery, in what might be called ophthalmology’s first international goodwill mission.

1824 The New York Eye Infirmary establishes the first otology service in New York City and the United States.

The New York Eye Infirmary relocates to its third home, inside the Old Marine Hospital at 139 Duane Street on the New York Hospital campus.

Delafield introduces the first formal lectures in ophthalmology for medical students attending the College of Physicians and Surgeons.

The infirmary creates its original seal depicting the Great Physician restoring the sight of Bartimaeus.

The American Ophthalmological Society adopts the infirmary’s seal as its own upon its founding 40 years later.

Dr. Wilhelm Tohme attempts the first keratoplasty.

The New York Eye Infirmary relocates to its fifth home, at 96 Elm Street.

1835 Dr. William MacKenzie publishes the symptoms and signs of glaucoma, advocating the sclera punch to relieve intraocular pressure.

1838 Dr. Richard Sharp Kissam attempts the first animal corneal graft to a human eye.

1839 The Wills Eye Hospital in Philadelphia starts the first eye residency program in the United States.

1840 The New York Eye Infirmary relocates to its sixth home, at 45-47 Howard Street.

1841 Dr. T. Konigshofer experiments on animals with the lamellar graft and describes using a double knife.

1842 Dr. Crawford W. Long pioneers the use of inhaled sulfuric ether as a general anesthetic.

179

18 0

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NYEE 200: A VISION OF HOPE

Timeline, continued 1844

1852

Dr. Horace Wells introduces nitrous oxide as a general anesthetic.

The Mount Sinai Hospital, then known as the Jews’ Hospital, is established.

1845

The New York Ophthalmic Hospital opens.

The New York Eye Infirmary relocates to its seventh home, at 97 Mercer Street.

1853

1846 Dr. William T. G. Morton demonstrates the use of ether-induced anesthesia at Massachusetts General Hospital in Boston to remove a jaw tumor, revolutionizing the field of surgery.

Thirty-one days later, Rodgers uses ether in a procedure to drain a perirectal abscess at New York Hospital.

1847 The New York Academy of Medicine is founded to promote public health.

1848 Rodgers is one of the first surgeons in New York City to ligate the innominate artery.

1850

Drs. Charles Gabriel Pravaz and Alexander Wood develop the modern syringe.

1854 Von Helmholtz demonstrates the keratometer.

1863

1856

Dr. Frans Cornelis Donders develops the first tonometer, an instrument to measure intraocular pressure in his lab in 1865.

Dr. Ernst Adolph Coccius describes retinal detachment and retinal tears.

The New York Eye Infirmary moves to its eighth and permanent home, at Second Avenue and East 13th Street, on April 25.

1857

The American Medical Association recognizes ophthalmology as a specialty.

Dr. Albrecht von Graefe reports the successful treatment of congestive glaucoma using iridectomy.

1864

Louis Pasteur, French microbiologist and chemist, identifies germs as the cause of disease.

Noyes and Agnew, with several of their colleagues from around the city, found the New York Ophthalmological Society, the first specialty medical society in the United States, that first meets on March 7.

1857

1851

Drs. Cornelius Agnew and Henry D. Noyes, two New York Eye Infirmary graduates, return home to New York after studying under von Graefe and initiate lectures about and demonstrations of the medical advances and state-of-the-art instrumentation practiced in Europe.

The New York Eye Infirmary’s Dr. Gurdon Buck, the “father of intralaryngeal surgery,” develops a method of laryngofissure to treat laryngeal carcinoma, as well as a technique to reduce edema of the glottis before the invention of the laryngoscope. He also makes contributions to orthopedic traction (Buck’s extension) and genitourinary tract anatomy. Buck’s fascia is named after him.

The New York Eye Infirmary appoints its first house surgeon.

Morton sues the New York Eye Infirmary for patent infringement and loses. The verdict establishes the landmark “patentability of a principle of nature” decision, freeing the medical profession to employ ether anesthesia without prejudice.

Dr. David Kearny McDonogh, American’s first African American ophthalmologist, adopts Dr. John Kearny Rodgers’s middle name in honor of his mentor, under whom he practiced for 11 years.

Dr. Hermann von Helmholtz demonstrates the ophthalmoscope in Europe.

Noyes, now Executive Director of the New York Eye Infirmary, is the first to photograph the retina of a living creature, a rabbit, laying the foundation for modern clinical retinal imaging.

Dr. Carl Friedrich Richard Foerster introduces the first perimeter.

1858

1862 Dr. Hermann von Snellen creates a test card for visual acuity.

Von Graefe introduces the small-incision surgery.

An Act of the New York State Legislature officially changes the name of the New York Eye Infirmary to the New York Eye and Ear Infirmary (NYEE), in formal recognition of its Otology Service, first established in 1824.

The American Ophthalmological Society (AOS), the second-oldest specialty medical society in the United States, is founded on June 7 by Noyes and Dr. Hasket Derby of Boston. They invite 16 of their esteemed colleagues to join, and name Delafield as the AOS’s first president. The organization’s first two annual meetings are held at the infirmary.

APPENDIXES

Chapter 2 1865–1905 1865 Dr. Henry Willard Williams introduces sutures for cataract surgery.

1866 Dr. Cornelius Agnew founds the Clinic for the Diseases of the Eye and Ear at the New York College of Physicians and Surgeons.

1867 Antiseptic surgical methods are introduced by Dr. Joseph Lister in his publication The Antiseptic Principal of the Practice of Surgery.

1868 Agnew helps to found the Brooklyn Eye and Ear Hospital.

At a meeting of the American Ophthamlogical Society, Dr. Henry D. Noyes, along with eight other members of that Society, propose the formation of the American Otological Society and compose its bylaws and constitution.

1869 Agnew helps to found the Manhattan Eye, Ear, and Throat Hospital.

1870

1873

1884

The NYEE Throat Department is established as the forerunner of the Head and Neck Service.

Dr. Carl Koller discovers the ability of cocaine solution to provide topical anesthesia.

NYEE physicians help found The New York Laryngological Society, the first of its kind in the United States and a precursor to the American Laryngological Society, established in 1878.

NYEE leases a one-story building on East 13th Street for the quarantine of contagious ophthalmia cases.

1874 NYEE surgeons begin to chart detailed accounts of their cases, as was already customary in Europe.

1876 Calabar bean extract, precursor of pilocarpine, is identified by Dr. Adolf Weber as a potential treatment for glaucoma.

1878 Regeneration of visual pigments in the dark as part of the visual cycle is first demonstrated by Dr. Friedrich Wilhelm Kühne.

NYEE expands with the opening of the Green Pavilion.

NYEE initiates its first voluntary 10 cent charge for prescriptions.

Dr. Emil Gruening joins the NYEE staff, where he becomes surgeon director.

Dr. Emil Gruening joins the NYEE staff, where he becomes a surgeon director.

1881

1871

Anthrax vaccine is first introduced by Louis Pasteur.

Dr. Isabel Hayes Chapin Barrows is the first woman to study ophthalmology at the University of Vienna and the first woman ophthalmologist to practice in the United States.

Agnew invents a new incision for draining the lacrimal sac made through the conjunctiva between the caruncle and the inner commissure of the eyelids.

1820–2020

Harlem Eye and Ear Infirmary opens.

1882 Rabies vaccine is first introduced by Pasteur.

TB bacillus is discovered by Dr. Robert Koch.

1883 Mycobacterium tuberculosi is identified by Dr. Julius von Michel as a cause of uveitis.

1885 Koller demonstrates cocaine anesthesia for ocular surgery at NYEE. Dr. William Wilmer, eventual founder of Johns Hopkins Wilmer Eye Institute, begins his internship at Mount Sinai Hospital.

The American Journal of Ophthalmology is established.

1886 Dr. A. Jess describes scleral buckle for the treatment of retinal detachment.

Sir Henry William Power, MD, advocates that human corneal tissue be used exclusively for keratoplasty for consistent success.

Agnew details a groundbreaking operation for divergent strabismus in an article titled “A Method of Operating for Divergent Squint,” published in the Transactions of the American Ophthalmological Society.

Dr. Francis Delafield, noted pathologist and son of Dr. Edward Delafield, is elected the first president of the Association of American Physicians. Delafield also mentors Dr. William Welch, founder of Johns Hopkins Medical School.

Haemophilus aegyptius, or Koch-Weeks bacillus, is discovered by Koch and Dr. John E. Weeks, head of the NYEE staff, as a cause of acute conjunctivitis.

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Timeline, continued 1887

1894

1904

First hard (glass) contact lenses are created by German glassblower F.E. Muller.

NYEE opens its five-story building and the Abram Du Bois Pavilion on Second Avenue and East 13th Street.

NYEE’s first X-ray Department is established by Weeks with the purchase of the infirmary’s first X-ray equipment.

1895

The first X-ray localization of a foreign body in a patient’s eye is performed by Weeks and Dr. George Dixon. Dixon subsequently develops the Weeks & Dixon method of ocular foreign body localization.

Wilmer joins Gruening as his assistant at Mount Sinai Hospital.

1888 Dr. Edward G. Loring enhances the Helmholtz Ophthalmoscope with design features to improve ergonomics for the clinician.

Radical mastoid drainage surgery is introduced to the United States by Gruening at Mount Sinai Hospital.

X-rays are discovered by Dr. Wilhelm Conrad Roentgen.

1896 American Academy of Ophthalmology, originally known as the Western Ophthalmological, Laryngological and Rhinological Association, is founded.

NYEE Executive Surgeon Dr. Henry D. Noyes publishes his groundbreaking Textbook on the Diseases of the Eye.

NYEE separates its ophthalmology and otolaryngology services.

Koller joins the NYEE staff. Subsequently, he becomes a member of the The Mount Sinai Hospital’s staff and is named chief of the Eye Clinic.

Aspirin is developed by chemist Felix Hoffman.

1890 The New York State Legislature passes the Howe Law mandating the use of silver nitrate for newborns to prevent ophthalmia neonatorum.

NYEE hosts a cornerstone-laying ceremony to celebrate its next major expansion.

After seven decades of conducting lectures and clinical training, NYEE’s School of Ophthalmology and Otolaryngology is officially recognized and chartered by the New York State Legislature.

Gruening organizes the Ear, Nose, Throat Clinic at Mount Sinai Hospital.

1893 NYEE publishes the first edition of The New York Eye and Ear Infirmary Reports.

1899

1905 Weeks donates his X-ray apparatus to the infirmary.

Dr. Eduard Zirm performs the first successful, full-thickness corneal transplant on a human patient, using a human donor cornea from a recent enucleation.

Dr. August Hjalmar Schiötz introduces his tonometer.

The New York Eye and Ear Infirmary Post-Graduate School for Nurses is created by the NYEE’s board of directors.

1901 The Bronx Eye and Ear Infirmary is chartered.

NYEE opens the James N. Platt Pavilion for the treatment of contagious eye diseases.

1902 The first electric hearing aid is invented.

1903 Helen Keller speaks as the guest of honor at the infirmary’s dedication of the William C. Schermerhorn Pavilion for the treatment of ear diseases.

NYEE initiates its first voluntary 25 cent charge for clinic visits, a fee that will stand for the next 50 years.

NYEE’s first X-ray room, 1905.

APPENDIXES

Chapter 3 1906–1945 1910

1917

1928

U.S. enters World War I.

Dr. Marc Amsler introduces the Amsler grid for detection of macular degeneration.

NYEE upgrades its radiology department with new X-ray technology donated by the Hartley-Jenkins family.

Dr. Ignacio Barraquer, a Spanish ophthalmologist, invents the erisophake, the first motorized vacuum instrument for intracapsular cataract extraction.

Dr. F. Phinizy Calhoun, NYEE resident from the class of 1908, returns to Atlanta to develop and lead the Department of Ophthalmology at Grady Hospital and Emory University for the next 30 years.

1919

1911 Dr. Allvar Gullstrand, a Swedish ophthalmologist and optician, is awarded the Nobel Prize in Physiology or Medicine for his work on the optical modeling of the eye.

Dr. Harvey J. Howard, NYEE resident, class of 1910, is recruited to head the Department of Ophthalmology at the University Medical School, Canton, China, and subsequently becomes ophthalmologist to the child emperor Puyi, the last emperor of China. Eventually, he establishes the Department of Ophthalmology at Washington University.

1913

NYEE becomes part of the New York United Hospital Fund charitable trust.

Dr. Bernard Samuels, an NYEE resident, takes charge of NYEE’s Pathology Department and eventually founds the Institute of Ophthalmology of the Americas.

1920 Dr. Jules Gonin introduces cautery for the repair of retinal detachment.

1922 Insulin is first used to treat diabetes.

The American Academy of Optometry is founded.

1924 The American Board of Otolaryngology is founded.

1925

Dr. Paul Dudley White pioneers the use of the electrocardiograph.

NYEE’s Social Service Department comes under the direction of the Auxiliary Social Service Committee.

1915

Dr. Algernon B. Reese, NYEE Class of 1925, contributes to the field of ocular oncology, including the recognition, classification, diagnosis, and treatment of retinoblastoma, research into retrolental fibroplasia, and classifications of ocular melanomas.

He establishes the Department of Ocular Pathology, more recently known as the Algernon Reese Pathology Laboratory, at Columbia University’s Vagelos College of Physicians and Surgeons.

NYEE’s Social Service Department is established under the direction of Florence M. Campbell.

The American Board of Ophthalmology establishes the first medical specialty board in the United States.

New York ophthalmologists comprise 10 of the 21 charter members.

Dr. Shinobu Ishihara, a Japanese ophthalmologist, publishes his definitive color vision test.

NYEE expands its footprint to East 14th Street with the acquisition of contiguous lots 310, 312, and 314 and, shortly thereafter, lot 308.

1820–2020

1926 NYEE’s Department of Research is created by Dr. Conrad Berens, NYEE Class of 1915.

Dr. Alexander Flemming discovers penicillin.

1929 Archives of Ophthalmology is established by the American Medical Association.

1930 Dr. Tsutomu Sato, a Japanese ophthalmologist, invents radial keratotomy treatment for myopia.

1931 Dr. Vladimir Filatov performs the first successful fullthickness corneal transplant using preserved human corneal tissue from a cadaver donor.

1933 Dr. John Martin Wheeler, NYEE Class of 1910, is chosen as the first director of the newly established Edward S. Harkness Eye Institute at Columbia University; he recruits his staff largely from the New York Eye and Ear Infirmary.

NYEE’s Orthoptic Clinic is created by Berens.

1934 Wheeler pioneers the specialty of ophthalmic plastic and reconstructive surgery with new techniques to repair eyelid abnormalities, including lower eyelid entropion, which is still in use today. He also introduces the first oculoplastic courses at the American Academy of Ophthalmology.

NYEE acquires New York City’s first eikonometer.

1935 The first wearable hearing aid, weighing 2.5 pounds, is introduced.

NYEE establishes the first School of Orthoptics in the United States under the direction of Berens and orthoptists Elizabeth K. Stark and Ethel Mueser.

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Timeline, continued 1936

1940

The American Academy of Ophthalmology and Otolaryngology selects NYEE as the site of its annual otolaryngologic section meeting.

Berens, along with Drs. Harry S. Gradle of Chicago and Moacyr E. Alvaro of São Paulo, coordinates the first Pan American Congress of Ophthalmology in Cleveland.

1937 Scleral buckling for the treatment of retinal detachment is introduced by Dr. A. Jess.

1941

1938

NYEE is accredited by the American College of Surgeons.

Dr. Ramon Castroviejo introduces his double knife at the annual meeting of the American Academy of Ophthalmology and begins a campaign to encourage people to will their corneas to science.

NYEE formalizes an academic affiliation with Columbia University College of Physicians and Surgeons enabling NYEE house officers to participate in basic science courses at Columbia Presbyterian Hospital.

NYEE surgeon Dr. Isaac Hartshorne develops a lowcost portable binocular gonioscope.

1939 Dr. Otto Barkan popularizes gonioscopy.

NYEE is asked to establish professional guidelines for orthoptic technicians and hosts the first national certifying examination of orthoptists.

NYEE’s Chief of Ophthalmic Plastic and Reconstructive Surgery, Dr. Wendell Hughes, develops the “Hughes Procedure” for reconstructing lower eyelid defects following the removal of large tumors. He is later honored by the American Society of Ophthalmic Plastic and Reconstructive Surgery with the establishment of the prestigious Wendell Hughes Lectureship.

Berens introduces thermoplastic prism bars for measurement of strabismic deviation, replacing heavy and expensive glass prism bars.

The United States enters World War II.

1942 Dr. Karl Theodore Dussik publishes the first paper on medical ultrasound.

1943 With 132 NYEE staff physicians serving in the U.S. Armed Forces, the infirmary suffers severe staff shortages and temporarily places its entire teaching program under the guidance of Columbia University’s College of Physicians and Surgeons.

Dr. Selman A. Waksman discovers the antibiotic streptomycin.

1944 NYEE establishes the Department of Audiology and Hearing Research to care for returning World War II GIs experiencing service-related hearing deficits.

Absorbable sutures for cataract surgery are introduced by NYEE Research Department physicians Hughes and Drs. Hunter H. Romaine and Loren P. Guy.

Chapter 4 1946–1985 1946 Dr. Charles Schepens demonstrates the headmounted binocular stereoscopic indirect ophthalmoscopy enabling scleral depression.

Dr. Gerd Meyer-Schwickerath begins to experiment with light photocoagulation.

NYEE affiliates with New York University.

1947 NYEE establishes the first Department of Hearing Testing, now the Department of Communicative Sciences, as an outgrowth of the World War II military aural rehabilitation center.

1948 Dr. Ignacio Barraquer invents a microkeratome and performs the first myopic keratomileusis.

The American Board of Ophthalmology ranks NYEE as one of only three A+ hospitals for residency training in the United States.

1949 Dr. Ernst Custodis reports on the successful use of the segmented sclera buckle, while Dr. Henricus J. M. Weve demonstrates the sclera stitch.

NYEE enters into a teaching affiliation with NYU/ Bellevue Medical Center.

NYEE-trained Dr. Louis J. Girard conducts the first clinical investigation of corneal contact lenses.

1945

1950

World War II ends.

Sir Nicholas Harold Lloyd Ridley, MD, creates and performs the first intraocular lens implant.

First influenza vaccine is introduced.

APPENDIXES

1951

1958

NYEE obtains a charter for its School of Otolaryngology.

NYEE’s Temporal Bone Laboratory, the first on the East Coast, is established to train otolaryngologists in temporal bone surgery.

NYEE reactivates the Department of Research.

NYEE opens the Maxillo-Facial Plastic Clinic.

Dr. Conrad Berens, an NYEE physician, and U.S. Marine Corps Capt. Dr. Jerry Hart Jacobson conduct pioneering clinical studies of electroretinography at NYEE.

Dr. Aran Safir, during his NYEE residency, invents an early electronic retinoscope and files for a patent.

1952

NYEE’s Center for Electroretinography is established

by Drs. Jerry Jacobson and John Weeks on the fifth floor of the South Building. Jacobson becomes a leading contributor to the development and standardization of clinical electroretinography.

Dr. Rosalind Franklin uses X-ray diffraction to study the structure of DNA.

NYEE’s Cornea and Glaucoma Subspecialty Services are created.

1953

Girard codesigns the first small, thin contact lens.

Drs. James Watson and Francis Crick announce they have determined the double-helix structure of the DNA molecule.

1954

Dr. Cornelius Binkhorst, a Dutch ophthalmologist, introduces the first iris-clip intraocular lens.

1959

Girard is the first ophthalmologist to perform and document corneoscleral transplantation.

David Alvis and Harold Novotny, two medical students, perform the first fluorescein angiography.

1955 Dr. Jonas Salk develops the first polio vaccine.

Dr. Bruno S. Priestley, an NYEE physician, establishes the Department of Pleoptics, the first of its kind in the United States and the largest of its kind in the Western Hemisphere.

1956

1960

Barraquer and Dr. H. Harms adapt the Zeiss optical microscope for eye surgery.

NYEE’s Social Service Department hires its first multilingual employee, who is fluent in English, Spanish, and Italian.

Dr. Hans Goldmann introduces his tonometer.

1957 Dr. Morton L. Rosenthal, an NYEE physician, establishes New York City’s first Retina Service.

Rosenthal introduces techniques of indirect ophthalmoscopy and fundus drawing for visualizing the retinal periphery ushering in a new era of modern retinal surgery.

NYEE opens new research laboratories in the renovated brownstone at 314 East 14th Street.

1961 Dr. Otto Wichterle creates the first soft contact lenses.

Rosenthal and Dr. Seymour Fradin, along with Dr. Charles Townes and Nobel Prize winning physicist Arthur Leonard Schawlow, conduct early studies of laser photocoagulation in rabbit retinas at Bell Labs that would eventually become the mainstay treatment for diabetic retinopathy.

1820–2020

Drs. Charles Campbell and Charles Koester report the first human ophthalmic laser treatment for a retinal tumor.

Dr. Tadeusz Krwawicz, a Polish ophthalmologist, introduces cryoextraction.

1962 Dr. Paul A. Cibis demonstrates the injection of silicone oil for the treatment of retinal detachment.

1964 Drs. Harvey Lincoff and John McLean describe cryosurgery for the treatment of retinal detachment.

Barraquer introduces the lamellar keratectomy surgery method of cryolathe keratomileusis.

Safir is awarded a patent for an early electronic retinoscope.

1966 “The Technique of Binocular Indirect Ophthalmoscopy,” a seminal article authored by Rosenthal and Fradin, published in Highlights of Ophthalmology with illustrations by Fradin, establishes a methodology for retinal exams still in use today.

1967 Drs. Ragar Granit, Haldan Hartline, and George Wald are awarded the Nobel Prize in Physiology or Medicine for demonstrating the primary neural organization of the retina and the role of vitamin A. Dr. Charles D. Kelman, an NYEE physician, devises the first revolutionary apparatus for phacoemulsification used in cataract surgery.

Dr. William B. Snyder introduces laser iridotomy.

NYEE dedicates its new North Building on East 14th Street. The original South Building is renovated and modernized to house the Eye Clinic, subspecialty services, a lecture hall, and private physician offices.

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Timeline, continued Dr. Norman B. Jaffe, an NYEE physician, is among the first three surgeons in the United States to implant an intraocular lens following cataract extraction. He becomes a seminal figure in the development of modern cataract surgical techniques.

1968 The National Eye Institute of the National Institutes of Health is established.

Dr. Francis A. L’Esperance Jr. conducts the first human trial using an ophthalmic laser treatment.

Dr. John Cairns introduces trabeculectomy.

Dr. Young Bin Choo, otolaryngologist and NYEE alumnus, is awarded an $85,000 Guggenheim Foundation grant to construct an 11-station, stateof-the-art Temporal Bone Laboratory. The only other laboratory of its kind anywhere in the world was located at the House Ontology Group in Los Angeles.

Both were designed by Jack Urban.

1974 The NYEE Staff Residence Building, a $5 million, 14-story, 123-apartment facility, opens at 326 East 13th Street.

NYEE opens its new North Building on East 14th Street with 207 beds and 10 state-of-the-art operating suites.

NYEE physicians Drs. David Krohn, Donald Morris, and Ron Jacobs pioneer the use of hematoporphyrin derivatives for diagnosis and photodynamic therapy of choroidal melanoma.

1970

1977

Dr. Robert Machemer demonstrates the first practical suction vitrectomy instrument for the treatment of retinal detachments.

The New York Eye and Ear Infirmary Quarterly Journal is launched by Drs. Richard S. Koplin and Virginia Lubkin.

NYEE celebrates 150 years of service.

1978

1971

Timolol maleate, a breakthrough eyedrop for glaucoma management, is introduced to the market.

The NYEE Retina Diagnostic Center, incorporating retinal photography and fluorescein angiography, is established by Dr. Thomas O. Muldoon, NYEE Class of 1966.

1972 The first commercial vitreous infusion suction cutter with fiber optics for illumination is developed by Machemer and manufactured by Klein.

Computerized axial tomography (CT scan) imaging system is introduced for medical diagnosis and research.

1979 NYEE’s Bioengineering and Computer Science Division is established by Koplin and Morton Gersten, an engineer, and the first digital A-scan ultrasound system for intraocular lens measurements is created.

1980 Dr. John Mallard of the University of Aberdeen, Scotland, obtains the first clinically useful MRI image of a patient’s internal tissues.

NYEE affiliates with New York Medical College and Dr. Michael Dunn becomes the first chair of ophthalmology.

1981 Drs. David Hubel and Torston Wiesel receive the Nobel Prize in Physiology or Medicine for revealing how visual information is coded in the retina and brain.

1982 Computerized corneal topographic mapping is introduced by Koplin, Lubkin, Dr. Dennis Gormley, and Gersten, leading the way to precision corneal vision correction.

1983 Dr. Robert Ritch joins the NYEE staff, expanding glaucoma research and creating the Ocular Imaging Center for the study of optic nerve structure and blood flow. The center becomes a world-class glaucoma imaging resource with the advent of highresolution ultrasound biomicroscopy in 1994 for investigating the anterior segment anomalies such as plateau iris, and in 1995 employs one of the first OCT systems outside MIT, where it was developed.

NYEE’s Department of Plastic Surgery is created by Dr. Donald Wood-Smith.

1984 The New York Eye Trauma Center, the first of its kind in New York City, opens at NYEE under the leadership of Koplin.

1985 NYEE establishes New York City’s first inpatient Diabetes Treatment Center, offering integrative care for patients with diabetes vision-related problems.

Dr. Theo Seiler, a German ophthalmologist and physicist, performs the first large area ablation in a human eye to remove a corneal scar, having previously performed T-incisions with an excimer laser to correct for astigmatism.

APPENDIXES

Chapter 5 1986–2020 1987 The first photorefractive keratoplasty in humans using an excimer laser is performed by Dr. Marguerite McDonald.

Drs. Aran Safir and Leonard Flom patent their idea for an iris identification system, basing it on the idea that no two irises are alike.

1988 NYEE’s Bioengineering and Computer Science Division becomes the Aborn Laboratory.

The first commercial manufactured corneal mapping device, TMS-1, invented in NYEE’s Bioengineering and Computer Science Laboratory, is introduced. It leads the way to precision corneal vision correction and is still widely in use today.

1991 NYEE creates an inpatient Diabetes Treatment Center program for intensive patient rehabilitation and education.

NYEE’s outpatient eye and ENT centers open following a major update and redesign.

With 70,000 eye visits annually, NYEE’s clinic volume is the largest in the United States The clinic is also the largest primary eye care provider in the New York metropolitan area.

With 51,902 ENT patients, NYEE’s Department of Otolaryngology/Head and Neck Surgery is the largest collection point of clinical material of any facility in North America.

1992

1989

NYEE Drs. Richard Rosen and Thomas O. Muldoon, and David Buzawa, an engineer, along with a team from Iris Medical, develop the first commercial transscleral laser retinopexy probe for repairing retinal tears and detachments.

Endoscopic sinus surgery is pioneered by NYEE otolaryngology chair Dr. Steven D. Schaefer.

NYEE opens New York City’s first pediatric glaucoma clinic.

1990

Hu, Ritch, and McCormick create NYEE’s Ocular Cell Culture Lab and develop the methodology for isolation and culture of human uveal melanocytes.

Exfoliation material is identified in tissue culture for the first time in cells extracted from glaucoma patients diagnosed with exfoliation syndrome.

Dr. Joseph B. Walsh becomes NYEE’s second Chairman of Ophthalmology.

NYEE Drs. Dan Ning Hu, Robert Ritch, and Steven A. McCormick, Chief of Pathology, develop the first successful methodology for isolation and culture of human iris pigment epithelial cells at NYEE’s Ocular Cell Cultural Laboratory.

NYEE is the first to use apraclonidine, an antiglaucoma drug, in the United States.

NYEE’s Department of Communicative Disorders offers speech therapy in Spanish to better serve Hispanic patients in the infirmary’s service area.

Drs. James G. Fujimoto and David Huang report the first optical coherence tomography (OCT) images of the eye, introducing optical biopsies of nearhistological quality in the clinic.

The New York Eye and Ear Infirmary Ophthalmology Associates, P.C., a self-sustaining organization for resident education and patient care, is formed to leverage the expertise of the infirmary’s large voluntary teaching staff of community ophthalmologists.

NYEE’s Ambulatory Surgery Center is created, dedicating an entire floor for pre- and postoperative patient management adjacent to operating and

1820–2020

recovery rooms that enables throughput of more than 100 surgical cases per day.

NYEE neuro-otologist Dr. Christopher L. Linstrom performs the infirmary’s first cochlear implant on 10-year-old Alex Carrasco.

NYEE acquires “Homage to Hippocrates,” a muralsized painting by artist Harold Stevenson, donated by board member Anastasios Karavias.

1995 NYEE celebrates its 175th anniversary.

Ritch demonstrates that laser therapy is a safe and effective alternative to eye drops as a first-line treatment for patients with newly diagnosed primary open-angle glaucoma.

NYEE establishes New York City’s first hospitalbased hearing aid dispensary.

NYEE receives New York City’s first OCT imaging device.

1996 3D ultrasound biomicroscopy imaging is developed

by Rosen, Ritch, and Drs. Ray Iezzi and Celso Tello for volumetric visualization of anterior segment eye trauma and tumors.

Iezzi, Rosen, and Drs. Paul T. Finger and Eliot L. Berson introduce self-illuminating brachytherapy plaques, enabling improved precision in the placement of radioactive plaques implanted for treatment of submacular choroidal melanomas.

1997 Muldoon, an early champion of advanced retinal diagnostics and therapeutics such as fluorescein angiography, ultrasound, laser, and vitrectomy, becomes the second chief of NYEE’s Retina Service.

The first multifocal intraocular lens is approved by the U.S. Food and Drug Administration.

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Timeline, continued 1999 NYEE becomes a member of Continuum Health Partners, Inc., along with Beth Israel Medical Center, St. Luke’s-Roosevelt Hospital Center, and Long Island College Hospital.

2000 The National Institutes of Health’s National Human Genome Research Institute sequences the complete human DNA genetic map.

NYEE’s Vestibular Rehabilitation Center opens.

2002 Rosen and Drs. Patricia Garcia and Mark Hathaway, and engineer Rishard Weitz, working with Drs. Adrian Podoleanu and George Dobre, combine en face OCT/ Confocal Scanning Laser Ophthalmoscope (SLO), developed at the University of Kent, with idocyanine green angiography (ICG) to create simultaneous multichannel OCT/SLO/ICG angiography.

2003 NYEE opens the Bendheim Family Retina Center, a 10,000-square-foot floor dedicated to state-of-theart diagnosis and treatment of retinal disease.

NYEE opens the Jorge N. Buxton, MD, Microsurgical Education Center.

NYEE’s Aborn Laboratory is renamed the AbornLubkin Laboratory in memory of Dr. Virginia Lubkin, its founder.

2005 NYEE’s Sleep Center is created.

NYEE’s Otolaryngology Department expands its presence in Brooklyn with the opening of a new office in Flushing.

NYEE holds the “Eye on the Future” colloquium, the first of its kind to bring together specialists focusing on the future of organ, tissue, and eye transplantation and donation.

NYEE Drs. Joseph Arigo and George Alexiades successfully perform the tristate area’s first fully implantable hearing aid surgery.

2006 NYEE’s Otolaryngology Department organizes an international conference at the United Nations to address radiation-induced thyroid cancer related to the Chernobyl nuclear accident.

Ritch is honored as the first recipient of the Shelley and Steven Einhorn Distinguished Chair of Ophthalmology.

NYEE ocular oncologist Dr. David Abramson introduces intra-arterial chemotherapy in the United States for treatment of retinoblastoma, leading to a major shift in the management of this condition.

2007 Rosen, Garcia, Dr. Gennady Landa, and Weitz, along with a Toronto-based Ophthalmic Technologies Inc. team, collaborate to integrate SLO microperimetry and OCT/SLO 3D topographic imaging, creating the first en face OCT that combines visual functional testing with 3D structural imaging in one instrument.

2008

2009 NYEE opens the Facial Paralysis Rehabilitation Center under the directorship of Dr. Anthony Sclafani.

NYEE establishes Project Chernobyl and the Thyroid Disease Center.

Walsh is honored as the first Belinda Bingham Pierce and Gerald G. Pierce, MD, Distinguished Chair of Ophthalmology.

Finger champions the use of vascular endothelial growth-factor inhibitors for treatment of radiationrelated maculopathy and optic neuropathy following brachytherapy for eye cancers.

The first femtosecond laser system for cataract surgery is approved by the U.S. Food and Drug Administration.

2010 NYEE opens the Shelley and Steven Einhorn Clinical Research Center.

Ritch pioneers the use of acupuncture for “lazy eye,” anisometropic amblyopia, replacing eye patches for many older children with this vision problem.

NYEE Ear Institute opens at 380 Second Avenue, centralizing NYEE, Beth Israel, and the Children’s Hearing Institute’s ear specialty services.

NYEE’s Otolaryngology Department expands into Short Hills, New Jersey, and an Ophthalmology/ Otolaryngology practice opens in Tribeca.

NYEE Drs. Robert Allen, Joshua Levine, and David Greenspun pioneer autologous microsurgical breast reconstruction as an alternative to traditional postmastectomy prosthetics.

2012

Rosen, the director of NYEE’s Retina Service and Ophthalmic Research, in collaboration with Dr. Mark Kupersmith, then director of Neuro-Ophthalmology and Continuum’s Department of Neurosurgery, develops the “Eye Attack Protocol” for the treatment of central retinal artery occlusion.

Rosen and NYEE Dr. Yuen Ping Toco Chui, under the auspices of NYEE’s David E. Marrus Adaptive Optics Laboratory, and in collaboration with Drs. Alfredo Dubra and Joseph Carroll from the Medical College of Wisconsin, introduce fluorescein angiography into human adaptive optics scanning light ophthalmoscopy to further highlight changes in retinal vasculature and study the variety and the internal fluid dynamics of retinal capillary microaneurysms.

APPENDIXES

(2012) NYEE expands its postanesthesia care unit (PACU) facility adjacent to the operating suite for enhanced perioperative care.

2013 NYEE, as a member of Continuum Health Partners, Inc., merges with Mount Sinai Medical Center, creating the Mount Sinai Health System, one of the nation’s largest not-for-profit health systems and the largest nongovernment employer in New York.

2014 Dynamic histopathology, introduced by Rosen and Chui, under the auspices of NYEE’s David E. Marrus Adaptive Optics Laboratory, uses serial adaptive optics scanning light ophthalmoscopy imaging. It allows physicians to study retinal capillary microvascular remodeling longitudinally in patients at extended time intervals.

Kupersmith leads an NIH-funded study, the results of which indicate that an inexpensive glaucoma drug can preserve and actually restore vision when added to a weight-loss plan for women who develop a blinding disorder linked to obesity.

Dr. Michael J. Pitman, an NYEE physician, performs the first American series of autologous temporalis fascia transplants to the vocal fold to restore patients’ voices.

2015 Rosen and Chui, under the auspices of NYEE’s David E. Marrus Adaptive Optics Laboratory, introduce quantitative analysis of capillary density using adaptive optics scanning laser ophthalmoscopy with fluorescein angiography to provide unprecedented clinical measurements of microvascularity in the retina.

2016 With the introduction of OCT angiography, the en face OCT perspective, originally pioneered at NYEE,

1820–2020

becomes widely adopted for monitoring vascular and structural changes in patients with glaucoma, diabetic retinopathy, and macular degeneration at resolution for clinical applications previously available only with adaptive optics.

transcription factors in a living mouse can successfully reprogram retinal glial cells into rod photoreceptors, enabling congenitally blind mice to see light for the first time.

Rosen and Chui, under the auspices of NYEE’s David E. Marrus Adaptive Optics Laboratory, translate their work in adaptive optics imaging to OCT angiography, introducing a full spectrum of quantitative tools for precision assessment and follow-up of clinical microvascular disease.

NYEE and Mount Sinai Health System merge their ophthalmology residency programs to form the largest ophthalmology residency program in the nation.

2017 The Mount Sinai/New York Eye and Ear (NYEE) Eye and Vision Research Institute is established. As the first of its kind in the New York City metropolitan region, the institute brings together eye and vision researchers from NYEE, the Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai.

NYEE research studies expand to include more than 100 clinical, translational, epidemiological, and bench investigations under the direction of faculty and trainees.

NYEE’s Ear Institute, led by Drs. George Wanna and Maura Cosetti, is the first to use the newly approved/ released SlimJ electrode in the Northeast.

NYEE’s Ear Institute introduces the transcanal endoscope for ear surgery and the endoscopic surgery of the lateral skull base using the exoscope, a cutting-edge extracorporeal video microscope.

2018 Rosen and Chui, under the auspices of NYEE’s David E. Marrus Adaptive Optics Laboratory and in collaboration with Carroll, develop the first normative data for OCT angiography, facilitating recognition of quantitative abnormalities in retinal blood flow.

Mount Sinai/New York Eye and Ear (NYEE) Eye and Vision Research Institute’s Dr. Bo Chen demonstrates how the gene transfer of ß-catenin and three

2019

NYEE, in collaboration with the Dutch developer of Preceyes Surgery System, introduces the first robotic interventional system for ocular surgery into the U.S., ushering in a new era of unlimited potential in precision surgery. Delivery is scheduled for 2020.

The Preceyes Surgery System in use, 2020.

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B. Presidents and Chairs of the NYEE Board of Directors 1821-2012 i 1821–1826

Col. William Few 1858–1864 President

Rev. Dr. Taylor President

1946–1948

Hugh Eustis Paine President

1827–1828

Henry I. Wyckoff President

1865–1883

Royal Phelps President

1949–1951

General Ephraim F. Jeffe President

1828–1833

(documents missing)

1884–1892

1952–1953

1834–1838

Henry I. Wycoff President

Benjamin H. Field President

W.A.W. Stewart Jr. President

1893–1899

1961–1976

1839

(documents missing) 1900–1902 Goold Hoyt President 1903–1905 (documents missing)

John Harsen Rhoades President

Gordon S. Braislin President

Wm. Watts Sherman President

1977–1980

Guy G. Rutherfurd ii President

James J. Higginson President

1981–1983

(documents missing)

1984–1986

Judith C. Zesiger iii Chairwoman

1987–1990

Austen T. Gray Chairman

1990–1992

Fred Cahill Chairman

1993–1994

Joseph R. Burkart Chairman

1994–2007

Peter Frelinghuysen, Esq. Chairman

2008–2012

Sorrell M. Mathes iv Chairman

1840 1841 1842

Goold Hoyt President

1906–1908

1843–1844

Rufas L. Lord President

Edward A. Wickes President

1909–1918

1845

(documents missing)

Lispenard Stewart President

1846

Rufas L. Lord President

1919–1925

John J. Riker President

1926–1934

Dexter Blagden President

1847

(documents missing)

1848–1854

Rufas L. Lord President

1935–1940

Hugh Eustis Paine President

1855–1857

John Oothout President

1941

(documents missing)

1942–1944

Robert Y. Youngs President

i. This list is based on available NYEE Annual Reports and documents. Special thanks go to Mrs. Susan Liebowitz, Dr. Thomas Muldoon, Paul Kessler, and Sorrell M. Mathes, who filled in significant gaps. ii. The title of the President of the Board evolved to the Chairman of the Board following Guy Rutherfurd’s tenure. iii. Judith C. Zesiger served as the New York Eye and Ear Infirmary’s first and only Chairwoman of the Board. iv. Upon the 2013 merger of Continuum Partners Inc. and Mount Sinai Medical Center that formed the Mount Sinai Health System, the New York Eye and Ear Infirmary Board of Directors was dissolved.

APPENDIXES

C. NYEE Administrative Leadership 1958-2020 i 1958–1967

Col. Charles E. Martin Administrator

1968–1981

Gerald McCoy Administrator

1982–1985

Frank Hayes Administrator

1986–1993

Paul R. Kessler ii President & CEO

1994

Joseph R. Burkart Acting President & CEO

1994–2006

Joseph P. Corcoran President & CEO

2007–2014

D. McWilliams Kessler President & CEO

2014

Allan Fine Acting President (5 months)

2014–present

James C. Tsai, MD , MBA, FACSiii President

i.

This chronology is based on available NYEE Annual Reports and documents, as well as contributions from Mrs. Susan Liebowitz, Dr. Thomas Muldoon, Paul Kessler, and Sorrell M. Mathes, who filled in significant gaps.

ii.

During Paul R. Kessler’s tenure, the title of Administrator evolved to President & CEO.

iii. As of Dr. Tsai’s tenure, the title of President & CEO evolved to President.

1820–2020

19 1

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D. Mount Sinai Health System Leadership 2020 Mount Sinai Health System Leadership Kenneth L. Davis, MD President and Chief Executive Officer, MSHS Dennis S. Charney, MD Anne and Joel Ehrenkranz Dean, ISMMS President, Academic Affairs, MSHS Jeremy Boal, MD President, MSD Executive Vice President and Chief Clinical Officer, MSHS

NYEE Executive Leadership James C. Tsai, MD, MBA, FACS President, NYEE Chair, Department of Ophthalmology, MSHS Barbara Barnett, MD, MHCDS, FACEP, FACP Senior Vice President and Chief Medical Officer, MSD/NYEE Christine Mahoney, RN, MS, AGACNP-BC, CCRN Senior Vice President, Patient Care Services Chief Nursing Officer, MSD/NYEE

Salvatore Loiacono, Jr., MPA,CMPE Deputy Chair for Finance and Administration, MSHS Vice President for Ophthalmology Services, NYEE

Thomas P. O’Brien Director, Development, NYEE and MS/NYEE Eye and Vision Research Institute

Patricia Wells Vice Chair/Administrator, Otolaryngology, MSHS

NYEE Medical Board Members

Paul A. Sidoti, MD Site Chair, Department of Ophthalmology, NYEE Chief, Glaucoma, MSHS George Wanna MD, FACS Site Chair, Otolaryngology, MSD/NYEE Director, Ear Institute, NYEE Chief, Division of Otology-Neurotology, MSHS Jordan Jacobs, MD Site Chair, Plastic and Reconstructive Surgery, MSD/NYEE Jodi Sassoon, MD Site Chair, Pathology, NYEE Matthew Weissman, MD, MBA, FAAP Site Chair, Department of Medicine, MSD/NYEE Scott Horn, MD Deputy Chief Medical Officer, NYEE

Christopher T. Spina, SM, FACHE Senior Vice President and Chief Operating Officer, NYEE

Jonathan Ascher, MD Director, Anesthesia Service, NYEE

Christopher Berner Vice President, Human Resources, MSD/NYEE

Azita S. Khorsandi, MD Director, Radiology Service, NYEE

Cynthia Girdusky, RN, CNOR, MPA, RNFA Vice President, Perioperative Services, MSD/NYEE

Alexandra Bissett, MBA Director, Marketing, Communications and Outreach Department of Ophthalmology, MSHS and NYEE

Ralph Lambiasi, MPA, FACHE Vice President, Business Development and Business Operations, NYEE

Anne Marie Middleton Director, Human Resources, NYEE

John Aljian, MD Secretary, NYEE Medical Board Surgeon Director, Ophthalmology Jonathan Ascher, MD Director, Anesthesia Service, NYEE Barbara Barnett, MD, MHCDS, FACEP, FACP Chief Medical Officer, MSD/NYEE J. George Braun, MD Surgeon Director, Otolaryngology Douglas F. Buxton, MD Surgeon Director, Ophthalmology Jacqueline Dauhajre, MD Chair, Pharmacy Committee Claude Douge, MD Senior Representative-At-Large, Otolaryngology Ronald C. Gentile, MD Senior Representative-At-Large, Ophthalmology Cynthia Girdusky, RN, CNOR, MPA, RNFA Vice President, Perioperative Services, MSD/NYEE Meenakashi Gupta, MD Chair, Infection Prevention Committee Jordan Jacobs, MD Site Chair, Plastic and Reconstructive Surgery, MSD/NYEE

ABBREVIATIONS ISMMS - Icahn School of Medicine at Mount Sinai NYEE - New York Eye and Ear Infirmary of Mount Sinai MSB - Mount Sinai Brooklyn MSBI - Mount Sinai Beth Israel

Nilesh Patel, MD Chairman, NYEE Medical Board

MSD – Mount Sinai Downtown MSHS - Mount Sinai Health System MSH - The Mount Sinai Hospital MSQ - Mount Sinai Queens

Azita S. Khorsandi, MD Director, Radiology Service, NYEE

APPENDIXES

Mark Kupersmith, MD Vice Chair for Translational Research in Ophthalmology

Jodi Sassoon, MD Site Chair, Pathology, NYEE

Leigh Lachman, MD Surgeon Director, Otolaryngology

Madeleine R. Schaberg, MD Senior Representative-at-Large, Otolaryngology

Joshua Levine, MD Surgeon Director, Plastic Surgery

Stimson Schantz, MD Surgeon Director, Otolaryngology

Christine Mahoney, RN, MS, AGACNP-BC, CCRN Senior Vice President, Patient Care Services and Chief Nursing Officer, MSD

Matthew Shawl, MD Senior Representative-at-Large, Otolaryngology

Kira Manusis, MD Surgeon Director, Ophthalmology Navin Mehta, MD Surgeon Director, Otolaryngology Margret Mendenhall Manager, Patient Experience, MSD/NYEE

1820–2020

Douglas R. Fredrick, MD Deputy Chair for Education, MSHS Chief, Pediatric Ophthalmology and Strabismus, MSHS Richard B. Rosen, MD, ScD (Hon), FACS, FASRS, FARVO, CRA Deputy Chair for Clinical Affairs, MSHS Vice Chair and Director of Ophthalmic Research, NYEE Chief, Retina Service, MSHS

Edward Shin, MD Surgeon Director, Otolaryngology

Salvatore Loiacono, Jr., MPA Deputy Chair for Finance and Administration, MSHS Vice President for Ophthalmology Services, NYEE

Paul Sidoti, MD Surgeon Director, Ophthalmology

Tamiesha Frempong, MD, MPH Vice Chair for Diversity and Inclusion, MSHS

Christopher T. Spina, SM, FACHE Senior Vice President and Chief Operating Officer, NYEE

Anita Gupta, MD Vice Chair for Professional Development, MSHS Director, Cornea and External Diseases, NYEE

Marc Napp, MD Senior Vice President, Medical Affairs and Deputy Chief Medical Officer, MSHS

George Wanna, MD Site Chair, Otolaryngology, MSD/NYEE Director, Ear Institute, NYEE Chief, Division of Otology-Neurotology, MSHS

Tal Raviv, MD Senior Representative-At-Large, Ophthalmology

Matthew Weissman, MD, MBA, FAAP Site Chair, Department of Medicine, MSD/NYEE

Mark Kupersmith, MD Vice Chair for Research in Translational Ophthalmology, MSHS Chief, Neuro-Ophthalmology, MSHS

Icahn School of Medicine at Mount Sinai Department of Ophthalmology Leadership

Sandra K. Masur, PhD Vice Chair for Academic Development and Mentoring, MSHS

Thomas Romo, III, MD Senior Representative-At-Large, Otolaryngology Richard Rosen, MD, ScD (Hon), FACS, FASRS, FARVO, CRA Surgeon Director, Ophthalmology Joseph Rousso, MD Junior Representative-at-Large, Otolaryngology James C. Tsai, MD, MBA, FACS President, NYEE Chair, Department of Ophthalmology, MSHS Sophia Saleem, MD Junior Representative-At-Large, Otolaryngology

James C. Tsai, MD, MBA, FACS President, NYEE Chair, Department of Ophthalmology, MSHS

Alon Harris, PhD Vice Chair for International Affairs, MSHS

Nisha Chadha, MD Director, Medical Student Education, ISMMS

Louis R. Pasquale, MD, FARVO Site Chair, Department of Ophthalmology, MSH/MSQ Deputy Chair for Research, MSHS Director, MS/NYEE Eye and Vision Research Institute

Priti Batta, MD Director, Medical Student Education, NYEE

Paul A. Sidoti, MD Site Chair, Department of Ophthalmology, NYEE Chief, Glaucoma, MSHS

Gareth Lema, MD, PhD Director, Quality, Safety, and Experience, MSHS

Sophia Saleem, MD Senior Director, Tele-Ophthalmology, MSHS

193

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Mount Sinai Health System Leadership 2020, continued NYEE Ophthalmology Residency and Fellowship Programs Douglas R. Fredrick, MD Deputy Chair for Education, MSHS Director, Ophthalmology Residency Program, MSH Director, Pediatric Ophthalmology Fellowship Program, NYEE Harsha S. Reddy, MD Director, Ophthalmology Residency Program, NYEE Medical Director, Ophthalmology Division, MSBI Paul S. Lee, MD Associate Residency Program Director, MSH President, NYEE/MSH Department of Ophthalmology Alumni Association Erin Walsh, MD Associate Residency Program Director, NYEE Co-Director, Pediatric Ophthalmology and Strabismus Service, NYEE Stephanie M. Llop Santiago, MD Director, Uveitis and Ocular Immunology Fellowship Program, NYEE Richard B. Rosen, MD, ScD (Hon), FACS, FASRS, FARVO, CRA Director, Vitreo-Retinal Fellowship Program, NYEE Kateki Vinod, MD Director, Glaucoma Fellowship Program, NYEE Angie E. Wen, MD Director, Cornea and External Diseases Fellowship Program, NYEE

Ophthalmology Medical Directors

Eye Trauma

Avnish Deobhakta, MD Medical Director, NYEE – East 85th Street

John Aljian, MD Ronald C. Gentile, MD Harsha S. Reddy, MD

Valerie Elmalem, MD Interim Medical Director – Mineola Robin N. Ginsburg, MD Medical Director, NYEE – East 102nd Street Gennady Landa, MD Medical Director, NYEE – Tribeca Kira Manusis, MD Medical Director, NYEE – Midwood Paul A. Sidoti, MD Medical Director, NYEE – East 14th Street Erin Walsh, MD Interim Director, Comprehensive Ophthalmology Clinic, NYEE Angie E. Wen, MD Medical Director, NYEE – Columbus Circle

Clinical Divisions at ISMMS Ophthalmology Faculty Practices Cornea, External Diseases, and Refractive Surgery Sumayya Ahmad, MD Priti Batta, MD Anita Gupta, MD David Harris, MD Kira Manusis, MD Neha Shaik, MD Angie E. Wen, MD

Glaucoma Paul A. Sidoti, MD Chief, Glaucoma, MSHS Nisha Chadha, MD Donna Gagliuso, MD Tsontcho Ianchulev, MD Louis R. Pasquale, MD, FARVO Nathan Radcliffe, MD Tania Tai, MD James C. Tsai, MD, MBA, FACS Kateki Vinod, MD Sze Wong, MD

Neuro-Ophthalmology Mark Kupersmith, MD Chief, Neuro-Ophthalmology, MSHS M. Abigail (Abbe) Craven, MD Valerie Elmalem, MD Joel Mindel, MD

Ocular Oncology Paul Finger, MD

Ophthalmic Pathology Jodi Sassoon, MD Site Chair, Pathology, NYEE Nada Farhat, MD Alan Friedman, MD Codrin Iacob, MD

APPENDIXES

1820–2020

Oculoplastic, Orbital, and Reconstructive Surgery

Uveitis and Ocular Immunology

Affiliated Leadership

Robert Della Rocca, MD Chief, Oculoplastic, Orbital and Reconstructive Surgery, MSHS

Varun K. Pawar, MD Stephanie M. Llop Santiago, MD Sophia Saleem, MD

Paul Lee, MD Chief of Ophthalmology, James J. Peters VA Medical Center

Basic Science/Translational Research Faculty

Robert Fischer, MD Director of Ophthalmology, Elmhurst Hospital

M. Abigail (Abbe) Craven, MD Monica Dweck, MD Valerie Elmalem, MD Yogita Kashyap, MD Harsha S. Reddy, MD

Pediatric Ophthalmology and Strabismus Douglas Fredrick, MD Chief, Pediatric Ophthalmology and Strabismus, MSHS Tamiesha Frempong, MD, MPH Edward Raab, MD Steven Rosenberg, MD Erin Walsh, MD

Primary Care Ophthalmology/Optometry Monica Dweck, MD Karen Hendler-Goldberg, MD Bessie Abraham, OD Jared Hayashi, OD Vanessa Hernandez, OD Elena Schmidt, OD Shreya Jayasimha, OD

Retina Richard B. Rosen, MD, ScD (Hon), FACS, FASRS, FARVO, CRA Chief, Retina Service, MSHS Avnish Deobhakta, MD Robin N. Ginsburg, MD Meenakashi Gupta, MD Gennady Landa, MD Gareth Lema, MD, PhD R. Theodore Smith, MD, PhD

Yuen Ping Toco Chui, PhD Bo Chen, PhD Alon Harris, PhD Jun Lin, MD, PhD R. Theodore Smith, MD, PhD J. Mario Wolosin, PhD

Voluntary Faculty Leadership John Aljian, MD Co-Director, Trauma Service (Anterior Segment), NYEE Ronald C. Gentile, MD Co-Director, Trauma Service (Posterior Segment), NYEE Douglas F. Buxton, MD President, Jorge N. Buxton, M.D. Microsurgical Education Foundation

Michelle Rhee, MD Associate Director of Ophthalmology, Elmhurst Hospital

Icahn School of Medicine at Mount Sinai Department of Otolaryngology Leadership Eric Genden, MD, FACS Chairman, Department of Otolaryngology, MSHS George Wanna MD, FACS Site Chair, Otolaryngology, MSD/NYEE Director, Ear Institute, MSHS Chief, Division of Otology-Neurotology, MSHS Edward J. Shin, MD Vice Chair, Otolaryngology, MSD/NYEE

Richard Koplin, MD Co-Director, Cataract Service, NYEE

Patricia Wells Vice Chair/Administrator, Otolaryngology, MSHS

Steven E. Rosenberg, MD Co-Director, Pediatric Ophthalmology and Strabismus Service, NYEE

Patrick Colley, MD Associate Director, Otolaryngology Residency Program, MSHS

Jeanne L. Rosenthal, MD Associate Director, Retina Service, NYEE

Maura K. Cosetti, MD Associate Professor, Otolaryngology and Neurosurgery, ISMMS Director, Cochlear Implant Program, Ear Institute, NYEE Director, Otology/Neurotology, MSD/NYEE Associate Director, Ear Institute, NYEE

Louis S. Angioletti, MD Chairman Emeritus, NYEE Medical Board

195

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Mount Sinai Health System Leadership 2020, continued Bryan D. Hujsak, PT, DPT, NCS Clinical Director, Vestibular Rehabilitation, NYEE Administrative Director, Ear Institute at NYEE

Otology

Gregory M. Levitin, MD Director, Vascular Birthmarks and Malformations, NYEE

Maura Cosetti, MD Enrique R. Perez, MD, MBA

Enrique R. Perez, MD, MBA Director, Otology, MSH

Pediatric Otolaryngology

Joseph Rousso, MD Director, Facial Plastic and Reconstructive Surgery, NYEE Madeline R. Schaberg, MD Director, Rhinology, MSD/NYEE Yan Tam Administrator, Otolaryngology, NYEE

Comprehensive Otolaryngology Claude Douge, MD Lisette Giraud, MD Ronald Hoffman, MD Edward Shin, MD

Facial Plastics and Reconstructive Surgery Joseph Rousso, MD Matthew Hirsch, MD

Laryngology Matthew Mori, MD

Rhinology and Sinus Disease Patrick Colley, MD Madeline Schaberg, MD

George Wanna MD, FACS Chief, Division of Otology-Neurotology, MSHS

Alyssa M. Hackett, MD

Vascular Birthmarks and Malformations Gregory M. Levitin, MD

APPENDIXES

1820–2020

Notes Chapter 1: Pages 1-31: So Wide a Field...

8

Op. Cit.: 503.

1

Delafield E. Biographical sketch of J. Kearny Rodgers’s, M.D. New York: GAC Van Beuren; 1852.

9

Kara GB. History of New York Eye and Ear Infirmary. NYS J Med 1973 Dec 1, 73 (23).

2

Two spellings of John Kearny Rodgers middle name—Kearney and Kearny—appear in authoritative sources. For consistency, the author has used the latter spelling, as it appears in Edward Delafield’s 1852 biographical sketch and in an account of the controversial medical decisions surrounding his untimely death in 1851 entitled “History of the Case of the Late John Kearny Rodgers, addressed to the Profession,” as well as being recorded as such on his daughter’s grave in Rome.

3

Burrows E. G. and Mike Wallace. Gotham: A History of New York City to 1898. New York: Oxford University Press; 1998:385 and 434. The author has drawn on this source extensively throughout this narrative with respect to the history of New York City.

4

Ibid.: 385.

5

Ibid.

6

Ibid.: 382

7

Starr, Paul. The social transformation of American medicine: The rise of a sovereign profession and the making of a vast industry. New York: Basic Books; 1982. p.150.

10 Kara, G.B. Two hundred years of ophthalmology in New York state. NYS J Med 1976, p.

1188.

11 Carpenter MW. A cultural history of ophthalmology in nineteenth century Britain.

BranchCollective.org http://www.branchcollective.org/?ps_articles=mary-wilsoncarpenter-a-cultural-history-of-ophthalmology-in-nineteenth-century-britain.

Accessed March 27, 2019.

12 Delafield E. Dedication address of the new building. New York: GAC Van Beuren; 1856, p. 6.

13 Ibid.

14 Samuels, Bernard, MD. The Foundation of the New York Eye and Ear Infirmary. NY Academy of Medicine. Section of Ophthalmology. 1932; 684-685.

P. 12: Moorfields Eye Hospital i

https://en.wikipedia.org/wiki/John_Cunningham_Saunders

ii

The content of this sidebar is largely drawn from the following sources: a) R ice, Neal, S.C. John Cunningham Saunders (1773-1810): His Contribution to the Surgery of Congenital Cataracts.

In: Documenta Ophthalmologica 81: 43-51. Kluwer Academic Publishers. 1992.

P. 6: Dr. Edward Delafield i

Samuels, Bernard, MD. (1939). “Edward Delafield: A Sketch” (https://www. ncbi.nim.nih.gov/pmc/articles/PMC 1315765/). Transactions of the American Ophthalmological Society. Vol. 37, pp. 77-90.

ii

https://en.wikipedia.org/w/index.php?title=Edward Delafield&oldid=838439542.

iii

Burrows, Edwin G, & Mike Wallace. Gotham: A History of New York City to 1898.

Oxford University Press. New York Oxford. 1999.

iv

Samuels, Bernard, MD. (1939). “Edward Delafield: A Sketch” (https://www. ncbi.nim.nih.gov/pmc/articles/PMC 1315765/). Transactions of the American Ophthalmological Society. Vol. 37, p. 90.

v

Ibid.: 89-90.

vi

Ibid.: 89.

P. 8: Dr. John Kearny Rogers i

The content of Dr. John Kearny Rodgers’s sidebar is based on the following sources:

b) R osen, Richard, MD. “New York Eye Infirmary and the Flowering of Ophthalmology in America.” http://www.cogansociety.org/past-presentations iii

https://archive.org/details/b28523659/page/n3.

iv

http://www.branchcollective.org/?ps_articles=mary-wilson-carpenter-a-culturalhistory-of-ophthalmology-in-nineteenth-century-britain

v

https://www.moorfields.nhs.uk/content/our-history

15 Ibid. According to Samuels, “The minds of the medical professional in this country, always sensitive to happenings in the mother country, were being directed to the subject of diseases of the eye by the work of Scarpa, which had been translated into English, and by the writings of Saunders, published posthumously, which found their way into the private libraries of the medical profession.”

a) D elafield, Edward. “Biographical sketch of J. Kearny Rodgers, MD” Printed by G.A.C. Van Beuren. New York. 1852.

16 Delafield and Rodgers turned to their mentors, Drs. Borrowe and Post respectively, for advice, realizing full well that their undertaking could only benefit from the older doctors’ credibility in New York’s rarified medical community and social circles.

b) R osen, Richard, MD. The New York Eye Infirmary and the Flowering of Ophthalmology in America. http://www.cogansociety.org/past-presentations

17 https://ohsu.pure.elsevier.com/en/publications/dr-elisha-north-and-the-first-eyeinfirmary-in-the-united-states

c) K ara, Gerald B. MD. ‘History of New York Eye and Ear Infirmary: One hundred fifty years of continuous service.” New York State Journal of Medicine, v.73, no.23, December 1, 1973. d) https://en.wikipedia.org/wiki/John_Kearney_Rodgers

Dr. Elisha North opened the New London Eye Infirmary in New London, Connecticut in 1817 and it remained operational for at least 12 years. It appears to have functioned predominantly as North’s private practice, unlike the New York Eye Infirmary that was specifically founded as a free clinic to treat the needy.

197

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Notes, continued 18 Samuels, Bernard, MD. The Foundation of the New York Eye and Ear Infirmary. NY Academy of Medicine. Section of Ophthalmology. 1932: 686.

19 Kara GB. History of New York Eye and Ear Infirmary. NYS J Med 1973 Dec 1, 73 (23).

20 Samuels suggests that “…because couching was not applicable in this form of cataract,” the patients may have been treated with needling, a method Saunders introduced for congenital cataracts shortly before his death.”

21 Samuels, Bernard, MD. The Foundation of the New York Eye and Ear Infirmary. NY Academy of Medicine. Section of Ophthalmology. 1932: 686.

42 Approximately $220,000 and $45,000 adjusted for 2018 inflation rates.

43 New York Eye and Ear Infirmary Annual Report. 1847.

44 New York Eye and Ear Infirmary Annual Report. 1855.

45 Op. Cit. P. 21: Revolutionary Insights i

22 Approximately $869 adjusted for 2018 inflation rates.

Kara, Gerald B., MD. “Two Hundred Years of Ophthalmology in New York State.”

New York State Journal of Medicine. July 1976: 1189.

23 Approximately $107 adjusted for 2018 inflation rates.

46 Approximately $283,376.32 and $566,752.64 adjusted for 2018 inflation rates.

24 Approximately $65 adjusted for 2018 inflation rates.

47 New York Eye and Ear Infirmary Annual Report. 1854.

25 Mattucci, Kenneth R., MD. “Otolaryngology in America: The Beginning. A historical review of the Department of Otolaryngology on the occasion of the 175th anniversary of the New York Eye and Ear Infirmary.” Centennial Series. Otolaryngology-Head and Neck Surgery. December 1996. Volume 115. Number 6:489.

48 New York Eye and Ear Infirmary Annual Report. 1856.

26 Samuels, Bernard, MD. An address delivered in abstract before the Section of Ophthalmology of the New York Academy of Medicine. Nov. 17,1933:689.

27 Ibid.

28 New York Eye and Ear Infirmary Annual Report. 1823.

29 New York Eye and Ear Infirmary Annual Report. 1943:12.

30 Kara, Gerald B., MD. “History of New York Eye and Ear Infirmary.” New York State Journal of Medicine. Vol 73. No. 23. December 1, 1973.

31 New York Eye and Ear Infirmary Annual Report. 1826.

32 New York Eye and Ear Infirmary Annual Report. 1825.

33 Burrows, Edwin G. and Mike Wallace. Gotham: A History of New York City to 1898. New York Oxford. Oxford University Press. 1998: 504.

34 New York Eye and Ear Infirmary Annual Report. 1820.

49 “The New Ophthalmic Hospital.” New York Daily Times (1851-1857). New York. N.Y. 02 Nov 1855:3.

50 Rosen, Richard, MD. “New York Eye Infirmary and the Flowering of Ophthalmology in America.” http://www.cogansociety.org/past-presentations 51 Kara, Gerald, MD. “History of New York Eye and Ear Infirmary.” New York State Journal of Medicine. Vol 73. No. 23. December 1, 1973:2806.

52 Delafield, Edward. An address at the dedication of the new building of the New York Eye Infirmary. April 25, 1856. G.A.C. Van Beuren, Printer. 223 Bleecker Street. New York. 1856:13-14.

53 Ibid.: 35.

54 Cunningham, Mary Elizabeth. An Historical Sketch of the New York Eye and Ear Infirmary, 1820-1880. Dissertation submitted in partial fulfillment of the requirements for the degree of Master of Science in Social Service in the Fordham University of Social Service. New York. 1948: 49.

P. 24: Dr. Cornelius Agnew

35 New York Eye and Ear Infirmary Annual Report. 1824.

i

36 Mattucci, Kenneth R., MD. “The New York Eye and Ear Infirmary at 175 Years: A historical review of the Department of Otolaryngology.” In: Bulletin of the New York Academy of Medicine. Volume 72, Number 2. Winter 1995:525.

Thomas, T. Gaillard, MD “Eulogy upon Cornelius Rae Agnew: read at the New York Academy of Medicine.” June 7, 1888:5 https://archive.org/stream/b22452552/ b22452552_djvu.txt

ii

Ibid.: 6.

37 Ibid.: 490.

iii

Ibid.: 7-8.

38 New York Eye and Ear Infirmary 175 Years of Caring. 1995:4.

iv

http://snaccooperative.org/ark:/99166/w66n8r45

39 New York Eye and Ear Infirmary Annual Report. 1844.

v

Cornelius Rae Agnew, MD is buried at Green-Wood Cemetery, Brooklyn, New York.

40 New York Eye and Ear Infirmary Annual Report. 1852.

vi

http://www.historyofscience.com/pdf/49.pdf

41 Cunningham, Mary Elizabeth. An Historical Sketch of the New York Eye and Ear Infirmary, 1820-1880. Dissertation submitted in partial fulfillment of the requirements for the degree of Master of Science in Social Service in the Fordham University of Social Service. New York. 1948:43.

vii

Albert, Daniel M., MD and Diane D. Edwards, M.S, M.A. History of Ophthalmology.

Blackwell Science Inc., Cambridge, Mass. 1996: 251.

NOTES

1820–2020

viii Thomas, T. Gaillard, MD. “Eulogy upon Cornelius Rae Agnew: read at the New York Academy of Medicine.” June 7, 1888:9 https://archive.org/stream/b22452552/ b22452552_djvu.txt

Colonization. Published by Boys of McDonogh School. 1898. no page # cited. iv

Obituary for Dr. David Kearny McDonogh. New York Tribune. January 24, 1893.

v

“The Legacy of Dr. David Kearney McDonogh.” In: National Medical Fellowships pamphlet. No date: page 4.

vi

Personal communication between Richard S. Koplin, MD, and Laurie Levin. July 20, 2020.

vii

https://nmfonline.org/nmf-holds-inaugural-dr-david-kearney-mcdonoghscholarship-reception-harlem-ny/

55 New York Eye and Ear Infirmary Annual Report. 1857.

56 Approximately $101.34 adjusted for 2018 inflation rates.

57 New York Eye and Ear Infirmary Annual Report. 1860.

58 Approximately $488,158.84 and $193,024.45 respectively adjusted for 2018 inflation rates.

viii https://www.giving.cuimc.columbia.edu/news/david-mcdonogh-memorialscholarship

59 www.longislandwins.com/news/national/immigrant-america-on-the-eve-of-the-civilwar/ P. 27: Dr. William T.G.Morton and Ether i

https://en.wikipedia.org/wiki/William_T._G._Morton

ii

https://www.woodlibrarymuseum.org/rarebooks/item/183/magruder-em.discovery-of-surgical-an%C3%A6sthesia,-1915.

Chapter 2: Pages 33-57: As New York Grows...

iii

https://books.google.com/books?id=170_AAAAYAAJ&pg=PA130&lpg=PA13 0&dq=Judge+Shipman+1862+Morton+decision&source=bl&ots=-qBQ7Su3l&sig=ACfU3U34KVYOGZ4e5tJ-luPn9SA6JyNZsg&hl=en&sa=X&ved=2ahUKEw iZps7hwsTiAhWKtp4KHbchC7UQ6AEwCnoECAgQAQ#v=onepage&q=Judge%20 Shipman%201862%20Morton%20decision&f=false

1

Burrows, Edwin G. and Mike Wallace. Gotham: A History of New York City to 1898. New York Oxford. Oxford University Press. 1998: 385.

2

https://www.nytimes.com/2012/04/03/science/civil-war-toll-up-by-20-percent-in-newestimate.html

iv

Ibid.

60 www.nytimes.com/2016/11/06/books/review/city-of-dreams-history-of-immigrant-newyork-tyler-anbinder.html

3

http://www.thomaslegion.net/totalcivilwarkilleddeadsoldiers.html

4

Oshinsky, David. Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital. New York. Doubleday. 2016: 93.

P. 36: Dr. Edward Curtis and Lincoln

61 Ibid.

i

62 Burrows, Edwin G. and Mike Wallace. Gotham: A History of New York City to 1898. New York Oxford. Oxford University Press. 1998: 385.

63 Oshinsky, David. Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital. New York. Doubleday. 2016: 93.

5

https://www.nlm.nih.gov/visibleproofs/galleries/cases/lincoln.html

Nightingale, Florence. “Notes on Matters Affecting Health, Efficiency and Hospital Administration of the British Army” (1858) “Notes on Nursing: What It is and What It Is Not.” (1859).

6

https://www.battlefields.org/learn/articles/civil-war-medicine

7

New York Eye and Ear Infirmary Annual Report. 1866.

8

Ibid.

65 New York Eye and Ear Infirmary Annual Report. 1864.

9

Ibid.

P. 30: Dr. David K. McDonogh

10 New York Eye and Ear Infirmary Annual Report. 1859.

64 Gutfreund, Owen. “Street Fight: The Draft Riots of 1863.” In: Thorn, John, ed. New York 400: A Visual History of America’s Greatest City. Running Press. Philadelphia.

2009:169.

David McDonogh to Walter Lowrie, 26 Nov. 1844. Board of Foreign Missions Correspondence. Presbyterian Historical Society.

11 New York Eye and Ear Infirmary Annual Report. 1870.

ii

Koplin, Richard S., MD America’s First Black Eye Specialist: David K. McDonogh and the remarkable story of a slave’s journey to a professional medical education.

American Academy of Ophthalmology; Scope, Fall 2016: vol 20:4.

iii

McDonogh, John and James Thomas Edwards. Some interesting Papers of John McDonogh: Chiefly Concerning the Louisiana Purchase and the Liberian

13 According to Dr. Mattucci, the Metropolitan Throat Hospital and Dispensary, founded in 1873 by Clinton Wagner and Dr. David Delevan, a consultant at the New York Eye and Ear Infirmary, was the first institution in the United States dedicated solely to ear, nose, and throat.

i

12 New York Eye and Ear Infirmary Annual Report. 1866.

14 New York Eye and Ear Infirmary Annual Report. 1871: 18-19.

199

20 0

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Notes, continued P. 38: A Tale of Toil and Appreciation i

New York Eye and Ear Infirmary Annual Report. 1870: 10-11.

15 New York Eye and Ear Infirmary Annual Report. 1874.

16 Cunningham, Mary Elizabeth. An Historical Sketch of the New York Eye and Ear Infirmary, 1820-1880. Dissertation submitted in partial fulfillment of the requirements for the degree of Master of Science in Social Service in the Fordham University of Social Service. New York. 1948: 55.

17 New York Eye and Ear Infirmary Annual Report. 1874.

18 Cunningham, Mary Elizabeth. An Historical Sketch of the New York Eye and Ear Infirmary, 1820-1880. Dissertation submitted in partial fulfillment of the requirements for the degree of Master of Science in Social Service in the Fordham University of Social Service. New York. 1948:55.

P. 42: John Cleve Green i https://sparedandshared.wordpress.com/letters/1841-henry-woodhull-green-tojohn-cleve-green/ ii https://etcweb.princeton.edu/CampusWWW/Companion/green_john.html iii Op. Cit. P. 43: Dr. Henry D. Noyes i

Bull, C.S., MD. “In Memoriam: Henry D. Noyes.” Transactions of the American Ophthalmological Society 1902; 9; 414.2-422. https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC1322312/

ii

Ibid.

iii

Samuels, Bernard, MD. “New York as an Ophthalmological Center.” American Journal of Ophthalmology. Vol. 30, No. 9, September 1947: 1083.

iv

Bull, C.S., MD. “In Memoriam: Henry D. Noyes.” Transactions of the American Ophthalmological Society 1902; 9; 414.2-422. https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC1322312/

v

Noyes, Henry, D., MD. “Sclerotico-Choroiditis Posterior” New York Journal of Medicine, VIII.

vi

Noyes, Henry D., MD. Textbook on the Diseases of the Eye. New York. First edition. William Wood & Company. 1881.

vii

Ibid.

19 New York Eye and Ear Infirmary Annual Report. 1875: 10.

20 Ibid.

21 Approximately $689,000 adjusted for 2018 inflation rates.

22 The Evening Post. March 22, 1877:5.

23 Ibid.

24 Ibid.

25 Cunningham, Mary Elizabeth. An Historical Sketch of the New York Eye and Ear Infirmary, 1820-1880. Dissertation submitted in partial fulfillment of the requirements for the degree of Master of Science in Social Service in the Fordham University of Social Service. New York. 1948:60.

P. 44: Dr. Carl Koller i

Long before the Spanish Conquest of Peru, the Incas chewed coca leaves to mitigate the effects of high altitudes, hunger, cold, and fatigue and evidence suggests that native healers spit their cocaine-laden saliva into the eye wounds of their patients. https://www.woodlibrarymuseum.org/history-of-anesthesia/

ii

Koller, Carl, MD. “Personal Reminiscences of the First use of Cocain [sic] as a Local Anesthetic in Eye Surgery.” Anesthesia and Analgesia-January-February.

1928: 9.

iii

Ibid.: 10. The two physicians secured a few grams of pure cocaine from Merck, the drug manufacturer in Darmstadt.

32 New York Eye and Ear Infirmary Annual Report. 1886: 11.

iv

Op. Cit.

33 Samuels, Bernard, MD. New York as an Ophthalmological Center. American Journal of Ophthalmology. Vol. 30, No.9, September, 1947: 1085-1086.

v

Albert, Daniel M., MD and Diane D. Edwards, M.S, M.A. History of Ophthalmology.

Blackwell Science Inc., Cambridge, Mass. 1996: 173.

P. 41: Dr. Francis Delafield

vi

Aufses Jr., Arthur H. and Barbara J. Niss. This House of Nobel Deeds: The Mount Sinai Hospital, 1852-2002. New York University Press. 2002: 162.

26 New York Eye and Ear Infirmary Annual Report. 1878: 10.

27 New York Eye and Ear Infirmary Annual Report. 1883: 8.

28 New York Eye and Ear Infirmary Annual Report. 1881: 7.

29 New York Eye and Ear Infirmary Annual Report. 1884: 11.

30 Burrows, Edwin G. and Mike Wallace. Gotham: A History of New York City to 1898. New York Oxford. Oxford University Press. 1998: 1041.

31 New York Eye and Ear Infirmary Annual Report. 1885: 7.

i https://en.wikipedia.org/wiki/Francis_Delafield

34 New York Eye and Ear Infirmary Annual Report. 1889: 8-9.

35 Ibid.

36 Ibid.

NOTES

37 New York Eye and Ear Infirmary Annual Report. 1890:12.

38 Approximately $6.7 million dollars adjusted to 2018 inflation rates.

39 New York Eye and Ear Infirmary Annual Report. 1890: 22-23.

40 https://en.wikipedia.org/wiki/New_York_Eye_and_Ear_Infirmary 41 Kara, Gerald, MD “History of New York Eye and Ear Infirmary.” In: New York State Journal of Medicine. Vol 73. No. 23. December 1, 1973:2807. According to Kara, “The overall design of the remodeled building was by Stanford White. The Schermerhorn Pavilion remains as one of only four structures standing in New York that can be attributed to the eminent architect, the other three being The Century Club, The University Club, and the Washington Arch.” No further documentation for this attribution is available. Neither Stanford White’s name nor his plans are included in the New York Eye and Ear Infirmary Annual Reports from 1890 to 1894.

42 The New York Times. July 3, 1872. This story reports that a single story had already been added to the original brownstone during the previous two years.

43 New York Eye and Ear Infirmary Annual Report. 1891.

44 “A Significant Innovation” In: The Evening Post. Oct 7, 1891: 9.

45 Kara, Gerald, MD. “History of New York Eye and Ear Infirmary.” In: New York State Journal of Medicine. Vol 73. No. 23. December 1, 1973: 2806.

46 New York Eye and Ear Infirmary Annual Report. 1897. By this year, sixty-five matriculants, hailing from twenty states and one from China, were attending the Infirmary’s School of Instruction that offered daily clinical instruction in all of the Infirmary’s departments as well as pathology and microscopical anatomy.

47 New York Eye and Ear Infirmary Annual Report. 1896.

48 New York Eye and Ear Infirmary Annual Report. 1898. By 1898, the library had grown to 1143 volumes and 1002 pamphlets, including 285 volumes pertaining to the history of Ophthalmology and General Medicine donated by Dr. Henry Noyes. A librarian in charge of rebinding and cataloguing had also been engaged.

49 Mattucci, Kenneth R., MD. The New York Eye and Ear Infirmary at 175 Years: A historical review of the Department of Otolaryngology. In: Bulletin of the New York Academy of Medicine. Volume 72, Number 2. Winter 1995:528.

1820–2020

55 Personal communication between Laurie Levin and Dr. Morsette Broderick. Email.

April 2019. When asked if the current building on the corner of 13th Street and Second Avenue was the work of Stanford White, Dr. Mosette Broderick, architectural historian, Director of Urban Design and Architecture Studies at NYU, and author of Triumvirate: McKim, Mead, & White: Art, Scandal, and Class in America’s Gilded Age. (Deckle Edge 2010), she replied, “I suspect it is a great architect who we have torn down all over the City, R. W. Gibson. [I] doubt White would interfere with another architect’s commission.

That was a particular point among architects. No poaching!”

56 https://hdl.handle.net/2027/mdp.39076000979018 The National Cyclopedia of American Biography. Vol.11: 324. The entry clearly names R.W. Gibson as the architect of the New York Eye and Ear Infirmary Building.

57 New York Eye and Ear Infirmary Annual Report. 1893: 3. References to the Endowment Fund and Permanent Fund are used interchangeably.

58 New York Eye and Ear Infirmary Annual Report. 1894.

59 Ibid.

60 New York Eye and Ear Infirmary Annual Report. 1896. The first operations of this kind were performed at the Infirmary in 1888.

61 Ibid.

62 New York Eye and Ear Infirmary Annual Report. 1895: 9.

63 Ibid.

64 New York Eye and Ear Infirmary Annual Report. 1893: 9.

65 “Temple of Hope and Help” The Evening World. May 5, 1894: 7.

66 New York Eye and Ear Infirmary Annual Report. 1899.

67 The Evening Post. June 12, 1899: 4 68 Ibid.

69 Mattucci, Kenneth R., MD. The New York Eye and Ear Infirmary at 175 Years: A historical review of the Department of Otolaryngology. In: Bulletin of the New York Academy of Medicine. Volume 72, Number 2. Winter 1995: 528.

70 New York Eye and Ear Infirmary Annual Report. 1901: 12.

50 New York Eye and Ear Infirmary Annual Report. 1891: 8.

71 New York Eye and Ear Infirmary Annual Report. 1900: 14.

51 New York Eye and Ear Infirmary Annual Report. 1892: 9.

72 Ibid.: 16.

52 New York Eye and Ear Infirmary Annual Report. 1893. Plans appended. No page number.

73 Ibid.: 17.

53 https://books.google.com/books?id=vRtLAQAAMAAJ&pg=RA2-PA43&lpg=RA2-PA43 &dq=R.W.+Gibson+American+Architect+and+Building+News+Jan-Mar+1894&source =bl&ots=DHuSlk9lek&sig=ACfU3U0pg3-5Szep9SG-5YraOVNQtAtmDw&hl=en&sa=X &ved=2ahUKEwjrkZb7kavhAhWFu54KHc8oCXUQ6AEwAHoECAgQAQ#v=onepage& q=R.W.%20Gibson%20American%20Architect%20and%20Building%20News%20JanMar%201894&f=false 54 New York Ear and Eye Infirmary Annual Report. 1893: 3.

74 Mattucci, Kenneth R., MD. Otolaryngology in America: The Beginning. An historical review of the Department of Otolaryngology on the occasion of the 175th anniversary of the New York Eye and Ear Infirmary. Centennial Series. Otolaryngology-Head and Neck Surgery. December 1996. Volume 115. Number 6: 495.

P. 51: A Temple of Hope and Help i

Excerpted from: “Temple of Hope and Help.” The Evening World. May 5, 1894: 7.

20 1

202

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Notes, continued P. 52: A Peek into a 19th Century Pharmacopia

Chapter 3: Pages 59-95: Their Spirit Lives With Us...

i

Verhoeff, F.H., MD. American Ophthalmology During the Past Century. In: Archives of Ophthalmology. Volume 39, Number 4. April 1948: 453.

1

Wallace, Mike. Greater Gotham: A History of New York City from 1898 to 1919. Oxford University Press. 2017: 8.

ii

Lewis, G. Griffin, MD, F.A.C.S. The Ophthalmic Nurse. W.B. Saunders Co. Philadelphia and London. 1920: 17.

2

www.smithsonianmag.com/history/the-financial-panic-of-1907-running-fromhistory-82176328/

3

Burrows, Edwin G. & Mike Wallace. Gotham: The History of New York City to 1898.

Oxford University Press. 1999.

4

Burrows, Edwin G. & Mike Wallace. Gotham: The History of New York City to 1898.

Oxford University Press. 1999: 1236.

5

Starr, Paul. The Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry. Basic Books. 1982:117-120. The AMA, founded in 1846 in response to the New York Medical Society’s push for medical education and a uniform code of professional ethics after the repeal of state licensing in 1844, was not widely embraced until a half a century later.

6

Wallace, Mike. Greater Gotham: A History of New York City from 1898 to 1919. Oxford University Press. 2017:552. According to the source, “Fledgling physicians seeking diagnostic experience and potential future patients would often work in [free-care facilities] part time, often without pay, dispensing medicine to huge numbers: in 1915, 92 of [New York City’s] 106 dispensaries and outpatient departments treated 2.2 million patients and about 3,000 of the city’s 8,000 doctors were working there.”

7

Ibid.:554. As a result of the AMA’s pressure to upgrade entry requirements, scientific standards, and training curriculum, the number of MD-granting institutions dropped from 160 with more than 28,000 students in 1904 to 85, training only 13,800 students by 1920.

8

Farrar, Cobb, AM, MD. “Report on the Management of the New York Eye and Ear Infirmary.” Boston. A. Mudge & Son. December 15, 1902.

9

Ibid.: 23.

75 “Deficit Faces Eye and Ear Infirmary” In: The Evening World. February 11, 1904: 5.

76 “Boycott Put on Hospital Nurses.” In: The Evening World. March 3,1903: 11.

77 Ibid.

78 Kara, Gerald, MD “History of New York Eye and Ear Infirmary.” In: New York State Journal of Medicine. Vol 73. No. 23. December 1, 1973: 2807.

79 Ibid.

80 “Deficit Faces Eye and Ear Infirmary.” In: The Evening World. February 11, 1904: 5.

81 “Noted Hospital’s Plight: In: The Sun. February 18, 1904: 12.

82 “Platt Eye Pavilion Closes: In: The Sun. March 2, 1904: 12.

83 Op. Cit. 84 Ibid.

85 “Where Shall Eye Patients Go?” In: The Sun. March 4, 1904: 5.

86 “Hope for the Eye Hospital.” In: The Sun. March 17, 1904: 4.

87 “Is New York Rich Enough For This?” In: The Evening World. March 9, 1904: 14.

88 “For the Eye and Ear Hospital” In: The Sun. March 19, 1904: 5.

P. 55: Miss Viola Allen i

“Viola Allen Was in Danger” In: The Sun. February 15, 1904: 1.

P. 56: Helen Keller at the Schermerhorn i

The New York Times. May 12, 1903.

89 New York Eye and Ear Infirmary Annual Report. 1905: 10.

90 Ibid.

91 Ibid.

92 Ibid.

93 Burrows, Edwin G. and Mike Wallace. Gotham: A History of New York City to 1898. New York Oxford. Oxford University Press. 1998: 1185.

10 Ibid.: 22-23.

11 Ibid.: 22.

12 Ibid.

13 Ibid.: 15.

14 Ibid.: 18.

15 New York Eye and Ear Infirmary Annual Report. 1906.

16 New York Eye and Ear Infirmary Annual Report. 1907.

P. 64-65: Ophthalmic Nursing

94 Wallace, Mike. Greater Gotham: A History of New York City from 1898-1919. Oxford University Press. 2017: 11-12.

i

Lewis, G. Griffin, M.D., F.A.C.S. The Ophthalmic Nurse. W.B. Saunders Co. Philadelphia and London. 1920: 17.

95 Ibid.

ii

Goodnow, Minnie. Outlines of Nursing History. W. B. Saunders Publishers.

Philadelphia. 1919: 158.

96 Running counter to this “moralistic” argument was the largesse of some of New York City’s most successful businessmen, among the most generous: J.P. Morgan, financier.

97 Op. Cit.: 1235-1236.

NOTES

iii

Cunningham, Mary Elizabeth. An Historical Sketch of the New York Eye and Ear Infirmary, 1820-1880. Dissertation submitted in partial fulfillment of the requirements for the degree of Master of Science in Social Service in the Fordham University of Social Service. New York. 1948: 54.

iv

The title of “nurse” was a term more generally applied to full-time caregivers who were certified through their on-the-job experience insofar as no degree programs existed at the time.

v

Cobb, Farrar, AM, MD. Report on the Management of the New York Eye and Ear Infirmary. Boston, Mass. December 16, 1902: 22.

vi

New York Eye and Ear Infirmary Annual Report. 1899.

vii

New York Eye and Ear Infirmary Annual Report. 1900.

1820–2020

19 New York Eye and Ear Infirmary. 1916.

P. 69: Helpful Hands i

Chappaqua is located on the east bank of the Hudson River in northern Westchester County, New York, approximately 30 miles north of New York City. It was one of several convalescent destinations employed by the Infirmary’s Social Service Department where children were placed for short-term recovery.

ii

New York Eye and Ear Infirmary Annual Report 1917: 64.

20 Ibid.: 58.

21 New York Eye and Ear Infirmary Annual Report. 1916:55. The name of the specific drug is not mentioned.

viii Ibid.: 24.

22 New York Eye and Ear Infirmary Annual Report. 1917.

ix

New York Eye and Ear Infirmary Annual Report. 1905:15.

23 Ibid.:13.

x

Ibid.: 21.

24 New York Eye and Ear Infirmary Annual Report. 1918: 13.

xi

Ibid.

25 New York Eye and Ear Infirmary Annual Report. 1918: 56.

xii New York Eye and Ear Infirmary Annual Report. 1908: 15.

26 Ibid.

xiii New York Eye and Ear Infirmary Annual Report. 1910.

27 New York Eye and Ear Infirmary Annual Report. 1917: 56.

xiv Ibid.: 15.

28 New York Eye and Ear Infirmary Annual Report. 1918: 56.

xv

29 New York Eye and Ear Infirmary Annual Report. 1918.

New York Eye and Ear Infirmary Annual Report. 1911: 13.

xvi New York Eye and Ear Infirmary Annual Report. 1922. xvii New York Eye and Ear Infirmary Annual Report. 1927. xviii New York Eye and Ear Infirmary Annual Report. 1929: 13. xix New York Eye and Ear Infirmary Annual Report. 1930: 51. xx New York Eye and Ear Infirmary Annual Report. 1933. xxi New York Eye and Ear Infirmary Annual Report. 1934:38 The nurses’ shift was reduced, yet again, to eight hours in 1936. xxii Ibid.

17 Ibid.

P. 72: An Endless Chain Letter i

“Nurse Would Break Her War-Aid Chain.” In: The New York Times. January 19, 1916: 22.

30 New York Eye and Ear Infirmary Annual Report. 1910.

P. 74: The Spanish Flu i

https://www.smithsonianmag.com/history/journal-plague-year-180965222/

ii

www.cdc.gov/features/1918-flu-pandemic/index.html

18 New York Eye and Ear Infirmary. 1910.

31 “Free Hospital Service At Stake.” The New York Times. November 2, 1919:7. https:// timesmachine.nytimes.com/timesmachine/1919/11/02/118175969.pdf

P. 67: One for the Road

32 Wallace, Mike. Greater Gotham: A History of New York City from 1898 to 1919. Oxford University Press.

2017: 552.

i

“Many Made Blind by Wood Alcohol.” In: The New York Times. April 8, 1910:2.

ii

“Dr. Emil Gruening, Noted Surgeon, Dies.” In: The New York Times. May 31, 1914:29 Dr. Emil Gruening, a former president of the American Ophthalmological and American Otological Societies and noted Mount Sinai Hospital surgeon, also developed the mastoid operation widely performed at the time.

iii

Op. Cit.

33 Ibid.

34 New York Eye and Ear Infirmary Annual Report. 1920: 13.

35 Ibid.:69 36 New York Eye and Ear Infirmary Annual Report. 1921: 66.

37 New York Eye and Ear Infirmary Annual Report: 1921: 81.

38 New York Eye and Ear Infirmary Annual Report. 1921.

203

20 4

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Notes, continued P. 76: A Little Help i

“Needs of Deaf and Blind Poor” To the editor of The New York Times. April 24, 1923:20.

48 Ibid.

49 “56 Hospital Heads Appeal to Public.” In: The New York Times. December 19, 1933:18.

50 Ibid.

39 New York Eye and Ear Infirmary Annual Report. 1925: 13.

51 New York Eye and Ear Annual Report. 1932: 39.

40 New York Eye and Ear Infirmary Annual Report. 1927.

52 Ibid.:47.

41 “Eye and Ear Infirmary Asks for $2,000,000 Fund.” In: The New York Times. May 13, 1928: 2.

53 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. For some unexplained reason, this October 18, 1934 entry is included in this volume.

42 New York Eye and Ear Infirmary Annual Report. 1929: 13.

P. 77: The Ties That Bind i

“1,200 Blind to Attend Play,” In: The New York Times. December 21, 1925: 26.

ii

https://en.wikipedia.org/wiki/Matilda_Ziegler_Magazine_for_the_Blind.

P. 78-79: The Gift of Giving i

New York Eye and Ear Infirmary Annual Report. 1896: 12.

ii

New York Eye and Ear Infirmary Annual Report. 1900: 25.

iii

New York Eye and Ear Infirmary Annual Report. 1902: 22.

iv

New York Eye and Ear Infirmary Annual Report. 1905: 21.

v

New York Eye and Ear Infirmary Annual Report. 1902: 22.

vi

New York Eye and Ear Infirmary Annual Report. 1924.

vii

New York Eye and Ear Infirmary Annual Report. 1930: 58.

viii https://www.nytimes.com/1935/10/07/archives/debutantes-will-model-stylestomorrow-for-benefit-of-the-eye-and.html ix

https://www.nytimes.com/1943/01/26/archives/theatre-party-feb-3-will-helpinfirmary-st-timothy-league-takes.html

x

New York Eye and Ear Infirmary News. Summer 1981: 2. The BSER purchase was facilitated by a grant from the Bodman Foundation with the assistance of the Auxiliary.

xi

Personal communication between Laurie Levin and Mrs. Susan Liebowitz. April 2019.

xii Op.Cit.

54 New York Eye and Ear Infirmary Annual Report. 1938. The New York Eye and Ear Infirmary hosted the first national certifying examination for orthoptic technicians, scheduled during the month of March 1939.

P. 82-84: NYEE Inquiring Minds i

bjo.bmj.com/content/bjophthalmol/78/12/902.full.pdf

ii

Dunnington JH, Calhoun FP, Alger EM. JOHN MARTIN WHEELER, MD. 1879-1938. Arch Ophthalmol.1938;20(5):885–891. doi:10.1001/ archopht.1938.00850230193016

iii

Samuels, Bernard. “New York as an Ophthalmological Center.” American Journal of Ophthalmology. Vol 30, No 9, September, 1947: 1088.

iv

Rosen, Richard, MD. “The New York Eye Infirmary and the Flowering of Ophthalmology in America.” http://www.cogansociety.org/past-presentations

v

https://www.columbiaeye.org/about-us/the-harkness-s-eye-institute Dr. Wheeler assumed the professorship when Dr. Arnold Knapp, son of Dr. Herman Knapp and founder of the Ophthalmic and Aural Institute in 1869, vacated the position.

vi

http://www.emoryhistory.emory.edu/facts-figures/people/makers-history/profiles/ calhoun.html

vii

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1310175/pdf/taos00036-0022.pdf

viii http://beckerexhibits.wustl.edu/mig/bios/howard.html ix

Ibid.

x

Ibid.

xi

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC505825/pdf/brjopthal00402-0063. pdf

43 Howard, Ella. “The New Deal and New York City’s Homeless.” In: Thorn, John, ed. New York 400. Running Press. Philadelphia. 2009: 306.

xii www.ajo.com/article/S0002-9394(14)75649-1/pdf

44 Ibid.

xiv Kara, Gerald B., MD. “History of the New York Eye and Ear Infirmary.” In: The New York State Journal of Medicine vol. 73. December 1, 1973: 2807-2809.

45 New York eye and Ear Infirmary Annual Report. 1930: 52.

46 New York Eye and Ear Infirmary Annual Report. 1931: 13.

47 New York eye and Ear Infirmary Annual Report. 1931.

xiii www.ncbi.nlm.nih.gov/pmc/articles/PMC1316360/

NOTES

1820–2020

55 New York Eye and Ear Infirmary Annual Report. 1938: 49.

72 Ibid.: 350.

56 New York Eye and Ear Infirmary Annual Report. 1939: 54.

73 Wallace, Mike. “Gotham Girds for War: The Right to Fight.” In: Thorn, John, ed. New York 400. Running Press. Philadelphia. 2009:351. Discriminatory training and hiring practices against black Americans were common and black men “who were in the 1-A eligibility pool went undrafted,” effectively closing off opportunities for their employment and income.

57 New York Eye and Ear Infirmary Annual Report. 1934.

58 New York Eye and Ear Infirmary Annual Report. 1938: 34.

59 New York Eye and Ear Infirmary Annual Report. 1939.

60 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. December 12, 1934. For some reason, earlier entries starting in December 12, 1934 entry are included in this volume.

74 Ibid.: 350.

P. 90: Dr. John Elmer Weeks

61 New York Eye and Ear Infirmary Annual Report. 1936.

i

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312791/pdf/taos00052-0038.pdf

62 New York Eye and Ear Infirmary Annual Report. 1936.

ii

Ibid.

63 New York Eye and Ear Infirmary Annual Report. 1936.

iii

64 Ibid.: April 21, 1937. Semi-private room rates were raised to $5.00 in 1941 “to be more or less in line with other hospitals.”

“The Infirmary: History of Radiology.” In: New York Eye and Ear Infirmary News.

Winter 1977: 3-4.

iv

65 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. May 19, 1937. No sale price is indicated.

Weeks, John E., MD. A Treatise on the Diseases of the Eye. Philadelphia. Lea & Febiger. 1910.

v

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312791/pdf/taos00052-0038.pdf

66 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. January 17, 1940. In another transaction, the Executive Committee voted to foreclose on the Horich $35,000 mortgage, a property located at 55-57 Main Street, Port Washington, Long Island, due to interest arrears and unpaid taxes.

67 New York Eye and Ear Infirmary Annual Report. 1943: 30.

P. 87: Dr. Edgar B. Burchell i

https://www.nytimes.com/1944/12/15/archives/exporter-feted-as-scientist-hereeb-burchell-73-appointed-an.html

ii

https://www.ajo.com/article/0002-9394(60)90699-1/pdf

iii

New York Eye and Ear Infirmary Annual Report. 1999: 4.

68 https://en.wikipedia.org/wiki/Works_Progress_Administration. The WPA was renamed the Works Projects Administration in 1939 and disbanded in 1943.

69 https://www.nationalww2museum.org/students-teachers/student-resources/researchstarters/draft-and-wwii 70 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. December 10, 1941.

71 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. October 24, 1945. After the war ended in 1945 the restrictions disqualifying appointment of surgeons sixty-five years or over were again enforced. A new committee was created known as Attending Advisory Committee “whereby the members enjoy the same privileges as surgeons, but will be named ex-officio members of the Board of Surgeons, and that all clinical material and the use of clinics be made available to them.” The three first members of the Attending Advisory Committee were Drs. Saunders, Samuels and McDannald.

75 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. April 19, 1939.

76 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. November 13, 1940.

77 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. January 17, 1940. Regrettably, no extant documents of these discussions are available in the New York Eye and Ear Infirmary holdings nor are they accessible in the New York University archives, due to the loss of a significant portion of their holdings caused by the flooding during Hurricane Sandy in 2012.

78 New York Eye and Ear Infirmary Annual Report. 1942: 13.

79 Ibid.

80 New York Eye and Ear Infirmary Annual Report. 1942.

81 New York Eye and Ear Infirmary Annual Report. 1945. 37.

82 https://www.nytimes.com/1943/06/28/archives/medical-training-switch-columbia-todirect-at-new-york-eye-and-ear.html 83 Mattucci, Kenneth F., MD. The New York Eye and Ear Infirmary at 175 Years: A Historical Review of the Department of Otolaryngology. Bulletin of the New York Academy of Medicine. Winter 1995: 531.

84 New York Eye and Ear Infirmary Annual Report. 1943: 13.

85 Ibid.

86 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. July 15, 1943.

87 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. April 19, 1944.

205

20 6

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Notes, continued 88 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. May 24, 1944.

9

Hanley, J. Swift, MD. Report to the Board of the Directors of the New York Eye and Ear Infirmary. January 23, 1958: 1-6.

89 New York Eye and Ear Infirmary Annual Report. 1944: 15.

10 Ibid.: 5.

90 New York and Ear Infirmary Annual Report. 1944: 31.

11 Ibid.: 2-3.

91 New York Eye and Ear Infirmary Annual Report. 1945.

12 New York Eye and Ear Infirmary Annual Report. 1953: 4.

92 Ibid.

13 New York Eye and Ear Infirmary Annual Report. 1957: 11.

93 New York Eye and Ear Infirmary Annual Report. 1945: 32.

14 New York Eye and Ear Infirmary Annual Report. 1955: 8.

P. 94: The New York at War Parade, and WWII Service Flag

15 New York Eye and Ear Infirmary Biannual Report. 1959-1960. No page numbers.

i

Unfortunately, there is no list of names that appeared on the flag. And whether or not more gold stars were added in addition to the two that were documented in the Annual Reports sited below, cannot be determined.

ii

New York Eye and Ear Infirmary Annual Report: 1943: 13.

iii

New York Eye and Ear Infirmary Annual Report. 1945: 15.

94 New York Eye and Ear Infirmary. Minutes of the Executive Committee: December 1936-December 1946. April 19, 1939.

16 “Expansion and Redevelopment: A Preliminary Announcement.” In: One Hundred and Fiftieth 1820-Anniversary-1970 promotional brochure. December 1964. No page numbers.

17 Jacobson, Jerry, H., MD., and Conrad Berens, MD. “Clinical electroretinography.” In: Quart. Rev. Ophth., 7:99, 1951.

18 Hanley, J. Swift, MD. Report to the Board of the Directors of the New York Eye and Ear Infirmary. January 23, 1958.

19 Ibid.: 5.

95 New York Eye and Ear Infirmary Annual Report. 1945: 14.

20 Report of Braislin, Porter & Wheelock, Inc. January 22, 1958: 2.

96 https://www.nytimes.com/1946/02/28/archives/eye-ear-infirmary-will-be-mergedcitys-oldest-hospital-to-be-part.html

21 Ibid.

97 Ibid.: 14.

Chapter 4: Pages 96-129: Reaching for More 1

One Hundred and Fiftieth 1820-Anniversary-1970: Expansion and Redevelopment.

November 1962.

2

www.griffinbenefits.com/employeebenefitsblog/history_of_healthcare

3

www.ncbi.nlm.nih.gov/pmc/articles/PMC4379645/

4

http://www.sciencecoalition.org/downloads/1392650023researchfundingtimeline.pdf

5

www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-neurologicaldisorders-stroke-nindsS.

6

New York Eye and Ear Infirmary Annual Report. 1951.

7

New York Eye and Ear Infirmary Annual Report. 1952.

8

Special Report of the President of the New York Eye and Ear Infirmary. General Ephraim F. Jeffe. May 4, 1949: 9-10.

P. 102: In Living Color i

New York Eye and Ear Infirmary Annual Report 1954:7. Dr. Bernard Samuels was the presiding President of the International Congress at the time.

22 Op. Cit.: 8.

23 Report of Braislin, Porter & Wheelock, Inc. January 22, 1958.

24 Ibid.: 3-4.

25 Ibid.: 4.

26 New York Eye and Ear Infirmary Bi-Annual Report. 1959-1960. No page numbers.

27 Ibid.

28 Ibid.

29 “Expansion and Redevelopment: A Preliminary Announcement.” In: One Hundred and Fiftieth 1820-Anniversary-1970 promotional brochure. December 1964. No page numbers.

30 NYEE/MS video interview with Seymour Fradin, MD. September 2018.

31 Ibid.

32 Ibid.

33 New York Eye and Ear Infirmary Triennial Report 1961-1962-1963. No page numbers.

34 Ibid.

35 Ibid.

36 1820-1990: A 170th Anniversary Retrospective. Uncredited typed historical chronology.

According to this document, an affiliation with Beth Israel Medical Center was reached in 1989.

NOTES

37 New York Eye and Ear Infirmary. 1959-1960 Bi-Annual Report. No page numbers.

1820–2020

and-ear-infirmary-in-75million.html

38 Ibid.

45 Ibid.

39 Ibid.

46 New York Eye and Ear Infirmary News. Spring/Summer. 1969: 3.

40 New York Eye and Ear Infirmary Triennial Report 1961-1962-1962. No page numbers.

47 New York Eye and Ear Infirmary Inside News. Spring/Summer 1969: 1.

41 Ibid.

48 Ibid.

42 Ibid.

49 Freeman, Joshua B. “Seeing It Through: New York in the 1970s.” In: Thorn, John, ed.

New York 400. Running Press. Philadelphia. 2009.

43 Ibid. One additional year of training as a surgical resident was required of those who applied for Otolaryngology.

P.107: Gordon S. Braislin i

https://www.nytimes.com/1990/04/05/obituaries/gordon-braislin-89-a-retiredchairman-of-the-dime-bank.html

ii

https://prabook.com/web/gordon_stuart.braislin/140083

iii

Kara, Gerald B., MD. “History of the New York Eye and Ear Infirmary.” In: New York State Journal of Medicine. Vol. 73. December 1, 1973:2808.

50 Ibid.: 416.

51 Ibid.: 415.

52 New York Eye and Ear Infirmary News. Spring/Summer. 1970: 5.

53 New York Eye and Ear Infirmary News. Spring/Summer. 1971: 1-4.

P. 117: Dr. Aran Safir i

New Medical Devices: Invention, Development, and Use. National Academy of Engineering (US); Institute of Medicine (US); Ekelman KB, editor. Washington (DC): National Academies Press (US); 1988. This profile is largely based and paraphrased on Safir’s first-person account.

ii

Aufses, Arthur. H. Jr., and Barbara J. Niss. This House of Nobel Deeds: The Mount Sinai Hospital 1852-2002. New York University Press. New York and London. 2002: 261.

iii

https://www.invent.org/inductees/search?combine=Aran%20Safir

P. 110: The Holdouts i

https://www.nytimes.com/1967/11/19/archives/new-wing-shown-by-hospital-hereeye-and-ear-infirmary-in-75million.html

P. 112-115: NYEE Inquiring Minds i

https://www.legacy.com/obituaries/houstonchronicle/obituary.aspx?n=louis-jgirard&pid=147468224&fhid=6290

ii

https://jamanetwork.com/journals/jamaophthalmology/fullarticle/412903

iii

The New York Eye and Ear Infirmary Annual Report. 1958: 5.

iv

https://prabook.com/web/virginia_leila.lubkin/786099

v

https://library-archives.cumc.columbia.edu/obit/virginia-lubkin

vi

https://www.nytimes.com/2002/10/24/classified/paid-notice-deaths-rosenthalmorton-lawrence-md.html

vii

https://jamanetwork.com/journals/jamaophthalmology/fullarticle/412903

viii https://www.aao.org/generations ix

Interview with NYEE/MS Video Team. September 2018.

x

Personal communication between Laurie Levin and Dr. Thomas O. Muldoon.

February 2019.

xi

Interview with NYEE/MS Video Team, September 2018.

xii Personal communications, Laurie Levin and Dr Thomas O. Muldoon, February 2019 and multiple occasions thereafter.

44 https://www.nytimes.com/1967/11/19/archives/new-wing-shown-by-hospital-here-eye-

54 New York Eye and Ear Infirmary News. Fall 1974. No page numbers.

P. 118: Dr. Charles D. Kelman i

https://ascrs.org/honorees/charles-d-kelman-md-1

ii

https://www.healio.com/ophthalmology/cataract-surgery/news/print/ocularsurgery-news/%7B0c283179-d00c-43f8-bac9-cc3c779c6e3c%7D/visionaryinventor-charles-d-kelman-is-dead-at-age-74

iii

https://jamanetwork.com/journals/jamaophthalmology/fullarticle/416873

iv

https://www.eyeworld.org/article-through-my-eyes--the-charlie-kelman-story

v

Obstbaum, Stephen A., MD. “Charles D. Kelman, MD (1930-2004). Arch Ophthalmol. 2005; 123(2):287-288. doi:10.1001/archopht.123.2.287.

vi

https://www.invent.org/inductees/charles-d-kelman

vii

Op.Cit.

viii https://en.wikipedia.org/wiki/Charles_Kelman ix

https://www.invent.org/inductees/charles-d-kelman

x

https://www.eyeworld.org/article-through-my-eyes--the-charlie-kelman-story

xi

Ibid.

207

20 8

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Notes, continued P.121: Career Days i

New York Eye and Ear Infirmary News. Spring/Summer 1969: 4-5. New York Eye and Ear Infirmary News. Spring/Summer 1969: 4-5.

Sesquicentennial Ball i

“Sesquicentennial Ball Great Success.” In: New York Eye and Ear Infirmary News.

Spring/Summer. 1970: 5.

Bicycle Bash i

New York Eye and Ear Infirmary News. Spring 1971.

55 https://www.nytimes.com/1972/11/10/archives/temporal-bone-laboratory-dedicatedat-hospital-here.html This 1972 expansion was supported by an $85,000 grant from the David and Florence Guggenheim Foundation.

56 New York Eye and Ear Infirmary Biennial Report 1975-1976. No page numbers.

57 Personal communication between Laurie Levin and Dr. Donald Wood-Smith. May 15, 2019.

58 “The Changing Face of Plastic Surgery.” In: Scope. Fall 1992: 2.

59 Ibid.

60 New York Eye and Ear Infirmary Biennial Report 1977-1978: 2.

xiii New York Eye and Ear Infirmary. Excellence in Specialty Care. 2007-2008: 10. xiv New York Eye and Ear Infirmary. Leading the Way. Summer/Fall 2006: 08. xv

New York Eye and Ear Infirmary of Mount Sinai. Department of Ophthalmology Chair Report. Fall 2016: 7.

xvi Ibid.

P.122: The Telephone Company Fire i

https://www.nytimes.com/1975/02/28/archives/fire-silences-170000-telephonesdisrupting-life-in-300block-area-of.html

ii

New York Eye and Ear Infirmary Biennial Report. 1975-1975: 6.

62 Letter written to Infirmary doctors by Gerald. J. McCoy, Executive Vice President of the New York Eye and Ear Infirmary. February 20, 1979.

63 “Outline of Plan of Merger of The New York Eye and Ear Infirmary with New York University Medical Center.” Preamble. In: Letter written by Guy, G. Rutherfurd, President of the Infirmary to the Infirmary Board of Directors. March 5, 1979 no page number.

64 “Outline of Plan of Merger of The New York Eye and Ear Infirmary with New York University Medical Center.” In: Letter written by Guy, G. Rutherfurd, President of the Infirmary to the Infirmary Board of Directors. May 18, 1979 no page number.

61 New York Eye and Ear Infirmary Biennial Report 1977-1978: 4-5.

65 Letter written to Infirmary doctors by Gerald. J. McCoy, Executive Vice President of the New York Eye and Ear Infirmary. February 20, 1979: 3.

P. 128: Bendheim Family Retina Center

66 Letter written to Infirmary doctors by Gerald. J. McCoy, Executive Vice President of the New York Eye and Ear Infirmary. February 20, 1979: 3

i

The New York Eye and Ear Infirmary Annual Report. 1957: 5.

ii

Personal communication between Laurie Levin and Jeanne L. Rosenthal, MD. March 2019.

iii

The New York Eye and Ear Infirmary Annual Report. 1957: 5.

iv

The New York Eye and Ear Infirmary Annual Report. 1958: 5.

v

Ibid.

vi

NYEE/MS video interview with Thomas O. Muldoon, MD. September 2018.

vii

New York Eye and Ear Infirmary Biennial Report. 1975-1976.

i

viii New York Eye and Ear Infirmary News. Fall 1974: no page number.

71 Ibid.

ix

New York Eye and Ear Infirmary Biennial Report. 1975-1976.

72 “Recommendations by the Affiliation Committee of NYE&E.” April 23, 1979.

x

New York Eye and Ear Infirmary Department of Ophthalmology Annual Report.

1999:33.

73 New York Eye and Ear Infirmary Board of Director Meeting Minutes. March 27, 1980: 4.

xi

New York Eye and Ear Infirmary. Department of Ophthalmology Annual Report 2003-2004:1.

75 New York Eye and Ear Infirmary News. Winter, 1980: 1-2.

xii Fradin, Seymour, MD, editor and contributor. “The New York Eye and Ear Infirmary at the Crossroads.” The Alumni Association. Annual Spring Dinner meeting. May 12, 2005: 25.

67 Outline of Plan of Merger of the New York Eye and Ear Infirmary with New York University Medical Center. May 18, 1979: 1-3.

68 New York Eye and Ear Infirmary Biennial Report. 1977-1978: 2.

69 New York Eye and Ear Infirmary Board of Director Meeting Minutes. January 25, 1979: 7.

70 New York Eye and Ear Infirmary Board of Director Meeting Minutes. March 29, 1979: 5.

P. 124: Alaska or Bust New York Eye and Ear Infirmary News. Spring/Summer 1970: 4.

74 Personal communication, Laurie Levin and Thomas O. Muldoon, MD. January 2019.

NOTES

P. 125: New York Medical College i

1820–2020

P. 134: The Eye Trauma Center

https://en.wikipedia.org/wiki/New_York_Medical_College pages 2-4.

P. 126: Pushing the Envelope i

Personal communication between Laurie Levin and Dr. Richard Koplin. February 2019.

ii

Personal communication between Laurie Levin and Dr. Richard Koplin. June 24, 2019.

iii

“Focus on Aborn Center for Eye Research.” In: The New York Eye and Ear Infirmary Scope. Spring 1990: 1-7.

iv

“The Center for Eye, Ear, and Related Disorders.” The New York Eye and Ear Infirmary. No date; no page number.

76 Ibid.

77 Ibid.

78 An indicator of the soaring numbers of specializations is the diversity of the Infirmary’s Post-Graduate Institute’s continuing education courses featured at the twenty-third series, attended by over 700 medical specialists representing forty-three states and six foreign countries. The offerings included such topics as: Anterior Segment Microsurgery, Intra-ocular Lens, a Basic Course in Temporal Bone Dissection, Neuro Ophthalmology, Basic Course and Workshop in Contact Lens Fitting, Medical and Surgical Glaucoma, The Lacrimal System, Fluorescein Angiography, Argon Laser, Diagnostic Ophthalmic Ultrasound and Biometry with Computer Analysis, and Oculoplastic and Reconstructive Surgery.

79 Starr, Paul. The Social transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry. Basic Books. 1982: 444-449.

P. 127: Spreading the Word i

New York Eye and Ear Infirmary News. Summer 1981: 2.

Chapter 5: Pages 130-169: A Vision of Hope 1

https://www.federalreservehistory.org/essays/recession_of_1981_82

2

Perl J. Goodbye to all that, in: Thorn J (ed). New York 400. Philadelphia: Running Press; 2009.

3

These rates are compared to those between 1981-1985. https://pdfs.semanticscholar. org/e37a/b34493a0c73be16fe42eda8268c306681d40.pdf

4

Ibid.

5

Dyssegaard DK. Immigrants reshape the city, in Thorn J (ed). New York 400.

Philadelphia: Running Press; 2009.

6

Kessler PR. An open letter from Paul R. Kessler.” Scope 1990; Spring: 3.

i

Ed Koch inaugurates eye trauma center. Eyes and Ears of the Infirmary 1986: Summer.

ii

https://www.nytimes.com/1986/01/12/nyregion/koch-wager-puts-moonachie-onmap.html?searchResultPosition=1

iii

NYEE’s eye trauma service advances ocular surgery. Department of Ophthalmology. New York Eye and Ear Infirmary of Mount Sinai. 2015; Fall: p. 4.

7

Personal communication, Dr. Joseph B. Walsh and Sorrell M. Mathes, Chair of the Board of Directors, The New York Eye and Ear Infirmary; Dr. Ralph A. O’Connell, Provost and Dean, New York Medical College; and D. McWilliams Kessler, President and CEO, The New York Eye and Ear Infirmary, June 1, 2011.

8

The Department of Ophthalmology Annual Report. The New York Eye and Ear Infirmary. 1988: p. 2.

9

Ibid.

10 This affiliation grew and strengthened over the next several years to include the consult services and also the Neonatology Unit, the Krueger Immunological Disease Center, the emergency room, and pediatric practice. This arrangement remained unaffected when Beth Israel switched its affiliation from The Mount Sinai School of Medicine to the Albert Einstein College of Medicine in 1993.

11 Kessler PR. An open letter from Paul R. Kessler. Scope 1992; Fall.

12 Report of the New York Eye and Ear Infirmary, 1991-1992.

13 The New York Eye and Ear Infirmary Department of Ophthalmology Annual Report, 1993.

14 Report of the New York Eye and Ear Infirmary, 1991-1992.

15 Personal communication, Laurie Levin and Dr. Thomas Muldoon, March 2, 2019.

16 Walsh JB. The New York Eye and Ear Infirmary Ophthalmology Associates, P.C., Twentieth Anniversary Celebration. 2013; March 15.

17 Walsh JB. Memorandum re: Ophthalmology Department reorganization committee.

1990; December 21.

18 Rosen RB. The New York Eye Infirmary and the flowering of ophthalmology in America. http://www.cogansociety.org/past-presentations/ 19 Mattucci KF. Otolaryngology in America: A historical review of the Department of Otolaryngology on the occasion of the 175th anniversary of the New York Eye and Ear Infirmary. Otolaryngology-Head and Neck Surgery. 1996; 115 (6): 498.

20 Personal communication, Laurie Levin and Dr. Thomas Muldoon, January 16, 2019.

21 Rosen RB. The New York Eye Infirmary and the flowering of ophthalmology in America. http://www.cogansociety.org/past-presentations/ 22 Ibid.

209

21 0

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Notes, continued P. 135: Bebop Heaven i

Infirmary doctor honored at White House. Scope 1992; Fall: 11.

P. 136-137: Dr. Joseph Brennan Walsh i

Rosen R. Eulogy for Joe. October 16, 2017.

ii

Personal communication, Dr. Joseph B. Walsh to Mr. Sorrell M. Mathes, Chair of the Board of Directors, The New York Eye and Ear Infirmary; Mr. Ralph A. O’Connell, MD, Provost and Dean, New York Medical College; and Mr. D. McWilliams, President and CEO, The New York Eye and Ear Infirmary, June 1, 2011.

iii

Ibid.

iv

https://www.legacy.com/obituaries/nytimes/obituary.aspx?n=josephwalsh&pid=186476525

v

Op. Cit.

vi

Ibid.

23 The New York Eye and Ear Infirmary 175 Years of Caring. Brochure. 1995: 2.

24 Ibid.

vii

https://www.ncbi.nlm.nih.gov/pubmed/26564918

viii New York Eye and Ear Infirmary Annual Report, 1933. ix

Op. Cit.

x

https://www.tandfonline.com/doi/abs/10.1080/0065955X.1985.11981652?src=recs ys

xi

New York Eye and Ear Infirmary Annual Report, 1949.

xii New York Eye and Ear Infirmary Annual Report, 1954. xiii New York Eye and Ear Infirmary Annual Report, 1955. xiv New York Eye and Ear Infirmary Bi-Annual Report, 1959-60. xv

https://www.ncbi.nlm.nih.gov/pubmed/26564918

xvi The New York Eye and Ear Infirmary Annual Report, 1968. xvii Private communication, Laurie Levin and Sara Shippman, May 17, 2019. xviii https://www.mountsinai.org/about/newsroom/2015/orthoptics-day-2015 xix Op. Cit. xx Ibid. xxi Ibid.

25 Ibid.

27 https://www.nytimes.com/1996/07/25/nyregion/2-more-hospitals-decide-to-merge-innew-york-city.html

26 Ibid.

P. 139: NYEE Ophthalmology Associates

28 https://www.nytimes.com/1996/07/25/nyregion/2-more-hospitals-decide-to-merge-innew-york-city.html

i

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.27.5.1305

ii

NYEE/MS video interview with Dr. Thomas O. Muldoon. September 2018.

29 Letter from Joseph B. Walsh, March 25, 1999: 4.

iii

New York Eye and Ear Infirmary Department of Ophthalmology Annual Report, 1999.

30 Letter from Joseph B. Walsh, March 25, 1999: 4.

iv

New York Eye and Ear Infirmary Department of Ophthalmology Annual Report, 1993.

32 Letter from Joseph B. Walsh, March 25, 1999: 4.

v

New York Eye and Ear Infirmary Department of Ophthalmology Annual Report, 1995.

P. 139: The Cochlear Implant Program i

Cochlear implant program initiated. Scope 1992; Fall: p. 1-5.

P. 140: Seeing Things Straight

31 Letter from Joseph B. Walsh, March 25, 1999: 2.

33 https://www.nytimes.com/1996/07/25/nyregion/2-more-hospitals-decide-to-merge-innew-york-city.html 34 https://www.nytimes.com/2001/03/14/nyregion/hospital-mergers-stumbling-asmarriages-of-convenience.html P. 143: Continuum Health i

http://www.fundinguniverse.com/company-histories/continuum-health-partnersinc-history/

ii

https://en.wikipedia.org/wiki/St._Luke%27s%E2%80%93Roosevelt_Hospital_ Center

i

https://en.wikipedia.org/wiki/Orthoptics

ii

https://www.ncbi.nlm.nih.gov/pubmed/4932942

iii

https://en.wikipedia.org/wiki/Ernest_Maddox

iii

https://en.wikipedia.org/wiki/Mount_Sinai_Beth_Israel

iv

https://en.wikipedia.org/wiki/Orthoptics

iv

v

https://www.ncbi.nlm.nih.gov/pubmed/4932942

http://www.fundinguniverse.com/company-histories/continuum-health-partnersinc-history/

vi

https://www.tandfonline.com/doi/abs/10.1080/0065955X.1985.11981652?src=recsys

v

Ibid.

NOTES

P. 144: Darkness Visible i

The New York Eye and Ear Infirmary treats heroes at Ground Zero. Connections.

Continuum Health Partners. November 2001; 5.

1820–2020

50 The New York Eye and Ear Infirmary Department of Ophthalmology Annual Report, 2005-2006.

51 Personal communication, Laurie Levin and Dr. Dennis Wood-Smith, May 15, 2019.

ii

Ibid.

52 Personal communication, Laurie Levin and Dr. Dennis Wood-Smith, May 15, 2019.

iii

Ibid.

53 New York Eye and Ear Infirmary Annual Report, 2005-2006.

iv

The New York Eye and Ear Infirmary strategic plan. 2002 community service plan. April 2003; 9.

54 Personal communication, Laurie Levin and Dr. Robert Della Rocca. March 23, 2019.

35 https://www.nytimes.com/1999/06/22/nyregion/metro-business-infirmary-will-joincontinuum-health.html 36 Ibid.

37 Some years prior, Dr. Newman had approached Dr. Muldoon—his former medical school roommate, trusted friend, and colleague—and broached the possibility of NYEE joining Continuum Health Partners.

38 https://www.nytimes.com/2001/03/14/nyregion/hospital-mergers-stumbling-asmarriages-of-convenience.html 39 Personal communication, Laurie Levin and Dr. Richard Rosen, January 28, 2019.

40 Message from Joseph P. Corcoran, President, The New York Eye and Ear Infirmary.

Philanthropic Partners brochure. 2000-2001; 1.

41 Continuum Health Partners, Inc. brochure. 2002; 12.

42 Ibid.

43 http://www.fundinguniverse.com/company-histories/continuum-health-partners-inchistory/ 44 https://www.nytimes.com/2001/03/14/nyregion/hospital-mergers-stumbling-asmarriages-of-convenience.html 45 Ibid.

55 Fradin S (ed). Perspectives: The New York Eye and Ear Infirmary at the crossroads.

Presented at the Alumni Association of the New York Eye and Ear Infirmary Annual Spring Dinner Meeting. May 12, 2005.

56 The New York Eye and Ear Infirmary. Excellence in Specialty Care brochure. 20072008.

57 Six outstanding hospitals, one outstanding health care system. Continuum Health Partners, Inc. brochure, 2007.

58 Leading the Way. Spring 2010: 4.

59 Personal communication, Laurie Levin and Dr. Robert Ritch, June 22, 2019. Over the course of his distinguished career, Dr. Ritch has received over 60 national and international medals and awards, including the Joanne G. Angle ARVO Service Award and the Dominick Purpura Distinguished Alumnus Annual Award from the Albert Einstein College of Medicine. He was a member of the Board of Directors of the International Council of Ophthalmology and elected to Academia Ophthalmologica Internationalis, which is limited to 100 members worldwide.

60 Personal communication, Laurie Levin and Dr. Robert Ritch, June 22, 2019.

P. 148: Project Chernobyl i

Six outstanding hospitals: one outstanding health care system. Continuum Health Partners, Inc. brochure. 2007: 27.

ii

NYEEI holds thyroid cancer conference at the United Nations. Connections 2006: March 20-26.

P. 146: An Eye for an Eye i

NYEEI sponsors conference on organ and eye donations. Connection 2005; September 12-18.

P. 146: A More Natural Approach i

Connections 2008; July 14-20.

ii

A body of work. The New York Eye and Ear Infirmary. Excellence in Specialty Care brochure. 2007-2008: 19.

46 The New York Eye and Ear Infirmary strategic plan. 2002 community service plan.

2003; April: 1.

47 The New York Eye and Ear Infirmary strategic plan. 2002 community service plan.

April 2003: 11.

61 https://www.glaucomafoundation.org/about_tgf.htm 62 The New York Eye and Ear Infirmary 2007 Thanks for Giving Ball, official program.

November 28, 2007.

63 Six outstanding hospitals: one outstanding health care system. Continuum Health Partners brochure. 2007: 26.

64 Ibid.: 27.

65 The New York Eye and Ear Infirmary. Excellence in Specialty Care brochure, 2007: 6.

66 The New York Eye and Ear Infirmary. Excellence in Specialty Care brochure, 20072008: 4.

48 Ibid.

67 Six outstanding hospitals: one outstanding health care system. Continuum Health Partners brochure. 2007: 27-8.

49 The New York Eye and Ear Infirmary Department of Ophthalmology Annual Report, 2003-2004.

69 https://www.modernhealthcare.com/article/20130930/NEWS/309309966

68 Ibid.

211

212

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Notes, continued 70 https://dspace.mssm.edu/bitstream/handle/123456789/31881/NYEEI%20Annual%20 Report%202012.pdf?sequence=1&isAllowed=y

iii

Leading the way. 2007; Spring.

iv

Leading the way. 2006; Winter.

71 Ibid.

v

Strides in clinical research and innovation. InSight 2018; Spring.

72 Ibid.

vi

Personal communication, Laurie Levin and Dr. George B. Wanna, July 24, 2019.

73 Ibid.

74 Ibid.

75 https://www.modernhealthcare.com/article/20131005/MAGAZINE/310059960/ consolidation-begins

P. 149: Susan Liebowitz

76 As of 2019, the Infirmary maintains 20 inpatient beds.

i

The New York Eye and Ear Infirmary Thanks for Giving Ball. Official program.

The Pierre, New York City. 2007; November 28.

P. 150: Practice Makes Perfect i

https://www.nyee.edu/education/microsurgical-education-center/history

ii

https://www.nyee.edu/education/microsurgical-education-center

iii

https://buxtoneye.com/the-foundation/

iv

Personal communication, Laurie Levin and Arthur Tortorelli, May 17, 2019.

v

The New York Eye and Ear Infirmary Annual Report, 1958.

vi

https://www.nytimes.com/1972/11/10/archives/temporal-bone-laboratorydedicated-at-hospital-here.html

vii

Personal communication, Laurie Levin and Dr. Douglas F. Buxton, March 27, 2019.

P. 152-155: Inquiring Minds (Dr. Della Rocca) i

“The Raven” refers to Dr. Della Rocca’s surgical mastery associated with cleaning up the orbit after the other sub-specialty doctors have been unable to save an eye.

ii

Personal communication, Laurie Levin and Dr. Richard Rosen, July 2, 2020.

iii

https://www.nyee.edu/files/MSHealth/Assets/HS/Newsroom/ SpecialtyReports/2018/Ophthalmology/Ophthalmology-Specialty-Report.pdf

(Dr. Mackool) iv https://mackooleyesurgery.com/about-us/dr-richard-j-mackool-m-d/ v https://crstoday.com/wp-content/themes/crst/assets/downloads/CRST0808_02.pdf (Dr. Kupersmith)

77 https://www.modernhealthcare.com/article/20131005/MAGAZINE/310059960/ consolidation-begins 78 Ibid.

79 https://www.nytimes.com/2012/06/07/nyregion/nyu-langone-and-continuum-agreeto-pursue-merger.html The deal would also be subject to regulatory approval by the Federal Trade Commission as well as the State Health Department and the State Dormitory Authority, a financing and construction agency that carried some debt for Continuum.

80 https://www.modernhealthcare.com/article/20160531/NEWS/160539996/mount-sinais-downsizing-leaves-valuable-manhattan-real-estate-on-the-table 81 Ibid. Having affiliated in 1998, Mount Sinai and NYU Langone dissolved their association shortly thereafter, reputedly due to irreconcilable differences between their respective medical schools. Continuum readily agreed to terminate its affiliation with New York Medical College upon its merger with Mount Sinai.

82 Ibid.

P. 160: Mount Sinai Health System i

Personal communication, Laurie Levin and Dr. Kenneth L. Davis, May 16, 2019.

ii

https://en.wikipedia.org/wiki/Mount_Sinai_Hospital_(Manhattan). Mount Sinai is the second oldest Jewish hospital built in the United States, preceded in 1847

by Cincinnati, Ohio’s Jewish Hospital.

iii

https://www.mountsinai.org/locations/mount-sinai/about/history

iv

Aufses AH Jr., Niss BJ. This house of noble deeds: The Mount Sinai Hospital, 18522002. New York: New York University Press. 2002: p. 1-16.

v

https://www.mountsinai.org/locations/mount-sinai/about/history The Mount Sinai Hospital School of Nursing closed in 1971 after graduating 4,700 nurses.

vi

https://www.nyee.edu/care/eye/neuro-ophthalmology

vi

Ibid.

vii

https://www.nyee.edu/care/eye/neuro-ophthalmology/team

vii

Aufses AH, Niss BJ. This house of noble deeds: The Mount Sinai Hospital, 18522002. New York: New York University Press; 2002: p. 11.

viii http://www.ncbi.nlm.nih.gov/sites/myncbi/mark.kupersmith.1/ bibliography/41159743/public/?sort=date&direction=ascending P. 158: The Opening Bell i

NY Stock Exchange opening bell heralds new ear institute. Echoes, April 2008.

ii

NYEEI opens Ear Institute. Connections 2008; March 24-30.

viii https://en.wikipedia.org/wiki/Icahn_School_of_Medicine_at_Mount_Sinai ix

Aufses AH, Niss BJ. This house of noble deeds: The Mount Sinai Hospital, 18522002. New York: New York University Press; 2002: p. 15.

x

Personal communication, Laurie Levin and Alan Flippen, October8,2019

NOTES

83 Personal communication, Laurie Levin and Dr. Jeremy Boal, May 14, 2019.

84 Personal communication, Laurie Levin and Dr. Jeremy Boal, May 14, 2019.

85 https://health.usnews.com/best-hospitals 86 Personal communication, Laurie Levin and Alan Flippen, July 11, 2019.

87 Personal communication, Laurie Levin and Dr. Donald Wood-Smith, May 15, 2019.

88 The Mount Sinai Integrative Sleep Center-Downtown Relocates Facility to NYEE. InSight. Summer 2018.

89 Chair’s Message. The New York Eye and Ear Infirmary of Mount Sinai. Department of Ophthalmology. Fall 2015.

90 Personal communication, Laurie Levin and Dr. James C. Tsai, March 25, 2019.

91 Ibid.

92 Personal communication, Laurie Levin and Christopher T. Spina, May 13, 2019.

93 Personal communication, Laurie Levin and Christopher T. Spina, June 26, 2019.

94 It’s not how hard you work, it’s how hard you work together. InSight. New York Eye and Ear Infirmary. Spring 2018: 1.

95 “Town Hall Meetings Help Keep the Lines of Communication Open.” In: InSight. New York Eye and Ear Infirmary. Summer 2018: 5.

P. 163: NYEE’s Eye Stroke Protocol i

An NYEE-Mount Sinai eye protocol saves a young woman’s sight. New York Eye and Ear Infirmary of Mount Sinai Department of Ophthalmology. Specialty Report. Fall 2018: insert.

96 Personal communication, Laurie Levin and Dr. Paul A. Sidoti, March 27, 2019.

1820–2020

P. 166: Dr. James C. Tsai i

CV references are adapted from Tsai JC-AA Biosketch-2019.

P. 168: Ahead of the Curve i

This i-doctor is transforming the field of ophthalmology. New York Eye and Ear Infirmary of Mount Sinai, Department of Ophthalmology Specialty Report. Fall 2018: 6-8.

ii

Personal communication, Laurie Levin and Dr. Tsontcho Ianchulev, May 16, 2019.

iii

Op. Cit.

iv

Ibid.

v

Personal communication, Laurie Levin and Dr. Richard Rosen. May 14, 2019.

vi

Personal communication, Laurie Levin and Dr. Tsontcho Ianchulev, May 16, 2019.

vii

Ibid.

P. 170: Exploring the Universe Within i

Imaging is a pivotal part of NYEE’s rich history. The New York Eye and Ear Infirmary of Mount Sinai. Department of Ophthalmology Specialty Report. Fall 2018.

ii

The unique technology of adaptive optics. The New York Eye and Ear Infirmary of Mount Sinai. Department of Ophthalmology Specialty Report. Fall 2018.

iii

Through a state-of-the-art imaging. New York Eye and Ear Infirmary of Mount Sinai. Department of Ophthalmology Specialty Report. Fall 2018.

iv

Personal communication, Laurie Levin and Dr. Richard Rosen, May 15, 2019.

P. 172: Passing It Forward

97 Enhancing our Reputation for World-Class Training. Department of Ophthalmology Specialty Report. New York Eye and Ear Infirmary. Fall 2019: 4.

i

Delafield E. An address of the dedication of the new building of the New York Eye Infirmary, April 25, 1856. New York: GAC Van Beuren, Printer. 1856: p. 20.

98 Ibid.

ii

Arch Ophthalmol. 1932;7(5): 681-699. doi:10.1001/archopht.1932.00820120031002

99 Personal communication, Laurie Levin and Dr. Paul A. Sidoti, March 27, 2019.

iii

Ibid.: 693.

100 Enhancing our Reputation for World-Class Training. Department of Ophthalmology Specialty Report. New York Eye and Ear Infirmary. Fall 2019: 4.

iv

Ibid.: 692.

v

Ibid.

101 Research breakthrough: gene transfer therapy restores vision in mice. New York Eye and Ear Infirmary. Department of Ophthalmology. Specialty Report. Fall 2018: 3.

vi

Personal communication, Laurie Levin and Dr. Paul Sidoti, March 27, 2019.

vii

Message from the president. New York Eye and Ear Infirmary of Mount Sinai.

Ophthalmology Residency Program brochure.

102 Chair’s Message. New York Eye and Ear Infirmary of Mount Sinai. Department of Ophthalmology. Fall 2015: 3.

103 Studying new stem cell therapies for vision recovery. Research frontiers. New York Eye and Ear Infirmary. Department of Ophthalmology. Fall 2015: 3.

104 Personal communication, Laurie Levin and Dr. Tsontcho Ianchulev, May 16, 2019.

P. 165: The Ocular Stem Cell Program i

Breaking new ground in gene transfer therapy to restore vision. New York Eye and Ear Infirmary of Mount Sinai, Department of Ophthalmology Specialty Report 2018; Fall: 4-5.

viii Message from the system chair of the Department of Ophthalmology. New York Eye and Ear Infirmary of Mount Sinai. Specialty Report. Fall 2018. ix

Ophthalmology Residency Program brochure. New York Eye and Ear Infirmary of Mount Sinai.

x

Personal communication, Laurie Levin and Lloyd Stanford, June 28, 2019.

xi

Personal communication, Laurie Levin and Dr. Paul Sidoti, March 27, 2019.

xii Personal communication, Laurie Levin and Dr. Claude Douge, March 25, 2019.

105 New York Eye and Ear Infirmary Annual Report, 1890.

213

214

New York Eye and Ear Infirmary

NYEE 200: A VISION OF HOPE

Acknowledgments Laurie Levin, Author

Larry Zempel, Designer

MY FIRST THANKS must go to Dr. Richard B. Rosen, Dr. James C. Tsai, and Christopher T. Spina for entrusting me with such an important project; the opportunity has been a privilege. I am also grateful to the New York Eye and Ear Infirmary of Mount Sinai (NYEE) and Mount Sinai Health System physicians, leaders, and staff who generously carved out time in their busy schedules to answer my endless questions. A Vision of Hope would not have been possible without their invaluable insights and contributions. In particular, Dr. Rosen’s encyclopedic knowledge of the Infirmary’s history proved indispensable. I wish, too, to express my appreciation to Alexandra Bissett, Director of Marketing, Communications, and Outreach, NYEE, and Director of Marketing and Communications, Department of Ophthalmology, Mount Sinai Health System, for her unflappable oversight of this sprawling responsibility, and to Lisa Mims, Executive Administrative Assistant to Dr. Tsai, for responding so graciously to all my requests related to logistical details large and small.

MY THANKS ALSO to Dr. Richard B. Rosen, the originator of this project, whose wonderful “scrapbook” of information and imagery, “The New York Eye and Ear Infirmary of New York: The Flowering of Ophthalmology in America” was an invaluable guide and resource for 200 years of imagery. And to the enthusiastic support of Dr. James C. Tsai, to Lisa Mims, for her cheerful assistance, and to Alexandra Bisset for her steady navigation through the complex process. (Proper titles are at left, in Laurie’s column.)

During the research phase of this project, I benefited greatly from the advice and direction of many unfailingly helpful librarians, archivists, and historians: Arlene Shaner, MA, MLS, Historical Collections Librarian at the New York Academy of Medicine; Barbara Niss, Director of the Arthur H. Aufses, Jr., MD, Archives and Mount Sinai Records Management Program; Diane Shaw, Director (ret.) for Special Collections and College Archives, Lafayette College; Jenny Benjamin, MA, Director of the Museum of Vision, American Academy of Ophthalmology; Andy McCarthy, Milstein Division, New York Public Library; Karen Bieterman, MLIS, Director of the Wood Library-Museum of Anesthesiology; Pam Severing, Past President, Cogan Ophthalmic History Society; Dr. Mosette Broderick, Director of Urban Design and Architecture Studies, New York University; and Lynda B. Kaplan, principal of the American History Workshop. And last but far from least, I owe a debt of gratitude to my scrupulous editors: Drs. James Tsai, Richard Rosen, Thomas O. Muldoon, and Robert Della Rocca; Helen Zelon; Alan Flippen, Senior Director of Publications and Communications, Mount Sinai Health System; and Rebecca Lingner, Director of Branding, Mount Sinai Health System, whose painstaking copy-editing, fact-checking and constructive comments improved this manuscript immeasurably. And to Larry Zempel, whose eye for impeccable images and design brought this book to life.

And of course, thanks to my partner in this venture, the intrepid researcher, interviewer, trailblazer, and author of this book, Laurie Levin.

For image research assistance, Arlene Shaner, of the New York Academy of Medicine; Andy McCarthy, of the New York Public Library; and especially Lynda B. Kaplan, of the American History Workshop.

And for their excellent design and production support, the indispensable team of Hilary Lentini, Allie Cormier, and Leanna Hanson of Lentini Design and Marketing, Los Angeles.

small specialty-focused hospital with a mission to serve the poor and afflicted citizens of

Laurie Levin is a Harvard

Manhattan with vision and hearing loss. Two centuries later, their dream has evolved into

University/UCLA-trained

one of the world’s leading centers for ophthalmology (EYE) and otolaryngology (ENT).

anthropologist and author who

Nevertheless, the same vision, mission, and values of its founders, Edward Delafield, MD,

specializes in non-fiction books

and John Kearny Rodgers, MD, still permeate the entire institution.

and institutional histories.

Dr. James C. Tsai

www.laurielevin.net

President, New York Eye and Ear Infirmary of Mount Sinai from the Foreword

1820

a V i s ion of

The esprit de corps of the NEW YORK EYE AND EAR INFIRMARY is legendary, based on vibrant fellowship, shared pride, and a deep sense of belonging. To be sure, bonds such these are rarely found on any standard job description. But ask insiders, especially those who have been there awhile, and they easily spell out what makes NYEE unique.

H ope

“The Infirmary has always been characterized by camaraderie and collegiality that you don’t find in other hospitals and academic departments.

Ever since I started here as a resident in 1989, the rapport between physicians, nurses and staff has always made this a wonderful place to work, teach, and care for patients.”

9.281”

Dr. Paul Sidoti Professor and Site Chair for the Department of Ophthalmology “In a nutshell, the Infirmary’s mission gets into your blood: groundbreaking research and teaching excellence, which translates into superb patient care, all make me extremely proud to be part of its 200-year history.”

THIS BOOK ... honors the thousands of men and women of the Infirmary over the past 200 years who have dedicated their lives to repair and enhance the lives of so many grateful

L AU R I E L E V I N

ISBN 978-0-578-61431-1 ISBN 978-0-578-61431-1

volume of stories and facts, highlighting our first 200 years.

ScD (Hon), FACS, FASRS, CRA Surgeon Director and Retinal Service Chief, New York Eye and Ear Infirmary of Mount Sinai

Larry Zempel, Zempelworks.com

12.312 .125

9 780578 614311

Victoria Toro 45-year staffer in the Infirmary’s Social Work Department

Printed in USA

from the Introduction

3.875

2020

T H E 20 0 -Y E A R H I S TO RY O F T H E 1820 -2020

Dr. Richard B. Rosen Book and cover design by

“NYEE touches peoples’ lives every day, in the best ways possible—but it’s really a two-way street. My patients have impacted my life, put everything into perspective and taught me the true meaning of resilience.”

N E W YO R K E Y E A N D E A R I N F I R M A RY

90000>

patients. In the spring of 2020, we look forward to sharing this lusciously illustrated family

Arthur Tortorelli Technical Director at the Jorge N. Buxton, MD, Microsurgical Education Center since 1977

.75

12.312

3.875 .125

9.281”

NYEE 200

TWO HUNDRED YEARS AGO, two visionary physicians dared to dream—founding a

ABOUT THE AUTHOR