medicine worcester
Volume 90 • Number 4 Published by Worcester District Medical Society July / August 2021
Medicine in Worcester: History of Leaders Leonard Morse, MD: Sherlock Holmes Meets Public Health John Meyers, MD: Steering the Future of Health Care Delivery Homer Gage, MD: Envisioning the Mass Med Society with a Journal Rebecca Barnard, MD + Mary Vincent O’Callahan, MD: Worcester’s Answer to the ‘Woman Question:’ The First Female Members of the WDMS
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Contents JULY / AUGUST 2021
on the cover Collage of featured healthcare leaders by Studio DiBella
Medicine in Worcester: A History of Leadership Clara Barton: An Influential Nurse from Central Massachusetts 15
Editorial 4 Dale Magee, MD
Joanne Lewis PhD, RN, ACNP-BC
Dr. Leonard Morse MD: Sherlock Holmes Meets Public Health 4 Cameron Thomson, MD, BS
Charlie Monahan and the Mass College of Pharmacy and Health Sciences 17
John Meyers, MD: Steering the Future of Health Care Delivery 6
Anna Morin, PharmD
Herbert Dean, MD
Legal Consult: Re-Opening During the Half-Life of a Pandemic 18
Homer Gage, MD: Envisioning the Mass Med Society with a Journal 7 Patricia Giunta, MA
Rebecca Barnard, MD and Mary Vincent O’Callaghan, MD: Worcester’s Answer to the ‘Woman Question’: The First Female Members of the WDMS 9 Madeline Ryan, PhD
May Salona Holmes, MD & the Belmont Isolation Hospital: She Could Do Everything 12
Peter Martin, Esq.
In Memoriam Dr. Seymour Solomon 19 Reprint from The Telegram & Gazette
Awards Berlin Creative Writing Award: Paper Planes 20 Jesse Sardell
Michael Urbanowski, PhD
Society Snippets 2021 Scholarship Fund for the Worcester District Medical Society 22
Howard Beal, MD: When Duty Calls 14
Melissa Boucher
Dale Magee, MD
published by
wdms editorial board
produced by
Worcester District Medical Society
Dale Magee, MD, Guest Editor
Studio DiBella
321 Main Street, Worcester, MA 01608 wdms.org | mwright@wdms.org | 508-753-1579
Lisa Beittel, MBA Anthony Esposito, MD Anna Morin, PharmD Nancy Morris, PhD, ANP Thoru Pederson, PhD Joel Popkin, MD Alwyn Rapose, MD Robert Sorrenti, MD Paul Steen, MD Ram Upadhyay, MD Peter Zacharia, MD Alex Newbury, MD Resident Representative Parul Sarwal, MD Resident Representative Alexandra Rabin, Student Representative
wdms officers
President Spiro Spanakis, DO Vice President Giles Whalen, MD Secretary Marianne Felice, MD Treasurer B. Dale Magee, MD wdms administration
Martha Wright, MBA, Executive Director Melissa Boucher, Administrative Assistant
thank you to
The Reliant Medical Group UMass Memorial Health Care Physicians Insurance Music Worcester Re/Max Vision advertising
Inquiries to Martha Wright mwright@wdms.org 508-753-1579
Worcester Medicine does not hold itself responsible for statements made by any contributor. Statements or opinions expressed in Worcester Medicine reflect the views of the author(s) and not the official policy of the Worcester District Medical Society unless so stated. Although all advertising material is expected to conform to ethical standards, acceptance does not imply endorsement by Worcester Medicine unless stated. Material printed in Worcester Medicine is covered by copyright. No copyright is claimed to any work of the U.S. government. No part of this publication may be reproduced or transmitted in any form without written permission. For information on subscriptions, permissions, reprints and other services contact the Worcester District Medical Society.
WORCESTER MEDICINE
Editorial The Power in Our Past
Dr. Leonard Morse, MD: Sherlock Holmes Meets Public Health
Dale Magee, MD
Cameron G. Thomson, MD, BS
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24/7 news cycle we may be so caught up the overwhelming flow of information that we lose sight of the big picture. We rarely have a chance to reflect on how much has been accomplished by those who came before us. Worcester in general, and the Worcester District Medical Society in particular, have been home to health care professionals that have made breakthrough discoveries, established institutional innovation and demonstrated remarkable insight and character. We have much to be proud of. We have a chance to look back in this issue of Worcester Medicine, thanks to our dedicated authors. Part of our roles as physicians is to look beyond the guidelines and the routine and detect the exception to the rule or the unsolved problem. Who better to illustrate this than Leonard Morse and his record of solving obscure problems in infectious disease? And when it comes to seeing the future of health care delivery, John Meyers provides a great example with his vision of integrated care, taking the broader view of dealing with not only illness but health maintenance. Imagine the Massachusetts Medical Society without the New England Journal of Medicine! You don’t have to, thanks to the insight of Homer Gage. May Selona Holmes was the vision of the dedicated physician functioning in a system that offered little to woman physicians. She took what she was able to get and ran with it. Nearly a decade before the Massachusetts Medical Society allowed admission of women physicians, the Worcester District addressed the “woman problem” with a favorable, if not enthusiastic, resolution to allow their admittance, a first step in getting us to the majority of medical students being women today. And, in Howard Beal we see a heroic character that saw a compelling role for the physician in the execution of war, a compulsion to help mitigate the injuries while feeling that there were instances when the violence was necessary to bring the peace. Bringing his power to heal to the battlefield was his way of aiding in what he felt was a just war. Outside of our medical society, we see Clara Barton and the development of the Red Cross, which remains a staple in our emergency preparedness. Whether it is maintaining a safe blood supply or responding to environmental disasters, the Red Cross is a vital part of our community. Finally, we have Charlie Monahan, experienced in practicing pharmacy as well as running a pharmacy operation. He brought his entrepreneurial skills to the Mass College of Pharmacy (now a university), and the result energized both the College and downtown Worcester. Take a moment to see these individuals whose energy, foresight, intelligence, and dedication contributed so much to making our world better. Let them inspire you to do more. +
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n our electronic
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in medicine having served as president of both the WDMS and MMS, as well as Commissioner of Public Health of Worcester. However, there is another side of Leonard Morse, whose clinical and deductive skills rival those of Sherlock Holmes. As an infectious disease expert, Dr. Morse was drawn to investigating outbreaks of unusual infectious diseases. One such investigation, for instance, piqued his interest when 16 UMass Memorial Hospital employees and patients developed Salmonella gastroenteritis. He observed that those affected had either recently eaten or worked in the hospital cafeteria, so he reviewed the daily lunch menus for a potential source. His investigation led him to discover that the cafeteria workers customarily enriched the ice cream with frozen, unpasteurized egg yolks, which, upon culturing, were found to be massively contaminated with numerous disease-causing bacteria, including Salmonella. Per Dr. Morse’s request, the hospital mandated rectal cultures of all hospital employees and patients and found that 167 individuals were primarily infected by the soiled ice cream. In his case report detailing the outbreak, Dr. Morse emphasized the importance of pasteurizing all dairy products, a controversial idea at the time. Another case involved six ICU patients who simultaneously developed Klebsiella septicemia. He cultured every surface imaginable and found that the hand lotion in the unit was overwhelmingly contaminated. To his horror, he discovered providers inadvertently spread Klebsiella to the sickest patients, one of whom ultimately died. In his concise yet effective case report, he discussed the dangers of hospital-acquired infections and emphasized the need for appropriate antisepsis.
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eonard morse is well known as a leader
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Dr. Leonard Morse, MD Continued His masterful detective work also led him to discover several new conditions, such as the transmission of paralytic polio from a recently vaccinated newborn to his unimmunized mother. Although the live-attenuated oral polio vaccine was associated with rare cases of the vaccine-acquired disease, this marked the first time this unique mode of transmission was described, illustrating the need for vaccinating all those at risk. The case of Dr. Morse’s career that garnered the most attention involved the Holy Cross football team. Returning from a disappointing 3-6-1 season, the 1969 Crusaders were determined to improve their record. Despite a strong preseason, the team suffered sluggish losses in their first two games. When several players complained of weak legs, and one even vomited at the line of scrimmage during the second game, it was clear something was wrong. The Crusaders canceled their remaining eight games and called in Dr. Morse to investigate. Easily observing jaundice amongst several players, he speculated that more than just the visibly sick were affected and requested blood samples from all players and coaches. Of the 97 samples collected, 90 returned positive for elevated bilirubin, indicating hepatitis. His suspicion was correct, and he set out to find an explanation. Dr. Morse visited the Holy Cross practice fields. Acute hepatitis has about a 30-day incubation period, so he had to look back in time. One possible culprit was the team’s water supply. Before practice, water was collected into large metal vats from a spigot adjacent to the fields. Tracing the pipe back to its origin, Dr. Morse observed that six subsurface faucets came off the line to irrigate the fields. Neighborhood children played in the fields’ sprinkler system, and Dr. Morse learned that four of them had been sick that summer. It was reasonable to think that the children shed an infectious agent into the field while they played, but how did that infected water enter the drinking supply? The last part of the puzzle required a review of the city’s records. On a particularly hot summer day, the city fire department battled a raging house fire in the surrounding residential neighborhood. When the nearby fire hydrants were opened, Dr. Morse speculated that the water table under the field experienced negative pressure, which sucked the infected groundwater into the drinking line through the sprinkler faucets. To test his hypothesis, he spread a water-soluble dye across the practice fields and had the fire department open the hydrants. Sure enough, the dye was easily detected in the Crusaders’ drinking water. His experiment proved that the team’s season was doomed an entire month before they even played their first game. Today, we know of the five distinct forms of viral hepatitis, but comparatively little was known about acute hepatitis in 1969. The hepatitis A virus was not
discovered until 1979, so Dr. Morse impressively established a diagnosis using only knowledge of probable exposure, length of the patient’s incubation period, and basic, liver-associated labs. Interestingly, later testing on the original blood samples confirmed that hepatitis A was the cause of the outbreak. Although the Crusaders missed out on the remainder of their season and were required to quarantine in their dorm rooms for the entire school semester, all team members fully recovered. Because of the unusual circumstances leading to the dramatic infection rate, the story gained significant attention. Through local and national news coverage, Dr. Morse advocated for improved drinking water systems. Additionally, his descriptive scientific publications about the outbreak significantly contributed to understanding the viral hepatitides, and the Holy Cross outbreak is still referenced in the medical literature today. A brilliant detective, clinician, and leader in medicine, Dr. Morse significantly improved the health and safety of the Worcester community and beyond over the course of his nearly five-decade-long career. Each case tested his cleverness, but he always found a concise and satisfying explanation that furthered the understanding of infectious disease. His scientific articles all share an unconventional theme: the methods section is the most enjoyable part to read. Through his descriptive narration, he takes the reader on an illustrative journey through his skillful deduction. Now 92 years old, he and his beloved wife, Maxine, live near one of their four children in Virginia. As a Worcester resident for 88 years, Dr. Morse still feels a strong connection to the city and continues to read the Worcester Telegram daily. + Cameron G Thomson, MD, BS bibliography:
1. Morse LJ, Rubenstein AD. A food-borne institutional outbreak of enteritis due to Salmonella blockley. JAMA. 1967;202(10):939-940. 2. Morse LJ, Williams HL, Grenn Jr FP, Eldridge EE, Rotta JR. Septicemia due to Klebsiella pneumoniae originating from a hand-cream dispenser. New England Journal of Medicine. 1967;277(9):472-473. 3. Morse LJ, Rubin HE, Blount RE. Vaccine-acquired paralytic poliomyelitis in an unvaccinated mother. JAMA. 1966;197(12):1034-1035. 4. Morse LJ, Bryan JA, Hurley JP, Murphy JF, O’Brien TF, Wacker WE. The Holy Cross college football team hepatitis outbreak. JAMA. 1972;219(6):706708. 5. Wacker WE, Riordan JF, Snodgrass PJ, et al. The Holy Cross hepatitis outbreak: Clinical and chemical abnormalities. Archives of Internal Medicine. 1972;130(3):357-360. 6. Friedman LS, O’Brien TF, Morse LJ, et al. Revisiting the Holy Cross football team hepatitis outbreak (1969) by serological analysis. JAMA. 1985;254(6):774776. 7. Koff RS. Feinstone SM, Kapikian AZ, Purcell RH. Hepatitis A: detection by immune electron microscopy of a virus like antigen associated with acute illness [Science 1973; 182: 1026–1028]. Journal of Hepatology. 2002;37(1):2-6. 8. Sherlock S. Landmarks in viral hepatitis. JAMA. 1984;252(3):402-406. 9. Neagle ME. 1969: The Missing Season. In: Holy Cross Magazine; 2004. 10. Toland J. 1969 Holy Cross football team members reflect on 50th anniversary of hepatitis outbreak that canceled games, ended careers, made national headlines. The Worcester Telegram. 2019. 11. The ACP Commitment to Being an Anti-Racist, Diverse, Equitable, and Inclusive Organization, 10/21/20, www.acponline.org JULY / AUGUST 2021
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Medicine in Worcester John Meyers, MD: Steering the Future of Health Care Delivery Herbert M. Dean, MD, FACP
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(jack) meyers arrived in Worcester in 1936 during his 4th year of medical school at Boston University Medical school and was sent to St. Vincent Hospital in recognition of his achievements and at the request of the hospital for interns. It was there that he completed his medical training and met John Fallon, Chief of Surgery, who would influence his medical career. Finishing his training in 1938, he set up a solo practice in the former Standish Hotel on Main Street and married Ann McCann, a St. Vincent nurse. 1942 proved a significant year with the birth of his daughter Arlene (Lian) and his entering the US Air Force as a Captain stationed in Texas, where he was involved in aviation medicine research, including high altitude sickness and oxygen deprivation in flight. Upon discharge from the military in 1945, he was recruited by Baylor University of Medicine to join the school and continue his research in flight physiology. Unexpectedly, John Fallon arrived and enticed him to join his surgical-oriented practice located at 10 Institute Road in Worcester. With the unexpected death of John Fallon in 1952, Meyers, along with the other 3 employed physicians, purchased the Fallon Clinic, and the concept of a multispecialty group practice similar to Mayo Clinic was born. Meyers and his colleagues, James Brosnan, a cardiologist and also Chief of Medicine at St. Vincent, John Manning, surgeon, and M. Elizabeth Fletcher, radiologist (both Manning and Fletcher were Mayo Clinic trained physicians), provided coordinated care, diagnostic lab and x-ray services on-site, as well as access to the use of a single medical record. The practice recruited other physicians to expand medical services and outgrew its space. The 10-member physician group, led by John Meyers as its President, built a new state-of-the-art facility overlooking rooklyn born john
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Lake Quinsigamond on Plantation Street. At the same time, the 290-highway extension was built through Fallon property with a Plantation Street exit providing patients and referrals by solo practitioners throughout Worcester County easy access to the Clinic. Dr. Meyers maintained a large referral practice based on his reputation as a skillful internist and his warmth and compassion with his patients. As his administrative responsibilities grew, he successfully transferred appropriate patients to his new associates. His day began making rounds at 6 AM at St. Vincent and he was back in his office by 8 AM, seeing as many as 30 to 40 patients. He brought home a box full of records to complete in the evening and often had evening meetings related to clinic business, including recruitment of new doctors. The Fallon Clinic grew with new doctors attracted by the egalitarian environment of a physician directed organization, which offered them benefits including resources needed to carry out their specialties, shared patient coverage, the opportunity to become partners after two years, and encouragement to participate in administrative duties, including election to the Board of Directors. Dr. Meyers was reelected and served as President of Fallon Clinic through his tenure at Fallon. In July 1965, President Lyndon Johnson signed Medicare into law and the demand by the underserved population of those 65 and older for healthcare services led to an explosive need for access to medical care now with a financing mechanism to pay for it. Health care remained fragmented and health care costs exploded, surpassing inflation and consuming close to 20% of the country’s gross national product. Seeing the need and an opportunity to improve healthcare delivery, Dr. Meyers in 1977, working with Blue Cross, formed the Fallon Community Health Plan. FCHP became the first federally approved Senior Plan HMO in Central MA, with the financing of health care services provided on a capitation basis rather than the traditional fee for service. He served as President of FCHP for eight years and saw managed care as a means through coordination of care with an emphasis on health education, preventive health initiatives such as cancer screening, smoking cessation programs, chronic disease management, and employing best practice models and guidelines as the means to control health care inflation and provide optimal care for patients – the right care, at the right time, and at the right cost.
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Medicine in Worcester
John Meyers, MD: Steering the Future of Health Care Delivery Continued Because Blue Cross went on to form its own HMO, it withdrew its relationship with FCHP soon after its creation. By 1984, the Fallon Clinic had over 30 locations throughout central Massachusetts, close to 300 physicians in the group practice, and FCHP had over 225,000 enrollees. He retired from practice in 1986 but continued to engage in health care issues such as patient drug compliance and improving medical access for seniors. Dr. Meyers somehow found time for non-medical pursuits, and his primary focus was steadfast devotion to his family and grandchildren. He enjoyed classical music, including opera, gardening in his “spare time,” photography and he was recognized as an accomplished sculptor. His sculptural pieces are featured in local churches and synagogues, as well as gifts to colleagues. His sculpture of Dr. Lamar Soutter, the first Chancellor at UMass Medical School, adorns the entry to the medical school library. His numerous accomplishments in health care were recognized nationally and locally. In 1983 he received the National Medical Executive Award by the American College of Medical Group Administrators. In 1987, he received Honorary Doctor of Humanities Degrees from UMass and from Anna Maria College in 1989. His interest in improving the delivery of health care through primary care initiatives was formally recognized by the creation of the Meyers Primary Care Institute in 1996, a joint venture by UMass Medical School, Fallon Clinic, and FCHP. + Herbert M. Dean, MD, FACP Former division chief of hematology/oncology and Former Executive, Vice-President, Fallon Clinic; Former President, FCHP
Homer Gage, MD: Envisioning the Mass Med Society with a Journal Patricia Giunta, MA
W
hen homer gage left worcester to begin his medical
training, the surgical field was in a period of rapid and revolutionary change. In 1846, Worcester County dentist Willian Morton held the first public demonstration of surgical anesthesia at the Ether Dome, ushering in an era of radical new procedures and expanding the boundaries of surgical intervention. In the late 1800s, while Gage was training in Boston, Joseph Lister applied Pasteur’s germ theory to patient care, proposing a controversial antiseptic technique that would counter the high mortality rates that plagued surgery. Emboldened by these breakthroughs, surgeons experimented with increasingly more invasive methods and intervened surgically earlier in the course of disease. In the annual oration to the Massachusetts Medical Society in 1913, Dr. Gage, then the president of the Worcester District Medical Society, reflected on this turbulent period of progress and offered an opposing perspective. Rather than taking these advances as carte blanche for experimentation, surgeons must remember “the only justification for JULY / AUGUST 2021
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Homer Gage, MD: Envisioning the Mass Med Society with a Journal Continued
surgical intervention: [...]the relief of suffering, with as little danger, distress and mutilation as possible.” (1) He emphasized the need for standardized training of surgeons and professional guidelines, noting their absence as one crucial factor enabling the radical procedures gaining popularity. This methodical and thoughtful approach reflects Homer Gage’s broader legacy. After Dr. Gage completed his education at Massachusetts General Hospital, one staff physician praised his talents by noting that “there was not a surgeon in Massachusetts, Boston not excepted, who could give [him] points.” (2) Although he undoubtedly possessed the intellect and resources to join the ranks of the Boston elite, Gage chose to return to Worcester and devote his life to community service and the advancement of the medical profession. Dr. Gage’s vision was central to the establishment of what is now the New England Journal of Medicine. At the turn of the century, the Boston Medical and Surgical Journal operated independently as the only weekly journal in New England. Although the Massachusetts Medical Society maintained a small quarterly newsletter, it lacked the resources to publish its own periodical and could not buy the Journal for fellows without raising annual dues. Several years later, new cost estimates gave the Society an opportunity to expand to a more robust monthly publication. Recognizing the competition this would no doubt create, Homer Gage proposed a partnership: rather than fund their own publication, the Society would buy into the Journal, securing their members a weekly copy and allowing them to publish at a more professional level. On July 1, 1914, the Boston Medical and Surgical Journal published its first issue as the official publication of the Massachusetts Medical Society. Despite this partnership, the Journal suffered from poor management; although an “Advisory Committee” of editors – among them Dr. Gage – was created, they were rarely involved in decision making and the actual editors lacked discipline, frequently publishing notices late or neglecting to include news items. In 1920, the owners resigned after a failed attempt to unite all of New England’s journals under one name, leaving behind a financially risky publication in an already unstable financial climate. The Massachusetts Medical Society seized this opportunity and in April 1921, led by Dr. Gage as Chairman, purchased the Journal and took over its management. As with every project that crossed his path, this new era was indicative of all
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of Gage’s work. The Journal published news both local and international, accepted correspondence from any contributors, maintained an organized directory of members and addresses, and provided updated medical resources. After expanding to represent the New Hampshire and Vermont Medical Societies in 1927, the paper assumed a new name; on February 23, 1928, the first issue of the New England Journal of Medicine was published. In advocating for ownership, Homer Gage guaranteed that all physicians represented by the Massachusetts Medical Society would have equitable access to medical knowledge, decentralizing Boston’s hold on the profession and laying the groundwork for progress throughout New England. More locally, Homer Gage’s family life and business career was central to the industrial development that defined Worcester’s history and left its mark on the city today. Dr. Gage worked for and later became president of his father-in-law’s business, Crompton and Knowles Loom Works, eventually retiring from medicine in 1923 to focus on the company. As in medicine, he quickly became a sought-out counselor by many of his colleagues and used his social position for philanthropic causes throughout the city and abroad. He and his wife, Mabel, had one son, Homer Gage Jr., who followed his father’s footsteps to Harvard and joined the American Ambulance Service in France during the war. Having survived the war and completed his degree, the young Homer Gage died unexpectedly of polio in 1925 at the age of 29. A few years after his death, Mabel and Homer Gage donated $50,000 to the Lincoln Square Boys Club to name their gymnasium after their son. A memorial tile in his honor, bearing the image of children playing and the words of a poem by Sir Henry Newbolt, is still maintained today, although the building has been converted from a high school to housing units. Dr. Homer Gage is remembered today both in the expansive texts written about him and in the physical memorials bearing his name. In Shrewsbury, the neighborhood that housed his and Mabel’s summer home, Iristhorpe, is now the site of Gage Lane, while across town a VFW post and a monument at Elm Street recognize his wartime service. In the mid-1920s, the Homer Gage Library was founded at Memorial Hospital to maintain a collection of resources accessible to physicians, residents, nurses, staff, and the public, filling an educational role that Gage would doubtlessly be honored to provide. As one of the driving forces in the creation of the New England Journal of Medicine, his efforts have led to a culture of collaboration and knowledge sharing across medicine. In obituaries by colleagues, it is clear that he was adored by all who worked with him and left an immeasurable and unique impression in all of the diverse fields he pursued. Above all, Homer Gage remains today an example of what a humanist physician can accomplish in the clinic, in society broadly, and here in Worcester. + Patricia Giunta, MA, is a third-year medical student at the University of Massachusetts. Before career changing, she studied Italian history and art in the era of the Black Death. Email: patricia.giunta@ umassmed.edu.
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Homer Gage, MD: Envisioning the Mass Med Society with a Journal Continued
bibliography:
1. Gage, Homer. “Some Abuses in Surgical Practice.” The Boston Medical and Surgical Journal 169, no. 1 (1913): 1-7.
Rebecca Barnard, MD and Mary Vincent O’Callaghan, MD: Worcester’s Answer to the ‘Woman Question’: The First Female Members of the WDMS Madeline Ryan, PhD
2. Bergin, Paul. “Some Worcester Doctors at the Turn of the Century.” In A History of the Worcester District Medical Society and the Worcester Medical Society 1794-1954. Worcester, Massachusetts: Worcester District Medical Society; 1994; 86. 3. Bergin, Paul. “Some Worcester Doctors at the Turn of the Century.” In A History of the Worcester District Medical Society and the Worcester Medical Society 1794-1954. Worcester, Massachusetts: Worcester District Medical Society; 1994. 4. Cheever, David. “HOMER GAGE.” Annals of Surgery 113, vol. 2 (1941):315-7. 5. Gage, Homer. “Some Abuses in Surgical Practice.” The Boston Medical and Surgical Journal 169, no. 1 (1913): 1-7. 6. Fitzharris, Lindsey. The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine. New York: Scientific American, 2017. 7. Reis, Jacqueline. “Memorial shows Gages’ love of son.” Worcester Telegram and Gazette. August 29, 2010. https://www. telegram.com/article/20100829/ news/8290384 8. Proceedings of the American Antiquarian Society Volume 48, Part 2 (1938): 170-174.
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19th century, the entry of women O’Cahhaghan; bottom: into medicine was hotly debated in Office of Dr. Barnard medical societies across the United States. The Massachusetts State Medical Society first confronted the debate in 1850, when Nancy Talbot Clark, a graduate of the Western Reserve Medical College of Cleveland, requested admission. Dr. Clark’s application was declined, and the MMS effectively tabled the question until 1873, when it sent notices to local medical societies throughout the state asking them to weigh in on the issue. In response, Oramel Martin of the Worcester District Medical Society proposed a resolution that “the wish of [the WDMS] is that women be admitted to all the rights and privileges of the Massachusetts Medical Society upon the same conditions as men.” (1) While the other members did not reject the resolution outright, Dr. Francis proposed an amendment that effectively neutered it, stating “that the present exigency demands no action on our part in regard to the admission of females into the Massachusetts Medical Society.” Dr. Woodward concurred, arguing that “this was only an attempt to drag the Woman Question into the [MMS] and so add another bone of contention for the medical profession.” The debate was finally resolved with a compromise, changing the words of the original resolution to state that the society “has no objection to” the admission of women – a less enthusiastic statement that reflected the contentiousness of the issue. The ambivalence and inertia surrounding the “Woman Question” persisted until 1884, by which time the United States was witnessing a “national trend toward the acceptance of women” in medicine. (2) That year, the By-Laws of the MMS were finally changed to allow female members. A little under a year later, on May 13, 1885, the WDMS
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Medicine in Worcester
Rebecca Barnard, MD and Mary Vincent O’Callaghan, MD Continued
admitted its first women: Dr. Rebecca Barnard and Dr. Mary Vincent O’Callaghan. (3) Despite their exclusion from the local and state medical societies, by the 1880s women had been practicing medicine in Worcester for more than forty years. One of the first female medical practitioners in the city was Maria Ann Barnard, who operated a practice in partnership with her husband, Franklin Barnard, on Goddard’s Row for over two decades, beginning in 1838. (4) The Barnards were students of Dr. Samuel Thomson, whose “Thomsonian system” substituted botanical remedies for the harsh heroic measures that were the mainstay of allopathic medicine at the time. The decision of local and state medical societies to admit women was partly a strategy undertaken to distinguish “legitimate” physicians from the practitioners of “alternative” therapies, such as Thomsonianism, homeopathy, and hydrotherapy. Because of the restraints placed on women seeking a medical education, many turned to these “unorthodox sects,” which were more accepting of female practitioners than regular medical schools. (5) Had she decided to pursue admission to one of the regular medical schools in New England, Maria Ann Barnard would likely have faced the same obstacles that plagued Harriot Kezia Hunt, who launched an unsuccessful campaign to gain admission to the lectures at Harvard’s medical school in the late 1840s. While the school’s dean, Oliver Wendell Holmes, saw no objection to Hunt’s attendance, the male medical students vociferously disagreed. All but one of the medical students signed a petition to block Hunt’s admission on account of her sex. (6) By the 1860s and 1870s, however, the tide had begun to turn in women’s favor. When she decided to pursue medicine following a twenty-year career in teaching, the Barnards’ daughter Rebecca (born in 1837) had a number of options that had not existed for the previous generation. There were now a handful of schools that offered a medical education to women, including the New England Female Medical College (est. 1848) and the Woman’s Medical College of Pennsylvania (est. 1850). However, both of these institutions struggled to secure well-trained faculty and proper facilities due to blacklisting by male physicians. The Woman’s Medical College of the New York Infirmary, opened in 1868, enjoyed a better reputation, thanks in part to the rigorous standards set by its highly educated founders, Drs. Elizabeth and Emily Blackwell. (7) This was the school that Rebecca Barnard chose to attend, graduating in 1878. She practiced in Worcester for several years before becoming one of the first two women admitted to the Worcester District Medical Society. The second of those women, Mary Vincent O’Callaghan (born in 1859), had the additional distinction of being the first Catholic woman to practice medicine in Worcester. Like Barnard, she had worked as a teacher for more than a decade before pursuing a medical career and had a close relative who was a physician: her older brother Thomas, a graduate of Holy Cross and McGill Medical College. After graduating from the Woman’s Medical College of Pennsylvania in 1885, O’Callaghan joined her brother’s practice in Worcester. In 1897, the siblings took on an additional partner: their niece Clara P. Fitzgerald, who had been inspired by her aunt to attend the Woman’s Medical College. The three lived together on Trumbull Street along with Thomas’s wife; the household
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would later expand to include several other nieces and nephews. Mary V. O’Callaghan succeeded her brother as the official physician of the Sisters of Notre Dame de Namur; served as physician for the State Industrial School for Girls at Lancaster and as the medical examiner for the Worcester County Courthouse; and was one of the founding physicians of St. Vincent Hospital. She died in 1930 at the age of 78 in City Hospital of injuries sustained from being hit by a car. At the time of her death, she had been practicing medicine in Worcester for over 40 years. (8) Dr. Barnard had a similarly illustrious career. Described as “a woman of great executive ability and strong character” who was “very generally and favorably known throughout the city,” she ran a “large and lucrative practice” out of her home in the ancient Baldwin Eaton House on Main Street. (9) Like many female physicians at the time, she was active in educational reform, serving as a member of the city’s school committee – a role that drew upon both her medical expertise and her two decades of experience as a teacher. While neither she nor O’Callaghan married, they never lacked for company – O’Callaghan with her large extended family, and Barnard with her long-term companion and “beloved friend” Louisa P. Claflin. Barnard died in 1905 at the age of 68. Barnard and O’Callaghan were only two among many dozens of women who practiced medicine in Worcester in the late 19th and early 20th centuries. Dr. Myrtle Smith, who operated a medical practice on Main Street in the 1910s (later moving to Shrewsbury), wrote that the “early reputation of Worcester as an educational and enlightened center attracted … able and progressive women physicians,” who became “pioneers of medicine in New England.” (10) In the 1870s and 1880s, around 10% of the physicians listed in Worcester’s city directory were women, representing a diverse set of educational backgrounds, personal histories, and specialties. Some existed outside the realm of medical orthodoxy, including homeopaths, metaphysical and magnetic healers, “medical clairvoyants,” botanic physicians, and at least two “Indian doctresses.” Others pursued careers that aimed to match their male counterparts’ achievements in allopathic medicine. After graduating from the Woman’s Medical College of Pennsylvania, Caroline A. Osborne worked at Memorial Hospital and earned a PhD in biology from Clark University, writing her dissertation on the role of sleep in infants’ physical and mental development. (11) Mary Studley, a graduate of Worcester High School
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Rebecca Barnard, MD and Mary Vincent O’Callaghan, MD Continued and the New York Infirmary, became a successful lecturer and writer on medical topics relating to girls and women, advocating physical exercise and practical clothing and arguing that women had the potential to be just as accomplished as men, should they be given the opportunity. Studley herself had been denied a position at Charity Hospital in New York City due to her sex, despite ranking higher than all but two male candidates. Her friends attributed Studley’s 1881 suicide to the “despondency” she suffered as a result of her stymied career. (12) The Worcester State Hospital offered employment to several prominent female physicians in the fields of psychiatry and pathology. Beginning in 1885, the hospital recruited women to head the female department of the institution. Emma W. Mooers served as the assistant pathologist at the WSH from 1897-1902; she later studied under Emil Kraepelin and Aloysius Alzheimer in Germany and became the custodian of the neuropathological collection of Harvard Medical School. (13) Women occupied the ranks of physicians at Memorial Hospital and City Hospital, and female homeopaths worked at Worcester’s Hahnemann Hospital. While the majority of physicians – both men and women – were white, at least one woman of color practiced medicine in Worcester during this time period. Dr. Mary Schuyler may have been the first black woman physician in the city. Born in New York State in 1834, Schuyler came to Worcester in the late 19th century to join her daughter, Luella Coshburn, who operated a successful salon and retail store out of Barnard, Sumner, & Putnam. It is unclear where she received her training; given the obstacles to black women’s medical education, it is likely that she learned the practice of medicine from lay practitioners in her community. According to a contemporary news article, Dr. Schuyler was “well known” in Worcester “on account of the great work she has done among the poorer people of her race.” (14) The admission of women into the Worcester District Medical Society in 1885, while an important achievement, represents just one point in the long timeline of the history of women in medicine in Worcester. Even before Maria Ann Barnard and her husband opened their joint practice in 1838, countless women – their names largely lost to history – took part in traditional, everyday practices of healing, nursing, and midwifery. With the professionalization of medicine that began in the mid-19th century, male physicians began a concerted effort to delineate the boundaries of “legitimate” medicine, thereby delegitimizing the many forms of healing practiced by women and relegating female practitioners to the sidelines. Nevertheless, women continued to strive to gain recognition and forge careers as medical practitioners, both inside and outside of medical orthodoxy. Worcester offered an environment that was relatively welcoming to female practitioners, enabling many to build flourishing practices. These practitioners played a crucial role in proving women’s aptitude as physicians, contrary to contemporary notions that depicted them as ill-suited to the profession, and thus forged the path for generations to come.+ references
+ footnotes:
Medicine in Worcester WDMS, Worcester Historical Museum. “Admission of Women,” Minutes of the Worcester District Medical Society, 9 July 1884, Collection of the WDMS, Worcester Historical Museum. 2. Kirschmann, Anne Taylor (1999). “Adding women to the ranks, 1860-1890: A new view with a homeopathic lens.” Bulletin of the History of Medicine, 73 (3): 429-446. 3. “Censors’ Meeting,” Minutes of the Worcester District Medical Society, 13 May 1885, Collection of the WDMS, Worcester Historical Museum. 4. Obituary: Maria A. Barnard. Undated newspaper clipping, Worcester Historical Museum. 5. Kirschmann 1999. 6. Notably, that same year, only 2/3 of the students petitioned to block the admission of three black male applicants, suggesting that sexual discrimination in medicine was even more pronounced than that of race. Glenn, Myra C. 2017. Women’s struggles to practice medicine in antebellum America: The troubled career of Boston physician Harriot Kezia Hunt. The New England Quarterly, 90 (2): 223-251. 7. Borst, Charlotte G. and Kathleen W. Jones. 2005. As patients and healers: The history of women and medicine. OAH Magazine of History 19 (5): 23-26. 8. Obituary: Mary V. O’Callaghan. Boston Globe, 1 November 1930: 13. 9. Crane, Ellery Bicknell. 1907. Historic Homes and Institutions and Genealogical and Personal Memoirs of Worcester County, Massachusetts. Lewis Publishing Company, New York: 349. 10. Smith, Myrtle. Pioneer women physicians made Worcester home. Worcester Evening Gazette, 11 April 1914: 5. 11. 1910. Clark University Register and Twenty-Second Official Announcement. Worcester, Massachusetts. 12. A woman ruled out on account of her sex. Wilmington Morning Star, 29 May 1872: 2. Our girls. Lake County Star, 27 August 1874: 1. Suicide of Mrs. Mary L. Studley. Boston Globe 7 May 1881: 4. 13. 1911. Obituaries: Emma W. Mooers, MD. Boston Medical and Surgical Journal CLXIV (23): 835. 14. Dodson, N. Barnett. Mrs. Coshburn’s rare privilege: Former Whitehall (NY) girl who married Walter M. Coshburn occupies influential place in the business life of Worcester. Illinois Recorder 22 January 1910: 1.
1. “Dr. Martins’ resolution in favor of admitting women,” Minutes of the Worcester District Medical Society, 12 March 1873, Collection of the JULY / AUGUST 2021
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Medicine in Worcester Mae Salona Holmes, MD & the Belmont Isolation Hospital: She Could Do Everything Michael Urbanowski, PhD
D
r. may salona holmes was born in lee, massachusetts around 1870. With a trace of humor, she called herself a “hill town Yankee”. She studied at Smith College and then at the Blackwell Sisters’ Woman’s Medical College of the New York City Infirmary, where she became a member of an early generation of female physicians in the United States. In 1895 she moved to Worcester Massachusetts for an internship at Memorial Hospital. Her passion was for the treatment of infectious diseases. One year later, at the remarkable age of 25, Dr. Holmes became the superintendent at a new hospital on Belmont Hill. For the next 44 years, she was one of the most influential figures in public health and infectious disease medicine in the City. Unfortunately, her name is not well known, possibly because she led a hospital long since demolished, or maybe because she was a woman working in a field that failed to credit her leadership and genius. Still, her story is both captivating and inspiring and deserves to be told. Approximately half of all US deaths in 1900 were attributed to an infectious cause (compared with approximately 12% in 2020 and 2% in 2019 before the COVID-19 pandemic). In Worcester, pneumonia and tuberculosis reigned “captain” of these causes, but diphtheria, cholera, typhoid fever and even malaria were common. Many cities began to focus on urban health. The Worcester Board of Health received support to build an isolation hospital on Belmont Hill (today, the site of the Worcester Technical High School). In 1896, endorsed by her Memorial Hospital mentors, Dr. Holmes was hired as superintendent and resident physician of the Belmont Isolation Hospital. Under Dr. Holmes’ leadership, the hospital grew from three wooden lodges designed for incineration in case of contamination to nine (ironically) fireproofed treatment buildings by her retirement in 1941. Dr. Holmes was no mere passenger for these changes; rather, she was a creative and passionate advocate for the hospital. In one story, property was donated for the construction of a tuberculosis ward, but the City hesitated in supporting the acquisition. On the day of the city council vote Dr. Holmes called as many of her colleagues as possible and encouraged them, in turn, to persuade their city officials to vote in favor of the addition. In 1914, the result of these efforts was a state-of-the-art tuberculosis building. By all accounts, Dr. May Salona Holmes was a physician’s physician. When asked why she had spent her life working in a hospital, she responded, “… because I liked bedside work, and I liked people.” She was a strong advocate for community health and recalled feeling deep dismay that so many children in Worcester drank unpasteurized milk. Dr. Holmes was also a scholar beyond the scope of her administrative responsibilities. Only five years into her career at the Belmont Hospital, she published an article entitled “A City Isolation Hospital” in The Boston Medical and Surgical Journal (now the NEJM). In this article, Dr. Holmes described the facility and its clinical successes in treating
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diphtheria with newly introduced antitoxin. Her writing in the article is elegant, clear, and unplagued by the stylistic obscurity and elitism that is present in many scientific manuscripts. It is impossible to discuss Dr. Holmes’ extraordinary work without also identifying the marks of obscene sexism that bookended her career. The Board of Health official who hired Dr. Holmes had said, “[of the Belmont Hospital] it’s way out in the country, and no man would stay there… and if we get a woman doctor, she can do just anything.” Similarly, an article published 43 years later in the Worcester Telegram announcing Dr. Holmes’ retirement both commended her many successes while also announcing the trustees’ preference for “preferably a man” successor. Dr. Holmes was neither ignorant nor passive to this sexism. She stated in a 1941 interview, near the end of her career, that the preference for a male doctor over a female doctor was “a prejudice that had never been overcome.” Reflecting on her own hiring, Dr. Holmes said “They chose me for Belmont Hospital [because]… then I could be a housekeeper and do everything… and I did, and liked it.” The contemporary reader might view Dr. Holmes’ response as defeatist or subservient to the cultural
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Medicine in Worcester
Mae Salona Holmes, MD & the Belmont Isolation Hospital: She Could Do Everything Continued norms of the time. Rather, an intricate ethos emerges of an actualized individual who used her many talents to advance the Belmont Isolation Hospital. Beyond her accomplishments, less is known about Dr. Holmes personally. One source suggested that the Belmont Hospital staff would have also liked to know her better. She did have a life-long friend and close personal confidant in Dr. Lois Nelson, another early female physician in Worcester and Dr. Holmes’ mentor at Memorial Hospital. After Dr. Holmes retired at the age of 73, she moved with her niece to Orleans on Cape Cod. During the next year, before she passed away in 1943, she spent time enjoying her rare book collection and growing herbs. The Belmont Isolation Hospital served the residents of Worcester for 15 years after Dr. Holmes’ retirement. The hospital was closed in 1956 in response to decreasing prevalence of infectious diseases. A final anecdote about Dr. Holmes illustrates her character. In 1895, during her residency, she traveled to her hometown of Lee. Familiar residents remarked about how successful she had become and asked whether she thought that a woman could be successful in medicine. Dr. Holmes responded with fierce support for her vocation. One evening, thirty years later, in 1928, Dr. Holmes, by then the veteran superintendent of the Belmont Isolation Hospital, was finishing work in preparation for a well-deserved vacation when she received an urgent call from Lee. A foodborne epidemic had broken out within the town and administrators were requesting her help. Dr. Holmes responded overnight with a team of specially trained nurses and doctors and was able to quickly control the epidemic and treat those who had become sick. Newspapers of the time credited Dr. Holmes’ interventions with saving over a hundred lives. +
Author’s Bibliographic Note: Significant effort in the search and aggregation of primary source documents preceded the Author’s own work on this topic. Special credit is due to Susan McDaniel Ceccacci for her work researching and writing the Historical Documentation Report on the Belmont Hospital Complex (2002). Credit is also due to the web-content authorship team at the Worcester Historical Museum. The Author read each primary source document referenced in this writing. Errors of interpretation, commentary, or content are solely the responsibility of the Author.
Michael E. Urbanowski, PhD (3rd year UMass Medical School Student)
10. Jones DS, Podolsky SH, Greene JA. “The Burden of Disease and the Changing Task of Medicine” The New England Journal of Medicine. June 21st, 2012. 366:2333-2338. Accessed on March 15th 2021 from: https://www.nejm. org/doi/full/10.1056/NEJMp1113569
bibliography:
1. Holmes MS. “A City Isolation Hospital.” Boston Medical and Surgical Journal. July 4th 1901. 2. “City Physicians, Nurses Fighting Epidemic at Lee.” Worcester Telegram. July 11th 1926. Accessed on March 15th 2021 from: https://worcesterhistorical.com/ digital-exhibits/worcester-hospitals/ (Note that the date printed on the article is likely a library error since the Lee Epidemic occurred in 1928) 3. Holmes MS. “Epidemic Septic Sore Throat: II. A Clinical Study of the 1928 Epidemic in Massachusetts” The New England Journal of Medicine. 200:805807. April 18th, 1929. Accessed on March 15th 2021from: https://www.nejm. org/doi/full/10.1056/NEJM192904182001602 4. “Dr. May S. Holmes To Resign May 19.” Worcester Telegram. March 2nd, 1941. Accessed on March 15th 2021 from: https://worcesterhistorical.com/digital-exhibits/worcester-hospitals/ 5. “The Woman Who ‘Did Everything’ At Belmont Hospital.” Sunday Telegram. April 20th, 1941. Accessed on March 15th 2021 from: https://worcesterhistorical.com/digital-exhibits/worcester-hospitals/ 6. “Dr. May S. Holmes Taken by Death.” Worcester Telegram. April 4th, 1943. Accessed on March 15th 2021 from: https://worcesterhistorical.com/digital-exhibits/worcester-hospitals/ 7. “Rites Wednesday For Dr. Holmes.” Worcester Evening Gazette. April 5th 1943. Accessed on March 15th, 2021 from: https://worcesterhistorical.com/ digital-exhibits/worcester-hospitals/ 8. SusanMcDaniel Ceccacci. “Historical Documentation Report: Belmont Hospital Complex, 251 Belmont Street, Worcester, Massachusetts.” January 2002. Accessed by personal correspondence with SM Ceccacci. 9. “Worcester Hospitals” Part of the Digital Exhibits online content of the Worcester Historical Museum. Accessed on March 15th 2021 from https:// worcesterhistorical.com/digital-exhibits/worcester-hospitals/
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Medicine in Worcester Howard Beal, MD: When Duty Calls Dale Magee, MD
M
ajor
howard
beal’s
to readers from Shrewsbury with the school named after him in 1923 and the new one, opening in 2021, continuing to carry his name. Few know that he was a physician. Born in Maine in 1869, educated at Philips Andover Academy and Harvard and trained in surgery and urology at Massachusetts General Hospital, he joined the Army Medical Service upon completing training in 1898 and then served in the Philippines. He came to Worcester in 1902, having married Henrietta Hobbs of Shrewsbury. Upon their marriage, her family provided them with the building known today as the Bull Mansion in Worcester for their home and his office. Here they lived and he practiced, passing the censors’ examination of the Medical Society in 1903 and doing his surgery in Worcester hospitals. In 1912 Beal moved his office to what was then the Peoples Bank building in Worcester at the corner of Main and Pleasant. They moved their home to the Waterlane Farm in Shrewsbury on Lake St. He was someone who felt that he should help wherever there were military conflicts and after his stint in 1898 he advocated with the federal government to establish a Physician Reserve Corps, an effort that was successful after he traveled to Washington and met with military leadership. When WWI started he again felt called to duty even before the US entered in 1917. He volunteered on one of the first Red Cross ships to leave for England in 1914 and served at a hospital in England for just over a year. While there the hospital was visited by Queen Mary who personally thanked him for his service. Returning to the US, he still felt pulled to serve and didn’t fully adjust to his return, not being able to accept the fact that most of those in America were not as compelled by the War as he was. When the US finally committed to enter the War, he spoke at the Worcester District Medical Society on April 11, 1917 and encouraged others to volunteer for the Medical Reserve Corps or to serve overseas. He then shipped out in June, 1917. He was in France on the evening of July 18, 1918 when, in the middle of a battle, with him near the front, a plane swooped low, and dropped a bomb. He was hit by shrapnel and died a few days later. He is buried in France at Suresnes American Cemetery. He was the only combat fatality of the Worcester District Medical Society in WWI. In 1922, after several years of trying to establish a WWI Memorial in Shrewsbury, the committee decided to name various sites in town for those who lost their lives in WWI. With Beal being the highest-ranking soldier to lose his life, and the school having just been completed, it was decided to name the new high school after him as part of the Town WWI memorial effort. name is well known
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I include here some quotes from his obituary from some who were with him: J.H. Perkins, Commissioner of the Red Cross for Europe: “When the horror of 1914 came upon the world, Europe, stunned and bleeding, pulled with ever insistent fingers upon the heartstrings of Dr. Beal. That he deemed this no less than his duty rose daily, uncompromisingly, before him. And so it was that long before all of Europe itself may be said to have realized its peril, he saw his way clearly and made the decision that was to bring him eventually not only the opportunity to help in binding the wounds of tortured humanity but to win for him, ultimately, the death of a soldier hero. At the field hospital after being wounded he was lying perfectly quiet and at first I thought he was asleep, but when I spoke to him he opened his eyes and answered. We had a little talk together. He described his wound and seemed perfectly calm and self possessed. I left him with a feeling that I had seldom seen a finer sight in the way in which a great strong man had met such an accident... He remained conscious in fact up until almost the time of his death and I always preserved the same attitude, fine courage and simple strength.” And from his colleague, Major Homer Gage, MD: “His professional skill, his industry and his good judgment made him an exceedingly valuable man to the community and to the institutions which he faithfully served but to all who had the privilege of enjoying his friendship, it was the character and the personality of the man that can never be forgotten. His modesty and gentleness, his kindness and eager willingness to do for others made him always a delightful companion. His fine presence, charming manners and his thoughtfulness that never lapsed, insured him a welcome in every circle.” About 50 of the letters that he wrote to his wife from July, 1917 until July 1918 survived and were published by a family friend in 1926. In the introduction, his friend, Louise Closser Hale, notes that “he was quick to discriminate between the gaudy and the gay, between trumpeting wrong and unvoiced right, between the lust of slaughter and the necessity for it. He knew the beauty if not the magic of the world that he lived in, the joy of little children and small animals, the soft rose bloom of a shrub. He knew the bitterness and the baseness of the world. This understanding was at once his armor and his hair shirt for his job as surgeon with the Forces of the American Expedition.” A truly heroic man.+
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Medicine in Worcester Clara Barton: An Influential Nurse from Central Massachusetts Joanne Lewis PhD, RN, ACNP-BC
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larissa (clara) harlowe barton was born on Christmas Day in Oxford, Massachusetts in 1821 to Captain Stephen Barton and Sarah Stone Barton. She was the youngest of five children and her older siblings took great interest in her education, as three of them later became teachers. Her father was a military man who taught Clara how to be precise and accurate and instilled a good work ethic. Her older brother, David, was adept at running farms and riding horses, and Clara loved to spend her wild childhood outdoors with him on their 300-acre farm. When Clara was 11 years old, her brother David fell off the roof of the barn and was badly hurt, sustaining a terrible head injury. Clara was instrumental in getting him back to walking and talking- something the local doctor said could never happen. (1) She was smart as a whip and quickly advanced her studies, and at 12-years-old went on to attend Oxford high school taught by Colonel Richard Stone, a wellknown militia officer. Oxford high school was known for its advanced scholars and often fed its pupils directly into Harvard and Yale. (2) Clara was very timid by nature, and her father recognized that while she wouldn’t stand up for herself, she would fiercely stand up for others. He encouraged her to become a teacher, and by the time she was 15, she had proven her extensive knowledge and began teaching at Oxford high school, often teaching men in their 20s. (1) She became a passionate advocate of education for all children and equal pay for teachers. She also worked as a bookkeeper and accountant for her brother, who owned several mills in central Massachusetts. (2) She earned her first teaching certificate in 1839 and after her mother died in 1851, she decided to attend college at the Clinton Liberal Institute in New York. While there, she learned about a lack of public schools in a nearby town so she took it upon herself to open a free school in Bordentown, New Jersey. She was successful for many years and helped teach over 600 pupils. Unfortunately, the school was taken over by a man as it was deemed unfitting for a woman to be in the position of leading such a large institution. Therefore in 1855, she moved to Washington DC and became the first paid female clerk in the US Patent Office. (3)
In 1861, while still living in Washington DC, the Civil War broke out. Barton wanted to help the men injured in battle, for some of these men she had grown up with and even taught. She quickly organized provisions for the wounded soldiers on the battlefield and used her many contacts throughout Massachusetts and Washington DC as suppliers. She finally gained support from Quartermaster Daniel Rucker to work on the front lines in 1862. (4) Barton helped both the Union and Confederate soldiers. She was nicknamed the “Florence Nightingale of America” and the “Angel of the Battlefield.” She worked side-by-side with front-line surgeons at such battles as Cedar Mountain in North Virginia and the Battle of Antietam. At this time, President Abraham Lincoln personally gave her the title of volunteer war nurse, giving her the ability to travel on the front lines without pause. (2) At the end of the war, she discovered thousands of unanswered letters addressed to the War Department from distraught families asking about their missing loved ones. She asked President Lincoln to allow her to respond to these inquiries officially. She ran the Office of Missing Soldiers with the purpose of trying to find or identify soldiers killed or missing in action. Barton and her assistants helped locate over 33,000 lost Union and Confederate soldiers. She used her own money to fund this, but was eventually awarded $15,000 from Congress. (3) From 1865 to 1868, she lectured around the country about her experiences. She met Susan B. Anthony and began working with the women’s suffrage movement. She also became acquainted with Frederick Douglass and became an activist for civil rights. (4) She traveled to Europe in 1868, and it was there that she was introduced to the International Society of the Red Cross. In 1870, she assisted the International Society of the Red Cross and military hospitals during the Franco-Prussian war. She was instrumental in providing public distribution of supplies and received honorable decorations for her work. When she came back to the United States, she lobbied the American government to institute an American branch of the International Committee of the Red Cross. (5) After meeting with President Chester Arthur, she finally gained
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Medicine in Worcester
Clara Barton: An Influential Nurse from Central Massachusetts Continued
support for the American branch. In 1881, she became the first president of the American Red Cross and was determined to respond to crises other than war, such as natural disasters. She went on to assist in the Spanish-American war, floods on the Ohio River, and provided food and supplies to Texas during the famine of 1887. She traveled internationally with the American Red Cross and responded to humanitarian crises in Europe. (6) She also worked until the age of 77 for hospitals in Cuba. She died at her home at the age of 90 in Maryland and is buried in North Cemetery in Oxford, Massachusetts. The house where she was born in Oxford still stands as a museum and is open to visitors. (4) Clara Barton was a true visionary of philanthropy. Her dedication, hard work, executive skills, and caring nature were bestowed upon not only the United States but also on many places around the world. While not having formal training as a nurse, she truly embodied all the elements of nursing. “I may be compelled to face danger, but never fear it, and while our soldiers can stand and fight, I can stand and feed and nurse them.” –Clara Barton (1) + Joanne Lewis PhD, RN, ACNP-BC is a nurse practitioner in General Surgery at UMASS Medical Center, Worcester, MA, instructor in the UMASS Graduate School of Nursing, Worcester, MA, and adjunct faculty at Regis College, Weston, MA. Email: Joanne.lewis2@umassmemorial.org
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references:
1. Barton, Clara. The Story of My Childhood. Baker & Taylor, 1907. Retrieved May 18, 2021. 2. Epler, Percy Harold. The Life of Clara Barton. Macmillan, 1915. Retrieved May 18, 2021. 3. Bacon-Foster, Corra. Clara Barton, Humanitarian: From official records, letters, and contemporary papers. Vol. 21. Columbia Historical Society, 1918. Retrieved May 21, 2021. 4. Pryor, Elizabeth Brown. Clara Barton, professional angel. University of Pennsylvania Press, 2011. 5. Barton, Clara. The Red Cross: A history of this remarkable international movement in the interest of humanity. American national Red cross, 1898. Retrieved May 19, 2021. 6. Schultz, Jane E. Women at the front: Hospital workers in Civil War America. Univ of North Carolina Press, 2004.
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Medicine in Worcester Charlie Monahan and the Mass College of Pharmacy and Health Sciences Anna K. Morin, PharmD
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(charlie) f. Monahan Jr., a life-long resident of Worcester, MA, graduated from the Massachusetts College of Pharmacy located in Boston, MA in 1962, he knew he wanted to own a pharmacy. He worked at Saint Vincent Hospital on Vernon Hill as a hospital pharmacist for a year, saving enough money to purchase and open his first “Monahan’s Pharmacy” store – a small narrow shop on the corner of Main and Beaver Streets, across from Clark University. Charlie made it a point to get to know his customers and enjoyed talking with them. He was constantly in search of ways to improve customer service and opportunities to expand the business. In partnership with his wife Lenny, one store quickly grew into six, including a medical supply store on Main Street. At “Monahan’s Pharmacy” not only could customers get their prescriptions filled, but, depending on the location and neighborhood needs, they could purchase school supplies and lottery tickets, pick up their mail, and pay their utility bills. Home delivery service was also provided. At the height of the business, there were 120 employees, many who were family. In addition to running the pharmacies in Worcester, Charlie was appointed to the Massachusetts Board of Registration in Pharmacy in 1976 and served in various roles until 1986. After serving as a board member since 1979, Charlie was appointed chairman of the Board of Trustees for the Massachusetts College of Pharmacy and Health Sciences in 1991 and in 1997 he was inaugurated as the fifth full-time MCPHS president. His experiences as a business owner and his passion for the profession of pharmacy served as the foundation for his goal to transform and grow MCPHS. Charlie, recognizing a national pharmacist shortage as an opportunity to expand the pharmacy school footprint, had a vision that brought MCPHS to his hometown of Worcester. In the summer of 1999, MCPHS University purchased and renovated the vacant Albert Spencer Lowell building located in downtown Worcester at the corner of Norwich and Foster Streets. This five-story, 102-year-old building was the ideal setting for the second MCPHS school of pharmacy due to close proximity to the city’s two medical centers - Saint Vincent Hospital and the University of Massachusetts Medical Center. The building at 19 Foster Street was renamed after alumna, pharmacist and benefactor Henrietta DeBenedictis and included state-of-the-art classrooms and laboratory facilities; conference rooms; faculty and academic support offices; two auditoriums with multi-media capacity; and the Blais Family library. In fall 2000, the School of Pharmacy-Worcester welcomed its first class of approximately 100 PharmD students. The School of Pharmacy-Worcester/Manchester (a PharmD cohort was added on the MCPHS Manchester campus in 2004) continues to offer a fully accredited, year-round, accelerated hen charles
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PharmD program that allows students to build on their previous bachelor’s degrees or sufficient pre-requisite credits to earn the PharmD degree in just 34 months, compared to the four-year professional phase of traditional PharmD programs. Over the past 20 plus years, the MCPHS University presence in Worcester has grown significantly, expanding to over 1400 students. The Worcester campus includes multiple academic, residential and administrative buildings throughout downtown Worcester and houses the School of Healthcare Business and numerous health profession programs, including the Forsyth School of Dental Hygiene, the School of Medical Imaging and Therapeutics, the New England School of Acupuncture (NESA), the School of Nursing, the School of Occupational Therapy, the School of Optometry, the School of Pharmacy, the School of Physical Therapy, and the School of Physician Assistant Studies. In addition to health and professional education, community service is central to the mission and vision of MCPHS University. For information on the patient clinics and services available on the Worcester campus, please visit: https://www.mcphs.edu/patient-centers. In January of 2020, Charlie Monahan retired from his position as president of MCPHS University after 23 years. Under his leadership, MCPHS University grew from a Boston-based college of pharmacy into a nationally ranked university offering more than 100 healthcare degree and certificate programs. Today, MCPHS University is home to a diverse group of more than 7,000 students and 2,000 faculty and staff across three campuses (Boston, Worcester and Manchester, NH) and online. + Anna K. Morin, PharmD Dean, School of Pharmacy-Worcester/Manchester Interim Chief Academic Officer, Worcester and Manchester Campuses references:
Gonsalves, Susan. Hometown Heroes: Charles F. Monahan Jr. of MCPHS; Worcester Magazine; November 27, 2019 (available at: https://www.worcestermag.com/entertainmentlife/20191127/hometown-heroes-charles-f-monahanjr-of-mcphs) The Bulletin: A Publication for MCPHS University Alumni and Friends. Winter 2019. (available at: https://issuu.com/ mcphspublications/docs/mcphs_winter_bulletin_2019) Johnson, Marguerite (Executive Editor). The Visionary Pharmacist: How a Worcester Boy Transformed MCPHS University. 2016; Ball Consulting Group, LLC; Newton, MA. MCPHS University Strategic Plan: 2018-2023. Available at: https://www.mcphs.edu/about-mcphs/mission-andcore-values. 17
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Legal Consult Re-Opening During the Half-Life of a Pandemic Peter Martin, Esq.
T
he virus known as SARS-CoV-2 is among us and will remain with us always. As the disease caused by that virus ceases to be a pandemic and the virus itself becomes part of the background viral environment, health care providers need to integrate that new reality into their office operations and practices. Keeping in mind potential disease variants and resurgences, practitioners are being forced to re-evaluate a great number of practice issues, some new and some appearing in a new light or with new urgency. What follows is a high-level scan of some of these issues, offered as a guide to stimulate consideration and further action.
The Patients How to encourage patients who may be reluctant to return to the office even for routine care will be an ongoing issue. As always, practitioners are well-advised to listen closely to their patients and family members to understand their concerns and to respond with clear, concise information about health and safety protocols that will deal with patient anxieties as they evolve with the disease’s prevalence. Practitioners should also review which patients have skipped routine visits and reach out to those patients to encourage their return to the office for ongoing care. Telehealth services have been widely adopted where appropriate and will likely continue. Given that fact, providers should review patient consent documents to ensure that patients are informed of the availability, risks, and benefits of such new treatment forms. The continuing availability of the telehealth option will also require providers to make individualized determinations about the appropriateness of recommending telehealth versus face-to-face treatment modes to patients. It is likely that patients will continue to find comfort in the obvious presence of hygienic supplies and distancing practices at the office, as well as common practices as asking for cell phone numbers for contact tracing purposes and maintaining logs of office visitors. It is possible that providers will find it advisable to maintain such practices and procedures even after they appear strictly required by COVID-19; they may become expected precautions during the annual flu season, for example.
The Staff Ongoing compliance with state, CDC and OSHA guidance regarding employment setting safety and health practices will, of course, be required as those rules change over time, requiring ongoing monitoring of the latest issuances of applicable state and federal guidance documents. Certain of these practices may endure even after no longer being required, such as asking staff to do self-screening prior to arriving at the office, re-arranging shifts to minimize the total number of staff in the office at any given time, and adopting new remote working policies and procedures. Providers who have been paid on some form of productivity basis may seek some form of adjustment to their compensation due to an inability to meet bonus thresholds due to no fault of their own. Obviously, a prac-
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tice’s response is going to be primarily governed by the specific contractual terms that establish incentive compensation. Practices may want to review those agreements for fairness and flexibility in anticipation of future pandemics and similar events. The extraordinary costs of COVID-related unemployment claims are paid through the Massachusetts Unemployment Trust Fund; given that Fund’s resultant multi-billion-dollar deficit, Massachusetts employers are and will continue to experience a significant increase in unemployment insurance tax rates in 2021 and beyond. This increase should be factored into practice budgets currently and for the foreseeable future. For those practices with staff members who formerly commuted from other states who are now working remotely, be aware that Massachusetts is extending Massachusetts income tax withholding to those remote workers. This action is being challenged by New Hampshire, but in the meantime Massachusetts employers are required to withhold Massachusetts income taxes from non-residents telecommuting during the pandemic or face significant penalties. Practices should evaluate whether this applies to their staff and whether further remote work benefits both parties, particularly if continuing that arrangement subjects the practice to other states’ laws. Practices are rightly concerned about the vaccination status of staff members, and recent guidance from the U.S. Equal Employment Opportunity Commission permits practices to ask or require staff to show proof of vaccination. However, practices must be careful to reasonably accommodate employees with disabilities and sincerely held religious practices or beliefs that might prevent them from getting vaccinated. Obviously, all information about staff vaccination status must be held securely and confidentially. Practices should be aware that the American Rescue Plan Act of 2021 extended the employee retention credit under the 2020 CARES Act through the end of 2021. The refundable credit against Social Security taxes has been increased to $7,000 per employee per calendar quarter and is now available to employers who suffered a pandemic-related suspension and whose gross receipts for the calendar quarter were less than 80% of gross receipts for the same calendar quarter in 2019 (this was increased from 50% under the original CARES Act). Practices that thought themselves ineligible for this credit under the original statute should re-evaluate that eligibility and compare the benefits under this program versus under the PPP loan program.
WORCESTER MEDICINE
In Memoriam
Legal Consult: Re-Opening During the Half-Life of a Pandemic Continued
Dr. Seymour Solomon
The Office Remote working expands the workspace to employees’ homes, and thus requires employers to adjust their policies and practices to secure electronic assets located in remote locations. Increased use of electronic records increases the threat of hacking and other security breaches. Practices should re-evaluate workstation security protocols and HIPAA privacy policies to adjust to this new reality. Remember that maintaining such new policies requires training and monitoring of remote workers, which is especially challenging. While we emerge from the pandemic, practices may want to establish separate zones in the office space for those patients with and without COVID-19. Practices may also want to maintain cleaning and personal hygiene supplies and PPE in anticipation of possible disease resurgences, keeping in mind previous experiences of supply shortages. In addition to these steps, ongoing attention to office ventilation and higher-frequency cleaning will likely survive the pandemic as a best practice. Engineering controls can reduce the spread of disease and exposure to infected individuals in the office. For example, investing in touchless faucets and dispensers, automatic door openers, replacing electrical switches with motion sensors, and the continued use of plexiglass barriers, where appropriate, may be worthwhile and in time considered standard.
The Money For those providers who have managed to obtain rental payment relief from their landlords, it may soon be time to review whatever payback obligations have been negotiated. The same applies to other ongoing financial obligations that may have been suspended or otherwise modified during the public health emergency. Examples may include vendors, utilities, PPP loans and third-party payers. As a further consideration, the new “work from home” trend may reduce the need for office space, leading to re-negotiation of how much leased space is desirable either now or upon lease renewal. Practitioners providing newly-covered telehealth services will need to monitor any new billing and coding rules applicable to those services. Similar attention should be paid to such rules pertaining to services specific to COVID-19 treatments. It may be prudent to alert practice insurance carriers of a resumption of full-time practice, or if telehealth services will become a permanent part of the practice’s services. Like other businesses, health care providers enter into many contracts, and have found that their, or their counterparties’ performance under these contracts may have been compromised during the pandemic. A review of those contracts’ “force majeure” clauses would now be timely to understand when the parties may be excused from performance under the contract in the event of another pandemic or public health emergency. Budgeting will have to account for increased operational expenses, any anticipated ramp-up in patient volumes, payback of deferred obligations and any financing of capital expenditures. Practices may find that their budgeting assumptions will not be “normal” for quite some time, as the longer-term financial consequences of the pandemic play themselves out. + JULY / AUGUST 2021
W
orcester - Dr. Seymour M. Solomon, 81, dedicated compassionate physician, giving man and avid recumbent cyclist passed away on April 5, 2021. Seymour was well known throughout the Worcester community, seen frequently bicycling throughout the streets of the city and adjacent communities. Seymour was a lifelong resident of Worcester. Born on October 12, 1939, Seymour was the son of the late Barney and Beatrice (Fischer) Solomon. He was preceded in death by his devoted brother, Herbert E. Solomon and is survived by his sister in law, Janet (Schultz) Solomon, and his caring niece and nephew, Beth I. Solomon of Brookeville, Maryland and Edward J. Solomon of Palm Beach Gardens, Florida. Seymour graduated from Classical High School and attended Franklin and Marshall University in Pennsylvania. He completed his medical degree at Tufts University in Boston, with completion of his residency at the Walter Reed Army Medical Center in Washington, D.C. Seymour’s was board-certified in dermatology and internal medicine. He spent greater than fifty years practicing medicine throughout the state of Massachusetts Seymour was a fun-loving, devoted, dedicated son and family man with a kind generosity to all. His compassion to medicine, helping and supporting those in need will always be remembered. Due to the pandemic, private graveside funeral services were held at Worcester Hebrew Cemetery in Auburn under the care of Richard Perlman of the Miles Funeral Home of Holden. Memorial contributions in Seymour’s memory can be made to either of his two favorite charities, St. Jude Children’s Research Hospital, 501 St. Jude Place, Memphis, TN 38105 and Doctors Without Borders, Attn: Donor Services, 40 Rector St., 16th Floor, New York, NY 10006 +
Source: https://www.legacy.com/ us/obituaries/telegram/name/ seymour-solomon-obituary?n=seymour-solomon&pid=198292300&fhid=30544
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WORCESTER MEDICINE
Awards The Gerald F. Berlin Creative Writing Award The Gerald F. Berlin Creative Writing Award at the University of Massachusetts Medical School honors the poetry, fiction and essays of medical students, physicians, in training (interns, residents and fellows), graduate students and nursing students from the medical school. The award was established to encourage creative writing by health professionals-in-training and to honor the father of Richard M. Berlin, MD, who sponsors the award.
Paper Cranes Jesse Sardell
Today she will call
Today she doesn’t care
Her sister
Because today she’ll imagine she’s on
Her son Her old friend from college And gently, patiently wait as they ask how she is So she can pass the conversation back to them And take in Breathe in Every trip to the grocery store stuck in traffic
Not for groceries, nor necessities, nor the Intricacies of human contact A lack of which is
overlook And stay until the parking lot fills And the view gets too crowded to call it her own And she’ll imagine returning home with her heart filled And her mind at ease Today she will not eat
Every bit of time that they have to offer her
Today she will breathe
To share with her
Meditate
As she pushes her mind further
Unsure of whether to focus on
On and on.
The front door is a border she will not cross
To watch the sunrise at the local
Every moment studying for exams or
Away from home Today
her way
everything Or nothing. No matter, for
Today
Today
She does not talk to God
she
She is still waiting on an apology
will
Because for so long she was fighting
breathe
for her life
And it will be enough.
Not
And she didn’t even know it
Until it isn’t.
What the doctor ordered
Didn’t know
Until she craves the sunlight once
But today, she is too tired.
what she now knows.
again, so
She now knows Today
she’s destined to return to the Earth
She will make her way to the bathroom
a little quicker than most.
To sit on the toilet,
Today, she will gaze through the windows at the sparrows, While creating her own paper cranes
Shower, strike a pose
Today
In the mirror
She will have toast
Freeing them across the living room,
Without a hat or a scarf –
And orange juice
Knowing what they are destined to
She’d rather not hide
And try not to dwell on the irony
what she does not have –
Of feeding a body
She’ll imagine passing a hand over her
That will not sustain her
scalp She already knows what it will feel like
and paper planes,
become But still watching every unimaginably graceful twirl
That will not return the favor
As they teeter, tumble, glide
Of trying to save her.
To the floor.
Having done it countless times She already knows what the couch will feel like Even before she lays down to pass the
Today Blind, mindless masses try to devour her, but
day away She will not leave the house today. 20
JULY / AUGUST 2021
Jesse Sardell is an M.D. candidate, class of 2024, at the University of Massachusetts Medical School. Email: jesse. sardell@umassmed.edu
WORCESTER MEDICINE
Society Snippets Scholarship Fund of the Worcester District Medical Society 2021 Scholarship Fund Drive Thanks to the generous support from our 2019-2020 donors, we were able to award twenty medical student scholarships at our 2020 Fall District Meeting. The students, all from Central Massachusetts ranged from second through fourth years and came from five different medical schools. Each one was exceptional, exemplifying our medical society’s values of community service, academic achievement and professional character. The recipients may hail from various medical schools in the country but all are from Central Massachusetts and all share one common pressing burden; student debt. The median debt upon graduation last year was $200,000. Please consider supporting the next generation of physicians through the Scholarship Fund of the Worcester District Medical Society. Your tax deductible contribution, in whatever amount, will allow us to continue this WDMS tradition. CLICK HERE TO DONATE Or Visit our website: www.wdms.org
Calling All Medical Students
2021 Medical Student Scholarships Available We are now accepting applications through September 1, 2021 Awards are based on scholastic achievement, financial need, and community service. Eligible applicants must be a 2nd, 3rd or 4th year medical student attending an accredited allopathic or osteopathic school and a legal resident of Central Massachusetts at the time of applying to medical school. May not currently be on leave, in a gap year or a degree program such as an MPH or PHD, or a fellowship year (Ie: student research, global health, etc.) at the time the award is dispersed. CLICK HERE FOR MORE INFORMATION AND TO COMPLETE AND SUBMIT AN APPLICATION
Or visit our website: www.wdms.org Questions? E-Mail: MBoucher@wdms.org Call: 508-753-1579
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JULY / AUGUST 2021
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