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History of The Johns Hopkins Hospital
Johns Hopkins: The University's Founder
Johns Hopkins was born in 1795. He inherited his unusual first name from his grandfather, who was named after Johns' great grandmother, Margaret Johns.
When Johns was 17, his mother sent him off to Baltimore to work for his uncle, a wholesale grocer. Speaking to her son just before he left, Hannah Hopkins made one of the greatest understatements on record: "Thee has business ability."
After working for his uncle, Johns went into business for three years with a friend, and then with three of his brothers, forming a wholesale provision house called Hopkins Brothers. The firm shipped whiskey into Baltimore in exchange for staple supplies that were shipped back to Western whiskey makers. Hopkins Brothers sold the whiskey under the brand name Hopkins Best.
Johns was to go far beyond shipping whiskey, however, as he was a genius at investing and lending. Two projects that particularly interested him were building warehouses around the harbor, and financing the Baltimore and Ohio (B&O) Railroad, of which he became the largest stockholder.
On Christmas Eve 1873, the life of this famous Baltimorean merchant came to an end, but Johns Hopkins' death marked the birth of two of America's greatest institutions. His will instructed that his fortune of nearly $7 million should be divided to establish The Johns Hopkins University and The Johns Hopkins Hospital. The University and Hospital seem fitting achievements for the life of Johns Hopkins. His Quaker upbringing helped him to develop a sense of charity. Johns was not able to receive the education he longed for, so he wanted to provide a University for others. Seeing the epidemics that ravaged Baltimore caused him to realize the need for a hospital. His business ability earned him the funds he needed to provide education and health care to citizens of Baltimore and the world.
The University was incorporated under the terms of Johns Hopkins's bequest, and instruction began in 1876.
Daniel Coit Gilman, a graduate of Yale in the class of 1852 and president of the University of California, was elected first president of The Johns Hopkins University. After a year of study, Gilman and the trustees decided to establish Hopkins as a research institution on the European model, with distinguished faculty and focus on graduate work. In his inaugural address, Gilman elaborated his philosophy of education, in terms both prophetic and practical, which was to become the guiding principle of the University. During President Gilman's 25 years of enlightened leadership, his high hopes came to full fruition. It was in this environment of the first true university in America that the School of Medicine evolved.
The School of Medicine
The School of Medicine was opened in 1893, 17 years after the founding of the University The delay resulted in part from the trustees' wish to have a fully equipped hospital before students were accepted. The Johns Hopkins Hospital was completed in 1889, and from the outset its destiny has been inextricably woven with that of the School of Medicine. This policy was established in a letter from Mr. Hopkins to the first trustees of the Hospital. "In all your arrangements in relation to this hospital," he wrote, "you will bear constantly in mind that it is my wish and purpose that the institution shall ultimately form a part of the Medical School of that university for which I have made ample provision by my will." Unfortunately, what was ample in 1867 was no longer so 20 years later.
The Department of Medicine
The Department of Medicine began auspiciously with the recruitment of its first chairman, Sir William Osler. Osler, perhaps the most renowned physician of his time, centered the training program upon the importance of bedside teaching.
A master clinician, author of the historic Principles and Practice of Medicine, and a warm and gracious mentor, Osler attracted talented men and women to Johns Hopkins for medical training. Each of the 11 Chairman who have followed Osler have helped the Department flourish not only by responding to the challenges of the times, but also by adhering to the Oslerian principles of the primacy of the patient and the importance of patient-based education. For example, under Dr. A. McGehee Harvey (1946-1973) the Department greatly expanded by establishing most of the current 13 divisions. Dr. Victor McKusick (1973-1985) founded the Firm System, which helped an enlarged residency program maintain the collegiality for which the program had been noted. During Dr. John D. Stobo's tenure (1985-1994) the Department's research activities grew rapidly. Dr. Edward J. Benz, Jr. (1995-1999) helped the Department maintain a patient-centered focus of training while responding to the challenges of managed care. Dr. Myron Weisfeldt became chair in 2001 and has renewed and strengthened the efforts to ensure that the Osler housestaff will once more provide the leadership for academic medicine in this country.
Women at Hopkins
In the end, the establishment of the school was made possible by the generosity of a number of Baltimore women, of whom Miss Mary E. Garrett was the principal donor. This allowed women such as Florence Sabin, Helen Taussig and Gertrude Stein to attend medical school at Hopkins at a time when many other institutes were closed to them.
The first woman to be awarded a degree was Florence Bascom, who received a Ph.D. in geology in 1893. The difficult and case-by-case admission of women scholars to the non-medical portion of Hopkins continued through 1907, when women were finally officially admitted to graduate programs at Hopkins.
The admission of women to undergraduate study was not a pricing issue for Johns Hopkins until well into the 1960s and early 1970s, when many elite all-male institutions such as Harvard, Yale, and Princeton changed their admissions policies. In 1969, a committee of students, faculty, and members of the administration strongly recommended admitting women undergraduates This recommendation was subsequently approved by the Academic Council and Board of Trustees. In September 1970,90 women broke a 94-year-old tradition at Johns Hopkins and entered the university as candidates for bachelor's degrees.
The Osler Medical Service
Few individuals exercised greater influence on American medicine than did Sir William Osler, clinician and teacher, the first Professor of Medicine and Physician-in-Chief at Hopkins.
Osler was born in Canada in1849, the son of a clergyman. He received his medical degree from McGill University, than traveled to Europe to study. He returned to teach at his alma mater before moving to the University of Pennsylvania as professor of medicine for five years. At the opening of the Johns Hopkins Hospital in 1889, Osler accepted the position of Physician-in-Chief. He quickly established a reputation as clinician, humanitarian and teacher. He presided over a rapidly-expanding domain. In the Hospital's first year of operation, when it had 220 beds, 788 patients were seen for a total of over 15,000 days of treatment. Sixteen years later, when Osler left for Oxford, over 4,200 patients were seen for a total of nearly 110,000 days of treatment.
Soon after coming to Baltimore, Osler began making dramatic, progressive changes in medical education. Until that point medical school consisted of basic science classes and didactic lectures where professors examined patients in large amphitheaters while students observed from above.
Osler established the full-time, sleep-in residency system whereby staff physicians lived in the Administration Building of the Hospital. As established, the residency was open-ended, and long tenure was the rule. Doctors spent as long as seven or eight years as residents, during which time they led a restricted, almost monastic life. Osler's contribution to medical education of which he was proudest was his idea of clinical clerkships--having third and fourth year students work with patients on the wards. He pioneered the practice of bedside teaching making rounds with a handful of students, demonstrating what one student referred to as his method of "incomparably thorough physical examination."
Osler's public speaking and writing were both done in a clear, lucid style. His most famous work, The Principles and Practice of Medicine, 1,079 pages of medical knowledge, quickly became a bible to students and clinicians alike. Osler's essays were important guides to physicians. The title of his most famous essay, Aequanimitas, espousing the importance of imperturbability, is used on the Osler housestaff tie and scarf.
Osler was a true Renaissance man -- a physician, clinician, pathologist, teacher, diagnostician, bibliophile, historian, classicist, essayist, conversationalist, organizer, manager and author. He established a tradition at Hopkins that became the goal of those who succeeded him.
The Johns Hopkins Hospital Today
Today, the Hospital complex is a collection of more than a dozen "mini-hospitals" and centers, 37 buildings, 226 separate clinical services and more than 1,000 beds sprawling over half of the 44 acres housing the Johns Hopkins Medical Institutions in East Baltimore. A new 420,000 square-foot Outpatient Center opened in May 1992, to consolidate and enhance outpatient treatment facilities. In 1999, a new Comprehensive Cancer and Research Center opened that consolidated cancer-related clinical and research facilities into two new buildings. The best patient treatment and family support facilities combined with ultramodern laboratories provide the ideal cancer research and treatment center for the 21st century.
The Hospital, along with its sister institutions, welcomes an estimated 10,000 visitors and employees each day. It is the work site of some 1,600 physicians, 600 residents and 1,500 nurses who provide 292,000 days of inpatient care each year, as well as services for 397,0000 outpatient visits and 85.000 emergency cases.
The Quest Continues
Johns Hopkins Medicine has recently launched one of the largest and most expensive private building campaigns in Maryland history – a $1 billion dollar reconstruction of its 52-acre East Baltimore medical campus. The plans calls for the construction of 2.2 million square feet of space over the net 7-10 years. It includes research facilities, a children’s building, maternal building, a cardiovascular and critical care tower, and renovation or demolition of many other structures.
As the practice of medicine has changed since Hopkins opened in 1889, administration remains committed in moving the hospital into a new era that will more closely integrate treatment, research and teaching in ways to adapt to future clinical technological and research advances.