A Place Alive

A Quarter Century of Stories from Hopkins Medicine, 1976-2001:
25 Years on Campus

[Related Articles: "25 Years of Medicine," "25 Years at the Bench," "25 Years of Building"]

March 1976
In the Beginning
In the six months since I have assumed the job of dean of the Johns Hopkins School of Medicine, I have become aware of the need for a publication specifically directed to all of the people who have spent an important portion of their lives at Hopkins. To remedy this, the leadership of the Johns Hopkins Medical and Surgical Association has agreed to join with the Medical School and Hospital in sponsoring a new publication, Hopkins Medical News.

—Dean Richard S. Ross

January 1977
Up Goes Medical School Tuition
Johns Hopkins University trustees broke with history when they announced that candidates for the doctor of medicine degree will pay more than other Hopkins students next year. Although the University tuition figure will go up to $3,750 (an increase of $250), the new figure for the School of Medicine’s M.D. program will be $4,200 (an increase of $700). According to Dean Richard S. Ross, the increase is necessary because of a drastic reduction in teaching support funds from the federal government and the possibility that the School of Medicine may elect to reject all such funds in the future as the price for maintaining independence from new government regulations.

September 1977
A Need for Charismatic M.D.’s
Concerned that many skills necessary for today’s physician are not measured by medical school admissions procedures, Hopkins has joined a group of medical schools, testing services and foundations that has initiated a three-year research project to design tests for measuring problem-solving and interpersonal skills.

Since the nature of a physician’s interaction with a patient may influence the course of treatment, the schools determined that there is a need to develop methods for measuring these interpersonal factors and to study their relationship to the performance of physicians in clinical practice.

November 1978
A Day of "Holy cows!"

1978: Ham Smith and Dan Nathans address the world as Nobel Prize winners.

There have been many firsts to come to the Johns Hopkins School of Medicine, but on October 12, 1978, all the other firsts seemed to fade. Daniel Nathans and Hamilton O. Smith, along with a Swiss colleague, Werner Arber, had been named Nobel laureates in Medicine for 1978. Nathans and Smith have the singular honor of being the first to receive the Nobel Prize while on the Hopkins staff. The news came with a call from a reporter at 8:30 a.m.

Both men smiled. Both obviously pleased. Both still somewhat surprised—even stunned. Escorted to their laboratories, the doctors casually allowed television crews to film the two of them working in the quarters where they are most comfortable.

The filming ended, and Nathans and Smith retreated to Nathans’ office. More interviews had to be scheduled for tomorrow.

"I would like to get a bite to eat," said Nathans quietly. "We’re still waiting to get official notification from Stockholm." It came.

"Their lives will never be the same," one onlooker said to another.

1980: With the opening of the Cooley Center, for the first time med students had workout facilities.

November 1980
Cooley to Keep in Shape
The Denton A. Cooley Recreation Center is slated to be dedicated on March 13, 1981. Included in the new building, directly behind Hampton House, will be a gymnasium, elevated running track, squash courts, racquetball courts, saunas, weightlifting room and a whirlpool bath.

November 1982
Psychiatry and Neurosciences Break the Barriers
In October, Johns Hopkins dedicated the Adolf Meyer Building, a $42 million center, and became one of the first major medical centers in the world to bring the specialties of psychiatry, neurology and neurosurgery under one roof. As the once distinct boundaries between mind and body, between a nerve cell and a thought, have increasingly blurred, Hopkins has united work on disorders of the brain and nervous system.

January/February 1983
A Journal Dies
The Johns Hopkins Medical Journal ended publication on December 20, 1982. Founded nearly a century ago, the journal was the first university-affiliated publication devoted to disseminating the results of basic and clinical medical research.

Fall 1983
Shakespeare and a Year Off
On July 1, Hopkins started a new admissions policy called the Flexible Medical Admissions Program, or simply, FlexMed. The program is designed to encourage students to take a more flexible approach to senior-year courses or to take time out between college and med school to broaden their experiences and background.

Fall 1984
Enter Francis Scott Key
The city of Baltimore has transferred ownership of Baltimore City Hospitals (BCH) to Johns Hopkins. In July, BCH officially was renamed Francis Scott Key Medical Center, a Johns Hopkins Medical Institution, during ceremonies on the Medical Center complex.

Winter 1988
AIDS, the Plague of the 80s
It all happened within a month. A Hopkins nurse was suspended for three days after she refused to scrub for heart surgery on a patient infected with human immunodeficiency virus (HIV). A pregnant woman, accidentally shot with a hunting arrow, bled heavily as rescue workers tried to save her. Then an autopsy revealed she was HIV-positive. A cardiology fellow and a nurse who tested positive for HIV filed lawsuits against Hopkins for charges ranging from breach of confidentiality to negligence.

Such incidents, and the emotions they stir in those who must deal with them, reflect the new and troubling issues facing any hospital confronted with the AIDS epidemic. Despite them, one thing stands clear, says a longtime Hopkins physician: "If you’re not ready to take care of HIV-infected patients, you shouldn’t be in this business."

Hopkins plans to expand its nine-bed AIDS unit, an outpatient clinic that treats 700 patients, and scientists armed for a major assault on the disease with $40 million in research and education grants. But taking on this leadership role has not been without cost.

"The nerves at this place are very raw because of all the things that have happened," says John G. Bartlett, chief of the Division of Infectious Diseases.

Fall 1988
Smoking Moves Outside
About once a week all spring, Fran Stillman and Don Hantula counted cigarette butts in ashtrays and flowerpots at 40 sites throughout the Hospital. "Sometimes there were Hundreds," says Stillman, a co-director of the Hospital’s Smoking Project. "We’d clean them out and come back later, and count again." Their goal was to assess every aspect of smoking in the Hospital, and they had just a few weeks left to do it. Come July 1, smoking inside the Hospital walls would become a thing of the past. Verboten. No more "designated smoking areas."

Before the ban, smokers would often light up in a sanctioned smoking area, then take the lit cigarette with them to other parts of the Hospital. It was difficult for non-smokers to get to a smoke-free oasis without encountering smoke. Patients would walk into the cafeteria through a haze of smoke. Some of them were on respirators and had chronic pulmonary disease.

Spring 1989
The JAMA Issue

1989: To celebrate the Centennial of Johns Hopkins Medicine, timed to the 100th birthday of the Hospital, Baltimore's Convention Center was transformed into a glittering fantasyland of balloons and dome-topped towers.

In an unprecedented commitment of editorial resources, The Journal of the American Medical Association will dedicate its entire issue of June 2 to the Centennial of Hopkins Medicine. All JAMA’s articles and features for the issue—including original scientific contributions, reviews, commentaries and editorials—will be from or about Hopkins faculty and staff.

"This is the first time in its 106-year history that JAMA has dedicated an entire issue to one institution," stated a letter to the faculty written jontly by Dean Richard Ross and the JAMA editor. "(It) will be a lasting tribute to Hopkins Medicine, past, present and future."

JAMA is the world’s most widely read medical journal. Its familiar fine-art cover and contents reach more than 600,000 physicians, including those who read its 11 international editions.

Summer 1990
Drug-Testing Doctors
Hopkins will soon become the first hospital in the country to begin routine, mandatory screening of its physicians for drugs, including alcohol, tranquilizers, barbiturates, cocaine, marijuana and opiates.

"We don’t think we have a special problem with drug use," says neurologist Hamilton Moses III, vice president for medical affairs. "However, because of concern about drug use in this country and a lack of specific information about prevalence among doctors, the Hopkins medical board felt action was needed "to protect our patients and reassure ourselves that we have done everything possible to discourage drug use among the staff."

Ross on Deaning
When he became dean of the School of Medicine, the average tenure for deans was three or four years. That was 15 years ago. Now, Richard S. Ross discusses, among other things, what he’ll miss (and won’t miss) about the job and his thoughts on deaning.

How would he explain the job to one of his four grandchildren? "A dean deals with people, and tries to provide leadership and direction in a very diffuse organization. A dean tries to avoid saying no any more than absolutely necessary—but is willing to say no when he has to. And the dean is responsible for providing an environment for the creative activities of research, teaching and patient care.

"So that means you also have to be concerned with money and space, the ingredients of the facilities," he continues. "I’m not sure a grandchild could understand that at the age of four."

Over the last few months, candidates for his job have asked Ross if he has enjoyed being dean. "My standard answer has been, ‘Yes, 51 percent of the time.’ But, it’s really much better than that—possibly 52 percent."

Spring 1991
The Prudential Plan
Another sign of changing times in the health care market: The Johns Hopkins Health Plan is being sold to Prudential Health Care, a subsidiary of the Prudential. Prudential is acquiring the insurance company functions of the Hopkins health maintenance organization: membership rolls and the marketing, enrollment, claims processing and client service operations.

When AIDS Hits Home
Rudolph Almaraz, a highly regarded Hopkins-affiliated breast surgeon, died of AIDS in November, at age 41. His death set in motion a maelstrom of events and emotions. For months, rumors about Almaraz had circulated, until finally reaching the ears of Baltimore Sun reporters. Their story appeared on Sunday, Dec. 2, the lead article on the front page.

In the article, lawyer Marvin Ellin, who represented the family, confirmed what Hopkins officials and Almaraz’s colleagues had been unable to ascertain: "He had AIDS, and he died of AIDS." And epidemiologist Timothy Townsend, senior director for medical affairs at Hopkins, revealed that the Hospital had made repeated efforts, beginning in the summer of 1990, to determine whether Almaraz was ill and the nature of his illness.

In all the commotion, one fact has stood basically unchallenged: The risk to patients of acquiring HIV, the AIDS virus, from a doctor is infinitesimally low.

Fall 1991
Hopkins Takes Over as No. 1
In a survey for U.S. News & World Report, nearly 1,000 physicians have rated Hopkins among the nation’s best hospitals in 13 out of 15 specialties, making it the No. 1 hospital in the nation. Hospital President Robert M. Heyssel accepted the news with fine Hopkins aequanimitas, grinning as he told a reporter: "We were No. 2 last year, and I always figured that was a mistake."

Spring 1992
On Leaving the Helm
Bob Heyssel leans back in his chair, arms crossed, looking corporate in a charcoal pin-striped suit accented by red tie and gold pen, and deliberates before he responds. The answer, when it comes, is characteristic—careful, direct, clear-thinking and tinged with impatience. This is the man who, over the last two decades, has guided the Hospital through some of its most turbulent years. The hand on the tiller has been steady, agree colleagues.

His longtime friend Edward Halle, senior vice president of the Hospital and Health System, ranks Heyssel as "outstanding" at seeing into the future: "Changes are apparent to him long before they are to most people," he says. Heyssel foresaw the dramatic decrease in length of stay. He also predicted increasing market penetration by HMOs.

Fall 1992
An Outpatient Center
It’s brand new, it’s spacious, light-filled and modern, and to many at Hopkins, the $140 million facility represents the future of medicine.

Winter 1993
Mountcastle Gives Up His ‘Heart’s Treasure’
Vernon Mountcastle, a familiar figure around Hopkins—white-haired, low-keyed and gracious, with a Virginia accent and, usually, a long white lab coat—retired this summer after more than a half-century here, of work that has paralleled, and in some instances, shaped, the development of the field of neuroscience.

Mountcastle’s career has been spent, he has said, listening to single nerve cells, considering the link between the mind and brain, and the impossibly intricate network of functions that enable us not merely to sense the world but to make sense of it, to respond not simply with movement but with complex behavior.

Winter 1994
Hillary and Husband at Hopkins

1994: The Clintons share private thoughts during their visit to Hopkins to promote Hillary's ill-fated health care plan.

Back at JHU just four months after her June visit to kick off the School of Medicine’s 100th birthday celebration, Hillary Rodham Clinton brought along her husband this time to see the place that she said "represents the past, the present and the future of health care."

But despite dizziness over yet another "royal visit," officials here were only cautiously optimistic about what the Clinton health-care proposals might mean. Dean Michael E. Johns, M.D., said the plan clearly poses threats to academic health centers because their mission to educate and conduct research forces them to charge more for treatment. They also see more seriously ill patients than community hospitals, again adding to their costs.

Spring 1994
Life Beneath Broadway
One hard hat refers to it as the Taj Mahal of subway stations; an architectural critic reports that it reveals new levels of sophistication for such projects. It’s the almost finished Broadway subway station beneath Johns Hopkins, soon to connect the medical campus to the city’s downtown and points beyond. When it opens, just about a year from now (one year behind schedule), it will become the second largest terminal in the Baltimore Metro system and the only one connected by a pedestrian passageway to a major facility.

Fall 1994
Speaking with One Voice
Call it the splicing of Johns Hopkins. Call it a concept, a framework, a think tank, a collaboration, but not a legal entity. Top leaders have unveiled "Johns Hopkins Medicine," the title of a new "seamless alliance" between the Hospital and the School of Medicine that will integrate health care delivery at the nation’s foremost medical center.

Winter 1997
New Man at the Top
"Good morning. I’ve called you together today to tell you that the Johns Hopkins Medicine board of trustees yesterday afternoon unanimously named Ed Miller the first CEO of Johns Hopkins Medicine and dean of the School of Medicine."

With those words, University President William R. Brody brought department directors the news they’d been waiting for for almost a year: the name of the person who would lead them into the 21st century at the helm of both the School of Medicine and the Hospital/Health System.

The faculty’s response to the historic appointment was delirious. Physicians had been working with Miller since last spring when he became acting dean. Miller’s friendly, consensus-building leadership style quickly earned physicians’ trust by demonstrating it was possible for the School of Medicine and the Hospital, under Ronald Peterson, to work together on tough health care issues.

Fall 1998
Goodbye to a Sage of Medicine
A. McGehee Harvey, mentor to generations of Johns Hopkins medical students, physician to world leaders, and a prolific medical historian and archivist, died at The Johns Hopkins Hospital May 8 following a stroke. His wife of 41 years, Elizabeth (SOM ’43), and four children were with him.

Be relentless, Harvey used to advise young physicians, in tracking down every scrap of information about a patient’s illness. Constantly evaluate and analyze your diagnosis, and don’t be too proud to change it if you reach the wrong conclusion at first.

Winter 2000
Farewell to a Quiet Man
One of Hopkins’ most revered citizens, Daniel Nathans, quiet, reserved Nobel laureate, mentor and champion who served as interim president of the University in the mid-1990s, died of leukemia in his Baltimore home on Nov. 16, 1999.