Tulane University School of Medicine - T Wave Yearbook (New Orleans, LA)

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Charity Hospital Complex circa 1940. The old Information wing has y been converted to the Cloaca Caf6 -J ji T - r- -I-- — many new clinical departments at Tulane. A special Tulane service was also initiated at Charity. Long made no attempt to block this move, yet in 1930 he abruptly dis- missed Dr. Alton Ochsner, then Chairman of Surgery at Tulane, from Charity, alle- gedly because of Ochsner ' s complaints about political constraints placed on his attempts to build a first-rate Surgery De- partment at Tulane. The Long-Ochsner- Vidrine affair, together with Tulane ' s fail- ure to award Long a law degree that he desired, quite possibly played a role in the establishment of the Louisiana State Uni- versity Medical School at that time. In addition, Long enriched his campaign funds by a systematic five-percent de- duction from the salaries of all Charity employees, the so-called deduct box. It had been clear for many years that the Charity Hospital building, then 100 years- old, again needed to be replaced. Following Long ' s assasination on September 9, 1935, Sister Stanislaus (1865-1949), a former Mother Superior for the Daughters of Charity who ser ed the sick faithfully. federal funds became available to build the current Charity Hospital, completed on June 27, 1939. During the World War II years at Charity, a reorganization act was passed in the state legislature to create the Department of Institutions. This administrative branch was to manage all state hospitals, causing a great deal of political bickering. Governor Sam Jones threatened to close the Hospital in 1942, and parts of it were actually closed for a while. By 1943, 400 Charity physi- cians entered the armed services, and in 1944 there were only 131 interns and residents to staff the entire hospital. Cha- rity ' s Anesthesiology Department and Blood Bank were also organized during these years by Dr. John Adriani. ' -22 --TW W ..

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condition. However, this was interpreted to mean only that care would be provided on an equal basis, and did not prevent the de- velopment of separate wards for whites and blacks later in Charity ' s history. Another important advance occurred at Charity in 1885 when the first ambulance service was inaugurated. Until that time, the sick travelled to Charity in horse-drawn wagons or similar bumpy transportation that hardly benefited the patient. The tradi- tion of Charity interns riding in ambulances lasted for almost 100 years, and was only discontinued in the 1960s. Many new additions were made to the Charity complex around the turn of the century, and the hospital probably con- tained almost 2,000 patient beds. Other hospitals in the city had perhaps only 150 beds combined, including even the larger ones such as Touro Infirmary and Hotel Dieu with 50 to 60 beds each. The population of New Orleans increased almost 30-fold between 1832 and 1926, while Charity ' s bed capacity had less than doubled. It was during this period that the Hospital was forced to place two patients to a bed, and sometimes even a third patient on a lower mattress near the floor. The conclusion of World War I in 1918 signaled the arrival of another war — that between School of Medicine and Charity Administrators, as increasing hostilities came to the fore. But the worst was to come as Huey P. Long ' s and subsequent admini- strations came to power. After Long was elected in 1928, he immediately introduced a bill in the legislature allowing the gov- ernor to reorganize and apppoint a new Charity Hospital Board of Administrators. He removed Charity ' s Superintendent, and replaced him with Dr. Arthur Vidrine, a 29 year-old Rhodes Scholar who was engaged in rural general practice. Medical education had became more complex, leading to the establishment of Dueling Doctors The mid- 1800s was the age of dueling, and many encounters between physi- cians and even professors at the Medical College took place, each of which repre- sents a story in itself. As an example, one acrimonious duel involving Charity Hospital physicians was fought in 1856 between bitter professional rivals, Drs. John Foster and Samuel Choppin, es- sentially stemming from the proper treatment of a medical student who had been shot by a law student in a Carnival ball fracas. Luckily, both Choppin and Foster missed each other when firing their shotguns, and the entire matter was settled without further ado. Three years later, however, Ch oppin and Foster were at it again. For this duel Foster armed himself with a self-cocking five-valve revolver and Choppin with a single-valve Derringer in each of his pants pockets, as well as a Bowie knife in a coattail pocket. Before Choppin could cock his pistol, Foster shot him through the neck, injuring the jugular vein. Dri- ven back several feet, Choppin ' s right pistol discharged, wounding his own left hand. Foster shot again, penetrating Choppin ' s upper thigh. Choppin then drew his other Derringer and fired at Foster who had turned to fire at him. Fortunately both missed. With his guns empty, Choppin drew his Bowie knife, and with blood streaming from his neck, charged at Foster. Foster was reluctant to kill his wounded opponent, and simply waved his revolver, imploring Choppin to stop. Luckily for Choppin, medical students at the scene rushed to his defense and separated the two men. C hoppin ' s lacerated jugular vein was promptly repaired and his other injuries treated. Foster was arrested, jailed over- night, and released the next day as Choppin, who made a fuU and speedy recovery, refused to press any charges against his opponent. First ambulance service in New Orleans. — pm W miW spttal T -W V 2 1

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At war ' s end in 1945, problems involving interrelationships developed not only for Charity, but also for the medical schools. The Ochsner Clinic had emerged as a large medical institution employing many of Tulane ' s faculty and developing its own residency training programs. The Veterans Administration Hospital also developed a residency program that further competed with Charity. With the rise of LSU Medi- cal School, the old controversies between Tulane and Charity were now simply extended to it as well. In the late 1950s many sweeping changes were considered for Charity and its asso- ciated schools. In the 1960s the ugly matter of segregation was faced and the colored and white wards that were on separate sides of the hospital were eliminated. By the late 1960s financial problems for the Hospital and both schools were paramount, particularly as Tulane was increasing its residency affiliation with hospitals other than Charity, likely for political and finan- cial reasons. The crucial nature of the • situation prompted the governor to visit Charity, and the hospital ' s director de- scribed it as having slipped from a position of national leadership as a teaching center and medical institution for the poor, to a position of inferiority. He warned that the tight money situation a Charity had begun to have an adverse impact on the life blood of the institution, namely its intern and residency programs. The director stated that if the numbers of residents continued to decrease, the hospital would soon be in serious trouble. Attempts were therefore made to improve the situation. The Health Education Authority of Louisiana was established to revive the entire Tulane-LSU-Charity Hospital complex; some progress was made, but Charity remained essentially unaffected. The Department of Health Human Resources, was also developed during the 1970s and control of Charity Hospital was moved to this large umbrella agency in Baton Rouge. . In 1974 LSU and Tulane signed an affi- liation agreement with Charity providing that at three-year intervals the schools M Dr. Alton Ochsner leads a Bullpen session in the 1950s. would alternate naming a medical direaor with an associate director being appointed by the other school. Under the new plan, a lay administrator was named as well. Other important contracts were signed with Charity at this time whereby the deans of the schools were reimbursed to pay faculty members for performing hospital funaions. Woefully inadequate financing continued at Charity, however, and the hospital has lost its accreditation on several occasions since 1975. This was threatening, not only for Charity, but for both schools and the entire medical education process. At present the Hospital ' s grossly inade- quate financing appears to be worse than ever despite a consistently high inpatient census and an outpatient clinic load that borders on intolerable. During the last year alone there have been several severe cuts in the hospital ' s budget. The situation at Charity has led to alleged poor working conditions for physician and student alike, and to reprimands by national residency review and accreditation comminees. And while many plans for problem solving are currently being developed, but the question remains, Is this grand old insti- tution a nineteenth century anachronism or can it be properly financed, funded, and equipped to provide the excellent care for patients and teaching opportunities for medical students that it has in the past? Although the future cannot be predicted with any accuracy, one can only hope that future administrations will act favorably on initiatives to improve the relatively poor state of affairs that currently exists. Times-Picayune editorial cartoon that acknowledged Charit s current tunding crisis. mtory of Choflfy Nospifal T-Wove 23