The Massachusetts General Hospital

Andy H. Hung, MASc
Northwestern University, Chicago, Illinois, United States (Summer 2014)

 The Massachusetts General Hospital Bulfinch Building in 1941
The Massachusetts General Hospital Bulfinch Building in 1941

The performance was about to begin. The great glass dome lit up the open center stage with bright skylight. It was October 16, 1846, a time in history when surgeons performed their art before spectators, and the audience was about to witness a historic performance. William Morton, a 25-year-old dentist, asked Edward Abbott if he was afraid. “No.”1 For a young printer about to endure a scalpel to his neck, Abbott’s response was as unusual as what followed. Meticulously, Morton lifted an ether-filled glass globe towards Abbott. Within minutes Abbott fell asleep. Dr. John Collins Warren, the attending surgeon, made a quick incision and tied down the vascular lesion. There was absolute silence. No scream. No sound.2 When Abbott came to, he remarked that it felt “as though the skin had been scratched,”3 to which Dr. Warren proclaimed, “Gentlemen, this is no humbug.”1 News of this public demonstration spread rapidly, marking the birth of anesthesia and painless surgery. That momentous morning was the first of many firsts that the  Massachusetts General Hospital would come to be known for in its bicentennial history.

The Massachusetts General Hospital (MGH) was founded in 1811 as the third general hospital in the United States.4 At that time, affluent patients received medical care at home by their physicians, and local facilities provided charity care for the less privileged.5 John Bartlett, a Harvard-educated chaplain who worked with the poor at the Boston Almhouse, dreamed of a new kind of hospital.5 It was a risky and innovative concept, modeled after the institutions in Philadelphia and New York – a general hospital that would provide state-of-the-art care for anyone and everyone.

Bartlett gathered some of the most prominent Boston citizens of his time, among them former and future presidents, and two physicians, Dr. James Jackson and Dr. John Collins Warren, who became pivotal in bringing his idea to fruition.6 Dr. Jackson was a Harvard physician who pioneered smallpox vaccination in New England.7 Dr. Warren later became the first dean of Harvard Medical School and established the prestigious New England Journal of Medicine.6 Together they wrote the famous Circular Letter. “When in distress, every man becomes our neighbor.”8 The letter decreed the mission of the hospital and raised funds for it. The founding donors commissioned Charles Bulfinch, the renowned architect of the United States Capitol, to bring the hospital into physical existence.5 The iconic design extended east-west from a central portico with grand columns topped by an amphitheater that would become the famed ether dome.

Eminent from the start, MGH’s prominence only increased as it pioneered medical advances over the next two centuries. In medical education, it was the first teaching hospital of the Harvard Medical School, fulfilling a critical role for medical students who at the time lacked clinical training.9 In medical history, the hospital’s record-keeping obsession created the most complete collection of 19th century medicine in existence.10 The detailed records trace to the hospital’s very first patient, a saddler who had contracted syphilis in New York.11 Today, MGH case records continue to be published and are taught around the world.

In 1905, MGH formed the nation’s first social work department.12 It was the brainchild of Dr. Richard Cabot, who believed that the patients’ economic, living, and family conditions were intimately linked to their health. He recruited the like-minded Ida Cannon, who became the chief of social service at a time when the only other two chiefs were those of medicine and surgery.12 Cabot and Cannon travelled widely and transformed patient care with the radical idea that health entailed engaging the patient beyond his disease.

In medical science, the MGH timeline is decorated with milestones.13 Since the ether dome, the hospital’s first pathologist identified appendicitis and proposed appendectomy in 1886.6 The year after the X-ray was discovered in Germany, Walter Dodd produced America’s first radiograph at MGH and later became its first radiologist.14 When Boston’s premiere nightclub Cocoanut Grove burst into the deadliest club fire in history, MGH modernized burns treatment and popularized penicillin with its first large-scale use.15 These accomplishments were followed by the first reattachment of a severed limb in 1962, the first laser tattoo treatment in 1988, and the new proton beam center in 2001.13 Currently, MGH operates the largest hospital research program in the world with a $750 million budget.16

The modern MGH remains a leader in medicine. In 1994, it became the first teaching hospital to merge with its rival, Brigham and Women’s Hospital, to create a healthcare network.5 The hospital renewed itself with the state-of-the-art Lunder building at its bicentennial. In 2012, MGH ranked No. 1 in America.17 After 200 years of innovation, the Massachusetts General Hospital is raising the curtain for another century of great firsts.

 

References

  1. Rice NP. Trials of a Public Benefactor as Illustrated by the Discovery of Etherization. New York, NY: Pudney and Russel; 1859.
  2. Mulliken JB, Young AE. Vascular birthmarks in folklore, history, art, and literature. In: Mulliken JB, Burrows PE, Fishman SJ, ed. Mulliken and Young’s Vascular Anomalies: Hemangiomas and Malformations. 2nd ed. New York, NY: Oxford University Press; 2013: 3-21.
  3. Bigelow HJ. Insensibility during surgical operations produced by inhalation. Boston Med Surg J. 1846;35: 309-317.
  4. The Massachusetts General Hospital: 1811-1961. Can Med Assoc J. 1961; 84(18): 1025.
  5. Kastor JA. Mergers of Teaching Hospitals in Boston, New York, and Northern California. Ann Arbor, MI: University of Michigan Press; 2003.
  6. Young RH, David NL. The Warrens and other pioneering clinician pathologists of the Massachusetts General Hospital during its early years: an appreciation on the 200th anniversary of the hospital founding. Modern Pathology. 2011; 24(10): 1285-1294.
  7. Contagion historical views of disease and epidemics: James Jackson, 1777-1867. http://ocp.hul.harvard.edu/contagion/jackson.html. Accessed November 17, 2013.
  8. MGH celebrates 200-year anniversary of the Circular Letter. http://www.massgeneral.org/about/newsarticle.aspx?id=2331. Published August 18, 2010. Accessed November 17, 2013.
  9. History trail – Massachusetts General Hospital, Boston, MA. http://www.massgeneral.org/history/exhibits/history-trail/.  Accessed November 24, 2013.
  10. Barker FG. The Massachusetts General Hospital: Early history and neurosurgery to 1939. Journal of Neurosurgery. 1993; 79(6): 948-958.
  11. A narrative history of Mass General. http://www.massgeneral.org/history/narrativehistory/. Accessed November 24, 2013.
  12. MGH Social Service history. http://www.mghpcs.org/socialservice/History.asp. Accessed November 30, 2013.
  13. Mass General in focus. http://www.massgeneral.org/about/infocus/. Accessed November 30, 2013.
  14. Brown P. American martyrs to radiology. Walter James Dodd (1869-1916). American Journal of Roentgenology. 1995; 165(1): 181-184.
  15. The Cocoanut Grove fire. http://www.cocoanutgrovefire.org/. Accessed November 30, 2013.
  16. Massachusetts General Hospital overview. http://www.massgeneral.org/about/overview.aspx. Accessed November 30, 2013.
  17. McMullen L. U.S. News ranks best hospitals 2012-13. U.S. News & World Report. July 16, 2012.

 


ANDY H. HUNG, MASc, is an MD-PhD student at the Northwestern University Feinberg School of Medicine, Chicago, Illinois.

 

 

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