Weill Cornell Medicine: A History of Cornell's Medical School

By Antonio M. Gotto, Jennifer Moon and Laurie H. Glimcher

Weill Cornell Medicine is a story of continuity and transformation. Throughout its colorful history, Cornell’s medical school has been a leader in education, patient care, and research—from its founding as Cornell University Medical College in 1898, to its renaming as Weill Cornell Medical College in 1998, and now in its current incarnation as Weill Cornell Medicine.

In this insightful and nuanced book, dean emeritus Antonio M. Gotto Jr., MD, and Jennifer Moon situate the history of Cornell’s medical school in the context of the development of modern medicine and health care. The book examines the triumphs, struggles, and controversies the medical college has undergone. It recounts events surrounding the medical school’s beginnings as one of the first to accept female students, its pioneering efforts to provide health care to patients in the emerging middle class, wartime and the creation of overseas military hospitals, medical research ranging from the effects of alcohol during Prohibition to classified partnerships with the Central Intelligence Agency, and the impact of the Depression, 1960s counterculture, and the Vietnam War on the institution. The authors describe how the medical school built itself back up after nearing the brink of financial ruin in the late 1970s, with philanthropic support and a renewal of its longstanding commitments to biomedical innovation and discovery.

Central to this story is the closely intertwined, and at times tumultuous, relationship between Weill Cornell and its hospital affiliate, now known as New York–Presbyterian. Today the medical school’s reach extends from its home base in Manhattan to a branch campus in Qatar and to partnerships with institutions in Houston, Tanzania, and Haiti. As Weill Cornell Medicine relates, the medical college has never been better poised to improve health around the globe than it is now.

• Language: English
• Publisher: Cornell University Press
• Release date: Apr 19, 2016
• ISBN: 9781501703669

Book preview

Weill Cornell Medicine

A History of Cornell’s Medical School

ANTONIO M. GOTTO JR., MD, AND JENNIFER MOON

Foreword by Laurie H. Glimcher, MD

Cornell University Press ITHACA AND LONDON

To the students, alumni,

faculty, staff, and board of

Weill Cornell Medicine

From the river the medical center rises in a single mass, its base on the highway along the shore, its subordinate units grouped around the white slab of a central tower, topped by the pointed arches which are the identifying features of its design. Within are a hospital, a medical college, a nursing school, a psychiatric clinic, a lying-in hospital, a hospital for special surgery. Nearby on the adjacent avenues are resident buildings, other specialized hospitals, a university. This is not so much an institution as a community.

ERIC LARRABEE, The Benevolent and Necessary Institution

Contents

Foreword

Preface

Acknowledgments

List of Abbreviations

1 Origins

2 Clinical Innovation and a Historic Partnership

3 A Move to Manhattan’s Upper East Side

4 The Medical School in Wartime

5 Postwar Boom

6 The Expansive 1960s

7 A Decade of Malaise

8 Discord and Disrepair

9 Renaming and Rebirth

10 Forging Ahead in the Twenty-First Century

Notes

Bibliography

Index

Foreword

In 1898, when Cornell University established its College of Medicine in New York City, both the education and the practice of medicine were not long removed from the primitive Civil War era, when for every three soldiers killed in battle, five more died of disease. Boston dentist William Morton had demonstrated general anesthesia fifty-two years previously in a historic operation in the Ether Dome at Massachusetts General Hospital, but it was still not universally used. The Pasteur Institute had been established only eleven years earlier as a first attempt to link basic chemical and biological research to practical applications. The Quaker surgeon Joseph Lister, whose 1867 invention of antisepsis came too late to save many of those Civil War casualties, was still trying to get his ideas accepted (the famed surgeon Lawson Tait, one of Lister’s enemies, had in 1898 still not even accepted the germ theory of disease).¹

That year, William McKinley was president of the United States (he had only three more years to live); the modern City of New York had just been created by annexation of land from the surrounding counties; the United States had just declared war on Spain (the Spanish-American War would end before the year did); the legendary Wild West sharpshooter Annie Oakley had just written a letter to President McKinley offering the government the services of a company of 50 lady sharpshooters (probably the earliest political move toward women’s rights for combat service in the United States military); and Robert Allison of Port Carbon, Pennsylvania, became the first person to buy an American-built automobile (he had seen it advertised not on radio or television, of course—the first commercial radio station wasn’t created until 1920, and Philo Farnsworth wouldn’t invent television until 1927—but in Scientific American). The year 1898 also saw the Bayer Company begin to market heroin—first synthesized from morphine in 1874—as a nonaddictive painkiller.

The history of Cornell University Medical College—now Weill Cornell Medicine—is essentially the history of modern medicine. To call either of their beginnings humble is like saying that a miser is not much given to overspending. As recounted in chapter 1, Cornell University Medical College began with just eight faculty, including William Polk, its first dean. Four of them, including Polk, had actually seceded from New York University earlier that year. Temporary housing for the medical college was provided by the Loomis Laboratory on East Twenty-Sixth Street and nearby rented buildings on the grounds of Bellevue Hospital. While a new building was in the process of construction, all classes took place in just four rooms.

At the turn of the century, medicine itself was similarly restricted, though for reasons other than the lack of proper facilities. Only 5 percent of American physicians in 1900 were women (and that was still the case in 1949). Many Americans still believed the theories of male physicians like Harvard’s Edward H. Clarke, who wrote in 1873 that women seeking advanced education would develop monstrous brains and puny bodies, abnormally active cerebration, and abnormally weak digestion; flowing thought and constipated bowels; lofty aspirations and neuralgic sensations.

From the first, Cornell University Medical College (CUMC) admitted women to the study of medicine; not many other medical schools did, except of course the women-only ones. The first class was 278 students, 26 of whom were female. A year later, the Woman’s Medical College of the New York Infirmary for Women and Children, founded by Elizabeth Blackwell, the first woman to receive a medical degree in the United States, merged with CUMC, adding almost seventy women to the student body. The first graduating class had twelve women out of sixty-seven degree recipients. One wonders what Dr. Blackwell would make of the fact that, out of a typical Weill Cornell Medicine graduating class of around one hundred today, roughly half are women. She would probably be more surprised to learn that the medical college now has a branch in an Arab country, Qatar, which graduates over forty additional MDs each year, and that roughly half of them are women. Women didn’t join the CUMC faculty until 1914, and the first female dean was appointed only in 2012, 114 years after William Polk.

Whether for men or women, medical education in the early days of CUMC was, like in the rest of the country, just starting to become scientifically based and rigorous. Only a few years previously, William Stewart Halsted had established the first formal surgical residency training program in the United States, and, amazingly, the legendary physician William Osler was just then introducing the radical idea of having third- and fourth-year medical students work with patients on the wards. Previously, believe it or not, they had not been required to leave the lecture hall for bedside clinical training. And in 1898 a college degree was not required for admission to any medical school in the United States (CUMC was to adopt such a requirement very early, in 1908).

As a new institution, CUMC was not wedded to the often hidebound conventions of the previous century, and from the first it embraced the latest advances in medical education. In 1910, professional educator Abraham Flexner issued his report on the state of the 155 medical schools in the United States and Canada. That report set the standard for medical education for the next one hundred years. He praised the new Cornell University Medical College but noted that neither it nor Columbia University School of Medicine as yet had an affiliated teaching hospital. (Interestingly, they now have the same one: both are affiliated with NewYork–Presbyterian Hospital, which has branches next to both schools, and which is generally considered the best teaching hospital in New York and one of the best in the world.) Affiliation with New York Hospital provided the third element of CUMC’s three-pronged mission: education, research, and clinical care—a mission unchanged today. Chapter 2 of this book tells the fascinating story of the birth of this historic partnership, which dates to 1913 and has done so much to elevate both the hospital and the medical college. Later chapters trace the development of the relationship, which, as is the case with all medical schools, had its rocky periods. Happily, today the partnership between Weill Cornell Medicine and NewYork–Presbyterian Hospital is a strong one, with excellent trust and cooperation on both sides. It enables the whole of the medical center to put the patient at the center of everything that is done here.

By the time the medical college and the hospital had completed their new medical center campus on the Upper East Side in 1932 (where it remains today), medicine had become a science-based discipline, and many of the academic departments we still associate with a modern medical center had been created. It was a time of extraordinary change in the way physicians were able to treat patients. Consider infectious disease, the leading cause of death for much of human history. Although traces of tetracycline have been found in human skeletal remains from ancient Nubia (Sudan) dating back seventeen hundred years, indicating the presence of this antibiotic in the diet, it was not until Paul Ehrlich’s discovery of the anti-syphilis drug salvarsan in 1909 and, especially, the development of the sulfa drugs in the 1930s and Alexander Fleming’s discovery of penicillin in 1928 (though it was not isolated and tested until the 1940s) that the era of antibiotics began to revolutionize public health. One has only to read Hemingway’s The Snows of Kilimanjaro, written in 1936, to be brought back to an era when the scratch of a thorn could lead to a fatal infection, and often did. Combined with vaccination, the use of antibiotics had enabled medicine to increase the average life expectancy in the United States from less than fifty years in 1900 to just over sixty in 1940—the greatest increase in any forty-year period in recorded history. And the universal use of anesthetics plus improved surgical training had eliminated much of the terror of the knife, allowing previously deadly operations such as caesarian section and open-heart surgery to be used routinely. Thanks to such developments, during World War II, literally millions of soldiers and civilians who would have died in any previous war were saved. Chapter 4 tells the fascinating story of the Cornell University Medical College during those war years.

But with these advances came an increased understanding of how much remained to be done. In the postwar period, recounted in chapter 5, as applications to medical school exploded and the involvement of the federal government in all aspects of life, including medical research, expanded greatly owing to Cold War pressures, attention began to turn to some of the remaining huge unmet medical needs, such as treatments for cancer and heart disease. The era of cancer chemotherapy began in the 1940s with the first use of nitrogen mustards and folic acid antagonist drugs, but these were like dropping a nuclear weapon on a tumor, and the collateral damage to the patient was enormous. It was clear that both basic and applied biomedical research were required to uncover the molecular causes of these diseases and find new approaches to their treatment. Cornell University Medical College was at the forefront of this new emphasis, as illustrated by the award, in 1955, to Vincent du Vigneaud, chair of the Department of Biochemistry, of the Nobel Prize in Chemistry for his discovery of oxytocin, a hormone that plays key roles before and after childbirth, and the award, in 1950, of the Albert Lasker Award for Clinical Medical Research to George Papanicolaou of the Department of Anatomy for the development of the Pap smear test for cervical cancer. With this growth in research activities came the establishment of a formal graduate program, which started with an enrollment of twenty-one students in 1953 and had more than doubled by the end of the decade.

Expansion of all three facets of CUMC’s mission accelerated in the 1960s, as events such as the passage of Medicare in 1965 drove a parallel expansion in the health system. Chapter 6 provides a look at the effects of these forces on the medical college. Not all were salutary. Growth, it seems, can become an end in itself, and when it does, it can dominate all other considerations. At the end of the 1950s, Cornell was able to accommodate the entire student body, including married students, in modern rooms or apartments for the first time. However, although CUMC and New York Hospital would expend $34 million in the first half of the 1960s to construct new buildings or renovate existing ones, there would still remain a seemingly insatiable need for more laboratories, more classrooms, and more patient exam rooms. The medical college consequently embarked on a building boom that would eventually strain its resources. The budget was growing at a rate of approximately $1 million per year (or nearly $8 million in 2014 dollars) at the beginning of the 1960s, largely due to the increase in federal funding for research. Although that doesn’t sound like much, it marked the beginning of what would become a seemingly insatiable appetite for research dollars. And concomitantly, the cost of medical education was rising rapidly, soon to outstrip the ability of many middle-class families to pay for it.

With the 1970s came a severe economic downturn, President Nixon’s announcement of the war on cancer, and the continuation of the ruinous conflict in Vietnam. Health care costs began their forty-year spiral out of control. As doctors became increasingly under the thumbs of insurance companies and government agencies, the doctor-patient relationship seemed to become more that of business-customer. And for the first time in over twenty years, federal funding for medical research failed to keep pace with rising costs.

Economic constraints began to take their toll on CUMC as well. Student and faculty quality began to decline. Construction basically came to a halt. The medical college budget began to show a yearly deficit of more than a million dollars; the hospital had one five times as large. The situation eventually became so dire that, as chapter 7 harrowingly reveals, in 1979 both a total rebuilding of the medical school in another location and CUMC’s complete dissolution were seriously discussed. Eventually neither was actually proposed, but in order to make ends meet the School of Nursing was closed, and the basic science faculty was reduced by 8 percent.

Still, not all was bleak. In 1972, CUMC and Rockefeller University launched a joint MD-PhD program, which was eventually expanded to include Memorial Sloan Kettering Cancer Center as well in 1992. Graduating students in the program receive an MD degree from CUMC and a PhD from Cornell’s Graduate School of Medical Sciences, Rockefeller University, or the Gerstner Sloan Kettering Graduate School. The Tri-Institutional MD-PhD Program, as it is now known, remains the jewel in the crown of Weill Cornell’s educational mission.

Unfortunately the 1980s, whose story is told in chapter 8, were not much better. The arrival of managed care, which actually did little to control rising health care costs, hit teaching hospitals like a bomb. All across the United States, the educational and research activities at medical schools, which had previously been subsidized by the clinical income of teaching hospitals and their academic faculty, began to decline. Enormous pressure was put on the research faculty to obtain additional funding (with its attendant overhead payments), usually from the federal government. Of course, institutions whose faculty quality had slipped had more trouble competing for such funds.

In 1983, just as things were looking dire, CUMC received a gift of $50 million from the philanthropist Ruth Uris—at that time, one of the largest single donations ever to an academic institution. It provided financial stability and foreshadowed an increasing dependence by CUMC and other academic medical centers on private donations as a major source of income.

By the early 1990s, clinical revenues provided half of Cornell University Medical Center’s income, leaving it vulnerable to the ongoing financial squeeze of managed care (chapter 9). Labs were outdated, space was scarce, and research programs needed revamping—all of which required money that the school simply didn’t have. Part of its response was to make significant cuts in a number of areas, but no institution has ever managed to cut its way to excellence, and quality, especially research quality, suffered. Fortunately, thanks to private philanthropy by donors such as Maurice R. Hank Greenberg, both the hospital and the medical college were able to embark on modest building programs, and the financial health of the hospital began to improve. But ultimately, something drastic appeared to be needed. CUMC and New York Hospital had some discussions about possibly merging with North Shore Hospital, as well as more casual discussions about CUMC merging with Mount Sinai School of Medicine or New York University. Most serious were talks concerning a four-way merger between CUMC, Columbia, New York Hospital, and Presbyterian Hospital, a scenario that had actually first been broached in 1917. Although those talks broke down in 1995, the two hospitals did merge a year later, creating NewYork–Presbyterian Hospital and inaugurating a wave of hospital mergers around the country, few of which proved to be nearly as successful.

So by the second half of the ’90s, CUMC was still on very shaky financial ground. All that was to change, though, when Antonio Gotto Jr. was chosen as dean in 1996. He immediately began to build a relationship with one of the overseers of the medical college, financial titan and self-made billionaire Sanford Sandy Weill. The outcome of that relationship was the historic meeting with Sandy and his wife, Joan, in March 1997 at which Dean Gotto and Cornell University president Hunter Rawlings III proposed renaming Cornell University Medical College after the Weills in return for a gift that would be one of the twenty largest philanthropic gifts in the history of American education. Astonishingly, the Weills agreed to the proposal the next day. As a result, in 1998, Cornell University Medical College officially became the Joan and Sanford I. Weill Medical College and Graduate School of Medical Sciences of Cornell University, a mouthful that usually, and mercifully, was shortened to Weill Cornell Medical College—now simply Weill Cornell Medicine.

Weill Cornell’s association with Sandy and Joan Weill would eventually result in the Weills contributing more than $600 million to the school over the next sixteen years, at the time an unprecedented history of generosity of one family for one institution. It also inaugurated an era of large philanthropic gifts and medical school renaming that continues across the country to this day. But perhaps most significantly, it led to a much deeper involvement by Sandy Weill with the medical college, whose board he chaired. His personal philanthropy set the pace for an unprecedented era of philanthropy to follow, including gifts from Hank Greenberg, the Starr Foundation, the Feil family, Robert and Renée Belfer, Sandy and Ed Meyer, the Qatar Foundation, Helen and Bob Appel, Caryl and Israel Englander, Gale and Ira Drukier, and Ronald Perelman. Many of these gifts, along with many more, were personally solicited by Sandy. So effective was Sandy in this role that, after I succeeded Dr. Gotto as dean in 2012, I remarked at an event honoring Sandy that, just as it was once said of Thomas Alva Edison that he would have been a great man even if he had never invented anything, Sandy would have deserved to have Cornell’s medical college named after him even if he had never given it a dime of his own money.

The medical college that I agreed to lead in 2012 is now, as detailed in the book’s final chapter, in sound financial shape; has excellent relations with its affiliated hospital and its leader, Dr. Steven Corwin; possesses outstanding faculty and students; has just opened (and already nearly filled) a new 480,000-square-foot, state-of-the-art research building named after the Belfer family that nearly doubles the research space on campus; and has seen the tenth graduating class of its affiliated medical school in Qatar, an endeavor that is transforming medical research and education throughout the Middle East. In every respect it is healthier and more influential than perhaps it has ever been.

Yet many challenges remain. In the past ten years federal funding for biomedical research has declined by more than 20 percent in inflation-adjusted dollars, leaving all academic medical centers more dependent than ever on private philanthropy, which is itself subject to the vagaries of the economy. Health care demand is still rising—though the Affordable Care Act has, at least temporarily, slowed the cost growth considerably—and the rapidly aging population is about to usher in a flood of age-related illnesses that we are unprepared to meet. Obesity and diabetes are becoming a national epidemic, and we lack treatments for Alzheimer’s disease, stroke, and many other killers. The country faces a physician shortage that will soon reach alarming proportions, especially in some subspecialties like primary care and geriatrics, yet medical schools are unable to expand because the government has not increased the allotment of residency slots. Never before have physicians been saddled with so much paperwork and pressure to bring in revenues, reducing the time they have to do what brought them into medicine in the first place: take care of the sick. Weill Cornell Medicine may be in good condition, but it is hard to avoid the feeling that the general health of the country and the health of the institution of medicine are not what they should be.

Nonetheless, I believe the future can be incredibly bright. In 1998, the same year that Cornell University Medical College was renamed and celebrated its one hundredth anniversary, the breast cancer drug Herceptin was the first therapeutic antibody targeted to a specific (HER2) cancer-related molecular marker to receive FDA approval. Three years later, the FDA approved the drug Gleevec, the first small-molecule cancer drug targeted at a specific molecular driver of a specific cancer. Two years after that, in 2003, the complete DNA sequence of the human genome was announced. The era of personalized medicine had begun. (I prefer the term precision medicine, for reasons I will illustrate.)

It took more than thirteen years and cost more than $3 billion to sequence the human genome. Today, less than thirteen years later, it costs under $1,000 and takes a day to sequence an individual human genome. Our ability to produce sequence information from any person’s DNA has outstripped our ability to make full use of it, but even now the consequences are breathtaking. Imagine someone with a potentially fatal, inoperable lung tumor in 1950. That person’s only hope would have been one of the cytotoxic chemotherapy drugs, a one-size-fits-all approach to many different tumors that often came as close to killing the patient with side effects as it did to killing the tumor cells. Now imagine that same patient today. The genome of the lung tumor can be sequenced for less than the cost of a chest X-ray. Really? With luck, that sequence will show that the tumor’s survival depends on a particular protein that is not so important for the patient’s normal cells—a protein for which a specific drug already exists. The patient can be treated with a drug that is precisely tailored for the subset of lung cancer that he or she happens to have. Because of its precision, that drug will be more effective at killing the tumor, with fewer side effects for the patient, than any other treatment. This is the world of medicine we are entering into.

In addition, after decades of failure, we have finally begun to harness a person’s own immune system to kill cancer cells and other invaders. We have started to find ways to use genes and stem cells as drugs. We are on the cusp of being able to grow new tissues and organs to replace diseased and damaged ones. And we may actually be able to fix genetic defects that cause horrible inherited diseases soon after birth.

To capitalize on these breakthroughs—and to find equivalent miracles for Alzheimer’s disease, stroke, osteoporosis, and other unmet medical needs—will require a new breed of physician, one trained to understand science and think scientifically as never before. It will also require new types of interdisciplinary research, plus researchers who are attuned to translating basic discoveries into clinical applications, and who can work hand in hand with clinicians. It will require doctors and scientists who can learn from patients as well as help them, who can recognize that the flow of medical science is not just from bench to bedside but also from bedside back to the laboratory. It will require financial and intellectual resources on a scale never seen before, but the payoff will be nothing less than a longer, healthier life for all people. And it will happen at academic medical centers, where education, research, and clinical care work not just side by side, but hand in hand.

Weill Cornell Medicine is a place where the medicine of tomorrow is happening today. As we plan for the future, it is well to remember the lessons of the past. You will find them here, in this wonderful book.

LAURIE H. GLIMCHER, MD

Stephen and Suzanne Weiss Dean, Weill Cornell Medical College

Provost for Medical Affairs, Cornell University

Preface

Weill Cornell Medicine is a story of continuity and transformation. Initially founded as Cornell University Medical College in 1898, Cornell’s medical school was renamed as Weill Cornell Medical College a century later and rebranded as Weill Cornell Medicine in 2015. Throughout its changes and colorful history, the institution has remained a leader in education, patient care, and research.

This book is the first devoted to the history of Weill Cornell Medicine. Just after Dr. Antonio Gotto completed a fifteen-year stint as dean of Weill Cornell, we embarked on this project, which focuses on the medical school’s deans and the issues they faced as administrative leaders. This perspective emphasizes people, buildings, and the organization of the medical school as a whole. It takes a broad view of key events, unusual episodes, and controversies in Weill Cornell’s history, stretching from its origins in the late nineteenth century and concluding with the end of Gotto’s tenure in 2011. Our narrative situates the history of Weill Cornell in the context of nationwide trends in medical education and health care, as well as the challenges posed by war, economic instability, and pervasive social change.

The shifts that have taken place in the teaching and practice of medicine since 1898 have been dramatic. Medical schools like Cornell’s have grown from small-scale institutions requiring little more than a high school diploma for admission into highly competitive, multibillion-dollar enterprises heavily supported by federal government funding and private philanthropy. The amount of medical information available at the beginning of the twenty-first century—from sophisticated imaging technologies, genomics, and vast patient databases—was unimaginable to bedside physicians practicing a hundred years earlier.

As writers of contemporary history, we found that this expansion in the world of medicine was reflected in the proliferation of archival material at our medical center, particularly starting in the 1960s. Our goal was to capture the highly publicized stories, crucial developments, and physical landscape that distinguish Weill Cornell from other medical schools and give it its unique flavor. There are many topics that deserve further exploration, such as the history of individual departments or the evolution of scientific knowledge on campus, that were simply beyond the scope of this volume.

This is not an official institutional history. Throughout the narrative, we have tried to be objective and balanced in synthesizing information from multiple sources and presenting our own interpretation of events. Neither is this a history of New York Hospital (now remade as NewYork–Presbyterian). The fates of Weill Cornell and its adjoining hospital are closely intertwined, and we have included details that are important in understanding the relationship between the two. However, we have not attempted to construct an independent chronology of the hospital, its leaders, and their administrative concerns.

Our principal sources for this book were archival material from the Medical Center Archives of NewYork–Presbyterian / Weill Cornell, especially papers from the Dean’s Office and annual reports submitted by deans of the medical college to the presidents of Cornell University. These records provided rich detail on institutional finances, personnel, affiliations, and educational, clinical, and research programs over time. Newspaper accounts in the New York Times proved especially helpful in identifying major milestones and engaging stories. Kenneth Ludmerer’s authoritative texts on medical education in the United States, Learning to Heal and Time to Heal, provided the framework for us to contextualize academic developments at the medical school.

As Weill Cornell moves into the twenty-first century, we are optimistic about its future. Over the course of its history, it has dedicated itself to improving human health by training doctors, investigating the underlying causes of disease, and providing the best care possible to patients in New York and around the world. It has weathered difficult times and rebuilt itself anew. We are eager to see what the coming years may bring.

Acknowledgments

We would like to thank all our current and past colleagues at Weill Cornell Medicine, Cornell University, and NewYork–Presbyterian, without whose dedication and commitment there would be no history of the medical college. We greatly appreciate the assistance of Elizabeth Shepard and Lisa Mix, who helped us navigate the historical documents and photographs at the Medical Center Archives of NewYork–Presbyterian / Weill Cornell. Special thanks to J. Robert Buchanan, Robert Michels, Laurie Glimcher, Rees Pritchett, David Hajjar, and Larry Schafer for sharing their insights and stories with us. For their contributions to this book, we are deeply grateful to Frank H. T. Rhodes, Louis F. Fritz Reuter IV, Kathleen Burke, Peter Hirtle, John Rodgers, Kara Greenblatt, Marko Kokic, Yvonne Singleton, Steve Cohen, James Kahn, William Cunningham, Gloria Kao, Tammy Ziccardi, Tina Georgeou, and Janet Miller. We are also indebted to our editor Peter Potter for his support of this project and insightful suggestions. Many thanks to Ange Romeo-Hall, Mahinder Kingra, Jonathan Hall, Glenn Novak, Dina Dineva, and everyone at Cornell University Press for making this book a reality.

AMG wishes to thank Anita Gotto for her support and encouragement. JM is thankful for having known Jo Beecham, for Eloise Harper Moon, and most of all, for Heather Seltzer.

Abbreviations

1 Origins

Ever since the University opened, its sanguine friends have dreamt of a medical department.

JACOB GOULD SCHURMAN, Annual Report of the President for the Year 1897–99

Although more than two hundred miles away from Cornell University’s campus in Ithaca, New York City was the most logical place to establish a medical school. Within a few years of Cornell’s founding in 1865, the university had started offering a four-year course in natural history leading to a bachelor of science degree. The program was considered good preparation for students contemplating a career in medicine, and a two-year version with classes in anatomy, physiology, histology, and chemistry was launched in 1878.¹ Both courses of study were directed by Burt Wilder, MD, a professor of comparative anatomy and natural history, a former surgeon in the army, and a man of eccentric interests that included brains, cats and war on athletic sports.² Although the programs were highly respected, there were no large hospitals near Ithaca that were suitable for training medical students. In order to gain sufficient experience with patients, Cornell undergraduates interested in medicine typically left after two years of study to finish their training at urban medical schools.³

It took several false starts before the right opportunity to create a medical school for Cornell presented itself—and when it finally did, it generated quite a bit of controversy. A group of independent physicians first tried to establish a medical school in New York between 1881 and 1885 but were unable to obtain sufficient funding to do so.⁴ In 1885, Charles Adams became Cornell’s second president and attempted to expand the university in Ithaca by creating a medical school, as well as a law school and a veterinary school. These efforts were frustrated when he failed to gain the support of Cornell’s board of trustees for such venturesome projects.⁵ Adams was also involved in extensive discussions in 1891–92 about a proposed merger between Cornell and Bellevue Hospital Medical College, a proprietary school in New York City.⁶ These negotiations fell through because Cornell and its trustees were averse to forming connections with the proprietary, or for-profit, medical schools of the time.

Medical education was undergoing a period of intense change at the end of the twentieth century. By 1876, there were seventy-six medical schools in the United States, and new ones were opening at a fast rate. Many of these were proprietary schools owned by professors, with lower entrance requirements than those required for high school. Very few were connected to a university or to a teaching hospital. Instruction consisted primarily of students listening to lectures that provided a very superficial knowledge of medicine, and anatomy was the only scientific subject taught in detail. After students completed two four-month terms, medical degrees were awarded regardless of academic performance.

Beginning in the 1870s, leading medical schools at Harvard, the University of Michigan, and the University of Pennsylvania began introducing educational reforms that marked a dramatic departure from the experience offered by the proprietary schools; the Johns Hopkins School of Medicine joined this vanguard after it opened in 1893. The length of medical school increased to three years, and eventually four. New subjects were introduced, and entrance requirements were raised. In addition to anatomy, students received instruction in physiology, physiological chemistry, pathology, pharmacology, and bacteriology. There was a shift in pedagogy; instead of being limited to passively listening to lectures and observing clinical demonstrations in amphitheaters, students became active participants in their own education. The introduction of laboratory work and clinical clerkships allowed students to learn by doing, rather than merely by watching. Students became increasingly engaged in the care of patients, and clinical teaching expanded beyond the traditional courses in medicine, surgery, and obstetrics to include gynecology, pediatrics, dermatology, genito-urinary diseases, laryngology, ophthalmology, otology, psychiatry, and hygiene.⁷

In the words of Jacob Gould Schurman, Cornell’s third president, the University shrank from even a nominal connection with proprietary institutions whose ultimate object was economic and financial, not scientific and educational, since such unions offered no prospect for the advancement of medical education.⁸ If Cornell decided to associate itself with a medical school, that institution would need to be committed to educational innovation. And in 1898, a proposal to create a new medical school that would maintain both high academic standards and financial stability presented itself. It was backed by the munificence of Colonel Oliver H. Payne and inspired by the close friendships he had formed with one of his classmates at Yale, Dr. Lewis Stimson, and with one of his physicians, Dr. Alfred L. Loomis.

Payne gave Stimson, Loomis, and an entire medical school faculty the means to escape from a university administration that had suddenly turned oppressive. In the late nineteenth century, Stimson, Loomis, and colleagues including Dr. William Polk were running the University Medical College. Organized in 1841, it was technically the medical department of New York University (NYU), although the professors who governed the school also owned it and were financially responsible for it. Their compensation was limited to any student tuition fees left over after operating expenses had been paid. Degrees were conferred by NYU, but otherwise the University Medical College was an independent institution. In 1883, the eight governing professors at the time purchased buildings for the school and formed a corporation called the Medical College Laboratory. In 1892, Colonel Payne made a $150,000 donation to help his friends pay off the mortgages on the buildings, which were then held in the name of the Medical College Laboratory.

Cornell University Medical College’s Founders

Oliver Hazard Payne was born to a wealthy Ohio family on July 21, 1839. He attended Yale as a member of the class of 1863 but left at the outbreak of the Civil War to join the Union army. While a solider, he received a gunshot wound to the thigh, which became a source of chronic pain and fueled a lifelong interest in health. After his discharge, Payne went into business and became a close associate of John D. Rockefeller and, later on, a treasurer and director of Standard Oil. He also had substantial investments in the American Tobacco Company and in coal, iron, steel, and paper. A bachelor, Payne moved in 1884 to New York City, where he spent a lot of time with Lewis Stimson.⁹ According to Stimson’s cousin Lewis Conner, Payne was a modest, reticent, and rather lonely man.¹⁰

Lewis Atterbury Stimson was born on August 24, 1844, in Paterson, New Jersey, and at the age of fifteen entered Yale, where he struck up a lifelong friendship with his crew teammate Oliver Payne. During the Civil War, he served as a general’s aide in the Union army. In 1866, he married Candace Wheeler, but her health soon began to deteriorate. Stimson abandoned a career in finance, began to study medicine in Europe, and ended up graduating from Bellevue Hospital Medical College in New York. Just two months after his wife died in 1876, he performed one of the first surgeries in the United States using antiseptic methods, a public demonstration of a leg amputation.¹¹ According to historian George Adams Boyd, Stimson look[ed] upon the world with the penetrating appraisal of a man sure of his integrity and who will tolerate no nonsense, hypocrisy or sham.¹² His cousin Lewis Conner wrote: His somewhat reserved manner and cold exterior hid a generous and kindly disposition, which showed itself particularly in his relations with his subordinates.¹³

Alfred L. Loomis is considered a founder of Cornell University Medical College because of his relationships with Payne and Stimson, although he died three years before the school’s establishment. An expert on physical diagnosis and tuberculosis, Loomis was associated with Bellevue Hospital and University Medical College, among other medical institutions in New York. Stimson, a close friend and colleague, introduced Loomis to Payne. After Loomis treated him for a pulmonary disorder in 1872, a grateful Colonel Payne donated $100,000 to build the Loomis Laboratory for medical research in 1886. Located across the street from Bellevue Hospital Medical College, the five-story Loomis Laboratory was used by physicians and students from Bellevue and University Medical College. After Loomis’s death in January 1895, his son Henry was appointed one of the first professors at Cornell’s medical school.¹⁴

In 1897, the governing faculty of the University Medical College began negotiations to become a full-fledged branch of NYU. They hoped that this arrangement would lead to greater administrative and financial stability. The two other major medical schools