Hospital de Santa Isabel, a dos siglos de su fundación / Hospital of Santa Isabel, two centuries from its foundation

RESUMEN Con el crecimiento económico, cultural y demográfico de Matanzas, alcanzado entre 1818 y 1839, se sentaron las bases para el surgimiento de edificaciones imprescindibles como el antiguo Hospital de Santa Isabel. Esta institución fue inaugurada el 24 de julio de 1838. Durante la Colonia fue usado con fines civiles y militares, y entregado al gobierno norteamericano en agosto de 1899. En la Neocolonia brindó atención ininterrumpida a la población matancera. Fue remodelado en 1947, y en el período revolucionario se instituyó como hospital general, civil y docente hasta 2016, en que se reacondiciona para convertirse en el actual Hospital Provincial Docente Ginecobstétrico José Ramón López Tabrane. Es el hospital más longevo en funciones de la Isla (AU).

ABSTRACT With the economic, cultural and demographic growth of Matanzas, reached between 1818 and 1839, the grounds were laid for the emergence of indispensable buildings such as the old Hospital de Santa Isabel. This institution was inaugurated on July 24, 1838. During the colonial period it was used for civilian and military purposes, and handed over to the American government in August 1899. In the neocolonial period, it provided uninterrupted attention to the population of Matanzas. It was remodeled in 1947, and in the revolutionary period it was instituted as a general, civil and teaching hospital until 2016, in which it was re-conditioned to become the current Provincial Teaching Gyneco-obstetric Hospital José Ramón López Tabrane. It is the longest functioning hospital on the Island (AU).

"We Do Not Want Him Because He Is a Jew": The Montreal Interns' Strike of 1934.

Speeches by modern-day White supremacists often include such statements as "Jews will not replace us." In 1934, the French-speaking medical interns of Montreal's Roman Catholic hospitals went on strike because, they alleged, a Jew "replaced" a Roman Catholic French Canadian. Anti-Semitic social and economic boycotts and educational quotas were in existence in Canada from the 19th through the mid-20th century. There were particularly strong anti-immigrant and anti-Semitic feelings in the first half of the 20th century in Quebec, along with anti-Semitic pro-fascist political parties. In 1934, Montreal's Hôpital Notre-Dame (HND), a teaching hospital of the Université de Montréal (UM) medical school, was unable to hire a full complement of medical interns from among the newly graduated French-speaking Roman Catholic medical students. The hospital hired a French-speaking Jewish graduate of UM, Samuel Rabinovitch. The prospective interns at HND submitted a petition demanding that Rabinovitch be fired, stating, "We do not want him because he is a Jew." On 14 and 15 June 1934, HND's interns went on strike to prevent Rabinovitch from taking up his duties. The strike spread to multiple hospitals in Montreal. A Jewish urology trainee at the Hôtel Dieu hospital, Abram Stilman, was also targeted. Rabinovitch resigned in order to bring the strike to an end. The strike buttressed the case in the first half of the 20th century for American and Canadian Jewish hospitals and medical schools to ensure the education of Jewish physicians, reminds us of the origins of the slogans of modern White supremacists, and reinforces the historical basis of efforts to promote diversity and inclusion in medical education.

Los hospitales docentes en la España contemporánea: El caso de los hospitales clínicos universitarios / Teaching hospitals in contemporary Spain: The case of university clinical hospitals

Desde el siglo XVIII se produjo un avance significativo en la función docente del hospital en Europa y en América del norte. La unificación entre la medicina y la cirugía y la integración de prácticas clínicas en los planes de estudio médicos generaron la necesidad de vincular las facultades de medicina a uno o varios hospitales. España se incorporó a este proceso progresiva y tardíamente con sus propias particularidades. El objetivo del artículo es presentar una primera aproximación a la historia de los hospitales clínicos universitarios, haciendo especial hincapié en la etapa en la que fueron gestionados por el Ministerio de Educación. Desde un punto de vista político se podrá observar cómo se establecen y desarrollan las relaciones entre las instituciones locales y el Estado central a la hora de gestionar la estructura hospitalaria en el país, y, en concreto, los hospitales docentes (AU)

Anesthesia in the late 1960s at Peter Bent Brigham Hospital, Boston: A case report.

BACKGROUND: Regional and general anesthesia were widely available in the United States in the late 1960s. The risk of permanent neurological sequelae resulting from spinal anesthesia had largely been dismissed. Although many academic departments of anesthesiology had gained independent status, a significant number operated as divisions within the department of surgery. We present a case report from Peter Bent Brigham Hospital to illustrate the state of anesthetic techniques in use during the late 1960s, and the power dynamics vis-à-vis physician anesthesiologists and surgeons. SOURCES: Hospital records and interviews with individuals familiar with the case. FINDINGS: An otherwise healthy patient underwent inguinal hernia repair. The resident anesthesiologist conducted a preoperative assessment the evening prior to surgery with the patient consenting to the spinal anesthesia, a plan agreeable to the faculty anesthesiologist. The attending surgeon was one of the most prominent surgeons in America and the chairman of their department. He disapproved of the planned anesthetic. Subsequent modifications to the anesthetic plans are discussed, as is the fallout from those actions. CONCLUSION: Spinal anesthesia remained a popular anesthetic option during the late 1960s. General anesthesia with ether, halothane, and other agents an alternative. This case highlights various aspects of perioperative management during a period when many American academic departments of anesthesiology existed as divisions within the department of surgery. It also touches upon the careers of two prominent American physicians.

Henry Jacob Bigelow Inhaled Nitrous Oxide While an Undergraduate at Harvard College.

When teenaged Henry Jacob Bigelow was an undergraduate at Harvard College in 1833-1837, he prepared nitrous oxide gas for demonstrations to other students. Bigelow's son, William Sturgis Bigelow, related the claim, and there is an eyewitness account from Augustus Goddard Peabody, a fellow Harvard undergraduate with Bigelow. Peabody wrote to Henry David Thoreau about a nitrous frolic. College chemistry primed Bigelow to support the concept of inhaled surgical anesthesia when the idea came to Boston in 1845-1846. Bigelow's chemistry professor was John White Webster. According to Harvard alumnus Edward Everett Hale, in addition to demonstrating effects of nitrous oxide, Webster presciently treated two cases of carbon monoxide poisoning with copious volumes of synthetic oxygen gas. The career of Webster was inhibited by financial difficulties that were suspected to be contributory when he was convicted of the 1849 murder of physician George Parkman at the Harvard Medical School, then adjacent to Massachusetts General Hospital and its Ether Dome. Webster suffered the death penalty in 1850.

A brief look at the history of the Deaconess Hospital, Edinburgh, 1894-1990.

The Deaconess Hospital, Edinburgh, opened in 1894 and was the first establishment of its kind in the UK, maintained and wholly funded as it was by the Reformed Church. Through its 96-year lifetime it changed and evolved to time and circumstance. It was a school: for the training of nurses and deaconesses who took their practical skills all over the world. It was a sanctum: for the sick-poor before the NHS. It was a subsidiary: for the bigger hospitals of Edinburgh after amalgamation into the NHS. It was a specialised centre: as the Urology Department in Edinburgh and the Scottish Lithotripter centre. And now it is currently student accommodation. There is no single source to account for its history. Through the use of original material made available by the Lothian Health Services Archives - including Church of Scotland publications, patient records, a doctor's casebook and annual reports - we review its conception, purpose, development and running; its fate on joining the NHS, its identity in the latter years and finally its closure.

John L. Cameron, MD: Overview of His Career.

: Introduction to the John Cameron Festschrift.

Hepatobiliary Hands of Hopkins.

OBJECTIVE: This historical perspective documents the role that John L. Cameron played in advancing hepatobiliary research, education, and surgery at Johns Hopkins in the 1970s, 1980s, and 1990s. SUMMARY OF BACKGROUND DATA: Dating back to William S. Halsted in the 19th century, leaders of the Department of Surgery at Johns Hopkins have been interested in hepatobiliary disease and surgery. John L. Cameron had broad hepato-pancreato-biliary (HPB) interests when he completed his surgical training. Over the next 3 decades, he focused on the pancreas. As a result, many faculty and trainee hepatobiliary careers were launched. METHODS: This perspective is based on 18 years of service as a surgical resident and faculty member at Johns Hopkins. An extensive literature search on the hepatobiliary publications of Halsted, Trimble, Blalock, Longmire, Zuidema, and Cameron was undertaken for this manuscript. Numerous hepatobiliary publications from Johns Hopkins from the 1970s, 1980s, 1990s, and early 2000s were also reviewed. RESULTS: John L. Cameron's early biliary interests included stones, infections, malignancies, and strictures. He was innovative with respect to portal hypertension and Budd-Chiari surgery and supportive when liver transplantation emerged in the 1980s. Volume-outcome studies in the 1990s included hepatic and complex biliary surgery. He supported and encouraged studies of biliary lithotripsy, laparoscopic cholecystectomy, clinical pathways, hepatobiliary cysts, and gallstone pathogenesis. CONCLUSION: Lessons learned by many who worked with John L. Cameron included the importance of mentorship, innovation, friendship, and collaboration. He taught leadership and change management by example. He fostered a multidisciplinary approach and encouraged randomized controlled trials.

State of the John L. Cameron, MD Division of Hepatobiliary and Pancreatic Surgery "The Program That John Cameron Built".

: The pancreatic surgery program at Johns Hopkins is recognized as being among the top programs in the field. It is part of the newly formed John L. Cameron Division of HPB surgery. This division of surgery is a highly productive group of academic surgeons in terms of clinical volume, research endeavors, and education. The division functions as part of a large multidisciplinary group at Johns Hopkins. The program has an interesting history and can trace its roots back to the actions of a single individual-John L. Cameron. The John L. Cameron Division of HPB surgery and the Johns Hopkins Pancreas Disease program would not exist without him. It is the program that Dr Cameron built.

[Brief history of the First Hospital of Harbin City (1913-2013)].

In 1913, after the Russian Prostitutes Sanatorium of Harbin Eastern Railway was received by the board of directors, they established the "Harbin City Board Hospital" and funded its expansion. In March 1926, the provisional Committee of the Harbin autonomous renamed the "City Board of First Hospital" to "The Public Hospital" . In November 1926, "The Public Hospital" was renamed as "Harbin Special Municipal Hospital" by the Harbin City Council and further funds were invested in its construction. In 1931, the Japanese invaded Northeast China, and controlled the "City Hospital" . In 1946, when Harbin was liberated, after the Communist's take-over of the Hospital, it developed sustainedly since then. From 1946-1949, The First Hospital of Harbin City dispatched manpower, material resources, and financial resources to support the people's Liberation Army, establishedthe medical service team, received and treated the wounded. From the 1930s, the Hospital was involved in the treatment of cholera, plague, scarlet fever, typhus and other infectious diseases, and participated in the medical rescue in Wenchuan of Sichuan and Xinjiang Aletai area. From 1928, the Hospital took over from Binjiang Hospital as the Teaching Hospital of Harbin Medical School, and later became the Harbin Medical University Teaching Hospital. It made contribution to the training of medical students.

Homenaje al profesor José María Segovia de Arana. Un referente en la historia de la educación médica / Tribute to Professor José María Segovia de Arana. A point of reference in the history of medical education

El profesor José María Segovia de Arana falleció en Madrid el día 4 de enero de 2016 a la edad de 96 años. Su figura es fundamental para poder entender el nivel alcanzado por la sanidad pública de nuestro país. Todas sus decisiones sirvieron para dar un salto exponencial en la calidad asistencial e investigadora de nuestros hospitales y centros de salud, así como de la educación médica en particular

Professor José María Segovia de Arana died in Madrid on 4th January 2016 at the age of 96 years. His professional career was fundamental in allowing the public health system to reach its current level in Spain. All his decisions served to provide an exponential leap in the quality of patient care and research in our hospitals and health care centers and especially with respect to medical education

The Hidden Story of Innovation: Charity Hospital, Angola Prison, and the Challenging of Surgical Dogma.

The late 1960s was a period of significant upheaval of social, cultural, and scientific norms. The generally accepted notion of mandatory laparotomy for all penetrating abdominal injuries was among those norms being called into question across the country and many advocated expectant management of selected patients presenting with this type of injury. Leaders of the surgical community published opinions on either side of the argument. The house staff at Charity Hospital during this period was among the busiest in the nation in treating these injuries, many of them inmates of the Louisiana State Penitentiary who used self-inflicted stab wounds to the abdomen as a means of temporary respite from the inhumane conditions in the prison. Inspired, in part, by the overabundance of negative laparotomies among this group, F. Carter Nance went on to systematically challenge the standard of care. This effort constitutes one of the major forces for change of the surgical dogma of mandatory laparotomy for all abdominal stab wounds. It is the first major study to show conclusively that delayed laparotomy for perforated viscous was not significantly detrimental and posed less of a risk than unnecessary laparotomy. The circumstances surrounding this initiative constitute a powerful and heretofore unknown chapter in the history of surgical innovation.

Thomas Hodgkin (1798-1866).

Thomas Hodgkin was a diligent, selfless and benevolent man whose name is instantly recognisable in the medical field due to his description of a type of the lymphoma that is named after him, 'Hodgkin's Lymphoma'. Based at Guy's Hospital, London, he created a vast catalogue of specimens in their Medical Museum and facilitated teaching at the establishment. He was dedicated to education, public health and social reform in the 19th century.

Establishment of the Department of Anaesthesia at Harvard Medical School-1969.

BACKGROUND: The first academic departments of anesthesia were established in the United States at the University of Wisconsin-Madison in 1927, with Ralph M. Waters named as chairman, and in the UK at Oxford University in 1937, with Robert Macintosh as chairman. Compared to these early departments, more than 3 decades would pass before Harvard Medical School decided it was time to establish a department of anaesthesia, in 1969. We examine the forces on both sides of the issue, for and against, and how they played out in the late 1960s. METHODS: Published articles, books, interviews, and biographical and autobiographical notes as well as primary source documents such as reports of department and medical school committee meetings were examined to obtain information relevant to our investigation. RESULTS: The late 1960s were an ideal time for the chiefs of anesthesia at the various Harvard teaching hospitals to make a strong argument in favor of establishment of an independent department of anaesthesia. Although strongly opposed by Francis Daniels Moore, Chief of Surgery at Peter Bent Brigham Hospital, an independent department at Harvard was established in 1969. CONCLUSIONS: The recognition of anesthesia as a distinctive specialty at universities across the country as well as the specific concerns over administration, hiring, and the future of the clinical service in the 1960s provided overwhelming support for the establishment of a separate, free-standing department of anaesthesia at one of the most tradition-bound universities in the United States-Harvard.

Adapting the forms of yesterday to the functions of today and the needs of tomorrow: a genealogical case study of clinical teaching units in Canada.

Emergent discourses of social responsibility and accountability have in part fuelled the expansion of distributed medical education (DME). In addition to its potential for redressing physician maldistribution, DME has conferred multiple unexpected educational benefits. In several countries, its recent rise has occurred around the boundaries of traditional medical education practices. Canada has been no exception, with DME proliferating against a backdrop of its longstanding central node, the clinical teaching unit (CTU). The CTU first appeared just over 50 years ago with its position in Canadian health care largely taken-for-granted. Given the increasing prominence of DME, however, it is timely to reconsider what the place of tertiary centre-based practices such as the CTU might be in shifting medical education systems. From a genealogical perspective, it becomes clear that the CTU did not just "happen". Rather, its creation was made possible by multiple interrelated cultural, social, and political changes in Canadian society that, while subtle, are powerfully influential. Making them visible offers a better opportunity to harmonize the benefits of longstanding entities such as the CTU with novel practices such as DME. In so doing, the medical education field may sidestep the pitfalls of investing significant resources that may only produce superficial changes while unwittingly obstructing deeper transformations and improvements. Although this work is refracted through a Canadian prism, reconceptualizing the overall design of medical education systems to take advantage of both tradition and innovation is a persistent challenge across the international spectrum, resistant to tests of time and constraints of context.

[The history of geriatric psychiatry at the University of Montreal: Pioneers, milestones, and future outlook]. / L'éclosion de la gérontopsychiatrie à l'Université de Montréal, une histoire à découvrir.

OBJECTIVES: Geriatric psychiatry became an official psychiatric subspecialty in Canada in 2009. The first board examinations from the Royal College of Physicians and Surgeons of Canada (RCPSC) took place in 2013. Geriatric Psychiatry focuses on the assessment, diagnosis, and treatment of complex mental disorders in late life, a time when the interface between physical and mental health issues often adds a new level of complexity.Little has been written on the history of geriatric psychiatry in Québec and in Canada. A lesser-known aspect is that from the 1970's onwards, the department of psychiatry at the Université de Montréal (UdeM) and its network of teaching hospitals have played a pioneering role in the development of geriatric psychiatry services and training. We seek to recount the history of geriatric psychiatry at UdeM, by tracing the milestones and identifying the main actors responsible for its development, from the inception of the department of psychiatry 50 years ago. This leads us to share reflections on some of the issues geriatric psychiatry is facing in Québec. METHODS: We interviewed several key actors, past and present, of geriatric psychiatry at UdeM. We read through relevant sources such as articles and monographs on the local history of psychiatric services, information bulletins and annual reports from hospitals and from UdeM, as well as other documentation from personal archives. RESULTS: One of the very first geriatric psychiatry services in Canada was founded in 1978 at the Institut universitaire en santé mentale de Montréal, with a dedicated inpatient unit for new admissions of elderly psychiatric patients. A geriatric psychiatry outpatient clinic was inaugurated the same year at the Pavillon Albert-Prévost. Throughout the years, geriatric psychiatry services were also developed in the remaining hospital sites affiliated with the department of psychiatry at the UdeM (Hôpital Maisonneuve-Rosemont, Centre hospitalier de l'Université de Montréal, Institut universitaire de gériatrie de Montréal), driven by dedicated individuals, in accordance with their respective historical background and mission. Clinical training is provided in each of these sites for medical students, psychiatry residents and more recently, for future geriatric psychiatrists. In 2014, the geriatric psychiatry residency program at UdeM was the first to be accredited in Québec by the RCPSC, as well as the first French language geriatric psychiatry program in North America. CONCLUSION: Geriatric psychiatry in 2015 is a burgeoning field, in a challenging demographic context. Despite the clinical need, major obstacles remain, particularly in the absence of specific geriatric psychiatry positions. Furthermore, the Québec healthcare system is going through a major restructuration in 2015, adding to the uncertainty. The 50th anniversary of the department of psychiatry at UdeM is an opportunity to underline the contribution of UdeM to the development of geriatric psychiatry in Québec, and to emphasize the specific needs of the elderly in terms of mental health care and geriatric psychiatry services.