The Architecture of Health Care (Part 2)

Today’s guest post is written by Bert Hansen, Ph.D., professor emeritus of history at Baruch College of CUNY.  He is the author of Picturing Medical Progress from Pasteur to Polio: A History of Mass Media Images and Popular Attitudes in America (Rutgers, 2009), and other studies of medicine and science in the visual arts.  He is presenting an illustrated lecture about historic New York City buildings, followed by two walking tours-Uptown (May 13) and Downtown (May 20).  His 6 pm talk on Thursday, May 11, is entitled “Facades and Fashions in Medical Architecture and the Texture of the Urban Landscape.”  To read more about this lecture and to register, go HERE.

Part 1 introduced readers to the architectural firm of Sawyer and York and two of their medical buildings.  Part 2 now looks at Charles B. Meyers, who was responsible for dozens of major buildings in New York City and farther afield, including more than a dozen hospitals just in the city.  Still, he remains largely unknown outside of architectural history circles.

Readers of this blog are likely to know the red brick Psychiatric Hospital at Bellevue and Manhattan’s towering Criminal Court Building and House of Detention (New Deal WPA, 1938-41), sometimes called “The Tombs,” taking the name of an earlier building in neo-Egyptian style.[1]  Less familiar will be Morrisania Hospital in the Bronx and the Baruch College administration building (originally Family Court, 1939) on 22nd Street and Lexington Avenue.[2]  Some will have seen or visited the giant cube on Worth Street that housed the City’s Department of Health until 2011.  But it’s unlikely many could connect any of these with an architect’s name.  Even fifty years after his death, the imprint of Meyers on the look of New York is enormous while his name and career remain obscure.  Readily familiar buildings are seldom remembered as his elegant work.

Charles Bradford Meyers (ca.1875-1958) was an alumnus of City College and of Pratt Institute.  Early he worked in the office of Arthur Napier.  By the 1910s, he had began to specialize in schools, hospitals, and other public buildings.  Among about a dozen New York City hospitals he built, the Psychiatric building at Bellevue (1931) is one of the most familiar, in the red-brick and white-stone Beaux-Arts style that McKim Mead and White had established in their master plan for the Bellevue campus.

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The original Bellevue Psychiatric Hospital building (462 First Avenue). Source: Wikipedia.

His headquarters building for the New York City Department of Health (1935) at 125 Worth Street, right near two be-columned neo-classical courthouses, is a sleek, if monumental Art Deco cube with the names of famous healers inscribed on all four facades.  This building was one of many supported by federal infrastructure funding through the New Deal.  Nearby is another monumental work of his, the Manhattan Criminal Court Building of 1938-1941).  It, too, was a New Deal effort, one of thousands of such projects that are being documented in a crowd-sourced web-site, The Living New Deal.[3]

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New York City Department of Health (125 Worth Street). Source: Bert Hansen.

The former Morrisania Hospital (1929) in the Highbridge section of the Bronx is now an apartment cooperative, not generally accessible to architecture buffs or the public in general.  But I had an opportunity to visit last October during the weekend of Open House New York, when hundreds of generally private spaces are opened to the curious.

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The former Morrisania Hospital (East 168th Street between Gerard and Walton Avenues in the southern Bronx). Source: New York Housing Conference.

In the mid 1970s, Morrisania Hospital was closed at the time of the city’s fiscal crisis of the 1970s, and the building sat empty for about twenty-five years.  During the time when its future was in doubt and it might have been demolished and lost to posterity, Christopher Gray wrote about it in his “Streetscapes” column in the New York Times (15 July 1990) with his characteristic blend of reportage and criticism:

“The façades are generally straw-colored brick, although they range from a light beige to a deep orange.  They are ornamented with delicately molded Renaissance-style terra cotta in acanthus leaf, egg and dart, Greek key and similar patterns.  Red roof tiles provide a final accent.  Although the main elevation, facing 168th Street, is fussy and over-decorated, the bulk of the complex is an educated, tasteful design—above the norm for municipal architecture in this period.”[4]

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Façade of the former Morrisania Hospital building. Source: Bert Hansen.

Gray wrote this column weekly from 1987 to 2014, offering such stimulating insights over more than twenty-five years.  I was one of his readers and, in retrospect, I now realize how much he shaped my awareness of the visual pleasures of the New York City’s historic architecture.  After Gray’s death earlier this spring, another New York Times writer on architecture and urban life, David W. Dunlap, called to mind Gray’s distinctive approach:  “Gray did not serve up conventional architectural assessments. . . .  His columns were narratives of creation, abandonment, and restoration that lovingly highlighted quirky design and backstairs gossip from decades past.”  And Gray himself, perhaps thinking of overlooked treasures like Morrisania Hospital, had once remarked, “I am much more interested in minor-league, oddball structures than in tour-bus monuments like the Woolworth Building.”[5]

Meyers was a prolific architect with a career of nearly sixty years.  His buildings exhibited a remarkable range of uses and aesthetic styles.  Because they are scattered around the city (and beyond), one can’t do a Charles B. Meyers walking tour.  But the historically curious can still visit former hospital buildings like Morrisania and Bellevue Psychiatry as well as the elegant downtown Art Deco cube that he built for the Health Department (since relocated to Queens) and that is now called the Health, Hospitals, and Sanitation Departments Building.

References:
[1] Norval White, Elliot Willensky, and Fran Leadon, AIA Guide to New York City, fifth ed. (Oxford University Press, 2010), p. 80.
[2]Alex Gelfand, “The Development and Evolution of the Baruch Campus,” (including photographs of architectural decoration on the Meyers building).
[3] The Living New Deal. “Manhattan Criminal Court Building-New York NY.”
[4] Christopher Gray, “Streetscapes: Morrisania Hospital; A Tidy Relic of the 1920’s Looking for a New Use,” New York Times, July 15, 1990, p. R8.
[5] David W. Dunlap, “Christopher Gray, Who Chronicled New York Architecture, Is Dead at 66,” New York Times, March 14, 2017, p. B15.

The Architecture of Health Care (Part 1)

Today’s guest post is written by Bert Hansen, Ph.D., professor emeritus of history at Baruch College of CUNY.  He is the author of Picturing Medical Progress from Pasteur to Polio: A History of Mass Media Images and Popular Attitudes in America (Rutgers, 2009), and other studies of medicine and science in the visual arts.  He is presenting an illustrated lecture about historic New York City buildings, followed by two walking tours-Uptown (May 13) and Downtown (May 20).  His 6 pm talk on Thursday, May 11, is entitled “Facades and Fashions in Medical Architecture and the Texture of the Urban Landscape.”  To read more about this lecture and to register, go HERE.

Even people who are not architecture buffs usually recognize big contemporary names in architecture like I. M. Pei (the Louvre pyramid) of Pei Cobb Fried and Partners (Bellevue’s new Atrium Pavilion, 2005) or Skidmore Owings and Merrill (New York University Medical School buildings in the 1950s and Mt. Sinai’s Annenberg Pavilion of 1976).  Most New Yorkers have also run into the firm of McKim Mead and White’s many New York City buildings and their master plans for Columbia University and the Bellevue Hospital campus.

But what about Charles B. Meyers and the firm of York and Sawyer—both from the early twentieth century?  New Yorkers certainly know several of their contributions to the architecture of health care and to the cityscape more widely, but usually without knowing the designers’ names.

This blog introduces York and Sawyer.  The work of Charles B. Meyer will appear in a subsequent installment.

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The former Flower-Fifth Avenue Hospital (1249 Fifth Avenue).  Source: © Matthew X. Kiernan/New York Big Apple Images.

In 1921, their handsome and stately Fifth Avenue Hospital in Beaux-Arts style was completed and dedicated.  It spanned the block between 105th and 106th Streets, facing the entrance to Central Park’s Conservatory Garden.  The lower parts of the facade were of light colored limestone blocks and the upper parts were stucco in the same color.  It had terra cotta trim and a tile roof.  Although its X-shape floor plan was traditional, this design broke new ground in being a hospital without wards—only private rooms.[1]  The hospital was later renamed Flower-Fifth Avenue Hospital, and the building is currently home to the Terence Cardinal Cooke Health Care Center.

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Flower-Fifth Avenue Hospital floor plan of the fourth and fifth floors. Source: Architecture Review (1920).

The principals of the firm were Edward York (1863–1928) and Philip Sawyer (1868–1949), who established their firm in 1898 after they met while both were employed at McKim Mead and White.  They continued the American version of Beaux-Arts principles exemplified by McKim Mean and White’s work even as they expanded classical and Renaissance style to high-rise buildings made possible by the invention of the Otis safety elevator.  Among their many New York City buildings, readers are probably familiar with the New York Historical Society on Central Park West, the Federal Reserve Bank on Liberty Street, the Bowery Savings Bank on East 42nd Street, and the Central Savings Bank on 73rd Street between Broadway and Amsterdam (now the Apple Bank for Savings).

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Federal Reserve Bank (33 Liberty Street). Source: Wikimedia Commons.

Just four years after the Fifth Avenue Hospital opened, the New York Academy of Medicine laid a cornerstone for its new home on Fifth Avenue at 103rd Street, also designed by York and Sawyer.  This building had a dedication on November 18, 1926, which the following day’s New York Times headlined “Medical Academy in $2,000,000 Home.”  (Adjusted for inflation that project would cost about $27 million today).  An Italianate palazzo with Romanesque and Byzantine elements and faced in large stone blocks of variegated greys, the Academy was quite different from the classical lines and the uniform light color of their nearby hospital.  But both were beautiful additions to a rapidly developing upper Fifth Avenue, now often called “Museum Mile.”  They were proud—and enduring—achievements for the architects and for the health care institutions they served so well.

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The New York Academy of Medicine (1216 Fifth Avenue).

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Entrance to the New York Academy of Medicine.

Reference:
[1] Anonymous, “The Fifth Avenue Hospital and Laura Franklin Free Hospital for Children, New York City: York & Sawyer, Architects, Wiley Egan Woodbury, M.D., Consultant,” The Architectural Review 11:5 (November 1920), 129-140 plus unnumbered glossy plates.

Ninety Years and Counting

By Arlene Shaner, Historical Collections Librarian

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Postcard showing entrance to The New York Academy of Medicine, n.d.

On Saturday, October 15th tours of The New York Academy of Medicine’s building will again be part of Open House New York, the city’s annual celebration of architecture and design.  This year’s event is a notable one for us because our building is ninety years old. On October 30, 1925, after sixteen years of fund-raising, searching for just the right location, and reviewing and approving plans drawn up by the architectural firm York & Sawyer, the trustees of the Academy laid the cornerstone for our present home. Slightly over a year later, on November 18, 1926, after an afternoon dedication ceremony, the building opened to the public.  The election of Honorary Fellows and the delivery of the Wesley M. Carpenter Lecture, by Professor Michael I. Pupin of Columbia University, took place that evening.

The building received quite a bit of attention in the press when it opened. The December 1, 1926, issue of the Medical Journal and Record devoted more than twenty pages to descriptions of the opening ceremonies, including the texts of several of the speeches from the November 17th dinner at the Waldorf Astoria that preceded the formal dedication, Arthur Duel’s account of the history of the Academy’s several homes, and Mabel Webster Brown’s detailed exploration of many of its architectural features.1

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Postcard with exterior view from 103rd Street of The New York Academy of Medicine, n.d.

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Postcard with view of Woerishoffer Hall, the Academy’s third floor reading room, constructed in 1925.

The building is a showcase of the Byzantine and Romanesque revival style popularized by York & Sawyer in collaboration with the interior design firm Barnet Phillips, whose other New York projects with the architects include the Central Savings Bank, the Bowery Savings Bank and the New York Athletic Club, all of which display similar design features.2 The Academy’s new home contained nine floors of library stacks; the main library reading room, Woerishoffer Hall, with its large arched windows looking out to the north and west; the auditorium, Hosack Hall; reception rooms; office spaces; and meeting rooms for the Academy and several other organizations. A carved lunette featuring Asclepius, the Greek god of medicine, and his daughter, Hygeia, the goddess of health, fills the archway above the front entrance, flanked by portraits of Hippocrates and Galen. Carved Latin inscriptions, selected by a committee of Academy fellows, fill niches above the front door and some of the windows. Elaborately painted beamed ceilings, depicting animals and plants important to the history of medicine, grace the main lobby area and the third floor reading rooms. The bronze animals and plants inlaid in the marble floor of the entrance lobby, along with the carved figures in the auditorium, add whimsical touches that still attract the attention of visitors today.

Above, a squirrel and a mandrake adorn the floors of our lobby.

In 1928, Architectural Forum, one of the most prominent national architecture magazines, featured the building in its April Architectural Design issue, providing floor plans as well as multiple photographs of the interior and exterior spaces. Matlack Price, in his preliminary comments, complimented the architects on their ability to make the design seem “so new, so fresh, so vital as to seem almost the same stuff as the modernistic trend of today, the difference being that this new revival of Byzantine and Romanesque is far better than most of the modernistic work is, or is likely to be. This structure is among the most interesting of recent buildings.”3

 Although the Academy expected its new building to provide sufficient space for at least twenty years of library growth, by 1930 the trustees were already exploring plans for an expansion. At the end of 1932 the addition that contains the rare book room suite and other office and study spaces rose above the auditorium on the northeast side.

While looking through the archives in preparation for this year’s tours, sets of postcards illustrating a number of the architectural features of the building came to light. We know that these cards could not have been made until after the spring of 1933, when the addition was completed because one of the cards shows the interior of the rare book room (below). The postcards, which are part of this post, show many of the elements of the building that are still visible today.

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Interior of our rare book room, now called the Drs. Barry and Bobbi Coller Rare Book Reading Room.  n.d., but after 1933.

References

1Duel, A. B., “The Building of the Academy,” Medical Journal and Record Dec. 1, 1926, pp. 718-721 and Brown, M.W., “Art and Architecture of the Academy of Medicine’s New Home, Medical Journal and Record Dec. 1, 1926, pp. 729-734.

2https://archive.org/stream/SelectionsFromTheWorkOfBarnetPhillipsCompanyArchitecturalDecorators/BarnetPhillipsCompanyCca107588#page/n0/mode/2up  Accessed on October 4, 2016.

 3Price, M., “The New York Academy of Medicine,” Architectural Forum, Part I: Architectural Design, v.XLVIII, no.4, April 1928, pp. 485-503.

Explore the Academy Library Timeline

By Robin Naughton, Head of Digital 

The New York Academy of Medicine Library began in 1847 with the intention of serving the Academy fellows, but in 1878, after the collection had expanded to include over 6,000 volumes, Academy President Samuel Purple and the Council voted to open the Library to the public.  It continues to serve both the Academy fellows and the general public, providing an unprecedented level of access to a private medical collection.  Today, the Academy Library is one of the most significant historical libraries in the history of medicine and public health in the world.

The Academy Library’s history spans almost 170 years and a glimpse into this history is documented in this interactive timeline. While the timeline does not represent everything that has occurred in the Library, notable milestones can be seen here. The story starts with the founding of the Library on January 13,1847, with a gift from Isaac Wood of Martyn Payne’s Medical and Physiological Commentaries and continues forward to the recent renovation and naming of the Drs. Barry and Bobbi Coller Rare Book Reading Room.

 

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Figure 1:  The New York Academy of Medicine Library Timeline (Created using Northwestern University’s Knight Lab Timeline JS).

 

Timeline Highlights


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New York Academy of Medicine, Archives.

 

 

 

Academy’s First Permanent Home: In 1875, the Academy purchased and moved into its first permanent home at 12 west 31st Street. This image of the Academy’s first building will take you back to a different time.

 

 

 

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New York Academy of Medicine, Archives.

 

 

 

 

Academy’s Current Home: In 1926, the Academy moved to its current location on 103rd Street and 5th Avenue. The architectural firm York & Sawyer designed the building.  A 1932 expansion added three new floors on the northeast side of the original structure above the existing floors.  Today, you can visit the Academy at this location and explore the historic building.

 

 

 

 

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Apicius’ de re culinaria, 830 A.D. 

 

 

Cookery Collection: In 1929, Margaret Barclay Wilson gave the Academy her collection of books on food and cookery, which includes a 9th-century manuscript (De re culinaria) attributed to Apicius, and sometimes referred to as the oldest cookbook in the West.

 

 

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George Washington’s lower denture, 1789.

 

 

George Washington’s Teeth:  Yes, that’s right!  In the spring of 1937, the descendants of John Greenwood gave the Academy the lower denture created by New York dentist John Greenwood for Washington in 1789. The denture is just one of the artifacts that the Library owns.

 

 

 

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Librarians Gertrude L. Annan and Janet Doe, both in The Bulletin of the New York Academy of Medicine., vol. 50, no. 10, 1974.

 

 

Honored Librarians: In 1974, the Academy honored Gertrude L. Annan and Janet Doe, long-time librarians for their contributions to the Library.

 

 

 

 

There are many more highlights in the timeline so click through and enjoy.

The Tech


The Academy Library timeline was created using Northwestern University’s Knight Lab open-source timeline tool called TimelineJS. The tool was released under the Mozilla Public License (MPL), making it possible for anyone to create timelines to embed and share publicly.

TimelineJS is an easy tool to create a timeline with just a few steps. Here are some things to keep in mind when creating a timeline:

Content: Have content ready prior to creating

It’s important to have content ready prior to creating the timeline.  For the Academy Library timeline, there was already a text version of the timeline that could be used to create the interactive timeline. Together Arlene Shaner, Historical Collections Librarian and I edited, updated and added images to the timeline. Starting with some content allowed us to devote time to enhancing the timeline by finding and adding associated images.

Media:  Make media publicly available

It is important that the media resources used in the timeline are publicly available.  TimelineJS uses URLs to access and display the media files (images, videos, maps, Wikipedia entries, Twitter, etc.). Thus, items behind firewalls or logins will not be accessible to the public. Make sure to upload images to a publicly available server and use that URL for the timeline.

Google Sheets: Add all content and links into spreadsheet and publish

Google Sheets is the data source for the timeline and this means that all data for the timeline is managed in Google Sheets. Once the Google Sheets file is published, the URL is used by TimelineJS to create the timeline, link to the timeline and embed code for websites.

If you’re familiar with Google Sheets or have used any spreadsheet program, then you know the process of adding content to the spreadsheet. If you haven’t used any spreadsheet program before, think of Google Sheets as a table with multiple columns and rows where you’ll input data for the timeline.

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Figure 2:  TimelineJS Google Sheets Template

To get started, the TimelineJS template and directions provide a good guide to the parameters of the timeline with each row representing a screen and each column a component of that screen. For example, the date structures are very flexible and the timeline can include a full date and time or just a year. Also, in the background column, adding a hex number for color can change the background color or including a link to image will show a background image.

 

The Influence of Sunshine and Pure Air: New York City Parks and Public Health

By Emily Miranker, Project Coordinator

My first picnic of the summer was picture-book perfect. Norman Rockwell would have approved: my friends and I clustered on blankets sipping lemonade, lightly toasted by the sun and gently cooled by a breeze, occasionally tossing a stray ball back to a child or sharing tidbit of our cold chicken lunch with an eager puppy.

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Central Park’s Harlem Meer.  Photo:  Emily Miranker

The belief that public parks are “a fundamental need of city life,”1  goes very deep. The father of American landscape architecture, Frederick Law Olmsted ‑to whom (along with Calvert Vaux) New York City owes not only Central Park; but Prospect Park, Carroll Park, Fort Greene Park, the Parade Ground and Von King Park,2 commented that it was more than delight in nature that made parks so vital. There was a health benefit too. “The enjoyment of scenery employs the mind without fatigue and yet exercises it; tranquilizes it and yet enlivens it; and thus, through the influence of the mind over the body gives the effect of refreshing rest and reinvigoration to the whole system.”3

The Park Association of New York City (today New Yorkers for Parks) took up Olmsted’s charge after his death. Several small associations banded together in 1908 to form The Parks and Playgrounds Association of the City of New York; primarily concerned with advocating for children with no outdoor spaces in their neighborhoods. This organization merged with the Battery Park Association and the Central Park Association to become the Park Association in 1928. “Our purpose,” they declared, was to advocate park extension, defense and betterment, as parks were “essential to the mental, moral and physical well-being of city dwellers.”4  The starting point was that ever persistent New York City need: land.

Our collection boasts a wonderfully-designed pamphlet from this period soliciting support for the Park Association.  The pamphlet argues for the maintenance of city parkland, and the acquisition and development of more land dedicated to greenspace.

The pamphlet includes a colorful fold-out map. On the map, green illustrates the city’s parks as of 1927, yellow, the land purchased and intended for park use but not yet developed, and red, land recommended for purchase by the 1927 Metropolitan Conference on Parks but not yet purchased by the city.

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Fold-out map published by the Park Association of New York City.  To Protect and Extend our City Parks for Posterity.  ca. 1927.

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Inside of pamphlet with introductory letter from President Nathan Straus.  To Protect and Extend our City Parks for Posterity.  ca. 1927.

The pamphlet’s call to action is to “make the yellow and red green.” Indeed, many of those patches on the map have since become green.

The Trust for Public Land (TPL), whose mission to create and protect land for people ensuring healthy and livable communities is much like the Park Association’s just on the national scale, spends a fair amount of time bolstering their advocacy for parks with research on the health benefits they provide. In 2006, TPL released a white paper on the health benefits of parks, underscoring the argument that parks are a wise investment for communities.5 You can read the report online for percentages, statistics, financials, and citations of peer-reviewed work; but in brief: greenways enable people to exercise, improve mental health, offer vital space for child play, and contribute to the creation of stable communities

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A 2011 geographic map of the distribution of parks and playgrounds done by the Built Environment and Health research team at Columbia University.6

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Map of New York City parkland (the dark green) created by The Trust for Public Land’s ParkScore rating system.7

A Fellow of The New York Academy of Medicine wrote on this very topic back in 1899. Dr. Orlando B. Douglas bemoans the lack of numbers to support his firm belief in the rejuvenating power of parks in The Relation of Public Parks to Public Health, written for the American Park and Outdoor Art Society. What he lacks in hard scientific data, he makes up for in poetic writing:

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Orlando B. Douglas’ The Relation of Public Parks to Public Health, published in 1899.

While he didn’t have the same kind of data to fortify his arguments available to TPL more than a hundred years later, Douglas supports his claims that “the public park system in cities resulted in diminishing the rate of nervous disease [and] the improvement of the general health in cities”9 with testimony from twenty-one other doctors throughout the state of New York. I imagine that Dr. Douglas would have been thrilled at our ability today to quantify the beneficial effects of parks; though his pamphlet is more enjoyable reading than modern white papers.

References

1.  To Protect and Extend our City Parks for Prosperity. New York: Park Association of New York City; 1929.

2. “Olmsted-Designed New York City Parks,” NYC Parks. Accessed June 14, 2016. https://www.nycgovparks.org/about/history/olmsted-parks

3. Frederick Law Olmsted, “The Yosemite Valley and the Mariposa Grove of Big Trees,” The Saturday Evening Post, July 18, 1868.

4. To Protect and Extend our City Parks for Prosperity. New York: Park Association of New York City; 1929.

5. “Parks,” Built Environment and Health Research Group at Columbia University. Accessed June 14, 2016. https://beh.columbia.edu/parks/

6. “ParkScore: New York, NY,” The Trust for Public Land. Accessed June 14, 2016. http://parkscore.tpl.org/map.php?city=New%20York

7.  https://www.tpl.org/health-benefits-parks accessed June 14, 2016.

8.  The Relation of Public Parks to Public Health. Boston: Rockwell and Churchill Press; 1899.

 

Have You Heard of the Lincoln Collective?

Today’s guest blogger, Merlin Chowkwanyun, is an assistant professor of sociomedical sciences at Columbia University’s Mailman School of Public Health. He will present “The Lincoln Collective: The World of New York City Health Activism in the 1970s” at the Academy on May 24. Learn more and register.

I’m really looking forward to visiting the New York Academy of Medicine next week, in no small part because the health activism I’m going to discuss took place in New York City itself. My talk will focus on a couple dozen physicians, fresh out of medical school, who decided to do their residencies at Lincoln Hospital in the South Bronx in the 1970s.

They arrived in the summer of 1970 and called themselves “the Lincoln Collective,” hoping to form a critical mass of politically conscious physicians who could effect change in one institution, and in the process, provide a model for other activists across the country to follow. In its recruitment pamphlet, the Collective’s founders wrote that they intended “to become part of the solution rather than part of the problem” and “affirm[ed] that we are in training to serve the community, and that we are committed to dealing with the problems of the urban ghetto community in a long-run way.” That commitment entailed not just ephemeral service projects that lasted a few weeks, but finding ways to facilitate more permanent community input into healthcare facilities’ operations.

Cover of a Lincoln Collective Recruitment pamphlet.

Cover of a Lincoln Collective Recruitment pamphlet.

Lincoln epitomized the overtaxed, under-resourced urban hospital. One official document described it as “a hopelessly inefficient and inadequate building” with “dirt and grime and general dilapidation [that] make it a completely improper place to care for the sick…” And locals had nicknamed it “The Butcher Shop.” By conventional standards, then, Lincoln was not exactly a desirable or prestigious choice for your typical medical graduate at this time. So what was it that set the Lincoln Collective’s members apart? Who were these people? And where did their values come from? What were they hoping to get by converging on one of the most dilapidated hospitals in one of the most resource-deprived areas of the United States? And most important of all, what did it all mean in the end, when the Lincoln Collective came to a close in the mid-1970s?

To answer these questions, I’ll place the Lincoln episode in a wider story about changes that wracked the healthcare sector during the 1960s and 1970s. Many Collective members had been involved in student organizing on medical campuses, not exactly known, then and now, as cauldrons of political foment. Others had come from community organizing. And some were not particularly political and simply looking for a place to serve the most indigent and medically deprived. They came to Lincoln when the health field was undergoing what I have called a “governance revolution”—multi-pronged efforts throughout the era to decrease hierarchy within medicine and increase the participation of professionals in healthcare governance.

Article on medical student unrest in Medical World News, Oct. 13, 1967, pp. 63–67.

Article on medical student unrest in Medical World News, Oct. 13, 1967, pp. 63–67.

The Collective arrived at a time of tumult around the hospital itself. Groups like the Black Panthers and the Young Lords had made healthcare equality a major tenet of their organizing. At times, the Collective’s relationship with these groups was cooperative and fruitful, at other times, tense and ambiguous. Much of that depended on Collective members’ individual ideological inclinations, which were hardly uniform throughout the group. Tensions undergirded the encounter between mostly white physicians and mostly non-white, non-professional activists, and I’ll explore these challenges throughout the talk.

Pamphlet of Health Revolutionary Unity Movement, a health-oriented adjunct of the Young Lords that also organized around Lincoln.

Pamphlet of Health Revolutionary Unity Movement, a health-oriented adjunct of the Young Lords that also organized around Lincoln.

I’ve been thinking about the Lincoln Collective for more than a decade now. The title of my talk is an utterance I heard repeatedly when I was a college student in New York City studying activist movements in public health and medicine. “Have you heard of the Lincoln Collective?” people would ask. Some who posed the question were in it (and some claimed to be but, I’d later discover, were not). When I went off to graduate school, I put the story aside for a long time. At the confused age of 22, I didn’t feel I had the political maturity to really write about some pretty politically fraught and emotional events. Now, with more distance, I’ve returned to it.

We’re now in an era when people in the health sector—in the wake of a wave of police brutality and the Flint disaster—are asking themselves serious questions about the role political activism should play in their work. Turning back the clock and looking at a group of health activists from 50 years ago is a way of moving that conversation forward.

Stories and Heritage of Nursing in New York City

The Fellows Nursing Section at The New York Academy of Medicine and the Academy Library invite you to join us next Thursday, April 14, at 6:00 PM for an evening exploring the stories and heritage of nursing in New York City. Admission is free but advanced registration is required. Register online.

The evening’s presenters include:

Dr. Joanne Singleton, Professor at Pace University and author of White Beret: The Story of an Urban Nurse, her fictional account of life in a pediatric unit in a New York City hospital.

Lisa Mix, Head, Medical Center Archives, New York-Presbyterian Hospital Weill-Cornell Medical College.

Barbara Niss, Director, Archives & Records Management at Mount Sinai Medical Center.

Arlene Shaner, Historical Collections Librarian, New York Academy of Medicine Library who will provide insights into the nursing heritage held in libraries and archives across the city.

Two tours of the Drs. Barry and Bobbi Coller Rare Book Reading Room will be held following the evenings speakers. Tours are limited to 15 people each; email culturalevents@nyam.org to register. Other nursing-related materials will be on display in the main meeting room.

Mental Health in the Metropolis: The Midtown Manhattan Study

By Paul Theerman, Associate Director, Center for the History of Medicine and Public Health

How can we improve urban health? That is one of the missions of the New York Academy of Medicine, and a question public health professionals have been asking for decades. One of the landmark urban health studies, Mental Health in the Metropolis: The Midtown Manhattan Study, was published more than half a century ago.1 The study was intended to be a deep and exhaustive look into the mental health of residents in one of the most urban environments in the country, Midtown Manhattan. In many ways it was to be a model of the state of urban health throughout the country.2 And it was shaped by the medical experience of World War II.

Title page of Mental Health in the Metropolis, 1962.

Title page of Mental Health in the Metropolis, 1962.

Many veterans developed mental illnesses over the course of the war. Dr. Thomas A. C. Rennie, associate professor of psychiatry at Cornell University Medical College, saw many cases directly. He organized rehabilitation services for veterans during the war, and in 1944 published When He Comes Back and If He Comes Back Nervous.3 This booklet was followed by Mental Health and Modern Society,4 a professional discussion of the effects of war on society. In his war and postwar experience, Rennie encountered many people suffering from mental difficulties, and concluded that the long and extended psychoanalytic approach would never treat them effectively, for lack of time and resources.

Dedication of Mental Health in the Metropolis to Thomas A. C. Rennie.

Dedication of Mental Health in the Metropolis to Thomas A. C. Rennie.

Instead, Rennie began to look at the relationship between mental health and the social community.5 In the process he created a new field—social psychiatry. In 1950, he was appointed the first professor of social psychiatry at Cornell, arguably holding the first position of this kind anywhere in the United States.6 He conceived the Midtown study this same year, and launched it in 1952. Upon Rennie’s sudden death from a cerebral hemorrhage in mid-1956, the program was continued by Dr. Alexander Leighton, a colleague, medical sociologist, and psychiatrist at Cornell. The study ended in 1960, with publication of its results in 1962.7 It was a large undertaking; overall, the project utilized the services of some 200 people.

What did the study look like? In the words of the lead author, sociologist Leo Srole of SUNY Medical Center Brooklyn (SUNY Downstate), “An investigation focused upon Midtown can, in a special sense, be likened to an intensive case study. Here a community, rather than an individual, is the case.”8 Mental health was investigated as an outcome of community function and dysfunction, as much as or even more so than of the individual. That community was studied along many lines: age, sex, marital status, socioeconomic status, “generation-in-the-U.S.,” and various frames of origination: rural or urban, nationality, and religious affiliation. Researchers also assessed access to and outcomes of mental health and psychiatric care by surveying community residents and treatment workers. Their work seemed to show that Midtown held large numbers of untreated ill individuals, most of whom still functioned at an acceptable level. But definitive results were difficult to come by, and more studies were called for.

Correspondence between sick-well ratios for 12 socioeconomic status strata, reported in 4 groups, with highest SES marked “1” and lowest “12”. The “sick-well” ratio is found by comparing the numbers of “impaired” persons in a particular grouping, with the number of “well” persons. Two other rankings lie between these designations: “mild symptom formation” and “moderate symptom formation.” Mental Health in the Metropolis, Figure 5, p. 231. Click to enlarge.

Correspondence between sick-well ratios for 12 socioeconomic status strata, reported in 4 groups, with highest SES marked “1” and lowest “12”. The “sick-well” ratio is found by comparing the numbers of “impaired” persons in a particular grouping, with the number of “well” persons. Two other rankings lie between these designations: “mild symptom formation” and “moderate symptom formation.” Mental Health in the Metropolis, Figure 5, p. 231. Click to enlarge.

Mental Health in the Metropolis was the report of a large and complex analysis, marrying the different disciplines of psychiatry and sociology to understand and address medical problems using social means. As such it was a child of the war—the war that created mass problems, and suggested ways towards solving them. And it was the harbinger of studies to come.

References

1. Authored by Leo Srole, Thomas S. Langner, Stanley T. Michael, Marvin K. Opler, and Thomas A. C. Rennie, volume 1 in the Thomas A. C. Rennie Series in Social Psychiatry (New York: Blakiston Division, McGraw-Hill, [1962]).

2. Mental Health in the Metropolis, p. 338. The precise boundaries of the study area were not disclosed for reasons of confidentiality; it was described as “more or less midway up the length of Manhattan Island,” bounded by the business district, two major thoroughfares, and a river, and “almost wholly residential in character,” with 175,000 inhabitants (p. 72, and fn 14). Using the name “Midtown” to describe this community was surely inspired by the famous “Middletown” studies of Muncie, Indiana, done by Robert Staughton Lynd and Helen Merrell Lynd, and published in 1929 and 1935.

3. With Luther E. Woodward: New York: The National Committee for Mental Hygiene, [c1944].

4. Also with Luther E. Woodward: New York: Commonwealth Fund, 1948.

5. He was not the first to explore this connection, of course, and he profited from his work with Adolf Meyer of The Johns Hopkins Medical School from 1931 to 1941, Oskar Diethelm, “Thomas A. C. Rennie, February 28, 1904 — May 21, 1956,” Cornell University Faculty Memorial Statement, https://ecommons.cornell.edu/handle/1813/17813, accessed March 18, 2016.

6. Mental Health in the Metropolis, pp. viii.

7. Mental Health in the Metropolis, pp. 336–37.

8. Mental Health in the Metropolis, p. 28.

Surviving the Great Blizzard of 1888

By Johanna Goldberg, Information Services Librarian

After the snowstorm on January 22–23, 2016 dropped 26.8 inches of snow on New York City, lists circulated of the worst snowstorms in the city’s history dating back to 1869. Of the top ten storms, only one occurred in the 19th century: the blizzard of 1888, which resulted in 21 inches of snow falling on the city from March 12–14 of that year.

"Entrance to the Astor House facing Broadway between Barclay and Vesey Streets. Taken in March 1888 during the Great Blizzard." From Strong, The Great Blizzard of 1888.

“Entrance to the Astor House facing Broadway between Barclay and Vesey Streets. Taken in March 1888 during the Great Blizzard.” From Strong, The Great Blizzard of 1888.

The blizzard arrived unexpectedly. The forecast for Sunday, March 11 called for slight wind and evening rain. But late that night, a storm from the south altered its course at the same time that the wind changed direction. Rain turned to sleet, hail, and finally snow. New Yorkers woke up on Monday to 10 inches of snow and bitter cold.

“Looking north on Madison Avenue during the March 1888 Blizzard.” From Strong, The Great Blizzard of 1888.

Not realizing that the worst was yet to come—11 more inches of wind-swept snow fell before the storm ended—many ended up stranded on their way to work or school. Eighty mile an hour wind gusts blew snow into drifts as high as second story windows and, along with the snow and ice, stopped elevated trains and toppled phone, electric, and telegraph poles. After the suspension of ferry service, people attempted to cross the frozen East River on foot (many were rescued by tugboats). More than 200 New Yorkers died as a result of the storm.1,2

"45th Street and Grand Central Depot, New York, Blizzard, March 1888." From Strong, The Great Blizzard of 1888.

“45th Street and Grand Central Depot, New York, Blizzard, March 1888.” From Strong, The Great Blizzard of 1888.

"149 Broadway, now the site of the Singer Building, March 1888." From Strong, The Great Blizzard of 1888.

“149 Broadway, now the site of the Singer Building, March 1888.” From Strong, The Great Blizzard of 1888.

In 1938, fifty years after the blizzard, Samuel Meredith Strong, M.D., “Former President of ‘The Blizzard Men of 1888,’” published The Great Blizzard of 1888, a collection of oral histories and printed articles from those who survived the storm. Below are some selections from the book:2

Excerpt from an article by Julian Ralph in the New York Sun, September 2, 1933:

“Few of the women who worked for a living could get to their work places. Never, perhaps, in the history of petticoats was the imbecility of their design better illustrated. ‘To get here I had to take my skirts up and clamber through the snowdrifts,’ said a washerwoman when she came to the house of the reporter who writes this. She was the only messenger from the world at large that reached that house up to half-past 10 o’clock. ‘With my dress down I could not move half a block.’ It was so with many thousands of women; the thousand few who did not turn back when they had started out.”2

11th Street, New York, looking west." From Strong, The Great Blizzard of 1888.

11th Street, New York, looking west.” From Strong, The Great Blizzard of 1888.

From Wm. Chamberlain, Maspeth, New York:

“Mount Olivet Cemetery at Maspeth, New York, had two orders for burials to take place that day, and the Superintendent had men with a small plow drawn by horses work to keep the roads in the cemetery open. Along about ten o’clock he got me on the job shoveling, and after dinner sent me for men in the neighborhood. I think I got two or three and with others and the plows we worked until about 4:30 in the afternoon, but it was no use as the wind blew the snow back faster than we could handle it. We quit, licked to a frazzle, cold and tired and hungry. The funerals, according to the records in the cemetery, did not take place until two or three days later.”

"Copy of photograph taken in Flushing, Long Island, by Mr. William James in March 1888. Mr. Frederick Morris at the left, Dan Beard standing in the center." From Strong, The Great Blizzard of 1888.

“Copy of photograph taken in Flushing, Long Island, by Mr. William James in March 1888. Mr. Frederick Morris at the left, Dan Beard standing in the center.” From Strong, The Great Blizzard of 1888.

Dr. Charles Gilmore Kerley, published in Medical Clinic of North America, November 1935:

“I was a resident physician at the New York Infant Asylum in Westchester County, N.Y. At this institution there were a few over 400 children and about 200 mothers. The age of the child population ranged from infants of a few weeks to children five or six years of age. Among those under one year were perhaps 100 who were partly or entirely dependent on cow’s milk feeding. Eight cans of loose milk a day were supplied by a dairy eight miles distant, the milk being delivered in a horse-drawn truck—then came the big blizzard completely blocking traffic of every nature—in our case for seven days. I well remember the consternation and alarm at the thought of being cut off from all food supplies with over 600 people to be cared for. A few days before the historic storm, through error a large consignment of Borden’s condensed milk arrived at the institution. Twelve dozen cans had been ordered and 12 gross (1728) cans were received. Our greatest anxiety naturally centered on the bottle fed; the condensed product was at once brought in to use and a blizzard feeding plan was inaugurated through dilution with barley water. Greatly to our surprise the marasmic and difficult feeders, struggling along on diluted sterilized milk, took on new life, began to smile and gain in weight.”

Baxter Street, New York, Blizzard, March 1888." From Strong, The Great Blizzard of 1888.

Baxter Street, New York, Blizzard, March 1888.” From Strong, The Great Blizzard of 1888.

John Potter of Lowville, New York:

At that time I had a room on West 24th Street. I was employed as bookkeeper by a firm on Beach Street and started for work at 8:00 o’clock on that morning, taking the 6th Avenue elevated railroad from West 23rd Street. The train proceeded slowly until we reached the curve at Bleeker and 8th Streets when we came to a standstill and remained there until 3:00 o’clock in the afternoon without any heat in the car. About that time a man appeared on the street from a corner saloon with a long ladder which he placed against the elevated railing. The railing being coated with ice it was a difficult matter to climb over and reach the ladder. I recall carrying a young woman and, missing my footing partly down, we both landed in a snow bank. The man charged us fifty cents for the privilege of using his ladder.”

Hotel Martin 17-19 University Place, corner of 9th Street during the March 1888 Blizzard. Abandoned horse-car." From Strong, The Great Blizzard of 1888.

Hotel Martin 17-19 University Place, corner of 9th Street during the March 1888 Blizzard. Abandoned horse-car.” From Strong, The Great Blizzard of 1888.

Caroline Kleindienst, from Cranbury, New Jersey:

“Through the long lone hours of that night we were blessed with our eleven pound boy, without nurse or doctor.… Next morning we found we were completely snowed in. My husband started to shovel his way out, through snow as deep as he was tall….It was three weeks before the roads were cleared and the Doctor then made his first visit to our home and congratulated me on the fine new baby who came into this world unaided and alone in the Big Blizzard of 1888 and twenty-six years and six months later left this world in the Wright chemical explosion [an accident at a factory in Elizabeth, NJ that killed three workers3].”

"Wreck at Coleman's Station, New York & Harlem R. R., March 13, 1888." From Strong, The Great Blizzard of 1888.

“Wreck at Coleman’s Station, New York & Harlem R. R., March 13, 1888.” From Strong, The Great Blizzard of 1888.

The blizzard contributed to slow but successful city efforts to move power lines underground and replace elevated trains with the underground subway. It also spurred a more organized response to future weather events from the Department of Street Cleaning, now called the Department of Sanitation.1

Park Place, Brooklyn, N. Y., March 14, 1888." From Strong, The Great Blizzard of 1888.

Park Place, Brooklyn, N. Y., March 14, 1888.” From Strong, The Great Blizzard of 1888.

The next time a blizzard comes to New York, be grateful for modern weather forecasting technology and heated subway cars. And don’t try to cross the East River by foot!

References

1. Virtual New York. Blizzard of 1888. Available at: http://www.virtualny.cuny.edu/blizzard/bliz_hp.html.

2. Strong SM, Overton M. The great blizzard of 1888. [New York]; 1938.

3. GUNCOTTON KILLS THREE. Explosion Wrecks Factory and Shakes a New Jersey County. New York Times. http://query.nytimes.com/gst/abstract.html?res=9D00EEDB1438EF32A2575AC1A96F9C946596D6CF. Published September 19, 1914. Accessed March 4, 2016.

From Cholera to Zika: What History’s Pandemics Tell Us about the Next Contagion

By Sonia Shah

Sonia Shah, today’s guest blogger, is a science journalist and author of Pandemic: Tracking Contagions from Cholera to Ebola, and Beyond (Sarah Crichton Books/Farrar, Straus & Giroux, February 2016), from which this piece, including illustrations, is adapted.

On February 23 at 6pm, Shah will moderate the panel “Where Will the Next Pandemic Come From?,” cosponsored by the Pulitzer Center on Crisis Reporting. Register to attend.

Over the past 50 years, more than 300 infectious diseases have either newly emerged or re-emerged into territory where they’ve never been seen before. The Zika virus, a once-obscure pathogen from the forests of Uganda now rampaging across the Americas, is just the latest example. It joins a legion of other diseases that have similarly broken out of earlier constraints, including Ebola in West Africa, Middle East Respiratory Syndrome (MERS) in the Middle East, and novel avian influenzas in Asia, one of which hit the U.S poultry industry last spring, causing the biggest animal disease epidemic in U.S history.

When such pathogens spread like a wave across continents and global populations, they cause pandemics, from the Greek pan (“all”) and demos (“people”). Given the number of pathogens in our midst with pandemic-causing biological capacities, pandemics themselves are relatively rare. In modern history, only a few pathogens have been able to cause them: Yersinia pestis, which causes bubonic plague; variola, which causes smallpox; influenza A; HIV; and cholera.

Cholera is one of the history’s most successful pandemic-causing pathogens. The first cholera pandemic began in the Sundarbans in present-day Bangladesh in 1817. Since then, it has ravaged the planet in no fewer than seven pandemics, the latest of which is currently smoldering just a few hundred miles off the coast of Florida, in Haiti.

Cholera first perfected the art of pandemics by exploiting the rapid changes in transportation, trade, and demography unleashed by the dawn of the factory age. New, fast-moving transatlantic clipper ships and sailing packets, which moved millions of Europeans into North America, brought cholera to the New World in 1832. Thanks to the opening of the Erie Canal in 1825, the bacterial pathogen easily spread throughout the country, including into the canal’s southern terminus, New York City, which suffered repeated cholera epidemics over the course of decades.

The spread of cholera after the opening of the Erie Canal.

Cholera was well-poised to exploit the filth of 19th-century cities. The pathogen spreads through contaminated human waste. And outhouses, privies, and cesspools covered about 1/12 of New York City, none of which were serviced by sewer systems and few of which were ever emptied. (Those that were had their untreated contents unceremoniously dumped into the Hudson or East Rivers.) The contents of countless privies and cesspools spilled out into the streets, leaked into the city’s shallow street-corner wells, and trickled into the groundwater.

Even those who enjoyed piped water were vulnerable to the contagion. The company chartered by New York State to deliver drinking water to the city’s residents—the Manhattan Company, which started a bank now known as JPMorgan Chase—dug their well among the tenements of the notoriously crowded Five Points slum, in what is today part of Chinatown. They delivered the slum’s undoubtedly contaminated groundwater to one third of the city’s residents.

The 1832 cholera outbreak in New York City. the Manhattan Company, now JP Morgan Chase, sank its well amidst the privies and cesspools of the Five Points slum, atop the site of the Collection Pond, which had been filled in with garbage. The water was distributed to 1/3 of the city of New York.

The 1832 cholera outbreak in New York City. The Manhattan Company, now JP Morgan Chase, sank its well amidst the privies and cesspools of the Five Points slum, atop the site of the Collection Pond, which had been filled in with garbage. The water was distributed to 1/3 of the city of New York.

Just as the Zika and MERS viruses confound modern-day medicine, so too did cholera confound 19th-century medicine. Under the 2,000-year-old spell of miasmatism—the medical theory that diseases spread through stinky airs, or miasmas—doctors couldn’t bring themselves to admit that cholera spread through water, despite convincing contemporary evidence that it did.

But that doesn’t mean there was nothing that could have been done to mitigate the cholera pandemics of the 19th century.

The Manhattan Company knew the water they distributed was dirty. As a former director of the company admitted in 1810, Manhattan Company water was rich with its users’ “own evacuations, as well as that of their Horses, Cows, Dogs, Cats, and other putrid liquids so plentifully dispensed.” New Yorkers decried its smell and taste, which they variously derided as “abominable” and “nauseating.”1 They suspected, too, that the company’s water made them sick. “I have no doubt,” one letter writer opined to a local paper in 1830, “that one cause of the numerous stomach affections so common in this city is the impure, I may say poisonous nature of the pernicious Manhattan water which thousands of us daily and constantly use.”2

And New York’s physicians knew that cholera was coming down the Erie Canal and the Hudson River, heading straight for the city. Dr Lewis Beck, who collected the data mapped above admitted that the pattern of disease did “favor the idea that cholera is contagious,”3 and travelling down the waterways into New York City. So many people feared the migrants coming down the waterways during cholera outbreaks that residents of towns lining the canal refused to let passengers on passing boats disembark. In 1893, in fear of a cholera outbreak, an armed mob surrounded the cholera-infected passengers of the Normannia, a vessel recently arrived from Hamburg, Germany, trapping hundreds aboard for days.

But despite the public’s fears of contagion and contaminated water, little was done to protect the city from either. The city’s leadership refused to enact quarantines along the canal or the Hudson for fear of disrupting the lucrative shipping trade that had transformed New York from a backwater to the Empire State. The Manhattan Company retained its charter, despite public outcry about the quality of their water. The political machinations of the infamous Aaron Burr, pursuing his murderous rivalry with the now-storied founding father Alexander Hamilton, assured that.

Instead, each wave of deadly contagion was met with minor adjustments to society’s defenses against pathogens. International conferences began in 1851 to organize cross-border quarantines against cholera and other diseases. New York City opened its first independent health department, staffed by physicians rather than political appointees, in 1865, as cholera loomed (thanks in large part to the efforts of the New York Academy of Medicine). These reactive, incremental measures couldn’t stave off nearly a century of deadly cholera pandemics, but as the decades passed, they formed the foundation for the global health system we enjoy today. Following New York City’s example, independent health departments were built across the country. The international conferences to tame cholera led to the formation of the World Health Organization, in 1946.

Today, we continue to fight contagions in a similarly reactive, incremental fashion. After Ebola infected tens of thousands in West Africa and elsewhere, hospitals in the United States and other countries beefed up their investments in infection control. After mosquito-borne Zika infected millions across the Americas, public health agencies focused anew on the problem of disease-carrying insects.

Whether these measures will be sufficient to defuse the next pandemic remains to be seen. But a more comprehensive, proactive approach to defanging pandemics is now possible, too. The history of pandemics reveals the role of human activity in the emergence and spread of new pathogens. Industrial developments that disrupt wildlife habitat; rapid, ad hoc urbanization; intensive livestock farming; sanitary crises; and accelerated trade and travel all play a critical role, just as they did in cholera’s heyday. In some places, we can diminish the pathogenic threat these activities pose. In others, we can step up surveillance for new pathogens, using new microbial sleuthing techniques. And when we find the next pandemic-worthy pathogen, we can work to contain it—before it starts to spread.

References

1. Pandemic, p 64. From Koeppel, Gerard T. Water for Gotham: A history. Princeton University Press, 2001, 121, 141.

2. Pandemic, p 63. from Blake, Nelson Manfred. Water for the cities: A history of the urban water supply problem in the United States. No. 3. Syracuse University Press, 1995, 126.

3. Pandemic, p 106. from Tuite, Ashleigh R., Christina H. Chan, and David N. Fisman. “Cholera, canals, and contagion: Rediscovering Dr Beck’s report.” Journal of public health policy 32.3 (2011): 320-333.