Archive for April, 2010

Target of ecstatic Times Square kiss still adorable after all these years

posted on April 26, 2010

By Ginny McPartland
Where were you on August 14, 1945? Not born yet? Most of us weren’t. You may remember the day President Kennedy was shot (November 22, 1963), the night the Beatles were on Ed Sullivan (February 4, 1964), the day the Berlin Wall was doomed to come down (November 9, 1989). Or maybe for you the biggest day in history was the night Barack Obama was elected president of the United States (November 4, 2008).

Kiss felt around the world

But for the generation that endured World War II (and, for many, the Great Depression), the day the war finally ended has no competition for the most significant day in American, if not world, history. Those left of the Greatest Generation in 2010, 65 years after the war ended, are making a valiant effort to get across to the latest generation why we can’t forget WWII.

I met one of the WWII history ambassadors and an icon –Edith Shain – the other day in Oakland. Her claim to fame is the unscripted role she played in a spontaneous drama in Times Square on the day the war ended. Her shapely legs with a nice turn of the ankle were part of the attraction of the photo of a sailor and a nurse kissing as if there were no tomorrow. She was adorable then, and she’s adorable now.

Tiny Edith is traveling around America at age 91 to spread the word of the WWII legacy. Spokeswoman for “Keeping the Spirit of ’45 Alive” with actor Hugh O’Brien (Wyatt Earp), she’s stumping with the message that “we” have to stick together like Americans did during the four-year nightmare to defeat Adolph Hitler and Japanese imperialists.

Edith Shain, Ginny McPartland

As someone who soaks up everything I can about  WWII, I was excited to meet Edith. I was especially jazzed because Kaiser Permanente is also celebrating our 65th anniversary. The health plan, set up to take care of Richmond shipyard workers during the war, opened to the public in October of 1945. So our heritage work gels beautifully with the Spirit of ‘45 initiatives.

The day the world could breathe again

Edith Shain, 1945

Edith was a part-time nurse and student at New York University on the day President Harry Truman announced the Japanese had surrendered. She and a friend, at work in Manhattan at Doctors Hospital, took the subway to Times Square when they heard the news. Still wearing her nursing whites, Shain joined the crowd in expressing their impossible-to-describe exhilaration that the horrors of world war were over.

Amid the pandemonium, Edith was suddenly grabbed, embraced and passionately kissed by the unknown sailor who’d forgotten his manners in the heat of the moment. Alert photojournalist Alfred Eisenstaedt and naval photographer Lt. Victor Jorgenson seized the opportunity for the image of a lifetime. Jorgenson’s version was published the next day in the New York Times; Eisenstaedt’s shot appeared on Life magazine’s cover.

Eisenstaedt’s iconic photo has for six decades epitomized the unbridled jubilation of all Americans on that day in history. People surmised the sailor and the nurse were being reunited as a couple at war’s end. But actually, after the kiss the ecstatic sailor went looking for another thrill. “He went one way and I went the other,” Shain said in a 2005 NPR interview following the dedication of a 26-foot bronze statue replicating the famous kiss.
http://www.npr.org/templates/story/story.php?storyId=4799520

Sharing the lessons of a world at war

Edith left nursing after the war and became a teacher of small children in West Los Angeles. She took on the mission of education with a vengeance, and today she wants to teach all generations about the lessons of war.
She laments: “The younger generation knows nothing about the war.” She complains our current military actions in the Middle East are not justified and we shouldn’t be there. “In World War II, we were fighting for something.”

The “Spirit of’45” campaign is to bring attention to the war legacy by sponsoring numerous events through 2010 to culminate with special events nationwide on August 14. The organization is asking people to write letters to their representatives in Congress to designate a day in August to commemorate World War II veterans. The group has set up a Web site for veterans and other people to share their war stories.
www.spiritof45.org

Permanente marks 65 years as public health plan

Permanente’s first years after the war were rough. We had a small membership so it was difficult to keep the enterprise going. Things picked up in 1950 when the longshoremen’s union, the retail clerks, cannery workers and other small groups brought an influx of members. Through these 65 years, the health plan has grown to 8 million-plus members in eight states – California, Oregon, Washington, Hawaii, Georgia, Ohio, Maryland (and Washington D.C.) and Colorado.

We will be marking the milestone along with our partners at the Rosie the Riveter National Park in Richmond, especially during the Home Front festival in October. With the park service, we are developing educational displays and other interpretive materials to highlight our shared history and the war legacy.
http://nps.gov/rori

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Kaiser Permanente and Earth Day 2010: It’s in Our DNA

posted on April 21, 2010

By Tom Debley, Director, Heritage Resources

Last week, Breathe California honored Kaiser Permanente with its leadership award “for its commitment to environmental sustainability through the promotion of healthy communities, green buildings, and green buying practices in the Kaiser medical network, serving as a model for the health care industry.”

Earth Day seems an appropriate moment to talk about the history behind such an honor. The values behind Kaiser Permanente’s commitment to the environment are, so to speak, part of our DNA.

1938 Grand Coulee Dam hospital featured repurposed air conditioning equipment from Dr. Sidney Garfield's very first hospital in 1933.

Back in 1938, for example, our founding physician, Sidney R. Garfield, retrofitted a hospital for Henry J. Kaiser’s workers at the construction site of Grand Coulee Dam in the eastern Washington desert. Never one to let anything go to waste if it could be recycled, Garfield ordered that the air conditioning system from a small, abandoned hospital he had built in Southern California’s Mojave Desert be shipped to Washington state and reassembled for his Grand Coulee hospital.

Garfield’s partner in medical care operations, Henry Kaiser, was no less committed to sustainability and environmental sensitivity in his vast industrial operations. In 1942, Kaiser built his steel mill in Fontana, Calif., to produce steel plate for ship construction during World War II. The first steel mill west of the Rocky Mountains, Kaiser insisted that his engineers make it the cleanest in the United States. As one of his biographers, Albert P. (Al) Heiner, recalled, “…His engineers and operators knew they would always have Kaiser’s backing in their efforts to be leaders in the field of air pollution control.”

And indeed they were leaders.

When Henry J. Kaiser built the first American steel mill west of the Rockies, seen here in the 1940s, he ordered his engineers to make it the cleanest in the U.S.

“When smog became a serious hazard in the mid-1950s, rapidly expanding operations at Fontana came under rigorous scrutiny,” wrote historian Mark S. Foster in his book “Henry J. Kaiser: Builder in the Modern American West.”  “Kaiser Steel installed the most sophisticated smokestack and furnace emission screening devices available.”

As the Christian Science Monitor reported in 1959, Kaiser’s engineers didn’t just install that advanced air pollution control equipment; they also built a laboratory to study the effects of air contaminants on plant life in three greenhouses constructed in the path of downwind smoke.

Consider, too, that in the months before there was an Earth Day, Kaiser Steel published a report to the community celebrating this history. “…We feel Kaiser Steel is a fully-responsible industrial citizen in our community. We’re pioneers in air pollution control research… We want clean air just as much as anyone else…maybe more.”

One of the people who probably had a hand in that was Al Heiner, who was Kaiser Steel’s vice president for public relations. But before you conclude that this was merely PR spin, consider that Al Heiner was a co-founder of the 53-year-old League to Save Lake Tahoe and co-author of the slogan used to this day by the conservation organization: “Keep Tahoe Blue.”

Such an activity from a Kaiser executive was the rule, not the exception, under Henry Kaiser’s leadership. As Heiner once recalled, “With his encouragement, Kaiser personnel at all levels played leading roles in nearly every worthwhile community activity…”

It comes as no historical surprise, then, that Kaiser Permanente also was in the forefront of environmental issues in the 1960s.

When some critics derided Rachel Carson’s 1962 book Silent Spring as “patently unsound” and filled with “oversimplifications and downright errors,” Kaiser Permanente invited her to deliver the keynote address at a 1963 symposium for 1,500 physicians, scientists, and journalists to explore issues related to pesticides, radiation, cigarettes, and drugs.

Acknowledging that “such viewpoints promote controversy,” Clifford H. Keene, MD, vice president and general manager of Kaiser Foundation Health Plan and Hospitals, opened the program saying the purpose was “to examine the propensity and the ability of man to harm man on a grand scale.”

“This endeavor,” Keene added, “is part of our continuing program of education integral to the professional climate of Kaiser Foundation Hospitals. …Those of us who are devoted to the physical and mental well-being of man look to scientists in every field for assistance and guidance in our task.”

On Earth Day 2010, dozens of activities are taking place across the country involving Kaiser Permanente facilities and employees and physicians.  Now, you may understand why.  It’s in our DNA.

KP’s Computerized Hospitals Trace Roots to Vision 40 Years Ago

posted on April 16, 2010

By Tom Debley
Director, Heritage Resources

“Matching the superb technology of present-day medicine with an effective delivery system can raise U.S. medical care to a level unparalleled in the world.”

Someone might have said that last week talking about electronic medical records, a potentially superb technology which have barely begun to penetrate U.S. hospitals

But actually, the vision quoted above came 40 years ago this month from Dr. Sidney R. Garfield, founding physician of Kaiser Permanente. He wrote about it in a groundbreaking April 1970 article published in Scientific American—the most important paper of his career.  Since 1970, it has been cited in other scientific and medical papers more than 200 times and reprinted three times.

"Computer Center" was at center of Dr. Sidney Garfield's vision 40 years ago.

Every time I look at this four-decade-old article, I’m awed when I turn to the page with Garfield’s own schematic illustration of health care delivery as he envisioned it in 1970 with a “computer center”—instead of a hospital—at the center.  Around the “computer center” Garfield placed four modules: health testing and referral, health care, preventive maintenance, and sick care.

“Health testing combines a detailed computerized medical history with a comprehensive panel of physiological tests administered by paramedical personnel,” Garfield wrote.  “Tests record the function of the heart, thyroid, neuromuscular system, respiratory system, vision and hearing. Other tests record height and weight, blood pressure, a urine analysis and a series of 20 blood chemistry measurements plus hematology.

“…By the time the entire process is completed the computerized results generate ‘advice’ rules that recommend further tests when needed or, depending on the urgency of any significant abnormalities, an immediate or routine appointment with a physician.

The entire record is stored by the computer as a health profile for future reference.

“Most important of all, it falls into place as the heart of a new and rational medical care delivery system.”

That last sentence helps to explain why last year 12 of the very first 13 American hospitals to be rewarded by HIMSS, the leading health IT association, for having the highest level of e-connectivity were Kaiser Permanente hospitals.  This year, 24 Kaiser Permanente hospitals have achieved that status, with more on the way.

Early Computing Center at Kaiser Permanente

Great achievements start with a grand vision, followed by persistence and hard work.  Garfield’s vision was indeed grand.  But it did not start with the Scientific American article. It was actually 50 years ago in May that he first proposed that Kaiser Permanente embrace the computer, with the Scientific American article coming after the first 10 years of research and testing.  More on that next month.

Meanwhile, if you want to read the Scientific American article, you can find the reprint in this link to The Permanente Journal.  Or, if you have a copy of my book, “The Story of Dr. Sidney R. Garfield: The Visionary Who Turned Sick Care into Health Care” (The Permanente Press, 2009), you will find it as Appendix 5.

Henry J. Kaiser: America’s No. 1 Civilian Hero

posted on April 13, 2010

By Tom Debley, Director, Heritage Resources

Henry J. Kaiser was featured as "Shipbuilder No. 1" in a 1943 Real Heroes comic book.

Sixty-five years ago this year Henry J. Kaiser emerged on the American scene as the single most popular civilian hero of World War II, which came to an end in 1945.

It was a Roper Poll that spring that reported that—in the words of Stephen B. Adams, author of “Mr. Kaiser goes to Washington”—the American public “believed Kaiser had done more to help the president win the war than any other civilian.”

A Gallup Poll a few months later found Kaiser at the top of the list of people Americans thought should be president—with Kaiser trailing only Generals Douglas MacArthur and Dwight Eisenhower. It is no surprise, then, that Kaiser was on President Roosevelt’s short list for vice president when he chose Harry Truman in the election of 1944.

Why not Kaiser? One answer comes from Michael Dobrin, guest curator of a special exhibit on Kaiser’s life at the Oakland Museum of California in 2004, who concluded Kaiser was too progressive for Democratic Party leaders.

“…Conservative party insiders—probably sensing coming postwar struggles over civil rights—balked at his overt advocacy of voter education, voters’ rights and support for unions,” Dobrin wrote in The Museum of California Magazine. “His name was dropped from the list.”

The public’s admiration for Henry Kaiser—whose most enduring legacy is co-founding with surgeon Sidney R. Garfield the medical care program that bears his name—lasted up to and beyond the end of his life in 1967. Indeed, he was so beloved that when he died in 1967 mourners flooded his memorial service with more than 20,000 white and red roses – said to be the entire supply of all florists in the San Francisco Bay Area. This was in addition to thousands of orchids and other flora from people in the Hawaiian Islands.

As President Lyndon B. Johnson said in condolences sent to Kaiser’s family, “Henry J. Kaiser embodied in his own career all that has been best in our country’s tradition. His own energy, imagination and determination gave him greatness—and he used that greatness to give unflaggingly for the betterment of his country and his fellow man.”

Today, of course, his efforts—and the legendary labor of almost a quarter million men and women of all races who worked for him in his West Coast ship building operations—are honored by the Rosie the Riveter / World War II Home Front National Historical Park in Richmond, Calif., which celebrates its 10th anniversary this year.

In addition, the newly renovated Oakland Museum of California will reopen May 1 with its first major redo in nearly 40 years. Its completely new Gallery of California History will include Henry J. Kaiser. According to the museum, the theme of the gallery will be Coming to California—“an idea that evokes not only the arrivals and departures of people throughout human history and their interactions with the inhabitants already here, but also the notion of coming to terms with the influence of California on our individual and collective identities.”

Late last year, Kaiser also was inducted into the California Hall of Fame and is featured in an exhibit at The California Museum  in Sacramento.

Interested in learning more about Henry J. Kaiser? Here are three good books, any one of which you might find in a local library (or for sale online):

“Henry J. Kaiser: Builder in the Modern American West,” Mark S. Foster, University of Texas Press, Austin, Texas, 1991.

“Henry J. Kaiser: Western Colossus,” Albert P. Heiner, Halo Books, San Francisco, Calif., 1991.

“Mr. Kaiser Goes to Washington, The Rise of a Government Entrepreneur,” Stephen B. Adams, The University of North Carolina Press, Chapel Hill, North Carolina, 1997.

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Replacing ‘Sick Care’ with ‘Health Care:’ Dr. Sidney Garfield’s Ideas in the National Reform Dialogue

posted on April 5, 2010

By Tom Debley, Director, Heritage Resources

It was fascinating to me to research and write a book about the life of Kaiser Permanente’s founding physician, Sidney R. Garfield, but it has become even more so to observe how visionary he was in his time as discussion continues in the wake of President Obama’s signature on health care reform.

Dr. Sidney R. Garfield, a surgeon, co-founded prevention-focused Kaiser Permanente with industrialist Henry J. Kaiser.

A month ago, I wrote a blog about Harvard Business School Professor Clayton Christensen, who argued in the pages of Business Week that health care needs business models like Kaiser Permanente—health care systems in which doctors and insurers are on the same side of the ledger as the patient. I observed that this was an idea Dr. Garfield put forward as the model for Kaiser Permanente in a speech in Portland, Oregon 65 years ago Sunday (April 4).

This Monday (April 5), I was struck by a quote in an article by Robert Pear in the New York Times.

“We don’t have a health care system in America,” said Senator Tom Harkin, the Iowa Democrat who chairs the Senate health committee. “We have a sick care system. If you get sick, you get care. But precious little is spent to keep people healthy in the first place.”

First Lady Eleanor Roosevelt, visiting World War II Home Front patient, asked Dr. Sidney R. Garfield to tell her about prevention-focused medical care.

Harkin’s statement is an interesting juxtaposition with an event exactly 67 years earlier—April 5, 1943—when First Lady Eleanor Roosevelt visited a World War II Kaiser Industries shipyard worker, a woman with a seriously injured left leg, as shipyard manager Edgar F. Kaiser looked on in Vancouver, Washington.

Whatever Mrs. Roosevelt heard about Dr. Garfield’s focus on injury and illness prevention efforts as he built the largest civilian medical care program on the Home Front of World War II, she was immediately intrigued. Returning to the White House, she dictated a note to Dr. Garfield, “I am interested in getting medical care, both preventive and curative, at the least cost to the people. What is your program on the preventive side?”

“Your expression of interest in preventive medicine is rather closely allied with our thoughts for medical care,” Dr. Garfield responded in a letter detailing his ideas.

What Dr. Garfield did on the Home Front is, of course, one of the historical stories told at the Rosie the Riveter / World War II Home Front National Historical Park in Richmond, Calif.

Dr. Garfield spent his whole professional life on these ideas. It was not easy, but his vision was central to the evolution of Kaiser Permanente as—in Dr. Garfield’s words—a “total health” system of care.

In the first 15 years of toil after World War II, Dr. Garfield’s big frustration was how challenging it was to move from a “sick plan” to a “health plan,” but he never gave up. His big breakthrough came 50 years ago next month, and I will write about that story in a blog in May.

In the meantime, if you are interested in learning more about Dr. Garfield, my book, “The Story of Dr. Sidney R. Garfield: The Visionary Who Turned Sick Care into Health Care,” is available from the publisher, The Permanente Press, as well as from Amazon.com in both book form and on Kindle.

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