Archive for the ‘Latest Blog posts’ Category

No Getting Round it: An Innovative Approach to Building Design

posted on June 23, 2017

Lincoln Cushing
Heritage writer

 

What is it about circular architecture in Henry J. Kaiser’s facilities?

We know that Henry J. Kaiser was a geodesic dome pioneer. Kaiser Aluminum and Chemical Corporation built two of the first civilian domes in 1957, one in Virginia and one in Hawaii. There’s another plan from the same year (never built) for a “Medical office building for the Kaiser Foundation Hospitals with Kaiser Aluminum dome.

The Permanente Foundation hospital at Panorama City (1962-2008) featured seven double circular floors, an example of Dr. Sidney Garfield’s “circles of service” concept. Dr. Garfield explained that in a 1974 interview:

In the center was a work space for the personnel, the supervisor right in the middle, with the public or patients coming in from an outside corridor – the peripheral corridor, central workspace concept. This would permit us to keep the central area clean, as the contaminated areas go out the outside corridors so you don’t get any cross traffic. It kept the orderlies and all the people who moved stretchers out of the central work space and so forth and the supervisor is right there so she can see everything.

Kaiser Child Service Center at Swan Island, circa 1943.

Yet there’s one more – the Portland Child Service Centers built in 1943 for the workers at the Oregonship and Swan Island shipyards. The center at Oregonship opened for children on November 8, 1943, Swan Island Center soon afterwards on November 18.

These structures represented an innovative approach to building that carries over to present at the Kaiser Permanente, although the organization is no longer builds round things – or does it?

Current hospital and building designs focus on environmental stewardship and patient safety, with a healthy dose of aesthetic brilliance thrown in. A news article on how design and healing go hand in hand called out the award-winning 2016 Kaiser Permanente, Kraemer Radiation Oncology Center in Anaheim, Calif., as featuring “fritted glass that evokes a forest and provides both light and privacy.” And it’s round, or at least rounded.

Frank Stewart, Administrator; George Wolff, Architect, Dr. Wallace Neighbor (pointing); Northern Permanente Foundation Hospital, circa 1942.

The 1943 Portland buildings were designed by the Portland, Ore., architectural firm of Wolff and Phillips (George M. Wolff and Truman E. Phillips), creators of several important Kaiser and Permanente facilities.

George Wolff (1899-1978) was a personal friend of Henry Kaiser’s son Edgar, and through that connection drew the firm into designing the worker’s housing at Bonneville Dam in Washington in 1934. In they created the 1942 Northern Permanente Foundation Hospital to serve the workers in Kaiser’s three northwest shipyards, as well as the wartime city of Vanport of almost 40,000 people.

After the war, the firm designed the conversion of Ford’s Willow Run plant in Michigan when Henry Kaiser took it over to produce automobiles, and later they designed the 1953 state-of-the art Kaiser Foundation Hospital in Los Angeles.

Playground core, Oregon child service center.

Unlike the more conventional design of the Maritime Child Development Center in Richmond, Calif., the Oregon centers put classrooms in a circle around six separate playgrounds.

We hear about this idea in a March 1944 article “Designed for 24-Hour Child Care” in Architectural Record, where Wolff and Phillips credited the facility design to the “ring school” concept originally conceived of by modernist architect Richard Joseph Neutra.

Neutra (1892 –1970) was an Austrian-American architect who spent most of his career in Southern California. Like Wolff and Phillips, his style was “modernist” with plentiful natural light and open space, and during the mid-1920s was evolving a radial site layout for public facilities.

Richard Neutra’s Ring Plan School project model, circa 1926.

A March 2000 article in UCLA Today explains more about Neutra’s role in this design concept:

Perhaps the most striking examples of this belief were the various schools designed by Neutra in Los Angeles. His project for a Ring Plan School, with its ring of classrooms around a play area and a running track on the roof, was adopted in 1934 by the Los Angeles School Board and built in the Bell district. The building was much celebrated for its qualities of light, relationship of classrooms to outdoors and color of materials.

One of his ring plan schools was built in 1960 at Lemoore Naval Air Station near Fresno; it’s now the Neutra Elementary School.

The design of the Portland Child Service Center was innovative, effective, and exemplary. A 2009 historic building assessment of the Portland public schools noted:

The building’s form and details rejected the architectural conventions that characterized the previous era of school construction. The Portland Child Service Center (demolished) captures the ideals that would be explored in Portland’s public schools in the post-war period.

Rejecting conventions and capturing ideals – that would be a good characterization of Henry J. Kaiser’s approach to solving national problems.

 

Short link to this article: http://k-p.li/2t4sIH8

 

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Henry J. Kaiser Jr. on Fathers and Family

posted on June 16, 2017

Lincoln Cushing
Heritage writer

 

Henry J. Kaiser, Jr, circa 1948

Henry J. Kaiser, Jr., (1917-1961) was Henry J. Kaiser’s younger son. On December 17, 1942, he spoke at a huge gathering of Kaiser Industries leaders under the theme “Together We Build.”

His comments resonate through the years on this Father’s Day 2017:

There has never been a time in my life when I could not turn to my father when I was in trouble and ask for counsel, no matter what he was doing. He had time enough, strength enough, to give me new strength, and new perspective. Dad, Edgar, and I have always talked things over. It is never one of us who fixes a problem, it is all of us.

And what is true of our personal family is true of every Kaiser enterprise. And we are the family, those of us here tonight, dependent on each other’s counsel.

Short link to this article: http://k-p.li/2sHcbrP

 

Kabat-Kaiser: Improving Quality of Life Through Rehabilitation

posted on June 14, 2017

Lincoln Cushing
Heritage writer

 

Kabat Kaiser Santa Monica, 1952, publicity photo with film and television actor Howard Keel.

Polio and multiple sclerosis. These disabling diseases of the nervous system posed daunting medical challenges as the Permanente Health Plan emerged from World War II and the nation looked toward an improved quality of life. Until a polio vaccine was developed in the mid-1950s, it was considered one of the most feared diseases in the United States, and MS is the most widespread disabling neurological condition affecting young adults in the world.

California’s first polio epidemic broke out in 1934-1935, with a second following in 1948. And, on a very personal note, Henry J. Kaiser’s youngest son Henry Junior (1917-1961) contracted MS in 1944.

Margaret “Maggie” Knott, PT, and Herman Kabat, MD, Washington, DC, 1947.

Henry J. Kaiser was determined to find the best therapy available, and through a 1946 Readers Digest article learned of Herman Kabat, MD, and his successful treatments. Kaiser sent Dr. Sidney Garfield, the founding physician of his successful World War II shipyard health plan, to assess the situation. Impressed with Dr. Kabat’s work, Dr. Garfield joined him to treat the younger Henry with considerable success. The rehabilitation program was deemed worthy of greater institutional support, and the Kabat-Kaiser Institute was born in Washington, D.C. (where Dr. Kabat practiced) in 1946. It was dedicated to “the restoration of the physically handicapped and to rehabilitate them to their optimum capacity, socially, economically, and physically.”

Eventually there would be two centers in California, providing the largest non-governmental civilian rehabilitation program in the United States for patients with neurological disorders. The Washington facility was followed by one in Vallejo (August, 1947) and a second in Santa Monica shortly thereafter. The Washington facility was closed soon after 1950 when Dr. Kabat moved to Vallejo to direct the program.

Kabat-Kaiser Santa Monica (large middle building)

The Santa Monica facility started out as the Edgewater Beach Hotel around 1925. In 1944 it was called the Ambassador Hotel and taken over by Army Air Corps as a Redistribution Station to rotate men out of combat. After the war, it became a private club, but not for long. The Permanente Foundation bought the building in October 1948 and opened it the next month as the Kabat-Kaiser Institute. A hospital ward was added January 1949.

A news account from 1952 described the setting:

First impression on entering the Santa Monica institute is that of stepping into a luxurious beach resort. A large swimming pool, beautifully furnished lounge, and inviting glassed-in beach-front patio are located on the ground floor. Shorts, pedal pushers, swim suits, and jeans are the principal attire. Second impression hits one like an avalanche. Every person in sight is either in a wheel chair, walking with crutches or body braces; or being pushed along on a gurney. Everyone appears happy and busy, going to or from a water therapy room, a physiotherapy section or exercise room.

“Many Will Rise and Walk” article by Paul du Kruif about Dr. Kabat, Readers Digest, February 1946.

Many volunteer welfare and social organizations contribute to the entertainment and special needs of the patients. Recreation includes nightly programs of moving pictures, “wheel-chair” square dances, bingo, water volley ball or variety shows.

Given the center’s proximity to Hollywood, it was often the site of cameo appearances by movie stars. But that relationship took a deeper step when the actress Ida Lupino directed (and co-wrote, and co-produced) a film there. Never Fear (1949, also titled The Young Lovers), a story about a beautiful young dancer with a promising career who contracted polio and struggled to recover, had personal meaning for Lupino, who had contracted polio herself in 1934. Lupino made the film to combat the public fear of polio during the 1948-49 epidemic, and captured the power of the center’s program using actual patients and, yes, a wheelchair dance.

Maggie Knott with patient, Kabat-Kaiser Institute, 1951.

The centers were busy; in 1950 the D.C. center was treating almost 200 patients, Vallejo saw over 400, and Santa Monica served almost 600. The staff at Santa Monica included over 60 therapists, psychologists and consulting physicians. Margaret “Maggie” Knott was the exceptional lead physical therapist who became world famous, along with Herman Kabat, for developing, practicing and teaching the technique of “proprioceptive neuromuscular facilitation.” PNF is a form of flexibility therapy that involves stretching and contracting targeted muscle groups.

Joel Bryan (1937-2005) was the Founder and Director of Disabled Students’ Services at UC Riverside and UC Davis. He was also a patient at Kabat-Kaiser Santa Monica from 1951 to 1954, and recalled his treatment in a 2000 interview:

Three months after I arrived there I could get up in a wheelchair for the first time. My spine was fused later, which straightened out my very significant scoliosis. I was 5’4″ when I got polio, and by the time I was sixteen or seventeen I was 6’2″ or 6’3″ – stretched out. There’s a lot of growing that occurs, and my back just wouldn’t support it. Those things got straightened out. I wound up with the use of my fingers on my right hand and the bicep on my left arm.

Station wagon for transporting patients to recreational activities donated to Kabat-Kaiser Institute in Santa Monica by the Federation of Women’s Telephone Workers of Southern California, 1952. Standing left is Raymond T. McHugh, K-K administrator, next to Mary V. Marsteller, president of the FWTWSC.

In 1955, Dr. Kabat left the organization. The Kaiser Foundation Hospitals assumed complete control and renamed the two facilities the California Rehabilitation Centers. In 1962 the name was changed to Kaiser Foundation Rehabilitation Center to avoid confusion with state institutions with a similar name.

Santa Monica’s rehabilitation portion closed in 1962, the convalescent facility remained open until patients could be reassigned, and the site was demolished in 1964. The Kaiser Foundation Rehabilitation Center and Hospital in Vallejo continues to this day.

 

To come: The story of Kabat Kaiser Vallejo.

Short link to this article: http://k-p.li/2t2tSPU

 

 

Edmund (Ted) Van Brunt, Former Kaiser Permanente Research Director and Pioneer of Electronic Health Records, Dies at age 91

posted on June 9, 2017

“Dr. Edmund Van Brunt, resident in Medicine at our Geary St . Hospital (center) answers questions of Jack Katzow, intern, and Mrs. Emily McEvoy, RN, about modern resuscitation equipment which all professional staff are instructed how to use in emergencies involving cardiac arrest.” Reporter, May 1961.

 

Excerpted from the Kaiser Permanente Division of Research obituary by Janet Byron

 

 

Edmund (Ted) Van Brunt, MD, former director of the Kaiser Permanente Division of Research and a pioneer in the use of electronic health records in medical science, died at his home in Berkeley on May 19, 2017.  A native of Oakland and longtime Berkeley resident, Dr. Van Brunt’s medical career with Kaiser Permanente spanned 36 years, from his appointment as staff physician in the Department of Internal Medicine in Kaiser Permanente’s San Francisco medical center in 1964, to his retirement as director of the Division of Research in 1991.

“Dr. Van Brunt’s devotion to research helped build our Division into a nationally respected group,” said Tracy Lieu, MD, MPH, current director of the Division of Research. “He was revered for his steadiness and breadth of vision.”

“Dr. Van Brunt demonstrates proper utilization of cardiac treatment equipment.” Planning for Health newsletter Summer 1967.

In 1966, Dr. Morris Collen appointed Dr. Van Brunt as project chief of the Medical Data System in Oakland and San Francisco, a computer-based patient medical record system with a database designed to support both patient care and health care delivery research. The Medical Data System project developed a multifacility, computer-based system to support the medical data requirements of one million health plan members, 1,000 physicians, and numerous professional and paramedical support staff. The system consisted of two IBM mainframe computers, and medical data from Kaiser Permanente’s multiphasic physical exam was recorded on punch cards for processing.

 

Short link: http://k-p.li/2snbzaB

 

Reaching for the Sky: How Kaiser Steel Helped Reshape San Francisco

posted on May 31, 2017

Topping out of Transamerica Pyramid, featuring Kaiser Steel, 3/28/1972.

Lincoln Cushing
Heritage writer

 

Forty five years after the Transamerica Pyramid redefined the San Francisco skyline, the city is witnessing a new exclamation mark – the Salesforce Tower. The upstart’s roof is 970 feet above the ground, and a top spike sprouts another 100 feet. It’s easily the tallest building in San Francisco and the second-tallest building west of the Mississippi River.

Until now, the Transamerica Pyramid was San Francisco’s distinctive giant. And it was built with Kaiser Steel.

News accounts featured the Pyramid’s “topping out” (or “topping off”) on March 28, 1972. It was 863 feet tall, and would have been taller at an even 1,000 feet but for a taxpayer’s lawsuit and other community opposition. And its unusual shape, intended to reduce its upper mass and improve views, was denounced by S.F. Chronicle architecture critic Alan Temko, who sniffed it “…would be out of place, even in Los Angeles, or in Las Vegas, where it belongs. It certainly doesn’t belong in San Francisco.”

Wrong.

Last year the S.F. Chronicle’s architecture and urban design critic John King praised its glories – “… an unforgettable . . . high-rise in an unforgettable setting… [which] stands serenely above the clutter of overhead wires and sidewalk fuss.”

The accompanying AP wirephoto of the “topping out” ceremony clearly shows the final steel beam being hoisted by crane – both emblazoned with KAISER STEEL.

Transamerica Pyramid construction, 5/3/1971.

Of all the businesses built by Henry J. Kaiser, historian Mark S. Foster called Kaiser Steel the “linchpin” of the powerful Kaiser industrial empire. That global reach used to include aluminum, cement, electronics, and automobile manufacturing, but all that’s left now is the Kaiser Permanente health care program. The 1980s were not kind to the American steel industry. Kaiser’s massive Fontana steel mill, built to make plate steel for cargo ships during World War II, was shut down in 1983 and sold off in 1984. Within a few years the company was all but gone.

Jesse Lee Beeson, Sr., who passed away this year, was the longtime foreman of Kaiser Steel’s “raising gang.” That team worked on giant construction projects all over the world, and placed the steel and assembled the precast concrete outer surface on the Pyramid. Mr. Beeson always considered this to be his greatest accomplishment.

Another detail in the news story was mention that the last beam sprouted “… a 4-foot redwood sapling.” It’s barely visible in the photo, but “… according to local [ironworker] custom, [a sapling] must accompany the last unit of a skyscraper’s skeleton. The sapling will be taken down and later planted in a half-acre plaza at the foot of the building.” That redwood joined 79 other siblings brought from a tree farm in the nearby Santa Cruz mountains. The Cultural Landscape Foundation praises this urban oasis.

Rather than a “curious local custom,” topping out is a widespread early Scandinavian construction practice, and was also followed in a recent Salesforce Tower event, hosted by Salesforce CEO (and health care philanthropist) Marc Benioff.

Reaching for the sky, the Henry J. Kaiser way. Welcome to San Francisco, Mr. Benioff.

 

Did you know that Kaiser Steel built the transbay tubes for Bay Area Rapid Transit in the late 1960s?
More Kaiser Steel stories to come.

 

Short link to this article: http://k-p.li/2rcOFBC

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Hot Off the Presses! Kaiser to Build Helicopters to Combat Submarine Menace

posted on May 17, 2017

Lincoln Cushing
Heritage writer

U.S. cargo routes, World War II; from Fore ‘n’ Aft, 5/26/1944.

Headline, April 30, 1943: “Kaiser to build helicopters to combat submarine menace.” By the mid-1940s, it seemed like there was almost no project that Henry J. Kaiser wasn’t trying to improve. Kaiser’s innovation wasn’t inventing things, it was looking at an existing problem and unleashing massive human talent to solve it. That worked for dams, that worked for ships, and that worked for health care.

Reporter Blair Moody of the North American Newspaper Alliance wrote about the U.S. Navy’s interest in using ship-based aircraft or helicopters to defend convoys against their number one threat: Hitler’s  U-boats. Moody offered some of the deal details:

While the Army termed the craft “still experimental” and the Navy’s position remained confusing, Kaiser walked off with a contract to develop and build them for the lend-lease administration in response to British demand. The contract was announced by R.W. Seabury, president of Cargoes, Inc., a government corporation subsidiary to [Under Secretary of State] Edward R. Stettinius Jr.’s lend-lease administration.

The Bristol Courier in Pennsylvania blared this headline the next day: “Kaiser May Build Helicopters Here” at Bristol’s Fleetwings aircraft plant.

Yet despite the best of intentions and the enormous efforts by many parties, helicopter technology was just taking off in World War II and didn’t get used to the extent envisioned.  The Igor I. Sikorsky Historical Archives, representing the preeminent U.S. helicopter developer, concedes “…helicopters remained largely untested and undeveloped and thus never played the role that many envisioned for them during the war. Given the declining submarine threat, those that wanted to develop the helicopter found it difficult to shift national policy.”

Vought-Sikorsky VS-300, 1941. When mounted with floats it was the first practical amphibious helicopter.

“Experimental” is the operative phrase here. These aircraft were still in their earliest stages, and the demands of combat flying – especially at sea – were daunting. What’s more, the expedited development of war technology caused friction between the Navy and the Army, and there were accusations that Kaiser’s efforts to take on the Navy helicopter contract would “interfere with the Army’s procurement program.” The Army had contracted with the Vought-Sikorsky Aircraft Company, a subsidiary of the powerful United Aircraft Corporation, to develop their helicopter.

Henry J. Kaiser confirmed that his contract would not in any way subvert United Aircraft’s work, and declared:

In line with my usual procedure, whenever I am requested by any department of the government to perform any specific task for the war effort. I gladly respond, especially when I am convinced personally that the work will contribute to victory. I have agreed with Mr. Seabury to build helicopters for him and the engineering is already under way.

And it was.

Henry J. Kaiser had just purchased a controlling interest in the aircraft manufacturer Fleetwings of Bristol, Penn., a month before to become a division of Kaiser Cargo, Inc. Fleetwings had a long and proud aviation history, which included the limited edition XBTK-1 torpedo bomber as a technical response to the need for smaller aircraft that could work well on compact aircraft carriers such as Kaiser’s CVE escort carriers.

But as we know, helicopters were in their infancy and . . . experimental. Sikorsky built the first production helicopter in the world; the military prototype was the XR4, and its first ferry flight was January 14, 1942.

Fleetwings plant, Bristol, Penn., November 1944

Before Kaiser’s acquisition of Fleetwings had gone through, he’d already been working on the helicopter project. A confidential memo dated March 26, 1943, from Frank de Ganahl [vice president and general manager of Fleetwings] reveals that Kaiser was pursuing two development tracks. One was called the “Sikorsky-type” helicopter, to be headed up and engineered by Ralph McClarren, Secretary of the Franklin Institute in Philadelphia, to design a two passenger, 2850-pound helicopter.  By late May, they had transferred all of that work to Fleetwings, whose primary role was to supply 25 percent of the floor space in the hangar so that McClarren and his crew could work.

Another highly confidential helicopter project would be headed up by Frank’s brother, Carl de Ganahl [President of Fleetwings], and would consist primarily of engineering studies with minor experimental shop projects.

A memo from Carl to Frank on March 29, 1943, described a meeting Carl had with Lieutenant Colonel H. F. Gregory at Wright Field. Henry J Kaiser had asked Carl to explore obtaining a production order for helicopters. Despite his reservations that the Sikorsky XR4 [later the CR4 or R4 model] might not really be ready for production, Col. Gregory had placed an order due to the urgency of the submarine menace and sought to determine which changes would be required to make shipboard operation practical in collaboration with the British Navy. Carl wrote of the efforts to attract working prototypes beyond the Sikorsky model:

I understood from Gregory that all rotary wing aircraft made to date in the size category approaching the size of the experimental order now with Sikorsky have not been successful. Just why, nobody seems to know. Gregory does not know if there is some fundamental aerodynamic problem inherent with the size of the machine, or just what it is.

Sikorsky R4 in use during World War II

History proved Col. Gregory’s concerns to be unwarranted; the R4 served as the most successful helicopter of the war. Production started in the first quarter of 1943 and by the end of the war close to 130 R4s were produced and used in the Pacific theater in a variety of roles.

When Carl informed Mr. Kaiser of his meeting, Kaiser suggested that Carl go back to Col. Gregory to get an experimental order for one large Sikorsky machine and a smaller one.

“This, Col. Gregory flatly refused to consider. He said that if we wish to come to him with a proposal on a helicopter with adequate design figures and drawings that they would be very glad to consider same; and on its merits would or would not give us a contract.”

Among other reasons, Col. Gregory was concerned that it would take Sikorsky valuable time to educate the Kaiser team rather than applying Sikorsky’s efforts to the development of its own machines.

On June 1943, Admiral Vickery (Vice-Chairman of the U.S, Maritime Commission) announced that experiments were being made to add a helicopter flight deck to a Liberty ship being built in Baltimore, the first time that a cargo vessel would be equipped with “aerial auxiliaries.” Vickery claimed that helicopters had been successfully flown off of tankers, but the effort was never completed.

Kaiser Fleetwings XH-10 helicopter, 1945

By May 1944, the Kaiser team had designed and flown one of their prototypes successfully. It was called the XH-10 “Twirleybird” two-seater, with a standard configuration of three main blades and a tail rotor, and was very similar to Sikorsky’s R4. But the XH-10 was never evaluated by the Army Air Force, and by then the war was winding down. Unlike his ships and planes, Henry J. Kaiser’s helicopters would not be part of the victory, and he moved on to other projects.

In the late 1950s Fleetwings had one more shot to produce a military turbine-powered observation helicopter, but the project stumbled and the company closed aircraft operations in 1962.

 

Short link to this article: http://k-p.li/2pXbaGR

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Mother of Invention: Henry J. Kaiser’s Inspiration for Building a Health Plan

posted on May 11, 2017

Lincoln Cushing
Heritage writer

 

Mary Kaiser in wedding dress, 1873; photo from Henry J. Kaiser: Western Colossus, by Albert Heiner.

Every institution has a story about how it started. For the health care plan now known as Kaiser Permanente, it began with Henry J. Kaiser’s mother.

In his last published interview, three and a half months before he passed away on August 14, 1967, Henry J. Kaiser stated “I see the day when no one need die for lack of medical care, as my own mother died in my arms when I was 16 years old.”

Mary Kaiser, a practical nurse, was only 52 years old when she died on December 1, 1899.

It was a story told and retold. During World War II medical author Paul de Kruif helped bring Kaiser’s novel health plan to national attention in Kaiser Wakes the Doctors. De Kruif described Kaiser’s motivation:

It was the lack of a doctor – who might have saved her life – that had killed Kaiser’s own mother at the age of 49… He was raw about this medical injustice. [Later in life] it offended him that he and his family could command the best medical advice, while millions of human beings were medically kicked around.

Henry Kaiser himself was vocal about his motivation. At a speech he made before a doctor’s group at San Francisco’s St. Francis Hotel June 9, 1948, he said:

Mother would not go to a hospital as a charity patient because she believed in giving, not taking, charity. … I propose to earn millions of dollars and put millions into hospitals and to devote my life toward helping my fellow citizens who, as my own Mother and Father did, suffer because they cannot pay for the full services they require.

Henry J. Kaiser speaking at dedication of Permanente Foundation Hospital, Oakland, August 21, 1942.

More details emerged over time. He later said that Mary’s specific condition was Bright’s Disease, a constellation of kidney diseases now known as chronic nephritis. In addition to relative poverty (Henry’s father also had health problems and was going blind), another complication for her care was that the family lived in small town in rural New York.

Historian Mark. S. Foster’s biography of Henry J. Kaiser points out some inconsistencies in Henry’s story. For one thing, Henry was actually 17 years old when his mother passed. And there’s no corroborating evidence that Henry was present at her death.

But all origin stories value mission over details, and this one is no different.

According to one of Kaiser Permanente’s founding physicians, Morris Collen, MD, Henry Kaiser told the audience at the dedication of the Oakland Hospital in 1942 “My mother died in my arms because she didn’t receive adequate medical care, and I vowed that I would do whatever I could so this wouldn’t happen to anybody else.”

The health plan that Henry Kaiser built has certainly been proof of a son’s love for his mother.
Happy Mother’s Day, Mary.

 

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Looking Through You: How a Kaiser Permanente Nurse Transformed Health Education

posted on May 4, 2017

Transparent woman on cover of 1967 Kaiser Foundation Medical Care Program report.

Lincoln Cushing
Heritage writer

 

In 1967, wife and husband Bobbie and Morrie Collen toured Montreal’s Expo 67 and were transfixed by a pair of transparent mannequins that rotated and lit up to reveal organs and display physiology. They later purchased the figures and shipped them back to Oakland to become the centerpiece of a major Kaiser Permanente health education program led by Bobbie.

Frances Bobbie Collen (née Diner, 1914-1996; always called Bobbie, never Frances) was an accomplished professional as well as being the wife of Morris “Morrie” Collen, MD. She was a nurse with a master’s degree in health education, and was the force behind the groundbreaking Health Education Research Center at the Kaiser Permanente Oakland hospital.

Bobbie graduated from Winnipeg (Canada) General Hospital as a Registered Nurse in 1937 and worked at the University of Minnesota Hospital where she met her future husband, Morrie. They wed secretly when he was a medical student because the university hospital would not hire married nurses. Later they moved to Chicago where he interned at Michael Reese Hospital and she was the evening supervisor at the Meyer House patient wing. While there she also a graduate student at the University of Chicago in Nursing Education.

Bobbie Collen, RN, circa 1980.

In 1939 the Collens moved to California where Dr. Collen began his residency at Los Angeles County Hospital. When World War II began, Dr. Collen’s 4-F status due to asthma kept him from serving in the military, but the Permanente health plan was ramping up to care for defense industry workers. Dr. Collen was one of the first ten physicians hired by Kaiser Permanente’s founding physician, Sidney Garfield, MD.

Bobbie was a founding member of the Permanente Medical Wives in Oakland, an important support group during the challenging postwar years. Dr. Collen’s oral history credits the group as a key factor in the success of Permanente medicine.

But it was Bobbie’s role in patient education that would be her lasting legacy in the advancement of health care. Dr. Garfield asked her to be the Director of the Educational Research Center in the spring of 1967: “Start with the development of a Health Exhibits Theater as an adjunct to our planned health care program for the healthy in our Health Plan membership, because this first step will be the easiest.”

Dr. Garfield with transparent man in Health Education Center

In May 1967 Bobbie submitted her thesis “Factors Associated with Continuing Education of Adult Women” for a Master of Arts in Education at U.C. Berkeley. Then the Collens toured a dozen facilities on the East Coast, including the Cleveland Health Museum and the Lankenau Hospital Education Center in Philadelphia.

Her field work in reviewing health education displays led her to this conclusion:

In my opinion, they have all missed one important feature which is a further step forward in preventive medicine, and that is, to demonstrate not only what the body looks like on the inside, and how it functions, but also how to care for it to keep it healthy. Here I think exists the potential which, when materialized in the shape of a Health Exhibits Theater, will provide a service to our membership that is unique in the country.

The Health Education Research Center at 3779 Piedmont Avenue in Oakland (next to the Kaiser Permanente Oakland hospital) opened its doors in January 1969 as a supporting function for Dr. Collen’s Multiphasic Health Testing Services.

The Principal Investigator for the demonstration research project was Krikor Soghikian, MD, and Bobbie Collen was the Education Director. The U.S. Public Health Service partially supported the Center through the Kaiser Foundation Research Institute because of the research component and its potential application elsewhere in the nation.

One key feature of the Center was the Health Library which opened July 1969, equipped with 24 individual projection booths for viewing films, slide-sound programs, and videotaped TV programs.  A patient would visit the library with a physician’s “prescription” to see a specific program.  Adjacent to the Library was an exhibit area that featured the transparent man and woman, a variety of health exhibits, and a children’s area with educational games, toys, and play figures. Later, when the Center was relocated, the children’s section included a doll with leg braces, a stuffed elephant with a hearing aid, and a monkey in a wheelchair.

Caren Quay, MLS, started as the Center’s first librarian in 1970. She recalled that from the beginning visitors requested more information, so she began to build an extensive collection of books and audiovisual materials, with every title reviewed by Permanente Medical Group physicians.

The health librarian would retrieve the prescribed audio-visual program from the files and play it on the projector in the individual’s booth. The list of educational videos grew to over 250 titles; a notation on one of the librarian’s catalogs records that the most popular subjects were stress, nutrition, birth control, breast self-examination, headaches, lifestyles, and high blood pressure.

Health Education Library for Patients, librarian Caren Quay at desk, circa 1974.

The program was quite successful. Audio-visual requests grew from 98 in 1969 to almost 8,000 by mid-1973. Attendance for women was triple that of men. Dr. Collen reflected on how well it reached members of the community:

They would bring in schoolchildren from all over Oakland, who would come in and go through this health education center. They would look at the exhibits—there was a normal lung and a smoker, smoker’s black lung, and I think that helped a lot of kids realize what smoking can do.

After Dr. Garfield and Mrs. Collen passed away (1984 and 1996, respectively) the education display lost its primary advocates. The grant money ran out and the Oakland hospital needed the space. The transparent man and woman went to U.C. Berkeley’s Lawrence Hall of Science. But what continued was an expanding role for health educators and the growth of health education centers at the Kaiser Permanente medical centers for patients and members of the community.

Health Education Library, 1978.

Ms. Quay later became the health information specialist in Northern California’s department of Patient Education and Health Promotion, and recently reflected on the legacy of the program:

The Health Library broke ground as the first library I know of in the U.S. to provide health and medical information to the lay person. It was the model and inspiration (and then flagship, resource, and consulting lead) for health education centers that provided health information (and more) for the Kaiser Permanente Medical Centers throughout Northern California and, eventually, for the other regions of the Medical Care Program. The library served as a model for Planetree in San Francisco and for others throughout the country.

Dr. Collen lamented in his oral history that “[Bobbie] doesn’t get enough credit . . . for all the things she contributed.”

On this Nurses Week we thank Bobbie Collen, RN, for improving public health through education.

 

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Sexually Transmitted Diseases in the World War II Shipyards

posted on April 26, 2017

Lincoln Cushing
Heritage writer

 

VD posters in Fore ‘n’ Aft, 3/3/1944.

During World War II, venereal diseases were called “the enemy in your pants,” and soldiers were warned that “your carelessness is their secret weapon.” But ordinary workers on the home front also confronted these communicable diseases, and the Permanente Health Plan stepped up to reduce that harm.

April is designated STD (Sexually Transmitted Disease) Awareness Month by the Centers for Disease Control and Prevention. Most of the research on pre-AIDS World War II focuses on venereal diseases in the military, but home front workers suffered as well.

Some of this threat appears to have been exaggerated at the time. An article in the Portland, Ore., area Kaiser shipyard newspaper The Bos’n’s Whistle dated April 14, 1944, about venereal disease on the home front reported an alarming – but false – statistic:

Health experts report syphilis and gonorrhea near top of list of most common communicable diseases; the toll since the war began is greater than total battle casualties.

Reviewing the actual numbers, this claim was both inaccurate and alarmist. U.S. military deaths for that war was 416,800. Home front data found in Vital statistics of the United States, published by the U.S. Bureau of the Census under “General Tables – Deaths from Selected Causes” gives us a total death toll for syphilis (the only STD singled out, which is unfortunate, since gonorrhea was also prevalent; a 1944 Kaiser shipyard article on illnesses in Washington state lists 1,666 cases of syphilis and 1,929 cases of gonorrhea) between 1942 and 1945 as 58,698. Still, that was a lot of people to see dying from a preventable disease.

“VD vs. Victory” in the Richmond, Calif., Kaiser shipyard paper Fore’n’Aft in early 1944 warned of the danger:

Four in every 100 industrial employees have syphilis… venereal disease is one of the greatest enemies of industry. The [California] State Federation of Labor considers it so important that the executive board has recommended a compulsory blood test for all union members.

A quack cannot cure you. You cannot safely treat yourself. The only way you can be sure you do not have syphilis is by a blood test. You should have a test once a year. If you find that you have caught the disease, it will still be in the early stages and a doctor can treat and cure you.

Blood test for VD in The Bos’n’s Whistle, 4/4/ 1944.

In the early years of the war the standard treatment for syphilis and gonorrhea were sulfa (sulfonamide) drugs, the first and only effective antibiotics available. The best cure – penicillin – wasn’t proven until 1943, when doctors at a U.S. Marine Hospital on Staten Island in New York successfully used it to treat four patients. And even then, this “wonder drug” was rationed for military use. It first was made available to home front workers in May 1944 to treat pneumonia, due to the efforts of Kaiser shipyard physician Dr. Morris Collen.

In language foreshadowing the challenge of treating the AIDS epidemic in the 1980s, the Bos’n’s Whistle article concluded that the biggest obstacle in attacking the problem of venereal disease was the stigma attached to it.

The important thing to remember is that to have a venereal disease does not constitute a crime, but to transmit it to others is definitely criminal. Authorities emphasize that most of the individual problems of persons having a venereal disease can be handled without resorting to law enforcement.

VD didn’t just affect men- the new shipyards were full of women as well. Hannah Peters, MD, was the Kaiser Richmond shipyard gynecologist and she co-authored Gynecology in Industry” in the Kaiser Foundation Medical Bulletin, July, 1945. There she outlined what she’d learned during her first two years serving a workforce composed of as many as 23,000 female employees.

Dr. Hannah Peters, Kaiser shipyard gynecologist

Her section on VD education explains the scope of the problem and efforts to reach out to women. She noted that during the period between March 1, 1944, and February 28, 1945, 2832 new cases were seen in the Gynecology Department of the Permanente Field Hospital in Richmond alone. Among these, there were 390 cases of gonorrhea. This meant that 13 per cent of all new gynecological cases proved to be infected with gonorrhea. The article goes on to report that the high percentage of infected women led physicians to introduce an educational outreach program in the shipyards:

Venereal disease educational material was placed in all women’s rest rooms in the yards. Literature, folders as well as booklets, supplied by the Public Health Department, were made easily available in wooden racks which were hung in conspicuous places in every women’s rest room. We were encouraged to find how quickly the literature disappeared. We know that the pamphlets were not only taken out of the rack, but they were actually read. We cannot measure their educational value; however, innumerable women have come into the clinic asking to be examined for a venereal disease because they think they might have some of the symptoms described in the literature which they found in the rest rooms.

The struggle for quality, affordable health care was vital to the war effort, which included the crop of STDs that debilitated the home front workforce. And just as the Permanente health plan rolled up its sleeves and took on that battle during World War II, it continues to do so today.

Last year, Kaiser Permanente led the nation in 21 quality measures, including screening for chlamydia. On top of our preventive testing practices, our doctors encourage a healthy conversation about STDs. A recent Total Health Radio podcast “So . . . This is Awkward” by a guest expert from Sexual Health Innovations offers helpful advice on how to talk about STDs to friends and loved ones.

 

Special thanks to Michael Sholinbeck, Outreach & Instruction Librarian at the Sheldon Margen Public Health Library, University of California Berkeley, for guidance on U.S. Census data.

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The Permanente Richmond Field Hospital – Proud Reminder of Health Care’s Role in World War II

posted on April 17, 2017

Lincoln Cushing
Heritage writer

 

Richmond Field Hospital matchbook cover, circa 1944; gift of retired Permanente physician John Igo.

A sprawling, single-story structure with a small tower sits at 1330 Cutting Boulevard in Richmond, Calif. Forlorn and all but forgotten, few know that it played a proud role during the World War II home front and in the subsequent history of the region. It was a humble, working-class hospital that opened August 10, 1942, and served thousands of patients until it closed in September 1995, when the new Kaiser Permanente Richmond Medical Center opened several blocks away.

When the United States was drawn into World War II in December 1941, Henry J. Kaiser was already running two shipyards in Richmond building cargo ships for Great Britain. Not only would the existing workforce composed primarily of healthy white men soon go off to war, the tidal wave of replacement workers were new to the shipbuilding trade, were performing under high-pressure conditions, and were often in poor health to begin with. Some 90,000 workers and their families migrated to the Richmond shipyards during the war, swamping all existing medical facilities. Enter the Field Hospital.

Lobby, Richmond Field Hospital, circa 1943. “Illness knows no color line here.”

There were six first aid stations in Kaiser’s Richmond shipyards for immediate care, and the newly refurbished, 70-bed flagship Permanente Hospital in Oakland was the health plan’s biggest facility. But in between, just blocks away from the yards, was the Permanente Richmond Field Hospital.

At first it only had 10 beds, but the demand for services was so high that before the year’s end a 75-bed expansion was underway. Sidney Garfield, MD, who was in charge of the medical program, later reflected on the nearly constant expansion during the war: “Most of our mistakes . . . came from underestimation.”

“They would be 20 deep in the hallways every day,” remembers Mrs. Bernice Brooks, who went to work at Richmond in January 1943.

Richmond Field Hospital under construction, 1942.

Mrs. Brooks was one of seven 25-year veteran Kaiser Permanente workers interviewed in a 1967 article celebrating the 25th anniversary of the hospital.

“We had five station wagons and three ambulances,” explains Ruth Schornick, a senior medical receptionist who spent 20 years in Emergency, starting in June, 1943. “Invariably, we couldn’t find a driver. I had a chauffeur’s license, so I would have to go down to the shipyards to pick up the injured. And we also had to use the station wagons to bring the nurses and other employees to work and to take them home.”

“It became routine for the ambulance driver to stop by and pick up the X-ray technician or anesthesiologist whenever he picked up a patient at night that might require one of us,” adds Olive Boyd, supervisor of Radiology.

Shipyard workers being treated, circa 1943.

The hospital was a significant asset to the Richmond community. An exhaustive survey of the Field Hospital produced in 2000 by the National Park Service includes this description:

The addition begun in the spring of 1943 allowed for families of the shipyard workers to be taken care of in the Field Hospital by their own physicians [on a fee-for-service basis, since they were not yet included in the Permanente Health Plan]. This provided a great service to the city, as its population was quickly outgrowing existing medical facilities. Up to this point, the hospital had been serving workers’ families only in cases of emergencies. The new facilities included “complete gynecology, obstetric, surgery, medical, orthopedic and all allied clinics,” which operated on a twenty-four-hour basis. Additionally, as an experimental program, families living in the Harbor Gate and other residential developments were invited to visit the hospital for emergency treatment and office appointments on a fee-per-service basis.

Recall that in 1942 many institutions, including all branches of the military, the United Service Organizations, and hospitals, were segregated. Not the Permanente facilities. “Illness knows no color line here,” wrote a reporter from the San Francisco Bulletin in 1943 about the racial diversity of patients in line for treatment and in neighboring hospital beds: “Red-helmeted men, women welders, Negroes, lined up for a checkup by the busy young doctors.”

Exterior, circa 1943.

An article titled “Berkeleyan Victim as Zoot-Suit Riots Spread” in the June 10, 1943, edition of the Berkeley Daily Gazette noted some of the racial tensions at the time, and the role of this stalwart care facility:

A young Berkeley Negro, Carl Oliver, said one of three unidentified sailors objected to his zoot suit garb and struck him on the forehead. Fearing serious trouble, he fled from the Richmond restaurant. At Richmond Field Hospital, Oliver was given emergency treatment and released. The victim is employed at Richmond Yard No. 1 as a burner, police said, and had stopped at the cafe on his way from work.

The commitment to inclusive care continued after the war’s end when the Richmond Field Hospital was again certified as a general treatment facility, accepting all inpatients regardless of race.  Black physicians returning from military service needed hospital privileges, and could get them at Kaiser because it had the beds.

In October 1945, Health Plan membership reached its lowest point – 14,500. Richmond hospital resources and staff were diverted to the Oakland hospital, which served most of these members. For a period of several months the hospital was run on an outpatient basis only with a skeleton staff of not more than 20-25 employees. Later, a laboratory for comparative biology research was set up under the supervision of Ellsworth Dougherty, MD, in February 1959, with a staff of 30 people.

Richmond Field Hospital renovations, circa 1953.

The hospital got a new lease on life in 1966, when it became the site of the Kaiser Foundation Psychiatric Center. One section was remodeled and refurbished to accommodate a 12-bed intensive care unit offering individual, group and occupational therapy. The center provided both inpatient care and day-care.

Eventually the hospital’s condition degraded, and in December 1973 the Kaiser Company purchased five acres in downtown Richmond to build a new hospital, a doctors’ office building and a parking structure.

The new medical offices opened in 1979, with many departments moving there from the Field Hospital. Remaining at the old facility, now referred to as the “Richmond Medical Center,” were an emergency department, inpatient services, physical therapy, a pharmacy, a laboratory, radiology department, and night and weekend clinics.  In September 1995, with the completion of the last segment of a new $56 million four-building Kaiser Permanente medical complex in downtown Richmond, the Field Hospital was finally closed, and its remaining services were moved into the new structure.

The site was purchased in 1999 by the Islamic Community of Northern California, which planned to renovate it into a community center and mosque, complete with Islamic architectural features. However, that conversion never happened and the site remains mostly vacant.

A nomination for the Field Hospital to the National Preservation Registry was drafted in 2004, and although it is not listed by itself, the facility is registered as an element in of the Rosie the Riveter/WWII Home Front National Historic Park. The Historic American Buildings Survey concluded with a powerful appraisal of the importance of the Richmond Field Hospital:

As one of the remaining World War II-era structures in Richmond, it represents an important historical moment, when thousands of workers converged on the small city to produce the hundreds of Liberty ships that helped to lead the Allied forces to victory. The Field Hospital is an outstanding contribution to the important narrative of the World War II American home front, demonstrating the great efforts made to provide social services to the thousands of men and women who labored in the defense industries during the war.

Ordinary people, doing extraordinary things.

 

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