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Kaiser Permanente and Group Health Cooperative – Working Together Since 1950

posted on March 22, 2017

Lincoln Cushing
Heritage writer

 

“Permanente pediatric clinic at 515 Market St, San Francisco – nurse giving Patricia Nisby, daughter of ILWU Local 10 member Wiley Nisby, a shot.” ILWU Dispatcher, 10/13/1950.

It’s official. Kaiser Permanente has acquired Group Health Cooperative, making Kaiser Permanente Washington our newest region, the first in over 30 years.

Although this merger is brand new, the two organizations began collaborating more than 65 years ago. Group Health Cooperative of Puget Sound (they dropped the “of Puget Sound” in 1995), like Kaiser Permanente, was always a mission-driven organization that approached health care in a very different way from traditional fee-for-service medicine.

In fact, few know that our common roots go as far back as 1950, just three years after Group Health Cooperative’s founding.

The relationship began in 1949 when the International Longshore and Warehouse Union [ILWU] approached Kaiser Permanente (then called the Permanente Health Plan) about taking on their membership. Initially it was the 20,000 members in the San Francisco Bay Area, with the understanding that it would soon be all of their members on the rest of the coast, from Seattle down to San Diego. Permanente and the ILWU had been in discussion since 1945. Among the many advantages raised was “The hospital’s facilities are open to all groups with no segregation of patients because of
creed or color.” Imagine that.

“Permanente Health Plan Recommended by Oakland Council for Future Contracts,” ILWU Dispatcher, 6/15/1945.

In a 1974 interview, Kaiser Permanente founding physician Sidney Garfield, MD, reflected on this earliest relation between Kaiser Permanente and Group Health Cooperative:

We were rather anxious to get the membership of course, but we couldn’t spread our service that far. We did have a service up in Portland, so that was fine. We got the doctors up there to accept those members, they wanted to do it too. In Los Angeles we had no service. We had it in Fontana, which is quite a distance away, maybe 70 miles from San Pedro. In San Diego we had no service.

[In the Northwest] what we did was arrange with… a prepaid plan up in Seattle, Group Health Association [Cooperative] I think they call it, so we talked them into taking on Longshoremen up there and there was a prepaid plan down in San Diego, a small one, and we talked them into taking on the Longshoremen, and we tackled the Los Angeles, San Francisco, Bay Area and the San Pedro area…

An article in the ILWU newspaper The Dispatcher January 6, 1950 proclaimed: “ILWU Coast Longshore and Shipsclerks Welfare Plan Goes Into Effect.”

The Pacific Maritime Association began making a 3 cents per man hour contribution to the Welfare Fund on December 26, 1949.

Hospital plans go into effect as of February 1, 1950. Permanente Foundation’s Health plan will cover the San Francisco, Los Angeles and Portland – Vancouver areas. There is already a setup in Portland similar to the one in the San Francisco Bay Area. Permanente will open a clinic in Wilmington, Calif., immediately upon the ratification of the Welfare Plan by all locals.

In Seattle, Wash., the Group Health Cooperative of Puget Sound made the offer of medical care on the same basis and at the same price as Permanente.

By year’s end, 90 percent of eligible ILWU member had signed up for the plan. It was voluntary; the Permanente Foundation Health Plan was committed to offering “dual choice” to groups, so that no member would feel resentful at having something forced on them.

Group Health Cooperative communicator Pat Bailey adds this point:

This contract for 2,200 ILWU enrollees for Group Health came at a time when the Cooperative was cash-starved. But as already noted, with the new enrollees came pent-up health needs. Before long, the waiting list for hernia operations numbered as many as 50.

“Anne Waybur of the ILWU Research Department interviewed more than 125 longshoremen, clerks, foremen and their wives in San Pedro, Calif. to find out what they think of the Permanente Health Plan coverage and service.” The Dispatcher, 1/5/1951.

It’s hard to overstate the deep impact that this contractually-negotiated benefit made in the lives of the ILWU members.

When the plan began, there was a big rush for treatment of such illnesses as hernias and hemorrhoids, conditions the men had suffered with and lived with for many years. They hadn’t been able to pay for medical care on their own. A 1951 brochure produced by the ILWU about the Multiphasic testing examination noted that “…many of our members have not been to the doctor until they practically collapsed on the job.”

A March 10, 1950, article in The Dispatcher put it this way:

“The Welfare Plan is the greatest thing since the hiring hall.” That’s the opinion of D.N. (Lefty) Vaughn, Local 13 longshoreman, hospitalized here under Permanente. Vaughn told Local 13 visitors last week that if it wasn’t for the Welfare Plan he would have had to sell his home in order to pay for the major operation he’s getting for nothing through the Plan.

An editorial three weeks later further explained:

Life can be beautiful if you’re healthy is the way the ad men put it. There’s no doubt they’ve got a point, though it’s oversimplified. Health is no fringe issue, not when you are required to make a choice between an operation which will allow you to go on working and living, and the home you must sell to pay for that operation. Longshoremen no longer have to make such choices. More than one home has been saved since the medical coverage section of the Welfare Plan became effective two months ago.

Kaiser Permanente and Group Health Cooperative– partnering to help working American families get good health care since 1950.

 

Short link to this article: http://k-p.li/2mUqseU
T
hanks to Robin Walker, ILWU archivist, for help with this article.

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Screening for Better Health: Enter the Computer

posted on March 15, 2017

Lincoln Cushing
Heritage writer

 

The Automated Multiphasic Examination
Second part, follows “Screening for Better Health: Medical Care as a Right

 

IBM 1440 computer processing room at Kaiser Permanente, circa 1964

Last summer a major medical news story splashed across the world: “Historic Kaiser Permanente Data to Aid in Long-Term Study to Determine Extent of Ethnic Disparities in Brain Health and Dementia; new $13 million study funded by National Institute on Aging will revisit patients who were first screened as long as 50 years ago.”

Where did this remarkable trove of data come from?

In 1961 the U.S. Public Health Service awarded the Kaiser Foundation Research Institute a grant to study the automation of the multiphasic health testing it had been conducting manually for 10 years. Members would now go through the screening stations with computer cards that got marked along the way.  At the end of the session, which took a couple of hours, there would now be a computerized medical record of their current health status. The Automated Multiphasic Health Test was born.

Multiphasic stations, from “The Multitest Laboratory in Health Care,” by Drs. Morris Collen and Lou Davis, Journal of Occupational Medicine, July 1969.

The first AMHT center was at a new building on the Oakland Hospital campus at 3779 Piedmont Ave. By the end of 1966, Kaiser Permanente had enlarged and updated its testing facility and laboratories nearby at a state-of-the-art center at 3772 Howe Street, and expanded the computer center and offices in the Piedmont building. A second center in San Francisco was linked to the mainframe computer in Oakland.

Dr. Collen, in the Journal of the American Medical Association (1966), accurately predicted that “The advent of automation and computers may introduce a new era of preventive medicine … [The computer] will probably have the greatest technological impact on medical science since the invention of the microscope.”

AMHT questionnaire card about occupational health

The AMHT continued to be seen as a vital tool in the diagnosis and treatment of occupational and industrial illnesses. A 1967 article in the Archives of Environmental Health discussed the employment data gathered, which included a list of 170 occupational titles and a battery of work-related health questions. “The computer storage of data on more than 40,000 adults annually permits extensive epidemiological research, especially directed toward the preventive aspects of chronic disease.”

It wasn’t just union members who benefitted. The Modern Hospital, May 1966 called the periodic health examinations to more than 4,000 patients monthly “… an impressive investment in the concept of ‘health medicine.’”

AMHT station 4 skin fold thickness test, a much more accurate indicator of obesity than BMI.

The test expanded to about 20 stations, measuring everything from hearing to heart function. It even went beyond mere testing – if recommended, a patient could get a tetanus booster via the new high-pressure injector system.

A 1970 article by Dr. Garfield in the prestigious New England Journal of Medicine with the provocative title “Multiphasic Health Testing and Medical Care as a Right” began with this abstract:

Although no long-term evidence exists that the course of disease is influenced by multiphasic health testing, this is largely irrelevant. Such programs are essential for other very important reasons. The existing and spreading concept of medical care as a right, with its elimination of personally paid fees, is creating a demand for periodic health checkups and health appraisals. This demand cannot be met by traditional methods totally involving the physician without great waste of doctor time.

Multiphasic health testing can help separate the entry mix of patients into the well, the asymptomatic sick and the sick. This separation makes possible optimum use of physicians’ services, which can be devoted to the area where they are most needed: the care of the sick.

The efficiencies of the AMHT were sufficient that these programs were sometimes adopted by private practice, large companies, and public health agencies. Dr. Collen remarked:

It is still of great interest to me and much personal satisfaction that the AMHT is still flourishing in Japan, Taiwan, and in China; and in the past when I visited them I found the AMHT centers in Japan to be primarily employer-sponsored for employees. I found the newest AMHT centers in Taiwan and China to be for-profit, marvels of efficiency and associated with health education centers open to the public, and with a high level of provider and patient satisfaction.

“Multiphasic Screening Comes to Portland,” Healthgram, Winter 1976

But despite the AMHT’s popularity, it was discontinued by Kaiser Permanente by the late 1970s when a federal grant supporting the work dried up and Kaiser Permanente declined to commit further resources.

Dr. Collen himself noted some of the challenges to quantifying the benefits of screening:

…Epidemiologists required us to report on gross mortality, and since the potentially postponable conditions comprised only about 15 percent of all the causes of death, most people died from other conditions … some of the criticism of urging checkups is based upon the fact that one does not decrease total gross mortality. That is, everyone eventually dies from something.

Gary Friedman, MD, former director of Kaiser Permanente’s Division of Research, recently explained additional medical limitations to the AMHT:

Kaiser Permanente silent film showing the Automated Multiphasic Health Test process, circa 1970. Click to play.

Initial enthusiasm for multiphasic health screening was tempered by experience in using it and by scientific studies that did not confirm benefits vs. costs of specific screening tests.  For example, it was initially hoped that routine chest x-rays, included in AMHT, would lead to early detection and increased curability of lung cancer.  Studies did not confirm this benefit.  A yes/no question about chest pain provoked by exercise and relieved by rest was included in the AMHT symptom questionnaire.  Although a yes answer seemed almost diagnostic of angina pectoris, this often did not prove to be the case in the follow-up examination by the physician, who could question the patient in greater detail, consuming valuable time.

Clearly however, the value of some screening tests has been amply confirmed.  Finding and treating high blood pressure in asymptomatic individuals prevents strokes.  And screening for colorectal cancer by the various tests available can lead to early detection and cure, or the removal of polyps that could later progress to cancer.

Despite these issues, Dr. Collen defended the value of the AMHT in a 1986 UC Berkeley oral history by Sally Smith Hughes:

…The study [on AMHT] did clearly demonstrate that for those conditions that are potentially postponable, there is a significant decrease in mortality.

He went on to note larger policy and commercial impediments to the AMHT:

Blue Cross/Blue Shield and other indemnity insurers to this day still do not pay for checkups. They take the position that periodic health checkups are schedulable and elective, so are not insurable events. Medicare to this day does not pay for checkups. The contrast, in other countries, like in Japan and in France, their social security and governmental supportive systems pay for periodic health checkups for well people, but do not pay for sick care. Just the opposite from the U.S. So if our Public Health Service is so interested in

Dr. Morris Collen at Multiphasic registration counter, circa 1966

preventive medicine, why do they fail to support the financing of checkups? A very key reason that multiphasic testing has not proliferated in the United States is because it is not reimbursed by any of the insuring agents. That has been reported by vendors who try to sell the systems.

I should point out that the Public Health Service had asked us to patent the system because it was an invention. Whether I was right or wrong, I refused to do so. I felt that it should be in the public domain, and it is. It’s never been patented.

Dr. Collen concluded with deep pride in the accomplishments:

We actually developed the most comprehensive inpatient and outpatient medical information system in the world. And this book, Hospital Computer Systems, describes that. There were only a half-a dozen others in the world that were doing that.

 

As the 2016 medical news story about the persistent value of the AMHT data shows, this was a significant accomplishment in medical practice. Thank you, Dr. Collen.

 

 

Short link to this article: http://k-p.li/2n00mcW

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Beatrice Lei, MD: From Shantou, China, to Richmond, California

posted on March 7, 2017

Alix Sabin, guest writer

 

Beatrice Lei, MD, circa 1930

“An inspiration to . . . women physicians.”

That was the shout-out to Beatrice Lei, MD, in 2002, as she was posthumously inducted into the Kaiser Permanente Diversity Hall of Fame.

“Through her quiet demeanor, excellence and dedication to quality care delivery and clear focus on what was required to be successful, she served as a role model and inspiration to the women physicians and Asian American physicians and employees who would follow.”

 

Dr. Lei arrived in San Francisco in the late 1930s from her native Shantou, China, determined to learn effective treatments for tuberculosis. She had intended to return to China, where the disease had become prevalent, but she was unable to go home after Japan seized Shantou during World War II.

Dr. Lei stayed in the United States, passed the California Medical Boards, and went on to work for Sidney Garfield, MD, at the Kaiser Richmond shipyards. In 1946, she became one of the 16 founding partners of The Permanente Medical Group, becoming TPMG’s first female and first Asian physician.

Several founders of The Permanente Medical Group have been well chronicled over the years, including Dr. Garfield, who created Permanente medicine; Cecil Cutting, MD, TPMG’s first executive director; and Morris Collen, MD, known for his pioneering work in applying computer technology to modern medicine. Dr Lei’s story is lesser known.

Born in Shantou, China in 1910, Pooi Tuen (Beatrice) Lei was one of 11 children. While it was highly unusual at that time for girls to attend school, Lei’s father wanted all of his children to get an education.

Beatrice Lei, MD, with infant patient, 1947. Kaiser Permanente hired Chinese immigrant Beatrice Lei as its first woman physician in 1946.

In 1928 she entered the Hackett Medical College for Women — the first (and at the time, the only) medical school in China for women — determined to help her family and her community of Shantou, which had no physicians. She received her medical degree in 1932, completed her residency in Shanghai in 1935, and returned to Shantou to practice medicine.

Once in the United States, Dr. Lei was recruited in 1944 to work for Dr. Garfield who was caring for the employees at the Kaiser Richmond shipyards.

When World War II ended, the shipyard workforce diminished significantly and many doctors left. But a core set, committed to the concept of prepaid group practice, remained. One was Dr. Lei.

“When the shipyards closed after the war, so many people moved out of the area that we thought we might have to close the facility,” Dr. Lei recalled during an interview in 1974. “Many of our doctors left the program and started private practice. Some of them asked me to join them, but I refused. There was still a need here. Besides that, I wanted to continue practicing in Richmond. It has always been like home to me.”

In 1945, Henry J. Kaiser and Dr. Garfield made the Permanente Health Plan available to the general public. The following year, Dr. Lei became a founding partner of The Permanente Medical Group.

Dr. Lei with Dr. Sidney Garfield at her 30 year service celebration

Dr. Lei served as chief of Pediatrics at the Kaiser Permanente Richmond Medical Center from 1946 to 1966, and continued practicing there until she retired in 1975. Frederic Geier, MD, who was physician-in-chief at Richmond Medical Center from 1955 to 1974, said, “Dr. Lei has always been one of the most popular pediatricians here. She has a wonderful rapport with children and their parents.”

During her tenure with TPMG, Dr. Lei also distinguished herself for her commitment to helping others. For instance, she hired and mentored many residents, provided free health care for people in need of assistance, and regularly helped and counseled Chinese students studying in the United States.

After Dr. Lei retired, she continued to dedicate herself to improving the health of her community by providing free medical treatment to family, friends and others who needed care but could not afford it. She died in 2002, at the age of 92.

At Dr. Lei’s induction into the Kaiser Permanente Hall of Fame, she was quoted as having offered this perspective on her immigrant story: “It is hard for Chinese to come to this country… nothing comes easy. We have to work very hard and appreciate what we have. It is critical that we study hard, work hard, contribute to the community, and make all Chinese people look good and feel proud.”

We honor Dr. Lei’s contributions on March 8, International Women’s Day.

 


Alix Sabin is a Senior Communications Consultant for TPMG – The Technology Group. A version of this article appeared in the Winter, 2017, issue of Permanente Excellence, a new quarterly magazine published by The Permanente Medical Group and distributed to TPMG Physicians. Research materials for this article were provided by Kaiser Permanente Heritage Resources.

Short link to this article: http://k-p.li/2lZhqN1

 

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Screening for Better Health: Medical Care as a Right

posted on March 1, 2017

Lincoln Cushing
Heritage writer

[Part one of two]

Permanente's First and Largest Coastwise Group", Planning for Health, 1951-Fall

“This local 10 longshoreman is having an electrocardiograph taken to detect any heart irregularity. This is one of the many tests in the recent program conducted for the ILWU by Permanente.” Planning for Health, Fall, 1951.

For many years a hallmark of Kaiser Permanente’s preventive health care program was a battery of tests, designed to alert doctors to trends and red flags in a patient’s health. And it started with service to industrial workers.

Lester Breslow, MD, published a seminal article in the March 1950 American Journal of Public Health titled “Multiphasic Screening Examinations: An Extension of the Mass Screening Technique.” Dr. Breslow, who worked for the California State Department of Public Health in Berkeley, challenged the limitations of periodic health examinations, and proposed the value of an integrated battery of preliminary examinations – a “multiphasic examination.” The advantages included one combined medical record, cost savings, and improved diagnoses. One passage in Dr. Breslow’s article stood out:

“This survey can be conducted in a time not much greater than would be required for screening for a single disease. Where such screening procedures are carried out among industrial populations the time element is especially important.”

At that time, the Permanente Health Plan was expanding to the public after having only served Henry J. Kaiser’s World War II employees, and much of that growth was from unions.  Dr. Breslow had been a college classmate of Kaiser Permanente’s Dr. Morris Collen, and the AJPH article offered a solution to the challenges of bringing in large numbers of industrial members with physically demanding jobs and poor health care.

"Are you ship shape?" brochure about ILWU member health testing; 1951; supplied scan, source of original unknown

“Are you ship shape?” brochure about ILWU member health testing; 1951

Since the main medical competitors, Blue Cross/Blue Shield, did not provide health checkups unless one had a medical complaint, the Permanente facilities saw a surge in well-patient testing that began to drain the system. Searching for solutions, Dr. Collen spoke with Dr. Breslow, who suggested setting up a multiphasic screening for a large new member organization – the International Longshore and Warehouse Union. Although the screening was coordinated under Permanente’s leadership, it included the cooperation of the United States Public Health Service, the California State Department of Health, the San Francisco Public Health Department, the Bureau of Vocational Rehabilitation, and the San Francisco Tuberculosis Association.

The screening was seen as a groundbreaking step public health. The ILWU Dispatcher article May 11, 1951 proclaimed:

The longshoremen’s program represents pioneer work in preventive medicine—the science of keeping people healthy. Multiple health tests for such a large group are a new procedure, in use only since 1948 and scientifically proved to be effective in detecting disease while there is still time for treatment.

Dr. Collen proceeded try his first group test at the ILWU’s Local 10 hall at pier 18 in San Francisco, and screened several thousand longshoremen. An article in The Dispatcher from August 17, 1951, was titled “ILWU Waterfront Health Tests ‘Complete Success’; 4,002 Go Through” boasted:

Follow-up tests and treatment are now being given to members whose test results showed any signs of disease by a special team of Permanente doctors assigned to the ILWU under the ILWU·PMA [Pacific Maritime Association] Welfare Plan.

At a dinner for all the people who worked on the project, Permanente Health Plan, Director Dr. E. Richard Weinerman said the health test program was a “complete success . . . The fact that this program was the first to be organized by a union, the first to provide so comprehensive an array of tests and the first to assure complete medical follow-up through the health plan made it an outstanding contribution to the field of preventive medicine.”

kp-reporter-may-1961-a

Longshore worker signing up for Multiphasic exam, 1961

Dr. Weinerman also noted the role of what we now call “culturally competent care.” In a Dispatcher article July 6, 1951, he said “In order to condition [our physicians] to do the best possible analysis, the union is taking them on a tour of the waterfront to observe working conditions. Then they will be able, to understand clearly how longshoremen work, and they can interpret symptoms more accurately.”

Dr. Collen later recalled the next steps of expanding the screening to all Permanente members in his oral history:

We started our multiphasic program in the Oakland clinic [on November 29, 1951]… After the clinics closed at five-thirty, we used the existing office space in the surgery clinic. We developed a whole series of arrows and put colored tapes on the floors so that patients would go in through the various rooms and have their height, weight, blood pressure, and other physiological measures taken, and then fill out a history form. Then they would be directed to the laboratory for blood and urine tests, to the x-ray department for a chest x-ray, and to the electrocardiography department for an electrocardiogram. In that way, we didn’t require any extra equipment or any extra facility space. We developed a team of personnel that would work in the evenings from about five-thirty to eight, and we examined some twenty-five to thirty patients every evening that way at a very low cost.

In 1952, the Kaiser Permanente clinic at 515 Market Street in San Francisco also opened a Multiphasic Health Test facility in a space that had formerly been used as an orthopedic clinic.

story-march-10-1961-b

Longshore worker taking Multiphasic exam, 1961

The process consisted of about 15 procedures and only required the presence of a single physician, assisted by paramedics. Dr. Collen went on to explain the beautiful medical logic of the testing:

. . . Health is the only condition in life when you find people are medically similar. That is, healthy people have a relatively normal distribution of their tests and measurements so that you can develop routine repetitive procedures to do these tests. The health checkup, the evaluation of a normal well person, is the most routine, repetitive procedure in medicine.

As soon as one has a variation from normal, which is the basic definition of being ill or sick, then one becomes unique. Every diabetic is different; every hypertensive is different, and a diabetic with hypertension is even more complicated. So it is difficult to develop routine rules for sick people. But for normal people, and by definition 95 percent of healthy people are within normal limits, you can develop routine repetitive procedures. And that is the secret of the efficiency and economy of a programmed, systematized, multiphasic checkup.

An article in the Permanente newsletter Planning for Health touted the Multiphasic:

A broad stride in the practice of Permanente’s fundamental principle of preventive medicine was accomplished with the recent inauguration of the Multiphasic Health Check-up program at the Oakland and San Francisco medical centers. A new type of general medical examination, Multiphasic Check-up, is based on the premise that early diagnosis and adequate treatment can materially reduce the ill effects from significant diseases.

By the mid-1950s, 30 to 40 percent of all new members were choosing the multiphasic on their first visit.

However, in the early 1960s changes in technology would transform the examination. And the future was . . . computers.

Part 2: The Automated Multiphasic Examination

Short link to this article: http://k-p.li/2mtLDb6

Special thanks to ILWU archivist Robin Walker for her help with this article.

 

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The Kaiser Dishwasher

posted on February 23, 2017

Lincoln Cushing
Heritage writer

 

Henry Kaiser with dishwasher and model

Henry J. Kaiser with dishwasher and model, circa 1946

World War II was not yet over, and Henry J. Kaiser was already anticipating the need for postwar housing – and houses need appliances. Henry J. Kaiser was one of the prominent American industrialists of the early 20th century who built everything from dams to ships to airplanes. Did his range extend to humble home appliances? Yes, it did.

The news broke on October 16, 1946:

“First Kaiser Cars Go on Display Here,” Berkeley Daily Gazette:

In the appliance line Kaiser Motors soon will distribute a machineless [motorless] dish-washer, now in production at Bristol, Pa. The dish-washer, which operates entirely by water pressure, is being produced in two models – a “chassis” type that will cost about $176 and can be made a permanent fixture of the home, and a “cabinet” dish-washer that can be moved from house to house. The “cabinet” dish-washer will sell for approximately $101.

The Kaiser-Frazer dealers have been offered franchises on the appliance and farm equipment lines in order to have something to sell the year round until new cars become plentiful.

Raymond Wilson’s dish washing machine patent, 1943

As with most of his accomplishments, Henry J. Kaiser didn’t invent the dishwasher – he looked at what was needed, found out who knew how to make it, and did it better.

The origins of the Kaiser dishwasher begin with Raymond W. Wilson, an inventor in Glendale, Calif. In 1943 Wilson was granted a patent for a dishwashing machine whose primary feature was that it was entirely operated by water pressure – no electricity was needed. “As easy to install as a new sink – your plumber will gladly make three simple connections.” The washer used standard municipal water pressure and hot water from a residential hot water heater (assumed to be 140 degrees F.) A basket would raise for loading and lower for washing with spray jets at the bottom.

Wilson began producing these machines under the “Q.E.D.” brand name in 1939 and applied for his patent in 1940. The patent rights were later purchased by Mr. W. J. Schworer of Alhambra, Calif., and the product name changed to “Steril-Dry.”

Unfortunately for the new dishwasher, soon the United States was deeply involved in World War II, and manufacturing capacity for consumer products was marshaled for the war effort. But by September 1944, Kaiser had started partnering with real estate developer Fritz B. Burns to build modern housing projects, and Burns wanted to include the Steril-Dry in new homes. So, in November they installed and tested one of the dishwashers in their Latham Square Building offices in Oakland.

qed-dishwasher-med

Q.E.D. item in Popular Science, November 1944

Although Schworer had begun negotiations with the Crane Company, the Kaiser Company managed to beat them out and buy the rights on November 10, 1944.

Arrangements were made to assemble and purchase six Steril-Dry machines from Schworer for installation at test locations including the Kaiser Steel mill in Fontana, Calif.; the Kaiser Cement plant in Permanente, Calif. (south of San Francisco near Cupertino); and the Fleetwings aircraft plant in Bristol, Penn. One was also set up at the residence of Eugene Trefethen, Jr. (1910-1986), a longtime Kaiser Industries employee who later rose to become president and vice chairman of Kaiser Industries.

And another one was installed at the Kaiser Richmond shipyard number 3 cafeteria, where it ran for more than 300 hours and washed 129,106 dishes. A report on that test included these findings:

The dishes are washed satisfactorily when the water is at the proper temperature (150-170 degrees F.), and they dry immediately. The same results occur when washing glassware. There has been absolutely no breaking or chipping of the dishes or glasses. If the water gets below 150 degrees the dishes are not washed as satisfactorily. The dishes and glassware come out clean with the exception of those that have lipstick on them. Other types of grease are easily removed, however.

sterildry-med

Steril-Dry brochure cover, circa 1945; uses same photo as Q.E.D. item above.

The pressure of the water does not seem quite sufficient. It is about 60 to 65 pounds. The only objection to the pressure is not from the dishwashing angle, but from trouble with the hydraulic lift.

Results were very satisfactory considering that the operators were untrained, unskilled people. They had no difficulty in operating the machine. It only takes a few minutes of instruction to the most unskilled person for her to understand the operation of the machine.

Another model kitchen and laboratory were set up to further test the machines. An extensive list of proposed modifications was drawn up, including everything from design (locating knobs in the front, making the top flat and square to serve as a working surface) to technical (jet redesign to minimize clogging, automatic soap dispenser).

By early 1946, the Kaiser Fleetwings Division of Kaiser Cargo in Bristol began manufacturing four models of the long-awaited Kaiser dishwasher.

Kaiser dishwasher ad, Better Homes and Gardens, 1948-02 [Web grab]

Kaiser dishwasher ad, Better Homes and Gardens, 1948

Research by dishwasher historian (yes, you read that correctly) Mike Haller of Peoria, Ill., describes what happened next in the “automaticdishwasher forum“:

Two major flaws existed: (1) Distribution was turned over to the Kaiser-Frazer Sales Corporation (the car division of the Kaiser conglomerate). The Kaiser-Frazer division was ill prepared to market and demonstrate the dishwasher. (2) Lack of adequate field testing did not pick up on the fact that not all water sources were able to deliver the required minimum water pressure [or temperature] for adequate operation.

Mainly because of customer dissatisfaction and the high cost of the dishwashers – upwards of $200 plus freight and taxes, — the sales started to decline…in early 1948, Sears Roebuck & Company was searching for an automobile that could be sold as a house-branded item. As part of the deal, the Dishwasher line became part of the package, along with factory floor space. However, Sears needed the floor space for other contract work, so the Kaiser Dishwasher line had to go.

In 1948 Fleetwings was renamed Kaiser Metal Products, where they continued to manufacture a range of consumer products. But Kaiser’s short venture into the world of dishwashers went down the drain.

 

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

 

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Experiments in radial hospital design – Denver’s Saint Joseph and Kaiser Permanente’s Panorama City

posted on February 17, 2017

Lincoln Cushing
Heritage writer

 

Kaiser Permanente Panorama City Hospital, California
Built 1962, decommissioned 2008, demolished 2016
Designed by Clarence Mayhew with partner Hal “H.L.” Thiederman, Dr. Sidney R. Garfield as medical consultant.

Saint Joseph Hospital, Denver, Colorado
Built 1964, demolished 2016
Designed by Robert Irwin.

 

st-jo-towers-med

Saint Joseph Hospital, Denver, circa 1970

When I was touring Denver’s Kaiser Permanente facilities in late 2016, my host pointed out a hospital that was being demolished. It was the venerable Saint Joseph Hospital, and what I noticed immediately was that it had two paired cylindrical (or “radial”) towers, just like our former Panorama City hospital, a design universally described as “binoculars.” But taller.

Even though the Kaiser Permanente Health Plan has been operating in Colorado since 1969, and has built numerous state-of-the-art medical office buildings, it has always contracted with local facilities for hospital space. Saint Joseph is one of them.

Although there’s no firm evidence that the Saint Joseph design was influenced by Panorama City, it’s surely not a coincidence. The workflow logic was identical, and the main differences were the stairwell, lobby placement, and lack of an external balcony. It looked more like an overhead view of the Starship Enterprise than a pair of binoculars.

st-jo-blueprint-med

Blueprint, Saint Joseph Hospital, July 27, 1961

“Building started at Saint Joseph,” Rocky Mountain News, Oct. 26, 1961:

Groundbreaking rites were held Wednesday for the new $8,771,560 addition to Saint Joseph Hospital. The new building, to replace most of the north hall of the hospital, will consist of a pair of 11-story circular towers. Each will a have nurses’ stations at the center, and no station will be more than 20 feet from any room.

The new circular towers will be the heart of the 88-year-old hospital. Saint Joseph will be the nation’s largest example of the new hospital design, according to Robert Irwin, architect. The circular concept means patients’ rooms and wards will radiate from the nurses’ stations in the center.

Fourth floor plan of tower, Kaiser Foundation Hospital at Panorama City. 1961 [circa]. [TPMG P1283]

Fourth floor plan of tower, Kaiser Foundation Hospital at Panorama City, circa 1961

Kaiser Permanente’s original Panorama City Medical Center was featured as The Modern Hospital’s “modern hospital of the month” in November 1962. In the seven-page article “Good Nursing is Core of Panorama Plan,” Sidney Garfield, MD, explained the “circles of service” design concept:

It saves steps for the nurses [in this case, patients are within 20 feet of the nursing station]; it reduces the number of special duty nurses; it keeps the nurses to a central area outside the patients’ door, and it is particularly useful for keeping patients under observation at night with a reduced nursing staff.

1964-new-old-towers146

Old and new Saint Joseph hospitals, circa 1964

Saint Joseph Hospital Communications Manager Colleen Magorian added these details:

The Saint Joseph Hospital “twin towers” were dedicated in 1964, so they were just more than 50 years old when our new hospital opened. The towers were part of an ever-expanding hospital that had been on the same site since 1898 and were inspired, in part, by the towers of the preexisting structure.

Predecessors to this design were a never-built Kaiser Permanente geodesic-dome-based facility from 1957, followed by the “Atomedic Hospital,” which originated in the early 1960s. But these facilities were never meant to be more than one or two stories tall.

Hospital architecture scholars Stephen Verderber and David J. Fine have noted that there are a few other examples of multistory “radial” layouts in the United States, all built in 1964-1965. These include the Lorain Community Hospital (Lorain, Ohio), the Scott & White Memorial Hospital (Temple, Texas), and the Central Kansas Medical Center (Great Bend, Kansas). The Prentice Women’s Hospital and Maternity Center in Chicago, which opened in 1975, was a unique version of this style with four radial towers. It was vacated in 2011 and was the subject of intense preservation efforts to avoid demolition. It was eventually torn down in 2014.

Prentice was designed by Bertrand Goldberg, who drew on learnings from anthropology and the field of “proxemics” (“the study of our use of space and how various differences in that use can make us feel more relaxed or anxious.”) It was praised for its innovative design and engineering prowess. However, many of the design weaknesses of the wedge-shaped rooms were noted as well. Architect and critic Jain Malkin pointed out that the most heavily trafficked side of the room was the narrowest, and in the case of Prentice, that the rounded exterior wall reflected and amplified sounds in a space that’s supposed to be quiet.

Of all of these architects, it was Dr. Garfield and his Panorama City vision that pioneered this bold experiment in improved workflow and patient care. And, as I saw in Denver that cold October morning, the circles of history closed in on the “circles of service.”

 

Special thanks to Stephen Verderber, and Colleen Magorian and Tiffany Anderson of Saint Joseph Hospital, for their help with this article.

Short link to this article: http://k-p.li/2lVI21V

 

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Mystery hospital device – the TravelLav

posted on February 9, 2017

 

Lincoln Cushing
Heritage writer

 

Travel-Lav compact lavatory, in hospital room setting, 1966 [circa]. [Scan from film negative #62594]

Travel-Lav compact lavatory, in Kaiser Permanente hospital room setting, circa 1960.

Hospitals are highly technical facilities always in search of safe and effective ways of providing health care. Usually the bright shiny objects get the news splash – a brand new X-ray machine, a sleek MRI – but for every big-ticket item, there are dozens far more mundane.

When members come to Kaiser Permanente – whether in Washington, D.C. or California – they expect to experience a brand promise of “Total Health.” The National Facilities Services department is responsible for the physical component of this task, evaluating every aspect of a building – even including the humble toilet.

Project Principal Linda Raker explains NFS’s design goals:

The emphasis is on providing an environment that helps create a warmer, hospitality experience, by contrast to the institutional environments of the past. We are especially mindful of creating what we call a ‘moment of pause’ in these rooms, where our members can achieve a measure of privacy away from the chaos of medical environments. The other objectives – improved lighting, individual mirrors, use of optimistic colors, etc. – are all designed to support this more positive member journey.

“Institutional environment of the past” is a kind reference to some earlier concepts that certainly weren’t focused on a private “moment of pause.”

Travel-Lav compact lavatory, in hospital room setting, 1966 [circa]. [Scan from film negative #62594]

Travel-Lav compact lavatory

While reviewing a set of large format film negatives in our archive, I ran across two photos that showed an unusual device installed in a patient room. On closer inspection it was two versions of a device, one designed to fit in a corner, and one for an open wall. Zooming in on the name plate revealed that these were products of the “TravelLav” (or Travel-Lav) company.

Extensive searching through newspaper archives and online sources revealed very little about these devices.

We know that they were the brainchild of a Philadelphia inventor:

Patent #2,725,575 approved December 6, 1955
“FOLDING WATER CLOSET” by Angelo Colonna, Philadelphia, PA.

The present invention relates to certain new and useful improvements in flush-type water closets which are expressly adapted to be used in wash rooms and similar quarters of limited size on railway cars, airplanes, boats, submarines and similar conveyances and has more particular reference to a hinge mounted toilet bowl or hopper of a so-called folding construction, that is, a structural adaptation wherein the bowl, when it is not in use, is swung up and into a storage and protective compartment provided therefor in a wall cabinet.

US2953103.pdf

Detail of folding toilet in railway car patent illustration, 1960

The Travel-Lav later shows up in a railway car patent:

Patent #2,953,103 approved September 20, 1960

“COMBINATION COACH AND SLEEPING CAR” by George W. Bohannon, Oak Park, and Walter Scowcroft, Palos Heights, Ill., assignors to The Pullman Company, a corporation of Illinois.

The washbowl and water closet or toilet are preferably a combined unit sold under the trademark “Travel-Lav” manufactured by Angelo Colonna of Philadelphia, Pennsylvania. Both the washbowl (72) and the water closet or toilet (76) fold down to a substantially horizontal position when they are to be used.

 

So, we at least know something about these folding water closet contraptions. These two photos imply that at one point, most likely around 1960, Kaiser Permanente installed or considered installing them in some patient rooms. But there’s no evidence that they lasted. It’s easy to imagine that the lack of privacy was a substantial deterrent to their acceptance, and that a device intended for cramped quarters – such as a submarine, or a bunker – would make less sense in a hospital.

 

Short link to this article: http://k-p.li/2kT4j2y

 

 

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Ellamae Simmons – Trailblazing African-American Physician

posted on February 3, 2017

Lincoln Cushing
Heritage writer


overcome-coverOvercome: My Life in Pursuit of a Dream

Ellamae Simmons, MD, with editorial collaboration by Rosemarie Robotham
Mill City Press, Minneapolis, 2016
Available via Google Books | Amazon

 

The arc of social justice relies on courageous individuals and Ellamae Simmons, MD, was one such individual. She was the first African-American woman to specialize in asthma, allergy, and immunology in the United States. She worked at Kaiser Permanente for 25 years, and to this day plays a central role in how Kaiser Permanente embraces diversity and inclusion.

Dr. Simmons’ new biography at the age of 97 is a valuable contribution to that history.  The book details her life and career, including graduating from Hampton (Virginia) nursing school in 1940, serving in the Army Nurse Corps during World War II, medical school at Meharry Medical College (Nashville) in 1954, and her Kaiser Permanente career.

Dr. Simmons’ chapter titled “The Interview” is about her coming to work at Kaiser Permanente during the summer of 1965. Dr. Simmons had been training in chest medicine at National Jewish Hospital in Denver, at which Irving Itkin, MD, was her supervisor and mentor:

When I told Dr. Itkin of my plan to move west at the end of my residency, he was full of advice. “If you’re going to California,” he told me, “there are only two places you should consider. One is the Scripps clinic in La Jolla in Southern California, and the other is Kaiser Permanente in Northern California. Now,” he continued, warming to the subject of my future training as an allergist, “Scripps is just another National Jewish. They write the same papers and conduct the same research. You’d basically be doing the same thing you did here.

At Kaiser, on the other hand, you’d round out your experience in a well-established outpatient allergy center, where asthmatics are well maintained on an established anti-allergenic regimen. And I recommend Ben Feingold, the chief of asthma-allergy at Kaiser. He’s a good allergist, does fine research. Of course, he’s difficult…. but I recommend you go there and learn everything he has to teach you about asthmatics whose condition is well controlled, who are ambulatory, who go to school or to work. After that you’ll be well set up to take care of anybody in this field.”

Ellamae Simmons school graduation Hampton nursing school, 1940, from Overcome book

Ellamae Simmons graduation Hampton nursing school, 1940, from Overcome

Dr. Simmons’ job interview with Ben Feingold, MD, has become legend in Kaiser Permanente history:

Dr. Ben Feingold sat back in his large bronze-studded black leather chair, scrutinizing me. He questioned me about my previous residencies, always calling me “Miss,” never “Doctor.” He asked me about my asthma-allergy fellowship, and more superficially about my chest medicine residency.

After about 30 minutes, he tented his fingers on his desk and said, “Well, I have my doubts about hiring anyone whom I have not trained, but please go out and see my secretary. We’ll have to continue this another day, as I have another meeting.” He told me to make an appointment with his secretary for the following Tuesday, which was five days away. I could ill afford the expense of additional nights at my hotel, plus meals, but I did not say this. Instead I made the appointment and spent the next few days exploring downtown San Francisco and biding my time.

I returned the following Tuesday for the continuation of our interview and entered Dr. Feingold’s office as scheduled. Again the department chief sat back in his chair and viewed me intently. He asked a few questions about specific allergic reactions and how they might be treated at the institution of my residency. I answered easily and in meticulous clinical detail. At last he said,

“Well, I see you know your stuff, but I’m afraid I cannot hire you, as I’ve never hired anyone whom I have not trained.”…

“Dr. Feingold,” I said, my voice steady, my gaze direct, “I’ve never applied for a job for which I was not fully qualified. In fact, I’ve usually been overqualified. So tell me, is the real reason you’ve decided not to hire me the fact that I’m black?”

She asked Dr. Feingold if there were any other black physicians at the Kaiser Permanente San Francisco hospital; it took him a while, but he finally remembered Granville Coggs, MD, a radiologist who’d joined the staff just a few months before. Dr. Simmons met with Dr. Coggs, and they shared experiences of racial discrimination pursuing their respective professions. She then returned to Dr. Feingold’s office, resigned to not getting the position.

Dr. Feingold didn’t respond at first. He just stared at me in that fixed way I was already becoming used to. I realized he was wrestling with a decision.

Finally, he spoke. “Stop by my secretary on your way out and sign your contract,” he said. “I’ll take you after all.”

Dr. Ella Mae Simmons, first black female physician in Northern CA

Dr. Ellamae Simmons, circa 1980

 

Among Dr. Simmons’ battles was that of housing discrimination. Even in the relatively progressive San Francisco Bay Area of the late 1960s, covenants and real estate practices perpetuated racially segregated neighborhoods.

This discrimination also was experienced by another early Kaiser Permanente physician, Eugene Hickman, MD. His unpublished memoir includes a chapter titled “House Hunting While Black”:

My major problem in Oakland was with housing…I would phone all numbers regarding places within a radius that would afford reasonable access to the hospital where I was going to work. I was up front with my racial identity, after which I would summarize my credentials, etc. The response was always the same: “I am very sure you would be a very desirable member of our community, but we promised our neighbors we would not rent or sell to Negroes.”

After several frustrating months, someone informed me of a place in Berkeley where I could go and apply for one of the homes that had been condemned to make way for the Grove-Shafter Freeway [California Highway 24]. We obtained an old house on 53rd St, near Children’s Hospital. I was then able to move our family here. Then we began the search for a permanent residence. My wife would go out with an agent during the day while I was working; the children were not yet in school. Some idiots frequently mistook my wife for a southern European. One agent…suggested that if I wanted to see the house, I should come around after dark.

And if that wasn’t discouraging enough, Dr. Hickman experienced discrimination about his choice of a job from an unexpected source. The Sinkler-Miller Medical Association in Oakland (named in honor of two outstanding black physicians) accepted him for membership, but insisted on characterizing him “as some sort of traitor to the black physician community” because of his affiliation with Kaiser Permanente.

 

Dr. Simmons’ personal story is a tribute to persistence and vision overcoming adversity. Although we have come a long way in building social justice, there is always more to do – and pioneers such as Dr. Simmons inspire and guide us.

 

Short link to this article: http://k-p.li/2l4yt05

 

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Japanese-American Doctors Overcame Internment Setbacks

posted on January 27, 2017

Lincoln Cushing
Heritage writer

 

Poster announcing Executive Order 9066 - 1942

Poster announcing implementation of Executive Order 9066 (detail), May 15, 1942

Ten weeks after the Japanese attack on Pearl Harbor, U.S. President Franklin D. Roosevelt signed Executive Order 9066. This law, enacted February 19, 1942, authorized the incarceration of Americans of Japanese descent and resident aliens from Japan. This measure only affected the American West; the U.S. military was given broad powers to ban any citizen from a fifty- to sixty-mile-wide coastal area stretching from Washington state to California and extending inland into southern Arizona. The order also authorized transporting identified citizens to military-run “internment” camps in California, Arizona, Washington state, and Oregon.

This controversial action was undertaken in the name of national security and affected almost 120,000 men, women, and children. The Order was suspended at the end of 1944 and internees were released, but many had lost their homes, savings, and businesses. Subsequent efforts by community and legal groups in the 1970s resulted in rescinding the Order and offering compensation to those affected, and legislation was passed to try to ensure that such a broad disruption of civil liberties would not happen again.

The impact of the war, and of the suspension of basic human rights, personally affected two of Kaiser Permanente’s first Japanese American physicians. Once hired, they remained here their entire professional careers.

 

Dr. Isamu "Sam" Nieda

Dr. Isamu Nieda, circa 1955

Isamu Nieda, MD (1918-1999)
Hired as a radiologist at Kaiser Permanente in 1954, retired 1987

Isamu “Sam” Nieda was born in Ashland, Calif. (a small community in the central East Bay of San Francisco) in 1918 to Japanese-born parents. He was an undergraduate at the University of California, Berkeley, and then went to medical school at U.C. San Francisco. Partway through his studies he heard the news of Executive Order 9066.

According to Dr. Nieda’s late sister, the family held a meeting with Sam and determined together that he would leave the evacuation area to continue his studies. Family lore stated that he had to sell his microscope to pay for the journey, and that the rest of his family chipped in as well. He then departed for Salt Lake City, where he worked briefly as an orderly, before continuing to Temple University in Philadelphia. The American Friends Service Committee (Quakers) helped Sam through the National Japanese American Student Relocation Council. This program worked with colleges and universities in the Midwest and Eastern States to admit qualified students from the camps, and placed four thousand students before war’s end.

Dr. Isamu "Sam" Nieda

Dr. Isamu Nieda, circa 1975

Dr. Nieda completed medical school in 1944 at Temple University, and after World War II he served as a Venereal Disease Control Officer in Japan, working for the Public Health and Welfare department of the U.S. Army Medical Corps during the American occupation (1945–1952).

Dr. Nieda returned to the U.S. and worked as a radiologist at Kaiser Permanente’s San Francisco Medical Center for 33 years.

Dr. Nieda always identified as a U.C. student, so it was meaningful to the family when in 2009 UCSF granted honorary degrees to all Japanese American students from the Medical, Dental, and Pharmacological schools who had to stop their studies due to internment. (Sam had passed away ten years prior.)

 

Planning for Health newsletter 1962-Fall

Dr. Ikuya Kurita, Planning for Health, 1962

Ikuya T. Kurita, MD (1922-2005)
Hired in respiratory medicine at Kaiser Permanente in 1957, retired in 1999.

Ikuya “Eek” Kurita, MD, was born in San Francisco in 1922 to Japanese-born parents. He attended U.C. Berkeley for two years until 1942, when he and his parents were relocated to an internment camp in Topaz, Utah. Internees could leave Topaz if they had a job or were admitted to school, so Kurita was able to complete his undergraduate degree at the University of Utah. He then served in the army from 1944 to 1947 and returned to the University of Utah where he graduated from medical school in 1950.

Dr. Kurita worked at Kaiser Permanente hospitals for 42 years, first in Oakland where he began as Chief of Emergency from 1957.

KP Reporter, 1975-06-13

Dr. Ikuya Kurita, KP Reporter, 1975

He was appointed chief of the Department of Emergency Services at the Oakland hospital in 1965, and in 1975 ran the new rehabilitation and educational clinic for patients with chronic obstructive pulmonary disease (COPD). An article in the KP Reporter described that program:

According to lkuya Kurita. MD., Emergency Department Chief at Oakland, and physician consultant for the Respiratory Care Clinic, the purpose of the program is to bridge the gap between acute hospital care and home management, with primary emphasis on reaching and helping patients before their condition erodes to the point of warranting hospital admission. “The clinic helps to fill the gap between acute care and what is often fragmented care,” says Dr. Kurita, who is a specialist in pulmonary diseases.

Dr. Kurita began working at the Martinez Medical Center in 1977 and retired from there in 1999.

 

Special thanks to the family of Isamu Nieda, retired Permanente physician Michael Gothelf, Dr. Ken Berniker of the TPMG Retired Physicians’ Association, scholar Elaine Elinson, and video producer Robert M. Horsting for their help with this article.

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

 

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Looking Back: Laura Robertson, 97, Recalls Roots in Kaiser Shipyards

posted on January 18, 2017

Lincoln Cushing
Heritage writer

 

"Rube" (Ruby) Bingham, worker at NW Kaiser shipyard, Portland, 1943-Fall (photo courtesy daughter Laura Robertson)

“Rube” (Ruby) Bingham, worker at Kaiser shipyard, Portland; Fall, 1943. (photo gift of daughter Laura Robertson)

Laura Robertson, 97, chuckles when her doctor in Kaiser Permanente’s Colorado Region stumbles on the tiny size of her pharmacy order. She takes so few medications that the doctor assumes something’s off – but Laura assures her she’s just in very good health.

Laura’s not just healthy, she’s been connected to the big Kaiser picture almost all her life. I had the chance to sit down with her last October, and she’s got quite a story to tell about roots in the Kaiser shipyards and experiences as Kaiser Permanente member.

 

Early Years: Portland before the War

I am the oldest survivor of my family. I have outlived all my original friends, including people I’ve worked with. There are too many people that live in the past, and I have no desire to do that. Day-to-day is much more interesting.

These younger people think you’re lying, that you’ve got a great imagination.

Map of three NW Kaiser shipyards, 1943; by Marguerite Gillespie, from Record Breakers publication, Oregon Shipbuilding Corporation

Map of Portland-area Kaiser shipyards and Northern Permanente Hospital, 1943; by Marguerite Gillespie, from Record Breakers, Oregon Shipbuilding Corporation.

I had to dig pretty deep for some of this stuff.

Portland. I went there with my mother, Rube (pronounced “Ruby”) Bingham, in 1938. I worked in a restaurant, and was a member of the Cooks and Bartenders Union. I made $20 a week.

I then left the restaurant business and went to a business school a half day and worked for the school a half day to pay for tuition. I worked nights and weekends in a restaurant. During the war years I worked for Industrial Claims, an insurance company that handled insurance for “high risk” industries.

I worked on the 13th floor of what I think was the Board of Trades building, right down on the waterfront.  You know the river splits the town in two – I lived on the West side, close enough that I could walk to work, or I could walk down to the corner and take the streetcar. When I got to work and took the elevator I could look down onto the decks of the foreign ships that were coming in and loading and unloading. And, of course, it took me a while to understand that they came in on the tides, and had to wait to go out on the tides. And when they went out, it was fresh water, and the decks were practically at the water level. But once they passed the bar, the sea water was more buoyant. There were all sorts of countries coming and going – German, Russian, Scandinavian.

I was married in 1941. My wedding ring was from a jewelry store in Portland. It cost $30, and we bought it on an installment plan of $5 a week. The girls in my office were envious because I actually had a diamond. It was just a chip!

 

Working in the Shipyards

My mother worked in the Kaiser shipyards. Here’s a photo of her in 1943, in her work clothes. She installed sheet metal ducting after it was insulated.

Migration chart map, Fortune magazine 1945-02. Infographics

Migration chart map, Fortune magazine, February, 1945. Design by Walt Disney studios.

I remember the change in Portland during the war years. Kaiser was advertising for help all over, and they were coming in from all areas. Before the war, Portland was a pretty typical city. The Chinese worked in restaurants and laundries, the Filipinos were in the food industry, the Japanese were vegetable farmers. I had never heard a foreign language until I went to Portland.

[Editor’s note: wartime workforce labor migration dramatically affected many West coast cities, including Portland. The largely white, urban, population experienced struggles with an influx of mostly poor rural people and immigrants of color. Before World War II, Black Americans made up only 1 percent of Oregon’s population; most of them lived in Portland. By war’s end, the black population had grown from 2,000 to 20,000. In a 1974 interview, Kaiser Permanente founding physician Dr. Sidney Garfield remarked on the impact of this wartime immigration: “Portland people were rather unhappy with the influx of workmen into their area because Portland was sort of a staid, stuffy community…”]

I grew up in a town of 300 in Iowa, right next to Missouri, and I finished high school in 1936. We were very close to the Mason-Dixon Line. Just 25 or 30 miles south of us the schools were segregated; where we were, what few blacks were there went to school with the whites. We didn’t experience some of the extremes that people did in the south.

But in wartime Portland, if they weren’t speaking a foreign language they might have well have, if you were trying to understand what they were trying to tell you. They all had their own lingo. That, too, created quite an interesting atmosphere. Everybody trying to understand all these different people, and they were having trouble trying to understand us.

Aerial photo, Vanport City, 1942 [circa]; [C-10 - Oregonship albums Box 4 - M-343]

Aerial photo, Vanport City, circa 1943

I remember Vanport. I had friends who lived there. It was in a vegetable garden, in a flood plain, and it did eventually flood – but I’d moved to Denver by then.

[Editor’s note: Henry J. Kaiser built Vanport – Oregon’s second-largest city – to handle the enormous need for temporary wartime housing, including most of the immigrant black labor force. It was the largest public housing project in the nation and included facilities such as schools, movie theaters, and the first publicly funded daycare center built in the United States. On May 28, 1948, a dike failed during unseasonably high flooding on the Columbia River, resulting in at least 15 deaths and the total destruction of the city.]

 

Denver: Becoming a Kaiser Permanente Member

I came to Denver in October, 1947. Denver was that much behind the coast, on lots of things. Denver was a completely different region and atmosphere.

I took a loss in wages. Because of my union connections, I got a job with the Joint Council of Teamster locals. I started working for Local 17, the freight dock workers, where I worked for seven years before being fired when a new manager came in.

Postcard of Bess Kaiser Hospital, Oregon, printed 1959. Given by Rube Bingham to daughter Laura Robertson, with message on back. Floors 3-5 are numbered by hand. Gift of Laura Robertson.

Postcard of Bess Kaiser Hospital, Oregon, printed 1959. Given by Rube Bingham to daughter Laura Robertson, with message on back (below). Floors 3-5 are numbered by hand.

I got a job working for the Atomic Energy Commission in Grand Junction, so I moved there with my husband. The paperwork to get a clearance was incredible. It took me weeks to prepare it. An official came out to my house to talk about my application – which was very unusual – and he said that after contacting all of my references they didn’t get one negative comment. I got the job. I was on the procurement desk for the expiration division. That meant a worker brought the yellowcake samples to my desk and I took them to the lab. I contacted the warehouses to check on availability of equipment needed. If none was available I completed a nine-carbon form that I presented to the proper authority for his signature so that the equipment could be ordered.

Postcard of Bess Kaiser Hospital, Oregon, printed 1959. Given by Rube Bingham to daughter Laura Robertson, with satirical message on back "My summer home."

Postcard of Bess Kaiser Hospital, Oregon; satirical message on back “My summer home.”

I worked about one year, and in 1962 returned to work for the Teamsters in their Grand Junction office. I walked in their office and organized their records, which were a mess. This was just about time the Teamsters came under federal investigation. I had to stall them for two days because my boss was out of town.

It was through my Teamster employment that I became a Kaiser Permanente member, and have been ever since.

My mother stayed in Portland. Here’s a Bess Kaiser Hospital postcard from my mother, on which she wrote “My Summer Home. Third floor, May 10, 1964 – Broken arm; fourth floor, September 3, 1964 – head-on collision. Fifth floor, August 1962 – gall bladder operation.”

 

-Special thanks to the Colorado Kaiser Permanente communications team for setting up this interview, and to member Laura Robertson for her patience and support in producing this story.

 

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

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