Archive for February, 2011

Country Joe brings Florence Nightingale’s legacy to life

posted on February 18, 2011

By Ginny McPartland
Heritage writer  

Nurses have a friend in the music business, I discovered recently. Country Joe McDonald, who many will remember as the creator of one of the most famous anti-Vietnam war anthems, has become enamored with nursing angel Florence Nightingale and her dedicated, compassionate and intelligent successors.  

McDonald, who inspired 300,000 Woodstock Festival revelers in 1969 with his “I Feel Like I’m Fixin’ to Die Rag,” today sings the praises of nurses who carry on the tradition begun by Nightingale in 19th century Europe.  

Country Joe at Nightingale's grave in East Wellow, England. Photo by David Bennett Cohen

He has developed a comprehensive Florence Nightingale Web site and a 50-minute live show that incorporates the story of Nightingale and of the many who have followed in her footsteps, especially in times of war. In the road show, McDonald performs four original songs of tribute to nurses. 

Nightingale marshaled female forces to care for war victims  

An upper-class Englishwoman, Nightingale (1820-1910) embarked on an aggressive nursing mission in her early 30s. In 1854, she essentially forced the English army to allow her and 37 other women to take care of wounded soldiers on the Turkey battlefront in the Crimean war. At first the army rejected the women’s help but relented and welcomed the nurses when the casualties became overwhelming.  

The first action Nightingale took was to clean up the hospitals and the patients to prevent unnecessary deaths from infections. After the war, she implemented sanitary measures in English hospitals and applied her mathematical skills to collecting data and showing how by insisting on sterile environments nurses could save lives.  

Nurses stand by soldiers in war  

McDonald, who co-founded the 1960s rock band Country Joe and the Fish, became interested in Nightingale when he went to a 1981 seminar about the problems of Vietnam veterans in Berkeley, California. His eyes were opened to the contribution of nurses throughout history, and he realized that nurses who cared for the war-injured had not been adequately recognized.  

“One speaker was a Vietnam War nurse named Lynda Van Devanter who was the first Vietnam War nurse to ‘come out’ and speak for women in the military. As a member of the audience I was stunned at the realization that I was also guilty of ignoring women in the military in my writings,” relates McDonald, who joined the U.S. Navy in 1959 but did not see action.  

After the seminar, he looked up nursing in the encyclopedia and found a biography of Florence Nightingale, considered the founder of modern nursing. Next he went to the now-defunct Holmes Bookstore in Oakland, California, and bought an autographed copy of Sir Edward Cook’s Nightingale biography. McDonald devoured all he could find about Nightingale’s life and work – and was hooked.  

“I visited Florence Nightingale’s home at Embley (England) along with her gravesite at East Wellow, her summer home Lea Hurst (in Derbyshire, England), the Selimiye Barracks Hospital in Turkey (scene of the care of the Crimean War victims), and Kaiserswerth in Germany (where she graduated from nursing school). I began work on a major film treatment of her life. I am still working on that film treatment and am still a student of her life,” he writes on his Web site.  

Singing praises to the lady nurse  

One of McDonald’s tribute songs, “Lady of the Lamp,” recalls Nightingale’s nightly walk among the mass of war injured during the Crimean War. Carrying a lamp, she covered a four-mile route as she checked on patients lying on cots 18 inches apart. Legend has it that the soldiers kissed her shadow as she passed.  

McDonald has also penned and performed three other songs, “The Girl Next Door (Combat Nurse),” “Clara Barton,” and “Thank the Nurse.” “The Girl Next Door” is the closest to McDonald’s Vietnam War protest message, with the lyrics pondering the “why” of war. The song begins:  

She grew up in America, just the girl next door
Never thought to question what we were fighting for
They sent her off to war and showed her death and pain
And the girl next door will never be the same.

You can see the similar sentiments in McDonald’s spirited and passionate “I Feel Like I’m Fixin’ to Die Rag:”  

Well come on all of you big strong men, Uncle Sam needs your help again,
he got himself in a terrible jam, way down yonder in Vietnam,
put down your books and pick up a gun, we’re gunna have a whole lotta fun.

and its 1,2,3 what are we fightin for?
don’t ask me i don’t give a dam, the next stop is Vietnam,
and its 5,6,7 open up the pearly gates. Well there aint no time to wonder why…WHOPEE we’re all gunna die.

now come on wall street don’t be slow, why man this’s war a-go-go,
there’s plenty good money to be made, supplyin’ the army with the tools of the trade,
just hope and pray that when they drop the bomb, they drop it on the Vietcong.

Affinity for nursing runs in the McDonald family  

The last song “Thank the Nurse” pays tribute to the everyday nurse who does the hard work of standing by the sick night and day. The lyrics are timeless but apropos for today. Joe McDonald should know about a nurse’s daily work: His wife Kathy McDonald is a labor and delivery nurse at Kaiser Permanente (KP) Oakland, California, and his brother Billy is a nurse practitioner at KP in nearby Richmond.  

Thank the Nurse that’s nursing you.
The one that nursed you through.
Thank the Nurse that’s nursing you,
For saving your life….for saving your life..

“Country Joe’s Tribute to Florence Nightingale and Nursing,” debuted at the Berkeley Fellowship of Unitarian Universalists in 2009. Joe continues to take the show on the road and will perform March 2 at Emporia State University in Emporia, Kansas. Audio clips of his songs and the lyrics are available online. 

McDonald’s Web site has an educational bent, and teachers can find encyclopedic quality facts about Florence Nightingale and her legacy. Visitors to the site can even access a YouTube video that has an 1890 audio of Nightingale speaking. She recorded a segment for an English cancer prevention campaign in which she said: When I am no longer even a memory – just a name, I hope my voice may perpetuate the great work of my life.”

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Henry J. Kaiser in Modern Healthcare’s Health Care Hall of Fame

posted on February 7, 2011
By Bryan Culp

Director of Heritage Resources

Henry J. Kaiser, inducted into Health Care Hall of Fame

Henry J. Kaiser (1882-1967), the co-founder of Kaiser Permanente and a titan of industry during the first half of the 20th Century, has been inducted into Modern Healthcare’s Health Care Hall of Fame for 2011.

Along with Sidney R. Garfield, MD (1906-1984), Kaiser was a champion for a new kind of health care system in a period when prepaid, group practice was not accepted by the American medical establishment. “He is greatly restless and restlessly great, one of America’s last real Horatio Algers,” the Oakland Tribune and Parade magazine said of him in 1958.

“I am very pleased to hear that my grandfather, Henry J. Kaiser, has been selected as one of Modern Healthcare’s 2011 Hall of Fame inductees,” said Kim J. Kaiser of the Kaiser Foundation Health Plan and Hospitals Board of Directors.

“Henry Kaiser created many successful businesses during his life, but he was most proud of Kaiser Permanente. It is fitting that he join 1988 Hall of Fame inductee, Sidney R. Garfield, MD, since it was the partnership between an entrepreneur and business leader, and a dedicated and innovative physician which created the Kaiser Permanente prepaid, integrated health care model. Henry Kaiser and Sid Garfield would be pleased to see how their partnership continues today.”

Henry Kaiser in good company in Hall of Fame

Modern Healthcare and the American College of Healthcare Executives created the Health Care Hall of Fame to honor men and women who have made outstanding contributions to the health care industry. Prior to this year’s inductees, 87 health care visionaries and innovators had been inducted.

Among those 87 are Sidney Garfield, MD, who was inducted in the hall of fame’s inaugural class in 1988. Other honorees include American Red Cross founder Clara Barton (1993), chairman of Johnson & Johnson Robert Wood Johnson (1990), former U. S. surgeon general C. Everett Koop (1997), and Massachusetts Senator Edward “Ted” Kennedy (2010).

At age 75 when Henry Kaiser’s industrial empire was at its zenith, the builder of some of the 20th century’s iconic bridges, dams, ships, airplanes, and automobiles said, “Of all the things that I’ve done, I expect only to be remembered for my hospitals.  They’re filling the people’s greatest need – good health.”

Health plan has roots in Great Depression

With Sidney Garfield, Kaiser forged Kaiser Permanente out of the challenge to provide Americans quality medical care during the Great Depression and World War II, when most people could not afford to go to a doctor.

The health care program that today bears his name emerged in all but name in the late 1930s when Kaiser was establishing his reputation as the builder of the great dams of the American West – Hoover, Bonneville, and Grand Coulee. In 1938 he partnered with Garfield to provide health care for his workers at the remote Grand Coulee site in Mason City, Washington.

Garfield had earlier successfully experimented with prepayment in a five-year industrial medical care program in the deserts of southern California.  Prepayment took the form of a modest, affordable, payroll deduction that spread the cost of care for the injured and ill over a large number of healthy people, and it ensured a stable income by which a medical care operation could meet expenses.

Workers’ health paramount to Kaiser

Garfield’s ideas resonated with Kaiser who viewed the experimentation as needed in those economically challenging times to find ways for people of modest means to obtain health care. Garfield remembered their first meeting – what he thought was to be a routine job site inspection – this way:

“To my surprise, he seemed more interested in the welfare of his workers, in the medical care program that we were developing for them, than he was in the progress of his job…. He spent the whole day going through our facilities, discussing our plans and questioning me on all the details of the operation … how we had developed the plan and what the principles were, and how and why it worked….”

“By the end of the day I felt like I had been vacuumed and completely drained of all information I knew about medical care.  When we had gone about as far as we could go … he said, ‘Young man I think you have a plan that should be made available to everybody in the country.’”

“From that time on we were bound together by this common belief and interest in developing our health plan,” Garfield said.

Core principles of health plan

The two health care pioneers founded Kaiser Permanente on the principle of prepayment that spread the cost of care over a large number of healthy people, and provided stable revenue for medical care, clinical research and education to enhance the quality of care. 

Prepayment triggered best practices in the prevention of injury and illness, to the betterment of workers’ lives and to the improvement of health care finances.  With the cost barriers removed, the ill presented earlier for treatment establishing a true practice in preventive care, the early detection of disease, and the emergence of lifestyle medicine to maintain health and enhance the quality of life. 

Multispecialty group medical practice maximized physicians’ abilities to care for patients through doctor-to-doctor consultation, through the training and mentoring of young physicians, and through the inherent quality controls built into the group. 

Facilities under one roof brought the doctors’ offices, laboratories, pharmacies and hospital all within proximity, reduced costs through economy of scale, and most effectively utilized the time of both physicians and patients. 

This is Henry Kaiser’s ninth inclusion in lists of hall-of-fame honorees, including the U.S. Labor Hall of Fame in Washington, D.C., where he was honored in 1990, and the California Hall of Fame in 2009.

Henry J. Kaiser was known in every American household for his renown as a builder and as the “patriot in pinstripes” that revolutionized shipbuilding during World War II.  Click on the video to see his appearance on the TV classic, “What’s My Line?” in September 1957.

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Early Permanente physicians: making do with makeshift facilities

posted on February 4, 2011

By Laura Thomas

Heritage correspondent

The first Kabat-Kaiser Institute was housed in this Washington, D.C. mansion.

In the early days of Permanente medicine, co-founder Dr. Sidney Garfield had to be nimble at getting the resources needed to take care of newly signed-up plan members. Working quickly to add new groups just after the war, often Garfield had to scramble to hire doctors and set up care facilities. Sometimes that meant occupying whatever building was available immediately – however seemingly unsuitable.

From the late 1940s into the 1950s, thousands of union workers in the Bay Area joined the Permanente plan and were able to get care at the new Kaiser Foundation Hospital on MacArthur Boulevard in Oakland. But the Bay Area was growing beyond the towns on the bay shore in the wake of the war’s great westward migration, and the medical plan had to grow with it.

Thus, when Henry Kaiser and Garfield took on members too far away to make an easy drive to central Oakland, the physicians moved into any building deemed workable. The health plan took over many wartime health facilities and small hospitals, but at different times, Permanente doctors and nurses saw patients in examining rooms fashioned out of the bedrooms of a motel and a once-stylish, turn-of-the-century hotel, the offices and storerooms of a San Francisco office building, the tight quarters above a modest dress shop and a ranch house on an historic estate.

First postwar facilities at Vallejo military-style hospital

Kaiser’s first opportunity to extend the health plan beyond the shipyards came right as the war ended.  Residents of the apartments and dormitories built for the workers that flooded Vallejo to work at Mare Island and the Benicia Arsenal had laid the groundwork in 1944 by lobbying for a government-sponsored hospital.

Vallejo military-style Permanente hospital in 1948

They succeeded in getting the Vallejo Community Hospital, which was built – military cantonment style – between a slough and a hillside on the north edge of town. Now that the war was ending, the barracks-like facility was slated for closure and the tenants re-grouped. They appealed to Permanente to come to Vallejo to care for up to 25,000 people living in eight housing projects.

In September 1945, the doctors moved into an infirmary downtown near the corner of Fourth and Maryland streets. The facility, which had been used by the U.S. Public Health Service during the war, was renamed the Permanente Medical Center. With only 60 beds, the makeshift hospital was temporary.

By 1947, Permanente re-opened the nearly new Vallejo Community Hospital and  – with the ample space it provided in several single story buildings spread over 30 acres – was also able to bring to Northern California the Kabat-Kaiser Institute, now called the Kaiser Foundation Rehabilitation Center. The original institute was established in Washington, D.C., at Henry Kaiser’s behest to help victims of neuromuscular disease, including his son, Henry J. Kaiser, Jr., who had multiple sclerosis (MS).

Later when a new Vallejo hospital was built in 1972, the campus continued to house the outpatient departments. In 2010 the newest Vallejo medical center was completed with 248 beds, a state-of-the-art rehabilitation wing with two gymnasia, and halls filled with natural sun light and the works of North Bay artists.

Next stop San Francisco

 The first doctors recruited by Garfield had no grandiose expectations. Most were committed to the ideal of health care for the masses, accepted the salary offered and the challenge of making do. It was all about “good humor and team spirit,” as long-time allergy supervisor Renee Owyang recalled in 1982 as she reflected on her early years in the first San Francisco clinic.

This former ambulance company building at 331 Pennsylvania St. in San Francisco was renamed Permanente Harbor Hospital in 1948.

In 1946, while the Alameda-Contra Costa County Medical Society was preparing an attack on Permanente medicine and its prepaid, group practice health model, shipyard workers at Hunters Point joined the health plan. To avoid attracting controversy in San Francisco, Garfield’s doctors took over a small clinic that had served the workers during the war on the third floor of an old lower Market Street office building and put the name of Dr. Cecil Cutting on the door.

In 1948, the Permanente Foundation acquired a 35-bed hospital in the Bayshore District of San Francisco near Hunter’s Point Naval Shipyard. The old structure at 331 Pennsylvania St. had been previously owned by an ambulance company. Garfield had the picturesque building refurbished and re-named it Permanente Harbor Hospital.

For years before the Market Street clinic merged with the new hospital on Geary Boulevard, the San Francisco staff saw patients and even began an allergy department in a loft area that was served only by stairs and a freight elevator. “We often served as elevator operators for our allergy patients who were unable to climb the stairs,” Owyang said. She remembers putting out several buckets on rainy days to catch drops falling in the waiting area from the roof and enjoying the various tunes created by the rhythmic plops: “often we were tempted to rotate the buckets to get a new tune.”

Rambling ranch house turned into Walnut Creek clinic

This Arts&Crafts style home in Walnut Creek was converted to a Permanente medical clinic in 1952.

In 1952, Henry Kaiser, who lived in Lafayette, was eyeing the small, but bustling town of Walnut Creek as the place to locate a new hospital and found a 5-acre site along Newell Avenue. The owner was Edward Counter, soon to be mayor of the town, who lived there in an old, rambling Arts&Crafts style house he and his wife had turned into a cultural center. “It was kind of a collecting place for all the little (old) ladies of Walnut Creek, you know, and they had a tea room,” remembered the hospital’s administrator, Jack Chapman, in 1982.

Chapman also noted in an oral history that the price had been fixed at $75,000, but the ever impatient Kaiser was seen at the property. “He couldn’t wait, you know, he stomped around here one night and somebody saw him and automatically it went up 25,000 bucks.”

The house that had once been surrounded by orchards was turned into a clinic, with an older home at the back becoming the housekeeping department and a swimming pool turned into a morgue, Chapman recalled. When the clinic opened, he was joined by a gardener, to take care of the grounds, a nurse, receptionist and three doctors. By the end of 1953, a new clinic and hospital had been built on the property and 35,000 people trooped through it during an open house that lasted two weeks.

And not a minute too soon, for in the same month (September), Local 1440 of the steelworkers union up the road in Pittsburg voted to join Kaiser –  after a bitter campaign by local doctors designed to dissuade them — and suddenly 10,000 more people became Permanente members. “They demanded then that we open a clinic,” Chapman said.

A motel on Los Medanos Street behind Pittsburg Post-Dispatch building was purchased and used for nine years until a larger clinic was built in Antioch. “So we bought this funny little building that was about to be a motel,” said Dr. Wallace Cook in 1982 “and turned each motel room into an office. It had a courtyard so you peeled off and went to surgery or medicine or wherever, depending on which motel room your doctor was in.”

Southern California coastal group finds space above a dress shop and in posh hotel

San Pedro Permanente medical offices expanded to Pacific Avenue over a dress shop in 1951.

In 1950 Ira “Buck” Wallin MD hurriedly set up shop in a medical office in downtown San Pedro when longshoremen union members joined the health plan. The interim clinic was pulled together in two weeks with Harry Bridges, leader of the International Longshoremen and Warehousemen’s union, breathing down Garfield’s neck.

There were 3,000 new members to handle and, within seven months, 30,000 retails clerks were added to the Southern California membership rolls, many living in the San Pedro-Long Beach communities. Busting at the seams, the plan found space for several more doctors and the administrative offices above a dress shop on South Pacific Avenue.

By 1954, a new clinic was opened in a large Victorian house on Atlantic Avenue in Long Beach, which had room for five internists, including a pediatrician, and had an X-ray department, but no laboratory. It became popular immediately and another site was opened in the turn-of-the-century Kennebec Hotel, which had been a center of action in Long Beach’s heyday as a beach resort.

Remodeled in 1950, the guest rooms were equipped with toilets and showers and accommodated surgery, internal medicine OB/Gyn, pediatrics and physical therapy.

The old Kennebec Hotel, across from The Pike amusement park, was used as a Permanente Long Beach clinic in the early 1950s.

“It was hot in the summer and cold in the winter but had a good view of The Pike,” said staffer Hannah Wilson. The Pike, the mile-long boardwalk and amusement park that was still roaring in the 1950s featured such attractions as a large indoor swimming pool, carousel, rollercoaster and 10-cent rides for children on Wednesdays.

In 1992, the Long Beach clinic relocated a fourth time to its present site on the Pacific Coast Highway, just before the traffic circle. On most days, members and staff have a clear view of the city’s high rise buildings and the Walter Pyramid at California State University, Long Beach.

The clinic is modern and efficient, but no doubt it has little of the charm of those earlier facilities, none of the pink bordello walls, warm ocean breezes or shrieks of delighted children, that the staff and doctors remember from the old Kennebec.

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