Permanente physician and wife hazard a hunt in dangerous waters of the Amazon
Editor’s note: Kaiser Permanente physician and educator Martin Shearn and his wife Lori traveled to Brazil in 1973 where Dr. Shearn served as chief of staff for the SS Hope hospital ship docked in Maceio, a poor coastal community in Northeast Brazil. The couple took a few days off from their health care duties to venture into the Amazon River region in September of 1973.
, Guest writer
We’d learned to trust our new young guide on the strenuous and magical jungle hike he’d led earlier in the day. An Indian, Manoel had lived on the Amazon all his life so he knew the rivulets and the inlets as well as the paths where there was terra firma to walk upon.
That night after dinner we embarked in earnest on our highly anticipated alligator hunt. Manoel had caught a jacaré¹ once before, he reported, and he had seen another one near where we’d docked our houseboat. We were extremely excited, bundled up in our canoe, aware of the dangers of the hunt. The mystifying sounds of the myriad of the Amazon’s night creatures made for an eerie scenario.
Just as we got ready to depart, a tremendous upheaval almost tipped the canoe as our cook Milton lowered his huge body into the back of the craft. He insisted his presence was essential to record the event on his brand-new tape recorder. Aliomar, our main guide for the Amazon trip, also came along. We were all in a gay mood, all giggles, as Milton planned (in jest) how he would fix the jacare for breakfast.
We could see Aliomar’s eyes shining with anticipation, for as our guide he wanted us to have a good time. Of course he also was a joyous young man on the hunt for a lark. Manoel, on the other hand, burdened with his responsibility and aware of the dangers, was solemn and quiet, acutely attuned to the sounds of the night. He sat in the front, paddling; Aliomar, Marty and I sat in the middle, and Milton weighted down the back. Manoel carried our weapon: a lengthy stick with a nail-like protrusion at its tip, and we each had a flashlight.
My mind was racing: How big was he?
We were gliding silently over the dark mirror of the river. We soon entered a nearby flooded riverbed (igapó).² We were told to shine our flashlights in slow circles over the surface – on for only a minute, then darkness again – on for a minute, followed by darkness. We could hear whispered conversation between Manoel and Aliomar, then scary sounds presaging all kinds of danger. There were lots of nervous giggles and jokes from each of us and then more silence. Suddenly – shhshhshh – Aliomar seriously hushing us: “I see one!”
Both of the young men became very intent, concentrating on the darkness ahead. Manoel directed their actions. Slowly we crept along the watery thicket, flashlights continually scanning the surface. “Look ahead there,” Manoel whispered. And then I saw two distinct red spots, obviously eyes paralyzed by the light and blinking in terror. It really was an alligator, he was clearly frightened and so were we! My mind was racing: How big was he? What if he lashed out with his tail and overturned the canoe and his family came along to capture us for a meal?
Marty still had not seen the eyes. He had to see them! We shined the flashlights again. Oh yes, there they were. Oh, how exciting! Gingerly, Aliomar maneuvered the canoe closer and closer to the spot. Hardly a sound. Then there was just a small tree between us and the shining red eyes.
When our trepidation subsided, I carefully drew close enough to admire the jacaré and even rub his smooth belly.
We were real hunters now, and while we caught our breath, Manoel kicked off his sandals, stealthily stepped into the water and with his bare hands reached out for our prey. There was a lot of splashing in the brief scuffle, and then, he had him! He held the alligator by the neck, the creature continued to flail his tail and his jaws attempted to snap. Manoel handed the jacaré to Aliomar and they allowed him to snap onto the wooden side of the canoe where he struggled for a while and then began to relax.
When our excitement and trepidation subsided, I carefully drew close enough to admire the jacaré and even rub his smooth belly. His eyes were on alert, but the perfect fingers on his front and back legs were now relaxed. He was resigned to his fate, whatever it was to be. We named him Jose dos Santos and jubilantly brought him back to the big boat.
Overnight, our nervous sleep was punctuated by a dozen giant toads that seemed to croak their disapproval. We were all up early the next morning. The river sparkled like a jewel and Jose was still in the washroom where we’d tied him up before we retired.
While I enjoyed my early morning swim, Milton the cook decided Jose would like a swim also. He made Jose a halter out of rope and dangled him into the water near me. Horrified, I thought Jose was free, and I was not convinced that it was safe to swim in the Amazon with a live alligator.
All through breakfast we bragged like successful hunters of old, recounting our tales of courage. And Milton had it all on audio tape! We played the great adventure over and over. At last the sun was high enough for us to get our photographs – triumphant hunters posing with our vigorously kicking prey, holding him this way and that for better angles.
Finally, we gave him his freedom back. He hesitated when he hit the water, but soon he carefully tested first one arm, then the other, and then with a powerful swish of his tail, he was gone. None of us will ever forget him. Quietly we all hoped he’d swim far enough away that we wouldn’t encounter him, bent on revenge, in our next dip in the mighty Amazon.
Martin summed up our adventure on the Amazon succinctly and excitedly in a September 1973 letter to friends back home:
“Lori and I just returned from an incredible journey on the Amazon replete with piranhas (Lori caught and ate one), lizards, alligators (caught one of those also) and various exotic birds.” (Martin had skipped the piranha experience because he was allergic to fish.)
“The submerged jungle called igapó was the most beautiful (sight we’ve seen). Ever changing and unchallenged. A remarkable experience and all the more so with not a single beer can or other evidence of garbage.”
¹Caiman yacare, jacaré in Portuguese
²Igapó (Portuguese pronunciation: [iɣɐˈpɔ]) is a word used in Brazil for blackwater-flooded Amazonian forests.
The Occupational Health and Safety Section of the American Public Health Association is celebrating its 100th birthday this year, and the progressive role of that branch of medicine will be highlighted at APHA’s annual conference in New Orleans November 15-19.
Among the media being generated to explore and learn from that history is a full-color poster. “Protecting Workers for a Century,” designed by Kaiser Permanente Heritage Resources archivist Lincoln Cushing, features 12 images covering a range of occupations and dates.
Six illustrations and six photographs offer visual evidence that work can be dangerous and that workplace safety is a constant battle. Two of the images are by Kaiser Permanente Labor Management Partnership photographer Robert Gumpert.
The poster image is featured as the first-ever color cover of the peer-reviewed independent journal New Solutions: A Journal of Environmental and Occupational Health Policy, for their special issue on the 100 year anniversary. The articles may be downloaded for free courtesy of NIOSH and the CDC.
For more on Kaiser Permanente’s long commitment to the field of occupational health and safety, see our earlier Heritage article here.
Happy birthday, OHS!
Image credits, upper left to lower right; all are cropped from original format.
Lewis Hine, “Breaker boys working in Ewen Breaker of Pennsylvania Coal Company,” 1911; Lincoln Cushing, “Mujeres embarazadas! Pregnant women!” 1979; Earl Dotter, Cable Inspectors on Verrazano Narrows Bridge, NY, 2000; Luther D. Bradley, “$acred Motherhood,” 1907; Earl Dotter, Brooklyn hospital laundry workers with needles found in linens, 1997; Richard V. Correll, “An injury to all,” 1980; Robert Gumpert, fiberglass insulation manufacturing, Willows, Calif., 2003; Marilyn Anderson, “100 years of solidarity,” 1989; Lewis Hine, “Bibb Mill No. 1, Macon, Georgia,” 1909; Simon Ng, Our Times magazine (Canada), 1985; Robert Gumpert, garment presser, NY, 1983; Domingo Ulloa, “Short-handled hoe,” 1969.
Short link to this article : http://bit.ly/1prejdp
, Heritage writer
During World War II, Permanente Health Plan physician Morris Collen experimented with the treatment of pneumonia as he managed a large number of cases in the Kaiser Richmond shipyards. Many of the workers were in poor health to begin with, and the round-the-clock ship production in all sorts of weather exacerbated the situation. Dr. Collen reflected on that challenging period:[i]
When we first started there was no treatment for lobar pneumonia, pneumococcal type, except horse serum, and the people almost always got sick with serum sickness. It was a terrible treatment, but was all we had. Then… came sulfanilamide, and then sulfathiazole and sulfadiazine, and a series of sulfa drugs, and we began to treat pneumonias with them. That’s where we began, I would say, our first clinical research, evaluating different treatments for pneumonia.
Among those experimental treatments was a new drug, penicillin.
But this was wartime, and supplies were limited. Ninety percent went to servicemen fighting overseas, and only the remainder was allocated for distribution in the United States. Collen:
We had so many pneumonias and we had reported already in a journal that we were treating large series of pneumonias. So we got the first dose of penicillin in California, and treated a young man with a very severe lobar pneumonia, type 7. They all died from that, and this poor fellow was going to die. So we gave him this one shot of 15,000 units, and to this day I keep saying it was a miracle. He recovered.
The Richmond shipyard newsletter Fore ‘n’ Aft proudly announced the availability of this “wonder drug” in its May 19, 1944, issue:
Early this year a young shipyard worker developed a growth of pneumonia germs on his heart valves. At the Permanente Foundation Hospital he was given all the standard modern treatments that are regularly dispensed there to members of the shipyards’ Health Plan. Even with sulfa drugs he showed no improvement. The rare new drug, penicillin, was finally used. He recovered quickly.
Later a 15-year-old boy developed a blood clot on his brain, following a case of severe sinusitis. Death results in nearly 100 per cent of such cases. This time penicillin was used. The hospital record reads, “Patient completely recovered. Discharged from hospital.”
Until few months ago, the Army and Navy took the whole production of penicillin. When military stockpiles had been built, the National Research Council began to release penicillin for civilian needs. It is still difficult to obtain. Only three hospitals in this area are allowed a supply. They are the three hospitals in the area which treat the largest number of patients. The Permanente Foundation is one of the institutions which is allowed to buy it.
The use of penicillin is made possible here by the financial support of the members of the Health Plan. Science’s new wonder-cure is now at the service of shipyard employees.
While the war raged on two fronts, Collen published the seminal article on his civilian treatment experiences. His summary showed remarkable results:[ii] “A series of 646 consecutive patients with pneumococcic pneumonia were treated with combined sulfadiazine and penicillin therapy with a resulting mortality rate of 1.1 percent.”
A subsequent Fore ‘n’ Aft article on the benefits of medical research boasted: “By using the facilities provided for doctors under prepaid, group medical practice – to wit, the Health Plan -they evolved a complex treatment involving a combination of sulfa drugs and penicillin that is making medical history. Payoff: Human lives.”[iii]
Dr. Collen’s wartime use of penicillin not only saved lives, it provided sound medical evidence for future treatment methods.
Short link to this article: http://bit.ly/1kcifjc
Also see: “The History of WWII Medicine”
[i]“Morris Collen, Kaiser Permanente Medical Care Oral History Project II, Year 1 Theme: Evidence-Based Medicine,” conducted by Martin Meeker in 2005, Regional Oral History Office, The Bancroft Library, University of California, Berkeley, 2007.
[ii] Morris F. Collen, M.D. and Alvin L. Sellers, M.D. “Penicillin Therapy of Pneumococcic Pneumonia – A Preliminary Report.” Permanente Foundation Medical Bulletin, April 1945.
[iii] “Research is Good Doctoring,” Fore ‘n’ Aft 10/19/1045.
, Heritage writer
Actor James Garner’s passing last weekend at age 86 brought new attention to his incredible body of work spanning half a century in Hollywood; his death also brings to mind Henry J. Kaiser’s bold foray into television.
In 1957, Kaiser bankrolled Garner’s star vehicle “Maverick,” a hugely popular television program. The largely unknown Garner played the amiable gambler Bret Maverick, a role that made him famous.
“Maverick” aired on Sunday evening prime time from 1957 to 1962 on the ABC network under the lone sponsorship of Kaiser Aluminum. The show, broadcast during the “Kaiser Aluminum Hour,” was an overnight sensation and the number-one-rated show in America for several seasons.
Henry J. Kaiser could not have been more pleased. He had taken a big gamble on “Maverick”. The single sponsorship network contract ran $7 million, a big commitment of advertising dollars for Kaiser Aluminum in 1957.
Kaiser polled his managers on the idea of underwriting a Sunday night TV western. There were 31 votes against and one in favor, Kaiser himself.
But Kaiser followed his own lights, as readers of these pages know. He was the first industrialist to champion employer-sponsored health care. He expanded roles for women in the workforce, and opened societal fissures for the pursuit of civil and equal rights.
Throughout his career, Garner moved smoothly from TV to movies and back again. He appeared in more than 50 films, including “The Children’s Hour” (1961) with Audrey Hepburn and “The Americanization of Emily” (1964) with Julie Andrews.
Garner also will be remembered as the bedeviled ex-con turned detective, Jim Rockford, in the long running series, “The Rockford Files,” in the 1970s. For more on his career see the remembrance in The New York Times.
It is not surprising then that Kaiser quickly took to Garner’s easy-going onscreen personality. The two men enjoyed each other’s company and Garner visited Kaiser at home in Lake Tahoe and in Hawaii.
So when you think fondly of the acting genius of James Garner – from his romantic scenes with Audrey Hepburn to his car chases in “Rockford Files” – recall that Henry J. Kaiser financed his first big break.
Anniversaries offer an opportunity to reflect on the past and anticipate the future. It is at such times that history helps an organization take a deep breath and focus again on its purpose and direction.
In 1982, two of the original Permanente Foundation hospitals – Oakland and Richmond – embarked on a campaign to celebrate “Caring and growing since 1942.” In addition to a special issue of the employee magazine KP Reporter, the hospitals produced a short video that swept from the World War II Kaiser shipyard health plan to the hugely expanded Oakland medical center, and beyond.
The Oakland Hospital opened August 1, 1942, with 70 beds. The Richmond Field Hospital, closer to the shipyards but with only 10 beds, opened August 10, 1942.
The video includes footage of wartime President Franklin D. Roosevelt chatting with Henry J. Kaiser at a ship launching, and founding physician Sidney R. Garfield, M.D., describing the goals of this remarkable health plan.
Short link to this article: http://bit.ly/1rs7AAt
, Heritage writer
Four years ago on July 17, a group of local citizens sat in silence near the shores of Suisun Bay at Port Chicago, upriver from the San Francisco Bay near the city of Concord.
The National Park Service had assembled the group to dedicate a new memorial at the site of the horrendous ammunition ship explosions that killed 320 people, including 202 black sailors, 70 years ago this week.
Silence and peace prevailed in this moment in 2010 because the group was under the spell of Yosemite National Park Service Ranger Shelton Johnson, keynote speaker.
Johnson, a black man from Detroit, commanded the crowd’s attention with his urging for everyone to close their eyes and imagine being in the same spot in July 1944 before tragedy struck. “They would have heard the same breeze blowing and seen the same sights.”
Johnson played a soothing Native American tune on his cedar flute, creating a mood that could not have contrasted more with the horrifying scene the night of July 17, 1944.
Much water has gone under the bridge since the night hell visited the naval ammunition depot and two earsplitting explosions six seconds apart disintegrated two cargo ships – both built by Henry J. Kaiser shipyard workers.
All the men on the ships and the loading dock were killed instantly; most bodies were impossible to recover or identify. The SS E.A. Bryan, a Liberty ship launched from the Kaiser Richmond Shipyards Feb. 29, 1944, was “vaporized”.
The SS Quinault Victory ship was launched from the Kaiser Portland shipyard just one month before the disaster, June 17, 1944, and was on its maiden voyage. Pieces of the Quinault were scattered over a two-mile area adjacent to the port.
What could have been written off as simply a tragedy of war – careless sailors in a hurry to load much needed firepower for the Allied forces in the Pacific – became a flash point for the Civil Rights Movement.
The biggest catastrophe on the World War II Home Front, the Port Chicago disaster and its aftermath shined a spotlight on U.S. Navy personnel practices, especially the treatment of African-American sailors.
By policy, the Navy and all branches of the service were segregated in 1944. Black enlisted men were not eligible for promotion and their duties were restricted to menial tasks. The men assigned to load the ships at Port Chicago were all black; the officers at the installation were all white. None of the men assigned to Port Chicago had ammunition-loading training.
Before the disaster, the black stevedores believed their work was relatively safe, as their officers had told them. But after they saw their colleagues killed, the men became afraid to go back to work unless the Navy improved conditions.
Three weeks later, the black sailors were assigned to load ammunition ships at nearby Mare Island; 258 refused. When told they would be charged with mutiny and could be executed, all but 50 of them agreed to go back to work.
In late 1944, the Navy beefed up munitions training and safety measures and assigned white enlisted men to join the black enlisted men on the rebuilt Port Chicago pier.
But it was too late for the black sailors who refused the assignment at Mare Island. Even though they agreed to go back to work, they were docked three months pay and given a “bad conduct” discharge, which meant they could not get veterans’ benefits.
Those who continued in their resistance became the subject of the biggest mutiny trial in U.S. Naval history and gained the moniker “The Port Chicago 50.” Their cause attracted the attention of Thurgood Marshall, then-attorney for the National Association for the Advancement of Colored People, who attended the trial.
In an appeal of the verdicts, Marshall argued that racism played a role in the trial and the charge should not have been mutiny but at most insubordination. He was unsuccessful in his appeal of the mutiny verdicts, and the 50 were sentenced to 15 years in prison.
Later, the sentences were reduced to eight to 10 years, and after the war, in 1946, all but one was released from prison and took assignments in the Pacific. Also in 1946, the Navy became the first branch of the U.S. military to fully integrate its forces.
Although Marshall’s mutiny appeal didn’t succeed, he scored a big win for the Civil Rights Movement in 1954 as attorney in the Brown vs. Board of Education of Topeka, the landmark case that resulted in the end of segregation in public schools.
As the Civil Rights movement gained momentum, Marshall played a key role, winning cases for civil rights activists: Browder v. Gayle, ended segregation on buses in 1956, and Garner v. Louisiana in 1961 protected peaceful civil rights demonstrators from prosecution under “disturbing the peace” laws.
These successes led to the passage of the Civil Rights Act of 1964, which outlawed discrimination based on race, color, religion, sex, or national origin. President Lyndon B. Johnson, who signed the act, appointed Marshall the first African-American U.S. Supreme Court Justice in 1967.
In 1994, a Navy review of the explosion and aftermath found that racism had played a role in the work at Port Chicago and in the mutiny trials. However, officials let the convictions stand.
The National Park Service and the Friends of Port Chicago National Memorial are sponsoring events July 17, 18 and 19, to mark the 70th anniversary of the Port Chicago disaster.
Flyer for event July 17 and 19; flyer for July 18 event.
Short link to this article: http://bit.ly/1oAvp58
, Heritage writer
Nathan Leonard (Len) Morgenstern, prominent physician, educator, (San Francisco) East Bay Area civic leader, and dedicated father and grandfather, passed away May 29 from head trauma following a fall. He was 91.
Dr. Morgenstern was a distinguished physician at the Kaiser Permanente Oakland Medical Center for 35 years, starting in 1954 and retiring in 1988 as chief of pathology. He authored several articles on cancer (including “Carcinoma of the Thyroid at Autopsy” in the AMA Archives of Internal Medicine, April 1, 1959), and taught as an adjunct professor of neuropathology at the University of California at San Francisco.
He was an active and beloved figure at the Oakland hospital, and over the years he took on many of the tasks that it takes to make a medical facility great.
A 1959 article in the employee newsletter KaiPermKapsul described how he conducted a training program for students who expected to make a career in pathology.
His one-year course in Medical Laboratory Technology was accredited by the AMA and the State of California, and affiliated with San Francisco State University, which gave credit for the work.
The article noted:
Rosario Bautista and Clyde James are among those receiving this thorough training in laboratory work, the former as an exchange student from the Philippines. Medical technologists in this state must all be licensed by the State Department of Public Health, following an examination.
Just to mention a few of the newer procedures they encounter in a Kaiser hospital laboratory: there are the microchemical analyses of blood, the assays on hormones, the tests on sensitivity of bacteria to various antibiotics, the investigation of allergic phenomena and use of new isotopes for the diagnosis and treatment of disease.
In many cases where the purpose of the test is the same, it is the method or equipment used which is the innovation. “Some of the procedures are complex and require very careful manipulation,” Dr. Morgenstern explained. “We try to adopt these as fast as we can satisfy ourselves of their worth. Where there’s doubt of the worth we may return to older, simpler methods. We rather incline toward the scientific caution ‘Don’t be first, and don’t be last’.”
In 1963, a Kaiser Permanente newsletter announced a research article he published in the medical journal Cancer, “Work with Doctors in Community” about early diagnosis and treatment of tumors in children, in collaboration with physicians from Kern County General Hospital, University of Southern California, and the Tumor Tissue Registry of the California Medical Association in Los Angeles.
A 1969 article touted the Oakland hospital’s School of Medical Technology, which had been in place for 20 years; as director of that program Dr. Morgenstern supervised the eight students — six women and two men. Each student in Oakland received a stipend of $3,600 for the year’s internship.
One of Dr. Morgenstern’s colleagues noted after his passing, “He always had time for teaching and clearly enjoyed it . . . He also had a great sense of humor and a wonderful kindness. He was a good man.”[i]
Short link to this article : http://bit.ly/1oCyHGh
[i] Dr. Art Levit, MD, comment in obituary memorial booklet.
How Kaiser Permanente medical center in South
San Francisco Bay Area looked then — and now
Click on any image to see a slideshow.
To close the slideshow and return to this page, click on “X” in upper
left of slideshow page.
Click on link to see a 1985 film about Santa Clara Medical Center.
Short URL for this blog: http://bit.ly/1lP71uQ
Henry J. Kaiser was in his Richmond, California shipyards the week of July 4, 1944 for the launch of the last Liberty class ship, the S.S. Benjamin Warner. “The West Coast came to the melancholy end of a shipbuilding era last week,” said the reporter at Time Magazine, July 10, 1944. “In Kaiser’s record-holding Richmond Shipbuilding Corp. Yard No. 2 in California, the S.S. Benjamin Warner (named after the father of Hollywood’s Warner brothers) slid into San Francisco Bay. It was the 1,147th Liberty ship launched on the West Coast—and the last. A few Liberties are still being finished at East Coast yards. But no more keels will be laid, East or West.”
, Heritage writer
Kaiser Permanente’s original flagship hospital complex in Oakland, now being replaced with a stunning state-of-the art facility across the street, has faithfully served since 1942. And although all institutions experience growth and remodeling, this particular one holds a distinction that others don’t.
When Kaiser Permanente decided to build the distinctive 12-story, 420-bed hospital tower in the late 1960s, they came up with a technical solution that reduced the inconvenience to members. It was built on top of the existing hospital, thus providing almost uninterrupted patient care during construction.
Here’s how the Kaiser Permanente member newsletter described the expansion in 1969:
Buildings have been built over existing buildings before – such as the new Madison Square Garden in New York City – but as far as we know, this is the first time a hospital has been built above an existing hospital. This method of construction was necessitated by the lack of additional land for expansion of the hospital. The present hospital covers 85 percent of the available land, which doesn’t leave enough land for conventional construction.
A temporary equipment scaffold was erected over the low buildings originally built during World War II to handle the huge shipyard worker population; over the course of four months, massive holes were drilled into the open courtyard areas and eight deep pilings were driven into the ground to an average depth of 120 feet. [i]
The complexity of the construction logistics were obvious and flashy, but it should be noted that huge staffing challenges had to be addressed as well. During and after the tower construction, providing a seamless positive patient experience was a herculean task. In an article submitted to the trade publication Hospital Housekeeping, Manuel Perez, executive housekeeper at the Oakland hospital, explained the issues:[ii]
The move itself was projected in minute detail and practiced by participating teams. After the move, work schedules were modernized and inequities were rectified. Results: high morale, improved effectiveness, and opportunity for cost control…Planning and rehearsals before the actual event had prepared all members of the teams. No undue incident occurred. All of the 150 patients who were to be moved were established in their new Tower rooms by three days of continuous work.
Later, as the original building was being upgraded, Perez reflected upon the lessons learned:
As the remodeling goes on, we constantly use techniques that we learned during the move to the Tower. We learned how to organize our efforts, how to work as a team. We learned to get basic information about details, then fit them together so that they function smoothly. We try to do all this at a minimum of cost. We try to achieve a maximum of satisfaction for patients, and for our fellow-workers in all other departments of the medical center. That kind of approach, we intend never to forget.
The original hospital complex is scheduled to be razed at the end of 2015, but the spirit of member service – affordable, quality care – lives on in the new hospital.
More photos of the history of the Oakland hospital here.
[i] Note that Henry J. Kaiser was no stranger to deep piling work. His Bridge Builders firm built the East Bay Substructure of the San Francisco-Oakland Bay Bridge – the 21 piers between Yerba Buena Island and the Oakland shoreline. This was no simple task, and included digging E-3, “the deepest pier known to man,” located 1,400 feet west of Yerba Buena Island and embedded 242 feet below the surface of the bay. This contract was completed December 24, 1934. See story here.
[ii] “Facility report: Kaiser Foundation Hospital Oakland – Moving into a Tower Addition,” manuscript by Manuel Perez, Oakland Hospital Executive Housekeeper, 11/27/1973.
Short link to this article http://bit.ly/1m9G09Z.