We know that Henry J. Kaiser was a geodesic dome pioneer. Kaiser Aluminum and Chemical Corporation built two of the first civilian domes in 1957, one in Virginia and one in Hawaii. There’s another plan from the same year (never built) for a “Medical office building for the Kaiser Foundation Hospitals with Kaiser Aluminum dome.”
The Permanente Foundation hospital at Panorama City (1962-2008) featured seven double circular floors, an example of Dr. Sidney Garfield’s “circles of service” concept. Dr. Garfield explained that in a 1974 interview:
In the center was a work space for the personnel, the supervisor right in the middle, with the public or patients coming in from an outside corridor – the peripheral corridor, central workspace concept. This would permit us to keep the central area clean, as the contaminated areas go out the outside corridors so you don’t get any cross traffic. It kept the orderlies and all the people who moved stretchers out of the central work space and so forth and the supervisor is right there so she can see everything.
Yet there’s one more – the Portland Child Service Centers built in 1943 for the workers at the Oregonship and Swan Island shipyards. The center at Oregonship opened for children on November 8, 1943, Swan Island Center soon afterwards on November 18.
These structures represented an innovative approach to building that carries over to present at the Kaiser Permanente, although the organization is no longer builds round things – or does it?
Current hospital and building designs focus on environmental stewardship and patient safety, with a healthy dose of aesthetic brilliance thrown in. A news article on how design and healing go hand in hand called out the award-winning 2016 Kaiser Permanente, Kraemer Radiation Oncology Center in Anaheim, Calif., as featuring “fritted glass that evokes a forest and provides both light and privacy.” And it’s round, or at least rounded.
The 1943 Portland buildings were designed by the Portland, Ore., architectural firm of Wolff and Phillips (George M. Wolff and Truman E. Phillips), creators of several important Kaiser and Permanente facilities.
George Wolff (1899-1978) was a personal friend of Henry Kaiser’s son Edgar, and through that connection drew the firm into designing the worker’s housing at Bonneville Dam in Washington in 1934. In they created the 1942 Northern Permanente Foundation Hospital to serve the workers in Kaiser’s three northwest shipyards, as well as the wartime city of Vanport of almost 40,000 people.
After the war, the firm designed the conversion of Ford’s Willow Run plant in Michigan when Henry Kaiser took it over to produce automobiles, and later they designed the 1953 state-of-the art Kaiser Foundation Hospital in Los Angeles.
Unlike the more conventional design of the Maritime Child Development Center in Richmond, Calif., the Oregon centers put classrooms in a circle around six separate playgrounds.
We hear about this idea in a March 1944 article “Designed for 24-Hour Child Care” in Architectural Record, where Wolff and Phillips credited the facility design to the “ring school” concept originally conceived of by modernist architect Richard Joseph Neutra.
Neutra (1892 –1970) was an Austrian-American architect who spent most of his career in Southern California. Like Wolff and Phillips, his style was “modernist” with plentiful natural light and open space, and during the mid-1920s was evolving a radial site layout for public facilities.
A March 2000 article in UCLA Today explains more about Neutra’s role in this design concept:
Perhaps the most striking examples of this belief were the various schools designed by Neutra in Los Angeles. His project for a Ring Plan School, with its ring of classrooms around a play area and a running track on the roof, was adopted in 1934 by the Los Angeles School Board and built in the Bell district. The building was much celebrated for its qualities of light, relationship of classrooms to outdoors and color of materials.
One of his ring plan schools was built in 1960 at Lemoore Naval Air Station near Fresno; it’s now the Neutra Elementary School.
The design of the Portland Child Service Center was innovative, effective, and exemplary. A 2009 historic building assessment of the Portland public schools noted:
The building’s form and details rejected the architectural conventions that characterized the previous era of school construction. The Portland Child Service Center (demolished) captures the ideals that would be explored in Portland’s public schools in the post-war period.
Rejecting conventions and capturing ideals – that would be a good characterization of Henry J. Kaiser’s approach to solving national problems.
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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.
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.
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.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.
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.
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
Fourth in a series on Kaiser Permanente’s 70th anniversary
“Problems are only opportunities in work clothes.”
– Henry J. Kaiser.
Innovation has been a part of Kaiser Permanente’s culture from the beginning. While many people think of a new technology or exotic surgical device when they hear the term “medical innovation,” Kaiser Permanente’s view is much broader.
From its very beginnings, Kaiser Permanente proposed a radical – and innovative – shift in the delivery of health care.
When Henry J. Kaiser and Sidney Garfield, MD., were taking care of the almost 200,000 workers on the Home Front during World War II, few of them had ever experienced routine medical care. People feared the expense of seeing a doctor, and delayed seeing caregivers, thus guaranteeing a more difficult treatment and a less positive result. But because the prepaid Permanente Health Plan was affordable and run under the same system that was already handling their industrial care, it changed how people accepted early treatment. Dr. Garfield himself was amazed by this phenomenon during his “dress rehearsal” of medical care for worker families at Grand Coulee Dam in 1938:
One of the most impressive lessons we learned was, prior to the family plan, you would go walking through our hospital and you would see quite a few very sick women and children – ruptured appendices, bad pneumonias and so forth, even diphtheria cases. Once the plan was in operation for a while, that changed. You no longer saw ruptured appendices, we saw early [inflamed but not ruptured] appendices. Never saw bad pneumonias, we would treat them early. And diphtheria entirely disappeared. In other words, people, once the barrier of cost was removed, were coming to us earlier and we could treat them earlier and keep them from getting complications and, I’m sure, keeping them from dying.[i]
Later, in the World War II shipyards, Dr. Garfield experienced the same conditions but on a much larger scale. He reflected on the challenges of treating the rookie workers:
Some of them were in such bad condition we jokingly would refer to our shipyard workers as a walking pathological museum. But in spite of all of that fact, they really built ships and built ’em fast. And not only that, but our plan was able to succeed and work and be sustaining with that tremendous load of all those sick people to take care of. It was a tremendous demonstration of the merits of our health plan and of its value of its economics.[ii]
Other preventive features of the shipyard health care plan included a rigorous process for assigning workers to suitable job classifications, training for the women in the industrial workforce, and extended child care services. And during the war, some of the more conventional medical innovation took place as well – such as Morris Collen, MD’s groundbreaking work on using penicillin to treat pneumonia cases.
Fast forward to the present, and Kaiser Permanente is continuing to promote preventive health services while also conducting high-quality, innovative research. Kaiser Permanente is coordinating a national health initiative to improve colon cancer screening rates to 80 percent by 2018, with a special emphasis on screening minorities and those without health insurance. And when a screening does detect cancer, a progressive Oncology Clinical Trials program selects promising new medications and techniques for members to consider, even before they are FDA approved and commercially available.
In Portland, Ore., Kaiser Permanente led a study showing that mailing test kits to patient homes improved colon cancer screening rates by 40 percent in underserved communities. Sometimes basic delivery systems — like the U.S. mail — can deliver innovative health care solutions.
As Henry Kaiser noted, not all medical innovations need to come forward as bright, shiny objects. Some of the most important ones appear in simple work clothes.
Short link to this article: http://k-p.li/1KmGi87
[i] “Sidney R. Garfield in First Person: An Oral History,” by Lewis E. Weeks, Hospital Administration Oral History Collection, 1986.
[ii] Dr. Sidney Garfield interview by Dan Scannell, 9/1978.
It’s always nice to get positive feedback on what you do. Here’s a letter sent by a patient in the Northern Permanente Foundation hospital, built to care for the workers in the three Kaiser shipyards in the Portland, Ore., region during World War II. The Pulse was the newsletter for hospital staff.
January 18, 1943
Northern Permanente Foundation
The Editor, The Pulse
Dear Sir or Madam:
I wish to express my sincere thanks and deep gratitude to your entire staff for making my short stay at your Hotel one of the pleasant experiences in my drab life. On my first visit as an outpatient I marvelled at the excellent waiting room. One hour later my small mind conjured up the motto “Keep ‘Em Waiting.”
After a week in bed I’m sure that “Keep ‘Em Smiling” should be the motto above nurses’ station, no need to worry about sugar when there’s so much concentrated sweetness, to minister to your needs.
In addition, expert medical care, plus good food, properly prepared, amid an atmosphere of cheerfulness, why, even a confirmed sourpuss will grin after a short stay in this environment.
Thank you one and all.
Jim Sansbury, Dorm F, Room 64, Hudson House
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It’s not every day a first lady visits a Kaiser facility, but it happened in the middle of World War II – and she visited two.
Eleanor Roosevelt came to the Kaiser Company shipyard on the Columbia River in Vancouver, Washington to personally launch the U.S.S. Casablanca, the first in a new class of small, versatile and inexpensive aircraft carriers.
The class was named for the Battle of Casablanca, fought November 8-12, 1942, where the U.S. Navy fought vessels under the control of Nazi-occupied France. The 50 ships the Kaiser yards produced comprised almost a third of the American carriers built during the war and were launched in less than two years.
The ship was known as the Alazon Bay while under construction and renamed the U.S.S. Casablanca two days before she slid down the ways on April 5, 1943. Five of the “baby flattops” were sunk in action during the war, and none survive today.
Health care, not warfare
But Eleanor wasn’t just there for the latest in military technology. She was more interested in the social programs affiliated with the massive shipbuilding projects, including child care, prepared meals for double-duty women, and health care.
Henry J. Kaiser listened to her and responded by introducing two controversial (at the time) programs for shipyard workers – model child care facilities near two of the shipyards and pre-cooked meals for working moms.
As for health care, Mr. Kaiser needed no convincing. Mrs. Roosevelt was given a grand tour of the state-of-the-art Northern Permanente Foundation Hospital built in September, 1942 for the shipyard workers.
Eleanor wrote a regular newspaper column, “My Day.” Her April 7, 1943, entry included this reflection on the Portland visit:
A little after 9:00 o’clock Monday morning we were met in Portland, Ore., by Mr. Henry J. Kaiser and his son Mr. Edgar Kaiser. A group of young Democrats presented me with a lovely bunch of red roses at the airport and then we were whisked off for a busy day.
Our first tour was in the Kaiser shipyard itself. It is certainly busy and businesslike. Everything seems to be in place and moving as quickly as possible along a regular line of production. I was particularly interested in the housing, so I was shown the dormitories and then the hospital, which is run on a species of health cooperative basis costing the employees seven cents a day. It looked to me very well-equipped and much used, but I was told there were few accidents in the shipyards owing to safety devices. The men come in for medical care and some surgery and their families are also cared for…
The ship went safely down the ways at the appointed time and was duly christened. It was interesting and impressive to see all the workers and their families gathered together for the occasion and I felt there was a spirit of good workmanship in this yard.
Mrs. Roosevelt was so intrigued with the new medical care program that she wrote Permanente’s founding physician, Dr. Sidney R. Garfield, who happened to be away at the time of her visit. “What is your plan for preventive care?” she asked.
“This is the solution of medical care for the majority of people in this country”
Dr. Sidney Garfield replied in a letter May 25, 1943, in which he took the opportunity to explain how aligned the first lady’s vision was with that of the Permanente Health Plan:
I regret very much not to have been present during your recent visit to Vancouver, Washington, and not to have had the opportunity of showing you through our medical facilities and hospitals in the Oakland-Richmond, California area.
Your expression of interest in preventive medicine is rather closely allied with our thoughts for medical care. Mr.Kaiser and I believe that preventive medicine is more important than the curative side. Our medical programs have always been developed with this fact in mind…
Because of the economy of such a medical plan the cost of medical care to the people is lowered. For the small amount charged at Coulee Dam we were able to provide the best of medical care and pay for the hospital facilities provided in a period of four years. When the cost ofthe facilities is paid for the charge per week to the people can be reduced, or the money used to provide more facilities, added equipment, and for research. Mr. Kaiser and all of us who have had a part in these programs feel that this is the solution of medical care for the majority of people in this country. It is self-sustaining and unites the medical profession, the employer and employee all in one common objective – “to keep the people well and to prevent their illness.”
Your interest in our organization is greatly appreciated. If we can be of further service in answering your questions please do not hesitate to call on us.
Sidney R. Garfield, M.D.
Medical Director, Kaiser Co., Inc., West Coast Shipyards
Years later, Eleanor Roosevelt’s light would shine on KP again.
In 2007 Kaiser Permanente was one of three recipients of the Eleanor Roosevelt Human Rights Award from American Rights at Work, an advocacy and public policy organization responsible for promoting and defending workers’ rights since 2003. Kaiser Permanente received the award for “creating a management-union partnership based on mutual trust and respect.”
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