Mobilization

The old-fashioned family physician has long since given place to the specialist. Now the specialist is finding place in the medical group. All the ills that flesh is heir to can soon be treated in one great clearing house: The New York Medical Centre, towering on the Northern tip of Manhattan. Twenty acres are its base, from 165th to 168th St., from Broadway to the Hudson River; twenty-two stories measure its majestic height; twenty millions of dollars have already gone into its construction and equipment; twenty years it has been planning; in this year of 1928 it stands completed, the greatest monument to medical progress in the world. On this single plot of ground will operate the following hitherto scattered Manhattan institutions:

The College of Physicians and Surgeons

of Columbia University The Presbyterian Hospital The Presbyterian Hospital School of

Nursing The School of Dental and Oral Surgery

of Columbia University The Vanderbilt Clinic The Neurological Institute The Babies' Hospital The N. Y. State Psychiatric Institute

Cripples, babies, insane, diabetics, men, women, children suffering from ingrown toe nails, toothache, or an untimely encounter with a taxi, all will come to the Medical Centre. Here everything known about medicine will be centralized with a threefold purpose:

1) To give the bewildered sick man a modern substitute for the family physician.

2) To enable the specialist to work with other specialists, coordinating his research with the discoveries of his colleagues. 3) To train doctors, dentists, nurses, social workers, pharmacists together as a working unit in the presence of situations which will later constitute their life work. Seen in mysterious cloudy perspective from the Jersey shore, they rise in squat masses which gradually pile up to an impressive futuristic pyramid. A close-up reveals a compact group of eight skyscrapers, the high flat walls uncompromising in their rectangular simplicity. The Presbyterian Hospital, the Sloane Maternity & Squier Urological Clinics form the main stem of the group. Wings come out starkly at right angles, reminding one a little of the flying buttresses of a cathedral, but they are built for service, not for support. Everywhere the walls are pierced by windows, thousands of windows which relieve their perpendicular severity. The skyline too is pleasantly broken by the varying heights of the horizontal roofs.

The Idea. Vienna, Berlin, London, Paris, Heidelberg have developed little medical principalities. Harvard Medical School in Boston, Johns Hopkins Medical School in Baltimore, Washington University Medical School in St. Louis, each forms the nucleus of a small group of hospitals. Rush Medical School in Chicago, one of the three oldest in the country, plans an association of hospitals on the Midway. In Cincinnati, the Municipal Medical School and Cincinnati General Hospital have fallen into line. The state universities of Michigan, Illinois, Iowa, Minnesota, Wisconsin have taken up the medical centre idea. Somewhat tardy, but by this very delay in a position to profit by all other experiences, certain citizens of New York, with a vigor and vision in keeping with their city's resources, have outdone all other medical establishments.

History. In 1921 a Joint Administration Board was formed to develop a complete medical centre. The plan was given a firm foundation by Mrs. Stephen V.

Harkness and her son Edward S. Harkness. For years they had held the tract of land on Washington Heights, once the American League Baseball Park. When the Yankees moved across the river the land fell into disuse. The Harknesses wished to give it to some worthy public enterprise. The idea of the New York Medical Centre was outlined on paper. And the park where Russell Ford once swung a -wicked bat, where Harold Chase caught many a man out on first to the cheers of thousands, was given over to doctors and all their delicate works.

Equipment. The familiar discomfort and feeling of oppressive sanitation that has so long been taken for granted is no more. No glaring white bed, chair, table, wall to affront the eye and emphasize the illness. No long narrow hospital wards, each bed a case, to affront the personality and emphasize poverty. Everything that ministers to personal care has been decentralized. The hospital has been divided into eleven units, each comprising three wards. The largest wards have twelve beds, many have only four. Each unit has its own serving room where individual tastes and needs in the matter of diet are attended to; its own social service staff; its own secretary and telephone so that inquiries about the patient are answered promptly by a trained official who is familiar with the patient's condition; its own solarium enabling patients to be moved into the sunshine without difficulty. Subdued restful colors predominate. Pleasing rugs (which no patient could guess are rubber) cover the floor. Each bed has its own shaded reading light, its own call system. Fawn colored rubber (to prevent spine-shivering noises) covers each bedside table.

Welcome. This regard for the patient as a human being is not limited to the sick room, it extends to the very boundaries of the land. Sick, discouraged, confused, the patient arrives at the hospital. Instead of the dreary delays in dismal waiting rooms he is now received in a small cheerful office where an expert is ready to pass upon his case immediately. An escort is in waiting to conduct him to the ward best suited for his needs. Meanwhile word is flashed to the clerk of that floor that Mr. John Doe requiring treatment for varicose veins is on his way up in elevator No. 3 and when Mr. Doe steps out there is a friend to greet him by name and help him to bed. The patient's window looks out upon lovely gardens and the peaceful Hudson with the Palisades forming a back drop. Roof gardens, music room, game room, gymnasium contribute toward a mental as well as physical cure.

Laundries, etc. Only the mechanics of the institution, the gross impersonal processes where efficiency is measured in terms of standardization, are centralized. The enormous laundry can handle ten tons of washing a day, the main kitchen can cook 6,000 meals. Heating, lighting, ventilation, hot water, ice water, sterilization and preparation of bandages, everything that ministers to impersonal welfare has been centralized.

Private Patients. The Harkness Pavilion for Private Patients occupies the west wing of the hospital. The income from the Pavilion will help run the hospital, and here indeed the atmosphere is that of the most luxurious modern hotel. Each private room has its private bath room, and many have sitting rooms forming a suite. Fine copies of period furniture, harmonious draperies, papered washable walls, all so treated as to be even more sanitary than tile or marble, create an atmosphere of pleasant ease. A la carte menus are provided for those whose desires may dictate their diets, and each patient has an individual locked refrigerator in the kitchen for such dainties as may have been brought or bought. One floor with private elevator has been set aside as a hotel for friends and relatives.

The Babies Hospital, which will be in the east wing of the hospital, is still in an early stage of construction. The campaign to raise $1,500,000 for this purpose was started last week by the Board of Directors and the Board of Women Managers.

Group. By 1929 the Medical Centre hopes to be functioning smoothly for every class of patient, rich and poor, requiring care in bed or in an office, suffering from any disease, requiring the attention of a single specialist, or a group, coming as an individual or as part of a community health problem. It will be training medical students, dental students, specialists, public health workers, nurses, social workers, pharmacists, hospital administrators; giving the older men in practice opportunity to keep in touch with new developments; forging in its laboratories new weapons to fight disease. Preservation of individuality applies to hospitals as well as patients. They have agreed upon association without consolidation, co-operation instead of competition, no overlapping of functions, economy of resources by joint action in the purchase of supplies, etc.