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Tag Archives: Toledo Medical College

Too Much History?

12 Wednesday Apr 2017

Posted by Nancy Clark in Writing Biographies

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biography, Chicago World's Fair 1893, Dr. Blaine, Garfield Assassination, historical fiction, Toledo Medical College

Last November I wrote about the dilemma of what to include and not to include in the biography of my great -grandfather. I’ still fighting that challenge to some degree, but now there is a new one on the table–or at least a variation.

As I start to put all my individual stories into some rough semblance of order, I’m beginning to see gaps that could be filled with historical content. The question becomes how much background history is necessary and how much could be a distraction. Some examples might make the dilemma a little clearer.

If you read my blog post from last April on private medical schools, you’ll remember that I included the Toledo Medical College as an example of those early attempts at medical education because Dr. Blaine had received a degree there and had also been on the faculty a short while. So far in the biography, I have mentioned the school only in passing. But is that enough? Should I use that school as a vehicle to give the reader a more detailed impression of the state of medical education in the late 1800s? And, if so, how much detail do I include? My files are bulging with facts about financial problems and disagreements about the administration of the school. Dr. Blaine and several other faculty members were even charged with trespassing when they attempted to attend a closed meeting of the board. Maybe all this does merit a separate chapter in the book!

Another example is not so closely tied to Dr. Blaine. It involves the assassination of President James Garfield in 1881. Like many other American citizens, the doctor followed closely the news reports of the shooting in June, the subsequent attempts to save the president’s life, his death in September, and the trial of the assassin Charles Guiteau. The main reason I am thinking of including this historical event is that it serves as a prime vehicle for revealing some of the misconceptions then prevalent in medical practice, misconceptions that actually hastened the president’s death!

In both of these examples, I can see evidence that the historical background does help to establish the setting of the story. And, as James Thom said in his book The Art and Craft of Writing Historical Fiction, “Most regular readers of historical fiction are reading to learn, and they gain historical knowledge from story to story. They take pride in having some knowledge they can keep and believe” (29). Since my book is turning out to be a combination of historical biography and fiction, maybe both of the examples I mentioned do fit!

I’m already committed to writing a chapter on the 1893 Chicago World’s FHistoryair because the doctor and his wife actually visited that remarkable event. So we’ll see what happens. Stay tuned!

And feel free to leave a comment on how much history is too much history in a historical-fiction-biography.

Source: Thom, James Alexander. The Art and Craft of Writing Historical Fiction. Writer’s Digest Books, 2010.

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The Death of Private Medical Schools

19 Tuesday Apr 2016

Posted by Nancy Clark in Interesting Facts about Medical Practice 1880-1930, Uncategorized

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Carnegie Foundation, early medical schools, Flexner Report, old time doctors, proprietary medical schools, Toledo Medical College

Medical EducationThink of the amount of formal medical education required to become a medical doctor in the 21st century. Got that in your mind? Now contrast that with what was required in the middle 1800s in America. What a difference!

With the demand for doctors spurred on by the Revolutionary War, medical education in our newly established country forged ahead with the establishment of what were called proprietary medical schools. Founded by doctors and run for profit, these schools had only the bare necessities: a building, desks, maybe some charts of human anatomy, and possibly a skeleton and a few miscellaneous specimens. Students were taught primarily through lecture and memorization.

Entrance requirements for these schools were almost nonexistent. Many of the students had less than a high school education, and some were even functionally illiterate. As long as a student paid his tuition, he was almost always awarded a degree, whether he regularly attended lectures or not, for an equivalent of one year of study. Young men often enrolled without any real understanding of the profession, being attracted mainly by the promise of “an easy road to wealth.” (The irony was that the only physicians who made a decent living from medicine in the 19th century were those who were educated in medical schools attached to universities and who practiced in large cities where there were wealthy clients. See the previous post: “Who Pays the Doctor?”)

By 1840, twenty-six new proprietary medical schools appeared; thirty years later, there were forty-seven more. The American Medical Association and other professional organizations urged the establishment of uniform requirements for entrance to and graduation from medical schools, but they fought an uphill battle. Then came the Flexner Report of 1910, which sounded the death knell for proprietary medical education.

The report emerged from a grant that was given to the Carnegie Foundation in 1905 to aid teachers in colleges and universities in the U.S. and Canada. But the list of institutions calling themselves colleges and universities revealed no uniform definition. Many so-called “colleges” were no more than secondary schools. So in 1908 the Foundation hired Abraham Flexner to do a study of existing medical schools to determine which, if any, were indeed institutions of higher learning.

Flexner took on the task with vengeance, personally visiting 150 schools in two years. And what he found in most of them shocked him. As an example, the report on the Toledo Medical College, which Dr. Blaine attended and then served as a faculty member for a short time, revealed these conditions. The entrance requirements were “a four-year high school education or its equivalent.” That seemed to be on track. But as for laboratory facilities, “The school has nothing that can be fairly dignified by the name of laboratory. Separate rooms, badly kept and with meager equipment, are provided for chemistry, anatomy, pathology, and bacteriology. The class-rooms are bare: no charts, bones, skeleton, or museum are in evidence. There is a small library in the office …. There is a wretched little dispensary in the college building.”

As you can imagine, Flexner’s judgmental tone raised the ire of faculty members and other supporters. They had been trying, as had other proprietary schools, to obtain more equipment, lengthen the number of required sessions, and tighten up on the entrance requirements. But in that highly competitive environment, increasing the requirements simply drove students to the less demanding schools. Unwilling or unable to spend the money, proprietary schools just couldn’t keep up with the fast-changing climate of scientific progress in medical education. In fact, enrollment in these schools had already begun to taper off  before 1910. Flexner’s devastating report simply drove them all out of business. Only a small number re-emerged as departments of established universities.

In the introduction to the Flexner Report, Henry Pritchett wrote, “Our hope is that this report will make plain once for all that the day of the commercial medical school has passed.” Obviously, their hope became reality.

References:

Duffy, John. From Humors to Medical Science: A History of American Medicine, 2nd Ed. Chicago: University of Illinois Press, 1993.

Flexner, Abraham. Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching. NY: The Carnegie Foundation, 1910.

 

 

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