Challenges, Choices and Changes
1947. Jackie Robinson stepped up to the plate
and took his first swing for the Brooklyn Dodgers, a monumental
hit to break professional baseball’s color barrier. Buffalo
Bob and his freckled puppet friend welcomed television viewers to
Doodyville. And in Roswell, N.M., some folks claimed that a mysterious
flying object and its other-worldly occupants had crashed nearby.
Across the Atlantic, the Marshall Plan was helping half of war-mangled
Europe get back on its feet while the Iron Curtain was keeping the
other half on its knees. Here at home, a lanky World War II ace
blasted through the sound barrier high above the California desert,
and Jonas Salk was setting up a lab at the University of Pittsburgh
to begin research that would lead to an important vaccine discovery
a few years later.
Indeed, 1947 was a year of novelty, discovery and change, and newly
appointed John VanNuys, MD – the School’s first exclusive
full-time dean – was pursuing new directions at the Indiana
University School of Medicine. He was doing so with the blessing
and counsel of one of the institution’s most strident supporters,
the irrepressible IU President
Herman B Wells, and the backing of faculty, students and staff.
Dr. VanNuys understood the School and its many systems well; he
was educated and completed his residency in it, and he was director
of its medical center.
The School faced numerous challenges, mainly the expansion and
upgrade of clinical space and supporting needs. The IU Medical Center’s
facilities were in dire need of maintenance. Space limitations for
private beds at Long, Coleman and Riley hospitals made it difficult
to hire full-time physicians. Medical equipment was outdated, much
of the grounds were a lunar-like landscape of muddy swampland, and
sidewalks and streets were crumbling.
During the war years, state lawmakers were forced to put the clamps
on spending and, as a result, there were no notable construction
projects on the Indianapolis campus. The medical school wasn’t
being singled out; all of the state’s public universities
had been forced to bite the bullet during World War II. Outside
contracts with the Department of War all but disappeared when peace
came.
Though the forty-four year-old School was facing a mid-life crisis
in many ways, its leadership was charting the course toward a promising
future.
Stepping Ahead
Applications to IUSM increased significantly after World War II
as veterans sought to beat their swords into stethoscopes and take
full advantage of education benefits under the GI Bill. Pressure
to admit more students was coming to bear in 1947, not only from
within the School but outside of it.
“I sincerely hope that the university is making ample plans
for accepting a greatly increased number of students at the Medical
School this fall,” Indiana Gov. Ralph Gates wrote to President
Wells, who was savvy enough to understand this was not merely the
wishful thinking of the state’s top elected official.
The demand for increased admissions had to be met, but not if it
meant jeopardizing the School’s accreditation by lowering
academic standards. In 1947, first-year enrollment expanded to 141
students, and class rolls continued to climb throughout the 1950s.
In the fall of 1963, IUSM admitted 216 first-year students, the
largest entering medical school class in the United States.
While the IUSM universe was changing, some things remained constant
in the overall medical student experience. “It was my first
day of class—a hot fall day—and we had just gathered
in the gross anatomy lab,” recalls Charles Weddle II, (MD,
’66) of Columbus, Ind. “The first simultaneous opening
of the cadaver vats and the smell that hit us resulted in an immediate
stream of ‘green’ freshmen medical students scrambling
to the rest room facilities.”
The opening of the Medical Sciences Building (later renamed in
honor of VanNuys) in 1958 made it possible for the School to offer
all four years of education at its Indianapolis campus. The following
year, the School launched the Medical Sciences Program, allowing
some students to continue taking the first two years of courses
at IU-Bloomington.
Although the School was growing in complexity and admitting more
students than ever before, classmates remained close-knit. Recalls
1963 graduate Robert W. Holden, who would later serve as Department
of Radiology chair and as dean (1995–2000): “If you
spend four years with 160 people, as our class did, you get to know
them very well. We knew the good and the bad of each of us. Basically,
we were under a lot of pressure to behave and to perform, but people
were very supportive of one another.”
The vision of broadening IUSM medical education did not end with
the bestowing of the initials MD. On the eve of the 1960s, the Combined
Degrees Program was established, permitting students to earn master’s
and doctorate degrees while completing their pre-clinical years.
Another education landmark was reached when the Division of Allied
Health Sciences and a graduate program were created within the School.
Leaders at the time were reassessing the curriculum. The curriculum
for third- and fourth-year students was changed to include clerkships
in various medical disciplines, thereby giving students more practical
experience and the opportunity to develop a deeper appreciation
of patients.
Long before “patient-focused medicine” entered the
lexicon of health care marketing, Dean John D.VanNuys held to the
belief that labs, lectures and the occasional clinical demonstration
did not fully educate medical students; science must be balanced
with humanism. The patient, he reasoned, is the focal point of physicians.
The man who brought so much vigor and vision to the School as its
first full-time dean died unexpectedly at his home in February 1964,
an apparent heart attack victim, not unlike many men of his age
at the time. Filling VanNuys’ shoes would be an awesome task,
but IU leaders did not have to look far. They found someone who
not only could wear those shoes but would refashion them to walk
down new pathways: 1944 graduate Glenn W. Irwin Jr., a faculty member
who earlier was responsible for developing the medical center’s
endocrine and metabolic clinic.
New Faces and Places
As was characteristic of the nation’s medical schools from
the late 1940s to the mid-1960s, the size of IUSM faculty and the
number of full-time departmental chairmen increased markedly. The
School’s leadership reasoned that the goal of attracting top-flight
physicians for full-time teaching posts would require allowing them
to have limited private practice.
One prominent recruitment occurred when Virgil K. Stoelting, MD
’36, was brought aboard to head the newly created Department
of Anesthesiology, one of the first of its kind in the nation. Other
new departments were formed with the combining of obstetrics and
gynecology, and the additions of radiology and orthopedic surgery.
In 1954, Surgery Chairman Harris B. Schumacker performed one of
the first open heart surgeries using a heart-lung bypass machine,
and brought distinction to the IU Medical Center by perfecting ways
to treat congenital heart defects.
Other notable physicians were hired to fill leadership needs in
other departments, and these new names would become synonymous with
the School: Lyman Meiks (pediatrics), John B. Hickham (medicine,
replacing the legendary J.O. Ritchey), John I. Nurnberger (psychiatry),
and John A. Campbell (radiology). John J. Mahoney was brought aboard
as associate dean to help VanNuys implement new programs
The expansion of the medical campus that began in the late 1940s
and continued for three decades was vast and reflected post war
medical education and health care needs. In 1949, the building that
formally housed the Indiana State Department of Health, was converted
into lab space and renamed Fesler Hall in honor of long-time IU
Trustee James W. Fesler. Two other building projects, one federal
and the other state, also extended IUSM’s reach: the 500-bed
Veterans Administration hospital and the 250-bed Larue Carter Hospital
for psychiatric patients.
Among the other new facilities and projects were the Riley Research
Unit, Student Union Building (which contained single rooms and apartments
for residents, students and their families, and other vital space
for faculty and guests), a fifth floor addition to Long Hospital,
Krannert Institute of Cardiology, and Indiana University Hospital
(dedicated in 1970) and Phase 2 of Riley Hospital.
Indeed, the IU School of Medicine was transforming in many ways
in the wake of World War II up through the late 1960s. But one constant
remained: The School’s major mission was to educate future
physicians. David Cousins was a second-year student and was asked
to start an IV for a blood transfusion on an elderly man named ”Adolphus.”
“I put the needle in his right arm and the vein popped,”
Cousins wrote in a reunion memory book of the Class of 1967. “I
did the same thing on his left arm and the vein popped—and
now I'm sweating. Adolphus looked at me and said, ‘Man, ain't
you never started an IV before? You gotta take that thing (tourniquet)
off before you can turn the blood on!‘ Believe me, it was
an education.”
John VanNuys would have been proud. Physicians can learn much
more about medicine when they focus on their patients.
Next issue: The final installment of this four-part series
looks at the statewide medical education system, advances in research
and other events that have shaped the IU School of Medicine into
what it is today.
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