Dedication of the Cushing General Hospital, Framingham, Massachusetts, 24 January 1944

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PROGRAM

Master of Ceremonies: Lt. Colonel Henry P. Dunbar

District Engineer, Boston District

Introduction of Distinguished Guests

Colonel Dunbar

Greetings of the Commonwealth of Massachusetts

His Excellency Leverett Saltonstall, the Governor

Address

Major General Sherman Miles, Commanding General, First Service Command

Presentation of the Hospital to the Medical Department, U. S. Army

Colonel George W. Gillette, Division Engineer, New England Division

Acceptance of the Hospital and Presentation to the Commanding Officer

Brigadier-General Fred W. Rankin, Representing the Surgeon General

Acceptance of the Hospital by the Commanding Officer

Colonel Edward A. Noyes, Commanding Officer

Dedicatory Address

PROGRAM

Master of Ceremonies: Lt. Colonel Henry P. Dunbar

District Engineer, Boston District

Introduction of Distinguished Guests

Colonel Dunbar

Greetings of the Commonwealth of Massachusetts

His Excellency Leverett Saltonstall, the Governor

Address

Major General Sherman Miles, Commanding General, First Service Command

Presentation of the Hospital to the Medical Department, U. S. Army

Colonel George W. Gillette, Division Engineer, New England Division

Acceptance of the Hospital and Presentation to the Commanding Officer

Brigadier-General Fred W. Rankin, Representing the Surgeon General

Acceptance of the Hospital by the Commanding Officer

Colonel Edward A. Noyes, Commanding Officer

Dedicatory Address

Dr. John F. Fulton, Sterling Professor of Physiology, Yale University

INTRODUCTION OF DISTINGUISHED GUESTS

Lt. Colonel Henry P. Dunbar

Mrs. Cushing, Governor Saltonstall, General Miles, General Rankin, Colonel Gillette, Colonel Noyes, distinguished guests, ladies and gentlemen:

We are here to join in the dedication of this General Hospital. It has been an important and interesting task throughout—involving the construction of 93 separate units of permanent masonry work, constituting the largest unit under one roof in Massachusetts. The newest practical developments of medical science and engineering skill have been incorporated into the design and construction of this medical center. It has afforded Colonel Gillette and me great satisfaction to know that this task has been commended by the Surgeon General and the Chief of Engineers and has been suggested as a model for others to follow.

This hospital is to be named for Doctor Harvey Cushing in recognition of the great and humane service he rendered during World War I and until his death in 1939.

His Excellency, Leverett Saltonstall, Governor of the Commonwealth of Massachusetts, has followed the construction of this hospital and has visited it on several occasions during construction, having a natural interest in this most valuable addition to the excellent medical facilities already existing in the Commonwealth.

I am privileged to present His Excellency, the Governor of Massachusetts.

GREETINGS OF THE COMMONWEALTH OF MASSACHUSETTS

His Excellency Leverett Saltonstall

Governor Saltonstall extended greetings from the Commonwealth and said:

“It is natural that in this State we should have a hospital concentrated on neurosurgery because of the great work Dr. Cushing did in that field here. The Commonwealth is proud that we have this great Hospital in our midst. We have seen the Hospital grow from the ground in eight months' time and in spite of the almost phenomenal rapidity of its construction, the great medical center is sturdily built.”

In conclusion he congratulated all who had a part in its establishment and promised the co-operation of the Commonwealth in every possible way.

Colonel Dunbar: The Cushing General Hospital will be under the jurisdiction of Major General Sherman Miles, Commanding General of the First Service Command. General Miles was active in the planning of this Hospital and has followed the progress of the work with his usual keen interest.

I have the honor to present to you General Miles.

ADDRESS

Major General Sherman Miles

The First Service Command is proud to include the Cushing General Hospital among its installations. It will memorialize a great soldier, a great surgeon, and a great gentleman. Harvey Cushing was all of these and more. Military men admired him because he exemplified all that is noble in the service. He insisted on seeing the First World War from the front lines, activated not by any quest for glory, but by his desire to fulfill his Hippocratic oath with complete disregard for his own safety and comfort.

He served with a Harvard ambulance unit in France in 1915 before the United States entered the war. Realizing that American participation was inevitable, he returned to this country and organized base hospital units as part of the general preparedness campaign. He sailed back to France in 1917 as director of Base Hospital No. 5, the second unit which our Army sent overseas. After his arrival in Europe he undertook a hundred different duties, adapting himself to a program that scorned the calendar and the clock. The major engagements at Château Thierry, St. Mihiel, and the Argonne claimed his presence and his almost miraculous surgical skill; so did the medical councils of Paris and London. His domain was boundless, stretching from front lines to base hospitals and touching postes de secours, ambulance trains, and casualty clearing stations.

A grateful government is paying part of its debt to this great man by providing a permanent memorial in the utilitarian form Dr. Cushing would most desire. The beauty and permanence of this structure are secondary to its purpose—ministration to the sick and wounded. The glory of war is transitory, but the horror of war will live in the broken bodies of soldiers who are returned here for treatment.

“For thence—a paradox which comforts while it mocks—shall life succeed in that it seems to fail.” Man, on the one hand, girds for war and destruction at tremendous costs; on the other, he provides great havens of mercy for the care of the victims of his wars. He is as determined to save life as to destroy it. Medicine maintains its place in the scientific race, matching each new destruction with a new cure. This hospital we are dedicating today is a model; it has been planned scientifically and equipped with the latest weapons for the war against sickness and suffering and death.

That men should pay for peace with their lives is sometimes inevitable. The Army's sole purpose is to purchase that peace at the least possible cost so far as human lives are the medium of exchange. Victory now appears certain, albeit remote. But the price of victory looms large. This great hospital, like the man for whom it is named, will strive to reduce that price. Every man and woman on its staff will have that end in mind; every man and woman will be dedicated to soothing the wounded, to mending their bodies and their minds, to sending them back into a world grown young and green again.

More than twenty-five years ago, Dr. Cushing sought to mobilize three Red Cross hospitals on Boston Common. He wanted to make people see what must be done to heal the wounds of war. He was frustrated by those who were blind to what he saw so clearly. So he sailed with his own unit for France. And now, in a later war, a grateful Army acknowledges his wisdom and offers to his memory this modern medical center. No memorial could be more fitting to the man. May it always exemplify his high ideals.

Colonel Dunbar: It is fitting that the Cushing General Hospital be of- ficially turned over to the Medical Department by Colonel George W. Gillette, New England Division Engineer. It was under his direction and guidance that the project was planned and completed. His satisfaction with the result attained will always be a source of gratification to me and to all other members of the Boston District organization who participated in the work.

PRESENTATION OF THE HOSPITAL TO THE MEDICAL DEPARTMENT, U. S. ARMY

Colonel George W. Gillette

It has been a great privilege indeed to be associated with, and to bear some of the responsibility for, the design and erection of this institution of service to humanity. That sense of privilege is enhanced by the fact that it will bear the name of Dr. Harvey Cushing, a great doctor, a great humanitarian, a great scientist, and a great soldier too.

It is with understandable pride that the people of this great Commonwealth think of Dr. Cushing as their very own; for most of his professional life was spent here and his great reputation and contribution to the world of medicine and science and humanity were made here. But their claims will be disputed by the rest of the country and indeed, by much of the rest of the world. For his was a universal kind of greatness that caused him to be claimed by every human being everywhere. And his kind of contribution was such that it is not limited by considerations of time but belongs to the ages. New techniques and ideas were developed by him which will for centuries to come serve as a foundation for the structure of continuing progress in the delicate and difficult field of medicine to which he devoted his life and genius.

This fine hospital will be a fitting monument to him. It will carry on the great work of healing and research which he began so many years ago. And it will minister, too, to the wounds and hurts of war-torn bodies and minds in much the same way that he did during the First World War. In that time, Dr. Cushing went to help the wounded on the field of battle. In this time, however, the wounded will be brought from the battlefield to this hospital bearing his name. The spirit of his accomplishments was an inspiration to the Engineers in the quality of their work during the construction. His accomplishments will inspire the kind and quality of work that will be done here in the future.

We have tried to make this hospital the best that careful planning and workmanship could make it, in line with the tradition of the Corps of Engineers. We hope we have succeeded. For whatever measure of success that was attained I should like to express my sincere appreciation to Colonel Noyes and Colonel Isherwood of the Army Medical Corps for their co-operation, and to the District Engineer, and his staff; the architects (Stevens, Curtin, Mason & Riley); Mr. William H. Nye, Vice-President of Turner Construction Company, and his staff; and the other contractors, all of whom have contributed so much by their co-operation to the final result which you see here today.

Let us all hope that those who enter here as patients will leave fully healed under the benevolent inspiration of the great man after whom this hospital has been named, the fine ministrations of Colonel Noyes and his staff, and the complete physical facilities that so many of us have helped to build together.

And now, General Rankin, it is with pleasure and pride that the Corps of Engineers turns over to the Medical Corps the Cushing General Hospital. May it serve humanity well and glorify the United States Army.

ACCEPTANCE OF THE HOSPITAL AND PRESENTATION TO THE COMMANDING OFFICER

Brigadier General Fred W. Rankin

It is a pleasant task for me to represent the Surgeon General of the U. S. Army at these ceremonies to dedicate the physical plant of a military hospital named in honor of one of the giants of surgery, Dr. Harvey Cushing. This installation now becomes another unit of our Army designed to fulfill a vital mission in support of our assembled military might.

Warfare is usually the result of an effort to impose by force the collective will and beliefs of a people on others and to obtain and establish dominion over them. The designs and character of our present-day conquest-minded enemies have long been apparent to many and, since their initial treacherous attack upon us, should be apparent to all. Our purpose in this life-and-death struggle is, therefore, crystal clear; we fight to resist enslavement and to assure our freedom and dignity. In order to achieve these objectives, we must, by combat superiority, completely destroy the fighting forces hostile to us. This is an immense task but one that we must and can do although it requires the vigorous, unflagging efforts and the unflinching determination of us all.

The successful prosecution of war consists largely of a combination of superior logistics and firepower. The former term connotes a more prosaic and less spectacular function but one that is equally important in waging war effectively since it is concerned with collecting, transporting and delivering the munitions and all other essentials of combat. In this category of supply service lies the function of the Medical Department. Its rôle is vital to the efficient operation of a military machine, for a sick soldier cannot fight, and an unhealthy army cannot do strong battle. We are charged with the conservation and maintenance of health conditions which will not only preserve but also enhance the physical endurance and mental powers of fighting men at the peak level required to assure strategic, tactical, and combat superiority. The number of soldiers we can keep firing guns and the number of sick and wounded we return to the fighting ranks is a measure of our efficiency. We are, therefore, intimately concerned with the soldier's health and all the factors that affect it, from the time he enters the Army until the day he leaves. The importance and magnitude of these responsibilities are reflected by the tremendous expansion of our medical-officer personnel which, by withdrawing approximately forty per cent of the usable physicians of this country, has strained the professional resources of the nation. We are providing our soldiers with a chain of medical care that extends through every echelon of service from the front line of battle to the general hospitals here at home. Representing the final link in this chain the general hospitals typify the ultimate in medical science and technical skill. Completely equipped with the most modern facilities and staffed with the most talented men of the profession, these hospitals are designed to provide the final phases of definitive medical and surgical care. Their highly important mission is concerned with the physical and mental rehabilitation of war casualties. The skilful reconstructive surgery and the expert psychological reconditioning that are instituted here will permit the salvage of the maximum number of these casualties and allow them to resume a happier and more useful place in industry and society. There are now forty-eight of these general hospitals in operation and provisions for eleven more have been made. A certain number of them have been designated as specialized centers for the treatment of conditions requiring a high degree of specialization and proficiency, such as surgery of the chest, vascular system, central nervous system and others.

This hospital named for the master neurological surgeon should be the capstone of the neurosurgical art as practiced in our Army. A memorial to his epochal contributions to medical science, both in war and in peace, it should serve to inspire to higher efforts all who have the privilege of working here.

Dr. Harvey Cushing lives in the hearts and minds of the present medical generation as a scientific investigator, a master surgeon, an inspiring teacher, a gallant soldier and a medical historian, celebrated throughout the world for his prolific investigations in the fields of physiology, pathology, and surgery of the central nervous system, for his originality of thought, and for the profound scope of his activities. Only those of us who were privileged to know him can fully appreciate the sterling qualities and the unique genius of this really great man. He was inately endowed with a grand heritage and many of his attributes and characteristics—for example, his untiring energy, his indomitable resoluteness, his apparent austerity and his pungent forth-rightness-reflect his Puritan stock and New England background. These attributes and characteristics, enhanced by brilliant environment and the careful tutelage of that illustrious surgeon, William Stewart Halsted, laid the foundation for his subsequent development and success. Of all of Halsted's eminent pupils, none was more receptive of his teachings, or acquired more thoroughly his concepts of the art of surgery. The importance of the meticulous and gentle technique which keynoted the mechanistic aspects of surgery in Halsted's clinic was quickly appreciated by Cushing. In this he recognized a new approach to further the boundaries of surgery and it undoubtedly played a major factor in permitting him to open and develop the field of neurosurgery. Introduced to the experimental laboratory, he soon realized that the future progress of clinical surgery was dependent upon a better knowledge of the fundamental chemobiological sciences and a more thorough comprehension of physiological disorders. Along these basic principles, he directed his prodigious efforts in all of his subsequent activities and upon them he built slowly but firmly the foundation of surgery of the central nervous system.

Dr. Cushing's interest in and contributions to military surgery augmented the record of the Medical Department of the U. S. Army in World War No. 1 enormously. With the beginning of that conflict, he turned his interest to the military and devoted his time and energy throughout the whole war to improving the surgical management of the wounded. Both as an active operating surgeon with our own and the British Expeditionary Forces, he contributed his mature experience to the end that intracranial injuries were handled expeditiously and with a hugely lessened mortality. It is safe to say that his invaluable knowledge and recognized capabilities in this field, which led to his appointment as chief consultant in Neurosurgery in the American Expeditionary Forces, evolved methods for the surgical care of these wounds, the soundness of which is shown by the fact that they are today utilized by all Armies engaged in the present global struggle.

It is not permitted me to give here even a brief account of Dr. Cushing's accomplishments and contributions to the sum total of medical knowledge nor to review the honors bestowed upon him by his own and foreign countries. That will be the happy assignment of his biographer, but as his sincere admirer I may emphasize that here was a man, inherently endowed with a remarkable versatility, with untiring industry, with a never-ending reserve of energy, with a keenly analytical and restless mentality, and with a rigid attitude of perfectionism, who was able during his life-span to embrace a wide scope of activities and to attain seemingly unscalable heights in all his endeavors. It is difficult, indeed impossible, to measure his greatness in terms of these invaluable achievements. His eminence transcends materialistic contributions. He belongs to that small but immortal group who pause briefly through the ages to give new meaning to life, to create new institutions for the betterment of mankind, and to leave to posterity an example which serves as a constant stimulus and source of inspiration.

This hospital which I now accept from the Engineering Corps, in the name of the Surgeon General, will, I am convinced, under the direction of its capable Commanding Officer and his staff, live up to the name it bears and add greater lustre to the record of the Medical Department of the United States Army.

ACCEPTANCE OF THE HOSPITAL

Colonel Edward A. Noyes

I believe that it is the ambition of every medical officer, at least of one who has made the Army his life work, to command a general hospital at some time during his career. After the United States entered this war and general hospitals began to spring up in every section of the country I began to wonder, at times, if I should ever realize that ambition. When I was ordered here in October, in time to see the hospital taking on its final form, I soon realized that I had been signally honored by the Surgeon General in being selected to command the Cushing General Hospital.

During last November I had an opportunity to visit and inspect most of the recently constructed general hospitals located in the Southern States. When I returned to this hospital, it was with the firm conviction that the Cushing General Hospital had many advantages over those that I had seen.

In assuming command of this hospital I appreciate fully that with the honor there goes a grave responsibility, a responsibility to the Surgeon General, to merit his confidence in my assignment, and a responsibility for the functioning of this hospital in a manner that will, at all times, do honor to the name it so proudly bears. To that end I pledge the full energy and effort of myself and my staff.

Colonel Dunbar: We are singularly fortunate in having with us Dr. John F. Fulton of the Yale University School of Medicine, distinguished physician, author, teacher, long an intimate associate of Dr. Cushing, presently engaged in writing Dr. Cushing's biography.

Surely no more appropriate person could be found to dedicate this hospital to Dr. Cushing's memory.

DEDICATORY ADDRESS

Dr. John F. Fulton

Some years ago, Dr. Cushing gave an address entitled The Personality of a Hospital.1 The occasion was the centennial of a sister institution of this state, the Massachusetts General Hospital—the “M.G.H.”—but the remarks made then apply quite as well now. “Many of us,” he said, “have known hospitals under perishable and tattered canvas which possessed an individuality, character and spirit often found lacking in others encased in a more enduring shell of brick and mortar…. So it is not the externals nor the inherited wealth, social position or occupation of an institution, any more than of an individual, which give it renown,—it is the character of the service it performs.”

The reference to perishable and tattered canvas stems from a wide knowledge of military hospitals and surgery, for Dr. Cushing had come from a long line of physicians, many of whom at one time or another had served in the armed forces. Matthew Cushing, his ancestor, had come to this country from England in 1638. Matthew begat John, from John came Matthew the 2nd; then Josiah who was followed by the two Davids, and Dr. David Cushing, Jr., physician of Rehoboth, Massachusetts, and father of Erastus, saw apprentice service during the American Revolution. Erastus, aged 10 during the War of 1812, found himself in Cleveland in 1835 as physician and head of a flourishing family. Henry Kirke, his eldest son, the father of Harvey, acted as chief surgeon to the 7th Regiment of Ohio Militia and was on active duty with the Northern Armies for four years; he cared for the wounded in many major battles including Gettysburg.

With this vigorous American background it was little wonder that Harvey, the tenth and youngest child of Henry Kirke Cushing by his wife, Betsey Williams, should have plunged into war activity once opportunity presented itself. Although much disappointed in 1899 because Dr. Simon Flexner had not taken him to the Philippines, early in 1915, as you are aware from the moving tributes of General Miles and General Rankin, Cushing organized a Harvard Unit and promptly took it abroad to serve with the American Hospital in Paris. In May 1917 after the United States had come into the war, he was appointed Director of Army Base Hospital No. 5 which served in France for nearly two years.

Dr. Cushing proved a dynamic force wherever he moved. His temperament, at times stormy, was also capable of infinite patience, but when he wished something done he was a man of persistence and unyielding determination. As a soldier from civil life he retained a quaint disregard for authority and he never quite accustomed himself to the use of military “channels,” but despite this he managed to emerge without being court-martialed, nor yet was he made Surgeon General; both contingencies, however, were at one time within the realm of possibility.

I cannot describe Dr. Cushing's many contributions to medicine and surgery. He did much to extend our understanding of wartime injuries of the head—cranial wound ballistics, as we now define them. He also proved that if a man has energy, curiosity and a driving desire to help the wounded, it is possible, even when under fire, to make scientific contributions of the first water. As with Vesalius, Ambroise Paré, and Weir Mitchell, war became a stimulus rather than a deterrent to positive achievement. One has only to enumerate his introduction of the use of suction in neurosurgical procedures, his employment of the magnet for withdrawing deeply embedded shell fragments, the silver clip for hemostasis, not to mention a host of other less dramatic procedures which together served to convert wartime surgery of the head from a horror into one of the most fruitful and gratifying of all branches of traumatic surgery.

Constantly striving for improved methods of hemostasis, he was led, some years after the last war, to introduce electrosurgical methods for ablation of vascular tumors; and today the coagulating- and cutting-current units are standard equipment in every large civilian and military American operating room. How fascinated and gratified Dr. Cushing would have been could he have known that his pupils in this war, following in his tradition, have similarly been inspired to positive achievement. Eagerly would he have read Hugh Cairns and Howard Florey's epic report2 on the use of penicillin in the campaign in Sicily, particularly as it was applied in dealing with head injuries; and, more recently, he would have heartily welcomed the discovery of Franc Ingraham and Orville Bailey3 that fibrin foam, a bi-product of Edwin Cohn's masterly separation of the various blood proteins for purposes of transfusion, can be used with dramatic effectiveness as a hemostatic agent both in neurological and general surgery, and also in dental surgery. A war that brings such things to the fore cannot have been fought wholly in vain.

The personnel of our Armed Services has gone forward in this spirit, and the subtle influence which Harvey Cushing exerted upon the whole medical profession finds expression today in the atmosphere and personality which you, Sir, [turning to Colonel Noyes] have already made so evident in this hospital. Completed nine months after it was first started, the Cushing General Hospital has already taken upon itself qualities distinctly human, not only in matters of time sequence, but in the spirit and achievements of its staff. The turbulent prenatal period of the institution was presided over by men who had a burning pride in their work. Indeed it would seem that Colonel Gillette and his colleagues of the Turner Construction Company wished to outdo Mother Nature and to have their brain-child precipitated, as it were, into Colonel Noyes' lap before he or his staff were ready for the delivery. The engineers and contractors who have performed this remarkable feat have shown the world that we in medicine are perhaps too conventional in our thinking—too hemmed in by our own biological concepts. From them we gain a new and vigorous point of view, which has characterized this and much else they have achieved in this war.

It is perhaps not known to many of you that Harvey Cushing, the surgeon, had once considered becoming an architect. From early childhood he had shown remarkable talents as a draughtsman, and during his years at Yale College his closest friend was Grosvenor Atterbury, the well-known architect who, exactly fifty years later, built at Yale the handsome Medical Library which now houses Dr. Cushing's great collections. Few therefore could have appreciated more than Cushing the miracle that has been wrought in erecting buildings of this size and quality in the brief interval necessitated by an urgent military time-table; and in the light of Dr. Cushing's own wartime experience as a surgeon,—for he knew well hospitals of “perishable and tattered canvas,” as well as those having a “more enduring shell of brick and mortar”-he would have appreciated particularly the dignified spirit of co-operation and service which Colonel Noyes has instilled into his entire staff, the hall-mark that gives to a hospital its individuality.

In coming here today, I have wished to set down something characteristic of Dr. Cushing himself. What would he have said or done in dedicating a hospital named for one of his former teachers? He would have inspected the operating rooms and the wards; he would have scrutinized the case histories, and no doubt would have made some lively comment on the record forms—his chief bête noire in the last war. Having explored these things, he would perhaps then have looked about for a library, for men cannot do effective work in any profession without access to books. Since Cushing himself was a voluminous writer, and since this hospital is to bear his name, I am authorized to carry the greetings of Yale University, Dr. Cushing's alma mater, and also to present to your Hospital as a gift from the University through its Medical Library, a collection of Dr. Cushing's published writings, including reprints of his papers, the originals of his many surgical monographs, and his literary essays. An attempt has been made to assemble as complete a collection as possible, and it is hoped that these may form the nucleus of an active Hospital Library.

In closing, I can only congratulate the Surgeons General of the Army, James Magee and his successor, Norman Kirk, and the distinguished men of their command, on thus adding to an already most illustrious record of achievement in this war,—adding to it the Cushing General Hospital of Framingham. I would also congratulate Colonels Gillette and Noyes upon the conspicuous parts that they have played in creating this hospital. In the name of the American medical profession, and particularly of those who were fortunate enough to have been Harvey Cushing's pupils, I wish Colonel Noyes and his staff, health and Godspeed in the days that lie ahead.

Thanks to the generous co-operation of Col. Noyes, the Society is pleased to be able to issue the full dedication proceedings of the Cushing General Hospital. The Society hopes that the Hospital may later bear the more appropriate official designation of the Harvey Cushing General Hospital.

Cushing, Harvey, The Personality of a Hospital. Ether Day Address—Massachusetts General Hospital. October 18, 1921. Boston med. surg. J., Nov. 3, 1921, 185: 529–536. (Reprinted in book form, Boston, 1930, 40 pp.)

Florey, H. W., and Cairns, Hugh (Brigadier, R.A.M.C.). Investigation of war wounds. Penicillin. A preliminary report to the War Office and the Medical Research Council on investigations concerning the use of penicillin in war wounds. [London] War Office (A.M.D. 7). October, 1943. 114 pp. [Not yet available for general distribution.]

Ingraham, Franc, and Bailey, Orville T. The use of products prepared from human fibrinogen and human thrombin in neurosurgery. Fibrin foams as hemostatic agents; fibrin films in repair of dural defects and in prevention of meningocerebral adhesions. J. Neurosurg., 1944, 1: 23–39.

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