HARVARD GAZETTE ARCHIVES

UHS Celebrates A Century

By William Cromie
Gazette Staff

Volunteers prepared hospital clothes during the flu pandemic that struck Boston and Harvard College in 1918-19. Photos courtesy of Harvard University Archives.

Henry Kemble Oliver felt queasy when he awoke one morning in 1850. Fearing that he was on the edge of the flu or something worse, the Harvard student shuffled over to the Cambridge office of Dr. Morill Wyman.

The waiting room was full of hacking, sneezing, wheezing people. After a frustratingly long wait, Oliver was told by the overwhelmed doctor that he would see only those who were obviously sick. The doctor had no time for a healthy-looking lad who only thought he might be sick.

Oliver got as much rest as he could but still felt ill two days later. He went back to the doctor's office but Wyman brushed him off again.

Angry and unwell, Oliver swore that someday he'd establish a Harvard professorship for a physician who would help all students, no matter how vague or mild their complaints.

A nurse checks a patient at the Stillman Infirmary, opened in 1901.

That sounds like the get-even raging of a rejected young man, but 49 years later Oliver made good on his vow. Many decades of medical practice left him with a considerable estate, and in 1899 he gave that estate to Harvard College to create a professorship for a doctor "without officiousness," "easily approached," and who would take an "earnest personal interest in the physical welfare of the undergraduates."

The professorship endowed by Oliver's gift was named for him in 1920, a year after his death. That same year saw the establishment of the Department of Hygiene, predecessor of the University Health Services (UHS).

This week the University honors Oliver, the six Oliver Professors, 100 years of UHS, and the silver anniversary of the Harvard University Group Health Plan. The focus of the celebration is a symposium today at the American Academy of Arts and Sciences in Cambridge. It will be followed by a reception and dinner, to be attended by President Neil L. Rudenstine, at the Charles Hotel.

"We have followed Dr. Oliver's legacy for 100 years," notes David Rosenthal, the present director of UHS. "That doesn't mean we no longer get complaints from students; but that we continually take an earnest personal interest in the physical welfare of our patients, and we work hard to provide the best health care available in a climate of high medical costs. I believe that today Dr. Oliver would feel very much at home here, and see the purposes he promoted very well served."

The Infirmary was the home of the University Health Services until 1962.

Lee Exercises Authority

The centennial will be marked by the publication of A Laboratory for Change, a history of UHS written by Michael Gross and Jeffrey Cruikshank. The book, which tells the history of UHS, describes how, in 1914, Roger Irving Lee, Henry Oliver's personal doctor, was appointed the first Oliver Professor of Hygiene.

Iconoclastic and large of girth, Lee believed that cold showers and exercise provided a solution to laziness as well as many of the health concerns of students. He initiated physical exams for all incoming freshmen, and compulsory exercise for undergraduates. Those who hated typical gymnasium workouts were ordered to play golf or tennis and report their scores. One student on crutches fulfilled his exercise requirement by walking the length of the football field each day.

Lee began a tradition of health research that continues to this day. He disproved the belief that rigorous physical activity damages the heart. He believed in the advantage of good posture and encouraged a distinguished orthopedist to study it at Harvard.

Lee took leave from Harvard to serve in "the war to end all wars." He returned during the infamous flu pandemic of 1918-19, which killed 500,000 Americans, 6,500 of them in Boston. Stillman Infirmary, near the present location of 1010 Memorial Drive, had opened in 1901, and 258 cases of flu were treated there in 1919. Only six of the patients died, a remarkable record for a disease that killed 30 to 70 percent of those stricken with it in other hospitals.

Henry Kemble Oliver, in 1899, provided funds to establish the Oliver Professorship of Hygiene.

A century later, David Rosenthal, the present Oliver Professor, examines a patient.

Sex, Teeth, and Morals

Lee resigned in 1924 and the Oliver chair was filled the following year by Alfred Worcester. Although in his 70s at the time, Worcester won a reputation among students as a colorful, pithy writer, a scintillating lecturer, and an innovative physician.

Worcester continued Lee's emphasis on exercise and classes for freshmen on posture, but the favorite subject in his freshman hygiene lectures was sex. He is quoted as saying: "Had I been in Dr. Wyman's office when [Henry K. Oliver] called [and] he knew not what was the matter with himself . . . I should have asked, 'Who is she?' That question often sufficed . . . in my hygiene office."

Dental and mental health also were important to Worcester. With assistance from the Dental School, a clinic was established in Stillman Infirmary. "Before a year was over," Worcester wrote, "the whole freshman class was clean mouthed." To his "regret," however, the college health service fee had to be increased from $5 to $7.50 to cover costs.

The Department of Hygiene employed a psychiatrist, but Worcester preferred to treat what he called "moral and spiritual illness" with religion. "Rabbis, priests, and ministers of all denominations . . . now answer as promptly our calls for help as do our medical and surgical specialists," he reported.

Worcester's tenure saw the creation and expansion of many departments, including mental health, dietary services, dentistry, and a clinic for employees of the College. He resigned in 1935 at age 81.

Brisk, Brusque, and Busy

Worcester was replaced by Arlen Vernon Bock, described as "blond, brisk, brusque, benign, belligerent, and always busy." Born in Iowa, Bock graduated from the Harvard Medical School in 1915, and became one of Boston's best-known internists.

Before he became the Oliver Professor of Hygiene, Bock and several colleagues founded the Harvard Fatigue Laboratory to study how the body adjusts to physical stress. The laboratory's researchers recommended salt tablets to counteract excessive perspiration and promoted use of extra oxygen for pilots flying at high altitudes.

Bock took over the Department of Hygiene in 1935 and ran it during the hectic days of World War II, the postwar enrollment boom, and a time of breathtaking advances in medical technology. He championed preventive medicine, responded to the needs of women (both students and spouses), and focused on an ongoing project to study "normal" young men.

In 1937, Bock recruited 268 healthy students who agreed to be studied for the rest of their lives. Bock expected the study - funded by the retail baron William T. Grant - to produce new information about how to keep physically and mentally well. With some intermittent interruptions and mergers with other investigations, the Grant Study, still under way, has become one of the world's most famous studies of human development.

In 1953, then-Harvard President James Bryant Conant appointed University Treasurer Henry L. Shattuck head of a commission to chart a future course for the Department of Hygiene. The commission recommended building a new facility that would replace the Stillman Infirmary and would house a centralized health service for students, faculty, and staff.

Veterans entering the University had swelled the 1945-46 student population to 12,000, and the G.I. Bill of Rights mandated that they be given free medical care. Infirmary fees jumped to $30, then $37.50, a term.

An examining room at the newly renovated University Health Services in Holyoke Center contains modern medical equipment.

The "Gray Elephant" Rises

Dana Farnsworth replaced Bock in 1954. During Farnsworth's 17-year tenure, the Department of Hygiene became University Health Services, which moved into the new, $12 million, multi-use Holyoke Center in 1962. While some people referred to the first high-rise in Harvard Square as the "Gray Elephant," others christened it "The Farnsworth Hilton."

Educated in a one-room schoolhouse in West Virginia, Farnsworth graduated from Harvard Medical School in 1933. He served aboard a troopship in World War II, headed health services at Williams College and M.I.T., and was widely considered the nation's foremost expert on student mental health.

At UHS, Farnsworth hired five full-time and two part-time psychiatrists, and he established relationships between them and each residential House and graduate school.

"Instead of waiting for sick students to come to them for help after a varying amount of damage has been done, the psychiatrists will work actively with teachers, administrators, and student leaders in their day-to-day attempts to improve . . . the conditions under which they work," Farnsworth wrote in 1955.

During planning of the Holyoke Center, he vowed that in the new building, "women are going to be people." As a result, Radcliffe provided 10 percent of the construction costs, closing its own infirmary. Health care had become co-ed.

Building a Safety Net

Farnsworth retired in 1971, and Warren Wacker, of the Medical School, replaced him. Wacker dedicated himself to expanding the scope of UHS to include the entire University community. He created the Harvard University Group Health Plan (HUGHP), which involved adding new services for dependents and the elderly, as well as maternal and child care.

Wacker was a favorite of the students. He spent six years as Master of Cabot House during the turbulent post-Vietnam times. "Anxiety and depression are the most common ailments, except for upper respiratory ailments, among undergraduates," he wrote. "Usually it's not too serious . . . but you've got to be attuned with a good referral system in the Houses and among Deans that adds up to a safety net."

Wacker established a Medical Social Services Department and created the position of Patient Advocate to help patients get the attention they needed and to handle problems and complaints.

"Of all the things I did as Oliver Professor," he said later, "I think the hiring of the advocate was the most important."

Wacker's expansion efforts ran into the sudden and steep rise in the cost of medical services in the 1980s. Health maintenance organizations (HMOs) began to dominate patient-doctor relationships in primary care. Nurse practitioners became the first faces that students saw when, like Henry K. Oliver, they woke up feeling in disrepair.

In 1989, Wacker retired and David Rosenthal took over the job of expanding UHS in the face of skyrocketing medical costs. After graduating from Harvard College in 1959 and earning an M.D. from Tufts University in 1963, Rosenthal had held positions at Brigham and Women's and Beth Israel hospitals and the Dana-Farber Cancer Institute.

Rosenthal immediately began updating computer technology to better handle patient appointments and medical records. "We streamlined our appointment system by leaving 40 percent of appointments open each day to provide same-day care," he notes.

Rosenthal oversaw the first major renovation of Holyoke Center in more than 30 years. The remodeling began in 1995 and took three years to complete.

"We are proud of the fact that we stayed open during the entire renovation," Rosenthal says.

Today, UHS operates six health and dental programs that insure 30,000 people. Its Holyoke Center facility and three satellite centers treat about 180,000 patients a year. Henry K. Oliver would never recognize the place. "But the spirit of his legacy has not been lost," Rosenthal says. "We are still directed and motivated by his vision."

"I congratulate the Oliver Professors," adds President Neil L. Rudenstine. "And I congratulate all who worked with them for so successfully running their 'laboratory for change' for nearly a century."