The Michael Reese Hospital Legacy

The long anticipated demise of Michael Reese Hospital, a stellar healthcare institution and a linchpin of Chicago’s South Side throughout most of the 20th Century, has become a certainty. (Note: This was originally posted Aug 13, 2008 at 1HeckOfAGuy.com, a predecessor of AllanShowalter.com)

A deservedly dignified elegy for Michael Reese, where I completed my psychiatric residency in the 1970s, appeared last week in the Chicago Tribune, prompting me to write this leave-taking post.

An excerpt from the Tribune’s obituary, Congregation To Mourn Destruction Of Temple And Loss Of A Hospital, offers the philosophical perspective on which Reese was was founded and which sustained it thereafter:

“Jews came [to America] with the basic premise we would take care of our own,” said [Marc] Slutsky1 who practiced psychiatry at Michael Reese for more than 20 years. “Jewish hospitals became a manifestation of that.”

Another selection from that article indicates the role Reese played in healthcare and its importance to Chicago and the South Side:

In its prime, Reese trained more doctors, did more research, delivered more babies and provided more free care to the indigent than any other private hospital in the area. A doctor there developed the first incubator for infants. Another pioneered major innovations in cardiac care. When much of its middle-class Jewish clientele and constituents migrated to the suburbs, Reese struck a deal with Mayor Richard J. Daley to stay and rehabilitate the South Side.

Wikipedia lists other medical accomplishments attributable to Reese:

Louis Katz, the Medical Research Institute’s first full-time investigator and former president of the American Heart Association, was one of the first to explore the relation of coronary heart disease to cholesterol concentration in the blood. Cardiovascular Institute researchers Dr. Alfred Pick and Dr. Richard Langendorf, perfected the use of the electrocardiograph. Leonidas Berry was a pioneer in the development and use of the gastroscope. Dr. Samuel Soskin and Dr. Rachmiel Levine made important discoveries about the “gatekeeper” action in insulin, which is of fundamental importance to the understanding of diabetes. Dr. Albert Milzer and his research team were the first to kill the polio virus and make an effective vaccine against this debilitating virus.

The introduction to Meeting the Future, Honoring the Past2 by Dorothy H. Gardner enlarges on the origins of the Hospital:

Fortunately for humankind, care for the poor is among the many great traditions of the Jewish faith. Historically, this has often meant caring for “our own.” This was a primary motivation of the Jewish philanthropists who founded Michael Reese Hospital in 1879. No less important was securing an environment to train Jewish physicians denied admitting privileges and access to medical education elsewhere.

The History Of Michael Reese Hospital

 

This summary of Reese’s founding and its early years, found in The Encyclopedia of Chicago, expands further on the hospital’s self-determined vision as well as laying out the pertinent factual data:

Among the many institutions destroyed by the Great Chicago Fire of 1871 was the hospital on LaSalle street (between Schiller and Goethe) established by the United Hebrew Relief Association. When Michael Reese, a wealthy real-estate developer, died in 1877 his will provided sufficient funds to build a new hospital. An 1836 Jewish immigrant from Bavaria, Reese had made a fortune in land speculation and silver mining by the 1850s. When the hospital was completed in 1880 Reese’s heirs requested that it be named in his honor and that it serve all of Chicago without regard to race, creed, or nationality.

The original Michael Reese building, located on the corner of 29th and Groveland Avenue, was replaced in 1907 by another, larger building on the same site. The hospital’s medical innovations included Julius Hess’s infant incubator (around 1915) and the first permanent incubator station for premature babies (1922). In 1946 Michael Reese Hospital along with a number of other area organizations formed the South Side Planning Board to refurbish the area surrounding the hospital, which had suffered considerable economic and physical decline. Like Illinois Institute of Technology and Mercy Hospital, Michael Reese preferred urban renewal to leaving the area altogether.

During my psychiatric residency at Michael Reese in the 1970s and my service on the Attending Staff for several years afterward, I became acutely aware that Reese was a flawed institution; at no time during my years there, however, did I detect any slippage from the mission that was embedded and integrated throughout the medical center. Reese took its role as benefactor to the ill very seriously and expected equal dedication from the clinicians it employed and those allowed to join its medical staff.

Of course, dedication to humanitarian goals is no guarantee of an organization’s survival – and may even be a cause of its decline.

Roy Grinker, MD And The Psychosomatic & Psychiatric Institute

The Psychosomatic and Psychiatric Institute (P&PI) holds special meaning for me because it was the site of my psychiatric training and practice at Michael Reese.

When I entered the residency, the head of P&PI was already one of the Grand Old Men of Psychiatry, Roy Grinker, MD. Rather than recount his numerous accomplishments here I will only note that he was an internationally prestigious and influential figure intimately associated with Reese, qualities apparent in this excerpt from The Biopsychosocial Model: Anything Goes?

After Meyer, Grinker (1900-1993), longtime chairman of the Michael Reese Department of Psychiatry in Chicago, can be seen as perhaps the leading thinker in this model. Roy Grinker, being one of Freud’s last analysands, had been trained not only in psychoanalysis but also in neurology and was an active clinical researcher whose empirical studies focused on the impact of war trauma on soldiers. He was highly critical of the orthodox evolution of the American Psychoanalytic Association and organized a rival group. For years, as the editor of the Archives of General Psychiatry, he had a major impact. He coined the term ‘biopsychosocial’ and emphasized its link to the then popular biological paradigm of ‘general systems theory’, a holistic view that saw reductionism as unscientific and that emphasized that the whole of a biological system is greater than its parts and that indeed no part could be understood except in relation to the whole.

Regardless of ones acceptance or rejection of the biopsychosocial model, Grinker’s leadership and the accomplishments of other senior psychiatric staff assured that Michael Reese psychiatry was treated with high regard.

Wexler Pavilion

When I arrived at Reese, Wexler Pavilion, then only a few years old, impressed me as a well appointed, attractive setting to practice outpatient psychiatric treatment. The awkwardness of the pie-shaped offices that occupied the perimeter of the building was a small price to pay for such relatively luxurious surroundings.3

The fate of Wexler Pavilion mirrors the course Michael Reese has taken. Lee Bey, who is responsible for the outstanding photos found in this post and who writes about architecture, among other topics, at Lee Bey: The Urban Observer, describes Wexler Pavilion in Michael Reese Hospital,

The empty circular Simon Wexler Psychiatric Research and Clinic Pavilion was designed by Chicago architects Ezra Gordon and Jack Levin. Built in 1962, this beautifully humane building was an outpatient facility with 35 interview rooms arranged around the circumference of the building. There is a skylight at the top and a research lab. Wexler was founder of Allied Radio Corp. His widow donated $150,000 of the building’s $450,000 cost. The photo below shows an interior staircase leading to the interview rooms. Peeling paint hangs from the ceiling and has collected on the floor.

Wexler Stairs: Those stairs connected the classrooms, administrative offices, and inpatient floors of P&PI with the outpatient offices of Wexler Pavilion.

David T. Siegel Institute for Communicative Disorders

Shown above is the obviously deteriorating building, constructed in 1970, that housed the Siegal Institute, which was dedicated to the treatment of children with defective fundamental communication processes secondary to blindness, deafness, or profound childhood psychological disorders such as aphasia.

The Passing Of An Era

When my residency began, Michael Reese was, at least by my reckoning,4 in the final phase of its Golden Age.

The entire medical center was then populated by extraordinarily skilled and talented nurses and outstanding physicians, many of whom commuted from the North Shore suburbs to Reese’s South Side location rather than work at medical centers that were more conveniently located and which served a far richer and better insured clientele. Both clinical staff and patients displayed high morale. Residencies in psychiatry and other medical fields were accounted not just competitive but desirable.

On the other hand, it was obvious that Reese was the victim of worsening fiscal disadvantages which were primarily the consequence of serving a population with an increasingly larger proportion of impoverished patients who received charity care and patients funded by government assistance at rates so low that the Hospital lost money on every day of treatment rendered. Less money meant an increasingly shabby environment, reduced staffing, and delays in purchasing new technology. Tellingly, senior physicians could be heard complaining that not every resident planned to remain at Reese after completing training.

This was also a period during which many of Reese’s clinical leaders were retiring or seeking greener pastures at other facilities. That Grinker’s directorship of P&PI ended during my residency did not directly cause the problems but did epitomize them.

Naive about organizational psychology, I was surprised by the rampant, readily apparent hubris on display at Michael Reese, a quality which condensed and petrified as the problems worsened. Flexibility was nonexistent at administrative levels, archaic rules limiting innovation on the part of the private staff were rigorously enforced, and a bunker mentality prevailed.

In many ways, the situation at Reese in those days evoked nothing quite so much as the movie scenes of war correspondents reporting on a civil war in one or another Latin American or African nation, all the while residing, between assignments, in the country’s one remaining luxury hotel. Transiently safe within the surrounding chaos, they can, while the generator is working, drink parasol laden drinks and nibble on canapes within earshot of both the government’s reassurance that the revolution is all but quelled and the gunshots of nearby skirmishes marking the advances of the rebels.

This inward turning bravado should be understood in the context of the times. Healthcare organizations were, in many respects, insular kingdoms. Consider that it was typical for medical students who served residencies at hospitals other than those associated with their medical schools to be re-taught procedures, their senior residents explaining, for example, “This is how we put in a central line at Johns Hopkins/UCLA/Loyola/Michael Reese.”

Regardless, exclusively internal validation in the guiding of an institution is risky. As late as the latter part of the 1980s, when I knew several individuals still working at Reese, its free-fall was apparent – as was its insistence that reshuffling of old, failed strategies would be successful.

Over the past decade, I have had little involvement with Michael Reese, but from news reports it appears that a succession of increasingly desperate schemes to improve the Hospital’s finances have failed.

The corporate entities responsible for Reese have now officially informed the appropriate governmental agencies that the facility is no longer fiscally viable and will be closed.

The finale for Reese is likely to be the transformation of its 37 acres into the Olympic Village as part of the city’s bid for the 2016 Games. While this notion has been bruited about for several months, a formal plan seems to have solidified, as reported in the 8 August 2008 Trib:

Last month, Chicago proposed an $85 million deal for the purchase of the Michael Reese Hospital property from Reese’s landlord Medline Industries as a potential site for a 2016 Olympic Village.

The Final Goodbye

Michael Reese certainly deserves the regrets, the mourning, and the commendations for its past accomplishments. And I will join my voice to that chorus.

But, it is instructive to consider one more building on the Reese campus, again photographed and described by Lee Bey.

Laz Chapman Pathology Institute

Excerpt and photo from Lee Bey: The Urban Observer – Michael Reese Hospital:

The former waiting room above–look at the dust settling on those red chairs like old ghosts–is the shuttered Laz Chapman Pathology Institute. The institute once hosted research on kidney and lung diseases. It had the very latest in electron microscopes, animal testing labs–even an autopsy room–when it was built in 1965. Laz Chapman, for whom the building is named, was CEO of H. Kramer & Co., a brass-smelting company in the Pilsen neighborhood. His estate funded the $400,000 cost of construction. And that painting, there, above the down staircase: I wonder if that’s Chapman himself looking out over the decay?

As the decrepit ruins of the Chapman Pathology Institute remind us, the demise of Michael Reese is also fittingly memorialized by Shelly’s poetic commentary on the desolation that mocks the hubris of the once great.

 

Ozymandias
by Percy Bysshe Shelley

I met a traveller from an antique land
Who said: Two vast and trunkless legs of stone
Stand in the desert. Near them on the sand,
Half sunk, a shatter’d visage lies, whose frown
And wrinkled lip and sneer of cold command
Tell that its sculptor well those passions read
Which yet survive, stamp’d on these lifeless things,
The hand that mock’d them and the heart that fed.
And on the pedestal these words appear:
“My name is Ozymandias, king of kings:
Look on my works, ye Mighty, and despair!”
Nothing beside remains: round the decay
Of that colossal wreck, boundless and bare,
The lone and level sands stretch far away.

Credit Due Department
The impressive photos in this post were taken by and used with the permission of Lee Bey, whose blog, Lee Bey: The Urban Observer, is worthy of perusal by anyone with an interest in Chicago or in architecture.

Note: Originally posted Aug 13, 2008 at 1HeckOfAGuy.com

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1. Marc Slutsky, a central figure in the Tribune article, was a newly minted Attending Physician at Reese when I entered my psychiatric residency there. Consequently, we were colleagues for several years. [↩]
2. Meeting the Future, Honoring the Past by Dorothy H. Gardner. Judaism and Health Care: March/April 2000, Issue 14. [↩]
3. Because mental health services typically do not require cutting edge, high priced technology that often calls for custom constructed spaces with esoteric requirements for power, protective devices, and other support, psychiatry and associated fields are routinely located in the oldest, least sophisticated areas of a healthcare facility. That was not the case at Reese. [↩]
4. I claim no special knowledge of the organization’s workings or insight into the future. I did perhaps have the debatable advantage of being an outsider (a Protestant from rural Missouri who knew little about Reese beyond its reputation for training psychiatrists) who was less influenced by the Reese mythology. [↩]