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The 21st General Hospital was the successor to Base Hospital 21, among the first American military hospitals to serve in France in World War I. Its officer corps had been drawn in large part from the medical staff of Washington University Medical School and Barnes Hospital (See RG006, Base Hospital 21). After returning to the United States in 1919, Base Hospital 21 was designated a Reserve Officer Corps unit of the General Hospital category. When war broke out again in Europe, the executive officer of the reserve unit was Lee D. Cady, M.D., a 1922 graduate of Washington University School of Medicine and member of the clinical faculty in medicine.
Following the Japanese attack on Pearl Harbor on December 7, 1941, mobilization orders were sent to reserve units throughout the country. Cady, now lieutenant colonel, and an advance party of other medical officers from St. Louis, traveled to Ft. Benning, Georgia. On January 12, 1942, the unit was activated as General Hospital 21. The ranks were increased by officers and enlisted men already in training at Ft. Benning. On February 1 they were joined by fifty-five nurses from Barnes Hospital and the Washington University School of Nursing led by Lt. Lucille S. Spalding. Col. Robert E. Thomas, a Regular Army medical officer, was named as unit commander on February 15. Before General Hospital 21 departed from Ft. Benning, Col. Thomas was replaced as commander by Col. Charles F. Davis.
On October 20, 1942 the unit embarked from New York aboard the SS Mariposa, bound for England. Following a zigzag course through the rough U-boat-infested waters of the North Atlantic, the vessel managed to reach its destination, Liverpool, in safety. From Liverpool, the 21st was sent by train and truck to a billet in a suburb of Birmingham, Pheasey Farms Estate. While in England, plans were announced that the hospital would be a part of "Operation Torch," an Allied offensive to establish control of North Africa. In Liverpool again, the 21st boarded the SS Monarch of Bermuda, which sailed in a convoy south along the Atlantic coast of Europe. From Gibraltar, the convoy crossed the Mediterranean to Algeria and landed at the Port of Mers-el-Kebir, near Oran, on December 6, 1942. Algeria had newly come under Free French control and thus its strategic resources were at Allied disposal.
The 21st bivouacked at Oran. From there, late in December, the unit was transported into the interior of Algeria. The hospital was assigned to establish operations at a hot water spa. The place, called Bou Hanifia, was located at an oasis in the rocky desert plateau sixty miles south of Oran. The largest building in Bou Hanifia, the Grand Hotel, was chosen to house the main medical and surgical functions. Several smaller hotels in town were also taken over for hospital uses. A solitary first patient was admitted December 24. Hospital functions began in earnest on January 2, 1943, when 472 beds were ready. For a time, there was a critical supply shortage. Makeshift instruments were used in the first days of surgical operations. Medicines and bandages were administered very sparingly. The problem was gradually alleviated as more and more Allied convoys reached the Mediterranean Base Section.
Col. Davis was unexpectedly transferred to another unit in late January. Left to assume temporary command was Lt. Col. Cady. Weeks went by without a replacement for Davis named. Ultimately, with the help of friends higher up, Cady was promoted to colonel and given permanent command of the hospital. Cady revealed a considerable talent for public relations. His many efforts to boost morale and to cement good relations with U.S. and Allied commanders paid off in terms of hospital efficiency. Bed capacity steadily increased. When all appropriate spaces in the hotels were full, temporary buildings were erected to house additional wards. A rehabilitation section was established for special treatment of the wounded. Battles in Tunisia in the spring of 1943 led to capture of thousands of German and Italian troops. Up to 200 of the enemy wounded were treated by the 21st at one time. Handling of prisoners of war necessarily increased the complexity of military operations at Bou Hanifia. At its largest while in Algeria, the 21st had over 4,000 beds. The staff was pressed to handle casualties from the American and British forces that invaded Sicily in July. The number of patients gradually began to decrease once the Allies conquered all of Sicily and launched attacks on the Italian mainland. In November, the order came to "cease construction" at Bou Hanifia and restore facilities of the spa to their prewar functions. In a year of service in the North African campaign, the hospital treated 20,989 patients.
With hospital equipment packed into more than three thousand crates, the unit gathered again at Oran. The destination this time was Naples, Italy. The nurses sailed December 4, 1943 on the hospital ship Shamrock. The remainder of the unit boarded the British transport vessel HMS Cameronia two days later. Col. Cady found himself to be the ranking American officer on board and thus in charge of all U.S. personal during the voyage. In Naples, the Allies converted a fair-grounds, the "Prima mostra delle terre italiane d"oltremare," into a medical center and assigned its operation to several units, including the 21st. Near the fairgrounds was another tourist attraction, Terme di Agnano, like Bou Hanifia a hot water spa. There the officers of the 21st were billeted.
After the relative comforts of Bou Hanifia, Naples afflicted substantial hardships again on the unit. Fierce fighting continued only a short distance away. Cold rains drenched the region throughout December and January. A good portion of the fairgrounds buildings were badly bomb damaged. Tents were used to shelter many of the sick and wounded while repairs were being made. During these difficult days, members of the unit were themselves hospitalized with upper respiratory infections and fatigue. But, despite all these problems, the hospital was able to regain operating efficiency within days of arrival at the fairgrounds. In January 1944 Allied forces invaded the central Italian coastline at Anzio. In the weeks that followed, attacks were launched on German positions in the mountains, notably at Cassino. Trainloads and shiploads of casualties from these engagements, as many as three hundred at a time, were brought to the hospital, straining staff and bed capacity to the utmost. In addition, the unit was called upon to help stem a typhus epidemic in Naples. The most critical period of service to the Italian campaign came in June, with battles leading to the fall of Rome. Bed capacity of the 21st at that time reached three thousand.
The success of the D Day invasion of Normandy (June 6, 1944) permitted Allied offensives in southern France in August. By September, territory as far north as Lorraine had been liberated from German control. Orders were sent for the 21st to follow and establish operations anew on French soil. On September 25, the unit pulled out of the Naples facility. Just short of 15,000 new patient records had been added to hospital statistics. The 21st was recognized as one of the finest medical units in the European theater, and not only by Americans. For assistance to the Free French forces, Gen Alphonse Juin awarded the 21st a French unit citation.
The new location for the 21st was a psychiatric hospital near Mirecourt, south of Nancy. Once again, the unit found itself uncomfortably close to a battle zone. On October 21, 1944, less than a month after the 21st had left Naples, it was accepting patients anew. The psychiatric hospital buildings had been in the final stages of construction when the war began. They were not damaged during the German occupation. Now, with finishing touches by American engineers, the facility was admirably suited to the needs of the 21st It boasted spacious wards and central heat. By November, over three thousand patients were being treated daily.
The 21st endured perhaps its hardest test in late December 1944, during the "Battle of the Bulge." The surprise German counteroffensive breached Allied lines in Belgium and Luxembourg and, for then critical days, threatened a new invasion of France. Plans to evacuate the hospital were hastily drawn up. On December 26, the buildings at Ravenel were strafed by enemy planes and one bomb hit the grounds, causing slight damage. On that very day the German drive was stopped. The hospital, of course, accepted a great many of the wounded from the battle. The pressure continued as the struggle crossed the border into Germany itself. In January 1945 the 21st expanded to 4,040 beds. On January 7 the hospital treated its 50,000th patient. The facilities at Ravenel were used to their fullest extent. Sick and wounded were cared for even in the attics of buildings. Ambulatory patients were pressed into service on the wards and in the hospital headquarters.
The early months of 1945 gradually brought an end to this crisis. The long-awaited end of the war in Europe, V-E Day, came May 8. But victory brought a new variety of challenges to the hospital command. The number of patients dwindled, but many severely wounded remained for treatment. Meanwhile, the medical and nursing officers were needed for other assignments and were rapidly transferred out of the unit, creating staffing shortages. Col. Cady and his remaining cadre struggled to maintain hospital services despite daily changes in the duty roster.
On September 20, the U.S. Army bestowed its meritorious Service Unit Plaque on the 21st. The citation read, in part: "The professional skill and tireless devotion to duty demonstrated by the personnel of the 21st General hospital were in keeping with the highest traditions of the Armed Forces of the United States." The award, it is true, came too late to be distributed personally to most hospital personnel. The portions of the staff remaining at Ravenel had, by this date, been relieved of medical duties and were packing for the return voyage.
Final statistics compiled by the unit were impressive. They indicate that the 21st admitted 65,503 patients in its nearly three years of overseas service. The total surgical operations numbered 33,440. Dental treatments amounted to 69,375. The hospital laboratories had run 246,805 tests. Blood transfusions given were 11,258. The Convalescent and Rehabilitation Section treated 21,175 patients. In three years, over 2,200 persons had served as members of the 21st.
After a short period at a staging area near Marseilles, Col. Cady and his staff boarded the victory ship Westminster, which sailed October 28. The ship landed at Boston November 7. The members of the 21st were taken to Camp Myles Standish, given an official welcome, and reoriented for their imminent return to civilian life.
The 21st ceased to exist as an active military unit at this point (it has since been revived as a U.S. Army Reserve General Hospital). Yet the careers of those who had served with the hospital during the war continued profoundly to be influenced by the experience. Cady became a director of Veterans Administration hospitals in Dallas and Houston. Many of the other medical and nursing officers returned to St. Louis, a substantial number to resume practice at the Washington University Medical Center.
*Source: "The Spa, the Fairgrounds, and the Psychiatric Hospital; the 21st General Hospital in World War II," by Paul G. Anderson, Outlook, Spring 1982, 2-9.
Nancy Hellman Senturia, was born in St. Louis. She was a long-time supporter and volunteer at Reproductive Health Services. Senturia graduated from Mills College In California. She was a longtime member or the Jewish Hospital School of Nursing board of directors and was active tor many years in the Greater St. Louis Visiting Nurse Association. She also was active In creating the Jeff Vander-Lou neighborhood development organization. Her mother, the late Alice Hellman, was one of the founders in the late 1930s of Maternal and Child Health, the predecessor of Planned Parenthood. She was married to Ben H. Senturia.
Source: Obituary, St. Louis Post-Dispatch, May 21, 1992.
William H. Olmsted (1887-1978) received his M.D. degree from Johns Hopkins University in 1913. He was an intern, 1913-1914 and resident and assistant resident, 1914-1917, at Barnes Hospital and afterwards served with Base Hospital 21, the medical unit sent by the hospital and WUSM to support American troops in World War 1. After the war, Olmsted re-joined the clinical faculty of the WUSM Department of Medicine, climbing the ladder from assistant in internal medicine to associate professor from 1915-1952.Olmsted became emeritus in 1952 .
In Barnes Hospital's first year of operation in 1914, Olmsted was the second medical resident to join the staff, along with acting as a clinical research pathologist, 1914. He was the first head of the hospital's chemical laboratory in 1920, and was the founding president of the Barnes Hospital Society in 1925. Olmsted became physician emeritus in 1952 .
From 1920 to 1963, Dr. Olmsted practiced as a private physician. He was certified in the practice of internal medicine in 1936, specializing in diabetes. In 1920, insulin was discovered to be effective in the treatment of diabetes, and Barnes Hospital was one of the first selected in the country to use the hormone to treat patients. Since Olmsted was the resident expert in diabetes, he became the first doctor to use insulin in St. Louis in the year 1922. Years later, in 1949, he founded the St. Louis Diabetes Association.
Ben Senturia (1910-1982) was an otolaryngologist who began his practice in St. Louis in 1939. Senturia was educated at Washington University earning his A.B. in 1931 and his M.D. in 1935. After an internship at the St. Louis City Hospital and an additional internship and residency in otolaryngology at the McMillan-Barnes Hospital, Dr. Senturia joined the faculty of Washington University School of Medicine in 1938. He also worked with closely with Max Goldstein and Dr. Richard Silverman at the Central Institute for the Deaf. His World War II service was with the U.S. Air Force in the research section of the School of Aviation Medicine where he conducted major investigation in noise induced hearing loss and in the infections of the external ear.
After the war, Senturia taught medical students and graduate students and conducted major research programs in otolaryngology. His clinical and basic research in external otitis resulted in two textbooks and over 80 scientific papers. In 1952, he became director of the department of otolaryngology at the Jewish Hospital of St. Louis. He was also president of the American Otological Society from 1972-1973. Arthur Proetz appointed him associate editor of the Annals of Otology, Rhinology, and Laryngology in 1958 and he became its editor in 1966.
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The history of Barnes Hospital begins with the will of St. Louis businessman and philanthropist Robert A. Barnes. In 1892, Barnes bequeathed funds to be used for, "erecting and maintaining a hospital for the sick and injured persons without distinction of creed." While plans for the hospital were being formalized, Washington University President Robert S. Brookings was searching for a teaching hospital with which to affiliate Washington University Medical School. He approached the trustees of Barnes Hospital, and by 1911 a contract between the two intuitions had been struck. The contract moved the location of Washington University School of Medicine to near the hospital's proposed Kingshighway location, and stipulated that the two institutions would share staff and other resources. On December 7, 1914, Barnes Hospital opened with 26 patients transferred from Washington University Hospital.
In the ensuing years, Barnes Hospital would continue to expand, offering new services, building larger facilities, and treating more patients. The 26 initial patients of 1914 became 3,501 admitted to Barnes and its operating hospitals in 1920, a number which grew to 22,000 admitted patients in 1950 and to 34,553 admitted patients in 1995. Facilities expanded to accommodate these patients, with the new East Pavilion rising in 1972 and the West Pavilion joining it in 1980. The pavilions linked with Queeny Tower, which had opened in 1965. Staff also expanded from the original 80 members in 1915. By 1995, Barnes employed 5,721 full time employees; had 1,433 physicians on staff; and housed 741 interns, residents, and fellows. Net revenue in the 100 years of operation increased from $3.675.77 in 1915 to $34,486 in 2015. As it has grown, Barnes Hospital and its staff members have achieved many medical innovations and firsts. These innovations are numerous and range from the first successful total pneumonectomy in 1933 to the country's first successful nerve transplantation in 1993.
Barnes Hospital would go on to be associated in various ways with many other medical facilities over the coming years, including St. Louis Children's Hospital; St. Louis Maternity Hospital; Mallinckrodt Radiological Institute; McMillan Hospital and Oscar Johnson Institute; David P. Wohl Hospital; Barnard Free Skin and Cancer Hospital; Renard Hospital; and the Alvin J. Siteman Cancer Center. In November 1992, Barnes and Jewish Hospitals signed an affiliation agreement, agreeing to pool resources wherever possible. This affiliation agreement was completed in March 1993 to create Barnes-Jewish, Incorporated (BJI). In April of 1993, BJI and Christian Health Services announced that they would affiliate to create BJC Health System, an affiliation which was finalized in June 1993. In January of 1996, a merger of Barnes and Jewish Hospital, built on the sharing of resources which began with the completion of the affiliation agreement in 1993, was legally completed, and the two became the present day Barnes-Jewish Hospital. Barnes-Jewish Hospital is consistently ranked among the best hospitals in America by U.S. News and World Report.
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In November 1992, Barnes and Jewish Hospitals signed an affiliation agreement, agreeing to pool resources wherever possible. This affiliation agreement was completed in March 1993 to create Barnes-Jewish, Incorporated (BJI). In April of 1993, BJI and Christian Health Services announced that they would affiliate to create BJC Health System, an affiliation which was finalized in June 1993. In January of 1996, a merger of Barnes and Jewish Hospital, built on the sharing of resources which began with the completion of the affiliation agreement in 1993, was legally completed, and the two became the present day Barnes-Jewish Hospital. Barnes-Jewish Hospital is consistently ranked among the best hospitals in America by U.S. News and World Report.
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The Department of Otolaryngology-Head & Neck Surgery at Washington University in St. Louis has a rich, 130-year history of leadership in our field that is built on the foundations of academic medicine: patient care, research, training and service. Our past leaders include luminaries in the field of otolaryngology, such as John Blasdel Shapleigh, MD; Greenfield Sluder, MD; Lee Wallace Dean, MD; Theodore Walsh, MD; Joseph Ogura, MD; John Fredrickson, MD; Richard A. Chole, MD, PhD; and, presently, Craig A. Buchman, MD, FACS. Even from our earliest days, prior to the inception of the McMillan Eye, Ear, Nose and Throat Hospital (circa 1943), excellence has been an integral part of the department's fabric. A look at former faculty and program graduates reveals many of the true innovators in our field. While we remain humbled by our beginnings and past achievements, we choose not to rest on our laurels. Rather, we aspire to further our commitment to improving patients' lives by leading our field and its clinical application.
-- 2019-2020 Bulletin Overview: http://bulletin.wustl.edu/medicine/departments/otolaryngology/#text
Joseph Hirosuke Ogura was born in San Francisco in 1915. He studied at the University of California, receiving his BA (1937) and MD (1941). From 1940-1948, he did internships and residencies at hospitals in California and Ohio as well as the WU School of Medicine and McMillan, Barnes, and St. Louis City Hospitals. Ogura's first teaching post at the School of Medicine in 1948 was instructor of Otolaryngology. He was promoted to assistant professor in 1951 and associate professor in 1953. He became full professor in 1960 and Lindburg Professor in 1966. He served as head of the department of Otolaryngology and otolaryngologist-in-chief at Barnes and St. Louis Children's Hospital for sixteen years, 1966-1982. He remained as staff otolaryngologist at Barnes and Childrens until his death in 1983 at the age of 67. The School of Medicine created the Ogura Lectureship in honor of him in 1977.
A superb academic physician and surgeon, Ogura developed refinements in the voice sparing operation for cancer of the larynx. Prior to his innovative laryngeal surgery, patients underwent total removal of the larynx. With his approach, he preserved larygeal function for speech and swallowing.
Ogura was an indefatigable contributor to medical literature and teaching programs of head and neck surgery. He was the author of more than 300 articles and 20 books. Head and neck cancer, ablative surgery,and reconstructive surgery were his specialties. His research interests included nasopulmonary mechanics, laryngeal physiology, and the study and care of progressive malignant exophthalmus and he explored the possibility of transplantation of the larynx.
Ogura was a member of 30 professional societies including the elite international society, Collegium Oto-Rhino-Larynogological Amicitiate Sacurum whose U.S. membership was limited to 20 active otolarynogologists. He was one of three physicians in the history of the American Larynogological Association to receive all three of its awards: the Casselberry Award, the James Newcombe Award and the DeRoalds Gold medial. He was president of the American Society for Head and Neck Surgery, the American Larynogological Association, and the Society of Academic Chairman of Otolaryngology. He was selected in 1980 to the Royal Society of Medicine, and appointed to the National Cancer Advisory Board by President Nixon in 1972.
*From WU Record, 04-21-1983 and Arch Otolaryngology 106:662-663, Nov. 1980.
Ludwig Bremer was a prominent St. Louis-based German doctor who came to the United States in 1865 to study medicine. He received his medical degree from St. Louis Medical College in 1870, and practiced in Carondelet and Belleville until 1880. After finishing his medical studies in Europe in 1883, Bremer returned to St. Louis, where he served as the chair of physiology and pathology at Missouri Medical College, and president of the St. Louis Medical Society. His areas of study included histology, pathology, neorology, and haematology.
Sidney Isaac Schwab was a neurologist and psychiatrist who began his practice in St. Louis. A native of Memphis, Tennessee, he graduated from Harvard Medical School in 1896. Upon graduation, Schwab traveled overseas to pursue postgraduate studies at universities in Paris, Berlin, and Vienna. Dr. Schwab took his first teaching post at St. Louis University as Professor of Nervous and Mental Diseases in 1904, and he held this position until 1912. In addition to his duties at St. Louis University, he also taught at the University of Missouri from 1909 to 1910.
After leaving his position at St. Louis University, Dr. Schwab joined the faculty of Washington University in 1913 where he maintained many responsibilities as Professor of Clinical Neurology. In addition to teaching, private practice, and research, he was on staff at the neurological clinic of the dispensary, and he worked as a neurologist at area hospitals including St. Louis City, Jewish, Barnes, McMillan and Children's. After the Red Cross called for the formation of a base hospital unit at Washington University during World War I, Schwab along with his fellow doctors and nurses traveled to Rouen, France where they treated soldiers from June 1917 until the end of the war. Dr. Schwab's exemplary service during WWI led to him becoming widely known for his work with shell shock cases.
After the war, Schwab became president of the American Neurological Association in 1921. He later collaborated with Borden Veeder on a landmark work The Adolescent: His Conflicts and Escapes in 1929. In 1930, he joined the editorial staff of the Journal of Nervous and Mental Disease. A prolific medical writer, his research focused on neuropsychiatric disease and the mechanism of neurosis. Many of Dr. Schwab's writings discuss war neurosis and the minor psychoses.
William B. Kountz was born in Saxton, Missouri in 1896 and attended schools in nearby St. Joseph. He entered Washington University as an undergraduate in 1918 and (without formally completing a bachelor's degree) continued on through medical school, graduating in 1926. Until 1928, Kountz was an intern and resident physician at Barnes, St. Louis Maternity, and St. Louis Children's Hospitals. He then became a physician with the cardiovascular service of the Washington University Dispensary. The award of a national Research Council Fellowship offered Kountz the opportunity for further training abroad, and for eighteen months beginning in 1930 he visited hospitals in Britain, Germany, and Egypt. (He later recalled that the chance to study Egyptian mummies inspired his interest in aging.) He returned in late 1931 to join the clinical faculty of the School and to launch he career as a leading cardiologist in St. Louis.
Kountz served on the staff of Barnes and Lutheran Hospitals, but became particularly well known for his treatment and study of aged patients at the St. Louis City Infirmary (later, St. Louis Chronic Hospital) on Arsenal Street. In 1938 he helped establish a special geriatrics research unit at the Infirmary. In 1946 WUSM organized a Division of Gerontology based at the Chronic Hospital and Kountz was named its director of clinical services. That same year Kountz became a founding member of the American Society for the Study of Arteriosclerosis, which later became a branch of the American Heart Association. In 1954 Kountz's work received additional support through the establishment of a St. Louis-based Gerontological Research Foundation.
Kountz died in 1962. He was succeeded as head of the Division of Gerontology by John Esben Kirk, under whom the program continued until 1973.