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CHAPTER 5 Medicine at the Beth, 1928–1947  At noon, on May 15, 1929, the switchboard of Sinai Hospital in Cleveland, Ohio, lit up with frantic telephone calls, alerting the Jewish hospital that its staff was about to receive the victims of the worst disaster “in the annals of hospitals.” Within a few minutes a caravan of ambulances, taxicabs, delivery trucks, and drays converged at the emergency room entrance. “Men from all walks of life, in gray and blue business suits, overalls, even rags . . . butchers, grocers, sailors, brokers, and clerks” carried the injured and dying into the hospital. Teams of nurses, interns, physicians, janitors, and scrubwomen worked at each bedside to treat the burns and administer artificial respiration. Interns rushed from other hospitals to Sinai, which had received nearly all the victims and was depleting the city’s oxygen supply. In the basement of the Cleveland Clinic, sometime early that morning, an exposed light bulb began to heat a stack of X-ray films in a storage room already piled high with more than seventy thousand nitro-cellulose X-ray films. At 11:30 A.M., the film ignited and exploded, shattering the inner walls and floors and sending upward plumes of fire and “instant death” as nitrous oxide, bromine, and chlorine gases filled the building. Eyewitnesses reported that, “Physicians, chemists, and nurses fell with instruments, charts, and test tubes in their hands . . . screaming figures on the roof were dimly seen through rolling orange-hued fog . . . piles of bodies were crammed into the stairwells and the elevator shaft . . . the faces of the dead and the walls were the same dark yellow color.” More than 123 patients and hospital staff died that day “as the very instrumentalities of advanced science turned against their users.”1 Two weeks later, Dr. Paul Keller entered the meeting room of the new Newark Beth Israel tower and knew from the anxious expressions of the 105 Administrative Committee that he had to allay their fears. The Cleveland Clinic tragedy had been a wake-up call to hospital administrators across the United States. Keller reassured them that because the Beth was a new hospital , there were no old films in storage, the current films were safely stored in steel cabinets in ventilated rooms, and plans were under way to construct a fireproof vault to meet the requirements of the Newark Fire Department.2 Keller then turned to the agenda for the meeting: the results of the May 6 survey for the American College of Surgeons completed by Dr. Fritjof H. Arestad. He announced that Arestad had recommended full accreditation for the hospital. Dr. N. P. Colwell, secretary of the ACS, had written to Keller, thanking him for extending his courtesy to Arestad and adding that Newark Beth Israel Hospital would remain on the AMA Council on Medical Education approved intern list.3 While the new hospital building did not match the architectural vision of Frank Grad and Dr. S. S. Goldwater, neither its structural integrity nor its medical facilities had been compromised; all had been built to meet the increasingly stringent standards of the ACS. In 1929, Arestad, a twentyfour -year-old graduate of the University of Minnesota Medical School, did not address the peeling paint and smelly incinerator, but the well-equipped and organized medical departments. His report began with an overview of the Beth, a 360-bed institution consisting of a “central eleven-story hospital building, an adjoining six-story nurses’ home and a three-story outpatient department,” as well as “excellent facilities available for the treatment of patients” and “excellent equipment.”4 Increasingly, those who judged the quality of medical institutions expected fine laboratory facilities, critical for diagnostic testing and additionally important to those physicians engaged in an active program of research. Arestad found the laboratory “built and organized so as to offer the best type of service to the patients and to be of the highest educational value to interns, residents, and staff members.” The lab was equipped for the standard medical diagnostics of the day, including urinalysis, blood tests, Wasserman tests, sputum examinations, and gynecological smears. There was ample facility for tissue examination, and the lab handled all blood transfusions from donors to recipients and basal metabolism tests. Arestad judged the facilities for autopsies well equipped, and the number of autopsies performed in 1928 (320 patients had died at the Beth and 230 autopsies were reported) indicated that “the hospital is interested in scientific medicine and in the teaching function...

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