This House of Noble Deeds: The Mount Sinai Hospital, 1852-2002

31 Department of Radiology

31 Department of Radiology THE ORIGINS OF the Department of Radiology provide us with a prime example of Mount Sinai’s perpetual need for more space. When the Hospital purchased its first x-ray machine in 1900, it was set up in the synagogue, a portion of which had already been converted to an operating room. There, the staff could use the machine as long as there were no religious services in progress. Eugene H. Eising, who was House Surgeon at the time, took the first x-ray plate. The resulting picture revealed a fracture of the upper thigh in a male patient. Eising and Walter Brickner were the first radiographers appointed to the Hospital. The initial success of the two radiographers was reflected in the Annual Report for 1901, which concluded that “All cases that have been studied on the operating or post-mortem table have verified our x-ray findings . . . and of the very large number of cases submitted to x-ray exam, not one has to our knowledge suffered the slightest burn.”1 Unfortunately, like many of the early experimenters with x-rays, Eising and Brickner were not so lucky. Both men acquired severe burns from repeatedly testing the machine by placing their left hand in front of the tube. In fact, as early as 1905, Brickner brought the matter of the safety of x-rays for the medical staff before the Medical Board: The frightful, even fatal skin injuries that have been suffered by several x-ray workers are quite familiar through the medical and lay press. That frequent exposure to the x-rays is also capable of effecting deeper injuries is just being discovered. Several members of the board are already familiar with the damages that the x-ray work have in- flicted upon my person. . . . The employment of shields and screens, therefore even if altogether practical in active diagnostic work, does not give sufficient promise of protection.2 Following Brickner’s recommendations, the Board adopted proposals to distribute the x-ray work between the x-ray staff and the rest 342 of the physician staff so that the x-ray workers would be exposed to less radiation. However, it was another thirty-five years before routine measurements of the stray radiation received by hospital employees were conducted by the Physics Department.3 Brickner served as Chief of the Department of Roentgenology until 1908, when he was appointed Assistant Attending Surgeon, and Leopold Jaches replaced him. Jaches emigrated to the United States from Latvia in 1892. He studied law and was admitted to the New York Bar in 1898, having become an American citizen the previous year. Later, he studied medicine, graduating from medical school in 1903, and became one of the pioneers of x-ray in America. During World War I, he was in charge of the X-ray Division of the United States Army in France. As Chief at Mount Sinai, Jaches would develop the Department “from small beginnings . . . into a large diagnostic and therapeutic institute.”4 By 1909, the rest of the Hospital was beginning to realize the importance and utility of radiology. According to the Annual Report for 1909, “The services of this department have been utilized to a much larger degree by the surgeons and physicians of the hospital, and by the profession, and this department is gaining in importance, as the value of this service and its practical application in the practice of surgery and medicine are more largely recognized.”5 As a reflection of this growing importance , the Department moved into larger quarters in the basement of the medical building the following year. By 1920, the total operating costs of the Department were $20,119, up from $3,370 in 1910, and the number of examinations increased from 1,724 to 10,777 in the same period. As the number of patients examined continued to climb, the Department decided in 1930 to begin using full-time lay technicians for diagnostic work, which up until then had been performed by interns. The 1920s were marked by a series of scientific achievements by members of the Department. Since radiography was fast becoming an important tool for many of the medical specialties, members of the Department were integrally involved in advances occurring throughout the Hospital. In 1923, Jaches and Harry Wessler published Clinical Roentgenology of Diseases of the Chest,6 which was long considered the standard American work on the subject. In 1926, an x-ray...