Chapter Five

Some people are so open-minded their brains fall out.

(Used by Dr. William Deadman)
Anonymous

Internships

After graduation with an M.B. in June of 1913, he sought an interneship. Internships prior to practice were not mandatory in Ontario until 1957¹ and most of his classmates would have gone directly into general practice. He could have returned to Beeton or any other smaller community for that matter and had an instant practice in the area, but he was not that interested in general practice. He felt that he wanted to do more. Besides, he commented once that he shared the anxiety of most graduating medical students that he really knew very little compared to all there was to know and he needed more experience before setting out on his own. He tells of his efforts to seek an internship.ⁱ

“I had in the meantime, graduated in Medicine, and that year (1913), had made application for internship to a number of Canadian hospitals. The Toronto General Hospital indicated to me that my class standing did not justify appointment there. However the Public General Hospital at Saint John, New Brunswick accepted me at a stipend of $50.00 per month, and the Hamilton City Hospital accepted me at nothing a month. I knew nothing of the Saint John hospital, but I had heard something of the Hamilton through my classmate Doctor Claude McClenahan who had an outstanding career in the Ontario Hospital Service,² and now living in Burlington. I discussed the matter of a choice with my father, who said, “Son I think I would go to the Hamilton City Hospital. I’ll let you have $100.00 for your year’s expenses.” I decided on Hamilton and reported for duty on July 1^st, 1913. on City Hospital through my classmate Doctor Claude McClenahan who had an outstanding career in the Ontario Hospital Service,³ and now living in Burlington. I discussed the matter of a choice with my father, who said, “Son I think I would go to the Hamilton City Hospital. I’ll let you have $100.00 for your year’s expenses.” I decided on Hamilton and reported for duty on July 1^st, 1913.

“Once again, I saw the old Stuart Street Station with its whitewashed stones. Finding my way up Barton Street, I walked in the front gate of the hospital, past the ornamental iron fountain, which graced the front lawn which isn’t there anymore, and found my friend Dr. Donald Warren in the superintendent’s office, Dr. Langrill having taken the holiday. I had known Dr. Warren since my freshman days at the University, having first met him during a clash between a parade of student freshmen of which I was one, and one of the august sophomores of which Don Warren was the organizer and leader. Don had just completed his year’s internship at the City Hospital and had taken over, for the day, to welcome, on behalf of Dr. Langrill the superintendent, the six new interns who were reporting for duty. I was registered, issued with a white suit and shown to the intern quarters on the third floor of the central main building which housed on the ground floor, the hospital offices, on the second floor, rooms for patients, and on the third floor, interns’ rooms.”

In a later version of his autobiographical writings, he described his internship at the City Hospital that he remembered in 1913: ⁱⁱ

“In 1913, the Hamilton City Hospital was already 70 years old. It was the oldest municipally operated hospital in Canada. It was a general hospital in every sense of the term. It’s Training School for nurses had been established in 1890 by the then superintendent, the late Doctor Ingersoll Olmstead. Dr. Olmstead lived in a large house on the corner of Markland Ave. and Bay Street that still stands.

The lead author (JCD) recalls:

“I remember the house well because as a young child, I accompanied my parents on their annual pre-Christmas visit to the home. By this time Dr. Olmstead would be mostly bedridden. I have a vivid recollection of one of these visits. Everyone was sitting in the parlour very formally having tea and biscuits. I was bored and restless but my mother told me to be still. I then asked to go to the bathroom and was directed by Mrs. Olmstead upstairs. I must have opened the wrong door because I realized I was in a bedroom and there was an older man lying in the bed. I quickly tried to withdraw but he spoke to me and invited me in. We had a brief chat and then in some embarrassment I quickly went downstairs as if nothing had happened. I was probably about 5 at the time. I never did find the bathroom.”

Bill’s recollections continue:

“There were some 40 nurses-in-training. For the year 1913-14 there were six interns, each of whom rotated through six intern services of two months duration each. That year there were three graduates of the University of Toronto, and three graduates of the University of Western Ontario. From Toronto came myself and two of my classmates, Dr. Ernest McCulloch, later a prominent Toronto physician, and Dr. Frank McLay,⁴ later a leading practitioner in Grimsby. From Western, came Dr. Frank R. Clegg, afterwards Professor of Obstetrics at his Alma Mater, Doctor W. A. Bodkin, now a senior Burlington physician and the late Doctor Frank Overholt, who, after 4 years overseas service, returned to Hamilton to become the Medical Director of the Hamilton Centre for the Discharged Soldiers Civil Re-establishment Department, which later became the Department of Veterans Affairs.

“My first a Career in Pathology (1911-1914) service as an intern was that on the Isolation Wards of the hospital, and in the City Laboratory as assistant to the City Pathologist. The City Laboratories served jointly as hospital clinical laboratory and as the Public Health Laboratory. Clinical laboratory work in those days was relatively simple, consisting mainly of urinalysis, blood counts, surgical pathology and a few autopsies. Public Health Laboratory work consisted mainly of the bacteriology of infectious diseases, particularly that of diphtheria, typhoid and venereal disease, and that of milk, food and the city water supply. Milk was not yet pasteurized and water was not yet chlorinated. Three quarters of the work passing through the laboratories was for the City Health Department.

The first City Pathologist was Doctor William Titler, a graduate of the University of Toronto. He organized and equipped the City Laboratories using funds from a generous grant by an interested citizen. He vacated the position after one year, and in 1911, Doctor Edward Fidlar became the City Pathologist. Dr. Fidlar vacated the position in 1912. He later was assistant Professor of Physiology at the University of Toronto. The third City Pathologist was Doctor Fred Bowman, who had after graduating from the University of Toronto, spent several years as a research bacteriologist with the United States Public Health Service in the Philippine Islands and who came to the position fresh from a post-graduate year in pathology at the relatively new Johns Hopkins Medical School in Baltimore. He was City Pathologist when I was allotted to service in the City Laboratories on July 1st, 1913.

“I had no sooner got into my white uniform than there came a call from the isolation ward that a patient was waiting to be admitted to the diphtheria ward. With some trepidation, I wended my way down to the ward to find a very sick looking patient lying on a stretcher in the horse-drawn police ambulance of the day. Calling for a tongue depressor and a clinical thermometer, I, mustering a professional air, inspected the throat, noted the odour, counted the pulse and took the temperature. I pronounced it a case of diphtheria to be admitted immediately.

Returning after a short interval to administer the antitoxin, I found the nurse in charge to be Miss Mae Belle Sampson, a native of Collingwood in my own County of Simcoe. She had graduated with that year’s class and would complete her three-year period of training in a few weeks. She was a charming young woman and a most capable nurse. She very sympathetically and diplomatically introduced me to the mysteries of filling a syringe with the requisite dose of antitoxin and of persuading the syringe needle to penetrate the skin of the patient’s arm with a minimum of apprehension and pain on the part of the patient. We became fast friends and when, in the autumn of 1914, she enlisted and went overseas with the First Canadian Division, I was not to see her again, for in June 1918 she lost her life in the submarine sinking of H. M. Hospital Ship Llandovery Castle. A plaque to her memory adorns the wall of the rotunda of the Hamilton General Hospital.”

He described the hospital of 1913… ⁱⁱⁱ

“The Hamilton City Hospital at the time of my internship was an institution of 250 beds. It had its training school for nurses, a staff of six interns, operating rooms, an embryo x-ray department with Dr. Leslie Hass in charge, and on the second floor of the Victoria Avenue wing ⁵ (called the Billings Wing) was the City Laboratories presided over by the City Pathologist Dr. Fred Bowman. The Central Main Building was of three stories and a mansard roof, similar to the one that graced the old Court House on Main Street, now demolished and replaced by a larger modern type of building. Wooden passageways connected the main building with two brick two storey wings, one on either side and both running forward towards Barton Street. Each wing had two large wards of 40 beds each.

“The east wing housed medical patients and the west wing surgical patients. Each ward had two fireplaces, back to back, after the fashion of English hospitals of the period. As a medical officer in the Royal Army Medical Corps, on the staff of the Cambridge Military Hospital in Aldershot, England in 1916, I worked in wards of a similar type, without, of course any central heating such as the City Hospital enjoyed. Extending northward from the level of the west wing was a two-storey wing for private called the Jubilee Wing, from its having been erected in 1897, the year of Queen Victoria’s Diamond Jubilee. This wing housed private patients, and, as well, an operating room and an emergency room. Extending northward from the central Main Building was a three-storey brick wing, opened in 1905, and named the Queen Alexandra wing after King Edward VII’s Queen, Alexandra. This wing provided a suite of major operating rooms at the north end of the third floor, the remainder of the floor being used for rooms for private patients. On the second floor were semi-private rooms for medical patients, and on the ground floor were rooms for semi-private medical patients.

“The Main Building and the Q.A. wing, as it was called, were serviced by the Hospital’s only electric elevator,⁶ manually operated by the redoubtable Charlie Kemp. Charlie was a close associate of the interns, for he had had his whole breastbone surgically removed on account of tuberculosis by one of the leading surgeons, Doctor Sam Cummings, and was consequently of considerable clinical interest. Charlie would periodically appeal for a loan of “a quarter” to be repaid “next pay day”. After the passing of several pay days, I said to Charlie on his next appeal, “What about last pay day, Charlie”. He responded with an injured look, ignored my query, and struck me off his list of future potential creditors.

“The basement of the Q.A. wing housed the hospital kitchens, the nurses’ dining-room and the interns’ dining-room with Edith Batchelor in charge, as well as an emergency room and an admitting room. At the north end and completely separate was a room without refrigeration or equipment which was designated as an autopsy room. Autopsies were rather infrequent in those days. The Diet Kitchen, in charge of Miss Lillian Burke, for private patients, was in the basement of the Jubilee Wing, and interns on night duty used to enjoy a midnight meal there with private duty nurses, under the watchful eye of Miss Torrey, the night supervisor.

“The out-patient department was housed in a short two-storey wing on Victoria Avenue,⁷ sharing the ground floor with the hospital pharmacy. There was no hospital pharmacist then; dispensing was done by the interns on a two-month rotation basis. A large room on the second floor of this wing housed the City Laboratories, and here the City Pathologist, Dr. Bowman, held sway. His staff consisted of an intern, fresh every two months, a nurse-in-training, changed each month, and the half-time services of a technician who “doubled in brass” for the X-ray Department as well. Charlie Gray was the technician. In 1914 he enlisted for overseas service with a military hospital organized by Queen’s University, and after the war remained with Queen’s in the Department of Pathology, then in charge of my good friend, the late Professor James Miller.

“To the north of the outpatient wing was a driving shed where the doctors parked their horses and buggies while in the hospital, for there were probably not more than a half-dozen automobiles in the City at that time. At one end of the driving shed was the hospital ice house, where blocks of ice cut from the bay in the winter time were stored in sawdust for summer use. At the back of the grounds was the four year old Southam Home for Tuberculosis patients, named for its donor. Next to it was a brick building which housed the maternity department, and an adjoining building housed the engine room and the heating plant. At the front, facing Barton Street, was the relatively new Hendrie Nurses Residence, built in 1902 and enlarged in 1911, the gift of the Hendrie family and largely due to the enthusiastic efforts of Mrs. William Hendrie.”

…and the history of the hospital with some personal experience: ^iv

“The City Hospital had been owned and operated by the City of Hamilton for about 70 years. It had its origin in sheds built near the harbour in the 1840’s for the accommodation of cholera patients from immigrant ships, at a time when European immigrants were arriving in Upper Canada in considerable numbers. It was operated by a Board of Governors appointed by the City Council and consisting of a number of prominent citizens and some members of the Council. In 1913 the Chairman was Mr. T. H. Pratt, who owned and operated a departments store at the corner of King William and James Streets, just across from the old City hall. Mr. Pratt was a somewhat irascible gentleman who spent endless time and energy in the interests of the Hospital, and who, on occasion, would cross the street to meetings of the Board of Control to demand the things which he knew the Hospital needed. I, on occasion, incurred his anger. On one occasion I proposed to the hospital Board a salary scale for the laboratory staff, and he took umbrage at “the impudence of the young pup”. However, in later years and after his retirement, he was one of my very good friends. On the occasion of my marriage in 1923, he came up one day to the laboratory to convey his good wishes, and he said to me, “Doctor, in the course of your life here there will occasionally be difficulties and unpleasantnesses. But keep your troubles here in the hospital; don’t take them home to your wife”. It was good advice and I never did.”

…local hospital politics, … ^v

“Doctor Langrill ⁸ had been medical superintendent then for eight years. He had previously been Medical Officer of health. His successor in that office was the late Doctor James Roberts. There was a certain amount of rivalry between the two departments, since there was a certain overlapping of function. The Hospital operated the isolation wards. The City Laboratories served both, and the budget was a charge on the funds of both. I, as City Pathologist, occasionally found myself in an uncomfortable position when there was controversy, as there periodically was. However the City of Hamilton never had more faithful efficient service than was rendered by these two capable, dedicated officials. I counted both among my best friends, and their friendship and support contributed very materially to any success I may have had in the discharge of my duties as City Pathologist.”

…other doctors, … ^vi

“The hospital’s medical staff consisted of about 25 of the leading medical men of the City. There were then less than one hundred physicians in the City of some 90,000 population. Dr. Ingersoll Olmsted was then at the peak of his career, and he was rated as one of Canada’s best surgeons. His associate was Doctor Sam Cummings, who later moved to Toronto, and his young assistants on the surgical service at that time were Doctor J. K. McGregor, fresh from postgraduate work at the Mayo Clinic, and Dr. John R. Parry, fresh from postgraduate work in Europe. The work of these men placed Hamilton and its City Hospital in the front rank as a Canadian surgical centre. The medical service was headed by Doctor J. A. Bauer and Doctor F. E. McLochlin, the latter taking considerable interest in the young X-ray Department. Dr. Griffen and a young associate, Dr. Douglas McIlwraith, were in charge of Obstetrics. Dr. John P. Morton was the only Eye, Ear, Nose and Throat specialist at that time, although his successor, Doctor P. B. Macfarlane, settled in Hamilton in 1931. paediatrics as a specialty was then in its infancy, and the only representatives were Dr. Charles Carter and Dr. Herbert Jones, the latter of whom died on active service in France. On his return from war service in 1919, Doctor Crossan Clark entered the paediatric field. These physicians, and most of the others in the City then, made their rounds by horse and buggy, for the automobile was still a novelty.

“The Hamilton Medical Society in 1913 had a membership of less than one hundred. It was then 12 years old. Among its members were many physicians whose careers shed lustre on Hamilton and Canadian Medicine. Among there were Dr. James Leslie, whose son, Norman, followed in his father’s footsteps and became a leading Hamilton physician; Dr. James White, whose son, Thomas, in now a leading Hamilton physician; Dr. Malloch, student of Lister, whose son, Archibald, was for many years Librarian of the new York Academy of Medicine and an authority on the History of Medicine; Doctor Mullin, whose son, Heurner, was Hamilton’s Chief Coroner for many years, and Dr. Douglas Storms, whose son, Harold, attained high standing in the field of physical medicine in Costa Rica. Also, there were Dr. Cockleburn, an outstanding surgeon, Dr. Bough, Dr. Philip, Dr. McCabe, Dr. R. Y. Parry and others whose names live in the annals of Hamilton Medicine. Dr. Howard Holbrook was the young medical superintendent of the Mountain Sanatorium which had opened a few years earlier with Doctor Alex Unsworth as superintendent. Doctor James Edgar, who had been Superintendent of the City Hospital for nine years after Doctor Olmsted’s retirement, and who had taken post graduate studies at the then new Johns Hopkins Medical School was a leading West End physician. He was an excellent surgeon and a well-trained internist, and his ability and personality soon gained for him the leading society practice in Hamilton’s West End.

“The suburban centres, too, had their outstanding personalities. Stoney Creek had its Dr. Green, whose son, Lloyd, became director of the Hamilton Clinic of the Ontario Cancer Treatment and Research Foundation. Ancaster had its Doctor (George) Devey Farmer, who organized and took overseas in World War I, No. 5 Field Ambulance, Canadian Expeditionary force, and whose son, Richard, took overseas in World War II, the Fifth Field Ambulance, Canadian Army Service Force, the direct descendent of the World War I No. 5. Field Ambulance.⁹ Dundas had its Doctor Arthur Rykart, who had a distinguished career in World War I, and whose son is now a prominent Toronto internist. Waterdown had it Doctor McGregor, father of Dr. J. K., who played so prominent a part in Hamilton Medicine, and Burlington had its well-loved Medical Officer of Health, Doctor A. H. Steers.

…and the Hamilton Medical Society, later the Hamilton Academy of Medicine:^vii

“The Medical Society then held its meetings in the old Royal Hotel at the northwest corner of Merrick and James Streets. The Royal was Hamilton’s leading hostelry and social centre. The Medical Society’s meetings culminated with the serving of beer and sandwiches, a custom which was interrupted in 1916 by the advent of the Ontario Temperance Act.¹⁰ When I returned in 1919, the meetings were being held in the new Royal Connaught Hotel on King Street East, but without the beer and sandwiches. The interns, however, enjoyed it while it lasted, as they did the “Bock” beer when it was on draught in the spring at Hanrahan’s Hotel on Barton Street.”

He then describes events in the city and in the hospital in 1913:^viii

“The summer of 1913 had two outstanding features. The centennial of the founding of the City on farm land owned by the Hamilton family in 1813¹¹ was marked by a week of revelry in August. In September one of the periodic investigations into the administration of the City hospital was staged, and this, for the interns, carried a good deal of interest. For some time the administration of the Hospital, in spite of the efforts of the Chairman, the Board of Governors and the Superintendent, had been under criticism, the common lot of publicly-operated institutions. Hamilton’s leading newspaper, the Spectator, had taken up the hue and cry, demanding an investigation, and finally one was ordered, with Judge Snider in charge. It was held in September of that year in the old City Hall. Sessions were held in the evening from 8 to 10 p.m., and continued for some three weeks. Interns not on duty were fairly regular attendants, and it was, for them, an evening’s entertainment to sit in on the hearings and listen to the evidence of nurses and supervisors with whom they were daily associated on the wards as they outlined their version of the events and happenings under study. It was a most trying time for the Chairman and the Superintendent. In the end, however, the Judge’s report showed that there was nothing wrong with the administration of the Hospital that could not be corrected by more generous appropriations on the part of City Council. It recommended certain improvements in the buildings, physical equipment and staffing of the Hospital. This report initiated a programme of expansion which raised the Hospital to the front rank of non-teaching hospitals in Canada.

“The superintendent of nurses was Miss Kate Madden^ix. She was a capable administrator, of likeable personality, albeit a firm disciplinarian. The nurses in training, to the number then about fifty, used to refer to her a “Maw”, and to Doctor Langrill as “Paw”, an indication of the respect in which each was held. The night supervisor was Miss Torrey, one of the early graduates of the Training School. Many life-long friendships were formed with the graduates of the School and of other schools who were on private duty at the Hospital. The nurses’ tour of duty was a 12 hour one, and the remuneration not more than Five Dollars per day. How times have changed!

“The Health Department was housed in two rooms in the southwest corner of the ground floor of the old City hall. Dr. Roberts was health Officer and he had a small staff, consisting of Doctor Shain, a veterinarian, Aubrey Shain, his son, Mr. Gomph, the Sanitary Inspector, and a few others. The public health nurse had not yet come on the scene. The responsibilities of the Health Officer and his Department were heavy in those days, for infectious diseases like diphtheria, scarlet fever and typhoid could not, as yet, controlled by immunization measures. Diphtheria and scarlet fever were rampant, and the summer of 1913 saw the medial wards filled with typhoid cases from an epidemic in the Crown Point area. Two thirds of the work passing through the laboratories was for the Health Department in the form of the bacteriology of infectious diseases, the routine examination of milk supplies, as yet not pasteurized, and the daily routine examination of the City water supply from the laboratory tap. Chlorination had not been introduced.

….and the City of Hamilton in 1913:^x

“The City itself was already a busy industrial centre, justifying the motto on its crest, “Commerce, Prudence, Industry”. Its population was about 90,000. Sherman Avenue was the eastern boundary, and a wooden trestle bridge was under construction to link the western limit with what later became Westdale. The area of Westdale was called the McKittrick survey, and the bridge, the McKittrick Bridge. The bay was the northern limit and the mountain the southern limit. Only a few hundred people lived on the mountain, but they were served by two incline railways, one at James Street and one at Wentworth Street.¹² Roads up and down the mountain face were rather primitive. The old City Hall was then about 30 years old and was a good example of the architecture of the period. The only sky scraper was the Bank of Hamilton on the corner of King and James streets. It housed the offices of Overholt and Kappele, Dentists, and I frequently visited them in company with my close friend and fellow intern, Frank Overholt, son of the dentist. The old Court House on Main Street was another of the City’s architectural adornments, and it too, like its fellow, the City Hall, has given place to a more modern structure.

“The old Toronto, Hamilton and Buffalo railway station was then on the level at James and Hunter Streets, but the Hunter Street tunnel had been put through a few years before.¹³ Hamilton was then the hub of an electric radial railway system, with lines running to Beamsville, to Oakville, to Dundas, and to Brantford, and with a central station and office building on the south side of King Street East, adjoining the Waldorf hotel. Directly behind the Radial Station building and extending to Main Street was the Temple Theatre, a vaudeville theatre in the same circuit as Shea’s in Toronto, and like Shea’s, a favourite Saturday afternoon haunt of off-duty interns. It was termed “Bennet’s Theatre” by the natives. The old Grand Opera house at James and Gore Streets, now being demolished, had been and was then the dramatic centre of the Hamilton area in Ontario, and its boards had been trodden by many of the world’s theatre greats of the period. The Savoy Theatre on Merrick Street was a going concern. Moving pictures, like automobiles, were in their infancy, and the Red Mill on James Street North was the leading “nickel show” as they were termed, from the price of admission. They were the progenitors of the Loews and Pantages moving-picture theatres which emerged during the War on King Street East, and which are still doing duty as the Capitol and the Palace. In summer, at the head of the Wentworth Street Incline Railway, was Summer’s¹⁴ stock open air theatre which provided relief and entertainment during the long and hot summer evenings of downtown Hamilton.

“Burlington Beach in those days was Hamilton’s summer resort. Many of the leading families of the City had summer residences there, such as Elsinore, the Sanford family summer home. Transportation was provided by the Oakville branch of the radial system, and by a commuter branch of the Grand Trunk Railway which ended at the ship canal. The Royal Hamilton Yacht Club had its club-house at the Canal, and one of the pleasant memories of my first month as an intern was being taken there for Sunday dinner by Dr. Heurner Mullin. The Clubhouse was burned during the War and was not rebuilt on the old site, but was later located on the south shore of the bay at the foot of James Street, where it now is.

“The Hamilton Golf and Country Club had not yet moved to Ancaster, but occupied the site presently used by the Chedoke Civic Golf Club. Entrance to the City from the east was still up and down hill past the Valley Inn.¹⁵ The bridges were not completed until the nineteen twenties, and the cement Toronto Hamilton highway had not yet been planned. The leading dancing academy was Hackett’s on Barton Street, across from Hanrahan’s Hotel, but formal affairs were usually held at the larger I.O.O.F Hall on Gore Street.

“The centennial of the City’s founding was an event which stands out in the memory of the 1913 interns. It was signalized by a whole week of celebration in August of that year, during which a carnival atmosphere enveloped the City. Hundreds of old Hamiltonians returned; there were receptions and dinners by the City Council; there were military parades, athletic events, aquatic sports on the bay, fireworks at night, and , generally speaking, a week of frantic gaiety. I remember my chief, Dr. Bowman, coming down to the laboratory on the day of a military parade, “booted and spurred”. He was Medical Officer with the 77th Regiment, of Dundas, and in those days all officers were expected to be equestrians. Never having had any military connections up to that time myself, I was secretly envious. On another day in the eastern part of the City, a brick house was “built in a day”, and was auctioned off in the evening. It was a thrilling week for all, and particularly for the six new interns at the hospital. The century old City of Hamilton relived many of its earlier days.”

He then returns to his own work in the hospital and his interest in laboratory medicine:^xi

“My work in the laboratory intrigued me from the beginning. What had been in college simply another subject with an examination at the end of the course came alive when it was possible to relate the laboratory findings to a sick patient in the hospital. When one could examine a smear of a throat culture with a microscope and see the diphtheria bacillus, and then go on the ward and see the sick individual; when one could learn the history of the patient whose inflamed appendix had arrived in the laboratory, or that of the patient whose blood culture revealed the presence of the typhoid bacillus, one could realize the real significance and the value of the laboratory in diagnosis and treatment. I found the microscopic study of cancer or of tuberculosis fascinating. The Wassermann test for syphilis which was new at the time was, to me, a marvellous procedure. Doctor Bowman was assiduous in instructing me and, at the end of the first two months, he asked me if I would like to take another two months on the laboratory service. My friend and classmate, Doctor Frank McLay, was willing to exchange with me, and so it was agreed that I should remain on the laboratory service for another two months. At the end of October, Doctor Bowman accepted an appointment with a medical clinic in Buffalo, and resigned from his position as Hamilton’s City Pathologist.

“Having had three City Pathologists in three years, Doctor Langrill came to me in distress. He said to me, “you seem to have learned a good deal about laboratory work, will you carry on until I can secure another pathologist? We will give you $50.00 per month.” Being, by then, intensely interested in the work, willing to help out the superintendent, and not unwilling to have a stipend of $50.00 per month in place of interns’ pay at nothing a month, I agreed, and assumed the role of “stand-in” for a future City Pathologist yet to be appointed. I carried on the work until the spring of 1914.

“In April Doctor Langrill came to me and said that he was corresponding with a young pathologist and was thinking of appointing him. He told me that the applicant had graduated from another Canadian University in 1913, and that he had been spending the year in post graduate work in pathology in New York City. I discussed the matter with the Superintendent, telling him that as I had assumed that he would be getting an experienced pathologist I had not applied, but that if he was thinking of appointing a relative amateur, I would like to apply. He said to me that he didn’t think there was much future in this line of work and that practice would be much better, but that if I really wanted to continue in this field, he would prefer to recommend me for the appointment.¹⁶ I must, however, agree to stay for a reasonable length of time, for he was sick and tired of annual changes. He asked me to give the matter serious consideration for two weeks before deciding. Before the two weeks were up I had made up my mind, and I informed him that I would like the appointment, which had to be approved by both the Board of health and the Hospital Board….”

Hamilton’s City Pathologist:^xii

“…I was appointed City Pathologist in April 1914, on the understanding that I would take six months post graduate work in pathology as soon as it could be arranged, and that I should agree to remain in the position for a reasonable time thereafter and not vacate it in a matter of months as had my predecessors. Doctor Fred Bowman who had recently come from Johns Hopkins Medical School in Baltimore wrote to the professor of Pathology there on my behalf, and I was accorded a six months’ appointment there from July 1, 1914. The “reasonable Period” of tenure of the appointment to City Pathologist ran to forty-two years.

“With my $50.00 per month as acting City Pathologist, I invested in a dress suit with accessories, which I purchased in the Semi-Ready Men’s Shop on James Street North, between Gore and King William Streets. I was then prepared for any social occasion, and one turned up in the spring in the form of a ball sponsored by the Medical Society, and held at the I.O.O.F. Hall on Gore Street. I asked by friend, Miss Mae Belle Sampson, now graduated and engaged in private duty nursing in the City, but she regretted very much that she would be out of town all week. Miss Mackintosh, who had in December been by assistant in the laboratory, had now graduated, so I asked her and she accepted. In the most approved fashion I sent her a corsage the day of the ball, engaged a carriage and pair from Temple’s Livery, which was a block away from the dance hall, called for by lady, drove her to the I.O.O.F. Hall and returned the carriage to the livery, to be taken out again when the ball was over.

As I prepared to check my coat, it came to me that I had left by dancing pumps in the carriage at the livery stable, with an apology to my lady, I trudged back to the livery and secured them, returning to the hall in time for the opening waltz. I saw a number of nurse and doctor friends there, and, somewhat to my astonishment and chagrin, I saw my friend, Miss Sampson, dancing with my friend, Doctor Don Warren, who had come in from Dunnville, where he was in practice, for the occasion. A dignified silence directed toward them was preserved for several dances, but, at intermission, the somewhat frigid atmosphere thawed to some extent, and the explanation emerged, it appeared that my friend, Mae Belle, had indeed been out of town for most of the week, but had returned a day early, and Don Warren, who had known her longer than I, had telephoned her and persuaded her to accept his invitation. We then laughed at the whole matter for the four of us were good friends, and Don and I have many times since recalled the incident.”

Johns Hopkins Hospital:

He then talks of the Johns Hopkins Hospital and Baltimore:

“On July 1, 1914, I arrived in Baltimore and reported to the Assistant Professor of Pathology, Dr. Milton Winternitz, afterwards Dean of Medicine at Yale University. Baltimore in 1914, with a population of about 300,000, was about the size of the Toronto of that time. Its chief claim to medical fame was the then 25 year old Johns Hopkins Medical School and Hospital, which already overshadowed the older Medical School of the University of Maryland. The thrill, to me, of entering the front door of the Broadway entrance to the Johns Hopkins Hospital was comparable to that of walking through the Norman doorway of University College in Toronto when I registered as a freshman. The memories of my four months at Hopkins are still green and my recollections of my stay in Maryland, just over the Mason and Dixon Line, are still vivid and pleasurable. The street names of Baltimore, and the place names of the whole State of Maryland bear silent but powerful witness to the love of the pioneers for the Motherland from which they had departed. The summer in Baltimore was hotter and more humid than that of Hamilton and a sail in the evening down Chesapeake Bay past Fort Sumter was most refreshing. My living quarters were about six blocks from the hospital. The walk home in the afternoon took me past several beer parlours, where the large 15 ounce glasses of American beer looked very inviting indeed. On Saturday afternoons I occasionally took in a baseball game at the park of the Baltimore Club of the short-lived Federal League.

“I enjoyed my work in the Department of Pathology at Johns Hopkins, where I worked under the direction of the assistant Professor, Doctor Milton Winternitz. The senior resident that year was Doctor Ernest Goodpasture, afterwards Professor of Pathology at Tulane University, New Orleans, who had a distinguished career in virus research. My immediate associate was Doctor Ben Kline, afterwards pathologist at Mt. Sinai Hospital in Cleveland and the originator of the well-known Kline-Khan precipitation test for syphilis. Before I left Hopkins at the end of October, Professor W. H. Welch,¹⁷ head of the Department of Pathology, and the last of Hopkins’ original “Four Horsemen”, returned from a summer abroad. The other three, Halsted, Kelly and Osler had retired from the scene. I had the privilege of attending a clinical pathological conference at which Osler’s successor, Professor Janeway, and “Popsy” Welch were the principal contributors.

“When I had been at Johns Hopkins for about two months, Professor Winternitz came to me one day and said that he had an opening for a demonstrator in pathology for the coming year, which he hoped I would take. The stipend was $50 per month plus full maintenance. The offer was an attractive one, for it would have introduced me to the topmost circles in Pathology in America. I explained to him, however, that I was on leave of absence from my hospital in Hamilton and felt morally obligated to return. He told me that my progress in a city without a medical school would be slow and unsatisfactory, whereas at Hopkins progress in the specialty could be rapid indeed. He gave me two weeks to think about it and decide. I had, however, already decided to honour my word to Dr. Langrill that I would stay with him for a reasonable time, and informed the professor that I was indeed sorry not to be in a position to accept the position. He was somewhat aloof for a week or two, but I think in the end respected by for my decision.

This must have been a difficult decision. But Bill was always a man of his word and a loyal friend, often sacrificing what would be seen as his best interests to honour a commitment he had made. But ultimately, the decision was taken out of his hands. In August, 1914, war was declared in Europe. Bill decided he would carry on with his training because everybody was saying that the war would be over in 6 months. Baltimore had a large German population and much of the discussion of the war had a strong pro-German slant. With his British background, WJD found this offensive. He decided in October to return to Canada and enlist. His narrative continues:

“War was declared on August 4th. It was disturbing to me, for my father had brought me up to have pride in our British traditions. I used to go down Baltimore Street to look at the news bulletins of the Baltimore Sun, and these, during my remaining three months, were continuously discouraging. The Baltimore population then was about one-third German in origin, and the comments which one heard from these citizens were somewhat hard to bear. Then, too, one of my fellow boarders at the house on Jackson Place was Max Broedel, at that time the leading American medical illustrator, whose work was appearing in many American Medical textbooks of that era. Max was a thorough-going German sympathizer, and our dinner-time arguments were sometimes hot and acrimonious. Had he not left to do some work in New York City, I would have had to change my living quarters. His place, however, was taken by a young Dr. Flexner, a nephew of the famous Dr. Simon Flexner, at that time Medical Director of the new Rockefeller Institute, whose views were pro-British, and so the boarding-house atmosphere was improved. I finally, however, wrote up to Hamilton to my friend, Captain D. A. McClenahan, who was an officer in the Canadian Army Medical Corps, asking him to let me know when the next Officers’ Training Class would be recruited. I was informed that none were in prospect, for there were more medical officers than could be utilized. Since we all believed in 1914 that the war would be won in about six months to a year, I decided that if I were to make any contribution to it, I had better get back to Canada, and so I terminated my stay at Johns Hopkins at the end of October, and returned to Hamilton.”

William was a harbinger of the future of medical practice in Canada: he eschewed general practice (for a variety of reasons) and entered the new world of laboratory medicine. The chance fashion in which this comes about tells us much about the degree of a kind of informality, or should we say, a lesser degree of bureaucratization than exists in medical education today. Added to this is the fact that the formal training in pathology is not a long programme by modern standards. One could study for 6 months or 18 months and would still be considered qualified in pathology.

The newness of his field – and perhaps its relative importance at that time in medical thinking – was not high, allowing a very junior man to assume a position of responsibility early in his career – in fact at its very start. The fact was that most graduating physicians were eager to get out into practice and felt that they had already learned all they needed to know. Since the Laboratory at HGH had been formed, there had been 4 directors in 4 years and one had left the position under a cloud. Dr. Fred Bowman, who had introduced WJD to the work in the HGH lab was eager to complete his tenure and get out into practice. As a result, public health, laboratory and pathology/bacteriology positions were hard to fill and those interested had many opportunities open to them.

The Great War was to provide another important chapter in the life of a budding pathologist. Even though he had abruptly ended his training at Johns Hopkins, his war service added equally valuable experience under much more adverse conditions. This is the story of the next chapter.

1 Internships and residency training was only required for specialty training in those years. Most graduating doctors went into general practice and then, when they found themselves interested in specialty practice, went back to take the required training. There were two main specialties in 1913, Medicine and Surgery. Other specialties were recognized in Europe and increasingly in the better schools in the United States but formal specialty recognition in Pathology did not come in Canada until the late 1930s.

By the time that a junior internship was made mandatory before embarking on general practice in 1957, most graduating physicians were doing internships anyway, so it was simply a recognition of established practice. It took effect in time for the graduating classes of 1958.

2 Claude McClenahan was Superintendent of the Ontario Hospital, Penetanguishine including the Hospital for the Criminally Insane (later the Oak Ridge Division), from 1940 to ’46.

3 Claude McClenahan was Superintendent of the Ontario Hospital, Penetanguishine including the Hospital for the Criminally Insane (later the Oak Ridge Division), from 1940 to ’46.

4 Dr. Francis James McLay also was overseas in WWI with WJD and at the end of the war married a Belgian woman, Jeannine Tchiderere and brought her back to Grimsby when he returned in 1919. WJD remained very close to his friends and when ‘Jimmy’ died by suicide in the 1930s, WJD continued to support Jeanine until his death in 1965. After the death of her husband, she moved to Toronto and then to Montreal where she was a French tutor for English students until her death in the early 1970s.

5 This wing was the location of the ‘Lab’ throughout WJDs entire tenure at HGH. By the 1950s when he retired, the Lab. occupied the entire second floor and most of the basement where the autopsy rooms were located. The building was not demolished until the mid-1980s when the entire hospital was rebuilt. It was on the site of the present multi-level parking garage.

6 When the hospital was first built, the three floors were connected by long ramps which would accommodate movement of patients on stretchers or wheel chairs. The lead author recalled that these wings were half a floor level different from the main building so that the ramps did not have to be as long.

7 This is the Victoria Avenue Wing referred to earlier.

8 Dr. Walter Langrill became a very close friend of WJD throughout this period.

9 The Fifth Field Ambulance has survived in the modern Canadian Army as the 23^rd Medical Company. In honour of its illustrious past, it was recently renamed the 23^rd Field Ambulance and has on its Senate the late Dr. Richard Farmer, a resident of Ancaster and the son of the World War II Commanding Officer and the grandson of its World War I C.O. Dr. G. D. Farmer.

10 Prohibition. WJD referred to this in other writings. Among other things it was the rise of the bootleggers and organized crime in Hamilton. There are a few references to Rocco Perri. Also, alcohol was still available for medical purposes on doctors’ prescription. WJD refers to weekends in Muskoka with doctor friends in which it was asked who had ordered the ‘oleo resini’ or medicinal brandy. Frequently patients would pay to have their doctor write a prescription for medicinal alcohol. Many doctors were criticised, even censured for too liberal ordering of medicinal alcohol.

11 Hamilton was first founded as a town in 1813. It was incorporated as a City in 1846.

12 These were similar to the funicular railways in many parts of Europe.

Author’s note: I remember them as a young child. My father always was going to give me a ride on them. Then in the depths of the Great Depression they were closed and later dismantled so I never got my ride.

13 The level crossing on James Street South was a problem for traffic as often there were trains across the street. In the 1930s, an overpass was constructed and a new station in the Art Deco style was built to replace the old one. It now houses the GO transit trains that come regularly to Hamilton.

14 The text spells this as “Summer’s” but clearly it was referring to the Somers family who operated the theatre for many years. Their name lives on in ‘Somers Lane’ at Hamilton Place.

15 An historic plaque marks the site.

16 This indicates the attitude towards branches of medicine which were more academic and less involved with direct care of patients. There was little interest in the medical profession in these pursuits and this is still true today. The lower levels of pay could be both a cause of this disinterest but it is also a consequence.

17 William Welch retired in 1916. He was the last of the “Four Horsemen…”

i Hamilton Memories. This was written earlier than Hamilton of the Teens and Twenties but contains much of the same material. Pp. 6-7.

iiMemories of the Hamilton of the Teens and Twenties – Part I – 1910-1919. This was one of the latest version of his autobiography, probably written in the late 1950s or early 1960s. There are several versions, some of them incomplete. This version was the most nearly complete and some gaps were filled in by reference to other versions. Obvious grammatical and context errors have been corrected; the editorial ‘we’ has been converted to ‘I’ wherever it occurs but otherwise the text is as written.

iii Memories of the Hamilton of the Teens and Twenties – Part I – 1910-1919. Ibid.

iv Memories of the Hamilton of the Teens and Twenties. Ibid.

v Ibid.

vi Ibid.

vii Ibid.

viii Ibifad.

ix There is a photograph showing Miss Madden.

x Ibid.

xi Ibid.

xii Ibid.