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Stanford Medical School during World War I

American involvement in World War I (April 6, 1917 - November 11, 1918) began only eight months after Hewlett's arrival at Stanford. As soon as the United States entered the war, the University placed the medical staff and clinical and hospital facilities in San Francisco at the disposal of the army and naval authorities for such use as may be required.

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U. S. Navy Training Schools

During the summer of 1917 there was maintained at the Medical School in San Francisco under the direction of the medical staff a training school for medical officers of the United States Navy, the course covering six weeks beginning July 25th. A second course was scheduled to begin on September 10th.

The Medical School also conducted a training school under the direction of Dr. Stanley Stillman for the instruction of fifty naval hospital apprentices, the work consisting of lectures, recitation and laboratory work in anatomy and physiology, first aid, and minor surgery, materia medica, pharmacy and toxicology, elementary hygiene, and sanitation and bacteriology, with experience in practical nursing in the medical and surgical wards of Lane Hospital. [12] [13]

During the academic year ending 31 July 1917 a course in emergency medicine and surgery was arranged for senior medical students, during the second semester, under the direction of the Chief Surgeon of the Emergency Hospital Service, the students spending about four hours a day for a month working in the various emergency hospitals of the city. Four of the graduates of the class of 1917 enrolled as assistant surgeons in the Navy. [14]

By the closing of the academic year ending 31 August 1918, a majority of the medical students had become members of the Medical Enlisted Reserve Corps, and were assigned by the War Department to the inactive list in order for them to continue their medical studies. [15]

In 1917 Red Cross Naval Base Hospital Unit No. 2 was organized in connection with the Medical School and included the following seven members of the faculty; Drs. G. D. Barnett, P. K. Gilman, A. W. Hewlett, T. G. Inman, Stanley Stillman, R. B. Tupper, and F. Wolfsohn; and about forty nurses. The Hospital was mobilized on 5 December 1917 and in February 1918 was safely transported across the U-boat infested North Atlantic to Strathpeffer in Scotland. [16]

Hewlett was a Lieutenant Commander during this period and came to know the University of Edinburgh well. There he learned of the legendary medical reasoning powers of Dr. Joseph Bell of that institution. It was Dr. Bell who gave rise in the mind of Sir Arthur Conan Doyle (physician and novelist) to that incomparable detective of fiction, Sherlock Holmes. This undoubtedly interested Hewlett greatly for he, himself, possessed extraordinary reasoning power. and applied it effectively in his medical teaching at Stanford. [17] [18]

Hewlett continued to serve with Naval Base Hospital No. 2 after it moved to France. There, in the summer of 1918, an influenza epidemic occurred of which he and W. M. Alberty wrote an excellent description. [19] [20]

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Additional Faculty that Joined the Armed Forces

In addition to those who went with the Base Hospital No. 2, the following seventeen members of the staff of the Medical School also left for active service: Drs. Thomas Addis, Shadworth O. Beasley, Emmet J. Brady, Joseph K. Brown, Edmund Butler, William. R. P. Clark, Ernest C. Dickson, Harold K. Faber, Frank R. Girard, Harry L. Langnecker, Charles N. Leach, Harold S. Moore, Harry K. Oliver, Alfred C. Reed, Jay M. Read, George Rothganger, and Henry A. Stephenson.

The ranks of the teaching staff were at this point so depleted that any further losses through entrance of members into active service would have led to the disorganization of medical teaching and it was only the fortunate early end of the war that enabled the Medical School to return soon to full operation. [21] [22]

The only member of the Medical Faculty to be killed during the war was Shadworth O. Beasley, M. D., '97, Assistant Clinical Professor of Obstetrics and Gynecology, who was among the first to be called into service when the United States entered the war in April of 1917. He died on October 14, 1918, while, as a major in the Medical Corps of the U. S. Army, he was rescuing the wounded under heavy fire on the Western Front. The Faculty memorialized his heroism and supreme sacrifice by mounting a bronze plaque, suitably inscribed, in the entrance to the Lane Library. [23]

photo of Dr. Shadsworth Beasley and others in a captured German dugout

Following the war, Hewlett continued his studies on the cardiovascular and respiratory systems, completing an extensive and noteworthy series of experiments and observations. These are discussed in detail by Professor McGehee Harvey and are beyond the scope of this commentary. [24]

During the summer of 1925 Dr. Hewlett was granted a leave of absence from April 29th to May 11th in order attend medical meetings in Washington, D. C. This leave being presumptive evidence of Dr. Hewlett's good health, it was a profound shock to the faculty to learn on 8 October 1925 that the Board of Trustees, because of Hewlett's rapidly failing health, had appointed a Committee to manage the Department of Medicine. [25] [26]

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The Illness of Dr. Hewlett [27]

As soon as it was recognized that Dr. Hewlett was suffering from a serious disease of the brain, it was decided to take him to some expert in brain surgery in order to give him the best possible chance for recovery. Dr. Harvey Cushing, Harvard's Mosely Professor of Surgery at the Peter Bent Brigham Hospital in Boston, and founder of neurosurgery in America, was first approached. Since Dr. Cushing was leaving for Europe, Dr. Charles H. Frazier of the University of Pennsylvania Hospital in Philadelphia was asked to take charge of his case which he gladly consented to do. Dr. Hewlett's colleague and friend, Dr. Henry George Mehrtens, Associate Professor of Medicine (Neurology) on the Stanford faculty, accompanied him on the long trip east to Philadelphia. The transcontinental journey by train was thus accomplished relatively easily.

Upon arrival in Philadelphia, Dr. Hewlett was promptly admitted to the University of Pennsylvania Hospital where Drs. Frazier and Weisenburg immediately took up the study of the case with the greatest interest They and their staffs vied with each other in attempting to establish the diagnosis and to give the patient what comfort they could.

Shortly after his hospitalization, rapid rise in Dr. Hewlett's intracranial pressure made it necessary to perform an operation to decompress the brain. At the same time a limited exploration was carried out that revealed no sign of either tumor or abscess. In spite of these efforts and the indefinite findings, Dr. Hewlett's condition steadily worsened and he died on 10 November 1925.

At the post mortem examination multiple subcortical gliomata, all of a very malignant type, were found in the brain. During the terminal stage of his illness, Dr. Hewlett was more or less unconscious and did not realize the gravity of his condition..

At the time of Dr. Hewlett's death a revision of his textbook on Pathological Physiology of Internal Diseases was in preparation. As an expression of their affection and respect, Hewlett's Stanford colleagues assumed the responsibility of finishing the final (1928) revision. Among those participating in the project were Drs. Thomas Addis, George DeForest Barnett, Walter Whitney Boardman, Ernest Charles Dickson, Henry George Mehrtens, William Ophüls, Jay Marion Read, Howard Frank West, and Harry Alphonso Wyckoff. The editorial supervision was under the direction of George DeForest Barnett and an appreciation was written by Ray Lyman Wilbur. [28]

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Memorials to Dr. Hewlett

In the annals of Stanford and its predecessor medical schools, no member of the faculty has been in his own day at once more highly respected by his colleagues and students as an investigator and teacher, and more warmly remembered as an exemplary physician and man.

Eulogy by Dean Ophüls

The following eulogy by Dean Ophüls is recorded in the Minutes of the Medical Faculty for 14 December 1925: [29]

Dr Hewlett was a great scholar in his chosen field and a successful and indefatigable investigator. He was thoroughly versed in both physiology and pathology and was the author of a most admirable book on Pathological Physiology of Internal Diseases. He was great as a clinician and an inspiring teacher to his students. With all this he combined a marvelous capacity for administration. He managed the affairs of the medical department very skillfully and successfully being ready at all times to do anything in his power to further the work of the younger men in his department. He held a very important position as a member of the Clinical Committee of our hospitals and of the training school of nurses. His associates in the Committee could always rely on his good judgment and on his willingness to devote time and energy to any serious questions that might arise. He was secretary of the medical faculty, and in this capacity facilitated the work of the Dean's Office to a great extent. He was particularly interested in the medical curriculum and was a leading spirit in repeated revisions of the same, each of which brought new progress. At the time of his death, he was contemplating a reorganization in the teaching of internal medicine by which it would be possible to have the third-year students in the wards of the hospital and the fourth-year students in the out-patient department.

Dr. Hewlett also had created for himself a most enviable position in the medical profession of San Francisco and California. He was much sought after as a medical consultant and he was always ready and willing to give his advice freely and liberally, but at the same time he managed in some way to prevent that this work should interfere to any considerable extent with what he regarded as his higher duties, namely, the investigation of problems in his chosen specialty and the instruction of medical students.

With all these multifarious duties, Dr. Hewlett never seemed rushed and in his systematic manner accomplished a tremendous amount of work apparently very easily. In spite of the eminence which he had attained, he was the most modest person. He was dearly beloved by all those who came in close personal contact with him

In Dr. Hewlett's death, the Medical School has suffered a great loss and it seems improbable that we shall ever find again a man who is so thoroughly well qualified to serve as the head of the most important department in our Medical School.

Resolution by the American Society for Clinical Investigation

In 1925 Dr. Hewlett was president of the American Society for Clinical Investigation of which he had become a charter member in 1908. The following are excerpts from the formal resolution in memory of Dr. Hewlett adopted by the Society at its eighteenth annual meeting in New Jersey in 1926, a year after his death: [30]

During the past year we have lost by death one of the small group of men to whom the foundation of this society was due and one who later became its president, Dr. Albion Walter Hewlett.

Dr. Hewlett possessed not only unusual intellectual equipment and ability as an investigator, as teacher and physician, he was possessed of a most attractive personality. Quiet and thoughtful and giving the impression of much reserve power and force, yet he was a most interesting and agreeable companion. All the members of the early group comprising this society were his personal friends. He was always interested in the younger members of this society and many of them became greatly influenced in their later careers by his writings and by his personal influence.

The profession of medicine has lost in Dr. Hewlett one of its ablest and most valuable colleagues, this society has lost one of its wisest and most capable members.

But we have lost much more, we have all lost a sincere and true friend.

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The Hewlett Club

After Hewlett's death a "Hewlett Club" was organized by former students to honor and perpetuate his memory.

One of Dr. Hewlett's students, Dr. Gunther Nagel (Stanford M. D. 1921), reported that chapters of the Hewlett Club continued active for a number of years in San Francisco, Oakland, and Los Angeles. The last meeting of which we have a good account was in Pasadena, California, on an evening in 1965 when, according to Dean Robert Glaser, he met with a group of local alumni members of the Club for a congenial and mutually informative discussion of Medical School affairs.

We were recently informed by alumnus Dr. Robert I Boyd (A. B. 1938, M. D. 1942) that he was himself President of the Hewlett Club in Southern California when its last meeting was held at Pasadena in April 1980. Prior to that meeting the attendance at periodic sessions of the Club had been decreasing so that no further meetings were called thereafter. [31] [32]

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The Hewlett Room

On May 31, 1968 a gift of $25,000 was made to the Department of Medicine by the W. R. Hewlett Foundation to establish an endowment fund "the income from this grant to be used for the continuing support of the Hewlett Room." [33]

In 1979 the Medical Department dedicated their spacious and intensively-used Conference Room and Library, located in the heart of the Department, to the memory of Dr. Hewlett. On the door to the room is mounted a bronze plaque bearing the inscription:

The Hewlett Room. Gift of Louise R. Hewlett in memory of her husband Albion Walter Hewlett, M. D. Professor and Executive Head. Department of Medicine. 1916-1925.

Through their use of the room, generations of medical students and faculty continue to be reminded of the distinguished life and legacy of Professor Hewlett, Pioneer Clinical Physiologist.

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The Hewlett Award

In 1983, the Stanford Department of Medicine established and funded the Albion Walter Hewlett Award to recognize and honor living physicians who had some Stanford background and were well-known at Stanford as dynamic role-models for future academicians and practitioners of scientific medicine, as was the case with Dr. Hewlett.

Most importantly those nominated for the award should symbolize the physician of care and skill who, in the tradition of Dr. Albion Walter Hewlett, is committed to using wisdom, compassion and biological knowledge to return patients to productive lives.

Recipients of the award are chosen by an award committee charged to recommend an award not more than once a year.

The award, which includes no financial component, is presented in concert with a major event in the Department of Medicine such as a special session of Medical Grand Rounds, attended also by the Hewlett family, at which the recipient of the award delivers a lecture. To commemorate the occasion, the awardee receives a parchment seal and silver medallion depicting figures from the distinguished metal sculpture created by Artist Agnese Udinotti symbolizing the physician in the service of mankind. The recipient will also have the opportunity to select books or journals for the Hewlett Room Library in an amount to be determined each year. Each book will bear a bookplate with a picture of the sculpture, the recipient's name and the date of the award. Other observances may include a dinner in the evening at which the recipient is joined by the Hewlett Family and invited guests.

On March 3, 1992 a fund was established by a gift of $50,000 from William R. Hewlitt to provide future support for the Albion Walter Hewlett Award program. [34]

The first Hewlett award was in 1983, the recipient being Saul Rosenberg, M. D., Maureen Lyles D'Ambrogio Professor of Medicine (Oncology) and Radiology. The most recent award, the tenth, was presented on November 14 1996 to Stanley L. Schrier, M. D., Professor of Medicine (Hematology). These periodic observances refresh institutional awareness, and reward individual emulation, of Dr. Hewlett's memorable contributions to science and humanity.

Based on our considerable knowledge, not only of Dr. Hewlett's academic stature but also of his admirable personal qualities, we can fairly conclude that his presence on the faculty from 1916 to 1925 contributed significantly to development of the extraordinary esprit de corp which characterized the Stanford medical faculty during that fondly-recalled interlude between 1916 and 1959 when the clinical departments joined the basic sciences in successfully fostering the scientific aspects of their disciplines while, happily, preserving a steadfast devotion to the practice and teaching of exemplary patient care.

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Other Critical Appointments

Arthur Bloomfield replaces Dr. Hewlett

Dr. Arthur L. Bloomfield, of Johns Hopkins Medical School, was selected to fill Dr. Hewlett's place as Professor and Executive Head of the Department of Medicine and its subdivisions on 1 September 1926.

Dr. Bloomfield received the degree of Doctor 0f Medicine from Johns Hopkins University in 1911. He was Assistant Resident Physician at the Johns Hopkins Hospital from 1911 to 1916 and Resident Physician from 1917 to 1920. He was Instructor in Medicine and Associate in Clinical Medicine from 1912 to 1922 and since then has been Associate Professor of Medicine at the Hopkins Medical School. [35]

Emile Holman replaces Dr. Stanley Stillman

On 1 September 1926 Dr. Stanley Stillman, Professor of Surgery, retired from active service on account of the age limit. Dr. Stillman was given the title of Professor of Surgery Emeritus, and Consultant at the Lane Hospital. In place of Dr. Stillman, Dr. Emile F. Holman was appointed Professor of Surgery and Executive Head of the Department of Surgery and its subdivisions effective 1 September 1926.

Dr. Holman received his A. B. degree at Stanford in 1911. He was a Rhodes Scholar at Oxford in 1916 and took his degree of Doctor of Medicine at Johns Hopkins University 1918. He was a research fellow at the Hunterian Laboratory of Experimental Surgery at Hopkins in 1918-19 and Resident Surgeon at Johns Hopkins Hospital from 1921 to 1923, and at the Peter Bent Brigham Hospital in 1923-24. In 1924 he went to Western Reserve University Medical School at Cleveland, Ohio, as Assistant Professor of Surgery. In December, 1925 he was called to Stanford as Associate Professor of Surgery. Dr. Holman was particularly interested in experimental surgery. [36]

By these two critical appointments the major Departments of Medicine and Surgery were placed in the capable hands of seasoned veterans of the rigorous Hopkins program. As we pointed out in Chapter 3, numerous other Hopkins graduates and trainees would ultimately join the Faculty to assure that Stanford would reflect the excellence of the Hopkins School.

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