Lane Library

Chapter XXXVII. The New Stanford Medical Center Planning and Building

  1. The New Stanford Medical Center Planning and Building

The New Stanford Medical Center Planning and Building
1953 - 1959

Immediately following the decision on July 15, 1953 to consolidate the medical school on the Stanford Campus, there was another surge of intensive planning, now to be conducted by the Medical Council's Standing Committee on Curriculum. Much work had to be done by the faculty in addition to their regular medical school duties and it was evident that strong leadership would be required to cope with the many internal and external problems involved in preparing for the move to the Campus [1]

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Deanship of Dr. Windsor Cutting (1953-1957)

photo of Dr. Windsor Cutting, 1907-1972. Dean of School of Medicine, 1953-1957

Dr. Windsor Cutting, Professor and Chairman of the Department of Pharmacology, succeeded Dr. Chandler in the deanship. Dr. Cutting served as Acting Dean from September 1953 to November 1953 and as Dean from December 1953 to March 1957. During Dean Cutting's four years in office there was little change in the operation of the Medical School program in San Francisco, but there were the following activities related to the pending move to the Campus:

Chronology
1953-1956

September 1953 - The Medical Council's Committee on Curriculum began its studies of the School's Program.

Summer 1955 - Architect Edward D. Stone commenced the design of Stanford Medical Center.

July 1956 - Report of Committee on Curriculum. "A Program of Education for Medicine at Stanford University." (To be discussed in detail later.)

August 1956 - Public Fund-raising Campaign for the Medical Center announced by the Hon. Herbert Hoover. [2]

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Deanship of Dr. Robert H. Alway (1957-1964)

Dr. Cutting resigned as Dean in March 1957 and was succeeded immediately by Dr. Robert H. Alway, Professor and Chairman of the Stanford Department of Pediatrics since 1955. Dr. Alway served as Acting Dean from 9 March 1957 through 14 May 1958, and as Dean from 15 May 1958 through 31 August 1964.

photo of Dr. Robert Alway

A native of Nebraska, Dr. Alway took his B. S. degree in 1937 and his M. D .in 1940 at the University of Minnesota. He interned at Jersey City Medical Center in 1939-40, and was pediatric fellow and resident at the University of Minnesota from 1940 to 43.

He was Instructor in Pediatrics at Utah University in 1943-44. He was Assistant Professor in Pediatrics in 1944-47; and Associate Professor in Pediatrics in 1947-49, all at Utah University.

He was an Associate Professor of Pediatrics at Stanford from 1949 to 1952. He then served as Professor of Pediatrics at Colorado in 1953-55. From there he returned to Stanford in 1955 as Professor of Pediatrics, a rank which he held for the remainder of his career. . [3]

Recruitment of New Department Heads

When Dr. Alway accepted the deanship, President Sterling made it clear that all department heads were expected to resign by August 31, 1958. All department chairs were vacated by that date and Dean Alway began his deanship with a clean slate. [4]

On the theory that the old Stanford had been weakened by too much scholastic inbreeding. Dean Alway promptly went scouting for new talent and quickly recruited a dazzling array of candidates for the vacant departmental chairs - pediatrician Norman Kretchmer from Cornell University; Nobel Prize-winning biochemist Arthur Kornberg (along with almost his entire department) from Washington University; Nobel Prize winning geneticist Joshua Lederberg from the University of Wisconsin; immunologist Halsted Holman from Rockefeller University; hand surgeon Robert Chase from Yale; and psychiatrist David Hamburg from the National Institutes of Health.

Two of the existing department chairmen in San Francisco - pharmacologist Avram Goldstein from Harvard and radiologist Henry Kaplan of the National Cancer Institute - were of similar academic stature to the new recruits and were therefore retained as chairmen of their respective departments of Pharmacology and Radiology. Alway also created a new department of Genetics, and added new full professors.

Almost overnight Stanford Medical School was catapulted to national prominence. The school began to attract a medical faculty whose talents and prestige enabled them to acquire funds for research as well as for a measure of departmental development.

Some of the faculty who were replaced were understandably bitter. None were more so than the staff of the Lane, Stanford and San Francisco County Hospitals. Their loyalties were with the old school and they believed the talent available in Palo Alto and the suburbs would be no match for that which Stanford had left behind in San Francisco.

The medical leaders at Stanford disagreed, pointing out that under the new curriculum, full-time salaried faculty and proximity to the university the school would be better able not only to teach the best methods of caring for patients, but also to increase knowledge and benefit the whole world by its diffusion.

Alway's approach to recruitment was reminiscent of Trustee Herbert Hoover's advice to President Ray Lyman Wilbur "to appoint Illustrious men."

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A Program for Education for Medicine at Stanford University (July 1956)

This Program is the crucial planning document of the School, exhaustively researched and clearly articulated by the Medical Council's Committee on Curriculum. The Program was originally approved by the Medical Council in 1956 and subsequently modified and endorsed by President Sterling and the Board of Trustees. [5] [6]

The Program addressed three critical issues: the move to the campus, a full-time faculty, and a new curriculum, with the following results.

Move to the Campus

The University began in 1951-52 a study of its Medical School in San Francisco. The most apparent need was for major replacement and refurbishing of its physical plant. The most urgent need was for annual financial support. Just to rebuild the physical plant would have cost ten to fifteen million dollars. To relieve the general funds of the University of the annual medical school charge would have required new endowment of an additional fifteen million dollars. In plant funds and endowment, the total need was $30,000,000.

The magnitude of the needed sum evoked the question: Would it be wiser to modernize and add to the existing Medical School facilities in San Francisco or to build anew on an alternative site? After more than a year of study the conclusion reached was embodied in the Board of Trustees' decision of July 15,1953 to move the Medical School to the University campus.

The basic reasoning behind this decision was that the future progress of the medical sciences would be inextricably linked with progress in the basic physical and biological sciences, and increasingly with the social sciences, such as psychology and sociology; therefore the closest possible relationship between teachers and investigators in all these fields would be desirable. Further, opportunities for enriching the general education of the medical student would be broader and simpler if the medical school were, by location, an integral part of the university.

Of greater importance than proximity was the creation of a university atmosphere in which the whole scholarly body of the institution, teachers and students of all levels of maturity, learn together and together advance knowledge.

It is of interest to recall that the Flexner Report of 1910 insisted that a medical school should be an organic part of its parent university and that divided and far distant departments should be altogether avoided. (See Chapter 31, Section 4.) [7]

Full-time Faculty System

The historical background of the full-time system is fully covered in Chapter 33. The Program for Education for Medicine at Stanford provided the following rationale for its adoption at Stanford.

There has been wide recognition that the increase of full-time faculties has improved medical education, but lacking funds for adequate salaries, American medical schools have adopted numerous systems under which the clinical faculty pays its own way. At Stanford, members of the preclinical medical faculty are on full-time appointment - that is, they devote all their time to medical school activities, are paid a salary, and receive no fees for other professional services. Members of the medical faculty in the clinical departments at Stanford are on geographic full-time. That is, all of their time is spent at the Medical School, part being devoted to teaching and research and part to the private practice of medicine, which provides a part, and in some cases all, of their income.

In the belief that a true university school of medicine will require their "entire time and devotion" the Stanford Medical Faculty adopted the principle of true full-time as a goal to be realized as financial resources permit. The Trustees discussed the issue of true full-time at their meeting in July of 1956 and affirmed it as a new policy for the School of Medicine.

In adopting this policy the members of the Faculty of the Stanford University School of Medicine have acknowledged:

That all University faculty members should be appointed on the same basis and should share the same privileges and responsibilities;

That the primary responsibility of a University faculty is teaching and research;

That faculty salaries should be derived from University sources;

That full-time members of a medical faculty should not engage in the practice of medicine for personal gain;

That the use of knowledge and skill as physicians for the benefit of humanity by rendering medical care is an obligation of any group as capable for such care as a medical faculty;

That the continued use of such knowledge and skill by clinical faculty members is essential to effective teaching;

That the patient care rendered by a medical faculty must be limited to the amount required for teaching and research;

That a direct relationship between any income from patient care and a faculty member's salary is incompatible with the maintenance of university status.

It was expected that these principles and policies would become effective as endowment funds for medical faculty salaries were obtained, that gradual transition to a true full-time status would be made as general University resources permitted. Flexibility will be required in the application of the general policy with respect to present senior faculty members, to allow for transition as vacancies occur through retirement or resignation. Income received for professional services to patients will be used in accordance with requirements of law and University policy.

The change to a full-time faculty will make no less important the position of the voluntary part-time faculty whose devotion to teaching and the advancement of knowledge has contributed so much to the Stanford Medical School. The change will make the great teacher increasingly important and should attract to medical education "the man of broad background and wide interest who has the capacity to kindle in his students the desire to join in an exciting life venture." [8]

A New Curriculum

In keeping with the concept that physicians must be broadly educated and understand the relationships between medicine and other aspects of society, Stanford's new curriculum is so designed that medical and non-medical studies can be carried on simultaneously and supplement each other.

The eight years between graduation from high school and graduation from medical school are looked upon as a continuum.

Students will be admitted to Medical School after three years of college work, as at present, but instead of devoting four years to the study of medicine, they will enter a Five-Year Program of medical work. (thus increasing the time normally required to earn the M. D. degree from four to five years).

Within the first three years of the Five-Year Program each student will complete the equivalent of an additional year of college work. Those students with interests and talents in non-medical subjects will be encouraged to continue and broaden their interests and to develop their talents at the same time that they study medicine.

Most students will follow the Five-Year Program, although for those who do complete four years of college work before entering Medical School, the curriculum is flexible enough to permit completion of basic medical education at the end of the eight years of college and university work.

Introduction of the Five-Year Program in 1959 was accompanied by adoption of a more liberal and more flexible admissions policy and by other innovations such as:

  • - stress upon principles rather than upon detailed mastery of subjects.

  • - a conjoint course in the basic sciences designed to overcome the splintering of biology into separate "subjects" which deal independently with structure, function and chemical processes.

  • - all laboratory exercises in biochemistry, physiology, microbiology, pharmacology and portions of pathology and anatomy will be combined into a single laboratory course to be conducted cooperatively by the six pre-clinical departments.

  • - the basic science course will be conducted in multi-discipline unit laboratories, each serving sixteen students as a "home laboratory" for a full year. These small laboratories are designed to foster a close relationship between students and the faculty members conducting the course.

  • - from the outset of their medical course, students will be guided toward increasingly greater degrees of independence in planning, executing, observing and interpreting experiments, in preparation for application of the skills and attitudes thus acquired to the advanced pre-clinical work which later will parallel related clinical experiences. The spread of the basic sciences throughout the medical program will permit an earlier introduction of clinical subjects. Here too, changes have been made to provide more unity in the curriculum.

These and many additional course innovations curriculum -wide were outlined in the Program of Education for Medicine.

There were those, of course, who predicted that increasing the duration of medical education from four to five years would price Stanford's new medical school out of the market. Such was not the case and when the first class was admitted in 1959 it was greatly overapplied.

By 1965, however, students had begun to complain that preclinical courses in the New Program had few linkages to subsequent clinical work and that the quality of teaching in required courses was poor. After students concluded that few course changes had occurred, they escalated their protest in the following year with formal petitions to the Dean's Office. The faculty Executive Committee concluded that the students' concerns were legitimate. [9]

As a result, Stanford's experimental Five-Year Program of Education for Medicine was after ten years replaced by a new curriculum crafted by contemporary faculty committees during the deanship of Dr. Robert J. Glaser and scheduled for implementation in September 1968. This new curriculum was viewed at the time as representing a further sequential step in the Stanford Program of Medical Education adopted in 1959, and designed to provide each student with an opportunity to pursue in depth, under the guidance of a group of faculty members, a study plan of his own choosing. [10]

In spite of manifest dissatisfaction with the Five-Year Program, when a class of graduates of the five-year science-oriented curriculum of 1959 was surveyed some years later, it was their unanimous verdict that the Five-Year Program was a remarkably successful experiment in medical education. [11] [12]

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Palo Alto's Hospitals

Before further discussion of programs and plans for a medical center on the Campus, let us consider the effect of this project on the hospitals in the area.

Peninsula Hospital

In 1908 a group of private physicians incorporated to found Peninsula Hospital, with the intention of providing hospital care for Palo Alto, Stanford and the Peninsula. A three-story frame structure was built on a tri-cornered lot bordered by Embarcadero Road, Cowper Street and Churchill Avenue in Palo Alto. In 1920 the hospital had 48 beds but averaged only 22 patients daily. However, it was of great benefit to the members of the Stanford faculty and to the students.

During World War I, the 48-bed facility's patient-load dropped further and the hospital began to lose money. In 1921 the private stockholders approached the Palo Alto City Council and offered to sell the institution.

Palo Alto Hospital

As the Council was mulling over its decision, a plan for city-Stanford cooperation to set up and operate the hospital was presented. The plan was proposed by Dr. George B. Somers, Physician Superintendent of the Stanford Hospitals in San Francisco. The plan was quickly approved by the City Council, and a $55,000 bond issue was passed by the city's voters. Upon purchase of the Peninsula Hospital the City Supervisors, for legal and other reasons, decided to change the name to Palo Alto Hospital. This act also had the advantage of calling attention to the fact that the hospital was under new management with new plans and goals.

On July 1 1921 the University took over administration of the Palo Alto Hospital. The contract with Stanford called for the University to operate the institution while the city retained ownership. In this way Stanford saved itself the cost of building a hospital for its students and faculty while providing Palo Alto Hospital with professional administration, medical equipment and student nurses from the Stanford Hospitals in San Francisco. [13] [14]

During the 1920s the Palo Alto Hospital did well financially under city ownership and Stanford administration, but problems began to loom. The frame structure was widely regarded as a fire-trap and the third story was condemned for patient use in the late 1920s.

Fortunately, fire never occurred and the hospital became more and more crowded as business flourished. The year 1925 was the best in history both in attendance and income. A considerable surplus was shown, enabling the hospital to turn over a substantial sum of money to the City of Palo Alto. As a result of these developments, the members of the Palo Alto Medical Association felt the pressing need for increased accommodations and during the year sent a formal petition to the City Council recommending the building of a new hospital. This subject received much attention and was discussed both in the public press and among local organizations. Two representative committees were appointed to investigate and report on the matter. [15]

No immediate action was taken, however, and by 1927 the capacity of the Palo Alto Hospital was taxed to the utmost. Conferences were held with the members of the staff and with representatives of the City Council regarding the need for expansion and Dr. Richard C. Broderick, Physician Superintendent of the Stanford Hospitals, was directed to prepare a general plan and to estimate the cost of construction of a new Palo Alto Hospital on the site occupied by the old one. [16]

In 1927 Stanford offered a plot of land on the Campus near El Camino Real for the new hospital and sentiment grew in the city to finance the operation. The plan was strongly endorsed by local doctors and the American Medical Association and in 1929 a $ 250,000 bond issue was approved by Palo Alto voters. The bonds covered only about half the cost of erecting the 100-bed, all-concrete structure which is still standing as the central portion of the old Palo Alto Hospital on the Stanford Campus. The money required to complete the building came from gifts by individuals and groups. In the campaign for funds, the Women's Auxiliary of the Palo Alto Hospital played an important role.

Finally, in 1930, construction began on the Palo Alto Hospital on the Stanford Campus. The new plant, more than double the size of the previous one, was occupied in 1931. [17]

photo of Palo Alto Hospital, 1931-1958
Palo Alto Hospital 1931 - 1958

The following account is excerpted from an article by Art German in the Daily Palo Alto Times dated September 15 1959. [18]

When the new Palo Alto Hospital on the Stanford Campus had been completed in 1931, the city was able to tear down the old Peninsula Hospital. During the 1930's the Works Progress Administration developed the hospital site at Embarcadero and Cowper into a small park.

The new Palo Alto Hospital on the Campus was operated under the same Palo Alto-Stanford agreement that was used for the Palo Alto Hospital. During the depression-years of the 1930's, the new hospital faced a problem common to many businesses throughout the nation. Patients simply didn't have money to pay their hospital bills.

To meet this problem, the Women's Auxiliary began a program of making interest-free loans to patients. Later, the Palo Alto City Council voted to pay $ 2. 50 per day toward the hospital bill of local residents when they were patients. In the 1930's, the city contribution constituted a major portion of the hospital bill.

Palo Alto continued its growth during the depression and in 1937 approved a $ 175,000 bond issue to finance an 80-bed addition to Palo Alto Hospital. After many delays, the new wing was completed in 1942, increasing the capacity of the hospital to 200 beds and making it the largest on the Peninsula south of San Francisco.

During the years of World War II from 1941 to 1945 the population in the Palo Alto area expanded further and, shortly after the war, the community began to talk again of enlarging the hospital but Stanford declined at first to lease any more land for an addition.

Finally, after years of study, plans were drawn for a 200-bed addition to Palo Alto Hospital. The four million dollars bond issue to finance construction came to a vote of the people in 1954, and it was overwhelmingly approved.

Palo Alto - Stanford Hospital, 1958

Before anything could be done to start construction, Stanford adopted the plan to move the clinical program of its medical school from San Francisco to the Campus. A survey showed that a single hospital facility built jointly by Stanford and the City of Palo Alto could be constructed more inexpensively and operated more efficiently than individual facilities.

Accordingly, a new bond campaign got under way, canceling out the 1954 effort. A four million dollar City bond proposal was again approved handsomely. Stanford put up its share of the money and plans were drawn for a 440-bed joint hospital to be known as the "Palo Alto-Stanford Hospital" and to be an integral part of a new "Palo Alto-Stanford Medical Center ".

As construction of the new Palo Alto-Stanford Medical Center was nearing completion Palo Alto City Councilmen and Stanford officials acted on a number of important issues including the following:

They agreed that the "old" Palo Alto Hospital on the Campus would have a different role after the Palo Alto-Stanford Medical Center was opened. Therefore, the "old" Palo Alto Hospital was closed in 1959 pending renovation to meet future needs. In 1964 it was reopened under the name of "Hoover Pavilion" primarily but not exclusively for the patients of community physicians and surgeons who were not members of the Stanford Faculty.

It was further agreed by Stanford and the Palo Alto City Council that a new administrative arrangement was in order and that, instead of placing the full administration of the hospitals in the hands of the University, an eight-member Board of Governors would be appointed to represent the two owners. On February 1, 1958 the Board appointed Dr. E. Dwight Barnett, a Stanford graduate and nationally known expert in Hospital Administration, as the first Director of the Palo Alto-Stanford Medical Center Hospital. [19]

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Construction and Occupation of the new Palo Alto - Stanford Medical Center Hospital
1957-1959

We have now traced in the foregoing paragraphs the far-reaching changes in faculty organization and curriculum resulting from adoption by the Faculty and Board of Trustees of the Program for Education for Medicine at Stanford.

We have also reviewed the long and complex history of the cooperation between Stanford and the City of Palo Alto in providing hospital services for the area. As we have now seen, this led ultimately to construction of the jointly-owned and operated Palo Alto - Stanford Hospital as an integral part of the Palo Alto - Stanford Medical Center.

We shall later see that the resultant hybrid institution failed to function as a "university hospital" in the Flexnerian sense of being devoted to a balanced program of research, teaching and patient care.

Meanwhile, administration, construction and occupancy of the new Medical Center proceeded on the following schedule: [20]

Chronology

March 1957 Dr. Robert H. Alway named Acting Dean, Medical School

June 1957 First construction activity begun with excavation for Palo Alto-Stanford Hospital.

May 1958 Dr. Alway appointed Dean

July 1959 Physical Therapy Department commenced operation in new Center. Outpatient Clinics opened in Center

August 1, 1959 Various Departments of Medical School move into new building. First patients admitted to Palo Alto-Stanford Hospital

August 17, 1959 Lane Library opens in new quarters

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Description of the New Palo Alto - Stanford Medical Center [21] [22]

As mentioned earlier, the Architect for Stanford's 21 and 1/2 million-dollar, 440-bed Palo Alto - Stanford Medical Center was Edward Durell Stone, noted for his design of the American Embassy at New Delhi and the United States Pavilion at the Brussels World Fair.

image of Architect's Model of Palo Alto/Stanford Hospital and Stanford University School of Medicine

The new Palo Alto - Stanford Medical Center consisted of three hospital and four medical school buildings interconnected by numerous arcades and open walkways. These seven structures shared a common roof in an "H" shape, each building being three stories in height and approximately 40 feet tall.

The Center was located on the Stanford University Campus a quarter mile west of the old Palo Alto Hospital (Hoover Pavilion). Architect Sloan designed the strikingly beautiful Center's 56-acre site along lines similar to those of Stanford's main quadrangle. For example, the same three-story height was maintained throughout and the concrete walls and columns of the Center were patterned to simulate the rusticated sandstone-block surfaces of the "Quad."

The Architect's characteristic grillwork was used extensively to sheath the exterior walls of the buildings. Flowered patios and walks lent a garden-like atmosphere, and a fountain-adorned entranceway created an impressive panorama on approaching the Center.

photo of Palo Alto/Stanford Medical Center photo of Stanford University Hospital, 1959

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Dedication of the New Medical Center
September 17-18, 1959

The major feature of the program dedicating the new Medical Center on September 17 and 18, 1959 was a symposium of speeches by six prominent men with interests in medicine and medical education.

The following is a list of the six participants in the dedication ceremony, and the subjects of their speeches:

Robert H Alway, M. D., Dean, Stanford University School of Medicine: "Introductory Remarks."

James A. Shannon, M. D., Director, National Institutes of Health: "Medicine, the University, and Society."

William W. McPeak, Vice President, The Ford Foundation: "The Small, Frantic Voice of the Patient."

Vernon W. Lippard, M. D., Dean, School of Medicine, Yale University: "Medical Science in the Academic Community."

Lester J. Evans, M. D., Former Executive Associate, Commonwealth Fund: "The Patient in University Medicine."

Frank Stanton, Ph. D., President, Columbia Broadcasting System. "Medicine for a New Age."

The University published the speeches in a booklet entitled Medical Care, the University, and Society to which President J. E. Wallace Sterling wrote the following Foreword. President Sterling's commentary is a concise statement of the ideals, objectives and benefits of the new Medical Center and is therefore reprinted here in full. [23]

Foreword

The dedication of the Stanford Medical Center in September 1959, marked the culmination of six years of effort which began in July, 1953, when the Stanford Trustees decided to relocate the University's Medical School on the campus near Palo Alto. The effort encompassed not only the physical move and its financing but also the development of a new program of education for medicine.

Central to this new Stanford program is the concept that the future progress of the medical sciences is inextricably linked with progress in the basic physical and biological sciences and increasingly with progress in the social sciences. It followed that the Medical School should be so located and organized as to promote the closest possible relationship between teachers, investigators and students in all these fields. It followed also that opportunities for enriching the general education of the medical student would be greater if the Medical School became, physically and philosophically, an integral part of the University.

The speeches delivered at the Medical Center dedication ceremonies on September 17 and 18, 1959, were variations on the central theme that medicine and medical education are the concern of both the University and society generally. Each of the papers herein supports the conviction held at Stanford that a university must be responsive not only to changes in the realm of man's knowledge but also to changes in the society in which new and old knowledge may be applied. Each of the distinguished speakers honored Stanford by his participation in the dedication ceremonies, and the presence of each bespeaks a more than local interest in Stanford's endeavors.

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Medical School Convened in the New Medical Center
September 30, 1959

The first-year class of the Medical School for the year 1959-60 assembled in the new Medical Center on September 30, 1959. This first medical class to be held in the new Center was composed of 64 students, and the total student body at the time was about 250. [24] [25]

Just 50 years previously, in September 1909, the newly-established Stanford Medical School was inaugurated in the San Francisco facilities.

Now, a half century later, Stanford's Medical School was no longer "divided " from its parent university and no longer subject to the inherent deficiencies of a "divided school" to which Abraham Flexner called special attention in 1910, and to which President Sterling pointedly alluded in his Foreword to the speeches delivered at the Dedication. [26]

The following are some of the main developments in the School during

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The Alway Years
1957-1964

Professor of Pediatrics Robert H. Alway agreed to serve as Acting Dean in 1957 at a time of great stress. A year later he was persuaded to assume the deanship and guide the redevelopment of the medical school on the Stanford campus. His leadership was marked by courage, integrity, and devotion to principle. Appointments to the faculty were dictated solely by "the best man for the job". Himself a clinician without extensive research experience, Alway nevertheless held that research is the lifeline of medicine and vigorously supported its development in the curriculum and at the laboratory bench and bedside. Yet there was no decrease in emphasis on heeding the faint cry of the patient as an individual or as a member of the community. Integrity, scholarship, compassion were in the forefront of his administration.

Dr. Alway resigned from the deanship effective August 31, 1964 and returned to full-time teaching as Professor of Pediatrics His resignation coincided with the completion of the first and major phase of development of the Stanford University Medical Center. A new physical plant had just been constructed, a geographical move accomplished, key faculty appointments made, clinical and research programs developed, and a new curriculum launched.

This was clearly an appropriate time for evaluation of Dr. Alway's accomplishments during his deanship. The task of evaluation was undertaken by members of the Medical Faculty who published a documentary in 1964 entitled The Alway Years, 1957-1964, intended as a tribute to Dean Alway for his effective role in guiding the school through these early and decisive years. Much of the following information is excerpted from this important document. [27]

As we have already noted, one of Dean Alway's first acts after the new Medical School opened in 1959 was the appointment of top scientists to department head positions. He went on to create new departments of genetics, anesthesia and dermatology and to double the size of the faculty with carefully selected candidates.

Because of his emphasis on high standards and productivity, research funds were tripled. For example, funds were received from the National institutes of Health in 1962 for the establishment of the first clinical research center for premature infants in the United Sates. Among other research programs with outside funding at this time were those in radiotherapy and organ transplantation.

At the same time Alway sought to maintain good relations with the Palo Alto medical community by orienting them to the programs and needs of the Medical School. By the end of his term as Dean he had convinced the local physicians to abandon their insistence that medical faculty see only patients referred to them as consultants, and the patient load at the School had risen so that it now satisfied many of the requirements of undergraduate clinical teaching.

It was a special source of pride that Stanford medical students excelled in national competition. Their performance on the last National Board of Medical Examiners tests was outstanding. They rated number one in every one of the six preclinical sciences tested. In overall performance their average of 88.2 % (46.8 % honors and 0.0 % failure) was at least 2 % higher than any of the other schools. This was all the more remarkable in that the Stanford program was not directed toward passing examinations. Such exceptional performance attests to the quality of students who are attracted by the Stanford curriculum, and can meet these external standards while pursuing other goals.

Alway was the first to deny sole responsibility for the success of the move to Palo Alto. "I didn't do these things, " he says. "I was blessed with a rabbit's foot, and a superior faculty."

As for the future of Medicine he said: "Medical education in the next few years will feel the weight of a movement for the production of family practitioners . . .Society must carefully evaluate the roles that deliverers of primary care can play in medicine, and determine how resources will be allocated between the nurse practitioner and the physician."

As for the requirements of the Medical Center, Alway cited a problem familiar to deans: "The most urgent need at present is space. Our most serious handicap is the lack of space to comfortably and effectively cope with even the present demands."

Upon his resignation from the deanship, Dr. Alway took up his duties as Professor of Pediatrics. But this was not the end of his administrative role at Stanford.

In 1975 he was appointed medical director of the Hospital and Associate Dean for Clinical Affairs. He also became a member of the Regional Medical Quality Review Committee serving Santa Clara County, and served on the board of the county Professional Standards Review Organization.

Retirement

In the fall of 1977, Dr. Robert H. Alway, Medical Director of Stanford Hospital and former Dean of the Medical School, announced his retirement as Professor of Pediatrics Emeritus effective December 31, 1977. [28]

Naming of Robert H. Alway Building

On May 21, 1988 the Medical School's "M" Building was formally named "The Robert H. Alway Building" at a ceremony honoring the contributions of the former dean and Stanford pediatrician during a critical period in the development of the Medical School. [29]

Obituary

Dr Robert H. Alway died at his home in Oak Harbor, Washington, on October 26, 1990. He was 77. [30]

Lane Library