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Eye Foundation Hospital Birmingham, Alabama
EDITORIAL
1062
EYE FOUNDATION H O S P I T A L BIRMINGHAM, ALABAMA A NEW FORCE AGAINST BLINDNESS
On January 1, 1964, the Eye Foundation Hospital of Birmingham, Alabama, admitted its first patient. It is a beautiful building (fig. 1) of modern architecture, in a garden setting. The inside is as excitingly modern as is the exterior. The one and one-half million dollars spent for the land, building and equipment were
Fig. 1 (Vail). The Eye Foundation Hospital of Birmingham, Alabama, which opened its doors for patients on January 1, 1964. given largely by local foundations, industries and eye patients. Although it is situated within the area of the University of Ala bama Medical Center, it is owned and oper ated on a nonprofit basis by an independent Board of Trustees, and not as a unit of the University. Here it is analogous to the great Shriner's Crippled Children's Hospital and the privately endowed Smolian Psychiatric Clinic nearby. There are 28 spacious rooms for patients, each with two beds, and two operating rooms with most modern fixtures that can handle two patients at a time. A dining room and adjacent cafeteria are centrally placed. The quarters provided for the residents are ex cellent, even luxurious. There is a fine clini cal laboratory, and a roomy, generously equipped Eye Clinic. This latter is supported
by the Alabama Sight Conservation Agency, which is a unified, philanthropic arm of the 200 Lions Clubs of Alabama. The A.S.C. raises more than $200,000.00 a year in sup port of the hospitalization, the provision of eyeglasses and drugs for indigents of all races. The utilities, air condition unit and a large ophthalmic library, the gift of one of the staff doctors, are to be found in the base ment. In addition here are the X-ray and photographic rooms and other large areas planned particularly for clinical research and future developments. There are no private offices for ophthal mologists in the hospital and private patients are not seen in the hospital, except as emer gency cases. The A.S.C, clinic, conducted by members of the attending staff, is operating full tilt three days a week, with provision for future expansion. The rooms for examination and treatment, the waiting space and the ranges for refraction and the taking of the fields of vision are so well equipped that any ophthal mologist who visits the place will be in a frenzy of envy. A training program for residents is now being organized. Several applicants will be selected each year, only, however, from among those who have already taken one of the recognized courses of basic ophthalmol ogy in this country. Membership on the attending staff, of which David McCoy, M.D., is chief and Beamon Cooley, M.D., the assistant chief, is open to all ophthalmologists who belong to the County Medical Society. A number of these have already joined. But, as one can always anticipate in a creation of any new and exciting venture, there has been some opposition by local ophthalmologists. It can, however, be foreseen that this opposition will decrease in time, when the great value and public service of the Hospital and Clinic to the community and the School of Medicine become apparent. The Board of Trustees is composed of
EDITORIAL
outstanding business leaders of the area. Alston Callahan, M.D., is the president of the Board. The Hospital is the direct result of his dreams, vision and talents. To see the fruition of these dreams must bring him great pleasure and satisfaction. It was my pleasure to attend the Dedica tion Ceremonies of the Hospital on Decem ber 7, 1963, and to address a large group of its friends, sponsors and enthusiastic sup porters, patients, physicians, and representa tives of the County Medical Society. The subject of this address was "The importance of an eye hospital to a large community." It was pointed out that in the early days of our specialty in the United States, a num ber of eye hospitals or infirmaries, many of them associated in ear, nose and throat work, were established by individual and private physicians, either alone or in conjunction with others. They almost always were op posed by some of their colleagues at the time. As examples, the first of these, the New London (Connecticut) Eye Infirmary, was founded in 1817 by Elisha North. It lasted about 14 years. Delafield and Rodgers founded the New York Eye and Ear Infir mary in 1820. It is still in existence and, since its inception, over 4,700,000 patients have been treated. Dr. George McClellan estab lished the Philadelphia Dispensary for the Diseases of the Eye in 1821. He later founded Jefferson Medical College. Eight prominent physicians started the Pennsyl vania Infirmary for Diseases of the Eye and Ear in 1822. This merged into the famous Wills Eye Hospital in 1830. In 1823, Dr. George Frick, the "father of American oph thalmology," established the Baltimore Dis pensary for the Cure of Diseases of the Eye. Reynolds and Jeffries established the Massa chusetts Charitable Eye and Ear Infirmary in 1824. In 1852, the New York Ophthalmic Hospital appeared. Agnew established the Manhattan Eye and Ear Hospital in 1869, and Hermann Knapp the New York Oph thalmic and Aural Institute that later became the Knapp Memorial Hospital on 57th Street
1063
and 10th Avenue which was in charge of the late eminent Arnold Knapp. In recent times this became amalgamated with the Eye Insti tute of Columbia-Presbyterian Medical Cen ter. Toward the end of the last century almost every large city in the United States had some sort of eye hospital ; in 1917, 58 of these were functioning. Since then, a number have been discontinued or absorbed, as the great modern general hospital and medical centers have evolved and multiplied. The modern trend therefore seems to be the grouping of hospitals devoted to the care of patients of a particular medical specialty, within a closely knitted area, and to get away from sterile isolation. Many of these medical centers are associated with the uni versities and staffed by their medical facul ties. More of these centers are sure to come as the methods of the practice of medicine change in the future. I think it is necessary and important that ophthalmologists have their own separate hospital facilities in which to perform their meticulous work of keeping people from becoming blind. It is also necessary, it seems to me, to have these facilities within the enclave of general medicine and subject to other mutual consultations and scientific ac tivities. A department of ophthalmology that is not autonomous is subject to the whims and fancies of the chief of surgery, who may or may not be particularly in sympathy with the special aims of ophthalmology. This may depend on whether or not he, or a member of his family, has experienced the threat of becoming blind, or other reasons known only to himself. We all know that the tender, precise care of the ophthalmic patient demands special equipment, facilities, laboratories and, par ticularly, specially trained nursing care. These things are often rather shabbily and even reluctantly provided for us in the usual general hospital, where an empty bed excites the members of the general medical staff
BOOK REVIEWS
1064
like the bleating of a lamb excites the tiger. If, however, our nonophthalmic friends and colleagues do not seem to appreciate us over much at times, our patients, the service clubs and the general public do, as is shown by the history of the development of the Eye Foundation Hospital of Birmingham. This beautiful, meticulously designed, wonderfully equipped and functioning eye facility means for all of us in the United States the addition of a potent weapon in our continual war against blindness. As a part of a big medical center area in one of our major southern cities, it has a great future for service in training, research and ophthal mic care of a large, growing and immensely important community. All those of generous good will rejoice in its establishment. Derrick Vail.
CORRESPONDENCE BETA-RAY LEAKAGE
Editor, American Journal of Ophthalmology: The successful treatment of pterygium requires the use of a beta-ray applicator postoperatively to prevent recurrence. Since the effective distance of this type of radia tion is very short, the material must be in corporated in a very thin layer near the sur face of the applicator and the chance of leakage with deposit of some of the element on the operative site is always present and, theoretically, such an accident could be cat astrophic. The Atomic Energy Commission requires a leak test on licensed applicators every six months but this obviously is not the solution to the problem. For several months we have been using a very thin layer of plastic material, such as that commonly used for enclosing merchan dise. We cut this into squares and sterilize it in the autoclave. When treatment is to be given, this plastic is laid over the eye and the applicator applied over it. If any leak
age occurs, it will be on the plastic material. Tests with a Geiger counter do not show any difference in the intensity of radiation and we have found no difference in the effectiveness of the treatment. (Signed) H. E. Crawford, Hilo, Hawaii. CORRECTION
Editor, American Journal of Ophthalmology: In my paper "Senile changes of the lens and the vitreous" which was published in THE
AMERICAN
JOURNAL
OF
OPHTHAL
(57: 1-13, 1964), there are some misprints which I beg you to indicate in a corrigendum: on page 4, line 6, it should be written "but more so" instead of "but less so." In Figure 7 on page 5, the indices of A should be in the reverse order, that is to say from right to left A^ A2, A3, and not from left to right. (Signed) Prof. H. Goldmann, Bern, Switzerland. MOLOGY
BOOK REVIEWS SENSORY MECHANISMS OF THE RETINA. By
Ragnor Granit, M.D. (Reprint of 1947 edition with corrections.) New York, Hafner Publishing Company, 1963. 343 pages, 173 illustrations, 2 appendixes, references, index. Price: $8.00. Professor Granit's classical book that appeared in 1947 and was published by the Oxford University Press is too well known by now to require an extensive review. Such a review will be found in T H E AMERICAN JOURNAL
OF OPHTHALMOLOGY,
30:1446,
1947, by James E. Lebensohn. The reprint here reported contains a delightful preface by the author. He quotes Ramon y Cajal, who called the retina his "youth's tender passion," and says he wishes to adopt this statement as his own. He goes on to say "There is no need here for reca-
1062
EYE FOUNDATION H O S P I T A L BIRMINGHAM, ALABAMA A NEW FORCE AGAINST BLINDNESS
On January 1, 1964, the Eye Foundation Hospital of Birmingham, Alabama, admitted its first patient. It is a beautiful building (fig. 1) of modern architecture, in a garden setting. The inside is as excitingly modern as is the exterior. The one and one-half million dollars spent for the land, building and equipment were
Fig. 1 (Vail). The Eye Foundation Hospital of Birmingham, Alabama, which opened its doors for patients on January 1, 1964. given largely by local foundations, industries and eye patients. Although it is situated within the area of the University of Ala bama Medical Center, it is owned and oper ated on a nonprofit basis by an independent Board of Trustees, and not as a unit of the University. Here it is analogous to the great Shriner's Crippled Children's Hospital and the privately endowed Smolian Psychiatric Clinic nearby. There are 28 spacious rooms for patients, each with two beds, and two operating rooms with most modern fixtures that can handle two patients at a time. A dining room and adjacent cafeteria are centrally placed. The quarters provided for the residents are ex cellent, even luxurious. There is a fine clini cal laboratory, and a roomy, generously equipped Eye Clinic. This latter is supported
by the Alabama Sight Conservation Agency, which is a unified, philanthropic arm of the 200 Lions Clubs of Alabama. The A.S.C. raises more than $200,000.00 a year in sup port of the hospitalization, the provision of eyeglasses and drugs for indigents of all races. The utilities, air condition unit and a large ophthalmic library, the gift of one of the staff doctors, are to be found in the base ment. In addition here are the X-ray and photographic rooms and other large areas planned particularly for clinical research and future developments. There are no private offices for ophthal mologists in the hospital and private patients are not seen in the hospital, except as emer gency cases. The A.S.C, clinic, conducted by members of the attending staff, is operating full tilt three days a week, with provision for future expansion. The rooms for examination and treatment, the waiting space and the ranges for refraction and the taking of the fields of vision are so well equipped that any ophthal mologist who visits the place will be in a frenzy of envy. A training program for residents is now being organized. Several applicants will be selected each year, only, however, from among those who have already taken one of the recognized courses of basic ophthalmol ogy in this country. Membership on the attending staff, of which David McCoy, M.D., is chief and Beamon Cooley, M.D., the assistant chief, is open to all ophthalmologists who belong to the County Medical Society. A number of these have already joined. But, as one can always anticipate in a creation of any new and exciting venture, there has been some opposition by local ophthalmologists. It can, however, be foreseen that this opposition will decrease in time, when the great value and public service of the Hospital and Clinic to the community and the School of Medicine become apparent. The Board of Trustees is composed of
EDITORIAL
outstanding business leaders of the area. Alston Callahan, M.D., is the president of the Board. The Hospital is the direct result of his dreams, vision and talents. To see the fruition of these dreams must bring him great pleasure and satisfaction. It was my pleasure to attend the Dedica tion Ceremonies of the Hospital on Decem ber 7, 1963, and to address a large group of its friends, sponsors and enthusiastic sup porters, patients, physicians, and representa tives of the County Medical Society. The subject of this address was "The importance of an eye hospital to a large community." It was pointed out that in the early days of our specialty in the United States, a num ber of eye hospitals or infirmaries, many of them associated in ear, nose and throat work, were established by individual and private physicians, either alone or in conjunction with others. They almost always were op posed by some of their colleagues at the time. As examples, the first of these, the New London (Connecticut) Eye Infirmary, was founded in 1817 by Elisha North. It lasted about 14 years. Delafield and Rodgers founded the New York Eye and Ear Infir mary in 1820. It is still in existence and, since its inception, over 4,700,000 patients have been treated. Dr. George McClellan estab lished the Philadelphia Dispensary for the Diseases of the Eye in 1821. He later founded Jefferson Medical College. Eight prominent physicians started the Pennsyl vania Infirmary for Diseases of the Eye and Ear in 1822. This merged into the famous Wills Eye Hospital in 1830. In 1823, Dr. George Frick, the "father of American oph thalmology," established the Baltimore Dis pensary for the Cure of Diseases of the Eye. Reynolds and Jeffries established the Massa chusetts Charitable Eye and Ear Infirmary in 1824. In 1852, the New York Ophthalmic Hospital appeared. Agnew established the Manhattan Eye and Ear Hospital in 1869, and Hermann Knapp the New York Oph thalmic and Aural Institute that later became the Knapp Memorial Hospital on 57th Street
1063
and 10th Avenue which was in charge of the late eminent Arnold Knapp. In recent times this became amalgamated with the Eye Insti tute of Columbia-Presbyterian Medical Cen ter. Toward the end of the last century almost every large city in the United States had some sort of eye hospital ; in 1917, 58 of these were functioning. Since then, a number have been discontinued or absorbed, as the great modern general hospital and medical centers have evolved and multiplied. The modern trend therefore seems to be the grouping of hospitals devoted to the care of patients of a particular medical specialty, within a closely knitted area, and to get away from sterile isolation. Many of these medical centers are associated with the uni versities and staffed by their medical facul ties. More of these centers are sure to come as the methods of the practice of medicine change in the future. I think it is necessary and important that ophthalmologists have their own separate hospital facilities in which to perform their meticulous work of keeping people from becoming blind. It is also necessary, it seems to me, to have these facilities within the enclave of general medicine and subject to other mutual consultations and scientific ac tivities. A department of ophthalmology that is not autonomous is subject to the whims and fancies of the chief of surgery, who may or may not be particularly in sympathy with the special aims of ophthalmology. This may depend on whether or not he, or a member of his family, has experienced the threat of becoming blind, or other reasons known only to himself. We all know that the tender, precise care of the ophthalmic patient demands special equipment, facilities, laboratories and, par ticularly, specially trained nursing care. These things are often rather shabbily and even reluctantly provided for us in the usual general hospital, where an empty bed excites the members of the general medical staff
BOOK REVIEWS
1064
like the bleating of a lamb excites the tiger. If, however, our nonophthalmic friends and colleagues do not seem to appreciate us over much at times, our patients, the service clubs and the general public do, as is shown by the history of the development of the Eye Foundation Hospital of Birmingham. This beautiful, meticulously designed, wonderfully equipped and functioning eye facility means for all of us in the United States the addition of a potent weapon in our continual war against blindness. As a part of a big medical center area in one of our major southern cities, it has a great future for service in training, research and ophthal mic care of a large, growing and immensely important community. All those of generous good will rejoice in its establishment. Derrick Vail.
CORRESPONDENCE BETA-RAY LEAKAGE
Editor, American Journal of Ophthalmology: The successful treatment of pterygium requires the use of a beta-ray applicator postoperatively to prevent recurrence. Since the effective distance of this type of radia tion is very short, the material must be in corporated in a very thin layer near the sur face of the applicator and the chance of leakage with deposit of some of the element on the operative site is always present and, theoretically, such an accident could be cat astrophic. The Atomic Energy Commission requires a leak test on licensed applicators every six months but this obviously is not the solution to the problem. For several months we have been using a very thin layer of plastic material, such as that commonly used for enclosing merchan dise. We cut this into squares and sterilize it in the autoclave. When treatment is to be given, this plastic is laid over the eye and the applicator applied over it. If any leak
age occurs, it will be on the plastic material. Tests with a Geiger counter do not show any difference in the intensity of radiation and we have found no difference in the effectiveness of the treatment. (Signed) H. E. Crawford, Hilo, Hawaii. CORRECTION
Editor, American Journal of Ophthalmology: In my paper "Senile changes of the lens and the vitreous" which was published in THE
AMERICAN
JOURNAL
OF
OPHTHAL
(57: 1-13, 1964), there are some misprints which I beg you to indicate in a corrigendum: on page 4, line 6, it should be written "but more so" instead of "but less so." In Figure 7 on page 5, the indices of A should be in the reverse order, that is to say from right to left A^ A2, A3, and not from left to right. (Signed) Prof. H. Goldmann, Bern, Switzerland. MOLOGY
BOOK REVIEWS SENSORY MECHANISMS OF THE RETINA. By
Ragnor Granit, M.D. (Reprint of 1947 edition with corrections.) New York, Hafner Publishing Company, 1963. 343 pages, 173 illustrations, 2 appendixes, references, index. Price: $8.00. Professor Granit's classical book that appeared in 1947 and was published by the Oxford University Press is too well known by now to require an extensive review. Such a review will be found in T H E AMERICAN JOURNAL
OF OPHTHALMOLOGY,
30:1446,
1947, by James E. Lebensohn. The reprint here reported contains a delightful preface by the author. He quotes Ramon y Cajal, who called the retina his "youth's tender passion," and says he wishes to adopt this statement as his own. He goes on to say "There is no need here for reca-