Johns Hopkins Hospital - Foundation

Foundation

Johns Hopkins, a Baltimore merchant and banker, left an estate of $7 million (US$123.8 million in 2009) when he died on Christmas Eve 1873 at the age of seventy-eight. In his will, he asked that his fortune be used to found two institutions that would bear his name: "Johns Hopkins University" and "The Johns Hopkins Hospital." At the time that it was made, Hopkins's gift was the largest philanthropic bequest in the history of the United States.

Toward the end of his life, Hopkins selected twelve prominent Baltimoreans to be the trustees for the project and a year before his death, sent a letter telling them that he was giving "thirteen acres of land, situated in the city of Baltimore, and bounded by Wolfe, Monument, Broadway and Jefferson streets upon which I desire you to erect a hospital." He wished for a hospital "which shall, in construction and arrangement, compare favorably with any other institution of like character in this country or in Europe" and directed his trustees to "secure for the service of the Hospital, physicians and surgeons of the highest character and greatest skill."

Most importantly, Hopkins told the trustees to "bear constantly in mind that it is my wish and purpose that the hospital shall ultimately form a part of the Medical School of that university for which I have made ample provision in my will." By calling for this integral relationship between patient care, as embodied in the hospital, and teaching and research, as embodied in the university, Hopkins laid the groundwork for a revolution in American medicine. Johns Hopkins' vision, of two institutions in which the practice of medicine would be wedded to medical research and medical education was nothing short of revolutionary.

Initial plans for the hospital were drafted by surgeon John Shaw Billings, and the architecture designed by John Rudolph Niernsee and completed by Edward Clarke Cabot of the Boston firm of Cabot and Chandler in a Queen Anne style. When completed in 1889 at a cost of $2,050,000 ($48.3 million in 2009 USD), the hospital included what was then state-of-the art concepts in heating and ventilation to check the spread of disease.

The trustees obtained the services of four outstanding physicians, known as the "Big Four," to serve as the founding staff of the hospital when it opened on May 7, 1889. They were pathologist William Henry Welch, surgeon William Stewart Halsted, internist William Osler, and gynecologist Howard Atwood Kelly.

Osler, the first chief of the Department of Medicine, is credited with originating the idea of a residency, whereby recently graduated doctors receive advanced training in their specialty while treating patients under supervision; then as now, residents comprise most of the medical staff of the hospital. He also introduced the idea of bringing medical students into actual patient care early in their training; at the time medical school consisted almost entirely of lectures. He once said he hoped his tombstone would say only, "He brought medical students into the wards for bedside teaching."

Halsted, the first chief of the Department of Surgery, established many other medical and surgical achievements at Johns Hopkins including modern surgical principles of control of bleeding, accurate anatomical dissection, complete sterility, and the first radical mastectomy for breast cancer (before this time, such a diagnosis was a virtual death sentence). His other achievements included the introduction of the surgical glove and advances in thyroid, biliary tree, hernia, intestinal and arterial aneurysm surgeries. Halsted also established the first formal surgical residency training program in the United States.

Kelly is credited with establishing gynecology as a true specialty. He created new surgical approaches to women's diseases and invented numerous medical devices, including a urinary cystoscope. He was one of the first to use radium to treat cancer.

Welch was responsible for training many of the outstanding physicians of the day, such as Walter Reed. He also founded at Hopkins the nation's first School of Public Health.

In 1912, Diamond Jim Brady donated $220,000 to the hospital, which created the James Buchanan Brady Urological Institute.

Ophthalmologist William Holland Wilmer opened the Wilmer Eye Institute in 1925, its home was completed four years later. Dr. Wilmer received an M.D. degree from the University of Virginia in 1885 and worked in New York, Washington D.C., in addition to Baltimore, where he established the institute.