The History of San Francisco General Hospital
Department of Surgery
The predecessor of San Francisco General Hospital (SFGH) was opened on
July 18, 1857 in a three story brick building built in 1854 as the North
Beach School on the corner of Francisco and Stockton Streets. By 1870
there were approximately 3000 annual admissions with infectious diseases
(tuberculosis, variola and pneumonia) and trauma as the leading causes
of admission and death. The original facility in North Beach was hopelessly
inadequate to the task and a new City-County Hospital was opened on August
28, 1872 on Potrero Avenue, the site of the current hospital. The “new
hospital”, a two story wooden building with six wards per floor
each accommodating 32 beds survived the 1906 earthquake.
Sanitary facilities were less than ideal. A typhoid epidemic followed
the earthquake overwhelming the hospital with patients. Rats overran the
city and an epidemic of the plague shortly followed. The plague spread
to the hospital staff and on September 17, 1907 the hospital was condemned
and subsequently destroyed. Seeking a temporary site, patients were housed
in stables and other buildings at the abandoned Ingleside Race Track located
on sand dunes in the remote southwest portion of San Francisco County.
The newly rebuilt hospital opened on May 1, 1915 and was an impressive
sight. The complex covered four city blocks between 22nd and 23rd streets
facing Potrero Avenue and consisted of four ward buildings and a centrally
located administration building with housing quarters for the resident
doctors. All the buildings were constructed in an Italian Renaissance
Style and the administration building had a terra cotta trim and gargoyles!!
A separate building to treat tuberculosis patients was completed in 1919.
These buildings comprised the main hospital until August 15, 1976 when
patients were transferred to a new $42.5 million dollar 653 bed hospital
built on the Potrero site adjacent to the 1915 structures.
The fundamental bond between SFGH and medical education was established
early in its history. By the turn of the 20th Century, six medical schools,
(the University of California (UC), the Cooper Medical College-the predecessor
of Stanford Medical School, the College of Physicians and Surgeons, Hahnemann
Medical College of the Pacific, the California Medical College and the
Polyclinic) were using the City and County Hospital of San Francisco for
the clinical instruction of medical students. Only the University of California
and the Stanford Medical Schools survived the restructuring of medical
education initiated by the Flexner report. Both schools had separate services
at the City and County Hospital until 1959 when Stanford moved its medical
school to Palo Alto. The University of California, San Francisco (UCSF)
developed an affiliation agreement with the City and County of San Francisco
and has been responsible for all medical professional activities at SFGH
The SFGH campus of UCSF plays a central role in the University’s
medical student and graduate medical education programs. The diversity
of the patient population, which includes a large immigrant population
from China, Southeast Asia, the Philippines, Mexico, Central and South
America, and the former Soviet Union, provides the teaching programs with
a unique variety of clinical problems rarely seen at the other teaching
hospitals. SFGH played a major role in the nation’s response to
the HIV epidemic and its clinical programs served as a model for many
hospitals around the world. Like many other public institutions, SFGH
also serves a disenfranchised, impoverished inner city population with
endemic violence, drug and alcohol use and advanced disease, both benign
and malignant, because of poor access to health care.
The UCSF research enterprise located at the SFGH campus is impressive.
Major Basic Science and Clinical Research programs exist in virtually
all departments including Surgery, supported by over $50 million in extramural
Wallace J. Terry was appointed Chief of the UC Surgery Service at SFGH
in 1907 and served until 1912 when he was appointed Chair of Surgery
at the UC Medical School. Harold Brunn succeeded him as Chief at SFGH
and served until 1942. In effect, Brunn really created the UC Service
at SFGH. Horace McCorkle briefly served as Acting Chief from 1942 until
1945. Leon Goldman (the father of Senator Dianne Feinstein) was then
appointed Chief of the UC Service and served until 1956 when he too
was appointed Chair of Surgery at UCSF. Clayton Lyons, a superb clinical
surgeon and teacher, served as Chief of the UC Service until 1960.
Emmet Rixford was Chief of the Stanford Service in the early 20th Century.
In addition to being an outstanding surgeon, he was a world authority
on snails and was a distinguished mountaineer. Mount Rixford, a 13,000-foot
peak in the southern Sierra Nevada, bears his name. Leo Eloesser was
appointed Chief of the Stanford Service in 1930. Eloesser was an eccentric,
charismatic man of diverse interests who influenced generations of SFGH
surgeons, even decades after his retirement. During World War 11, the
Stanford Service formed the famous 59th Evacuation Hospital which saw
action in North Africa and Italy. Carleton Mathewson was the Chief of
the “59th Evac” and was appointed Chief of the Stanford
Service in 1946 upon Eloesser’s retirement. Roy Cohen was the
Assistant Chief. The Stanford Service ended in 1959 when the Stanford
Medical School moved to Palo Alto.
All of these Chiefs of Surgery were in private practice and served as
Chief of their respective services for minimal compensation. The first
full time Chief of Surgery was William Silen who served from 1960-1966
before becoming Chief of Surgery at the Beth Israel Hospital in Boston.
F. William Blaisdell was appointed Chief of Surgery in 1966. He developed
one of the first Trauma Services in the United States, secured an NIH
Trauma Training Grant in 1972 and recruited an outstanding full time
faculty including Robert Lim, Muriel Steele, Arthur Thomas, George Sheldon,
Donald Trunkey and Frank Lewis. Jack McAninch became Chief of Urology
and Michael Chapman Chief of Orthopedics. This group had a major influence
on the care of the Trauma Patient nationwide. In 1978, Blaisdell left
to become Chair at the University of California, Davis and was succeeded
by Trunkey. Donald Trunkey served as Chief of Surgery at SFGH from 1978
until 1986 when he was appointed Chair of Surgery at the University
of Oregon Health Sciences Center. Trunkey was a major force in pushing
the Trauma agenda. He served as Chair of the American College of Surgeons
(ACS) Committee on Trauma and during his tenure, both the Advanced Trauma
Life Support Course and Trauma Center Verification Program were adopted
by the ACS. The use of the CT scan in the evaluation of blunt abdominal
injury and early experience with non-operative management of selected
liver injuries were important clinical advances initiated at SFGH during
the Trunkey years.
Frank Lewis served as Chief of Surgery from 1986 until 1992 when he
left to become Chief of Surgery at the Henry Ford Hospital in Detroit.
Lewis secured an Injury Center Grant funded by the Centers for Disease
Control (CDC) and made important advances in the understanding of lung
injury after Trauma.
William Schecter was appointed Chief of Surgery in 1992. The Division
currently has $11.7 million dollars in extramural research grant support.
A 5,000 square foot state-of-the-art basic science research laboratory
opened in 1997 and currently has six Principal Investigators studying
various aspects of the Heat Shock Protein response to cellular stress.
The laboratory was directed by William Welch until 2002 and is currently
directed by Nancy Boudreau. Peggy Knudson directs the CDC funded Injury
Prevention Center and Robert Mackersie directs the Trauma Program and
the Violence Prevention Center. Andre Campbell directs the Fellowship
in Surgical Critical Care. David Young directs the Division of Plastic
and Reconstructive Surgery and the Burn Service assisted by Mahesh Mankani.
Both Mankani and Young, as well as Jan Horn and Hobart Harris are Principal
Investigators in the Laboratory. Stanley Rogers has an NIH funded clinical
research program studying various aspects of videoendoscopic surgery.
Arthur Hill was appointed Chief of Thoracic Surgery at SFGH in 2000
upon the retirement of Arthur Thomas after 30 years of distinguished
service. John Lane was recently appointed as Chief of Vascular Surgery.
The clinical, research and teaching programs of the UCSF Division of
Surgery at SFGH focus on illness and injury associated with poverty.
We face the future with optimism in constant pursuit of excellence in
the care of the disenfranchised.
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