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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 since then.

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 grant support

Department of Surgery

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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Updated: May 18, 2007
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