local hospitals. He had arrived in Baltimore just two years before,
shattered. Slowly, the former metropolitan bon vivant was reclaiming
pride of profession, and a major decision now faced the administration at
Johns Hopkins. Who would be hired as surgeon at the new hospital?
The Johns Hopkins Hospital opened in May 1889. Although the
Pathology division had been functional under William Welch for several
years, a full-time surgeon was only hired in the months before the hospital
opened. Today, every hospital in America thrives or dies based upon
surgical volume. In the 21st century, surgeons find themselves in very
advantaged positions based upon the revenue generated by their work. In
1889, there were fewer than ten physicians in the United States whose
practices were limited to surgery,^21 such was the nascent nature of the
profession. It is not so surprising that President Gilman had already hired
the scientist and pathologist Welch, and then in turn employed William
Osler to be the founding internist. Osler, a Canadian by birth, moved from
the University of Pennsylvania and would become the preeminent
physician in the world, eventually settling at Oxford as the Regius Chair of
Medicine.
Just months before the opening of the hospital there was still no
surgeon on staff. The leaders at Hopkins determined that their fledgling
institution would be one of the rare hospitals that would hire a fully
engaged surgeon. The successor to John Lister in Glasgow, Sir William
Macewen was a pioneering surgeon in his own right. An important
innovator in brain and bone surgery, Macewen’s prospects unraveled when
his insistence on bringing his entire nursing staff was not acceded to. Now
scrambling, the board of trustees at the hospital faced a difficult decision,
hire the one surgeon known to them, warts and all, or scurry to find
another European candidate.
After some deliberation, and more than a little trepidation, Halsted was
invited to be the surgeon-in-chief to the dispensary and acting surgeon to
the hospital in February of 1889. Three months later the hospital would
open, and more than three years would transpire before the medical school
commenced.
High on a hill above Baltimore, the domed redbrick buildings with
intricate roof lines were rising in magisterial dominion. The dome of the
administrative building, perched on the western edge of the campus, has
become synonymous with Hopkins medicine, but Welch and Halsted were