Dean Wagner's Genealogy - Ah-Gwah-Ching, Minnesota

Ah-Gwah-Ching

Ah-Gwah-Ching, Cass County, Minnesota, USA

Tuberculosis - Intermediate Years

from
"A Brief History of the Minnesota State Sanatorium --
Ah-Gwah-Ching Nursing Home
1907 - 1982
In Commemoration of our 75th Diamond Jubilee"
By Skip Oliver
© June 1982
Pages 10-16

Following Dr. P. M. Hall's death in 1928, Dr. H. A. Burns was named Superintendent. No one could have foreseen at this time the progress which would be made by this great man in the care and treatment of tuberculosis. Dr. Burns received his Doctor of Medicine from the University of Minnesota in 1908. He was clinical instructor in obstetrics at General Hospital and pathologist at Swedish Hospital in 1911 and 1912. He served as epidemiologist with the State Board of Health from 1912 to 1920, taking leave from 1917 to 1919 to serve in World War I. From 1920 to 1923 he was supervisor of tuberculosis trainees at the Veterans Bureau.

Dr. Burns' medical background, together with his administrative ability, and his insistence on high standards, brought many changes to the Sanatoriun. As early as 1928 he requested the serices of an epidemiologist on his staff. He was of the strong opinion that it did no good to admit the tubercular patient, treat him, and send him on his way. The same patient had already spread the infection to others before he was admitted, and would, after release, be exposed to infection again and again. Dr. Burns' philosophy, and much later in our history, we see another proponent of this same philosophy, Dr. M. M. Williams, -that unless epidemiology was practiced, the spread of infection would continue. Epidemiology --- WHERE DID THE PATIENT GET HIS INFECTION, FROM WHOM, -- AND WHO DID HE GIVE IT TO?

Hall Memorial Pavilion was completed during Dr. Burns' first biennium (1928-1930) as superintendent and housed 34 children.

Construction on the Nurses' Home was begun in May of 1930 and completed in December. The first nurses moved into their new home on December 18, 1930. Each room was furnished with a metal bed, dresser, table, chairs and a rug. For the first time since the Sanatorium was opened in 1907, our nurses were provided with adequate living quarters.

During Dr. Burns first year as superintendent he was faced with infectious abortion in the dairy herd. Tests by the Livestock Sanitary Board showed bacilli melitus infection of the herd. Milk produced at the farm could not be used, thus requiring the purchase of milk from the outside. Much of the herd had to be destroyed. Working closely with the Liverstock Sanitary Board, and replacing cattle with registered Holsteins, the herd was gradually rid of disease until the dairy became fully accredited in 1930. A modern pasteurization plant was installed and the consumption of dairy products by the Sanatorium increased.

In July of 1930 a change was made in the Dietary Department. Rose Stone, Dietitian, initiated the cafeteria system for ambulatory patients. This change was brought about because of food waste (it was hard to estimate the amount of food for each table); savings in employee complement -- no need to hire waiters and waitresses; eliminate stocks of large serving pieces, which were the most expensive items of crockery; eliminate use of large amount of linens. Previous to this period, meals were served by waiters and waitresses. Tables were set family style, with serving dishes and linens. Miss Stone's cafeteria system proved a savings in food waste as the patient helped himself to what he could eat. Previously, any bread, butter, or left-over hot dishes from the tables could not be used due to the fact the patient was tubercular. A good deal of saving was experiericed in employee wages by eliminating hiring of waiters and waitresses. Miss Stone's cafeteria style plan for sanatoriums was presented before the 1932 Minnesota Hospital Association and reprinted in Hospital Management for August, 1932.

Dr. Burns' request for an epidemiologist was realized during the biennium ending in 1932. Dr. F. M. Feldman was hired to fill this newly created position on the Sanatorium staff in September of 1931. Dr. Feldman's first annual report showed 6,024 Mantoux tests being performed in the field. A real effort was made on Dr. Feldman's part to aid the family physician in preventing the spread of tuberculosis by bringing those exposed, to his supervision. All mantoux surveys were followed by x-ray of positive reactors.

During Dr. Burns' first year, a program of Bird Banding was begun. Both the employee and the patient were involved in this program. A permit was obtained from the Department of Agriculture to "capture migratory birds for scientific banding purposes". Much enjoyment was derived by the patient from this program. Records were kept of the "returns"; information was compiled as to the migratory habits of various species.

In the spring of 1932, a real effort was made to reforest the grounds of the Sanatorium. The severe windstorm in Ju1y of 1921 had taken its toll of the Norway and White Pine, destroying most of the forest, including the area only one-half mile from the buildings. Approximately 10,000 White Pine and Norway Pine, from the Cass Lake Nursery, were set out in an area in front of the Nurses' Home on the bluff overlooking Leech Lake; and 2600 White Pine up to ten years of age were transplanted around the grounds and 2300 Norway Pine, four to six years, were transplanted in a like manner. About 500 Balsam and Spruce received from property owners in the vicinity were transplanted around the farm buildings to develop a wing-break and hedge. About 15,000 White Pine seedlings were set out in the woods directly north of the Power Plant.

The cost of care for the biennium ending in 1932 was $l.40 per day.

During Dr. Burns' first year, Hall Memorial Pavillion was used for children. Dr. Burns discontinued this practice early in his tenure. He felt that more harm than good was generated bringing children into an institution. The Hall Memorial Pavillion was converted to the care and treatment of contagious cases of adults. Dr. Burns paper: THE NEED OF SANATORIUM TREATMENT FOR CHILDHOOD TUBERCULOSIS, was presented to the Minnesota Trudeau Society in November of 1928, and appeared in Journal Lancet in 1929.

Dr. Burns was writing widely at this time on the topic Tuberculosis, and his studies and recommendations were noted by the medical profession. THE MANAGEMENT OF TUBERCULOSIS was presented to the Tuberculosis Institute, Ah-gwah-ching, in 1929. TUBERCULOSIS A PUBLIC HEALTH PROBLEM presented to the Minnesota State Sanitary Confercnce, Saint Paul, in 1930, and THE INSTITUTIONAL CARE OF TUBERCULOSIS, presented before the Lymanhurst Medical Staff in 1930.

Dr. Burns developed HOSPITAL TECHNIQUE during the fall of 1932 to help protect nurses and other employees against danger of infection. HOSPITAL TECHNIQUE was instituted throughout the institution. No infractions were tolerated. This practice continued until the close of the sanatorium in December, 1961.

Amulance service was established in 1932 to the University Hospital in Minneapolis. One hundred forty eight patients were transferred for surgery that first year.

Other changes during this biennium was the tearing down of the depot. Passenger train service was no long available. In the spring of 1933 bus service up to the institution buildings was established. The nurses' band was organized under the leadership of Grover Sattler.

The C Building was completed in 1933 adding 80 more beds to the capacity of the Sanatorium. The capacity of the Sanatorium was now 350 at the close of 1934. The charge for board and treatment continued at $1.40 per day.

Because of the magnitude of the problem of tuberculosis in our state institutions Dr. Burns made a complete survey in 1934 of the inmates and personnel of our state institutions, including the prisons. Of the nine institutions for the mentally ill, 82% of the inmates had primary tuberculosIs as manifested by the tuberculin reaction. Within the next few years extensive surveys and tests were made to deterinine that there was an extremely high incidence of tuberculosis in mental hospitals and in the prisons, and the incidence was increasing each year. (This study by Dr. Burns was called to the attention of Governor Harold Stassen, who appointed Dr. Burns, on November 17, 1942, chief of the tuberculosis control unit of the State Division of Institutions for the purpose of working with the staffs of the state mental hospitals and prisons, with the single objective of controlling tuberculosis.)

In 1933 Congress passed a bill whereby the sum of $250,000.00 be set aside for the extension and betterment of the state sanatorium buildings -- provided that said buildings shall be available for the care and treatment of Minnesota Indians. Following this legislation, one acre was deeded to the Federal Government on which the present F Building was constructed. This building, with a capacity of 117 beds, was opened for occupancy on August 1, 1935. With the addition of the Indian Building the bed capacity of the Sanatorium had now reached 480. The cost for care was still $1.40 per day.

The library for patients continued to improve and with the employment of Rachel Rothnem in 1934, a graduate in Library Science from the University of Minnesota the library took on a new dimension. Under her direction the library was soon housed in delightful quarters. Miss Rothnem lectured regularly to the Hospital Library Class at the University of Minnesota, in addition to her duties as librarian of the State Sanatorium.

The circulation statistics for the patients' library for the period ending June 30, 1934 indicated 10,697 books and 4,430 periodicals. Miss Rothnem added a library for Medical Staff and an Employees' Library during her first year as librarian.

The Polaris Stamp Club was organized under the direction of Miss Rachel Rothnem, Librarian, in February of 1938 and composed of members from the patient population. Meetings were monthly. Miss Rothnem provided bedside service to patients who could not attend the meetings, keeping them informed of the meetings and assisting them with their exchange of stamps with other members.

THE MOCASSIN, a monthly patient publication, was organized in 1938 also. Miss Rothnem, Librarian, served as advisor to this organization. THE PINE KNOT, an earlier patient publication started in 1913, had discontinued circulation in 1924. The first issue of the MOCASSIN was dedicated to Miss Healey, Director of Nurses, "in appreciation of her unfailing kindness and untiring efforts to put us on the road to health". Dr. Burns' editorial in the first issue comments: "It has been thirteen years since the Pine Knot, this paper's forerunner, ceased publication. We truly desire to help this magazine in its early beginnings to become in every sense of the word a journal giving voice to the patient."

The State Tuberculosis Advisory Commission decided to introduce Occupational Therapy to the tuberculosis patients of the various sanatoriums in Minnesota in 1916. Miss Beatrice Lindberg of Faribault was appointed director of Occupational Therapy and instructed to visit the various sanatoriums. Working directly under the physicians in charge, she instructed both bed and ambulatory patients in suitable handwork. Her position called for a visit to the State Sanatorium twice a year. She arranged the program for occupational therapy and established a paid instructor who was in charge of the work. It was the intent of the Tuberculosis Advisory Commission that such a program was a means of making a patient more content by busying his hands and mind, thus breaking the monotony of the long, weary hours spent on the "cure". Products made in occupational therapy were often sold and provided a means of income for patients.

Miss Lindberg submitted articles on occupational therapy in the PINE KNOT in issues as early as 1923, and detailed instructions were included in making specific articles of handiwork.

In 1934, Miss Martha Emig was hire as an Occupational Therapist. Miss Emig transferred from Faribault where she had been employed in the School for the Blind. In 1938 Miss Magdelena Emig was added to the Occupational Therapy Department. This department, under the able direction of the Emig sisters, grew to be one of the finest departments in the state. Patients were instructed in dressmaking, weaving, knitting, needlework, hand painting, card work, wood carving, leather tooling, book binding, rug weaving and beadwork. Completed work was fumigated before mailing, or being sold.

Many WPA projects became part of the State Sanatorium operation during 1938. The wing of the D Building was remodeled to house the Chapel, Patients' Library, and Occupational Therapy Department.

In 1935 and 1936, the operating room at the Sanatorium was being used for Pneumothorax-collapse therapy, phrenic exereris and minor surgery. All major operations such as thoracoplasties and spinal fusions, were referred to the University Hospital. Patients were taken by ambulance to Minneapolis for major surgical procedures.

A definite upturn in medical services began to emerge in the 1930's. While an operating room was available for minor surgery, no attempt had yet been made for performing some of the major procedures necessary in the treatment of lung disease. Dr. Burns had requested of the Board of Control an expansion of his medical staff for this purpose as early as 1933. If major medical services were to be offered, a more complete laboratory and x-ray department must also be considered. The board of Control, acting on Dr. Burns' request, permitted an increase to the medical staff and funded changes for enlarging and improving the facilities of the laboratory and x-ray department.

Miss Ardis Olson was hired as Medical Technician on September 26, 1934. For the fiscal year ending June 30, 1935, a total of 19,390 laboratory procedures had been accomplished.

Two additional physicians and a part-time pharmacist were added to the medical staff during the biennium ending in 1936.

In October of 1936, Dr. M. M. Williams joined the staff as Assistant Superintendent. Appearing in the first issue of THE MOCCASIN was Jim White's article - - MEET DR. WILLIAMS, which is reprinted here in its entirety together with the drawing MAKING ROUNDS.

MEET DR. WILLIAMS Jim White

If you know a doctor at Ah-gwahching who can do a neat 220-yard dash with a gown on, who has little difficulty in raising a mustache, and who can rattle off almost any piece of classical music on a piano, the chances are that you are happily and luckily acquainted with Dr. Williams. Doctor Williams seems to have lived a guarded life, where few, especially ladies, have ever appeared, but more of that later, and now to the task of listing a few technical bits of information that will help you catalogue him.

His name, Mervyn E. M. Williams, seems to denote a hidden power. Doctor claims he was born in Minneapolis on December 6, 1907 with an ancestry predominently Dutch and Scotch. However, he adds, that there is no pedigree.

Mother, brother, and sister are all of Minneapolis. His father was also a physician and he served as flight surgeon of the 109th Air squadron.

Attended Douglas School, Central High School, Minnesota College and the University of Minnesota (all in Minneapolis), where he earned the Doctor of Medicine (M.D.) degree that means many hours and years of work. He reminds us not to forget his Bachelor of Science degree, with accent on the bachelor part (we won't-don't worry!). Internship at St. Mary's Hospital, Minneapolis.

Arrival? "Already stated above. However 28 years, 10 months, and 6 days later I arrived at Ah-gwah-ching."

Private Practice: Marshall, Minnesota, 1935 and again in '36. Grand Rapids, Minnesota in the winter of 1935.

Affiliations: "My mustache" and Chapter 27, local number 10.

Hobbies: - Thinking music, Reading music, Playing music, and Music - likes Music.

Sports: Hunting, fishing, and yumph. The Doctor is very indefinite: he does'nt say whether he hunts for ducks or fishes for pike or even what the English translation of "yumph" is. We are inclined to suspect that it is an international word and means the same in all languages. However, that again is a conjecture.

Pets: 1937 Chevrolet, DeLuxe Town Sedan, Super de Super; mycrobacteria tuberculosis.

Likes: (Purely personal).

Dislikes: Sham, V-8 Fords, football and noise, during rest hours. (Nice variety, don't you think?)

Ambitions: To hang one more gadget on his Chevrolet (any contribution will be gladly accepted and may be addressed to the Moccasin. You needn't worry about harming any color scheme, because there is none); To grow hair. (Here, again all remedies and recipes are wanted. Already several learned medicine men have conjured up "heap strong spells" but still the Doctor's hair remains black and his head white. One contributor insists the "when the roots are lost the tree cannot be saved.")

From influential people "on the inside" we find that no pipes, cigarettes, or cigars interest Doctor Williams. Not even one friendly old Mershaum pipe can be found in his apartment. Incidently, the Doctor resides in the main office building, where his "thumb is always on the pulse of the 'San'". There you can usually find him in the evenings reading and studying his favorite subjects, which are bound to include the latest word in the field of psychology.

We know he likes the game of basketball, because he used to attend the girls' basketball games last winter.

In November of 1937, Dr. Herbert Carlson was employed and during the same biennium Dr. H. W. Hiebert also joined the staff. Extensive change had taken place in the laboratory and x-ray departments. Tissue work was now being carried out by the laboratory because of added guinea pig inoculations and post-mortems. During the biennium ending 1938, 80 guinea pigs were inoculated and 5 post-mortems performed. With the addition of needed equipment for surgery and additional medical staff, Dr. Burns felt the surgery department was now able to offer the additional medical services. The Board of Control permitted Dr. Burns to hire a part-time eye, ear, nose and throat specialist. The parttime pharmacist position created the previous year was changed to a full time position.

The Sanatorium became fully approved by the American College of Surgeons during the biennium endinq in l938. Dr. Burns' efforts to include surgical procedures as part of the Sanatorium program were finally realized.