Tuesday, July 9, 2019

Dr. Daniel Hale Williams and the First Open Heart Surgery

Dr. Daniel Hale Williams performing the first successful open heart surgery at Provident Hospital in Chicago.
Things were tense in the operating room of two year old Provident Hospital in Chicago on July 10, 1893.  James Cornish had been carried to the hospital with what was surely a fatal wound—a knife was sticking out of his chest and lodged in the heart.  The only way to save him—open the chest, remove the knife and suture the pericardium—the tough double layered membrane which covers the heart—would probably kill him.  No one had previously survived the handful of attempts at the procedure.
Dr. Daniel Hale Williams, a 37 year old surgeon and founder of the only hospital in Chicago with an integrated staff, was used to breaking new ground and confident in his skills.  He was also a pioneer of the sterile operating room, being one of the first American surgeons to heed the ground breaking research of Louis Pasteur and Joseph Lister at a time when older doctors were still performing multiple operations on the same bloody table without washing their hands in between.  That reform alone had greatly boosted survival rates among his patients.
Dr. Daniel Hale Williams.
Without the benefit of modern antibiotics and with unreliable anesthetics he went to work.  And he had to work fast because he also had no access to blood transfusions.  He quickly and skillfully cracked the chest, removed the knife, sutured the pericardium, closed and sutured the chest.  Within ten days Cornish had fully recovered and went on to live a normal life for many years.
Dr. Williams had just performed the first successful open heart surgery.
James Cornish recovering from his heart surgery
Did I mention that he was Black?
Williams was born on January 18, 1856 in Hollidaysburg, Pennsylvania.  His parents were free Blacks and his father made a good living as a barber.  The elder Williams was also a community leader and active in the Equal Rights League, an early civil rights organization active during the Reconstruction Era.
At the age of ten the boy’s security was shattered with the sudden death of his father.  He was sent to live with relatives in Baltimore where he got a little more basic education before being unhappily apprenticed to a shoemaker.
Dissatisfied, he left Maryland to join his mother and other members of his family who had relocated to Chicago.  He took up his father’s trade and was soon made enough money to better himself by apprenticing to Dr. Henry Palmer, a highly accomplished surgeon. He then completed formal training at Chicago Medical College, one of the few schools in the country to accept Black students.
Unable to gain a position or admitting status at any Chicago hospital because of his race, Williams set up a private practice on the South Side.  Then he was hired as a doctor for the Chicago Street Railway, treating mostly white workers and injured passengers.  Despite the general racism of the times, he was well thought of by the men and affectionately called Dr. Dan.
Private practice or the Railway offices, however did not offer the kind of recovery facilities necessary to perform the most difficult and challenging operations.  For that he needed a full service hospital.  He also wanted to encourage more blacks to enter medicine, not only as doctors, but as nurses and other support personnel.  
The original Providence Hospital building.
So in 1891 Dr. Williams founded Provident Hospital and Training School for Nurses, the nation’s first hospital with a nursing and intern program that had a racially integrated staff.
Dr. Williams work soon attracted the attention of the aging abolitionist Fredrick Douglas who championed him among friends in Washington.  As a result in 1894 Williams was appointed the chief surgeon of the Freedmen’s Hospital, serving former slaves.  It was a daunting task.  Poorly equipped and funded from its beginning in the Reconstruction Era, it had been allowed to deteriorate and offered substandard care with an astonishing mortality rate.
Freedmen's Hospital in Washington, D.C.
Williams worked feverishly on the turn-around, instituting modern hygienic standards, re-training the staff, improving surgical procedures including public viewing of surgeries which he believed would be an incentive to the staff to operate on the highest level.  He also added specialists in more fields, launched an ambulance service, and on the model of Provident, adding a multiracial staff, continuing to provide opportunities for black physicians and nursing students.
The following year, in 1895 William co-founded the National Medical Association, an alternative to the American Medical Association, which didn’t allow African-American membership.
The school for nursing was an important part of Provident hospital and bringing Black women into medical careers one of the most treasured parts of Dr. Williams' legacy.
In his years in Washington, Williams met Alice Johnson who he married in 1898.  The couple returned to Chicago where he resumed his position at Provident.  Later he would practice at Cook County Hospital and St. Luke’s, major modern hospitals who could no longer deny privileges to one of the most distinguished surgeons in the nation.
From 1901 he spent part of every year in Nashville where he was a voluntary visiting clinical professor at Meharry Medical College for more than two decades. He became a charter member of the American College of Surgeons in 1913.
Dr. Williams was active until he suffered a stroke in 1926.  On August 4, 1931 he died in Idlewild, Michigan.
Williams was widely honored in his lifetime and his story has become a staple of Black History Month commemorations.  But he is largely unknown to white Americans.
Williams’s beloved Providence Hospital, one of the few full service hospitals on the under-served South Side, was forced to close in 1987 due to financial problems.  In 1993 it reopened in as Provident Hospital of Cook County, part of the Cook County Bureau of Health Services.  Finances continue to threaten the public hospital and its future is far from certain.

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