Tuberculosis Strikes the Class of 1944
by John Anderies, our marvelous volunteer
Members of the class of 1944 pose with Dr. Kuhlenbeck at Somerton Airport, Philadelphia. Drexel University College of Medicine, Legacy Center: Archives and Special Collections on Women in Medicine and Homeopathy
Following their first demanding year at Woman's Medical College of Pennsylvania, the women of the class of 1944 were rewarded with a trip to Somerton Airport in northeast Philadelphia. There, Professor of Anatomy Hartwig Kuhlenbeck, himself a licensed pilot, took the young women on flights in his Challenger biplane. A German immigrant who later served in the United States Army Medical Corps during WWII, Kuhlenbeck kept a detailed Tagbuch or Daybook for much of his life:
Donnerstag, Freitag und Sonnabend, den 29., 30., und 31. Mai fliege ich zu Somerton in meinem Challenger zahlreiche kurze Passagierfluge fur meine Studentinnen vom Woman's Medical College. Ich habe zum Schluss dieses akademischen Jahres die Klasse des ersten Studienjahres - die "freshman class" - zu einem Fluge eingeladen und wir haben diese Klasse von 39 Studentinnen hierzu in drei Gruppen auf drei aufeinanderfolgende Tage verteilt - ich kann bei jedem Fluge je zwei Passagiere im vorderen Cockpit unterbringen. Auch meine Assistentinnen und die Laborantin sind bei dieser Veranstaltung einbegriffen1.
On Thursday, Friday, and Saturday, the 29th, 30th, and 31st of May, I’m flying many short passenger flights in my Challenger at Somerton for my students from the Woman’s Medical College. For the end of this academic year, I invited the first-year class (the “freshman class”) to take a flight, and we’ve divided this class of thirty-nine students into three groups on three successive days. I can accommodate two passengers in the front cockpit on each flight. My assistants and laboratory technician are also included in this event.
The class of 1944 was originally composed of 41 women. During this weekend of sailing through the skies, none would have expected the changes that were to come. According to an oral history interview conducted with one classmate, almost a third of the women had to drop out of medical school because they contracted tuberculosis. Most of these women did not make it back to finish their degrees. Sadly, at least two of the women died of the disease.
Tuberculosis is caused by a bacteria called Mycobacterium tuberculosis or one of a number of related bacteria. It most often affects the lungs, but can also cause harm to other parts of the body. It is usually spread through the air by way of respiratory fluid from an individual with an active infection. Much less common, it can be transmitted through the air during an autopsy when opening the chest cavity or even from the chest compressions of moving an infected body. The symptoms of tuberculosis include chest pain and persistent cough producing sputum. Some patients cough up blood. The infection can cause extensive scarring in the upper lobes of the lungs. A typical tuberculosis treatment of the time emphasized rest and fresh air. Many tuberculosis patients underwent a procedure called pneumothorax or "pneumo" for short. It is the action of introducing air into the space between the chest wall and the lung, causing the lung or just a lobe to collapse. This was known as "resting the lung."
Tuberculosis was a pervasive source of misery in society until the advent of antibiotic treatment in the early 1950s. For men and women studying to become medical professionals it was an especially common prospect. A 1937 study on the "Development of Tuberculosis in Adult Life," was one of the first to recognize the increased risk of infection for medical students:
In this student body of approximately 12,000 the number of students enrolled in the schools of nursing and medicine is a relatively small group, yet there is an overwhelming preponderance of lesions in this minor group, indicating to us that the problem of tuberculosis among young adults is most acute among those students who while in line of duty come in contact with tuberculous patients.2
Furthermore, a study of University of Pennsylvania medical students showed that as medical students progressed through their program their risk of contracting the disease increased, leading to serious efforts to track the disease among medical students and try to reduce their risk of infection. At Woman's Medical College of Pennsylvania, Dr. Sarah Morris, a specialist in preventive medicine who conducted a 10-year study of tuberculosis patients, was charged with overseeing those who had contracted the disease while enrolled at WMCP. Her program was described in a 1938 article on tuberculosis in medical students:
Among other procedures all entrants are tested with tuberculin and, when not reacting, every six months thereafter until positive. X-ray studies are made of all students each year and more often if desirable. They are also made of those changing from tuberculin negative to tuberculin positive during the year. Tuberculin testing in successive years has shown that 100% react positively in the fourth year. On the other hand the positive reactions on entrance from 1932 through 1937-38 fell from a maximum of 63% in 1933-34 to a minimum of 32% in 1937-38. As to lung pathology, the 1937 survey showed in the school's enrollment of 107 students, 1 healed parenchymal lesion in the first year against 8 in the third and fourth years respectively. Of unstabilized lesions there was none in the first year, but there were 4 in the fourth year. Of frank cases there was none in the first year against 1 in the third year and 2 in the fourth year. The last 3 cases were sent away for treatment.3
While the program of studying and containing the disease at Woman's Medical College was lauded in this article, within a short period of time, the situation seems to have become much worse. In 1941, Dr. Morris requested to be released from the duties associated with student health, which had become overwhelming due to the number of tuberculosis cases. The Corporation minutes describe the perilous situation of student health on June 6, 1941:
With regard to the student health situation, [Dean] Dr. Craighill states that with the revision of our nursing program we will have to take care of the student nurses, as well as the 100-odd medical students, the internes [sic] and the Hospital personnel. It is out of the question for Dr. Morris to take care of this and with it teach Preventive Medicine which has grown enormously since Dr. Morris has come to the College. Dean Craighill suggested the setting up of a Student Health Department of its own, and has been in contact with two very good young women [Drs. Catherine Magee and Mildred Pfeiffer] who have been accustomed to doing this kind of work. It would probably be better to have the two alternating rather than one there all the time, and it will mean a salary expenditure of $2000 or more. In view of our student and nurse health situation this is very urgent. Out of the senior class at the present time there is one student in a sanitorium now, another with active tuberculosis and a third year student who had to go home three weeks ago, besides five or six out in sanitoria at the present time.... 4
And three days later, on June 9, 1941:
It was voted to authorize the Dean to organize a separate department of Student Health, and be allowed a budget of $2400 for this purpose.... Our student health is a great problem. There is at present one girl who took her examinations in the hospital and is in a sanitorium, one or two who are in class who have active tuberculosis, and six or eight students now in sanitoriums.5
By the beginning of the fall semester, the Corporation noted some positive results from the new Student Health Department. From the minutes of September 17, 1941:
The Student Health Service has already shown its value, in not admitting two students because of health, whose preliminary examinations by their family physicians were satisfactory. One showed evidence of tuberculosis and the other was a cardiac case who was given a very bad prognosis by Dr. Leaman and was not allowed to stay. 6
Still the problem was anything but controlled. Faculty minutes from the decade include numerous instances of students having to leave due to infection or seeking permission to return upon successful treatment. For instance, the faculty minutes for September 2, 1942 contain a report from the Committee on Student Promotion which lists several students, all of whom had been infected with tuberculosis, who hoped to return to the College (their names have been omitted, below):
Miss [A], who withdrew from the second year in March, 1942 after several periods of illness; went to Eagleville Sanitorium in June; is now stabilized and Student Health approves her return to college at this time. She will take only part-time work, Pathology and Topographical Anatomy.
Miss [B], who withdrew at the end of her third year in 1941, because of tuberculosis. The Faculty ruled at that time that she be required to stay out of college for one year and then repeat the third year of the course. Her X-ray is unsatisfactory and Student Health does not approve her return to college.
Miss [C], who withdrew in good standing in September, 1940 because of tuberculosis, is now stabilized and Student Health approved her return to college.
Miss [D], who withdrew in good standing in December, 1940 because of incipient tuberculosis, is now stabilized and Student Health approved her return to college.
Miss [E] - withdrew in October, 1939, with tuberculosis. She returned last fall prepared to go into third year, but X-ray showed that the lesion was still active and we did not allow her to register. She came back again this fall. Our Student Health Service advised her to see Dr. Amberson in New York, but instead she went to see Dr. Hetherington at Phipps. Dr. Het[h]erington acknowledges that Miss [E] is unstable, but says that if he were in her place he would go on to medical school and take the chance. Student Health feels that she should not be allowed to come back. The Committee discussed her case at some length and agreed that she might be a menace to other students, and recommends that she be not allowed to return to college at this time. 7
X-ray results. February 24, 1947. Dr. Miriam Bell is reading the results of a student's chest x-ray. From Woman's Medical College of Pennsylvania: Photograph Collection, 1850-present. Drexel University College of Medicine, Legacy Center: Archives and Special Collections on Women in Medicine and Homeopathy.
Students were not the only ones to be affected by the disease. There was concern too for the faculty and they were implored on multiple occasions to comply with regular chest x-rays. On January 20, 1943 in the matter of Unfinished Business: "The Dean reported that only forty-four members of the faculty have had chest X-rays. She asked Dr. Magee to present an informal report on tuberculosis." And just a few months later, on July 7, 1943: "Heads of departments were asked to check with members of their staff on chest x-rays." 8
By 1945, the situation called for more support from faculty for Student Health, which was now being administered by Dr. Miriam Bell. From May 16, 1945, New Business, a Committee on Tuberculosis was formed:
The Dean announced that at the suggestion of Dr. Miriam Bell and after conferring with Dr. William Leaman, a committee to advise with Dr. Bell on student cases of tuberculosis has been appointed. The committee consists of Dr. Isabel Balph, Dr. Jacob H. Vastine, Dr. Charles A. Heiken, and Dr. Katharine R. Boucot. The various cases which come up in the student body will be referred to the committee by Bell. 9
So, was the class of 1944 affected to such a degree as one alumna describes? It's difficult to tell for certain from a cursory search of the archival records of Woman's Medical College. The faculty minutes include the names of some of the students who left because of tuberculosis or asked to return after treatment, but not all of them. And unlike those who graduate, once students drop out of school their lives and careers usually cease to be tracked by the school.
Of the 41 students who entered the class of 1944, only 12 would graduate on time. Seven would graduate from one to seven years late. The remaining 22 did not complete their course of study at Woman's Medical College.n
However, looking at the make-up of the original class of 1944 and comparing the names year after year in the College Annual Announcement, we see that a great many students did not stay in school through graduation, and a few took longer, some significantly longer, to graduate. 10 It is likely that some of these students, especially those who dropped out before graduation in 1944, did so because of contracting the disease. Further research may reveal just how devastating this disease was to the female medical students of this time.
1Tagenbuchblaetter, 1938-1941. Hartwig Kuhlenbeck papers. Drexel University College of Medicine, Legacy Center: Archives and Special Collections on Women in Medicine and Homeopathy.
2J.H. Myers, H.S. Diehl, R.E. Boynton and B. Trach. Development of Tuberculosis in Adult Life. Archives of Internal Medicine, vol. 59 (1937).
3Willard B. Soper and J. Burns Amerson. Pulmonary Tuberculosis in Young Adults, Particularly Among Medical Students and Nurses. Transactions of the American Clinical and Climatological Association, vol. 54 (January 1938): 193-220.
4Woman's Medical College of Pennsylvania. Corporation Minutes. Apr. 1941-June 1943 and Sept. 1945-June 1949.
7Woman’s Medical College of Pennsylvania. Minutes of Faculty Meetings (Sept. 1940-July 1945).
10Woman’s Medical College of Pennsylvania. Annual Announcement, vols. 91-100 (1940/41-1949-50).