Lessons from Mass General

When someone tells you his or her life story for 20 or 30 hours, you can't help learning something. Imagine, then, listening to 100 of the world's best doctors and nurses recounting their careers during more than 200 hours of interviewing, while you research and write the history of the third oldest hospital in America, Massachusetts General Hospital. This is what I've been doing for the past 30 months, ending Tuesday. That's when I turned over the manuscript—all 213,000 words—to a copyeditor.

I have learned some lessons, some stories to tell. Let me begin with Richard Clarke Cabot (left).

In the history of this grand hospital, he is not the most illustrious figure, but he is the one who most captured my heart, and he has been dead for over 70 years. No, I did not interview him.

Maybe you've heard the famous bit of doggerel that goes:

So here’s to dear old Boston
Home of the bean and the cod
Where the Lowells speak only to Cabots
And the Cabots speak only to God.

Richard Clarke Cabot was one of those Cabots—a “Boston Brahmin” par excellence. Born in 1868 in Brookline, a proper Bostonian borough, he prepared for college (“prepped”) at Noble and Greenough School, then went to Harvard and Harvard Medical School. His father had been a friend of Ralph Waldo Emerson, and so Richard Cabot was a bit of a philosopher, and because he was independently wealthy, he could choose to be a wastrel or a saint. He chose the latter.

At a time when doctors were coming into their own—and profiting from it—Cabot chose his own path. At MGH in 1905, he founded the first social service department in an American hospital. While most doctors cared especially about their patients when the patients were in treatment, Cabot was concerned about what happened to patients after they left the hospital. Using his own funds initially, he started a small office at Mass General where he and a nurse, “Miss” Ida Cannon, sister of a fellow Harvard professor, made a point of following up with departed patients. It was a thankless mission, perceived as eccentric by some of Cabot’s medical contemporaries. It is not surprising that, although he was thought to be in line for the position, Richard Cabot was passed over for chief of medicine when the position went vacant in 1912.

Richard Clarke Cabot is the only doctor at Mass General that I want to write a biography about. Except maybe Jim O’Connell, founder of the Boston Health Care for the Homeless Program. I will make Jim the subject of another post. It is enough here to say that among the doctors who inspired O’Connell to spend 90 hours a week for 25 years caring for homeless people in Boston was none other than Richard Clarke Cabot.

At a time when health care has become a political football, a bone of contention fought over by dogs left and right, it is wonderful to “sit in the presence” of Richard Cabot and Jim O’Connell, two doctors separated by nearly a century who managed to remember that the health in health care refers to the patient, not the doctor.