(Adapted from Evans, AUR 1994; 163:983-986)

A short history of one of the great medical centers of the United States that documents the important contribution of its department of radiology. 

1771-1927

The New York Hospital is the second oldest hospital in the United States and was created by a royal charter from King George III in 1771. Its opening, however, was delayed for 20 years because of the Revolutionary War. During the British occupation of New York City, the newly finished hospital building was converted into barracks for the British soldiers. 

After the occupation, the building was converted back to its original purpose, providing New York with its first hospital. Samuel Bard, a famous physician of the era, was appointed the first attending physician at The New York Hospital. In June 1789, Dr. Bard operated on George Washington, who had been president for only 1 month. The operation was done in the executive mansion, then located in New York City. A large carbuncle in the left thigh, which Dr. Bard thought was a symptom of anthrax, was excised, but an uncomplicated recovery made this diagnosis dubious. By the early part of the 19th century, the Old Hospital, as it was then called, was no longer adequate and was demolished.

The second The New York Hospital was located between l5th Street and l6th Street, west of Fifth Avenue. Over the entrance was a stained glass medallion that was 2.5 ft (76.2 cm) in diameter and represented the seal of the hospital. The Good Samaritan, and his motto: "Go and Do Thou Likewise." In The Benevolent and Necessary Institution (1), Eric Larrabee states: "Among American surgeons of the first half of the 19th Century one of the most distinguished and by far the most famous to operate in The New York Hospital was Dr. Valentine Mott, a pioneer in vascular surgery."

Cornell University Medical College was created in 1898 and was located at First Avenue between 27th Street and 28th Street. The original building was designed by famous architect Sanford White. In l908, the Medical College made a daring innovation by requiring a 4-year college degree for admission (1), becoming the first medical school to establish what would become a universally accepted preadmission requirement.
 
 

1927-1976

In 1927, The New York Hospital and Cornell University Medical College joined to become The New York Hospital-Cornell Medical Center and moved to the present location along the East River, between 68th Street and 70th Street. The architectural design of the hospital buildings, particularly the Gothic arches forming the facades, was inspired by the Pope's Palace at Avignon, France. The architect, Henry R. Shapley, was awarded the gold medal of the Architectural League of New York. 

Affiliated institutions include Memorial Hospital, Memorial Sloan Kettering Cancer Center, and The Hospital for Special Surgery. A distinguished institution with which The New York Hospital-Cornell Medical Center has a combined MD-PhD program is The Rockefeller University. This large and complex medical community extends for along the East River from 63rd Street to 72nd Street and west to First Avenue.

Among the distinguished faculty in the formative years of The New York Hospital-Cornell Medical Center was Lewis Gregory Cole (1874-1954), professor of radiology. Dr. Cole was one of the pioneers in this new specialty. He was a brilliant clinical radiologist, an accomplished teacher, and an innovator in equipment design. Although Dr. Cole had a broad range of clinical interests, his major contributions were in gastrointestinal radiology (2), a field in which he made many important and original observations. The quality of his work was universally recognized, and he was published in Acta Radiologica and other prestigious foreign journals. His most provocative and controversial article was entitled "The Pathological Yardstick" (3). In this article, he presented to a group of world-renowned pathologists microscopic sections of organic gastric lesions and asked the pathologists to answer the following questions. 

  1. Is the lesion malignant?
  2. What type of lesion is it - carcinoma or sarcoma, etc.? 
  3. On what criteria is the opinion based? 
The diversity of the answers was surprising. For example, for about one-fourth of the gastric lesions, there was a difference of opinion among the pathologists as to whether a lesion was malignant and an even greater difference of opinion as to type of neoplasm. The published findings drew considerable criticism and some ill will from the pathologists. However, the article represents one of the first studies of observer performance in medicine.

In 1932, John Russell Carty was appointed chairman of radiology. Dr. Carty's father was General John J. Carty, a celebrated inventor and electrical engineer credited with perfecting long-distance telephone operation. Dr. Carty was a regular participant in the meetings of the New York Roentgen Society and was a frequent contributor to the radiologic literature. He was particularly interested in soft-tissue radiography and wrote a number of articles on this subject. He was forced to resign in 1943 because of poor health and died shortly thereafter at an early age. Harold L. Temple was appointed acting radiologist-in-chief in June 1943 and radiologist-in-chief in July 1946. He resigned in September 1948 to enter private practice.

Robert P. Ball, who had been an associate of Ross Golden at Columbia Presbyterian Medical Center, held the position of radiologist-in-chief and professor of radiology from 1948 to 1851. Sydney Weintraub, who had been in charge of gastrointestinal radiology, served as acting radiologist-in-chief from March 15, 1951, to December 31, 1951.

In 1952, John A. Evans was appointed radiologist-in-chief and professor of radiology, positions that he; until his retirement in 1976. In these two decades, the department of radiology expanded and differentiated, and its academic programs were strengthened. Dr. Evans was a strong advocate of separating radiology into diagnosis and therapy and, during his tenure on the American Board of Radiology, was instrumental in implementing this separation. This issue provoked considerable controversy in the field of radiology and at times much emotional discussion. However, the decision proved to be the right one. Dr. Evans delivered the annual oration of the Radiological Society of North America in 1963 (4). He was also the recipient of the society's gold medal in 1967. He served as president of the American Board of Radiology from 1967 to 1969 and was chairman of the committee that organized the board's first written examination. He was a chancellor of the American College of Radiology from 1958 to 1962 and was a recipient of its gold medal in 1985. A significant part of his time also was spent in postgraduate education.

The Robb-Steinberg method of visualizing the four chambers of the heart, the aorta, and the major pulmonary vessels (5) was a remarkable achievement and ranks with the major medical accomplishments of the 20th century. 

During the 1950s, Israel Steinberg and Charles Dotter gained wide recognition and fame for their work in angiocardiography. Their studies of congenital and acquired heart diseases (6) contributed to the successful surgical treatment of these diseases. They aggressively and successfully applied this technique to many medical and surgical diagnostic problems. Their studies had a major impact on the management of heart disease, aneurysms, lung, mediastinal and abdominal tumors, vascular anomalies, and vascular degenerative disease. Their busy angiographic suite in the department of radiology hosted visitors from radiology departments all over the world, a situation that added to its frenetic atmosphere. Dr. Dotter left in 1953 to become chairman of radiology at the University of Oregon. While there, he continued to bring enthusiasm, brilliance, and innovation to vascular radiology. Dr. Steinberg, although an internist by training, spent his professional career performing angiocardiography in the department of radiology. Drs. Dotter and Steinberg will take their place among the great names of radiology. 

After the Dotter-Steinberg era, important clinical, teaching and research contributions in radiology were made by Harry Stein, Richard J. Fleming, Harold Baltaxe, Robin Watson, and the current head of the cardiovascular/interventional radiology division, Thomas A. Sos. Dr. Sos is a skillful interventional radiologist, conducts a rigorous training program, is an accomplished teacher, lecturer, and honest investigator and has made innovative contributions to the field. He is a past president of the Society of Cardiovascular and Interventional Radiologists. 

In 1957, Robert Freiberger was appointed director of radiology at The Hospital for Special Surgery, professor of radiology at Cornell University Medical College and attending radiologist at The New York Hospital. Dr. Freiberger and his associates were influential in popularizing arthrography as an important diagnostic tool through publications and postgraduate courses with live demonstrations of the technique. Their contributions to the field of orthopedic and rheumatic diseases helped define musculoskeletal radiology as a distinct subspecialty. Dr. Freiberger resigned as director of radiology at The Hospital for Special Surgery in 1988 and retired in 1997.

In 1957, David Baker initiated a pediatric radiology service at The New York Hospital after completing both pediatric and radiology residencies. However, after only 1 year, he left to replace the distinguished pediatric radiologist John Caffey as director of radiology at Babies Hospital, Columbia Presbyterian Medical Center. Before 1957, Dr. Caffey had been a consulant and visiting professor in the department of radiology at The New York Hospital. His weekly conferences undoubtedly influenced Dr. Baker in his decision to become a pediatric radiologist. Dr. Baker's appointment as Dr. Caffey's successor was also probably influenced by Dr. Caffey's opinion that a pediatric radiologist should have received training in pediatrics. Since 1970, the chief of the division at The New York Hospital has been Patricia Winchester.

In the l960s, the department of radiology was involved in the development and introduction of a number of new radiographic and interventional diagnostic techniques; these included nephrotomography for the differential diagnosis of renal masses, percutaneous splenoportography for use in patients with portal hypertension, percutaneous transhepatic cholangiography for the diagnosis of obstructive bile duct disease, percutaneous lung biopsy (a technique that, although used extensively in Sweden, was not being used in the United States), and the Seldinger technique of percutaneous transfemoral arteriography. 

In 1967, D. Gordon Potts was appointed professor of radiology and chief of the section of neuroradiology. He quickly established strong clinical, teaching, and research programs. His fellowship program was highly regarded, and many of his former fellows are now in charge of academic neuroradiology programs. Dr. Potts implemented a well-funded research program whose major emphasis was the study of the basic anatomic and physiologic mechanisms involved in the production and absorption of CSF. In support of such studies, he obtained an electron microscope, the first of its kind to be used in the hospital. His publications have been substantial, and his five-volume text on neuroradiology, coedited by Hans Newton (7), was considered the definitive work in this field. Dr. Potts left The New York Hospital-Cornell Medical Center in March 1985 to accept the chairmanship of radiology at the University of Toronto.

Elias Kazam, professor of radiology, organized the section of ultrasound in 1967and later organized sections of body CT and MR imaging. His early cross-sectional CT and MR imaging studies are classical clinical contributions. His clinical work and writings are distinguished by their high quality. 

Morton A. Meyers was in charge of gastrointestinal radiology from 1970 to 1978. His clinical skills resulted in several important anatomic and physiologic radiologic observations for several gastrointestinal disorders. His monograph entitled Dynamic Radiology of the Abdomen: Normal and Pathologic Anatomy (8) is a popular reference source for medical students and radiology residents. In 1978, Dr. Meyers became chairman of radiology at the State University of New York at Stony Brook.
 
 

1976-1994

On July 1, 1976, Joseph P. Whalen was appointed radiologist-in-chief and professor of radiology and continued in this capacity for the next 16 years. During Dr. Whalen's tenure and under his guidance and planning, new space was acquired in the Starr Building; this acquisition permitted more centralization of diagnostic facilities. In addition, all sections of the department of radiology were given new equipment. Additional staff, resident, and fellowship positions were added; these additions strengthened the clinical, teaching, and research programs. It is generally recognized that Dr. Whalen's cross-sectional anatomic-radiologic correlations laid the basis for the later interpretation of CT scans and MR images. He gave the New Horizons Lecture at the annual meeting of the Radiological Society of North America in 1972 and the Caldwell Lecture at the annual meeting of the American Roentgen Ray Society in 1979. In 1989, the State University of New York Health Science Center, Syracuse, awarded him the honorary degree of doctor of science. 

In 1992, Dr. Whalen resigned from his positions in the hospital and medical college to accept an appointment as dean of the College of Medicine and vice president of biomedical and medical education at the State University of New York Health Science Center, Syracuse. After Dr. Whalen's resignation, Michael D.F. Deck , who had been vice chairman of the department of radiology as well as chief of the section of neuroradiology, was appointed acting chairman of the department in June 1992.
 
 

1994-1999

Dr. H. Dirk Sostman was appointed radiologist-in-chief and chairman of the department on July 1, 1995.  During this period, many changes occurred in the medical center and the department. 
In the summer of 1996, the New York Hospital announced its intention to merge with the renowned Presbyterian Hospital to form a single corporation, the New York-Presbyterian Hospital and this merger was completed on the last day of 1997.  This exciting initiative created one of the most distinguished academic health centers and one of the largest not-for-profit health care networks in the United States. 
The New York Hospital opened an entirely new patient bed tower in mid-1997. Rising above the East River, this new building houses all patient beds and inpatient operating rooms; it is part of the commitment by the New York Hospital to remain at the forefront of health care delivery into the twenty-first century.   The department of radiology again acquired new and more functionally organized clinical space, and completely renewed its equipment.
Columbia University and Cornell University formed a joint-venture company for the purpose of joint health care contracting and management.  This company, through the departments of radiology at the two medical schools, also formed a joint-venture company with the New York-Presbyterian Hospital for joint radiology ventures.
Many outstanding new clinical and science faculty were added to the radiology department staff.  In addition, new initiatives in information technology (such as a campus-wide PACS system) and clinical organization were implemented with successful early results; these initiatives will be on-going for several years.
Significant investments were made by the department and the Medical College in imaging research, including construction of a new imaging center with high-field MRI/MRS, PET and a cyclotron, scheduled for completion in January, 2001.
 The future chapters of this illustrious department of radiology are yet to be recorded, but it is clear that they will depend upon the efforts and creativity of the many dedicated faculty, trainees and staff who have succeeded their distinguished predecessors. 
 
 

REFERENCES

  1. Larrabee E. The Benevolent and Necessary Institution. NewYork:Doubleday, 1971. 
  2. Cole LG. Physiology of the pylorus, pilleus ventriculi and duodenum as observed roentgenographically. American Medical Association, September 6, 1913; LXI:762-766. 
  3. Cole LG. The pathological yardstick. Surg Gynecol Obstet 1936; 63:689-716. 
  4. Evans JA. Specialized roentgen diagnostic techniques in the investigation of abdominal disease. Radiology 1964; 82:579-594. 
  5. Robb GB,Steinberg I. Visualization of the chambers of the heart, the pulmonary circulation and the great blood vessels in man: a practical method. AJR 1939; 41:1-17. 
  6. Dotter CT,Steinberg I. Angiography in congenital heart disease. Am J Med 1952; 12:219-237 
  7. Newton H, Potts DG, eds. Radiology of the skull and brain, lst ed. St. Louis: Mosby,1971:1-459 
  8. Meyers MA. Dynamic radiology of the abdomen: normal and pathologic anatomy, lst ed. New York: Springer-Verlag, 1976: 1-352.