Stanford University School of Medicine and the Predecessor Schools: An Historical Perspective
Part V. The Stanford Era 1909-

Chapter 36. Dean Loren R. Chandler's Administration
1933 - 1953

Dr. Loren R. Chandler, Dean, School of Medicine, 1933-1953

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A photo of Dr. Loren R. Chandler, Dean, School of Medicine, 1933-1953

Dr. Chandler's twenty years as Dean of the Stanford Medical School (the longest tenure of any of the Stanford Medical Deans) included the Great Depression, World War II and the decision to move the School to the Stanford Campus. He dealt with these and other significant issues with a mature judgment and equanimity which led his successor (Dean Windsor Cutting, 1953-1957) to refer to him as "one of the wisest and most respected men in Stanford's history." Administrative talent was indeed his greatest endowment, continually called upon in coping with the many issues with which he dealt during his 20 years in office. [1]

Dr. Chandler was born in 1895 on a farm in San Joachin Valley near Fresno, California and had his primary and secondary education in Fresno. While In high school he went out for football. On his first day the coach saw him standing alone on the football field and asked: "Who is that tall Yankee over there?" Within a week he became known as "Yank Chandler," a name that graced his personality well and stayed with him for the rest of his life.

Yank's Father, Wilbur F. Chandler, was a grape grower, oilman and state senator. The family migrated from St. Johnsbury, Vermont, to the San Joaquin Valley where farming was the way of life for Yank and his four brothers, all raised in a Spartan environment of hard work. [2]

Curriculum Vitae

Stanford Degrees. A combination of scholarship, leadership, and sterling personal qualities won Yank Chandler admission to Stanford University where he received an A. B. degree in 1920 and an M. D. in 1923.

Stanford Appointments

  • 1923-24 Senior Intern in Surgery, Stanford University Hospitals
  • 1923-25 Teaching Assistant, Department of Surgery, Stanford
  • 1924-25 Resident Surgeon, Stanford University Hospitals
  • 1925-33 Clinical Instructor in Surgery, Stanford
  • 1933-38 Associate Professor of Surgery, Stanford
  • 1933-53 Dean, Stanford University School of Medicine
  • 1938-60 Professor of Surgery, Department of Surgery, Stanford

Experience

  • 1938-53 Trustee and Vice President, College of Physicians and Surgeons, School of Dentistry, San Francisco
  • 1941-45 Advisory Committee on Medical Education, War Manpower Commission 1942-46 National Committee for Physician Procurement and Assignment, United States Selective Service System
  • 1942-46 California State Committee for Physician Procurement and Assignment, United States Selective Service System
  • 1942-46 San Francisco Committee for Physician Procurement and Assignment, United States Selective Service System
  • 1947-59 Consultant, Letterman Army Hospital, San Francisco
  • 1947-49 Consultant, United States Navy Hospital, Oakland
  • 1948-53 Member, Surgical Study Committee, Research Grants Division, United States Public Health Service
  • 1949-50 Dr. Chandler was one of a commission of three appointed by the American Medical Association to study the effects of the British National Health Science Act on health and education in Britain. He concluded that it would be "folly" to institute such a plan in the United States.
  • 1951-53 Advisory Board for Medical Specialties, (President, 1951-53)
  • 1955-56 Consultant, Grant Foundation, Albert Schweitzer Memorial Hospital in Haiti

Honors

  • Nu Sigma Nu; Alpha Omega Alpha; Sigma Xi;
  • 1952 Sc. D., University of Southern California
  • 1959 Stanford Honorary Fellowship (one of the highest and seldom bestowed honors of the University)

Association Officer

  • Pacific Coast Surgery Association (President, 1954-55
  • San Francisco Surgical Society (President, 1949)
  • California Academy of Medicine (Vice President, 1941; President 1942)
  • Association of American Medical Colleges (Vice President, 1937-38; President, 1941-42) [3]

Appointment as Dean (1933)

Upon completion of his residency training in Surgery at Stanford University Hospitals in 1925, Dr. Chandler joined the faculty as a Clinical Instructor in Surgery and entered surgical practice in downtown San Francisco. Over the ensuing decade he developed one of the largest surgical practices in the city, specialized in pediatric surgery and continued to serve on the faculty.

Dr. Arthur Bloomfield came to Stanford University School of Medicine as a full-time professor of medicine in 1926 and Dr. Emile Holman arrived as a full-time professor of surgery in 1925, just as Dr. Chandler started his career in practice and teaching. He admired the new excellence in teaching and patient care which they brought to Stanford and worked with them through the depression years as a geographic full-time faculty member. It was during this period that Dr. Chandler's talents as a teacher and administrator caught the favorable attention not only of the senior faculty but also of President Ray Lyman Wilbur who interested Dr. Chandler in the concept of voluntary prepaid health insurance, and introduced him to University Trustee Herbert Hoover.

Small wonder then that, when Dr. Ophüls retired as Dean in 1933, Dr. Chandler was appointed Dean of the Stanford University School of Medicine for he had by that time gained the support of President Wilbur, Trustee Herbert Hoover, and both the Full-time and the Clinical Faculty. [4]

Dr. Chandler's deanship was above all distinguished by the respect and affection with which he was universally regarded. His long tenure in office was fondly remembered by the faculty, students and alumni of his day as a golden era of devotion to learning in an atmosphere of cooperation, pride in the alma mater and lasting friendships.

Loren Roscoe Chandler (1895-1982) with unidentified persons

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A photo of Loren Roscoe Chandler (1895-1982) talking with unidentified medical personel

Such then was the wholesome influence of the personality and administrative style of Dr. Chandler on the affairs of the Medical School that we shall now turn directly to his own views on the subject.

Dr. Chandler's Reflections on his Deanship

"I think my contribution to Stanford, if any, has been in personnel rather than fundamental science research or basic changes in educational technique. I've always believed that you should get the right man in the right place and then let him alone. Be sure he is an expert in his field. Be sure he knows how to teach. And don't fence him in with too many rules and regulations made by somebody who is not an expert. That's what deans are for. And, I think, they are also meant to say 'yes' most of the time. They should think hard before they tell one of the crew 'No, you can't have that.' The dean's major task is to keep up the faculty's enthusiasm and excitement for the job." [5]

Running a medical school is something like running a team of 100-odd horses of different speeds, of different temperaments, and of different degrees of irascibility, but Dr. Chandler managed to keep the faculty functioning as "a big happy family." This doesn't mean that he was "soft." In fact, he did not believe that a medical school could be run by committees. "The more committees you have," he said, "the more time elapses until you can make a decision. Somebody has to sit at the head of the table."

Loren Roscoe Chandler (1895-1982) with Emile Holman (1890-1977), Arthur Bloomfield (1888-1962), Anthony J.J. Rourke, William Northway (1932-), John A. Anderson (1908-), Charles E. McLennan (1909-1986); Henry Kaplan (1918-1984)

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A group photo of Loren Roscoe Chandler (1895-1982) with Emile Holman (1890-1977), Arthur Bloomfield (1888-1962), Anthony J.J. Rourke, William Northway (1932-), John A. Anderson (1908-), Charles E. McLennan (1909-1986); Henry Kaplan (1918-1984), sitting at the long board room table

Dr. Chandler took charge of the medical school in the depths of a depression when financial difficulties severely afflicted both the school and the students. The task of financing medical research and teaching through private support did not come easy in those days. An astonishing medical revolution also took place during Dr. Chandler's deanship, brought on by the discovery of antibiotics, newer diagnostic techniques for cancer and heart disease, and the phenomenal advances in general surgery that led to the present day developments in open-heart surgery and organ transplantation.

In spite of these innovations one thing did not change - Dr. Chandler's conviction that it is the faculty that makes a medical school tick. "You can have all the buildings you want," he said, "but you must also have the experts - the masters who can make a thing so simple that the student wonders why he didn't think of it himself. You need experts who can teach and good teachers will produce others, who at the same professional age will be better than they were."

Arthur L. Bloomfield (1888-1962) with Robert Evans, William Kirby and unidentified patient

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A photo of Arthur L. Bloomfield (1888-1962) with Robert Evans, William Kirby with an unidentified patient

Funding Teaching Patients

One of the major problems he encountered as a dean was meeting the hospital and other costs of teaching patients. Dr. Chandler solved this problem by a plan he championed - that of including not only the "medically indigent " in the teaching program, but also the great mass of patients covered by Blue Cross and the California Physicians Service and other programs of prepaid medical care of which he was a strong advocate. The policy of including private patients in the teaching program was later to become standard practice in the school. [6]

Ruth Lucy Stern Research Laboratory

Obtaining funds for research was also particularly difficult during the depression years which made the gift of a research building by Mrs. Sternin 1939 both unexpected and especially welcome. Dean Chandler's surprise and gratification are apparent in his account of receiving the gift [7]

We received a magnificent gift from the late Mrs. Lucy Stern, known to Stanford students as "Aunt Lucy." This was a promise to pay the bills for the construction of a three-story building located on Clay Street opposite the Stanford University Hospitals and to be devoted entirely to medical research. This was like money from home. Promptly, and without delay, a building was planned and constructed, equipped, dedicated and opened for operation in the autumn of 1939, Mrs. Sterns paying all the bills. To this day I don't know and I don't know anyone else who does know exactly how much that building and its extras cost.

World War II

"On 24 August 1939 the Western World was stupefied by the news that Stalin and Hitler, who had been violently abusing each other for five years, had shaken hands in a non-aggression pact. The world did not yet know the secret clauses, in which they also agreed to partition Poland. After his usual preparatory propaganda of fake frontier incidents, Hitler launched his attack on Poland on 1 September 1939. Two days later Britain and France declared war on Germany. The British Dominions followed suit shortly, and World War II was on." [8]

In response to the events in Europe, the peaceful progress of the medical school was interrupted by the declaration of a state of National Emergency on October 17, 1940. This included the establishment of compulsory military service for all males from 18 to 36 years of age. Also on October 17, 1940 orders went out from Washington to establish selective service agencies and put them in action throughout the various states and counties. Volunteer selective service boards were established by districts within larger cities and in all counties. The immediate problems of the medical school were, first, the deferment from military service of medical students so they could complete their medical education and serve as physicians, second, some method of deferring premedical students who were likely candidates for admission to medical school and third, the problem of maintaining an adequate faculty. [9]

The dark days of all-out war came with the Japanese bombing of Pearl Harbor at Honolulu on December 7, 1941. Immediately, practically everything in the United States went on a war schedule. Industry began to expand, employment on the West Coast doubled or tripled, new ship-yards were built, airplane factories, munitions plants, and equipment manufacturers went into high gear. Because of the speedup in industry , particularly in the San Francisco Bay Area, salaries kept rising to a fantastic amount for day labor, either full-time of part time. The depression was finally a thing of the past.

Shortly after the Declaration of War against Japan on December 8 , 1941 the medical schools went on a continuous teaching program known as the 9.9.9 Medical Plan. This meant that Stanford Medical School opened its regular classes in September, 1941, continued for the 9 months ending on a Friday afternoon in June, 1942, but the following Monday the next academic year was begun. This continued throughout the period of war and, during the four years, five classes were graduated from the medical school.

Approximately 35% of the Stanford Medical Faculty were on military leaves of absence, many of them serving in Army Evacuation Hospital No. 59 in the European theater during the war. The Staff of this special unit was composed of members of the staff of the San Francisco Hospital, all but four were members of the Stanford University Medical Faculty or the Stanford resident staff. This Evacuation Hospital made an outstanding record in the European theater. The report of its accomplishments, the number of patients cared for, the low mortality rate of the large number or patients cleared through the hospital was the subject of a laudatory special Report by the Historical Division, Office of the Surgeon General, U. S. Army.

World War II ended in Europe with the crushing defeat of the German army. German General Jodl signed an unconditional surrender at Allied headquarters in Rheims on 7 May 1945.

The Combined Allied Chiefs of Staff, meeting at Quebec in September 1944 predicted that it would take eighteen months after the surrender of Germany to defeat Japan. Actually, the war in the Pacific was ended in 1945 only three months after V E Day as a direct result of the cataclysmic explosion of the first atomic bomb over Hiroshima on August 6 and a second atomic bomb over Nagasaki on August 9.

Although many Americans have expressed contrition over exploding the first atomic bombs, it is difficult to see how the Pacific war could otherwise have been concluded , except by a long and bitter invasion of Japan.

Even after the two atomic bombs had been dropped, and the Potsdam declaration had be clarified to assure Japan that she could keep her emperor, the surrender was a very near thing. Emperor Hirohito had to override his two chief military advisers and take the responsibility of accepting the Potsdam terms. That he did on 14 August 1945, but even after that a military coup d'état to sequester the emperor, kill his cabinet, and continue the war was narrowly averted. Hirohito showed great moral courage; and the promise to retain him in power despite the wishes of Russia (which wanted the war prolonged and Japan given over to anarchy) was a very wise decision.

After preliminary arrangements had been made at Manila with General MacArthur's and Admiral Nimitz's staff, an advance party was flown into Atsugi airfield near Tokyo on 28 August 1945. Scores of ships of the United States Pacific Fleet, and of the British Far Eastern Fleet, then entered Tokyo Bay.

On 2 September 1945 World War II ended with the signing by General Umezu, the Japanese Foreign Minister, of the surrender document. The signing took place on the deck of the American Battleship Missouri in Tokyo Bay and in the presence of representatives of the Allied countries.

At 9:25 a. m., as the formalities closed, a flight of hundreds of aircraft swept over the Missouri and her sister ships. Then General Douglas MacArthur, the presiding officer, broadcast an address to the people of the United States:

Today the guns are silent. A great tragedy has ended. A great victory has been won. . . A new era is upon us. . . [10]

It was indeed a new era for Stanford Medical School and its prospects for moving to the Campus, a major deterrent to which had been insufficient population on the Peninsula to provide patients for teaching and research. Now World War II and its aftermath had resulted in a massive influx of war related activities and population - the latter augmented by immigration of families seeking a better life on the Peninsula.

Another significant effect of World War II was the accelerated federal funding of educational and research programs. During the war years Dean Chandler accepted these government programs as necessary to meet wartime goals. However, it was his successors in the deanship who took full advantage of the tremendous postwar increase of federal funding to enlarge and strengthen Stanford Medical School along new lines, including its transfer to the University campus.

Deans Committee Veterans Hospitals

While he was in general cautious about accepting federal funds, Dr. Chandler approved the concept of Veterans hospitals and of medical school involvement with them.

On July 1, 1946 Stanford and the University of California Schools of Medicine jointly took over the professional staffing of the Fort Miley Veteran's Hospital in San Francisco and the medical care of all its patients The arrangement was made possible by the Veterans Administration's establishment of the "Deans Committee Veterans Hospitals" throughout the country. These teaching facilities were available for interns and residents but not for medical students. The affiliation of medical schools with Veterans Hospital proved invaluable to both the veterans and to the schools.

It was to a major degree due to Dean Chandler's efforts that Stanford and the University of California took over the professional staffing of Fort Miley Veterans Hospital. After Stanford Medical School moved to Palo Alto, Dr. Chandler served from 1959 until his retirement in 1968 as chief of surgery at the Palo Alto Veterans Administration Hospital. He played a key role in its original development as a teaching hospital under a Stanford Dean's Committee. [11]

The Quality of Education at Stanford

Dean Chandler believed that the contribution and stature of Stanford Medical School could be best measured by the accomplishments of its graduates. He proudly cited the following outstanding Stanford graduates in a wide range of medical fields as proof that the Stanford system of medical education was remarkably effective. Numbered among the eminent Stanford alumni who graduated during the Chandler years were Albert Snoke, Executive Director of Yale-New Have Hospital; Sherman Mellinkoff, Dean of UCLA School of Medicine; Arthur Richardson, Dean of Emory University School of Medicine; Philip Lee, Assistant Secretary of Health, Education, and Welfare; and pioneer surgeons Frank Gerbode, Victor Richards and Roy Cohn. [12]

It is of interest to note that the above list of those considered the outstanding graduates of the School during the Chandler years includes none devoted to investigation in the basic sciences.

President Tresidder's Plans for the Medical School

When President Donald Tresidder succeeded President Wilbur in the presidency of the University in January of 1943 he learned of Dr. Wilbur's ambitious Endowment Campaign which called for generous grants to the medical school to build new facilities in San Francisco. President Tresidder also learned that none of these facilities had been funded and that the offer of a large gift by an anonymous donor for a medical school building was not acquired because of failure of the University - after prodigious efforts -to raise the necessary matching funds. In short, President Wilbur's earnest fund-raising activities on behalf of the Medical School over the previous twenty-five years had been largely unsuccessful while the medical facilities in San Francisco had continued to deteriorate and the academic program to grow.

In 1944 the University Board of Trustees asked President Tresidder to review everything the University was doing to determine what was good and should be kept and expanded, what wasn't so good, should be approved or stopped, and what was not being done that should be done.

The Medical School component of this University-wide review was prepared by a committee appointed by Dean Chandler. This committee was comprised of Professors Harold K. Faber, Charles E. Smith, and Edwin W. Schultz (the so-called "Faber Committee")

The Faber Committee's study was completed in 1946 and at that time was approved by the Board of Trustees The Committee's most important recommendation was that the medical school buildings in San Francisco should be modernized and expanded. Specifications for the new construction were prepared and a definite fund-raising campaign for the School of Medicine was incorporated in an overall plan of securing additional gifts and contributions to the University as a whole. Insignificant progress was made, however, and the death of President Donald Tresidder in January 1948, put all these Medical School plans and activities in abeyance for five years. [13]

Before considering further developments in the final years of Dr. Chandler's deanship, let us comment briefly on a major reason for continuing reluctance to move the Medical School from San Francisco to the Stanford Campus. It was no secret that President Tresidder and Dean Chandler and some faculty members were keenly interested in the possibility of an integrated medical school on the Campus. This was in spite of the determined opposition of faculty members with established medical practices in San Francisco.

In order to explore thoroughly the concept of an integrated School President Tresidder and Dean. Chandler visited the universities of Illinois, Cornell, Duke, and Michigan to learn from their experience in this regard. After these visits the President and Dean concluded that a move to the Campus would be unwise until the school could be assured of an adequate number of patients for teaching and research in that location, a condition requiring the cooperation of the local physicians.

Evidence of poor cooperation by the local physicians in the Campus area already existed. To be specific, previous efforts by Stanford to affiliate with the county hospitals in Santa Clara and San Mateo Counties had failed because of local politics and disagreement over who would control appointment of the service chiefs. To President Tresidder and Dean Chandler these rebuffs meant that the local doctors were not ready to cooperate with a Stanford Medical School in their midst and that an attempt to consolidate the School on the Campus was therefore premature.

Later experience showed that President Tresidder and Dean Chandler were correct in predicting that there would be significant friction between the Medical School and the local practitioners when the School moved to the Campus, but mistaken in their assumption that this negative disposition could not be overcome. [14]

President Sterling's Plans for the Medical School

In April 1949, J. E. Wallace Sterling was named President of the University to succeed the late President Tresidder, and in March 1951 the Board of Trustees reaffirmed their intention to proceed with plans to expand and modernize the medical school in San Francisco, as recommended by the Faber Committee in 1946. The Alumni and the public were informed. A drive for funds was started and, as on previous occasions, it was unsuccessful.

In view of the lack of progress, President Sterling and the Board of Trustees decided in the spring of 1952, to review again the whole problem of the Medical School's future. For this purpose President Sterling appointed the following eight-man committee of the Medical Council, known as the Sterling Committee, to conduct yet another study and determine what would be best for medical education at Stanford:

The Sterling Committee

  • Dr. R. L. Chandler, Dean
  • Dr. Arthur L. Bloomfield, Professor of Medicine
  • Dr. Windsor C. Cutting Professor of Pharmacy
  • Dr. William W. Greulich, Professor of Anatomy
  • Dr. Henry S. Kaplan, Professor of Radiology
  • Dr. William H. Northway, Professor of Medicine
  • Dr. Victor Richards, Asst. Professor of Surgery
  • Dr. Lowell A. Rantz., Associate Professor of Medicine

The Sterling Committee made a remarkably comprehensive study of medical education in general and the Stanford Medical School in particular, and reported its findings to President Sterling in the spring of 1952. Unaccountably, the question of moving the school to the campus was not addressed by the Committee and the inference of the Sterling Report was that the medical school would remain in San Francisco. [15]

Decision to Move to the Campus

Meanwhile President Sterling and the Board of Trustees had been considering the long-range advantages of consolidating the Medical School on the campus On July 15, 1953 the Board of Trustees announced their decision. The conditions were now, at last, favorable. They would establish a united Medical School on the Stanford campus.

Resignation of Dean Chandler

One month later, on August 31, 1953, Dean Chandler resigned the deanship he had held for the past twenty years, describing his decision enigmatically as "a necessary move to keep the Stanford University vital and growing. " Dean Chandler personally believed that the move of the Medical School from San Francisco to the campus was inevitable and only a matter of timing - and that President Sterling would provide the necessary leadership. [16]

For an insightful and nostalgic memoir of the Chandler years, see Medicine and the Stanford University School of Medicine: Circa 1932, The Way It Was by Dr. David A. Rytand, Arthur I. Bloomfield Professor of Medicine, published in 1984 by the Department of Medicine and Alumni Association, Stanford University School of Medicine.

Endnotes

  1. Windsor Cutting , Loren R. Chandler et al, The First Hundred years: A Compendium of Decanal and Departmental Reports (Glendale, California: Mirro-Graphic Yearbooks, c. 1959): p. 8.
  2. Spyros G. Andreopoulos , "Stanford's Yank Extraordinary," Stanford M. D., Series 6, Number 3 (October 1967): pp. 2-4.Lane Library catalog record
  3. Transcript of an Interview with Loren R. Chandler, May 26, 1960, by Samuel Moffitt, Information Officer for Stanford Medical Center, 26 pp., with attached Curriculum Vitae.Lane Library catalog record
  4. Victor Richards , "In Memoriam, Loren Roscoe Chandler," American Journal of Surgery 146, no. 1 (Jul 1983): 152-154.Lane Library catalog record
  5. Spyros G. Andreopoulos , "Stanford's Yank Extraordinary," Stanford M. D., Series 6, Number 3 (October 1967): pp. 2-5.Lane Library catalog record
  6. Spyros G. Andreopoulos , "Stanford's Yank Extraordinary," Stanford M. D., Series 6, Number 3 (October 1967), p. 6.Lane Library catalog record
  7. Windsor Cutting , Loren R. Chandler et al, The First Hundred years: A Compendium of Decanal and Departmental Reports (Glendale, California: Mirro-Graphic Yearbooks, c. 1959): p. 93.
  8. Samuel Eliot Morison , The Oxford History of the American People (New York: Oxford University Press, 1965), pp. 992-993.
  9. Windsor Cutting , Loren R. Chandler et al, The First Hundred years: A Compendium of Decanal and Departmental Reports (Glendale, California: Mirro-Graphic Yearbooks, c. 1959): p. 93.
  10. Samuel Eliot Morison , The Oxford History of the American People (New York: Oxford University Press. 1965), pp. 1044-1045.
  11. Spyros G. Andreopoulos , "Stanford's Yank Extraordinary," Stanford M. D., Series 6 Number 3 (October 1967): pp. 2-4.Lane Library catalog record
  12. Spyros G. Andreopoulos , "Stanford's Yank Extraordinary," Stanford M. D., Series 6 Number 3 (October 1967): pp. 2-4.Lane Library catalog record
  13. Windsor Cutting , Loren R. Chandler et al, The First Hundred years: A Compendium of Decanal and Departmental Reports (Glendale, California: Mirro-Graphic Yearbooks, c. 1959): p. 95-96.
  14. Spyros G. Andreopoulos , "Stanford's Yank Extraordinary," Stanford M. D., Series 6, Number 3 (October 1967): pp. 4-5.Lane Library catalog record
  15. Stanford University School of Medicine. Stanford Medical School Council Report, 1952. Lane Medical Library H747 S78 1952.
  16. Spyros G. Andreopoulos , "Stanford's Yank Extraordinary," Stanford M. D., Series 6, Number 3 (October 1967): pp. 4-5.Lane Library catalog record
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