Stanford University School of Medicine and the Predecessor Schools: An Historical Perspective
Part I. Background History & E.S. Cooper's Midwestern Years.

The history of Stanford Medical School begins in 1858 with the founding in San Francisco by Dr. Elias Samuel Cooper of the first medical school on the Pacific Coast, known as the Medical Department of the University of the Pacific. Stanford's School of Medicine is the lineal descendant of this pioneer medical school. ^[1]

Dr. Cooper (1820-1862), founder of the new school, was a controversial but able surgeon in Peoria, Illinois, when in 1854 at the age of 34, and with premonitions of failing health, he abruptly gave up his flourishing practice to pursue postgraduate studies in Europe. Leaving New York on October 4, he arrived in Liverpool 10 days later on 14 October, and proceeded on to Edinburgh. There he joined his younger brother Jacob, who was engaged in religious studies at the University of Edinburgh.

After his arrival in Edinburgh, Dr. Cooper had time to reflect on his Atlantic crossing. It had been a memorable experience for him. He had never before traveled beyond the Middle West, and this was his first sea voyage. The Cunard Line's wooden steamship, S. S. Arabia, on which he embarked at New York was a 2400-ton side wheeler, said to be fitted with the largest and most powerful steam engines ever put into a vessel. Her accommodations for 180 passengers, all first-class, represented the height of Victorian comfort. Her length of 285 feet provided space below deck for two libraries; sumptuous, steam-heated cabins; a children's nursery; a dining saloon seating 160, and other amenities. The promenade deck extended from stem to stern. ^[2]

The Arabia was popular in the Atlantic trade because of her agreeable appointments, and these were doubtless favorable to the blooming of those pleasant shipboard friendships that not infrequently spring up naturally during the leisure and confinement of sea travel. Indeed, for Dr. Cooper the most gratifying aspect of the voyage was the companionship of a fellow passenger, Hugh Keenan, who was en route to his post as U.S. Consul in Cork, Ireland. Within a few days of his arrival in Edinburgh, Dr. Cooper addressed the following letter to Mr. Keenan:

It was only recently that a copy of this letter to Keenan in Cooper's handwriting was discovered among miscellaneous correspondence in the Medical School Archives. We shall probably never learn why he chose to reveal to Keenan (and, as far as we know, only to Keenan) his closely-guarded plan to found a medical school in San Francisco. No doubt he meant the sharing of what had now become his life's purpose to be the ultimate expression of esteem for his new friend. And perhaps a homesick Cooper sought intuitively to lessen the lonely burden of his crucial decision by disclosing it to a sympathetic confidant.^[3][4]

Years later Dr. Levi Cooper Lane, Cooper's nephew, wrote that Cooper had as early as 1851 spoken of his interest in establishing a medical school. It was later that Cooper decided on California as the site for his endeavors. It is said that this ambition was inspired in Cooper by the example of his friend and surgical colleague Dr. Daniel Brainard who eight years earlier, at the age of 31, had founded Rush Medical College in Chicago in 1843. Illinois was then on the rapidly advancing frontier of the country.^[5][6]

By the early 1850s the frontier had moved to the Pacific Coast, and Cooper astutely concluded that San Francisco, burgeoning seaport and gateway to the gold fields, was a more promising site for a new medical school than the Middle West. Adventurous spirits, aspiring to perform great deeds, must often seek out a place where great deeds are possible. So it was with Cooper who, upon his return to Peoria from Europe and in accordance with his covert plan, joined the westward migration then at full flood. He arrived in San Francisco in 1855, traveling by the sea route from the East Coast via Nicaragua.

After reaching San Francisco, Cooper recalled his crucial decision to leave Illinois in search of his destiny in California, and these were his thoughts:

In three years, and in spite of ridicule, professional misadventures and chronic illness, obstacles that would have defeated a lesser man, Cooper succeeded in 1858 in establishing the first medical school in the vast territory between Iowa and the Pacific.

Memorable achievements that determine the course of history are generally traceable to exceptional individuals such as Elias Cooper. Clearly the beginnings of medical education in California, and the existence of Stanford Medical School, are the legacy of Cooper's vision and determination. It will therefore be fitting, in recognition of biography as the essence of history, to begin this chronicle of the School with an account of Cooper's life and work.^[8]

The history of Stanford Medical School and its antecedent institutions spans the years from 1858 to the present. During this interval, four distinct chronological periods in the annals of the School can be identified. Because of the length and complexity of the School's evolution, the following Synopsis is provided as an overview of the events to be discussed in subsequent chapters.

It has already been noted that the first medical school in the Far West was founded in San Francisco in 1858 by Dr. Elias Samuel Cooper (1820-1862) as the Medical Department of the University of the Pacific; and that this original medical college was the forerunner of Stanford Medical School.

The University of the Pacific was established in 1851 by the Methodist Church and was the first college to be chartered by the State of California. It was located at that time in the town of Santa Clara, some 48 miles south of San Francisco. In 1871, the school moved to San Jose, and from there to Stockton in 1921. The University of the Pacific had authority from the State to grant degrees, including the MD For this reason Cooper and his colleagues petitioned the Trustees of the University to create a Medical Department with them as the faculty, and their request was granted.^[9]

The school and Cooper were both subjected from the outset to virulent criticism from a strong faction of San Francisco physicians. The school would certainly have had a brief and hapless life but for Cooper's vigorous advocacy, and his perceptive choice of five resolute and loyal men who joined him in the enterprise, and with him constituted the original faculty. Providentially, there was soon the addition to the faculty of a new member who was ultimately by his own efforts and personal resources to ensure the survival of the school. This was Cooper's nephew, Dr. Levi Cooper Lane (1828-1902), appointed Professor of Physiology in 1861.

Having just begun to gain acceptance in the region and to award some 5 MD degrees each year, the school entered the most precarious period of its entire existence. Elias Cooper died in 1862, finally succumbing at the age of 41 to the obscure neurological disorder first manifest at the time of his departure from Peoria, Illinois for California. Without his leadership, the school's momentum slackened.

During the first few years of the new School, Cooper's most prestigious surgical rival, Dr. Hugh Huger Toland (1806-1880) perfected his own plan to found a medical school, and constructed a new building for the purpose on Stockton Street near Chestnut in downtown San Francisco. He announced in 1864 that the Toland Medical School would open in the fall. Outclassed and outflanked, the Medical Department of the University of the Pacific suspended operation while Dr. Lane and several key faculty colleagues from the Medical Department accepted the invitation of Dr. Toland to join the faculty of his new school. However, they later regretted their decision and in 1870 withdrew from the Toland School. They then reactivated the Medical Department of the University of the Pacific which had been suspended from 1865 through 1869.

In 1873 the Toland School became the Medical Department of the University of California (now the University of California School of Medicine in San Francisco). And so we see that the sometime competitive relationship between UCSF, Stanford Medical School and their antecedents dates from 1864.

The revival of the Medical Department of the University of the Pacific in 1870 marks the close of the school's hectic, fledgling period, wherein a self-taught and contentious surgeon from Peoria, Elias Samuel Cooper, was the indomitable moving spirit. In a sense, Cooper can be said to be responsible for the founding of not one, but two medical schools in San Francisco. There can be no doubt that the impetus for the Toland School was Dr. Toland's rivalry with Cooper and the craving to trump his hand.

When the Medical Department of the University of the Pacific reopened in 1870 it was located on Stockton Street south of Geary in San Francisco next to the laboratories of University (City) College, a Presbyterian school founded in 1860. The first regular course of medical lectures of the revived school was held in the Chapel of the College. In order to gain permanent access to the conveniently located facilities of the College, the faculty arranged an amicable transfer of the school from University of the Pacific to University (City) College in 1872, and the school then became known as the Medical College of the Pacific.^[10]

After 1870 the size and breadth of the faculty increased progressively with the result that the Medical College of the Pacific, an entirely self-sustaining enterprise, competed successfully for students and in other respects with the Medical Department of the University of California. In 1876 each school awarded about 20 diplomas.

When the school was reorganized in 1870, Levi Cooper Lane was designated Professor of Surgery and Surgical Anatomy, a dual appointment formerly held by Elias Samuel Cooper. Lane also assumed the leadership role that Cooper had previously filled in the affairs of the school. At the same time Lane proceeded, quietly and without the knowledge of his associates, to execute his own personal plan for the future of the school.

Lane's plan was divulged in 1882 when he donated to the school an impressive new building, constructed with his own private funds at the corner of Sacramento and Webster Streets in San Francisco. That building, said to have no superior in the world for medical education at the time, was in continuous use as a medical school for the next 77 years (1882-1959). On moving to the new facility, the school was incorporated as an independent institution and the name was changed from Medical College of the Pacific to Cooper Medical College in honor of Lane's Uncle Elias.

In 1890 a handsome new addition, the same size as the original medical school building, was constructed also at Lane's expense and donated to the school. It included a lecture hall, laboratories and other features.

Lane next turned his attention to improving resources for clinical teaching. With this in view, the 200-bed Lane Hospital was constructed during 1893 and 1894 at Clay and Webster Streets adjacent to the medical school, and inaugurated in 1895. Funds for the land and building were provided by various donors, but the major contributor was Dr. Lane who at the same time established the Lane Hospital Training School for Nurses, later to become the Stanford School of Nursing.

The final detail in Lane's grand design for the school was revealed when he announced in 1898 that he and Mrs. Lane had provided in their wills that the residue of their property should be devoted to the purposes of a medical library. Their bequest was the basis for the founding of Lane Medical Library which has proven to be a priceless asset to Stanford Medical School. The Library and the Lane Medical Lectures are the sole operational reminder in the present day of Stanford Medical School's earnest and resourceful forerunners in the century past.^[11]

We must tell in a later section of this history how the wording of Mrs. Lane's will, the restrictions of California law, and the perfidy of the President of Cooper Medical College resulted in the Library receiving only one-third of the Lanes' considerable estate, all of which they had intended for the Library.

Levi Cooper Lane died in 1902, but not before he came to realize that medical progress demanded improvements in medical education best attainable within the academic environment of a university. Just prior to his death he made it possible for the Cooper Board of Directors to exercise their own judgment with respect to the future of Cooper Medical College. This they did by arranging in 1908 for the transfer of Cooper Medical College and all its property in San Francisco as a gift to Stanford University for the purpose of establishing a Medical Department in the University. Approval by the Stanford Board of Trustees of this transfer, apprehensive as they were about the future cost of medical education, would never have been granted except for the unwavering support of David Starr Jordan, University President from 1891 to 1913.

The first class of students entered the Stanford Medical Department (now the Stanford University School of Medicine) in September 1909. The last class of Cooper students graduated in May 1912, and Cooper Medical College ceased to exist.

Thus Stanford, like many other American universities, acquired a medical school by adopting an existing independent medical college.

Throughout most of the 50-year period from 1908 to 1959, instruction in Stanford Medical School consisted of 2 years of basic science teaching on the Stanford campus 35 miles south of San Francisco, followed by 2 years of clinical teaching centered on the San Francisco facilities that Stanford inherited from Cooper Medical College.

Two major additions were made to these facilities by Stanford. In 1912 an imposing new building was completed to house the Lane Medical Library, the finest medical collection west of Chicago. In 1917, the 180-bed Stanford University Hospital was inaugurated.

These developments were accompanied by continuing efforts by the School to keep pace with progress in medical education which, increasingly after World War II, called for a strong cadre of full-time faculty with the capability and resources to advance the frontiers of biomedical research. As for medical education at Stanford, it was distinguished by excellent clinical teaching, and by faculty and students whose dedication and esprit de corps are recalled to this day with pride and affection by alumni.

Nevertheless, aging and outmoded facilities both in San Francisco and on the Campus; lag in the basic science area and in research productivity generally; inertia in the educational program; and other factors caused grave doubts about the School's capacity with existing resources to meet increasingly rigorous national norms. In response to these circumstances, the Medical Faculty and the University, with the indispensable guidance of J.E. Wallace Sterling, University President from 1949 to 1968, carried out a bold and timely plan that consolidated the School in a new medical center on the Stanford Campus in 1959.

Again at a crucial juncture in the affairs of the School, its future hinged on the foresight and intervention of a single individual: first Cooper, next Lane, then Jordan, and now Sterling.

In 1959 the Palo Alto-Stanford Hospital Center (School of Medicine, Stanford Clinics and Palo Alto-Stanford Hospital) opened on the Stanford Campus, and the teaching, research and clinical programs in San Francisco were transferred to these new facilities. Palo Alto-Stanford Hospital (440 beds) was jointly financed by the University and the City of Palo Alto for the purpose of providing teaching, research and clinical resources for the University, and hospital beds for Palo Alto patients.

After its move to the Campus, the School grew steadily in national stature until it attained and now holds a respected place in the front rank of medical education, scientific achievement and clinical medicine. This remarkable progress was the result of the following strategy:

• Recruit a distinguished, research-oriented faculty.
• Appoint faculty on a strict full-time basis.
• Implement an innovative curriculum.
• Attract exceptionally able medical students.
• Commit to the relentless pursuit of excellence.

In 1968 Stanford University purchased the City of Palo Alto's entire interest in the Hospital properties and facilities, and its membership in the Hospital corporation. The now 580-bed hospital was renamed the Stanford University Hospital, and it came fully under the management of the University. This critical acquisition made it possible to allocate hospital resources more efficiently in support of the teaching, research and clinical programs that are the raison d'être for the University Hospital.

Since 1968 teaching, research and clinical activities in the School have increased significantly, accompanied by commensurate growth of faculty, student body, postdoctoral trainees and facilities.^[12]

This is the last of the four chronological periods in the School's history that began in 1858 with the founding of the first medical school in California and the Far West, and concluded with the hospital purchase and consolidation as Stanford University Hospital in 1968.

1. The only comprehensive history of Stanford Medical School ever written is a thesis submitted to the Stanford School of Education in 1949 by Robert G. Whitfield in partial fulfillment of the requirement for the degree of Master of Arts. Whitfield's excellent survey entitled "Historical Development of the Stanford School of Medicine" has never been published, but photocopies of the original manuscript are available in the School's Lane Medical Library. Whitfield's thesis is included among 25 books and articles that comprise the principal sources of information about Dr. Elias Samuel Cooper and the evolution of Stanford Medical School. Lane Library catalog record
2. For further information about the steamship Arabia see Babcock, F. L. , Spanning the Atlantic (New York: Alfred A. Knopf, 1931), pp. 97-99 ; Bonsor, N. R. P. , North Atlantic Seaway: An Illustrated History of the Passenger Services Linking the Old World and the New (Prescott, Lancashire: T. Stephenson, 1955), pp.15 and 36; Dodman, F. E. , Ships of the Cunard Line (New York: John De Graff, Inc., 1955), pp. 33-36; and Gibbs, C. R. V. , Passenger Liners of the Western Ocean: A Record of the North Atlantic Steam and Motor Vessels from 1838 to the Present Day, 2nd ed. (New York: John De Graff, Inc., 1957), pp. 62-63.
3. The actual dates of Dr. Cooper's departure for and arrival in England in 1854 have been determined as follows. We learn from his letter to fellow passenger Hugh Keenan posted in Edinburgh on 18 October 1954 that they sailed on the S. S. Arabia. At the time of Cooper's voyage, the Arabia was operated by the Cunard Steam-Ship Line whose records are preserved in Liverpool University Archives. Among these records is the Arabia's Passage Book for the period from January to December 1854. According to Liverpool University Archivist Michael Cook, the Passage Book shows that the ship's last three sailings in 1854 from New York to Liverpool were 23 August to 2 September; 4 October to 14 October; and 15 November to 26 November. On 4 December 1854 the Arabia sailed as a Crimean War Troopship with gunpowder to Marseilles where she picked up French troops. No Passenger Lists for the Arabia are available. Assuming that Cooper wrote the Keenan letter as soon as possible after arriving in England, it seems reasonable to conclude that Cooper's Atlantic crossing was from 4 to 14 October 1854.
4. Hugh Keenan was serving as United States Consul at Cork, Ireland, on 30 September 1855 and on 30 September 1857 according to the Register of all Officers and Agents, Civil, Military and Naval, in the Service of the United States, compiled and printed under the direction of the Secretary of State in Washington, D.C.: A.O.P. Nicholson, Public Printer, 1855 and 1857. Keenan is not listed in the Register as being employed in the consular service as of 30 September 1853 or 30 September 1859. He therefore must have taken up his post at some time between September 1853 and September 1855. This would be consistent with his passage on the Arabia in October 1854. Keenan is shown in the Register as a native of Ireland, and a naturalized U.S. citizen. He was appointed to the Consular Service from Pennsylvania. We have no record of a response by Keenan to Cooper's letter of 18 October 1854, and no other reference to Keenan can be found among Cooper's personal papers, many of which have unfortunately been lost.
5. Lane, L. C. , "Dr. Henry Gibbons. In Memoriam," Pacific Medical and Surgical Journal and Western Lancet 28, no. 2 (Feb 1885): 59. Lane Library catalog record
6. Rixford, E. , "Early medical schools on the Pacific Coast," Pacific Medical Journal 56, no. 3 (Mar 1913): 158. Lane Library catalog record
7. Correspondence, n.d. - Box 1, Folder 5, Elias Samuel Cooper Papers - MS 458, California Historical Society, North Baker Research Library.
8. The quotation from Emerson (1803-1882) is from "Essays: First Series. History" ,[1841] The Essays of Ralph Waldo Emerson, Illustrated Modern Library (USA: Random House, Inc, 1944), p. 7. Thomas Carlyle (1795-1881), a contemporary and friend of Emerson, had originally expressed a similar view of biography in 1830: "History is the essence of innumerable Biographies." ( "Essay on History," in Critical and Miscellaneous Essays in Five Volumes, vol. 2 (New York: Charles Scribner's Sons, 1899), p. 86.) Carlyle repeated the same theme in 1840: "The History of the world is but the Biography of great men." ( "Lecture on The Hero as Divinity," in Heroes, Hero-Worship and the Heroic in History (New York: The Macmillan Company, 1897), p. 39.)
9. Hunt, R. D. , History of the College of the Pacific, 1851-1951 (Stockton, California: Published by The College of the Pacific, 1951), pp. 1-15.
10. University (City) College, a Presbyterian school, was founded in 1860 under the name of City College. The name was changed to University College in 1868, but was thereafter commonly referred to as University (City) College. It was located at Stockton and Geary Streets in San Francisco in 1872. Because of financial difficulty, the College sold its land at Stockton and Geary in 1875; purchased a frontage of 400 feet at 129 Haight Street; and moved some of its buildings to that location at considerable expense. College classes were essentially suspended after 1875. When fund-raising efforts proved unsuccessful, the College property was sold to a private party in 1879, but the new buyer was never able for financial reasons to open a school at the Haight Street site. For additional details see Clifford Drury , William Anderson Scott - A Biography (Glendale, CA: Arthur Clark, 1967); and Coote RB and Maaga M. , ""Why is San Francisco Theological Seminary in San Anselmo?"" Pacific Theological Review 21, no. 2 (Spring 1988):
11. Addresses by Timothy Hopkins, Emmet Rixford and David Starr Jordan, Dedication of the Lane Medical Library, Leland Stanford Jr. University, San Francisco, November 3, 1912, Leland Stanford Junior University Publications, Trustees Series No. 22 (Stanford University, California: Published by the University, 1912), pp. 8 and 20; Christina Man-wei Li , "The History of the Lane Medical Library, 1912-1967," (A Thesis Presented to the Faculty of the Department of Librarianship, San Jose State College, in Partial Fulfillment of the Requirements for the Degree of Master of Arts, January 1968), 87 pp. Lane Library catalog record
    Lane Library catalog record
12. Construction data obtained from "Physical Plant - A Report." Last Revised 25 September 1990. Prepared by Stanford Medical School Facilities Planning Office.