The Kelloggs Page 10
The most lasting and significant professional relationship John made during his Bellevue days was with Stephen Smith. A surgeon, public health reformer, and an early proponent of the antiseptic surgical techniques prescribed by Joseph Lister, Dr. Smith unleashed a tornado of modern surgical techniques that rippled widely across his admiring medical students at Bellevue and beyond. Internationally respected, Smith was a founder of the American Public Health Association and a prominent member of virtually every major local, state, and national public health board.22 John often “rounded” with Dr. Smith during his weekly trips to the city’s contagious disease ward (mostly smallpox) on nearby Blackwell’s Island.23 In his later life, John pointed with pride to the time he served on the Michigan State Board of Health from 1878 to 1891 and, then again, from 1911 to 1917. It was Stephen Smith, he reliably recounted, who first inspired him to take a strong interest in the newly emerging field of public health and introduced him to the basic language of vital statistics while studying the infant mortality rates of New York City.
In the outpatient clinics, John learned the practical tasks of how to set a broken leg, deliver a baby, quarantine a household, and treat pneumonia, heart attacks, cirrhosis, and the infectious diseases of childhood. Along Bellevue’s famous insanity ward, he studied women and men mad with mania, depression, and alcohol and opium abuse.24 When it came to applying the lancet to “scarify,” or bleed, a patient, for a variety of maladies, John noted that while “the question of blood letting is important to consider, it is now a remedy scarcely ever employed by many physicians. Some don’t ever use it, don’t have the means for doing it.” The medical student also jotted down an anecdote Dr. Flint relayed about a colleague “who bled and bled a patient with peritonitis and yet the patient died.”25
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LECTURES, patient rounds, “quizzes,” and studying occupied the entirety of John’s days and much of his nights. There was little time to carve out for rest. Money was scarce and John subsisted on an extremely limited budget, having spent most of the money the Whites lent him for tuition and course fees. He lived in the attic of a cheap lodging house on East 28th Street and Third Avenue, which was then a rather shabby and impoverished neighborhood. His landlady provided no board. Each term, John went down to one of the warehouse markets off the foul-smelling East River and purchased one barrel of apples and a second one filled with graham crackers. For every meal, he consumed “two apples and seven crackers.” He gleefully wrote to his parents that his dietary choice cost a mere 16 cents a day (about $3.43 in 2016) and was so nutritious he had gained seventeen pounds!26 On the days after completing a tough set of examinations, John would treat himself to a roasted potato purchased from a street vendor near the hospital.
The most important meal he ever consumed during his medical student years occurred on the afternoon a grocer sold him a package of “steam cooked” oatmeal. John was disappointed to discover that this “new” preparation was almost as time-consuming as cooking any other hot grain cereal. Nevertheless, it was a finding that proved to be a watershed moment in John’s creative life. Decades later, he recalled this moment as the birth of prepared cereals: “It…occurred to me that it should be possible to purchase cereals at [the grocery store] already cooked and ready to eat and I considered different ways in which this might be done.”27
On the other end of his alimentary tract, the house’s sanitary facilities could not have pleased the fastidious John. He had weekly access to a washtub (“filled” with a few pitchers of lukewarm water and not drained until each resident in the house had his bath) and when nature called he endured long lines to a communal privy in the alley behind the building. According to the 1867 New York City Tenement House Law, the ratio of tenants to privies was “at least one to every 20 occupants,” but the lines must have seemed longer when John stood in them.28 “Night soil” removers only occasionally rinsed the privies out and, by all accounts, the stench emanating from a tenement house’s privy was truly “sickening.”29
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GRADUATES OF BELLEVUE were required to present signed certificates attesting to attendance of two terms of the predetermined curriculum (e.g., anatomy, materia medica, chemistry, physiology, the theory and practice of medicine, surgery, and obstetrics). An equally steep requirement was the composition of “an acceptable thesis composed by, and in the handwriting of, the candidate.”30 Unlike many of his classmates who wrote lengthy reviews of a particular illness or drug, John’s dissertation asked the far broader question “What Is Disease?” It serves as a superb glimpse into the mind of a young man who would go on to author more than fifty medical books and edit a monthly health magazine for more than half a century. John’s thoughtful, declarative sentences take the reader on a long journey into the history of disease concepts across Western civilization, beginning with Antiquity and extending all the way to the decade after the Civil War. Disease, he argued, resulted from a derangement of the body’s natural functions and represented “an effort of nature to rid itself of obnoxious encumbrances.” John insisted that the physician must discard toxic drugs and the lancet to become a guide who helps the patient naturally resolve that derangement and return to a proper state of health.31 What remains so interesting about John’s doctoral thesis is that it articulates a theory of medicine he would burnish to a high sheen for the remainder of his career. Specifically, he dedicated himself to the prevention of disease long before it had an opportunity to cause serious harm. The damaged body, John elegantly wrote, could be repaired and disease entirely avoided or, at least, attenuated by living within a carefully considered set of dietary and physical rules.
Gathering the mandatory “proper testimonials of character” was probably the most time-consuming requirement for graduating from Bellevue. Such letters of recommendation were only to be dispensed upon “three years’ pupilage, after eighteen years of age, with a regular physician in good standing.”32 The italics of emphasis were part of Bellevue’s boilerplate medical school catalog and the descriptor “regular” was neither casual nor expansive; it had a specific and strict meaning. Only those doctors studying at allopathic, or “regularly-organized medical colleges,” were qualified to teach Bellevue students. “The tickets and diplomas of Eclectic, Homeopathic, or Botanic Colleges, or colleges devoted to any peculiar system of medicine are considered irregular.” Students were further warned that preceptors who “advertise or violate in any way the code of ethics adopted by the profession, will not be received under any circumstance, even if the preceptors be regular graduates in Medicine.”33
Three years of service must have seemed like an eternity to the young medical student and neither time nor the huge amount of money it represented were commodities John had at his disposal. Even though he divested himself of the diploma he earned at Russell Trall’s Hygeio Therapeutic College, he did have one occasion to use this connection to his professional advantage. Despite the Bellevue Medical College’s clearly written requirements for training only under specific types of physicians, John took the huge risk of choosing a Brooklyn-based doctor named O. T. Lines to endorse his apprenticeship certificates.34
The young man from Battle Creek met Dr. Lines two years earlier, while still a student at Trall’s makeshift medical school. Hardly what the good Doctors Flint or Janeway would deem a “regular” physician, Dr. Lines was a full-throated, practicing homeopath and hydropath. John may have excelled in his coursework but he, nevertheless, defied Bellevue’s strict rules by completing his all-important clinical preceptorship with an “irregular” physician. Some have argued this lapse as a function of the poor supervision by the Bellevue medical faculty; others might cynically suggest that, like many medical students past and present, John opportunistically cut a few corners to get on with his medical career.
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THE PLOY WORKED. On the cold, blustery afternoon of February 25, 1875, there was John lined up with the rest of his class for a grand commencement ceremony held at the New York Aca
demy of Music. Located on 14th Street and Irving Place, the Academy boasted a four-thousand-seat auditorium, one of the largest in the city. Two decades old, The New York Times once declared the hall to be an acoustical “triumph.”35
Promptly at 3:00 p.m., the New York Philharmonic Society began blasting Wagner’s “Kaiser March,” conducted by the German-born cellist and conductor Carl Bergmann, who in 1852 first introduced American audiences to Wagner’s work.36 A committed alcoholic, the Maestro was well into his cups as the commencement commenced. Despite his chemical impairment, once the grandiose march wound down, he woozily lifted his baton to signal the orchestra to segue into Meyerbeer’s dramatic “Conjuration et Bénédiction des poignards” from the fourth act of the hugely popular 1836 opera Les Huguenots. The opening notes of the Meyerbeer served as the cue for John and his other 192 classmates to make their processional entrance.37 Waiting on the stage, poised to swear the students into the profession, was a receiving line of the faculty; the former governor and U.S. senator of New York Edwin D. Morgan; the graduation speaker, Judge John R. Brady; and an assortment of clergymen, all of them gussied up in their best frock coats and black silk cravats tightly wound around starched and sharply pointed, wing-tipped collars.
Caps and gowns were not yet part of the medical school graduation ritual in 1875. Instead, the graduates wore somber black morning coats. John, eager to appear as well groomed as his fellows, saved up until he had enough to buy new togs. The woolen suit was made to measure and the tailor promised it would be ready in time for the big day. After picking it up, an exuberant John left the haberdashery shop and dashed home with glee. Once there, he carefully hung the new suit up in the tiny, makeshift “closet” in his room, which was actually a bar jammed into a corner covered by a curtain.
The night before the ceremony, a crisis struck that ruined John’s plans. Returning home, after one last nostalgic tour of the hospital, he disrobed and got himself ready to sleep. As he hung up the threadbare and frayed suit coat that was his daily uniform for the past two years, he discovered his new garment had been stolen. No description of the sensation of his sinking stomach survives but it must have been palpable, especially since the young man had neither the capital nor the time to replace the loss. Forced to wear his old suit, he realized shortly before receiving his diploma that there was a gaping hole in the seat of his battle-worn pants. Fleet of mind, John slowed down his march up to the stage so that the graduate behind him was close enough to block his exposure problem.38
An hour later, the newly minted Doctor Kellogg proudly walked out of the Academy of Music, diploma in hand, to the stirring chords of Strauss’s “Egyptian March.” He then joined his comrades for a boisterous and celebratory banquet. Later that evening, after a meaty dinner that must have repelled the abstemious young man, John wrote to William C. White, the son of Ellen and James White, a boyhood friend and a fellow traveler to the Trall College, “I was one of the 193 graduates who were sworn into the profession to make ‘regular kills.’…I feel more than 50 lb. bigger since getting a certain piece of sheepskin about two feet square. It’s a bona-fide sheep too, by the way, none of your bogus paper concerns like the [Trall] hygeio-therapeutic document.”39
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AFTER GRADUATION, John spent several weeks in the reading rooms of the Astor Library, the forerunner to today’s New York Public Library, as well as the Cooper Union and New York Academy of Medicine libraries. There, he pored over the latest medical texts, including a newly collected set of papers echoing his favorite physiological popularizer, Sylvester Graham. Writing home to William White, John recounted how he hoped to apply these lessons to his nascent medical practice: “I find he left some very fine ‘nuggets’ and I am gathering them up. I leave the smelting and coining until I get home.”40
John’s most intriguing postgraduate medical adventure was his enrollment in a private course on electrotherapeutics conducted by George Miller Beard.41 Dr. Beard was one of the nation’s most respected experts on “nervous diseases,” or mental illness, in the pre-Freudian era and served as an expert witness in defense of Charles Guiteau, the man who murdered President James Garfield in 1881.42
Dr. Beard coined the term “neurasthenia,” or “American nervousness,” to describe the condition he most often diagnosed among his many wealthy, jangled, and overwrought patients. This syndrome was marked by fatigue, exhaustion, depression, headaches, dyspepsia, insomnia, psychogenic paralysis, painful neuralgias, and even bouts of hysteria. Beard hypothesized that the neurasthenic had dissipated his or her “nerve force” by engaging in all sorts of stressful or untoward activities, such as masturbation, illicit sex, gambling, excessive work, and over-worrying, as opposed to pursuing “finer and spiritual things.” In his 1881 treatise American Nervousness, Beard eloquently compared the ancient but placid Greeks to the harried, modern American: “the modern differ from the ancient civilizations mainly in five elements—steam power, the periodical press, the telegraph, the sciences and the mental activity of women. When civilization, plus these five factors, invades any nation, it must carry nervousness and nervous diseases with it.”43
Whether these patients suffered from clinical depression, chronic fatigue syndrome, fibromyalgia, or some other entity is difficult to gauge, especially in light of the chronological blockade against interviewing and examining Dr. Beard or his patients. What is clear is that these patients were suffering and desperate for a plan of action, no matter how remote the chance of a “cure” might be. Given the “invalids,” worried but well, and psychologically damaged patients Dr. Kellogg would soon be attending at the Battle Creek Sanitarium, George Beard was the perfect guide into this poorly understood but all too common byway of American medical practice. That said, as medical historian Charles Rosenberg once described Dr. Beard, he was “careless, visionary, uncritical, and ambitious to a degree which compromised his ability as a scientist.”44 In the years to come, this appraisal might be easily applied to the often overenthusiastic John Harvey Kellogg.
When John studied under Beard, the senior physician was experimenting with the therapeutic uses of electricity and was “shocking” his willing patients with low-voltage waves from the brass leads of a galvanic battery. Dr. Beard made loud public claims that his patients responded well to the treatment and published an influential medical monograph on the topic.45 John did not record how much he paid Dr. Beard for the tutorial privilege but the fee was likely similar to what Drs. Flint and Janeway charged. Whatever the cost, John convinced the Whites that it was worth the expense. Throughout his career, Dr. Kellogg applied a variety of electrotherapies of his own design for treating neurasthenia, hysteria, depression, and many other psychogenic disorders.46
By the time John returned to Battle Creek in late June of 1875, his mentors were eager to appoint him medical director of the Western Institute. The physicians working there, however, blew a strong gust of resentment aimed at John’s favored status with the Whites. John, too, had reservations about running a health institute bound by the strictures of religious beliefs alone and was eager to test out the newer scientific principles he learned at Bellevue. He told the Whites he wanted to devote his time to conducting research, writing, and advancing medical knowledge and turned down their initial offer.
By 1876, it was clear the Western Institute required a drastic change if it was going to succeed in the manner the Whites envisioned. Throughout the winter and spring of that year, John served as the secretary of the institute’s board of directors, sat in on their meetings, and engaged in several conversations with James and Ellen White; Uriah Smith, the editor of the Advent Review and Sabbath Herald; and Professor Sidney Brownsberger, the president of the Adventist Battle Creek College.47 These exercises helped John sharpen his vision for placing the health reform institute on a more modern footing. His sponsors, even more impressed by the diminutive doctor’s abilities, redoubled their efforts to get him to direct the place.48 John understood both his debt to the Whites a
nd their expectation that he would apply his expensive medical education to the Adventist health reform cause, but the young man still needed more time before fully committing.
Specifically, he wanted to take one more trip back east to visit the United States International, or Centennial, Exhibition of 1876 (in honor of the hundredth anniversary of the signing of the Declaration of Independence), where “never before in the history of mankind have the civilized nations contributed such a display of their peculiar treasures.”49 It was the first world’s fair to be held in the United States, at Philadelphia’s Fairmount Park along the banks of the Schuylkill River, and was designed both to impress and announce America’s dominance in modern technology and industry. The Whites agreed to this pre-employment sabbatical provided that following the exhibition John visit Wilmington, Delaware. There, he was to be the guest of a married team of Adventist doctors named Pusey and Mary Heald, who ran a water cure clinic called the Healds’ Hygeian Home.50
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BEYOND THE SHEER FUN of it, John attended the World’s Fair of 1876 to help staff Dr. Stephen Smith’s health exhibit for the International Temperance Conference, from June 13 to 16. In this capacity, he prepared pamphlets and exhibit cards warning fairgoers about the many health risks of imbibing.51 Fortunately, his temperance work did not occupy too much time, leaving him with plenty more to explore the fair.52
As he wandered through the buildings and exhibits of the exposition, John made certain to avoid the vast Brewer’s Hall, which offered up cold draughts of beer, ale, porter, and stout from around the globe. He was equally quick to sidestep the sumptuous French and Italian wine exhibits and the many food booths serving up fresh, hot (and greasy) waffles, funnel cakes, frankfurters, cotton candy, and ice cream sundaes. He did, however, thrill to the sight of the completed copper arm holding the torch of Liberty, a limb of the famous statue that was France’s gift to the United States on the occasion of its hundredth birthday. He perused the enormous displays of artwork, from oil paintings and sculptures to exotic fine art to jewelry. And, considering his love of gadgets, he was mesmerized by the exhibition featuring Alexander Graham Bell’s miraculous new invention called the telephone (from the Greek for “distant voice”), the original John Bull steam locomotive, the Remington Typographic Machine, or typewriter (a machine he would never master during his prolific writing career), and a giant printing press that could put out 35,000 copies of a neatly folded broadsheet newspaper in only an hour.53