Commitment to the Profession - Being a Physician Early in the 20th Century

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Two generations after the Great Famine drove his ancestors to America, my father, John J. Young Jr., began notable career in medicine in New York City. One of the first Irish Catholic New Yorkers to graduate from the distinguished school of medicine at Columbia University, he went on to become a member of the university's teaching faculty, a member of the army medical corps in the American Expeditionary Forces in World War I, a successful private practitioner in Brooklyn, chief surgeon for the New York City Police Department, and a devoted husband and father who combined inquisitiveness, energy, generosity, and a love of fun witha strong commitment to his profession.


The connections of John J. Young to New York began in Manhattan and in Brooklyn. Six months before the Battle of Gettysburg my grandmother, Ellen E. McAlareny was born in 1863. Nellie, as she was known, was baptized at St. Mary's Church on Grand Street on the Lower East Side of Manhattan and lived in that enclave of Irish immigrants. Her parents Michael McAlareny and Ellen Wood McAlarney had arrived in America about 1850, refugees of the Great Famine. My grandfather, John J. Young Sr., was born at home on Sheffield Avenue in the East New York section of Brooklyn in 1861. That site today is occupied by the Cemetery of the Evergreens. His parents were Peter Young of Scots-Irish ancestry from Belfast and Sarah Farmer from Dublin. They too had arrived in John J. Young Ill lives in Neponsit, Queens, and practices dentistry in Manhattan. He is a member of the New York Irish History Roundtable.


Copyright ? 2001. Published with permission of John J. Young Ill.


Illustration: John Young Jr. (third row, first at left) as member of the class of 1915 at the College of Physicians and Surgeons at Columbia University. Photo taken in 1913. Vol.15, 2001 PAGE 5 NEW YORK 1RISH HISTORY He remained in France through 1919 and then returned to confront the Flu epidemic.


America about 1850, and Peter was employed with the East New York Horse Cars, having worked on the horse farms in Ireland.


John and Nellie were married at Old St. Patrick's Church on Mott Street in November 1888. After their marriage they bought a house at 149 Bedford Avenue at North Fifth Street in the Williamsburg section of Brooklyn and became parents to six children. My father, John Jr., their second child, was born at home on at January 9, 1892. DR. YOUNG, THE HORSE DOCTOR My grandfather Young operated a stable and horse infirmary at 191-193 Berry Street, a few blocks from his home. He was always known as "Dr. Young, the horse doctor." My father often reflected on my grandfather's long hours of labor he regularly rose before dawn, made his house calls throughout the neighborhood treating sick and injured horses, and possessed a broad knowledge of pharmacy and medications. To this day, his veterinary instruments are in my possession. They include hypodermic syringes, sutures and needles, files for the treatment of teeth to allow proper chewing and digestion of oats, and halters and slings to raise horses to attempt healing fractured legs rather than destroying the animals. In 1920 my grandfather was admitted to the New York State Veterinary Association, being "grandfathered" into that society without benefit of a formal veterinaryschool education. Where he served his apprenticeship I do not know. I believe his love for his trade must have stemmed from his own father who had worked the horse farms in Ireland. Pop, as we always called my grandfather, had trained others in the trade, including Dr. James Carey, a retired major in the U.S. Army's horsedrawn artillery. Dr. and Mrs. Carey lived in Mount Airy, New Jersey, very close to Lambertville, and Pop took me frequently to visit them. At the Cary's home I became responsible for priming the pump and drawing well water for Mrs. Carey's kitchen needs. I met neighbor farmer kids, visited a one-room schoolhouse, fed animals, and collected eggs from the chicken coop. I remember the harvest season, the gathering and grinding of fodder, and storing it for winter feed. Life on a farm was high adventure for a child from the big city of Brooklyn during the years just prior to our entry into World War II. Pop's business caring for horses declined with the success of the automobile, and after the death of my grandmother he was left with time on his hands; thus I became his companion. 1 recall vividly his eclectic interests. We traveled together to Goshen, New York, home of the Hambletonian races, to the Danbury Fair, and to Sailors Snug Harbor. We visited aboard the German naval ships about 1937-1938 on their "goodwill" tour to New York. I remember Pop's interest in the movies and his taking me to see Spencer Tracy and Freddie Bartholomew in Captains Courageous.


FROM GRAMMAR SCHOOL THROUGH MEDICAL SCHOOL My father attended St. Vincent de Paul's Academy on North Sixth Street, founded by the Franciscan Brothers in 1886. He graduated from there in 1904 at the age of twelve. Then he attended St Francis College on Butler Street in Brooklyn, graduating in 1911 at the age of nineteen. The Franciscan Brothers educated boys from Catholic families when protestantism and the common schools were viewed as a threat to the faith. The education system at that time included a high school and college curriculum in a seven-year program. The course of studies included Latin, Greek, modern language, mathematics, theology, philosophy, rhetoric and science. It was incumbent upon this generation of parents to be sure their children received a proper grounding in the apologetics and tenets of the Catholic religion. My father was a good student and remained so throughout his life, his Franciscan training standing by him in the years ahead when he entered another world in the field of medicine. After his graduation from St. Francis, my father applied to Columbia University's medical school but was first denied entry on the basis of inadequate preparation in the sciences. He attended summer school, completed those courses that were required, and became one of the first Catholic college graduates to gain admission to Columbia's College of Physicians and Surgeons. His success reflected great determination on his part, the encourage-Vol.15, 2001 NEW YORK 1RISH HISTORY PAGE 7 ment he received from his Franciscan teachers, and the support of his parents.


Shortly before 1911 medical schools in the United States had undergone major changes. The Flexner Report was commissioned by the American Medical Association to describe and analyze conditions and discipline in the American Medical Schools. As result, their number was reduced from about four-hundred proprietary schools to about forty accredited university-affiliated schools. Certainly it was no mean achievement to gain entry into Columbia's medical school during that time.


The end of the nineteenth and the beginning of the twentieth centuries were the age of modern medicine. My father's birth in 1892 was ten years after the death of Darwin, three years before Roentgen's discovery of the X-ray, six years before the Curie's discovery of radium, and nineteen years before Banting and Best found insulin deficiency the cause of diabetes. Lister's description of aseptic surgery, Koch's postulates as specific cause of bacterial disease, and Pasteur's work on inoculation were heralds of this new age.


After graduating in 1915, my father served as a house resident - an intern in today's terminology at Bellevue Hospital in Columbia's first division, the second and third divisions being staffed by NYU and Cornell, respectively. Bellevue was a center of teaching and learning, vying with the University of Pennsylvania and Johns Hopkins in reputation and prestige.' My father completed his training at Bellevue, having served two years from 1915 to 1917. He then received appointment to the visiting staff (called today attending physicians), and thus began his early vocation as teacher to younger interns. He was an exceedingly good diagnostic physician, always willing to share his knowledge with others.


At that time differential diagnosis depended on good patient history, stethoscopic examination, physical examination including percussion and palpation, and limited laboratory tests. My father had an unusual ability to use information obtained to make a proper diagnosis and, in turn, to conduct "show and tell" for resident physicians. His contribution to the literature, "Tricuspid Stenosis and Tricuspid Insufficiency," Illustration: (above) Dr. Young outside home in Rockaway in 1917, prior to embarkation to France with American Expeditionary Forces. was published in 1920 in the New York Journal of Medicine, providing descriptions of diseases that are still valid.


WORLD WAR I AND THE SPANISH FLU When America entered World War I in 1917, my father was granted leave from Bellevue to serve in the U.S. Army Medical Corps. He embarked for France with the American Expeditionary Forces and was stationed with the Ninety-first Base Hospital in the village of Commercy, close to Bar-le-Duc, and St. -Mihiel in the Argonne region, near the village of Domremy, Joan of Arc's birthplace. He served on duty there, attending the sick and wounded American soldiers and German prisoners of war. After the armistice was signed in November 1918, 15 gremained at that base hospital through 1919. The Great War was catastrophic in fury and destruction, unmatched in the numbers of people sickened, injured, and killed. The armistice was signed and met with great jubilation, but sick and wounded remained to be cared for, in some cases for the rest of their lives. My father remained on duty through 1919 at the Base Hospital in Commercy. He returned to America and was Vol.15, 2001 PAGE B NEW YORK 1R15H HISTORY Illustration: French and German shell casings formed into decorative vases by hospitalized | soldiers during World War I. Note cut and braided metal work, and inscriptions "Argonne" and "Verdun." Vol.15, 2001 assigned to Fort Dix, New Jersey, to confront the Spanish Flu epidemic.


This influenza strain was lethal, and the virus spread to all parts of the world. From dollars per year. He married my mother on July 6, 1925 at Nativity Church in Brooklyn.


My parents resided at 1362 East Twentietheighth Street, Brooklyn, in the parish of Our Lady Help of Christians. I was one of the first baptisms in that new parish in 1928. My parents had met sometime between 1923 and 1924 in Rockaway Beach, where my grandfather John owned a summer home on Beach 112th Street.


My mother, Mary C. Maher, had been born in Long Island City in 1894, the daughter of James Maher and Mary Cain Maher. Her father was New York City policeman and father of five children. My mother was the third child of that marriage. Mary Cain Maher died in childbirth in 1899, when my mother was five years old and her younger sister, Frances, was three. Her father could not manage these two infant girls plus his duties as breadwinner. After consultation, the girls were sent to Brentwood, Long Island, to be with the sisters of St. Joseph. Here they lived, were educated, and grew to adulthood (both became teachers in the New York City public school system). They spent their vacation times at the Convent of St. Joseph on Beach 110-111th Street, presently the site of Stella Maris High School. As it turned out, my mother and father were practically next-door neighbors at times! At the outset of the 1930s, my father faced an important decision. My sister Joan had been born in 1926 (twins Mary and Paul were to be born in 1931). He now had to make a living for his larger family and end the period as a penniless professor of medicine, His letters of resignation and withdrawal from Bellevue and Columbia were accepted with regret. He practiced in Brooklyn and became attending physician at St. Peter's, Cumberland, and Coney Island hospitals. At Coney Island Hospital, he also became director of the Department of Internal Medicine and was able to continue his vocation of teaching.


APPOINTMENT AS DISTRICT SURGEON My grandfather, policeman James Maher, implored my father to take the civil-service examination for appointment to the Medical Office of the New York City Police and Fire Departments. My father was practically led by the hand to the 1918 through 1919, it killed more than 10,000,000 people. My father treated the patients at Fort Dix who were victims of this epidemic. Treatment was symptomatic, involving bed rest, reduction of fever (with antipyretics and forced fluids), reduction of nasal obstruction, steam inhalation, and codeine cough suppressants. Secondary bacterial pneumonia was the most common complication (antibiotics were not yet discovered), and digitalis was the drug of choice in treating these patients. My father's good fortune in not contracting the highly contagious disease while treating his patients allowed his discharge from the Army and his return to Bellevue Hospital in 1920. TEACHING MEDICINE At Bellevue he continued on the visiting staff. He also received appointment as a Clinical Instructor in Medicine at Columbia's College of Physicians and Surgeons. He taught medicine to the undergraduates and to the hospital staff from 1920 to 1930, probably at a salary of about six hundred NEW YORK 1R15H HISTORY PAGE 9 exam site, where his high score placed him seventh on the list of examinees. He was then moved to fourth spot because of his veterans rights, and was appointed a district surgeon in the Police Department in 1930. As district surgeon he covered several precincts in Brooklyn and Queens, one being the 100th Precinct in Rockaway. I remember as a child the adventure of going with him in his Willy's Knight automotheir illnesses; to order further treatments for thoese officers who were seriously ill, and to recommend return to duty for those who were able to perform their duty. A very thin line in decision-making sometimes existed, one that depended upon good judgment. Reports were submitted to the chief surgeon, who then acted upon the district surgeon's judgment. My father performed these duties always seriously and bile down Flatbush Avenue, past Floyd Bennett Field, to the ferry slip and the ride over to Rockaway when he had to visit cops on sickreport. The construction of the Marine Park Bridge in 1937 ended the isolation of that strange and lonely section of Queens.


A district surgeon's responsibilities were to treat in his office those policemen who were on sick report and who were ambulatory; to visit the homes of policemen who were confined to beds or homes in order to diagnose and treat compassionately to those who were ill, and to those who were not, he gave nohold. These proved difficult days for my father, with the task of making judgments on other men's lives certainly outside the bounds of his true vocation as teacher.


My father's private practice included local people of Flatbush, as well as many families from where he grew upand was known in Greenpoint and Williamsburg. These were mostly working families with modest income, and he treated Illustration: Members of the First Medical Division, Bellevue Hospital, 1921. Dr. Young is in back row, fourth from left.


Vol.15, 2001 PAGE 10 NEW YORK 1R15H HISTORY Vol.15, 2001 Illustration: Dr. Young at Bellevue, c1921. while he attended patients in the living room. We had to move! In 1933 we relocated to a lovely house at Beverly and Westminster Roads in Holy Innocents parish, where we lived for the next twenty-one years. My father's civil service and private-practice incomes allowed him to own house, with a medical office, during the dark days of bank foreclosures and economic depression.


During World War II, food, clothing, health, and tuition for us were my parents' highest priorities. We all attended Holy Innocents Grammar School. My sisters Joan and Mary went on to St. Savior High School, and then to Mount St. Vincent's and Notre Dame on Staten Island, respectively. Paul and them for, among other things, heart and infectious diseases, truly devastating conditions in an age without the advantages of modern miracle drugs. He loved his work and his patients very much, and he devoted much time and energy to their needs.


Our family soon outgrew the little house on Twenty-eighth Street. It had become too crowded with my father's medical practice occupying the living room and front porch. Dad could not stand the sounds of four kids playing in the dining room attended high school at Brooklyn Prep and then went to Fordham College.


APPOINTMENT AS CHIEF SURGEON In 1948 the Medical Office of the Police Department was in serious need of a medical doctor knowledgeable in internal medicine. My father was the logical choice, and he received appointment as assistant chief surgeon, which ended his days as a district surgeon. He was transferred to Police Headquarters on Centre Street. In 1951 he was appointed chief surgeon of the Department.


The chief surgeon's duties were to review medical findings of the district surgeons and to act on them: to recommend limited duty to some officers: to judge medical disability discharge with pay to others: to pass upon physical fitness of applicants for appointments to the Department, and to complete their medical examinations. This a was a very sensitive position, to be sure. I don't believe he ever really enjoyed his position in power, but he did carry out his duties faithfully until he resigned in 1955. His poor health ended his medical practice, his hospital teaching assignments, and his position as chief surgeon late in that year. He failed to attend the fiftieth anniversary celebration of his graduation from St. Francis College in 1961. He died in November 1962, just short of his seventieth birthday. He was survived by my mother, four children, and eighteen grandchildren.


As ADMINISTRATOR AND TEACHER My father's position as an administrator was in deep contrast to his real vocation of teacher and physician. His life and interests were truly bipolar. His intellectual ability and pursuits allowed his entry as a graduate from St. Francis College to the Columbia University College of Physicians and Surgeons, overcoming many existing barriers of the time. The climate of that period is justly illustrated by the presidential election of 1928, with its crushing defeat of Alfred E. Smith because of his Catholic faith. My father was forced from his own insular culture to a very alien one, but continued his life journey as a dedicated son of the church. His responsibility to his profession, to his family, and his devotion to his religion stemmed from NEW YORK 1R1SH HISTORY PAGE 11 his mother and father and his Franciscan training. From his father he had also received the gifts of seriousness, austerity, devotion to his work, inquisitiveness, energy and generosity; from his mother, his love of good times, deep emotional attachments, a bit of Irish wit. His inquisitiveness led to interests in literature and philosophy. His bookshelf included Theories of Knowledge by L.J. Walker, S.J., First Principles by John Rickerby, S.J., Moral Philosophy Joseph Rickaby, S.J., and the writings of Thomas Merton and Dorothy Day. Proper food preparation for his father led him to become a gourmet cook, and his soup preparations kept us all healthy throughout World War II. His postagestamp-size garden was abundant with dahlias and roses. A well-spent day in his life was to wander through the stacks of the Strand Bookstore and return home with good find.


When I was a student at Fordham he would eagerly grab all my books and read them long before I did. He played a good game of billiards and enjoyed poker games lasting until two in the morning. His love of our liturgy took him regularly to St. Vincent Ferrer Church to hear the beauty of its Dominican choir. His 78-rpm record collection of Georgian chant, opera, and classical music was all we heard at home until my sister Joan became a teenager and the sounds of Glen Miller, the Dorseys, and Benny Goodman reverberated through our living room. We suffered WQXR during dinner, for which he was always present. Table manners and proper decorum were enforced. My father's obligation to my grandfather's old-age needs included shopping for groceries, cooking meals, cleaning up, and bringing him to live with us during his final infirmities in the last four years of his life.


Dad was never a joiner he was not a member of the Veterans of Foreign War or the American Legion. He did attend meetings of the Brooklyn Medical Society but never sought office. He never accepted gifts other than a pair of tickets to a Rocky Marciano fight at Yankee Stadium or a couple of blue tickets to Steeplechase Park for his children. After 1933, when Prohibition ended, he never took another drink. In his early years he defied the Eighteenth Amendment, as many did, his favorite restaurant and speakeasy being Cavanaugh's on Twenty-third Street. He was most liberal with his children, always anxious for us to break new ground. We were introduced to the world of books, summer camping, travel, gardening, fly-fishing and horseback riding. He supported all our efforts. His love of baseball-as a young man, he had excelled as a left-handed side-arm (nearly underhand) pitcher with his AEF medical unit-took us to Yankee Stadium and the Polo Grounds. I can remember watching Bob Feller of the Cleveland Indians pitch a twoor three-hitter against the Yankees when Dad had tickets behind home plate. His experiences in World War I caused him to become a staunch isolationist during the thirties and to oppose our entry into another European war. A week at home without Father Coughlin's radio program and a copy of Social Justice, a newspaper that opposed socialism, New Dealism, and supported America-first policies before the attack on Pearl Harbor, never occurred.


My father was truly deserving of his title Illustration: Members of the Young family early in the 1930s: Nellie, Mary, and children Joan, John, and twins Mary and Paul.


Vol.15, 2001 PAGE 12 NEW YORK 1R15H HISTORY Illustration: Dr. Young, as chief surgeon for the NYPD, examines candidates for entry to the Police Academy early in the 1950s.


Vol.15, 2001 doctor in its original meaning a teacher. He is still remembered in that role by his students. His code of duty, honor and profession still reverberate in my own mind. Sir William Osler's beliefs, published in his essay "Aequanimitas,"' describe the qualities of a dedicated physician as availability, amiability, and ability, in that order. John Young, M.D., had all these attributes.


Notes 1. An indication of Bellevue's reputation is reflected by the work of Walter Reed and William Gorgas. Walter Reed had trained for one year at Bellevue, and William Gorgas had graduated from NYU Medical and been a house resident at Bellevue Hospital. Reed and Gorgas served on the Yellow Fever Commission in Havana, Cuba. Reed's discoveries, which were dramatized in Sidney Howard's play, Yellow Jack and subsequently made into a very popular movie, were based upon the findings of Carlos Finlay, a Cuban physician, who had investigated and theorized that the specific carrier of yellow fever virus was a mosquito, and: very specific mosquito, Aedes aegypti. Finlay was right, but what he did not know and what Reed demonstrated, was that the vector transmits the disease on a very particular time schedule. The female mosquito sucks blood from yellow fever victim within the first through the fourth day of the victims infection, (the prodromal stage where symptoms are not present). The virus maturates in the stomach of the mosquito in two to three weeks time; it then transmits the disease by its bite to new victim. Measures to control the mosquitos reduced the death rate from 1400 in 1900 to 37 in 1901 and to 0 in 1902. Gorgas went on to be the Health Officer in charge during the construction of the Panama Canal, eradicating both yellow fever and malaria and allowing the Canal's completion in 1914, following the prior French failure, due in great part to yellow fever and malaria which had killed 22,000 workers.