“Twilight Sleep: Simple Discoveries in Painless Childbirth” ~ 1914 ~ Links to chs 1-8 Links of historical book
Currently being edited, not really ready for prime time yet!
Directory –> 1914 Historical Publication
Subdirectory #1–> Dr J. Whitridge Williams, MD
and Dr. Henry Smith Williams, MD
Twilight Sleep
A Simple Discoveries
in Painless Childbirth
As told to science writer Dr. H.S Williams, MD, JD
by Dr. J.W. Williams, MD
Individual links to all 8 chapters
You can also follow the link at the bottom of each page to the next chapter in the series. I recommend reading chapters 1 first, these chapters 5, 6, 7, and 8, first, then going back to chapters 2, 3, and 4.
Chapter 1 |
Chapter 2 |
Chapter 3 |
Chapter 4 |
Chapter 5 |
Chapter 6 |
Chapter 7 |
Chapter 8 |
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Key Background Information for Readers
Dr. J. W. Williams was a gynecological surgeon employed in 1893 by Johns Hopkins Hospital in Baltimore, Maryland. He served as Chief of Obstetrics at Johns Hopkins from 1899 to 1911. He was appointed Dean of the School of Medicine in 1911. After nine years as an administrator, he returned in 1919 to what he loved best — being a full-time professor of obstetrics, authoring “Williams’ Obstetrics” and spokesman for the obstetrical profession until his untimely death in 1931.
Dr. J. W. Williams’ personal dream and professional vision
Dr. J.W. Williams’s dream and his vision was to find or figure out how to fund a national system of privately-owned general hospitals and do so with absolutely no federal money! This systematic approach to realistically meeting the life-and-death medical needs of all Americans would be available in major metropolitan areas and every geographical region of the country, accessible with a reasonable driving time, no matter where you lived, and able to provide state-of-the-art comprehensive care across the whole spectrum of physical illness and injury, irrespective of the gender or age of the patient.
As noted above, absolutely none of the money could come from the state or federal government!
Dr. JWW envisioned these American hospitals to be as well-equipped and staffed as the large regional hospitals in Western Europe, which he personally knew a lot about. When he graduated from medical school in 1886, American medical schools did not include any “clinical” or ‘hands-on’ training. However, he came from a family of doctors whose medical training included clinical courses in different European countries. So Dr. JWW sailed to Europe on two different occasions and at different times enrolled in two “clinical training” two-year programs — pathology and obstetrics. As a result, he was trained in some of the best and biggest hospitals in Austria, Germany, and France. Then he sailed back home and shortly thereafter was hired by Johns Hopkins University Hospital to set up their brand-new gynecological surgery department.
As a result of this experience, Dr. JWW was acutely aware of just how pitiful and dangerous the general hospital situation was in the US. Compared to other highly developed countries, we were a third-world country in regard to the sophistication (lack there of) of our hospitals. Despite having 8,000 hospitals in America (historical estimate for the early 20th century), only about 50 or so hospitals were equipped to provide “comprehensive” medical and surgical services. This is complex, labor-intensive (lots of doctors and nurses) and often continues for protracted periods. Examples include accident victims of all kinds, heart attacks, burns, children, adults and the elderly with very serious illnesses, brain tumors and other malignancies, complicated pregnancies, tiny premature babies, and those who need end-of-life care.
General hospitals in the US compared to the UK and Europe
Dr. JWW knew how badly Americans needed this same kind of coordinated hospital care system, but also well aware of just how strikingly different and irreconcilable our two very different economic systems were. In stark contrast to the US, the majority of large regional hospitals in Western Europe were funded by their national governments. This public healthcare service system worked very well on the other side of the “pond”, but Dr. JWW knew the American Medical Association would never, ever, under any circumstance allow such a system to exist in the US.
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The material below is a work-n-progress with obvious mistakes and a few unfinished sentences.
As they say “Parden our Dust“.
The “sacred doctor-patient relationship” as defined by the AMA
From the perspective of the AMA, Europe’s state-sponsored hospital system represented the very worst type of “socialized medicine”. The clarion call of the AMA was then and still is the “sacred doctor-patient relationship“. This phrase does not mean what most people think; it has nothing to do with religion or other spiritual matters.
What it really means is that no other person in the whole world can, according to the AMA’s definition of the “sacred doctor-patient relationship”, ever for any reason “second guess” another doctor’s diagnosis, treatment plan, skills, professional fees, nor the manner that he interacts with his patients — not a physician colleague, not the hospital administrator, not GOD, not even the Supreme Court. You have to BE a doctor to in any way JUDGE a doctor, and so far, there are no MDs on the Country’s highest Court.
The reasoning for this is simple, at least as described by the AMA — no one else in the world has a higher level of medical education and thus authority than a medical doctor with a valid license to practice medicine in regard to questions about their medical judgment. The only exception to that rule is when a physician becomes the employee of another doctor or is formally hired by an incorporated business such as a hospital or clinic, but more about that later.
During this period — 1900 to the present day — the unbridled entrepreneurial right to practice medicine has been under the umbrella of the “sacred doctor-patient relationship”, which meant doing things “your own way”. This made the many long years and high cost of schooling, inconvenience of being on call, getting up in the middle of the night, and the like — all worth it. As a self-employed / self-made man”, you were your own boss, could do everything just the way you wanted to.
Any time a government provided free hospital care, organized medicine saw this as socialism, which was a ‘hanging crime as far as the AMA was concerned. But there was one even more unforgivable sin. This unforgivable sin was doctors on the hospital staff that were employees of the institution they worked in. These medical practitioners often were also professors who also provided clinical instructions to other medical students. But the AMA only cared that they were that most awful turn coat of all employees of the hospital. This was seen as intolerable because the AMA insisted that the practice of medicine by American doctors was primarily a grand entrepreneurial opportunity. Doctor who thought like that described the doctors in the big regional hospitals in the UK and Europe as poor suckers because they were merely employees, the medical version indentured servanthood, Just one cut above outright slavery!
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Turning Dr JWW’s dream turned into a “Plan” that provided a blueprint that enabled tiny hospitals create to a large and dependable revenue by putting in a “lying-in ward” as their “cash cow”. By seeking out the patronage of well-off middle and upper-class maternity patients, they would be able to generate a dependable and substantial revenue stream that would pay for all the remodeling and upgraded equipment
While these would all be they would still lay the groundwork that over considerable time (20 or more years) would create
and eventually for a brand new wing for executive offices, a new surgical suite, capital-intensive technology like a new x-ray machine, a new ceramic-titled OR with a big and very bright new spotlight over the operating room table.
In 1914 when Dr. JW Williams told Dr. HJ Smith (author of record) about his plan, there were approximately 8,000 mostly private (for-profit) hospitals owned and run by one or two of the town’s doctors that typically only had 2 to 10 beds and a staff of one or two trained on the job nurses. These 2 to 10-bed boutique hospitals had little or no electronic equipment (such as an x-ray machine) beyond electric lights, hopefully running water, and a telephone.
As a result, they were far more like a “nursing home” for the elderly or disabled than what we expect of a “real hospital” today.
This was to be accomplished by having thousands of private doctor-owned hospitals to use an empty room or repurpose a room supply closet into a “lying-in ward”.
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