T H E

H O S P I T A L

O F

S A I N T

R A P H A E L

nswering the call to care for more than

100

years.

Hospital of Saint Raphael

A member of the Saint Raphael Healthcare System

SPONSORED BY:

WWW.SR HS. ORG

Answering the call to care

1 0 0 y ears of h op e an d h e ali n g at t he hos p i tal of s ain t r ap hae l

Hospital of Saint Raphael

A member of the Saint Raphael Healthcare System

MISSION OF THE SAINT RAPHAEL H E A LT H C A R E S YS T E M

Our Mission
M I S S I O N O F T H E H O S P I TA L OF SAINT RAPHAEL
The Hospital is a community teaching hospital and health care resource sponsored and guided by the values of the Sisters of Charity of Saint Elizabeth and of the Roman Catholic Church. Our mission is to witness, share in and promote excellence in the healing ministry of Jesus Christ. We are committed to preserving the dignity and wellbeing of each individual, and to assuring that every person is treated according to the principles of charity and justice. We accept the Gospel challenge that prompted our founders of the sponsoring congregation, Saint Vincent DePaul, Saint Elizabeth Ann Seton and Mother Mary Xavier Mehegan, by pledging every loving service in our power to reach out to those in need of our services.

The mission of the Saint Raphael Healthcare System, sponsored by the Sisters of Charity of Saint Elizabeth, is to care for and improve the health of our patients, with compassion and with a special concern for the underserved, poor and elderly.

T H E M I S S I O N VA L U E S O N W H I C H WERE FOUNDED AND T H AT G U I D E A L L D E C I S I O N S A N D AC T I O N S

Charity Justice Service Stewardship Dignity Excellence Integrity

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edicated to past and present Sisters of Charity of Saint Elizabeth, employees, physicians, trustees, volunteers and Auxilians. Each of our rst 100 years of excellence is because of you, and we commit to carrying on your legacy. This book is based on information and recollections from many sources. These include wonderful old scrapbooks, memorabilia, reports and other materials from Saint Raphaels archives, materials and photographs from the archives of the Sisters of Charity of Saint Elizabeth, taped oral histories of persons now deceased, and countless interviews. Every effort has been made to validate dates and other facts, some of which vary by source.

E D I TO R S N OT E
Working on this book has had special signicance. I joined Saint Raphaels in late 1981 to help plan its 75th birthday observance, never thinking I would celebrate the 100th as well! But my roots are deeper than that. While working on the 75th, I organized years of accumulated materials into what evolved as Saint Raphaels archives. In the process, I learned that the New Haven architectural rm of Brown & von Beren, led by my great-grandfather and then grandfather, designed the hospitals rst new construction, the Saint Marys Building. It is an honor and privilege to be part of this organization, to have learned from the Sisters of Charity of Saint Elizabeth, and to have worked side by side with extraordinary colleagues. And to contributing writer Alix Boyle and contributing writer/editor Published 2008 Cynthia Wolfe Boynton. Editor: Cindy von Beren, vice president/Corporate Affairs A special thanks to the many individuals who were part of the research, writing, editing, fact-checking and production of this history, with particular gratitude to: Patricia Mich, art director Jennifer Duarte, graphic designer Michael Dabbraccio, staff photographer Christine Mora, director, Public Relations & Marketing Pat Wales, director, Health Sciences Library

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Contents
an s we ri n g t h e C all to C are
CHAPTER 8 INTRODUCTION CHAPTER 1 CHAPTER 2 CHAPTER 3 CHAPTER 4 CHAPTER 5 CHAPTER 6 CHAPTER 7

Saint Raphael Auxiliary and volunteers 1960s and 1970s 1980s and 1990s Sister Anne Virginie Grimes Advancing the science and art of medicine Entering the new millennium 2007: A milestone anniversary to remember The Sisters of Charity of Saint Elizabeth

Beginningsa hospital is born William Francis Verdi, M.D. The rst 30 years Saint Raphael School of Nursing World War II The 1940s and 1950s Sister Louise Anthony Geronemo

CHAPTER 9 CHAPTER 10 CHAPTER 11 CHAPTER 12 CHAPTER 13 CHAPTER 14 CHAPTER 15

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If Saint Raphael s future is anything like its history, great things are ahead for all of us.

Saint Raphael Healthcare System President and CEO David W. Benfer, FACHE Sisters of Charity of Saint Elizabeth General Superior Sister Maureen Shaughnessy, chairperson of the Saint Raphael Healthcare System Board of Trustees.

Introduction
1 0 0 ye ar s of C ar in g

hen the Sisters of Charity of Saint Elizabeth and Catholic Hospital Association agreed on January 30, 1907, to join forces and found Saint Raphaels, their goal was to create a hospital that all members of the community could call their own. It was to be a place where every patientregardless of race, religion, ethnicity or income levelreceived the best care, with the most compassionate touch. A century later, this caring mission still guides Saint Raphaels, and is what our physicians, nurses and other professionals strive to give patients every day. Our long history of medical excellence, and the roots weve established in Greater New Haven, made us proud and excited to celebrate Saint Raphaels 100th birthday in 2007. Thank you for opening this book and celebrating this milestone with us. Within these pages, youll nd great old photographs, facts and memories about both the hospital and its place in the Greater New Haven community. Its a community that has embraced and supported Saint Raphaels for each of these 100 years. And for this, we are most grateful. Youll see in Chapter 1 that at the same time the Hospital of Saint Raphael opened its doors, both the community and the eld of medicine were changing. Most people at the start of the 20th century received medical care in their homes from family doctors. Family members were expected to take care of loved ones. Hospitals at that time were said to be for the poor and the friendless.

Yet as medicine advanced in the early 1900sthe beginnings of modern surgery; the development of vaccines; an understanding of how germs spread and the need for safe public health practices people came to realize that hospitals were the best and safest places for the delivery of increasingly sophisticated medical care. Ready to meet that new demand for hospital care in New Haven was Saint Raphaels. A 1913 New Haven Union newspaper article praised Saint Raphaels for offering the best scientic medical treatment available, calling the hospital a pioneer. One hundred-plus years later, these phrases still describe Saint Raphaels. As you go through this book, youll see stories and photographs showing how Saint Raphaels has grown to match advances in medicine; how Saint Raphael physicians were among the rst to perform many breakthrough procedures; how compassion, dignity and respect for patients have always made the Saint Raphael difference; and how Saint Raphaels has formed an enduring partnership with the community. We wish it had been possible to include the names of every person, department, treatment and procedure thats made a difference over our rst century. For that, however, wed need a book this size for each of the hospitals 100 years. Instead, weve done our best to cull stories, memories and photographs that best

The invitation to the corner-stone placement for the Saint Marys Building, and related news coverage.

represent the spirit and achievements of both our hospital and health providers. Please read on and enjoy. Caring for the sick is a divine trust, said the Sisters who started and continue to sponsor Saint Raphaels. As a faith-based organization and one of four Catholicsponsored acute care hospitals in Connecticut, Saint Raphaels holds rm to this belief, which will undoubtedly continue for the next 100 yearsand beyond. Thank you for your belief, support and trust in us. If Saint Raphaels future is anything like its history, great things are ahead for all of us.

Early patient ward.

In Hebrew, Raphe means heal and El means God. Thus together, Rapha-el means God heals.
On behalf of the Catholic Hospital Association, urologist Francis H. Reilly, M.D., wrote to the Sisters of Charity of Saint Elizabeth, requesting their help. The silver trowel used to lay the cornerstone for the Saint Marys Building (below).

Chapter 1
BEGIN N I N GS

ll over the United States, the early 1900s was a time of new beginnings. New Haven was no different, as Italian, Irish and other immigrants came to work for local factories and start new lives. Downtown New Haven was bustling with tradesmen, trolleys and tenements, and on every street corner were new accents, voices and dreams. Not everyone, however, embraced this changing, more colorful community. Institutions begun by white, Protestant menthose who founded the citywerent always eager to welcome those with different faiths, faces and cultures. Doctors of Irish, Catholic, Jewish and Italian descent quickly discovered that because of their faith or nationality, they werent welcomed to practice at New Havens two existing hospitals, Grace and New Haven (today Yale-New Haven). Many of New Havens new, diverse residents found the same unwelcoming attitude for themselves and loved ones when professional medical care was needed.

based hospital where any doctor could offer careand any person be cared forregardless of race, religion, culture or nancial status. Knowing they could not take on such an enormous task alone, the doctors approached the Sisters of Charity of Saint Elizabeth. At the time, the Sisters were already running Saint John the Evangelist School in New Haven. Renowned for their charitable work in both education and health care, their home base was in Convent Station, N.J., and they operated schools, hospitals and orphanages in New York, New Jersey and Massachusetts. That the Sisters took on helping build a new hospital despite many other commitments is testament to the intrepid faith and far-reaching vision of 81-year-old Reverend Mother Mary Xavier Mehegan. Not only did Mother Xavier agree to manage and help staff the hospital, but she mortgaged the Sisters of Charity Motherhouse in New Jersey for much-needed funds. The Catholic Hospital Association had already purchased the Barnes residence, a stately home at 1442 Chapel St., with $23,000 in donations raised from local individuals, organizations and clergy. But more was needed to convert the home into a hospital, plus build a new structure on adjoining property. Initial estimates indicated it would cost $125,000 to $135,000 to construct the new building.

B OT H G RO U P S N E E D E D A H O S P I TA L TO C A L L T H E I R OW N
This need prompted William Francis Verdi, M.D., and 13 other physicians to form the Catholic Hospital Association. Not all 14 men in the group were Catholic. But they all had a vision to create a faith-

It was a huge sum for the time, but small compared to the grandness of what they hoped to accomplish. Mother Xavier believed that if the Sisters held the deed to the property and were in a position of nancial control, they would never be forced to compromise their mission. This mission, the Sisters and doctors agreed, would be to receive and care for all patients without regard to race, creed or color; to extend charity to the sick, the poor and the needy, as required; and to open to all members of the medical profession an institution in which they could administer to their own patients. To make this happen, four Sisters arrived in New Haven on Feb. 2, 1907. Sisters Mary Irmina McDonough, Mary Eustelle Kivlehan, Rose Ulrica Farley and Alice Veronica Flynn were charged with taking the rst steps to create the new hospital, which the Corporation of the Sisters of Charity of Saint Elizabeth had already decided would be named Saint Raphaels. Its not documented exactly why the Sisters chose this name. But its speculated that Saint Raphael refers to the Archangel Raphael, who is the Catholic patron saint of healing. Theres also meaning within the word Raphael. In Hebrew, Raphe means heal, and El means God. Thus together,

Raphael means God heals. By giving this name to the new hospital, the Sisters acknowledged their belief that God heals through medicine, and that caring for the sick is a divine trust.

WO R K B E G I N S I N E A R N E S T
With faith and funds in hand, work to get the Hospital of Saint Raphael up and running began almost immediately upon the Sisters arrival, and took two paths. On July 28, 2007, ground was broken for the ve-story Saint Marys Building, which would not be ready for two years. So to accommodate patients in the meantime, the Sisters focused on the Barnes residence. Bedrooms in the Barnes home were turned into nursing wards, and the front parlor converted to a chapel. The kitchen and other parts of the building were left to perform their regular functions, and in less than a year the 12-bed hospital was ready to open. Mrs. Winifred Dugan, 70, was admitted as Saint Raphaels rst patient on Jan. 10, 1908. In large, elegant script, the hospitals rst ledger lists patients names, ages, countries of origin, occupations, diagnoses, physicians and outcomes. Mrs. Dugan, from Ireland, was admitted for apoplexy, cared for by James Flynn, M.D., and died in the hospital on May 28.
The Saint Marys Building.

Barnes residence (foreground) with the Saint Marys Building in the background.

Though the Sisters of Charity assigned to start Saint Raphaels exemplified the noble ideals of self-denial and charity, they were down-to-earth and pragmatic when it came to accomplishing their goals. Before Saint Raphaels ever opened its doors, the Sisters sought financial aid from the State of Connecticut. They must have made a compelling argument on the need for the hospital, because the Connecticut General Assembly appropriated $2,500 to Saint Raphaels. The provisions were that the hospital have a competent staff of physicians and surgeons and be in operation for at least three months. It was the first of many significant state grants over the years that would help Saint Raphaels grow.

However, according to the ledger, she had the facility to herself for more than a month. This was probably because during the 19th and early 20th centuries, most doctors made house calls, and ill family members were generally cared for at home. Hospitals were reserved for the indigent, seriously ill, or those who did not have loved ones to care for them. However, when a re broke out on Feb. 28, 1908, at nearby Grace Hospital, 39 patients were carried from the aming structure to Saint Raphaels. Newspaper reports called the re a providential happening, with Saint Raphaels response helping win community acceptance and dispelling any prejudices against a Catholic-sponsored facility. The people of New Haven were blessed and fortunate to have a new hospital open in its hour of need. If not for Saint Raphaels, surely more patients would have died, newspaper reports claimed. At the same time renovations were going on at the Barnes residence, ground was being broken on land next door for a larger, more suitable building. A 1913 tribute to Saint Raphaels published in The New Haven Union looked back at the time: Prior to 1906, the hospitals of New Haven maintained a position bordering on a closed corporation. For once a patient entered a hospital here, the relatives whose presence and sympathy would have aided in their recovery were debarred from visiting. These detriments were realized and often protested against, but without avail until 1907

At left, a newspaper clipping about early fundraising activities.

when Saint Raphaels became the pioneer in that new curative methodcombining the best scientic medical treatment, while allowing each patient to have his or her own physician. Condence in the minds of those they know helps the invalids. Clergymen of their own faith and the frequent presence of friends is always a consolation to the sick. Then why deprive them of it? So a new era in the management of hospitals born of a humanitarian regard for the feelings of patients, as well as for the professional treatment of their bodies, was established in this city when Saint Raphaels hospital was built. Perhaps the writer of this piece had been allowed to look at Saint Raphaels patient ledger, and had seen the multiethnic, multicultural population turning to the new hospital for care. Almost one-third of the patients admitted to Saint Raphaels by 1910 were foreign-born immigrants, with Sweden, England, Ireland, Germany and Italy some of the many native countries listed. Patient occupations included laundress, stenographer, baseball player, blacksmith, butler, tinsmith, farmer, box maker, school boy and housewife, with conditions as equally variedhernia, cesarean section, tongue cancer, alcoholism, appendicitis, gunshot wound, breast cancer, apoplexy, chronic diarrhea and goiter among them.

By many standards, it was a humble clientele. Yet the founding Sisters and physicians were determined to make Saint Raphaels anything but ordinary. The new Saint Marys Building, opened on Feb. 22, 1909, was hailed in newspaper reports as a splendid structure, and one of the most complete in New England. This state-of-the-art facility boasted such new and modern features as an electric elevator, electric lighting and a telephone on each oor. And its latest sanitary appointments included one that attracted national attention: All walls and ceilings have rounded corners to make them perfectly sanitary in every respect. The brick building set a standard for medical excellence that would continue throughout all of Saint Raphaels rst 100 years. Even at this early date, Saint Raphaels patient rooms and technology were designed to not just offer the most advanced care, but the safest and most comfortable care, too. The Saint Marys building boasted between 125 and 135 beds (accounts vary) in nursing wards and a handful of private rooms. Staying in the public wards cost $7 per week. Private rooms included the rst nurse call buttons which, when pushed, would cause a small red ag to rise outside the patients door. Each oor also had two toilet rooms with large bath apartments, a large kitchen connected to a dumb waiter, and a linen room.

SaI N t R ap ha E l f I R St S
First building Barnes residence at 1442 Chapel St. It consisted of 12 beds, a pharmacy, laboratory and an operating room and was staffed by 16 employees.

First surgery
Cesarean sectiona difficult and dangerous operation, a newspaper reported performed by William Verdi, M.D., on Mrs. John Ladino of Palmer Street. Mother and child did splendidly, the newspaper announced.

First administrator
Sister Mary Irmina McDonough

Among the donations listed in the first annual report (1910)

A total of $1,050 donated by1,050 people. Each gave $1. Ten turkeys Crate of oranges Three cases of lemon soda A Bermuda lily Ten gallons of ice cream

First patient
70-year-old Winifred Dugan admitted for apoplexy on Jan. 10, 1908. She stayed hospitalized until she died of the condition on May 28.

First ambulances
There were twoone horse-drawn, one electric.

Saint Raphaels two-room operating department was termed one of the most up-to-date and modern of its kind in the country and the most perfect in every detail in this country or abroad. The main operating room was well-lighted with a large glass roof, tile walls and marble oors. There was also a room where patients were etherized, a room for instrumental sterilization, and two padded cells for delirious patients. Also revolutionary was that the entire building was reproof with concrete oors, iron stairs and well-planned and arranged re escapes, newspapers wrote. The basement contained a small, brick-lined morgue, a boiler room, laundry and cooking department, plus nurses and doctors dining rooms. Yet more than physical growth was taking place. To assure the best-trained nurses were caring for Saint Raphael patients, the hospital organized and opened

The 14 Catholic and non-Catholic physicians who on May 3, 1906, founded the Catholic Hospital Association and with the Sisters of Charity of Saint Elizabeth eventually founded Saint Raphaels were: Leonard Bacon, M.D. William Butler, M.D. Jeremiah Cohane, M.D. James Flynn, M.D. Norton Hotchkiss, M.D.
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John Luby, M.D. Stephen Maher, M.D. Edward McCabe, M.D. Matthew OConnor, M.D.

Francis Reilly, M.D. William Sheehan, M.D. John Sullivan, M.D. William Verdi, M.D. Frank Whittemore, M.D.

the Training School for Nurses (Read about the Saint Raphael School of Nursing in Chapter 4.). To support the hospitals many endeavors, a Ladies Auxiliary also formed. (Turn to Chapter 8 for more on the Auxiliary.) Presiding over these many dramatic changes was Sister Mary Irminaone of the four original sistersserving as hospital superintendent. The motto she and the founding physicians adapted
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was ad majorem dei gloriamLatin for the greater glory of God. They had the saying carved into Saint Marys cornerstone to guide them. And its obvious how all believed in the motto, and clearly saw the need for the hospital and its caring mission. What they didnt see, however, was how quickly Saint Raphaels would grow beyond any of their visions.

Like the way Mozart looked at a piano and knew how to play, (Verdi) looked at the human body and knew his way around it. There is great honor and nobility in being a physician. To heal and to serve is a real calling. William Verdi had that calling.
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Chapter 2
WI LLI AM FRANCIS VE RDI, M.D.

f the Sisters of Charity of Saint Elizabeth provided the greatest group inuence on the early hospital, the greatest individual inuence was William Francis Verdi, M.D. Verdi was an internationally renowned surgeon whose patients ranged from the president of Yale University to his gardeners wife. For more than half a century, Verdi provided superb medical care to all who needed him, regardless of their ability to pay. He combined a dexterous pair of hands with an intuitive gift for knowing what was wrong, and how to best x it. The surgeon is concernedintensely concernedwith the recovery of the patient, Verdi once wrote. He is interested in pulling the patient through. And he suffers as the family suffers. A tragedy is never taken more at heart than by the surgeon. It could not be otherwise for a good doctor. Described as a regal and impeccably dressed man, he is listed as being 5-foot-7, and 165 pounds on a 1917 hunting license. At the time he was in his 40s, and despite his very public stature within the community, he was a very private man. He so disliked publicity that he refused to be interviewed for a 1926 newspaper article about his surgical accomplishments. He instead referred the reporter to his brother-in-law, then-Connecticut Secretary of State Francis A. Pallotti, who provided all the information.

He was most comfortable at work. Old surgical logs show him performing as many as 10 operations a dayan amazing number by todays standards. He preferred an operating room with natural light and demanded silence while he worked. He was also, in every sense of the term, a general surgeon, operating on just about every part of the body during his almost 60 pioneering years in the eldvery often under extreme or unusually challenging circumstances. Those who worked with Verdi also remember him being a great admirer of Saint Raphael nurses for the skill they obtained at the Saint Raphael School of Nursing and then showed in the operating room. There, he furthered most of their medical educations, teaching various nuances about the human body and how it could be healed. This ability to mentor, coupled with Verdis great skill as a surgeon, spurred the Yale University School of Medicine to ask Verdi to help train students at his alma mater. Eventually, he became involved in almost every aspect of life in New Haven, from city planning to serving on its school board. He was also a big supporter of the artsmusic especially. He was known for the musical parties he and his sister Loretta hosted at their home. One soiree, held for American Surgical Association fellows who came to New Haven for a conference, was reported to include a performance by three renowned operatic voices from the Metropolitan Opera House and Philadelphia Opera Company.

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According to a newspaper society page, Mayo Clinic founder Charles Mayo, M.D., and his wife were among Verdis houseguests. His great-niece Victoria DiSesa, a New Haven attorney and former Saint Raphael trustee, remembers hearing family stories about Verdis parties. Her sister Susan owns the piano from the music room. He served lavish dinners and lived an elegant life, DiSesa recalled. Above all, however, he was a surgeon, said medical historian Sherwin Nuland, M.D.: How good was he? He was so gifted that patients came from everywhere to have him operate on them. Verdi had more talent than anyone at that time.

E A R LY Y E A R S

William Francis Verdi was born Guglielmo Francesco Verdi on Nov. 27, 1872, in Montechiaro Vico Equense, Naples, Italy, the son of Domenic and Rose Ruggiero Verdi. Domenic was a sailor in the Italian navy, and when Verdi was 18 months old, Domenic decided to bring his family to the United States. They settled in New Haven, with Domenic taking a job as a foreman in a rubber factory. Verdis brother Antonie also made the ocean trip, with their sisters Rose, Mary and Loretta born in New Haven in quick succession.

Verdi (far left) at the age of 18 in the barbershop.

Although Verdi liked school and was a good student, he quit Hillhouse High School to take a job in a barber shop to help support his family. It was a move that alarmed school ofcials, who must have seen Verdis potential. Determined to get Verdi to return to high school, the Hillhouse principal went to Verdis house and refused to leave until Verdi agreed. It may be said that the world owes the surgical ability and genius of Verdi to the insistence of Principal James D. Whitmore, wrote the New Haven Journal-Courier. In 1891, Verdi became the rst native Italian to graduate from Hillhouse. Fascinated with medicineand because in those days students did not need to attend college before medical schoolVerdi went right from Hillhouse to Yale Medical School (todays Yale University School of Medicine). He paid his tuition by working as an Italian interpreter in the New Haven Courthouse and teaching English to immigrants. Records show that when he graduated Yale in 1894, he considered becoming a priest or a lawyer.

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Instead, he enrolled in a surgical internship, and worked to earn enough money to travel to Germany and Austria. Physicians there were performing advanced surgical procedures only talked about in New Haven. Thus began a series of routine summer visits to Europe, furthering knowledge of his eld. Yet New Haven was his home and where he wanted to be. He opened his rst practice at 172 John Street. Quickly, his reputation as both a skilled and caring physician began to grow. Like other physicians of the day, he made house calls by horse and buggy and performed surgery atop kitchen tables, or on his own portable one. Instruments were sterilized on wood-burning kitchen stoves. Old receipts show Verdi charged $100 for an appendectomy. And soon, he was able to hire a chauffeur. Egisto Cinquini (known as Gisto), whose drivers license lists him as 20 in 1910, would work for Verdi for many years. The story we were always told growing up is that Egisto would drive Verdi to a home in the middle of the night and then remove one of the head lamps from the car and hold it up while Verdi operated, remembered Verdis great-niece Susan DiSesa Sheeline. When Verdi was nished, he would say

to Egisto, You can put the lamp down now. And Egisto would reply, I cant; my arm is stuck. Despite Verdis John Street ofce, receipts for both horse shoeing and automobile parts suggest Verdi must have been constantly on the road and at work. Indeed, historian Nuland believed part of Verdis reason for starting a hospital was weariness of traveling: He wanted easy access to a hospital of his own.
T H E R I G H T T I M E F O R A M OV E

At the same time, the idea of hospitals being a more appropriate setting for medical care was increasingly accepted. Unfortunately, as an Italian-American and a Catholic, Verdi was not accepted at New Havens existing hospitals, particularly New Haven Hospital. Anti-Catholic discrimination was not just common, but rabid at the time.

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Verdi in the operating room, late 1930s.

As a founding physician, Verdi was a driving force in not just creating the Hospital of Saint Raphaels physical structure, but in helping create its constitution and bylaws. He donated $500 of his own money to the new hospital, and was chairman of the group that raised money to fund the initial construction. Apparently, he was an effective fundraiser. An old newspaper article noted Verdi was able to convince an anonymous donor to give $4,500 toward building a modern operating room. The donation was a fortune at the time. In his day-to-day work at Saint Raphaels, Verdi was surgeon-in-chief. People marveled at his hands, and their almost mystical ability to diagnose and heal. He had the lightest touch, says Mary Sexton, a long-time Saint Raphael nurse who cared for many of Verdis patients. When he examined you, you could scarcely feel it. The late Mario Garofalo, M.D., Saint Raphaels chief of anesthesia from 1940 to 1972, was also in awe of Verdis talent. He was the most versatile surgeon I had ever known, Garofalo wrote in tribute to Verdi. He did neurosurgery, chest surgery, abdominal surgery, gynecology, orthopedics, gastrointestinal surgery, plastic surgery. He also extracted teeth when it was necessary. He couldnt understand why (dentists) used so many instruments, while he got along with one. The only procedure I had never seen him do was tonsillectomy. This quirky fact is almost legendary at Saint Raphaels a bit of did-he-or-didnt-he trivia. Nulands take was it might have been the only operation Verdi didnt perform. The reason: At the time, tonsillectomies could lead to uncontrollableand often fatalbleeding. In speeches and newspaper articles, Verdi himself attributed his hands and surgical abilities to his mother, Rose. My mother gave me a pair of dexterous hands, he was quoted as saying.
Writings and drawings from Verdis notebooks.

Three of Verdis many honors for medical achievements came from Italys King Emmanuele in recognition of his high standing in the medical profession and services to Italian soldiers in the interest of humanity. In 1914, Verdi received the title of Chevalier of the Order of the Crown of Italy, and was later raised to the rank of Commeneatore. In 1929, he was named Grande Officiale of the Order of the Crown.

That inheritance has been the most valuable possession of

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Verdi making rounds with his nephew, Orlando Pelliccia, M.D., and Sister Columba. Circa 1949.

my life. She could knit, crochet, sewin fact, do anything with her hands. She gave me some of her skill. Verdi honored his mother in 1927 by donating $10,000 in her name to the Yale Endowment Fund for a New Haven student to attend Yale Medical School. He also donated $10,000 in her name for an organ at St. Michaels Church. Its still in use today. Generally, however, it was Verdi being honored. Connecticut Gov. Simeon Baldwin named him state surgeon general; he was consulting surgeon for Choate School in Wallingford; and, in 1913, he was elected president of the New Haven Medical Association. In 1916, he was admitted to the prestigious New England Surgical Society a group exclusive to the 100 best surgeons in the region. Verdi was as great as his reputation and more so. He even operated with Carmalt, said historian Nuland, referring to former Yale University School of Medicine Dean William H. Carmalt. Carmalt was an excellent leader. But he was not as great a surgeon as Verdi. They operated together
19

on Saturday afternoons at New Haven Hospital, even though Verdi didnt have staff privileges there. They were doing big stuff: removing the stomach or a kidney. Today these things are fairly routine. But back then, it was complicated. The fact that he was invited into the New England Surgical Society shows he was held in huge esteem. He was enormously talented, and his results were excellent for that time.

As wonderful as these years were, however, they werent without down times. For reasons that arent clearly documented but appear to be over use of the operating room, Verdi resigned from Saint Raphaels in July 1910, citing the many disturbances between the hospital management and the Medical Board. Thankfully, whatever those disturbances were, they cleared fairly quickly. Two years later, Verdi rejoined the Saint Raphael staff, resumed his old position as chief surgeon and accepted a seat on the hospital Board of Trustees. After this, only service in France from July 1918

On June 20, 1945, medical staff members gathered outside the hospital after a surprise party to honor Verdi. He gave copies of this photograph to all who attended the celebration, which Verdi called one of the happiest surprises of my life. Verdi is the 16th man from the left, standing. Hes holding his hands behind his back.

A L ONG , DI STING UISHED C ARE E R

Verdis dedication to medicine, New Haven and helping people live better, longer lives continued throughout his career. He was recognized for it many times, in many forums. But his receipt of the Advertising Club of New Havens Sixth Gold Medal Award in 1940 for outstanding service to humanity is worth noting. More than 600 people attended the dinner to see Connecticut Gov. Raymond E. Baldwin honor Verdi. But its not these facts that make the event interesting. What makes it stand out is that it was one of the very few times Verdi spokein typically self-effacing fashionabout his career. The speech was printed in the New Haven Journal-Courier. An excerpt: As I thoughtfully review my career, I am impressed by the realization that I have responded to an environment created here in New Haven many decades ago. It is true that I may have been endowed through inheritance with certain faculties. I constantly recall that my mother was blessed with extraordinary deftness. Her hands did what her mind willed quickly and without apparent effort. That gift probably was passed on, and I am grateful for that blessing. However, it has occurred to me frequently that if I had been brought to

another community, it is quite possible that I might have become a stone mason, a street car motorman or a bricklayer. These are all honorable occupations. I mean no disparagement of them. I wish only to convey my conviction that it was the environment of this community which inspired me almost forced me into a profession which is continuously conspicuous for services to others.

Even as a young boy living in a humble home with Old World parents, I was aware of the tremendous prestige and influence of one of the worlds greatest universities. I became aware at an early age of the opportunity which a community like this affords. But as the sense of opportunity came to me, I was also conscious of the obligations which accompany such opportunity. In accepting this honor, I wish to express the ardent hope that the same spirit of friendliness, the same urge toward improvement, the same understanding of our natural interdependence which have characterized this city throughout its history may continue and be an example among other communities of the best way in which to live

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At the outbreak of World War I, 46-year-old Verdi volunteered his surgical skills to the U.S. Army and was commissioned a Medical Corps major. He served units near the front lines as chief of the Chateau Thierry operating team and later played an important part in caring for men wounded uring the Battle of MeuseArgonne. While overseas, he helped pioneer a new lung-chest operation that led to countless saved lives on the battlefield. For this and other accomplishments, he was awarded a Distinguished Service Medal.

to January 1919 during World War I would take him away from Saint Raphaels. He was there to stay.
V E R D I S T RU LY G R A N D RO U N D S

Back at the job and hospital he loved, Verdi worked seven days a week; rarely took a vacation; and became famousif not somewhat infamousfor the way he conducted patient rounds. Garofalo recorded a detailed account of these truly grand rounds. Wrote Garofalo: The performance would start at about 9 a.m. Gisto, his chauffeur, would drive him to the entrance of H.S.R. In walked this tall, very handsome, well-built man who was impeccably dressed and distinguished looking. As he walked along, there was an aura of greatness about him. Sister Columba would meet him at the entrance and put a ower in his

From left, Jeremiah B. Sullivan, M.D., Verdi, Nurse McKenna and Joseph D. Russo, M.D.

lapel. Then she escorted him, arm in arm, up to (the top oor of the hospital) Private 6. In the meantime, Dr. Allen, his ever-faithful and long-time assistant, prepared the way and made sure that every detail was taken care of. The procession started, and there followed oor nurses, central supply nurses, interns, residents, referring physicians, etc. It was quite a spectacle. The entourage moved from one patients room to another. Then they would descend to the next oor, until all the patients were seen. Judging by the profound respect and affection Verdis coworkers appeared to have for him, no one seemed to be put off by these regal displays. Perhaps this is because Verdi was as hard working as he was gifted. When emergency surgeries were needed at night, Verdi was often the rst to respond. In his mind, the patient came rstalways. If you didnt treat that patient well, hed go wild, recalled the late surgeon Mario G. Conte, M.D., during a 1990 interview. If (you didnt follow his rules) in the operating room, you got hell. No wonder nurses and staff would shake in their bootsas many accounts recalled when they saw Verdi coming.

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Verdi performing surgery. Circa 1942.

Nurse Sexton, who in the 40s took care of many of Verdis patients, remembers Verdi as being immaculate: Whatever he was doing, he always did it perfectly, whether it was surgery or his appearance. He was a perfectionist and would scold people if they didnt do the right thing. He also deeply cared for people. Sexton remembers one time when Verdi thought she was too skinny and poured her a glass of milk. When an emergency required surgery in the middle of the night, Verdi would have Gisto bring the staff rolls, bread, coffee and pastries. Dr. Verdi was so good to the nurses, Sexton said. Surgery and work were his whole life. It gave him such pleasure to see patients get well. He instinctively knew what to do. Former New Haven City Engineer William Bolton shared with the New Haven Evening Register a tale about Verdis kindness. Bolton recalled how when he was a former band leader, one of his musicians needed an operation, but had no money to pay for it. Verdi successfully operated on the impoverished musiciana Yale student named Rudy Valleeand refused any payment.

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After Vallee became a famous crooner, he tried several times to pay for the operation, but Verdi continually refused. Determined to pay in some way, Vallee appeared at Saint Raphaels one day and gave a private concert for Verdis patients. I am in love with my work, Verdi once remarked. If I had my life to live over again, Id follow the same path. Friends ask me why I dont retire. Why, I couldnt retire! I love my work so much I want to be at it every waking moment. Nine years after that speech, in 1949, Verdi collapsed in the operating room. Many believe he suffered a stroke. Sadly, he was unable to work again. In the last few years of his life, he allegedly suffered dementia. Verdi died on Easter Sunday, April 21, 1957, at the age of 84. Yet it seems that for all of those last years, Saint Raphaels was rarely out of his thoughts. Doctors, friends, family and community leaders made up a steady stream of visitors. And the nurse who once cared for his patients, Mary Sexton, became his private nurse at home. In a bittersweet memory, Sexton recalled seeing Verdi sitting at the breakfast table during those last years. He would pick up a butter knife, fork or fountain pen and go through the motions of cutting, suturing and performing surgery. His hands remembered what his mind did not. Verdi was absolutely intuitive, said his great-niece Susan DiSesa Sheeline. Like the way Mozart looked at a piano and knew how to play, my great uncle looked at the human body and knew his way around it. There is great honor and nobility in being a physician. To heal and to serve is a real calling. William Verdi had that calling.

Verdi groomed his nephew, Orlando Pelliccia, Jr., M.D., to succeed him as Saint Raphaels surgery chief. Pelliccia took over this job in 1953, after being one of the first Italian-Americans to attend the prestigious Choate School in Wallingford and then graduate from Yale University and Johns Hopkins Medical School. Pelliccia was the son of Verdis sister Rose, Verdi Pelliccia, who worked as a bandage washer and surgical assistant during Verdis early years. Relatives believe Pellicciawho fondly referred to Verdi as Uncle Nineyhad the same inherent gift for medicine as his uncle. And Verdi was determined to make sure his nephew was a success. Medicine was in his blood, said Mary Pelliccia, M.D., of Madison, Dr. Pelliccias second wife. (Verdi) adored Orlando, but was harder on him than the other doctors, because he recognized Orlandos potential. He wouldnt let Orlando get away with anything, and Orlando never stopped being afraid of him.

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the tiny seed sown in 1907 has flourished by God s grace

Chapter 3
t he f i rs t th irt y y ear s

ith doctors like William Verdi and a state-of-the-art medical facility, Saint Raphaels quickly became the hospital of choice for many New Haven residents. But success brought its own share of problems. Just ve years after opening its doors, the Hospital of Saint Raphael was already bursting at the seams. The Saint Marys Building could no longer accommodate the everincreasing number of patients turning to Saint Raphaels for care. The School of Nursing dorm was at capacity with 40 students, forcing staff to turn away qualied applicants. And the Saint Raphael chapelessential to the institutionhad become too small to accommodate the Sisters for daily Mass, let alone physicians, staff and patients.

Although this hospital is the youngest institution of its kind in the city, the amount of relief it has afforded those sick and suffering, and its success from a medical standpoint, cannot be over-estimated. The amount of free treatment furnished to those unable to pay reects unbounded credit on Saint Raphaels staff and on the humanitarian spirit of (its) management No doubt many of the good feelings about the hospital came from staff members themselves. It was an exciting time; a happy time, with employees feeling like members of one big family. In the early 1900s, healthcare workers didnt have highly specialized roles as they do today. There was a formal atmosphere and a rigid chain of command. But like a family, everyone pitched in as necessary. In

DA I LY L I F E H A D B E C O M E A DA I LY L O G J A M
The hospitals 1912 annual report shows Saint Raphaels caring for an amazing 2,136 patients1,386 Catholics, 83 Hebrews, 653 Protestants and 14 of unknown religion. Following the caring mission the Sisters of Charity established (and Saint Raphaels continues today), much of this care was delivered free; 5,250 days of free board and treatment, the report states. Saint Raphaels was winning the heart of the community, as a newspaper editorial from the time proves:

crises, the cooks helped roll bandages. The bookkeeper chipped in to help move patients. And when high tides and heavy rains made the sewer system back up, everyone grabbed a mop. Employees worked long and hard with little vacation and meager compensation. But the Sisters living and working at the hospital inspired staff members to give as selessly as they did. Although Saint Raphaels founding Sisters left no written account of these early days, some history has been preserved, passed down by word of mouth. Former Saint Raphael Administrator Sister Louise Anthony shared some of these stories before she died in 1997. (Read

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more about Sister Louise in Chapter 7.) On a cassette recorded for the Saint Raphael archives, Sister Louise talked about the original Sisters rst few years. The Sisters lived in a makeshift apartment in the Barnes mansion attic and had nothing, Sister Louise explained. They sat on orange crates. They didnt even have a spoon. If they wanted a cup of coffee, they had to stir it with a nail. There was also no time for rest or relaxation. During the day, the Sisters cared for patients, plus cleaned and ran the hospital. At night, they did all the hospital laundryby hand. They struggled and they worked very hard, Sister Louise said. World events also conspired to compound the challenges Saint Raphaels was facing. World War I raged from 1914-18, and many physicians, interns and nurses enlisted and served for several years. Saint Raphael nurse Irene Flynn, School of Nursing Class of 1916, was among the Americans who died nursing the wounded in France. In 1918, a virulent influenza epidemic caused sick and dying patients to crowd hospitals around the world, including Saint Raphaels. The hospital treated 196 cases in three months with 48 patients and two student nurses dying. Yet with the same faith and gumption

that helped found Saint Raphaels, the hospital continued to grow.Construction began on a new four-story wing named the Saint Ritas Pavilion in 1919. It opened in 1921, increasing hospital capacity to 200 (accounts vary slightly). One of the rst facilities to devote entire oors (the second and third) to private rooms, it also housed the X-ray department, laboratory, labor rooms and, from the mid-40s to mid-60s, the convent. After the convent was relocated, these rooms were transformed to deluxe patient rooms with bathrooms, carpeting

and meals served on ne chinamore like a hotel than a hospital. For many patients, the Saint Rita rooms felt like home. Not only was the dcor home-like, but some people at this time stayed hospitalized for several weeks, months or even years. A newspaper account in the late 1920s on the death of Charles P. Bohan, who suffered from paralysis, said he had been a patient at Saint Raphaels for 17 years! Records show it wasnt uncommon for homeless residents, or those without family, to stay for two to three years.

Saint Ritas Chapel circa 1944. The central portions of the windows were saved and are now displayed in the hospital. (left)

Perhaps the most cherished feature of Saint Ritas, however, was the spacious chapel with intricate stained glass windows. Everything important happened in the chapel, remembered Dorothy Scott, a member of the Saint Raphael School of Nursing Class of 1948. It was the core of all our spiritual training. The chaplain gave classes in religion, the nuns played the organ. On feast days, the student body would sing. Some of my classmates got married in the chapel, they loved it so much. Looking back at this era, Saint Raphaels in 1928 published a review of its rst 20 years. In 1908, 256 patients were treated at the hospital. By 1927, that number increased 18-fold to 4,668. These patients reported a diversity of occupations, ranging from a candy maker, corsetiere, corset cutter and pugilist, to gate keepers, hatters, remen, physicians, stenographers and teachers. Their ailments varied, but one report noted a striking variety of surgical pathology cases, including an unusual series of rare tumors of the mouth. One case apparently showed a secondary tumor of the ankle, representing the only instance on record in American literature. Another very remarkable operative specimen was a resected portion of the esophagus due to cancer. The number of physicians more than doubled in the rst two decades, with a total of 33 on the medical staff. There were also now four medical school residents; 10 special department technicians; 80 student nurses; and 50 assistants and hired helpers.
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the Great Depression. Although there was an overall economic downturn across the nation and the world, New Haven was not hit as hard as many cities. Still, times were hard, and its not surprising that Saint Raphaels launched no headline-grabbing construction during the 30s, erecting only a laundry facility and small pediatric pavilion. During this period, the Sisters of Charity worked tirelessly to meet the
School of Nursing class of 1912. The first class in 1911 only had one graduate.

strong and undismayed by virtue of her obediencemet and overcame almost insuperable obstacles. Her quiet forcefulness inspired her coworkers with condence, and soon their energy, and hers was felt in every department. Her prayerfulness, gentleness and strength of character created an atmosphere of spirituality, affability, and loyalty.

increasing needs of many people in the community. In September 1933, a clinic offering pre-natal and post-natal care to deserving mothers moved to Saint Raphaels from Saint Anthonys Infant Home at Prince and Gold streets. Along with clinic care, patients received six weeks of home infant care instructions, supported by the Catholic Charity League. But it was a difcult decade as well, because many of those so instrumental in the hospitals founding died or retired. Sister Immaculatas 22-yearadministration came to an end with her resignation in 1932; she died four years later. In a tribute, the hospital administration recognized her unique place in Saint Raphaels history: Sister M. Immaculata came to New Haven to take charge of the Hospital of Saint Raphael Sister

T H E WAY I T WA S
Its fairly easy to document, and show the scope, of Saint Raphaels physical growth in these early decades. Increases in buildings, beds, funds, patients and staff can be seen in black and white. What isnt so easy to capture is the camaraderie, color and feel of daily hospital life. But because these years created the foundation for what Saint Raphaels is today, its important to try. For help, we turn to the recollections of surgeon Mario Conte, M.D., who came to Saint Raphaels as an intern in 1935. Everything was for the patients comfort, said Conte, who studied medicine in Naples, Italy. At the time, the hospital was divided into private rooms, where patients were attended by their own private physicians, and wards, where patients were treated by residents and interns who were supervised

Overseeing these caregivers, other staff and patients were 12 Sisters of Charity who lived on-site at the hospital. The score of years (past) since the founding of Saint Raphaels has brought its share of trials and adversities incident to such undertakings, the 1928 report stated. But the tiny seed sown in 1907 has ourished by Gods grace, and its laborers look forward to the progress that lies ahead, condent that Divine Guidance will not fail them and that the blessings they invoke on the friends and benefactors of the institution will be given to the hundredfold.

TIME OF TRANSITION
With the stock market crash of 1929, New Haven and the rest of the nation sank into

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by the attending physicians. The average cost of staying on the public ward was $7 a week. Everybody got wonderful attention from the attendings, said Conte of the ward patients, as good as if they were private patients. He and the other interns lived at Saint Raphaels during their training and worked a grueling schedule. Like todays interns, each was assigned to different areas of the hospital on a rotating basis. Unlike todays interns, who by law cant work more than 80 hours a week, Conte and his colleagues sometimes worked around the clockeven, when needed, going out on ambulance duty. If you were in the surgery department, you got up early in the morning, collected the patients blood and analyzed it. We did all the lab work and had a couple of nights off a week. But when you were off at 5 p.m., you had to be back on by 7 a.m. We were also on call every night. For this, each intern earned $10 a month plus room, board and uniforms. When Conte became a resident, his salary was raised to $35 a month. And after some complaining, we got $50, Conte chuckled. Because there were no recovery rooms or intensive care units, interns, residents and nurses had to closely care for surgery patients

Working closely with the Sisters, the medical staff guided Saint Raphaels growth by:

1910 Opening a fully equipped pharmacy

1911 Opening of a modern laboratory (beyond the one first established in the Barnes residence)

1919 Establishing a dedicated urology department.

1926 Opening St.Vincents Pediatric Pavilion

1928 Hiring two women for key positions: Helen M. Scoville, M.D., as a part-time pathologist, and Marguerite A. Eichstaedt, R.N., as the hospitals first full-time nurse anesthetist.

1932 Hiring Robert Nesbit, M.D., as the first full-time pathologist. He further developed Saint Raphaels clinical laboratories and formed the Pathology Department.

1933 Opening a dental clinic under the direction of Drs. George Fahy, Donald Johnson, and William Flynn.

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and monitor conditions. Conte recalled how Saint Raphael nurses were trained to demonstrate a type of discipline almost militaristic by todays standards. In their crisp white uniforms and caps, nurses were expected to stop what they were doing and stand at attention whenever a doctor came into the roomand they did. Doctors of the time were rarely sued, though they still carried malpractice insurance. A physicians and surgeons liability policy found in the Saint Raphael archive for Israel Kleiner, M.D., Frank McGuire, M.D., and others cost $12.50 a year. The policy covered up to $10,000 for one patient, with a $25,000 maximum for multiple claims in a one-year period.

As simple as the healthcare system was in the 20s and 30s, many look back on it with fondness. Everybody cared for everybody, said former nurse Edna Ribikoff, who was interviewed in the mid-1990s for the hospitals 90th anniversary. And although those in authority demanded respect, they also showed great kindness to employees and patients. One such gure was the head nurse in obstetrics, whom Ribikoff and many others remember as Ma Ryan. Her real name was Margaret Connolly Ryan, and she had emigrated from Ireland as a young woman. When her husband died in 1923 and left her with a 14-year- old son to support, she entered Saint Raphaels School of Nursing, where she picked up the nickname that would distinguish her in Saint Raphaels history.

Her son Jimmy Ryan, who served as an altar boy in the hospitals main chapel for many years, explained how she got the nickname: Historically, student nurses were kids right out of high school. When a student nurse has a 14-year-old son, theres a bit of a difference there, and thats where Ma Ryan came into play. Ma Ryans career got off to a fast start when, three days before she graduated as an R.N. in 1927, an Italian diplomat was shot in his ofce and became a patient of Dr. Verdis. They wanted a mature, good nurse, Ryan explained, and they allowed my mother out of training early. Ma Ryan proved herself eminently capable and soon became maternity supervisor.

First three decades of Saint Raphael administrators

19071909: Sister Mary Irmina McDonoughone of the four founding sisters 19091910: 19101932: 19321937: 19371939: Sister Rose Vincent Sister Immaculata Sister Catherine Regina Sister Elenita

In February 1918, the cost of care at Saint Raphaels was

$1.50 a night for a bed in a multi-person ward $2 to $5 a night for a private room $2 for an ambulance call within city limits $3 to $10 for each X-ray plate By 1928, the cost of care rose to $17.50 per week in a general ward; $19 per week in a semi-private room (including medical and surgical attendance, medications, nursing and laundry); and $30-$60 per week in a private room

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We had to tow the line, Ribikoff remembered. There was no hanky panky with her. It had to be done and done the right way. At the same time, she was friendly, fun to work with and devoted to her patients. She used to see when the mashed potatoes came up from the kitchen downstairs that they had extra butter and extra cream. She really and truly took care of her patients. Remember, they used to spend 14 days in the hospital after having a baby. Like soldiers, nurses and other employees learned to take a certain amount of sternness from their superiors in stride and even to expect it. As Ribikoff put it, We were ruled and ruled properly.

ON PEOPLE AND PERSONALITIES

Like Ma Ryan, there are countless people who made an everlasting mark on Saint Raphaels. In some cases, entire familieslike the Flynn familyplayed an important role.

No photos exist of the hospitals first x-ray machine, installed in 1912. But heres how the technology looked in 1937.

James H. Flynn, M.D., was one of the hospitals founding physicians and patriarch of a New Haven medical dynasty that

The community was very generous in its support, a commitment that continues today. Among the donations recorded in 1928
2 dozen pairs of window curtains 6 dozen articles of clothing from the Needle Work Guild of America Jelly, preserves, vegetables, condiments, ice cream, eggs, andat Thanksgiving and Christmas12 prime turkeys and 2 geese 30 volumes of fiction for the library from graduate nurses Down mattress, hair mattress, feather pillows, and linens Hand-painted china tea set and bon bon dishes Paschal candle, embroidered chapel linens, sanctuary carpet and chimes

served both Saint Raphaels and the community. His nephew, Charles T. Flynn, M.D., served as a Saint Raphael attending ear, nose and throat surgeon for more than 50 years. Always active in civic affairs, he was a presidential elector for President Franklin D. Roosevelt and Vice President John N. Garner in 1936. He was also a licensed pharmacist. During his years of practice, Charles Flynn saw many unusual cases. One involved a 3-year old boy who had swallowed a whistle that became lodged in his vocal chords. Every time the boy breathed out, he whistled uncontrollably. Fortunately, the doctor was able to retrieve the whistle with a long pair of forceps.

Another case was that of Albina Gejea, whose experience of inhaling a tack made local headlines. She was admitted to Saint Raphaels, where Charles Flynn performed a 20-minute procedure using a bronchoscope to dislodge the tack from the mass of tissue that had formed around it. Yet the Flynn saga doesnt end with Charles. His younger brother, William Henry Flynn, became the dentist who started Saint Raphaels rst dental clinic in 1933. In addition, two of Charles Flynns children became doctors and two became dentists, some of whom practiced at Saint Raphaels. There are notable patients, as well. Today, patient condentiality is paramount. But back in the early 20th century, injuries, surgery and illness were routinely covered in local newspapers, including the New Haven Register.

Back Broken, Dennis Boyle Will Recover was one such Register headline in May 1911, after the man fell from a building on Crown Street. Later that month, there was a follow-up story: Lives with Broken Back, Case of Dennis Boyle Regarded as Wonderful. First in History of St. Raphaels. His Many Friends Hope Ultimate Recovery. The article claimed Boyle was living with a completely severed spinal column and resting on an air bed. In June 1911, Operation on Womans Skull Restores Mind was the title of a story about Mrs. M.M. Bard of Cleveland, Ohio, who was prone to severe nervous attacks and decided to have surgery at Saint Raphaels while visiting her sister in New Haven. Morris D. Slattery, M.D., removed a section of Mrs. Bards skull and brain. Before the operation, Mrs. Bard had a perfect craze for piano playing, feared water, feared being at the top of any elevation and

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The buildings of Arnold College (right), acquired by Saint Raphaels in 1939. The buildings were razed to make way for the new construction (below).

M OV I N G A H E A D
As these stories colorfully illustrate, life at the young institution was was subject to shocking nervous attacks, a New Haven newspaper reported. The operation has effected a complete and marvelous cure and Mrs. Bard is now a perfectly normal woman. Around the same time, Frank Steele of Old Saybrook got caught in a motorized washtub that tore off his clothes and mangled his left arm. Thankfully, he was successfully treated by a Dr. Crowe (rst name unknown) at Saint Raphaels. seldom dull. It also, apparently, was never empty. By the end of the 1930s, overcrowding was again an issue. With insurance and prepayment plans making hospitalization more accessible to more people, the demand for Saint Raphael services (as well as semiprivate and private rooms) was growing. Even with 220 beds, 40 bassinets plus 57 extra beds crowded in, many patients were being turned away in 1938 for lack of room. To get needed space, the Sisters negotiated the purchase of the Arnold College property abutting the hospital. The $110,000 dealfor land and buildings at what is today the corner of Chapel Street and Sherman Avenuewould provide the space needed to expand.

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The morality of society depends upon the woman. She is the mother, the teacher and the nurse

Chapter 4
SAI NT RAPHAE L SCHOOL OF NURSING

hen the School of Nursing graduated 11 students in 1912, the Right Rev. John Joseph Nilan, archbishop of Hartford, addressed the graduates. Whether modern readers chuckle or wince at his sexist humor, the heart of his message was that nursing is a Godgiven and noble profession. And perhaps nowhere has that belief been more closely held than at Saint Raphaels. There are some things that a woman is unt for. She cant throw a stone at a chicken without working harm to everyone but the chicken. Its possible she has a right to the ballot, but its probable shell never get it. I wouldnt trust her with a knife, but if a question of endurance or patience is concerned, she is preeminently in her place. In doing everything about the sick room, in soothing the fevered brow, in bandaging wounds, in lifting the aching limb, excuse me, doctors, she is your superior. Nursing, as a profession (requires you to) recognize you are not dealing with logs or machines, but with the noblest work of God, the human body. In it is the immortal soul, and you must reverence that body as the temple of the Holy Ghost. Be faithful to your physicians and patients, but above all be loyal to the commandments of God. The morality of society depends upon the woman. She is the mother, the teacher and the nurse, and she must not forego any of her womanly prerogatives Nilan said.
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From the rst nursing student who entered in 1908 to the last class that graduated in 1977, the Saint Raphael School of Nursing produced not just some of the most compassionate and dedicated nurses, but some of the most skilled. The founding physicians and Sisters of Charity demanded that early nurses meet the highest standards of professional ability and decorum, and thats what the School of Nursing produced for all of its 69 years.

H OW I T S TA RT E D
With the Sisters of Charitys expertise as both educators and caregivers, opening a school of nursing seemed natural. It also assured a steady stream of superbly trained nurses to staff the new hospital. First called the Training School for Nurses, the school opened with the arrival of its rst student, Mary Agnes Smith, in 1908. Like all future students, she lived on the hospital campus, which provided total immersion in the eld and almost round-the-clock training. She was also the lone graduate in 1911. More students quickly followed, and in 1912 the rst formal graduation ceremony was held. Eleven students received diplomas. The following year, the name was changed to the Saint Raphael School of Nursing, with more students applying than room allowed.

1927 class ring

Avenue and Chapel Street. The multi-story brick building was subsequently moved to a new location on George Street. The sight of the massive structure inching along on railroad ties is one that few of the spectators would forget. It was a tremendous undertaking and not one single brick was out of place. It was a masterpiece, said Mary Crocco, a member of the School of Nursing class of 1942. They told us it was the rst brick building that had ever been moved in Connecticut, Sister Louise Anthony recalled in an oral history taped years ago. It was moved manually, not with horses. Even the piano was still in there. In its new location, the gym was renamed the Education Building. Although it did house classrooms, it also retained some of its original function. The gymnasium on the upper oor was retained and used by nursing students for basketball, roller skating, archery and other activities. But the odds-on favorite was basketball. When I was there, they had basketball teams, and they had good games, said former instructor Sister Jean Vincent, who taught at Saint Raphaels from 1953 to 1960. One thing I remember was a girl whose name was Phyllis Fitzgerald. At the same time we had a doctor who was great at

The class had grown to 40 members, with the school being praised for the quality of nurses being produced. Most credited the mix of practical and classroom training for students success. And apparently, this good work paid off in many ways. Saint Raphaels received many compliments for the great care nurses provided. In 1924, however, it also received a muchneeded nancial one. In thanks for the loving care his wife received at Saint Raphaels, Waterbury resident Truman S. Lewis donated the funds to build and furnish a dedicated School of Nursing building. With this new building, the school was able to more than triple enrollment. For the next 50 years, as many as 150 students could beand wereenrolled at any given time. Another milestone in the development of the schools physical plant came with the 1939 purchase of the Arnold College gymnasium on the corner of Sherman

A $100,000 donation from retired Waterbury manufacturer Truman S. Lewis created a modern, four-story brick building for nursing students to learn and live in. Named after Lewis late wife Selina M. Lewis in honor of the loving care she received here, the building still stands today on the George Street side of the Saint Raphael campus, next to the Father Michael J. McGivney Center for Cancer Care parking lot. When construction was completed in December 1925, newspapers described the building, including a nursing school office; lecture and demonstration rooms; 62 private and 27 double bedrooms; basement laundry and ironing rooms; and an electric elevator for easy access. This memorial is no bleak, lifeless monument in stone, but a spacious, handsome house of dwelling ... (fit) for those caring for the sick and the injured, the newspaper extolled. Today the Selina Lewis building houses the Saint Raphael Foundation and various administrative offices.

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cheerleading, and hed be up in the balcony and hed say, Go FitzgeraldDeadeye Fitzgerald! Sister Louise recalled that on some nights, she would listen to the sounds of roller skates and laughter emanating from the Education Building as she tried to fall asleep. We Sisters were still young
A sing-a-long in the Education Building.

enough to wish that we were over there, she said.

The Sisters were known to join in student basketball games.

School of Nursing basketball team.

A DAY I N T H E L I F E
Judging from many former students recollections, the Saint Raphael School of Nursing may have been more aptly named Saint Raphaels Boot Camp for Nurses. Once students completed six months of classroom training, they were expected to begin supervised, handson training with hospital patients. Many of these young nurses were no more than 18 years old. Students followed this schedule for three full years with just two weeks vacation each year. When not in class or on a nursing oor, students were expected to study in their rooms. Class of 1944 member Emily Frances Cavallaro Granata recalls one of her rst hands-on learning experiences at the hospital when she encountered a young, scared woman who said it was time to deliver her babyright now. I responded Dont do it now! Granata wrote in a memoir about the time. Then, she said, doctors gave her scissors and shoestring. Saint Raphaels had a way of teaching you so you never forgot. For all students, curfew was 10 p.m. But on special occasions, they were given a late night when they could stay out until 11. They were allowed to go home every other weekend from noon Saturday to Sunday evening, plus had a half-day off each week. Additional, specialized training was offered on a rotating basis at: Connecticut State Hospital in Middletown, psychiatric care Laurel Heights Sanatorium in Shelton, tuberculosis nursing McCook Memorial Hospital in Hartford, communicable diseases Most of our teachers were nuns, so we obeyed them out of admiration, recalled Mary Sexton, a 1941 graduate. Girls sometimes sneaked out to meet boys, but you had to take the consequences if you were caught. They could send you home. We always lived a little bit in fear, but it made us some of the greatest nurses ever.

HERE WAS A TYPICAL DAY

6 a.m. or earlier Breakfast in the basement coffee and a hard roll. 6:30 a.m. Mass. 7 a.m. Serve breakfast trays to patients; give baths, treatments and medications. 9 a.m. to 3 p.m. Classesanatomy and physiology, medical nursing, pharmacology, ethics and religion. 3 to 11 p.m. or 11 p.m. to 7 a.m. Staff medical floors under guidance of registered nurse. 7:30 to 9:30 p.m. Tuesdays and Thursdays: Participate in athletic program.

Sexton went on to become a Hospital of Saint Raphael head nurse, supervisor and School of Nursing teacher. Nurses I taught who then worked here at the hospital would tell me I was strict. It was very rewardingseeing those girls progress and get promoted. In 1951, the school was among the rst in the U.S. to be accredited by the National League of Nursing. While students were challenged by the rigors of a boot camp, they also enjoyed the social bonding of a sorority house. Rita

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According to a recruitment brochure, the Saint Raphael School of Nursing would help students: Cultivate character based on religious principles Teach the art of expert bedside nursing Develop a sense of personal responsibility Teach social graces Learn health maintenance and disease prevention Above all, it was a place to reinforce the values that Saint Raphaels founders lived by: Discipline. Team Spirit. Selflessness. Charity. The Sisters were intent on passing on not just the mechanics of health care, but the spirit. As the catalog states: the hospital and the School of Nursing function under the Catholic ideal of nursing, namely that to serve suffering humanity is to serve Christ himself

The nurses trained at Saint Raphaels were industrious and respectful, and they bent over backward to please, said Paul Goldstein, M.D., a pediatrician who served as Saint Raphaels Ambulatory Services chairman from 1975 to 1995. They were meticulous in patient care, and in pediatrics very loving of children. Student nurses were allowed to wear traditional white, pointed nursing caps after a six-month pre-clinical probationary period. The caps marked the students ability to step away from the classroom and further their educations with hands-on, bedside training. This was a privilege and honornow we felt like responsible, dedicated nurses, wrote Class of 1924 graduate Ruth Anderson McNamara Durkin.

WHEN NURSES WERE PLENTIFUL!

Callahan Hutchinson remembers being indoctrinated into a strict sisterhood of rules and regulations. The hem of your uniform had to measure 18 inches from the oor, Hutchinson said with a laugh. If your shoes were dirty or you didnt have a hairnet, you got campusedgrounded, so to speak. But we had such closeness, formed lifelong friendships and had a lot of fun. Maybeth Creagan Edwards recalled bursting into tears when she learned nursing students had to work on Christmas Day. I had no idea, Edwards said. I thought we got holidays off, like any other school or job. Edwards must have decided to accept the holiday commitment, because she went on to work at Saint Raphaels for 42 years, eventually become an evening nursing supervisor.
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Despite todays national nursing shortage, there were times when there were more nurses than opportunities. While student nurses worked in all hospital areas in the mid-1940s, there were often no hospital jobs for them after graduation. Many went on to become visiting nurses, including Gertrude (Luft) Russell whose comment about being a New Haven visiting nurse in 1932 is included in Saint Raphaels archives. It says a lot of about the compassion of Saint Raphael nurses, and the Sisters who worked with them: I went to a home on Congress Avenue. It was a high rise and this woman lived on the third oor, and when I got in to her, all crippled up and in bed, oh, it was awfulno heat. It was the dead of winter. I got back and met with one of the Sisters and told her about the woman. She had me give her the name

and street number and she called right then and there and had coal delivered to that house.

RESPECTED FOR SKILL AND DIVERSITY

Elaine Hardy and the late Doris Jackson were the schools rst AfricanAmerican students. Both graduated in 1949, with Hardy recalling a superb education and very few run-ins regarding her skin color, despite racial tensions of the day. After graduation, she moved to New York City to seek advanced training as a nurse anesthetist and earned a bachelors degree from New York University. My old-fashioned, three-year training at Saint Raphaels served me in good stead, Hardy said. They saturated us with knowledge, so that it was in you forever. Class yearbooks give clues to the close, spirited relationships among students. In 1950, the senior class song, entitled The Smoker, referred to the basement room in the Selina Lewis building where smoking was permitted. Long before hospitals like Saint Raphaels became smoke-free, this hazy hideaway was a hub of the schools social life. Sung to the tune of Ive Been Working on the Railroad, the songs lyrics are: Weve been sitting in the smoker All the livelong day Were the high and mighty Seniors Just to pass the time away How about a little bridge game? What dya sayYou have to go to class? Ah, sit down and have a Camel Thats the way to pass.
Taking a break in the Selina Lewis basement. At work in the classroom. Class of 1959.

Sister Louise Anthony with two nurses. Date unknown.

In the evening, there were often sing-a-longs at the piano, and on special occasions, the school held dances in the former Arnold Gym. Sometimes, the students could even squeeze in a few hours for courting, according to Sister Jean Vincent. Many of the students would have men ocking at the door to take them out, she said. The young woman would walk down the steps into the lobby like a queen, and the young man would be standing there and would say, Give me your coat. And he would hold it, and she would slip her arm in. And he would run and open the door.

The Sisters kept a detailed ledger about nursing students, with handwritten notes next to each name. Most of these notes are short and succinct. But they convey a sense of the times and hint at dramatic stories long forgotten, offering a personal side of the profession. For example, reasons for nursing students leaving Saint Raphaels included: Too delicate for the work. Very easily discouraged. Home sick. Failed exams, became discouraged. Weak heart, related aches. Died Oct. 13, 1918 of Spanish influenza. A good, willing subject, but of too nervous temperament for nursing. Sent by the government during war; resigned when hostilities ceased. Unable to do class work required. Married secretly while in training. (Students were required to be single.)

G O N E , BU T N OT F O R G OT T E N
Despite the dedication of students and alumniand Saint Raphaels devotion to themthe School of Nursing closed in 1977. On April 3, 1974, the seemingly inevitable news was released: The Hospital of Saint Raphael today announced its board of trustees has voted to close the hospitals schools of nursing and medical technology Two factors contributed to the decision. First was a national trend toward replacing three-year, hospital-based diploma nursing schools with four-year, college-based degree programs. It was a change promoted in 1966 by the American Nurses Association, which the Sisters felt compelled to follow, recalled former Saint Raphael President Sister Anne Virginie. Saint Raphaels and many U.S. diploma schools of nursing3,000 at their peak in 1926 closed, with only 311 remaining by 1980. It was a very traumatic timevery traumatic, Sister Anne said.

In the Selina Lewis building parlor, 1942.

The second factor was increasing pressure from the federal government for hospitals to reevaluate and cut back on costly educational efforts, recalled Sister Louise Anthony. And there was no doubt the school was costly. Even though students were charged annual tuition, the school was not self-sustaining. Saint Raphaels absorbed many thousands of dollars of expenses each year.

The School of Nursings incoming freshman class that graduated in 1977 was its last. At the time of the announcement, 146 students were enrolled. Sister Louise, herself an alumna, said the following in a hospital news release: The Hospital of Saint Raphael School of Nursing has enjoyed a long and proud tradition. I am personally saddened that the school must close, but the long-range interests of

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Class of 63 alumnae worked across the hall in the operating room, Dolores Guarino and Arlene DeLuca Granata. What makes Saint Raphaels so special that the ve would stay on for so long? Saint Raphaels was always like a family, Wnek said. When I got married in 1966, Sister Columba, who was on Private 3 with me, gave me a beautiful hand-carved statue of the Blessed Virgin Mary that I still
School of Nursing overflow dormitory on Orchard Street.

To our hallowed halls of learning To our uniforms so neat To the hours we have labored To the friendships, warm and sweet, Now as our voices are raised in song Hearts so true and memories strong Long may Saint Raphaels to us belong To the ones who walked before us Be they far, or be they near To the ones who walk behind us To their joys and to their tears Let it be known the paths we trod Worn by a steady and sacred rod Think of the glory you gave to God To our peers who stood beside us And became a guiding light To the conscience that will guide us Bless each day and bless each night Strong are the ties that find us here Linked to the bands of yesteryears Long may Saint Raphaels be held so dear

have to this day. It was that kind of warm, caring place. Mary Kennedy has worked at Saint Raphaels since graduating in 1977, mostly in the Emergency Department (ED) and mostly nights. I love working in the ED because you learn so much, Kennedy said. You see certain traumas at night that you wouldnt see on the day shift. We once delivered a baby in a car just after it pulled into the driveway of the hospital. Thats a good night in the ED, when a baby is born. Kennedy said shes proud to be a Saint Raphael School of Nursing graduate. The hands-on training made her immediately ready after graduation to go to work on a oor: When the school closed, it was the end of an era.

both the hospital and nursing education are best served by this decision. Today, the spirit of the school is kept alive in the more than 400 active alumni, said Alumni Association President Theresa (Terry) Santore Swan. Many graduates live in the area and continue to meet regularly. Its a tradition the groups held since its founding in 1914. Joan Kulack Wnek, a member of the Class of 1963, entered the nursing school when she was 17 and in 2007 celebrated working at Saint Raphaels for 44 years. Before retiring, she worked in Short-Term Surgery with two of her classmates, Kathy McKiernan Magel and Karen Zeender McCarthy. Two other

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Here, in the midst of a global war of destruction and chaos, our little American city banded together to create a wonderful symbol of peace (the Hospital of Saint Raphael)
Saint Raphaels Grey Ladies contributed to the war effort, rolling bandages; tending to soldiers who stopped here to rest; and helping throughout the hospital.

Chapter 5
WORLD WAR II

he determination and resourcefulness that helped open Saint Raphaels doors were needed again in the early 40s, as dozens of doctors, nurses and other hospital employees were called to serve in World War II. Each day, it seemed, presented a new problem or challenge for the hospital: Fresh meat, vegetables, milk, linens and other supplies needed for soldiers were scarce here at home. Nursing wards and other departments were overworked and undermanned. And few men were available to perform needed maintenance and improvements to the physical structure. The small staff was also forced to deal with daily threats of a possible war-related attack. Though none of World War IIs ghting took place in the United States, New Haven (like most American cities) was required to black out each night at sunset. Lights were turned out, and curtains drawn, to make the city look invisible from above. Emily Frances Cavallaro Granata, a member of the Saint Raphael School of Nursing Class of 1944, remembered this tense, frightening time. Saint Raphael student nurses were on call during these black-outs, ready to assist with any medical emergencies that might occur in the community. Thankfully, few arose. We were on call for night work at the hospital, including in the operating room, Granata wrote in a memoir about her days as a nurse and nursing student. We didnt have time to play very much,

but we managed to have fun in the recreation room. We had our own dances without any boys. Sometimes, we invited (soldiers) who were stationed (in New Haven). Many of our nurses met their husbands at this time. However, many more nurses graduating from the School of Nursing during these years, 1941-45, left to serve as nurse cadets in the U.S. Army, Navy or Marines. In fact, the School of Nursing in 1943 was approved to participate in the U.S. Cadet Nurse Corps program. It graduated, and sent into service, hundreds of highly-skilled nurses. Mary Sexton, a 1941 School of Nursing graduate, remembers it being a proud time: World War II forced the hospital to learn how to care for patients with extreme shortages of doctors and nurses, she recalled. We rose to the occasion. Although many hospitals were forced to close entire oors or wards due to the shortage of nurses, Saint Raphaels was able to make all of its hospital beds available, attributed at the time to the loyalty of its graduate nurses and despite the fact that a very large number of nurses left its staff for military service. No doubt it was a busy, challenging time. Volunteers called Grey Ladies spent countless hours at Saint Raphaels rolling bandages to be shipped overseas, while the Education Building gym was outtted with 100 cots for military transport truckers to rest, sleep and eat.

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Class of 1946 members participated in U.S. Cadet Nurse Corps training. Here, at a Yale Bowl football game, are (from left) Christine Aldieri Keyes, Florence Chomicz Gorden, Mildred Sepko Anderson, Marjorie Poppendick Thompson.

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MARIO GAROFALO, M. D.
Of all the Saint Raphael physicians who served in the war, Anesthesiologist
October 19th, 1944 Captain Mario Garofalo Winter General Hospital Topeka, Kansas Dear Gary (Garofalos nickname): my hope to anesthesia is in a desperate plight and The situation at the hospital in regard now that war is more or less shattered. It looks that there would be an early end to the we are unt, acco one knows for how long. On this the war will go over into 1945, and no an anesthetist. forced to make some arrangement for thetist of ist who now is assistant to the chief anes I had a chance to interview an anesthet le sing a out with fine type of man, modest and St. Lukes Hospital in New York. He is a the of g ndin seems to have an excellent understa trace of officiousness in his makeup. He se, of cour our hospital over, met Sister Rose and, whole subject of anesthesia. He looked 00 a year. $7,0 over little a t ly agreed upon abou liked the hospital. His salary was tentative ary 1, 1945 He said he would be ready to come Janu will be employed permanently. The agreement Do not for one moment think he will be in New remain until you return. When you were that if he comes he will be allowed to the Army from se mation as to when your relea Haven you were not able to give any infor had any you g released now and I wondered if would be. I know that many men are bein I am of your returning before the war ends. idea at this time what the chances are rtment. depa the in ulty diffic want you to know our sending you this information because I ors feel doct the know y to have you back, and I Sisters Rose and Josephine would be happ the same way. falo. Thank enience. Give my regards to Mrs. Garo Let me hear from you at the earliest conv you for your kindness. With regards I am Sincerely, Verdi

Mario Garofalo, M.D., might have been missed most of all. The hardship his absence created for the hospital can be gleaned from the following letters sent to him during that time:

September 18, 1945 Dear Dr. Garofalo: Your letter of Aug. 27, 1945 made me feel that at long last there is some possibility of greeting you back at Saint Raphaels. You will never know how much you have been missed and how dreadfully hard it has been to keep the operating plant rolling without you and several of the nurses who have joined up with the Army. In a way, we have managed to get along, but we have been hoping and praying since V J day you might find it possible to gain your release from the service. I do believe that you have sufficient reason for using [sic] the adjutant general to grant your discharge. You are more essential now than ever. I hope you will find it convenient to let me know what response you get from Washington as to the possibility of your early return to New Haven. I was very sorry to learn that you had been laid up with phlebitis and at the same time, I dont know why you could not use that as an excuse to get back to Saint Raphaels. Give my kindest regards to Mrs. Garofalo, and while I do not know what the climate is in Topeka, I do think that the Connecticut climate is much better for your children. Hoping to hear from you soon again, I am Very sincerely yours, William Verdi

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Dr. Garofalo.

October 27, 1945 Dear Dr. Garofalo, We had just reached the stage where we were beginning to inquire whether the morning mail had arrived, when your very disappointing letter reached us. Of course, we know that you have done what you could, and when the higherups say that your request is considered unfavorable, that answer sounds final. However, we believe in the old adage If at first you dont succ eed; try, try again. With that in mind, we therefore called Dr. Barker, who has shown great interest in our needs, and asked him wha t he thought. He suggested you immediately file form #209* and that he would back you up. He says that he is sure that you can secure a copy of this form there. In the meantime, we shall keep on praying that if it is Gods Will, you may soon obtain your release. Very kind regards to you and Mrs. Garo falo from all of us. We trust that you are in good health, and that we shall have the plea sure of welcoming you back to Saint Rap hael s in a very shor t time. Sincerely yours, Sister Rose Alexis P.S. *Request for Deferment War Dep artment Circular #209 September 22, 1945

October 11, 1945 Dear Dr. Garofalo: you, and praying that by day for some word from day ng aiti aw sly iou anx We are charge. ore you will receive your dis it will not be long now bef ry day we t department for almost eve tha in ly rib ter iled spo n You must have bee r presence seemed to I wish Gary were back! You hear one saying, Oh, how t means a great deal. inspire confidence, and tha t that there was m us again, but we though fro r hea to g itin wa are Perhaps you ngton. A few of the ed some word from Washi eiv rec you il unt say ld cou first of the year. nothing we others expect to be by the l era sev and e, hom ady Doctors are alre s stand now? Ver y kind regard , please, as to how matters you m fro r and hea you we of y h Ma bot trust that from all at the Hospital. We to you and Mrs. Garofalo d health. the children are enjoying goo Sincerely yours, Sister Rose Alexis

Garofalo with Saint Raphael nurses, all but one are graduates of the School of Nursing 1947.

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Saint Raphael pharmacist Sister Maria Lucia Gerty.

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Yet hope, and the belief that Saint Raphaels and the community would successfully make it through the war, never wavered for the Sisters. Several years after World War II ended in 1945, the Sisters reected on its impact, describing how remaining staff and volunteers worked together to form a nucleus of peace in the heart of the community. The Sisters wrote in a remembrance of the time: Our trust in the good Lord during those trying days played the most important role. Here, in the midst of a global war of destruction and chaos, our little American city banded together to create a wonderful symbol of peace(the Hospital of Saint Raphael), dedicated to the welfare and well-being of its people. We worked against all odds during the war period, obtaining the most out of the least in supplies, personnel and facilities, planning a peaceful future, when our young men and women would return from war to resume their positions in bringing to the community a hospital (for) those in need. With so many of Saint Raphaels young physicians overseas, older medical staff members worked extra shifts, and in different wards, working more like general practitioners than specialists. Ear, nose and throat physician Charles Flynn, M.D., spent many of his extra hours working in the hospital pharmacy, mixing the powders and liquids his colleagues prescribed. Hed go back to old books and look up things, former hospital pharmacist Sister Maria Lucia Gerty recalled during an interview in the 1990s. He loved the big, older books, nding prescription recipes and commenting: Theyre old, but theyre good. Volunteer Red Cross nurses aides also gave thousands of hours to Saint Raphaels and other area hospitals, feeding and bathing patients; delivering meals; sitting with patients as they recovered

after surgery; and performing any and all other jobs they could safely be trained to do.

Joseph F. Maiorano, Jr., M.D., Carl V. Pantaleo, M.D., Elliot Brand, M.D., and William Verdi, M.D. (in scrubs), with nurses Mary Brennan, Eileen Rigby, and Ruth Nichols. 1943.

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Local resident Gertrude L. Smith penned this recollection: I made rounds with Dr. Verdi. The staff was so small. At one time, there were only two residents and no interns. I was the representative on the Red Cross Board. Without this large, faithful group, care would not have been done for all patients. We gave thousands of hoursdays and evenings. Not everything was glum, however. Volunteers and staff members supported and laughed with each other. Life-long friendships were formed. And people truly cared for each other. Wartime also brought a special doctor to Saint Raphaelscardiologist Oscar Roth, M.D. This gentle, soft-spoken Jew ed war-torn Vienna with little more than the clothes he was wearing. Grateful for his arrival, Administrator Sister Rose Alexis provided Roth with new clothing, food and a place to liveand Roth never forgot it. He spent 43 years paying back the Sisters as one of Saint Raphaels most dedicated, distinguished and generous physicians. His wife, Stefanie, was also a Saint Raphael physician, specializing in obstetrics and gynecology.

Just three years after arriving at Saint Raphaels, however, he was drafted to enter the U.S. Army Medical Corps to be stationed at the Army Hospital in Topeka, Kansas. Physicians who could both administer and teach anesthetic techniques were desperately needed. Garofalo did both, helping anesthesiology become a recognized medical specialty during this time. To the relief of many at Saint Raphaels, Garofalo returned in 1946 and set about building a model anesthesia department from the ground up. He started with one assistant, and soon trained a resident physician. In addition to standard surgical cases, the anesthesiologists covered obstetrical and emergency room cases. We covered a lot of territory, Garofalo said in an interview before he died in 1999. When we rst started working as a group, our day would start at 8 oclock, and one of us would have to be on call. There were three of us, so each had to take calls every third night. As we increased, it was every fourth, then every sixth. Seeing the need to develop a more stable anesthesia service for such an active hospital, Garofalo developed clinical and administrative protocols that have become models for hospitals across the country. The war called many of our nurses, doctors and non-professional employees to the far-ung battleelds of the earth, while at home our little group held together the nucleus of peace in the heart of the community, stated the Report of the Hospital of Saint Raphael, 19381948, looking back at the time. It continued:

T H E I M P O RTA N C E O F A N E M E R G I N G S C I E N C E
It was during World War II that Saint Raphaelsand perhaps hospitals nationwiderealized the importance of the growing science of anesthesiology. Up until the late 30s, surgeons or nurses were responsible for anesthetizing patients. This was the practice at Saint Raphaels until Oct. 1, 1940, when Mario Garofalo, M.D., joined the staff as the hospitals rst anesthesiologist. His single status made him the automatic head of the department, though his skills proved he deserved it. He served as Anesthesia chief until he retired from Saint Raphaels in 1972.

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We worked against all odds during the war period, obtaining the most out of the least in supplies, personnel and facilities, planning a peaceful future when our young men and women would return from the war to resume their positions in bringing to the community a hospital service to those in need of aid during the time of illness or accident. Though the world is still suffering from the wounds of the war, we must continue to meet our responsibilities to the human needs at home, and also contribute in a spiritual as well as a material way to those needing aid. While we have many reasons to rejoice, we have sustained losses by death which were and are sadly felt by all concerned in the welfare of the hospital. A living tribute to the devotion and loyalty of our departed friends, is the hospital that will continue to move forward through life in Gods chosen pattern.

Oscar Roth, M.D., and Sister Louise Anthony in Coronary Care Unit, July 1965.

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A precursor to Saint Raphaels Occupational Medicine program: an industrial R.N. caring for an Eastern Machine employee (per caption on photo). 1944.

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most people gravitated to Saint Raphael s compassionate care

THE 1 9 4 0s AND 19 5 0s: TWENTY YE ARS OF ME DI C AL FIRSTS

Chapter 6

nquestionably, the 1940s and 1950s were two of Saint Raphaels greatest decades. The campus underwent signicant physical changes, but even more importantly, clinical specialization exploded. Saint Raphael physicians were not only using state-of-theart procedures to treat cancer, heart problems and brain tumors, but were pioneering these new, life-saving techniques. The caliber of physicians and staffand the willingness of the Sisters to support themestablished the Hospital of Saint Raphael as a leader in medical care and education. During these decades, the foundation for what continues to be several of Saint Raphaels clinical centers of excellence was rmly laid.

One of Sister Rose Alexis rst projects: adding beds to meet demand for Saint Raphael services. Having acquired the adjoining Arnold College property in 1939, the Sisters set about getting it ready for hospital expansion. The college gym was moved from the Chapel Street side of the campus around the corner to George Street. It became the School of Nursings Education Building. The other college buildings were razed, making way for construction of two new hospital buildings. On Oct. 24, 1942the Feast of Saint Raphaelthe new buildings were dedicated. One, facing Chapel Street, was called the Main Building and became the primary hospital facility. Also dedicated was the building running parallel to Sherman Avenue, known today as the Private Pavilion. Together, they cost $2 million and became the location for many of the technological and patient care advances that were about to occur. On the other side of the hospital campus, and spilling over into the community and newspapers, was a bitter battle to merge Grace Community Hospital on what is now Orchard Street with New Haven Hospital (todays Yale-New Haven Hospital). The battle had actually begun almost 20 years earlier but was abandoned due to opposition from Graces medical staff. Grace Hospital had struggled nancially in the 1920s, but a public fundraising campaign kept it in existence. By the early 1940s, faced with antiquated facilities and mounting debt, the two hospitals again entered into negotiations.

C H A N G E I N E V E RY D I R E C T I O N
The decades were a major time of new ideas and transition for most at Saint Raphaels, and administrator Sister Rose Alexis oversaw it all. Described as a tall, dignied woman with an English accent, Sister Rose Alexis worked from morning to night and earned the respect of all who worked with her, remembered surgeon Mario Conte, M.D. Her ofce was easily accessible to patients, visitors and employees alike, located just a few steps off the main lobby. If you had any kind of problem, you went to go see Sister Rose Alexis, he said. She was the boss, but she always had time to listen to you.

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News reports indicate that the New Haven County Medical Association vehemently opposed the merger. Physicians, including Dr. Verdi, alleged that New Haven Hospital intended to turn over Grace Hospitals wards to Yale medical school students for practice, experiment and training. This would enable Yale to meet American Medical Society requirements for a Class A medical school, which called for a greater patient caseload than medical students were seeing. It was reported that New Haven Hospital would raise its rates to $25 per day, making it inaccessible to people of ordinary means. Since it was also widely reported that Saint Raphaels was beyond capacity, these patients would have no other alternative, physicians claimed, than to become Grace Hospitals test and practice cases. Despite the loud opposition, the merger occurred on July 16, 1945. Many believe Saint Raphaels ended up beneting, as several Grace physicians chose to come to here. One of them was Robert Shapiro, M.D., who in 1951 helped Saint Raphaels begin planning for what would become Southern New Englands rst free-standing, selfcontained radiation therapy center for cancer patients. He also set about founding a school to train X-ray technologists, the Saint Raphael School of Radiologic Technology. Shapiro was not alone in his vision of what Saint Raphaels could become. Beginning in 1940 and continuing through 1957 when the radiation center opened, focused departments were formed for neurology, psychiatry, hematology, orthopedics, cardiology, diabetes services, anesthesia, outpatient services, thoracic services, neurosurgery, and consulting services in allergy and dermatology. To ensure availability of qualied staff to work in these areas, and consistent with the Sisters commitment to education, Saint Raphaels supplemented its School of Nursing by opening a School of
Max Carter, M.D., with the heart-lung machine.

Medical Technology in 1948. It was one of the rst in the nation and was founded by pathologist Robert Nesbit, M.D. That was followed in 1951 by Dr. Shapiros School of Radiologic Technology. (see Chapter 12 for more on Saint Raphaels role in educating healthcare and other professionals) By the time the hospital was ready to celebrate its Golden Jubilee in 1957, it had grown to 370 beds, 60 bassinets, and a staff of more than 800. Some patients continued to receive care in nursing wards. Those who could afford private rooms enjoyed curtains,

A GROWING MED IC AL CE NTE R

In 1948, Saint Raphaels published a retrospective of the preceding decade. Some excerpts: In Surgery, two operating rooms were increased to 11all superbly equipped and arranged. Ten years ago, the surgical staff numbered 22. The present staff is more than twice that number. Operations have increased at a phenomenal pace: from 2,449 in 1938 to 6,538 in 1948. House staff members totaled 24. In Obstetrical and Gynecological Services, modern methods have made it possible for a new mother to go home after a five-day hospital stay, rather than the traditional 10 to 12 days. Births rose sharply from 975 deliveries in 1940 to 1,931 in 1943. As many as 2,585 (births) are expected for 1948. In Anesthesiology, this modern department is far removed from the days when a skillfully wielded mallet applied to the skull was the method of use, joked department Chairman Mario Garofalo, M.D. Special inhalation therapy; newborn and adult resuscitation; intolerable pain relief; preoperative surgical consultation; and anesthesia administration were among its ever-widening scope of services.

china and other comforts. But both groups received the same, excellent medical care, said long-time attending physician and general practitioner Andrew Laudano, M.D. Saint Raphaels was the rst hospital to take care of people with no insurance, he added. Most people gravitated to Saint Raphaels compassionate care. Sister Louise Anthony Geronemo had been named administrator in 1956 and would ensure that legacy continued (more about Sister Louise in chapter 7). But the hospital was increasingly known for more than compassionate care. The 50s saw the advent of truly revolutionary clinical developments. Among the most notable:

MAX CARTER, M.D.CARDIAC CARE. In 1958, when Carter

Sister Louise with Wayne Whitcomb, M.D.

performed the hospitals rst open-heart surgery, Saint Raphaels was said to be the rst community hospital in Connecticut and possibly New England to offer the procedure. Carter and thoracic surgeon George L. Wilson, M.D., performed the surgery on a woman who had a hole between two chambers of her heart. The procedure was made possible by a remarkable new invention called a heart-lung machine, which Carter had seen successfully used in Philadelphia. Before this landmark device, surgeons had to attempt to operate on the heart through a small hole, carefully feeling their way without seeing inside. It was a dream, said Carter in a 1988 interview at the opening of Saint Raphaels Cardiothoracic Intensive Care Unit, named in his honor. Hardly anyone was doing iteverybody was learning on their own. Saint Raphael cardiologist Philip Fazzone, M.D., who as a medical student rst met Carter, remembered being dazzled by him. Carter had all the qualities of a great doctoran impressive presence, welltrained, skilled and courageous. He brought all these skills into a community hospital where this type of heart surgery had never been done before. Because in these days there were no post-surgical intensive care units, Carter provided the care himself, often staying at a patients bedside for as long as 48 hours. He was a humble person and offered patients no more than what he thought he could deliver, Fazzone remembered.
Sister Anne Virginie unveils the Wayne Whitcomb Radiation Therapy Center. Saint Raphaels first cancer treatment facility was renamed after its founders death.

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Carter served as the chief of cardiothoracic surgery for 34 years, until his retirement in 1983.
ROBERT SHAPIRO, M.D., AND WAYNE T. WHITCOMB, M.D. CANCER CARE. Together, these two doctors led the way for Saint

most important thing was sensitivity toward the patients, Virginia remembered. They felt it was of the utmost importance. Saint Raphaels is still very good at that. When Whitcomb died in 1976, the radiation therapy building was named for him. Shapiro, who served as Radiology chairman from 1948 to 1984, went on to write several textbooks and articles and became a leader in the eld. Saint Raphaels current Radiology Chairman Diego Nunez, M.D., was one of Shapiros students and remembers him fondly: He was an inspiring teacher. I have never met anyone whos had the same command of knowledge about radiology.
FRANKLIN ROBINSON, M.D.NEUROSURGERY. Robinson

Raphaels to construct New Englands most modern, powerful standalone cancer center at the time. The one-story structure (Saint Raphaels Father Michael J. McGivney Center for Cancer Care now stands on the site) was completed in 1957. The $350,000 facility was funded through donations from the New Haven Foundation, Ford Foundation, private benefactors and a federal grant. In those days, the practice of using radioactive materials to treat cancer was in its infancy, said Whitcombs widow, Virginia, in an interview. Her husband convinced architects to make the building bigger than the original plan because he anticipatedcorrectlythat radiation therapy was an expanding eld. Aside from their drive for new technology, Shapiro and Whitcomb were dedicated to compassionate patient care. When Wayne and Dr. Shapiro were hiring people to work in the department, they said the

founded Saint Raphaels Neurosurgery department in 1951 and served as its chairman for nearly 40 years. Former Neurosurgery Section Chief and Saint Raphael Healthcare System Trustee Isaac Goodrich, M.D., met Robinson in the 1960s, when Goodrich was a medical resident.

Among the many notable dates in these two decades:

1945 Additional floor added to Private Pavilion.

1953 Orlando Pelliccia Jr., M.D., succeeds his uncle, William F. Verdi, M.D., as chief of surgery.

1957 William F. Verdi, M.D., dies at home, April 21

1957 Volunteer Services is founded.

1957 Saint Raphael Auxiliary opens the Glass Door Gift Shop, which today is located in the main lobby.

1958 The hospitals first newsletter, the St. Raphael Gauzette, begins publication. It was named by then-intern Donald Zehl, M.D., who said the idea for the name hit him like a roll of gauze as he dashed by Central Supply on his way to an emergency.

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Robert Shapiro, M.D.

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Although he was a superb surgeon, what impressed me most were his clinical skills, Goodrich said. He taught me when to operate and when not to operate. He was highly ethical and would never operate on a patient unless he thought he could help. Robinson also believed it was every doctors responsibility to reach out to poor and underserved patients, as well as to help in the Emergency Department. He used his own money to purchase Saint Raphaels rst EEG machine and was a vocal advocate for Saint Raphaels having only the latest, most effective medical equipment. Robinson once told the hospital newsletter that he thought the 1950s were a real turning point in the direction of the Hospital of Saint Raphael. Perhaps one of the greatest and most historic of these turning points occurred in 1956, when Sister Rose Alexis became ill and ended her more than 17-year administration. Her successor, Sister Louise Anthony, would not just hold the post for 22 years, but carve herself a legendary niche in Saint Raphael history.

Franklin Robinson, M.D.

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The pace was fast, the opportunities exciting.

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Chapter 10
THE 1 9 8 0 s AND 1 9 90s

cquiring the latest and most effective technology for patient care. Corporate restructuring. Even more physical growth. Expanding community outreach programs to help those in greatest need. More than any other time in Saint Raphaels history, the 1980s and 1990s brought unprecedented changefrom almost every direction. While large building projects and often astounding clinical advancements highlighted prior years, these nal decades of the 20th century saw an almost total change to the Hospital campus, extraordinary clinical developments, evolution of a formal continuum of care, new partnerships, and a new governance structure. The ultimate goal: position Saint Raphaels for the future and ensure continued mission fulllment. In hindsight, that was a lot to do in 20 years. The pace was fast, the opportunities exciting. There were also plenty of challenges, some out of Saint Raphaels immediate control. Insurance companies began managing care, limiting the number of days they would pay for patients to be hospitalized. Prevention, wellness and less costly alternatives to acute hospital care were rightfully called for. Cutbacks in government reimbursement rates threatened the survival of hospitals like Saint Raphaels, which treated large numbers of poor or uninsured people. Technology was advancing at lightening speedmarvelous for patients and the

eld of medicine, but extremely costly for the institutions that wanted to use it. Like hospitals across the country, Saint Raphaels took a hard look at how it did business, evaluating how and where it could most effectively deliver care. Results included a new outpatient surgical facility on its main campus and a huge surge in community-based preventive and primary care in venues as diverse as tractor tailors, schools, work sites and housing complexes.

R E AC H I N G O U T
Through its history, Saint Raphaels always opened its doors and extended a caring arm to the community. Now it was time to take care to those in need. The hospital began using the City Health Departments mobile clinic to offer blood pressure screenings and provide health information. An effective way to reach people with transportation or other barriers to accessing care, it led to the creation of Project Mothercare. The 18-foot tractor trailer hit the streets in 1990, taking primary and prenatal care to the areas neediest residents. The model was replicated again in 2000 by Smiles to Go, the states rst mobile dental clinic for children, offering basic and preventive services.

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Care was also being brought to xed sites in the community. In 1992, Sister Ann Matthew, S.C., began the Parish Nurse Program, helping nurses identify and address their own parishs healthcare needs. That same year, the rst of several Project ElderCare clinics opened, offering preventive and primary care in low income and elderly housing complexes in New Haven and West Haven. And in 1991, local businesses and their employees began to receive on-site services through the Occupational Health & Treatment Center, later known as Occupational Health Plus. In a different type of outreach, Saint Raphaels developed and implemented a plan in 1992 to help stabilize, strengthen and enhance its neighborhood. The multi-pronged plan, with components continuing today, included support for economic development, safety and beautication initiatives, and nancial incentives for employees to purchase neighborhood homes. It also included partnerships with neighboring Timothy Dwight Elementary School and Troup Magnet Academy of Sciences, including opening school-based clinics. A clinic at Barnard Environmental Studies Magnet Elementary School opened in 2007.

THE EXCELLENT 80s

Impressive as erection of the Verdi Memorial Building was in the 70s, the 1980s saw Saint Raphaels undertake a construction project of unprecedented magnitude. In July 1985, the main Chapel Street entrance was closed for the rst time since it opened in October 1942. The beloved entrance, with its circular driveway, gave way to a $33 million expansion and renovation project. It required demolishing parts of the hospitals history. The Saint Ritas and Saint Marys buildings fell to a wrecking ball, so new, more modern buildings could be constructed. The project meant state-of-the-art accommodations for every patient, along with
Project Mothercare.

Other highlights of the 1980s at Saint Raphaels included:

1981 Saint Raphael cardiologists John P. Chandler, M.D., and Phillip R. Fazzone, M.D., perform Saint Raphaels first angioplasty for blocked arteries.

1982 Oral surgery center opens.

1983 Laser Surgery Center opens.

1985 Saint Raphael becomes the first Connecticut hospital with a LifeStar heliport.

1987 Saint Raphaels acquires the 125-bed Saint Regis Health Center skilled nursing facility, today named the Sister Anne Virginie Grimes Health Center.

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The Main Building, which provided the hospitals front door from 1942-1985. The Saint Ritas Building is to the left.

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Celebrating construction of the Celentano building: (from left) The Hon. Richard C. Lee and Fred Marcheski, campaign chairs; Sister Maria Lucia Gerty; Sister Anne Virginie; John Rodrigues, project superintendent; Luca E. Celentano, M.D.; Terry Philcox, project manager; Sister Louise Anthony; Phil Paolella, campaign chair; Sister Julia Cronin.

enhanced efciency for diagnosis and treatment services. Two twin patient care buildings were constructed facing Chapel Street: the Dr. Luca E. Celentano Building named after one of the hospitals venerable physicians who practiced well into his mid-80s, and the Sister Louise Anthony Building in honor of one of the hospitals most beloved administrators.

Upon project completion in 1988, a new, main Chapel Street entrance opened. Hospital employees raised $300,000 for the project and won the honor of naming the building that housed the new entrance and lobby, plus linked the Verdi Building to the Celentano and Sister Louise Anthony buildings. Their choice: the Sisters of Charity Center for Caring, in recognition of the hospitals founders and sponsors.

N E W C L I N I C A L F RO N T I E R S
Certainly, Saint Raphaels success and ability to provide state-of-the-art care has always been intertwined with its Medical Staff. A whole new generation of clinical pioneers carried on the tradition in the 1980s and 1990s. The Section of Otolaryngology set the blazing pace. Led by Section Chief Keat-Jin Lee, M.D., it had begun pioneering work in the late 1970s, using lasers to treat head and neck diseases and disorders. Often the only New England site with this technology, the hospital evolved as a referral center for these cases. By 1983 when Saint Raphaels opened its Laser Surgery Center, it did more laser surgery procedures than any Connecticut hospital in multiple specialties: head and neck, neurosurgery, plastic surgery, obstetrics, gynecology,

Howard Smith, M.D., Eiji Yanagisawa, M.D., and K.J. Lee, M.D.

A N E W H E A LT H C A R E S YS T E M
A signicant change was creation of the Saint Raphael Corporation in 1985. Later renamed the Saint Raphael Healthcare System, it provided a more efcient governance structure for the growing organization, creating an umbrella to oversee the hospital and its afliates. In one of the boldest aspects of the new arrangement, hospital President Sister Anne Virginie became president of the new parent corporation, andfor the rst time in Saint Raphaels history a layperson, Robert Beeman, became hospital president. We knew we werent always going to have Sisters available to take on these positions, said Sister Anne. Beeman was promoted after serving as hospital chief operating ofcer, working closely with the Board of Trustees and Sisters. I had enormous condence in Bob Beeman. Sadly, he lost a battle with cancer shortly after assuming the position. Dan Rissing came from the midwest to take the position in 1988, followed by James J. Cullen in 1991. Cullen, a certied public accountant, joined Saint Raphaels in 1982, serving as hospital chief nancial ofcer and then chief operating ofcer. He and Sister Anne shared a vision. More than offering the highest-quality care for an acute illness or injury, they wanted Saint Raphaels to offer a comprehensive continuum of care for people of all agesdisease prevention/education, post-hospital rehabilitation services, home ophthalmology, and general surgery. The following year, Drs. Lee and Julian Henley-Cohn collaborated with different scientic partners to develop articial larynxes for patients who had lost their voice boxes due to disease or traumatic injuries. That was followed by more headlines as Drs. Lee, Eiji Yanagisawa and Gordon Strothers pioneered two different ear implants. care, and beyond. We were always trying to look into the future to see the best, most cost-effective ways to provide services that people really need. The system was a signicant piece of our plan, Cullen said. Toward this end, the System today has grown to include the 125-bed Sister Anne Virginie Grimes Health Center skilled nursing and short-term

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Sister Anne Virginie

Robert Beeman

Daniel Rissing

James J. Cullen

David W. Benfer

TWO D EC ADE S OF LE AD ERS

19781986 19861987 19881991 19911998 1999present Sister Anne Virginie Grimes, hospital president; 1986-99 Saint Raphael Healthcare System president and CEO; 19992001 Saint Raphael Board of Trustees vice chairperson Robert Beeman, hospital presidentthe first lay person to hold the position Daniel Rissing, hospital president James Cullen, hospital president and CEO; 1994-1998 Saint Raphael Healthcare System COO David W. Benfer, FACHE, Saint Raphael Healthcare System and Hospital of Saint Raphael president and CEOfirst lay person to hold the position of System president and chief executive officer

rehabilitation facility; Saint Raphael Foundation; DePaul Health Services, which oversees the Hamden Surgery Center, homecare afliate VNA Services, and joint ventures with other providers to offer dialysis and MRI services; among other entities.

focused collaborations with a variety of partners to further their goals and vision. Saint Raphaels forged relationships with other hospitals and providers to offer home-based infusion, oxygen/respiratory and durable medical equipment services; participate in the Connecticut Hospital Laboratory Network for contracting and reference lab services; join with the states Catholic and other hospitals to form the Family Health Alliance for Medicaid managed care contracting purposes; and form a network with about a dozen area homecare agencies, further integrating homecare into the Saint Raphael continuum.

I N TO T H E 9 0 s
Throughout its history, Saint Raphaels has worked with a variety of groups and individuals to meet community needs. Yet healthcare was requiring a new type of partnership. Some hospitalsin Connecticut and across the countrychose to form or merge with multi-hospital systems. Others, including Saint Raphaels, opted for

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It also entered into a strategic alliance with the Hartford Health Care Corporation. The goal was to identify collaborative opportunities for sharing best practices and quality improvement initiatives, managed care contracting, and realizing cost savings. However, Saint Raphaels distance from other members, many wholly-owned by the Hartford system, made its full participation difcult.

AWARDS/DE SIGNATIO NS
Assessment and public reporting of hospital clinical performance surged in the late 1990s. Saint Raphaels was proud to be recognized many times: One of the Top 100 Hospitals in the U.S. for overall services, by Thomson Healthcare (a national, independent health information company formerly known as Solucient, HCIA and HCIA/Sachs). One of three Connecticut hospitals named in 1998 (others were both in Hartford). The only Connecticut hospital recognized in 1999. One of the Top 100 Hospitals in the U.S. for orthopedic services. 1999. One of the Top 100 Hospitals in the U.S. for cardiac services. 1999. One of Americas Best Hospitals (top 50) by U.S.News & World Report in cardiology/cardiac surgery, hormonal disorders, respiratory disorders. 1999.

S TAY I N G AT T H E F O R E F RO N T OF CLINICAL CARE

Along with continued acquisition of technology and development of advanced procedures came large construction projects. Since Saint Raphaels opened its doors, cancer had been a constantand dreadedpresence. By the early 1990s, Saint Raphaels radiation center was beyond capacity. It was time to update and expand. With the vision of Arthur Knowlton, M.D., respected for his clinical expertise and beloved for his compassionate care, construction of a two-level, state-of-the-art facility began.

Other medical achievements this decade included:

1997 Led by radiation oncologist Joseph Cardinale, M.D., Saint Raphaels starts using brachytherapy (implanted radioactive seeds) for prostate cancer, offering more powerful disease-fighting radiation with fewer side effects. The Emergency Department is designated a Level II Trauma Centerone of nine in the state.

1998 Saint Raphaels, becomes the first hospital in New England to perform beating heart bypass surgery. This is one of many cardiac firsts attributed to Vasant Khachane, M.D.

1999 First area hospital to use powerful, high-dose stereotactic radiosurgery to treat brain tumors. This non-invasive treatment was pioneered by Isaac Goodrich, M.D., a long-time member of the Medical Staff and neurosurgeon whose career had centered on using a scalpel. Saint Raphaels opens a Joint Restoration Center, reinforcing its commitment to offer the most advanced orthopedic care. At the time, our orthopedic surgeons were replacing almost 600 joints a year.

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Time capsule placement in the Ambulatory Services Building, which had a new Short-Term Surgery unit and auditorium, expanded Emergency Department, and outpatient Radiology area. From left: Peter Duffy, Sister Winifred Marie, Judy Catalano, Olga Lewis, Hospital Chief Operating Officer Roberta Saunders-Gray, and Sister Anne Virginie. Duffy and Catalano were employee chairpersons of a fundraising campaign; Lewis was the employee who most closely guessed the number of staff who signed a scroll placed in the capsule. 1999.

A Campaign for Cancer Care kicked off and was met with overwhelming support, raising more than $9.5 million. This included an extraordinary $3 million gift the largest single donation in Saint Raphaels history at the timefrom the Knights of Columbus. It earned the Knights the right to name the new facility when it opened in 1994. They chose the Father Michael J. McGivney Center for Cancer Care, honoring their founder. In 2006, the Knights made another $3 million commitment to Saint Raphaels in support of its Second Century of Caring Campaign. Another sign of the times was the continued trend toward outpatient procedures, especially surgeries. Saint Raphaels experienced an almost 60 percent increase in one-day surgeries between 1989 and 1999. New, minimally invasive procedures in almost all disciplines meant smaller incisions, less time under anesthesia, and thus less patient pain and recovery time. By 1994, more than half of all Saint Raphael surgeries were performed on an outpatient basis.
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To

meet

growing

demand,

Saint

Raphaels in 1996 kicked off a $25 million project to build a new, larger short-term surgery facility, expanded Emergency Department, and outpatient Radiology suite on the Orchard Street side of the campus. In Saint Raphaels 1998 Annual Report, Cullen and Sister Anne looked at the hospitals successes like this: The real difference [is] not in what we did, but in how growing numbers of healthcare consumers have

come to recognize and appreciate what Saint Raphaels has to offer. People are placing an increasing value on the things Saint Raphaels has always represented: clinical excellence, exceptional physicians, extraordinary employees, a commitment to quality, a sense of spirituality, responsibility, stability and accountability. These principles and values have steered us for nearly a century. Talk of more new procedures and technological advances made the late-90s an exciting time. It also marked the promise of a new beginning. In July 1999, David Benfer arrived from the Provena Saint Joseph/ Morris Health Network in Illinois to take over as Saint Raphael Healthcare System president and chief executive ofcer, and to lead Saint Raphaels into a new millennium.

The lobby of the Sisters of Charity Center for Caring building takes shape.

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We believe in being a good neighbor and being a part of peoples lives in the community

Chapter 11
SI ST E R A N N E V IR G I NIE

hy, yet determined; strongly committed, yet full of fun, Sister Anne Virginie Grimes is respected for not just a keen business sense, but a knack for making people feel special. When she retired as Saint Raphael Healthcare System president and CEO in September 2001, she was honored for more than three decades of involvement with Saint Raphaels, along with the great work she accomplished by living the Saint Raphael mission, and serving as a model of public service to the communitya legacy that still holds strong today. Saint Raphaels 125-bed skilled nursing facility, the Sister Anne Virginie Grimes Health Center, is a brick-and-mortar reminder of her many contributions. Yet even without it, Sister Anne would be difcult to forget. Fiercely loyal to Saint Raphaels mission and its employees, and dedicated to helping underserved residents get needed care, her work here led to huge expansions in services; medical care becoming even more accessible to underserved populations; and the Hospital of Saint Raphael becoming an even more integral part of the New Haven community. I value being in a position of leadership because it enables me to help other people, Sister Anne told the New Haven Register in 1990. It isnt just a job. Its a very special opportunity to care for people.

HUMBLE BEGINNINGS
Born April 5, 1928, in Waterbury, Margaret Mary Grimes was the oldest of four children. Even as a young child, she knew it was her calling to be a nun. She loved the nuns who taught at her Catholic elementary and high schools and her aunt was a Sister of Charity. In addition, her uncle was a priest and she was greatly inspired by her mothers sense of spirituality. Her parents asked her to wait until she was 21, and spend some time working before joining an order. So she attended Post College to study typing and bookkeeping; worked at Southern New England Telephone Co.; dated; and spent weekend nights out with friends. But there was no doubt the Sisterhood was what Margaret Mary wanted. Sure of her calling, she entered the Sisters of Charity of Saint Elizabeth on Oct. 2, 1949. I just knew it was right for me, she said in 1999 during her Golden Jubilee celebration. Like all novice nuns, she needed to choose a new religious name. She selected Anne Vincent to honor her parents Anne in honor of her mother, Anna, and Vincent after her fathers middle name. But the combination was already taken, as were two others she chose. Thats when the general superior stepped in. Ill pick out a nice name for you, Sister Anne remembered the general superior saying. My fathers rst reaction was, I cant even pronounce it!

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Sister Anne (standing) on her 10th birthday, with her brother Jimmy and sister Anita.

Yet as Sister Anne Virginie (pronounced veer-gin-nee), she quickly began to excel. She earned a degree in business administration from the College of Saint Elizabeth and spent nine years teaching at a New Jersey parochial school, then becoming a high school business skills teacher. During her summers off, she earned a masters degree in business administration from Notre Dame University. She loved teachingthe atmosphere, the students, the potential inuence she had to help shape these young peoples lives. But God had different plans for me, Sister Anne said, remembering the day she learned she was being transferred to one of the Sisters New Jersey hospitals. God has a hand in all of our lives, and He pointed mine in a differentbut ultimately wonderfuldirection. She spent the next several years as a hospital administrator, and earned a masters degree in health administration from Saint Louis University. Then in 1967, she was elected the Sisters of Charitys rst provincial of the Northern Province. Overseeing the Sisters work in this region required moving to New Haven and becoming a member of the Hospital of Saint Raphael Board of Trustees. Right from the start, Sister Anne said, she and Saint Raphaels were a perfect match. All of us involvedthe Sisters, employees, physicians, volunteersseemed to see ourselves as part of a ministry, rather than part of an industry. And we worked with that in mind. For her personally, coming to New Haven was also like coming home: Its near where I grew up and brought me back to family and friends.

LEADING BY EXAMPLE
By the end of Sister Annes six-year term as provincial, she was eager for a more hands-on role to help both Saint Raphaels and the New Haven community. As she told the Waterbury Republican newspaper years later in 1986, she was inspired by her belief that Catholic hospitals like Saint Raphaels help carry out the healing mission of Jesus Christ: What is it about a Catholic hospital thats different from a non-sectarian or private one? I hope the answer is an increased awareness of the dignity of the person, which is manifested in many waysthrough the availability of our staff, through the responsiveness to needs, through a deeper understanding, through listening to the patient. Saint Raphaels does this with a great deal of skill, with great compassion, and always with a high level of excellence and care. Appointed Saint Raphael associate administrator in 1973, Sister Anne became Administrator Sister Louise Anthonys right hand,

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learning about the organization, the people who kept it running, and those in the community who relied on its services. Upon Sister Louises retirement in 1979, Sister Anne became administrator, but under a new titlehospital president. It was an exciting time as Sister Anne assumed this role. The Verdi Building was newly-opened, the hospital was caring for greater numbers of patientsrequiring greater numbers of staff. Every year brought new clinical advances. But it was also a challenging time. As state and federal agencies became more involved with healthcare delivery and billing, Saint Raphaels needed to advocate for what seemed like every new piece of new technology or improvement it planned. It felt like we were always in Hartford ghting for new beds, new equipment, and defending our position to serve the needs of the people through expansion, Sister Anne said, noting that the hospitals goal

was to make many of these improvements without having to raise hospital rates. The hard work, however, paid off. During Sister Annes rst several years as president, Saint Raphaels was able to grow both physically and technologically with no rate increase. Former Trustee Donald P. Calcagnini, who sat on the Saint Raphael board for 27 years, remembers how much he and his colleagues admired Sister Anne for both her business acumen and commitment to serving poor and disadvantaged residents. Sister Anne had a great sense of how to best care for the sick and deliver rst-class health care, and she understood the complexities of running a hospital business, Calcagnini said. She adjusted to a changing industry and never stopped educating herself. She became involved and knew how to surround herself with competent people. She was a motivator who could bring out the best qualities in people. She helped make Saint Raphaels what it is today. Business decisions required Sister Anne to be at her desk as early as 7:30 a.m. many days, and stay late many evenings. Hours, she said, were often gobbled up by meetings. Yet she felt it was essential to make time for daily rounds, visiting as many nursing units as possible. She wanted to know each employee by name, said long-time employee and Coronary Care Unit Patient Care Manager Maggie Acampora, R.N. Said Sister Anne in the 1980s about this responsibility: My rounds give me time to visit patients, to go to areas of the hospital that I dont normally get to, to talk with employees. It helps me recognize that we all need one another.

Sister Louise Anthony, the Hon. Richard C. Lee, Sister Anne Virginie. June 18, 1970.

She was everywhere with her twinkling Irish eyes, said longtime friend Sister Ann Matthew. Anne took every phone call and saw anyone who came to the ofce. On snowy days, she would make a point of thanking staff for their extra efforts in coming in. She put her whole heart and soul into the work. One of the results of this dedication came in 1986, when Sister Anne was named president and CEO of the newly formed Saint Raphael Corporation, predecessor of the current Saint Raphael Healthcare System. Another milestone for Sister Anne came in 1987, when she led Saint Raphaels to acquire the neighboring Saint Regis Health Center, adding a skilled nursing facility to the corporation. The 125-bed facility was renamed the Sister Anne Virginie Grimes Health Center in 2003. Today, the remodeled and expanded center offers compassionate, yet advanced, long-term care, as well as short-term rehabilitation for patients whove undergone a joint replacement or similar surgery. Its New Havens only Catholic-sponsored nursing home. Also under Sister Annes leadership was the $33 million expansion and renovation project, begun in 1985, that resulted in the Sister Louise Anthony Building, Dr. Luca E. Celentano Building and Sisters of Charity Center for Caring; as well as construction and the 1994 dedication of the new, state-of-the-art Father Michael J. McGivney Center for Cancer Care, offering advanced outpatient cancer treatment.

Opening of the McGivney Center: Sisters of Charity General Superior Sister Mary Canavan, Sister Anne Virginie, New Haven Mayor John DeStefano, U.S. Congresswoman Rosa DeLauro, Hospital Medical Staff President Jerome Freedman, M.D., Board Chairperson Barbara Pearce, Radiation Oncology Manager Eileen OConnor, McGivney Center Medical Director Arthur Knowlton, M.D., 1994.

C O M M I T T E D TO T H E C O M M U N I T Y
It was our communitys neediest residents, however, that concerned Sister Anne the most. She focused much of her energy on bringing medical care to the poor, the elderly and those without the means to access traditional care by urging Saint Raphaels to establish dozens of community-based outreach programs and services. In 1987 under her leadership, geriatric outreach services began. Known today as Saint Raphaels Community Health & Outreach department, it still helps fulll the hospitals mission by reaching out to those in need particularly seniorswith every loving service in our power, Sister Anne said. Sister Anne is equally well-known for the time she spent in the community giving to other organizations. In addition to giving her time and talent, she was a champion fundraiser. Sister Anne helped co-found Life Haven, a New Haven shelter for pregnant teenagers. She also was involved in leadership roles with such groups as the Greater

The Hon. Richard C. Lee; U.S. Senator Edward M. Kennedy; and Sister Anne Virginie. Sept. 13, 1986, benefit for Life Haven and honoring Sister Anne.

New Haven Chamber of Commerce, Connecticut Easter Seal Society, Connecticut Hospital Association, New England Conference of Catholic Hospitals, Shubert Theater, The Mercy Center, Presidents Advisory Board at Teikyo Post University and Governor William ONeills Special Task Force on the Nursing Shortage. Her involvement resulted in dozens of awards, including the 1993 T. Stewart Hamilton Distinguished Service Award from the Connecticut Hospital Association and the Anti-Defamation League Torch of Liberty Award in 1991. In 1998, she received the Greater New Haven Chamber of

Commerces

distinguished

Community

hospital President James Cullen, who worked with Sister Anne for 16 years. She stressed the importance of everyone pulling together to make the best hospital possible for the people we served. She ingrained in me that hospital work is about people caring about people. At retirement, Sister Anne said her years as Saint Raphael president and CEO were her favorite: I got the opportunity to interact with people at every level of the organization, plus so many from outside the hospital. It also provided an opportunity to inuence the future of Saint Raphaels. I cherish that.

Leadership Award, followed in 2000 by the UNITAS Clubs Distinguished Service Award, New Haven Colony Historical Societys Seal of the City Award in 2001 and Woman of Today Award in 2003 from Y-ME Connecticut, a breast cancer support organization. On July 1, 1999, Sister Anne stepped down as president and CEO to become vice chairperson of the Saint Raphael Healthcare System Board, which allowed her to focus on fundraising and strengthening community relationships. She retired on Sept. 30, 2001. Sister was the glue that held Saint Raphaels together, remembered former
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The 21st century began in January 2000 with computer-assisted healthcare technology advancing at an unprecedented pacewith no signs of stopping.

Chapter 13
2 0 00 : A NEW MI LLENNI UM ARRI VE S

hat the stethoscope was to Saint Raphaels earliest physicians, computers became to physicians and other health professionals at the start of the new millennium. The 21st century began in January 2000 with computer-assisted healthcare technology advancing at an unprecedented pacewith no signs of stopping. Each year has seen new sophisticated equipment and techniques that allow physicians to diagnose illnesses earlier, and treat them more effectively, than ever before. Its been a fast-moving time dened by terms like minimally invasive; magnetically-guided; and 3-D imaging. Out of context, they might not mean a lot. Yet within the world of health care, they describe state-of-the-art diagnostic and treatment toolsat Saint Raphaels or anywhere. Gratifyingly, the result of the Hospital of Saint Raphael offering these advances has been regional and national recognition, increased demand for services, and new initiatives to even better meet community needs. Patients are very savvy, said Department of Medicine Chairman Alan Kliger, M.D., a nephrologist. They use the internet to research illnesses and conditions. They come into the doctors ofce with information theyve found online, read in a newspaper, or heard about from a friend. Understandably, a person whos sick wants the best, most effective care possibleits imperative that we stay on the forefront of clinical developments. Its also what the Sisters wanted

when they started the hospital 100 years agoto offer all patients the best care available anywhere. And Saint Raphaels does that.

O N A T E C H N O L O G I C A L RO L L
Among areas where clinical advances have been most astounding are cardiac and cancer care. Saint Raphael physicians continue the traditions of their pioneering forefathers, resulting in the hospitals recognition as: First in New England to use mini-maze surgery to correct atrial brillation First in Connecticut to use the minimally-invasive Stereotaxis magnetic navigation technology to better map and treat heart rhythm problems First in Connecticut to use catheter cyroablation to treat irregular heartbeats One of the rst in Connecticut to implant a biventricular debrillator to better manage congestive heart failure Its also a new era for cancer treatment. New medications target and attack cancerous cells, while avoiding healthy ones. Advanced radiation treatments do the same, sending high-powered, cancer-ghting radiation beams to precisely attack even the most oddly-shaped tumors, without harming nearby healthy tissue. Cancer is now a disease that many people manage and live with. Key advances at Saint Raphaels include:

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Christopher Lynch, M.D., and Fuad Alkhoury, M.D., perform knee replacement surgery using computer navigation technology in 2007.

Intensity modulated radiation therapy and brachytherapy for prostate and breast cancer MammoSite radiation therapy for breast cancer Stereotactic radiosurgery for brain, head and neck tumors PET-CT and 3 Tesla MRI scans for early disease detection and treatment staging. Other clinical specialties are also making headlines. In 2005, Saint Raphael surgeons were among the rst in New England to successfully perform a minimally invasive esophagectomy procedure to for esophageal cancer. fatal Surgeons also performed a landmark new repair potentially abdominal aortic aneurysms. Neurosurgeons and orthopedic surgeons have teamed up to perform complex, collaborative spinal fusion surgery, while interventional radiologists use veterbroplasty, a special cement to strengthen broken bones and treat spinal injuries and problems. And Saint Raphaels dominance in obesity surgeryfrom the full continuum of care it offers to its superb outcomesled to its being named an American Society for Bariatric Surgery Center of Excellence in 2006.

TA K I N G A L E A D E R S H I P RO L E I N T H E E V E R - C H A N G I N G D E L I V E RY S YS T E M
Hospitals increasingly are pressured from many angles: A desire, coupled with that of insurers, to deliver care in the most cost-effective manner Busy, faced-pace lifestyles causing people to seek care thats as convenient as it is effective Increasing government mandates that improve patient care and safety, but with no funding mechanisms Increasing numbers of un- and under-insured patients

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A VE RY SPECI AL FRIEND
Cronins Crossing, a pedestrian bridge stretching over Orchard Street, connects Saint Raphaels Orchard Medical Center with its parking garage. Its named after Saint Raphael Auxilian and Foundation trustee Lorraine D. Cronin and her late husband, Robert J. Cronin, M.D. Many people familiar with Saint Raphaels recognize Lorraine Cronins name. Yet few probably know it was a nun and a fishing pole that got her hooked on the hospital: Fishing was one of Sister Louise Anthonys favorite pastimes, said Cronin of the former hospital administrator, and I owned a fishing store in Branford. During the summer, Sister Louise visited our store to stock up on supplies, and sometimes she fished at
Raymond J. Peach, Saint Raphael Foundation chairperson; David W. Benfer, System president; Sister Joan Granville, Foundation president, and Dominic Proto, Cancer campaign chairperson at the Cronins Crossing ribbon cutting, July 2005.

our home on the water in Branford. I got to know Sister Louise and Saint Raphaels very well. My husband always said it was the nuns that made Saint Raphaels a special place.

Once again, Saint Raphaels is proactive and decisive, advocating for change, particularly in ensuring that every person has a right to health care. Its the right thing to do, said David W. Benfer, FACHE, Saint Raphael Healthcare System president and chief executive ofcer. Benfer, who serves on the board of the Catholic Health Association of the United States, is an active proponent of healthcare reform at state and national levels. It is more cost-effective and efcient to insure people, so they can get preventive care and care early in an illness. Imagine having to choose between feeding your family or seeking medical care,
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because you cant afford both. Its what many residents face every day, is inconsistent with our values of respect and dignity, and is what we want to help stop. Hes also led Saint Raphaels to continue to nd ways to offer care in the most clinically appropriate and patient-focused setting. Saint Raphaels opened the freestanding Hamden Surgery Center in 2000. Patients were eager to use the 2080 Whitney Ave. facility as soon as it opened its doors, said Surgery Center medical director and anesthesiologist David Van Ess, M.D.: Nobody looks forward to having surgery. But many more are being done on an outpatient

basis. Incisions are smaller, and new anesthesia methods allow patients to wake up and recover more quickly. This is what patients want. And having a surgery center closer to home is an added plus. And more care is being provided in non-clinical settings. In 2005, Saint Raphaels acquired VNA Services, Inc., a homecare provider serving 34 towns in this region. Disease prevention and early detection, especially in low-income and high-risk populations, is also a focus. A good example is Project Brotherhood, created with a grant from Bayer HealthCare. This cancer prevention, education and screening program helps men make healthier lifestyle choices. In keeping with the hospitals mission, uninsured men who might not otherwise receive needed screenings are the focus. This complements the Sister-to-Sister program, begun in 1996, to provide early cancer detection and treatment to undereserved women. Outreach for these programs is done one-on-one at the grassroots level. That personal touch can really make a difference, especially when so much of healthcare has become very impersonal, said Saint Raphael Integrative Medicine Manager Deborah DelVecchio-Scully. Its interesting, because we need technology for the best treatments and earliest diagnoses. Yet we must remember that the best healthcare always includes a personal touchsomething Saint Raphaels has always been known for.

AWARDS/DE SIGNATIO NS
Top 100 Hospital in the U.S. for stroke care, by Thomson Healthcare. 2000. Top 100 Hospital in the U.S. for intensive care. 2001. Top 50 Hospital in the U.S., reported in AARPs Modern Maturity, May/June 2002. Study by Consumers Checkbook, a Washington, D.C.-based nonprofit consumer education organization. One of Americas Best Hospitals (top 50) by U.S.News & World Report in neurology/neurosurgery and otolaryngology. 2003. Top 100 Hospital in the U.S. for cardio-

FORGING AHEAD
Saint Raphaels ability to diagnose and treat patients will continue to grow and improve with scientific advancements. Community-based outreach programs will continue to expand to bring care to those who need it mostthe poor, elderly, underserved and uninsured. And as patients wellness, spiritual and support needs change, Saint Raphaels will change to meet them. Undoubtedly, our physical shape will also change over the next 100 years. What wont change, however, is Saint Raphaels commitment to reaching out and caring for all in need, regardless of race, beliefs, culture or ethnicity. Its what the physicians and Sisters of Charity of Saint Elizabeth who founded Saint Raphaels set out to create: a hospital that all could call their owna hospital where every patient would receive the same high-quality care, respect and dignity each one of us deserves.

vascular services. 2005, 2004, 2003. One of Americas Best Hospitals (top 50) by U.S. News & World Report in ear, nose and throat services. 2007.

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Vascular surgeon Ralph DeNatale, M.D., (left) performs endovascular surgery with support from Peter Petrillo, PA, (right) and Fred Garmone.

Project Brotherhood screening.

I am proud to be at Saint Raphaels helm as we enter our second century of caring because I truly believe we will surpass the wonderful contributions weve made to this community and its residents during our rst 100 years, Benfer said. The Sisters of Charity of Saint Elizabeth set a standard. Its been upheld and furthered by the employees, physicians, volunteers, donors and others who came before us, and the people here todaywith their talent, creativity and leadershipwill help us exceed that standard. Our mission is unwavering and our goal is to do the very best, both in providing clinical care and in reaching out to work with our community to meet other healthcare needs.

STE AD FA ST CO MMITME NT TO THE FOUNDI NG PRI NCI PLES

In fiscal year 2006, the hospital dedicated approximately 9% of its operating expenses toward community benefit programming in Greater New Haven totaling $35.33 million and serving 183,595 individuals. This includes charity care, the unpaid cost of public programs, community programs and services, and health education and research. These efforts are quantified through a specific protocol of the Catholic Health Association of the United States.

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CLINI C AL EXCE LLE NCE

Saint Raphaels is consistently the regional healthcare provider chosen most often by adults for inpatient surgical services and by people 65 and older for all services, according to Connecticut Hospital Association data. Contributing to this are extraordinary clinical services and a caring, personal touch.

Orthopedics: Performs more bilateral knee and hip replacements than any Connecticut hospital, and does more single joint replacements (hip, knee, ankle, hand, wrist, and shoulder), and more general hip and knee procedures, than any hospital in Southern Connecticut. To meet growing demand, a new Bone and Joint Center opened in July 2007. Cancer: The state leader in the care of patients with respiratory cancers, including lung cancer; among the top three hospitals for head and neck cancers; and the regional leader for colorectal cancers. Ear, nose and throat diseases and disorders: Recognized as one of Americas Best Hospitals by U.S. News & World Report in 2007. Its a leader in adopting technology such as image-guided surgery, supporting tremendous patient safety advances. Minimally invasive surgery: Generally with a smaller incision, less pain and less blood loss. Many clinical specialties have adopted this approach. First Connecticut hospital to perform the minimally invasive laparoscopic gastric banding procedure for weight loss. Surgeons also perform minimally invasive, computer-guided knee and hip replacement surgeries.

Robotic surgery: Use of robotic surgery began in the mid-70s, when Vazrick Mansourian, M.D., and Elmer Valin, M.D., were first in New England to use AESOP (automated endoscopic system for optimal positioning) for laparoscopic surgery. In 2005, Saint Raphaels became the first in New England, second in the nation, to perform fully robotic obesity surgery. It also made headlines as the first southern Connecticut hospital to use the robotic daVinci Surgical System. By mimicking a surgeons precise hand, wrist and finger movements, and turning its arms a full 360 degrees, it can reach hard-to-reach areas and odd angles during surgery.

Geoffrey Nadzam, M.D., director of Robotic Surgery, and program director, General Surgery residency program.

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We value the extraordinary support that has contributed to our 100 year legacy and ensures its continuation

2 00 7 : A MI LESTONE ANNI VE RSARY TO RE ME MBER

Chapter 14
physicians and patients in this region.

hen the Hospital of Saint Raphael opened its doors, birthday parties for 100-year-olds were generally unheard ofcertainly for patients and even for most organizations. Yet when the hospital noted its 100th birthday in 2007, it celebrated in great company. Other centenarians that year were the Hershey Kiss, state of Oklahoma, United Parcel Service (UPS), and the rst Maytag clothes washer. This special milestone gave the Saint Raphael community an opportunity to look back, acknowledge accomplishments along its 100-year journey, celebrate its heritage, and fondly remember the many wonderful people who have made it possible. Highlights of anniversary activities included: A community-wide Mass celebrated by the Most Rev. Henry J. Mansell, archbishop of the Archdiocese of Hartford Presentation of a special proclamation in state Senate Chambers by New Haven Senators the Hon. Toni Harp and Martin Looney on March 14, acknowledging the 100th anniversary of the hospitals incorporation by the state Recognition of the sponsoring Sisters of Charity of Saint Elizabeth at a special Centennial Gala and annual Presidents Ball Special anniversary-themed activities for staff, physicians and volunteers

Never an organization to rest on its laurels, the milestone anniversary provided a perfect opportunity for Saint Raphaels to kick off its second century of caring for this community. The Saint Raphael Healthcare System Board of Trustees devoted much of 2007 to reassessing and modifying the System mission, vision and values statements, and developing a new strategic plan. Our goal as we embark on this new century: to be the provider of choice for patients, Several initiatives were begun to help fulll this goal. The state Ofce of Health Care Access approved two signicant projects that will further enhance our ability to provide extraordinary, state-of-theart cancer care in this community. First, Saint Raphaels will build a satellite Father Michael J. McGivney Cancer Center in Hamden, adjacent to its Hamden Surgery Center. The satellite is expected to open in early 2009. It, along with equipment upgrades at the main campus Father Michael J. McGivney Center for Cancer Care, are being funded through a $15 million philanthropic capital campaign. Second, the hospital was given the go-ahead to acquire the amazing CyberKnife stereotactic radiosurgery system. It will be the rst hospital in this region, only the third in Connecticut, to offer this leading edge technology. CyberKnife is able to destroy inoperable and operable tumors anywhere in the body, including tumors of the brain, spine, neck, lung, liver, prostate and pancreas.

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Cyberknife program coordinator Vanna Dest with the advanced technology.

Its pinpoint accuracy enables it to track tumors that move with breathing and to target multiple locations during a single session. There is no pain, anesthesia nor incisions and remarkably, its done as an outpatient procedure in one to ve visits. To increase capacity, allow for volume growth, and compete with suburban hospitals that have newer facilities, a deliberate process began to enhance the hospitals physical plant. A two-oor addition to the Verdi Building opened in July, with one oor housing the Scheduled Admissions Unit and the other our Bone & Joint Center. Sister Louise Anthony 2 was renovated as a surgical telemetry unit, while Verdi 4 North was renovated as a new medical unit. A schematic design was developed for a new Obstetrics/ Gynecology/Newborn Intensive Care/Pediatric Unit using the LDRP (labor, delivery, recovery, postpartum) model of care. The Obstetrics program grew signicantly in 2007, with admissions and births exceeding expectations. Contributing to this was the hiring of a new obstetrician and ve certied midwives. Program enhancements include opening of the Emergency Departments Fast Track area for less emergent care needs. A new Womens Center for Breast Health began offering a coordinated, multidisciplinary approach to care. Its also personalized due to the presence of a patient navigator and allows women to access a complete array of services, from diagnosis to advanced treatment and psychological and support services. A Wound Care Center and hospital-based apothecary pharmacy also opened.

2 0 0 7 CLI NIC AL AWARDS/D ESIGNATI ONS

One of Americas Best Hospitals (top 50) for ear, nose and throat services. U.S.News & World Report In top 10% of hospitals nationwide for cardiac care. HealthGrades.com. In top 5% of hospitals nationwide for patient safety. HealthGrades.com. Rated top general hospital in Connecticut by Department of Mental Health and Addiction Services clients VNA Services clinical outcomes place it in the top 25% of U.S. homecare providers, earning designation as an Elite Agency. OCS (national benchmarking firm) in collaboration with Decision Health (homecare specialty publication)

2 007 LEADE RSHIP RO LES

State-wide leader - Bariatric (obesity) surgery - Bilateral joint replacement - Treatment of lung cancer Provider of choice for this region - Adult inpatient surgical services - Inpatient services to persons 65 and older - Orthopedic surgery (particularly single joint replacements)

From Project ElderCares high touch approach to primary care (above), to a new high tech operating room (right).

The state approved Saint Raphaels request to assume ownership of an adolescent outpatient psychiatric program in Branford. This supports the Systems growth strategy; enhances continuity of care; better meets the needs of CPES (Childrens Psychiatric Emergency Service) patients residing on the shoreline; and expands our shoreline presence. Under Saint Raphaels leadership, the day hospital will provide intensive therapy in a highly structured therapeutic environment to 11 to 17-year-olds. From 12 beds to 511 from a handful of staff to more than 4,100 employees from campaigns to ll the kitchen pantry to one that has raised $12.4 million toward a satellite Father Michael J. McGivney Cancer Center in Hamden. How the Hospital of Saint Raphael has evolved is undoubtedly beyond the vision of the founding Sisters of Charity of Saint Elizabeth and 14 community physicians. Yet never varying has been the hospital missionto provide extraordinary care to all persons regardless of their faith, heritage or economic means.

The Sisters of Charity of Saint Elizabeth are proud of our ministry in New Haven and are deeply committed to continuing the strong presence of the Catholic healthcare ministry, said Sister Maureen Shaughnessy, general superior of the Sisters of Charity of Saint Elizabeth and chairperson of the Saint Raphael Healthcare System Board of Trustees. We are women of strong faith,

principles care

and

vision, today.

despite We value

the the

extraordinary challenges faced by healthproviders extraordinary support of the Greater New Haven community, our dedicated staff, physicians and volunteers, and everyone else who has contributed to our 100 year legacy and who will ensure its continuation into the future.

From left: David Benfer, president, Saint Raphael Healthcare System; the Most Rev. Peter Rosazza, auxiliary bishop of the Archdiocese of Hartford; Raymond J. Peach, chairman, Saint Raphael Foundation Board of Trustees; Hamden Mayor Craig Henrici; Dennis Savoie, deputy grand knight, Knights of Columbus; Dominic Proto, chairman of the cancer fundraising campaign; and Francis Cardinale, M.D., and Joseph Cardinale, M.D.

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20 0 7: CONTI NUING A TRAD I TI ON OF PIONE ERI NG ME D I CI NE

Magnetic Resonance Imaging Center: First in the U.S. accredited by the American College of Radiology for cardiac imaging services. Electrophysiologist Mark Schoenfeld, M.D., performs the hospitals first catheter ablation for atrial fibrillation. Department of Surgery Chairman Scott Helton, M.D., performs Saint Raphaels first minimally invasive radiofrequency ablation (removal) of a liver tumor. He also does minimally invasive resections of the liver and pancreas. Greenlight Laser introduced as a less invasive method to treat the prostate causing frequent, incomplete urination in middle-aged and older men. Image-guided radiation therapy added to the hospitals cancerfighting arsenal. It combines a CT scanner and linear accelerator, producing highly accurate images of the body where tumors have been discovered, directing radiation directly at the tumor, and using a laser guidance system to precisely target the beam. It also varies the radiation strength as needed in response to tumor changes. CyberKnife stereotactic radiosurgery system is approved

With Saint Raphaels leadership, Greater New Haven receives a grant from Misys Healthcare Systems to establish a communitywide health information network. Valued at about $4 million, the grant provides electronic health record software to physician practices and other providers to be used in forming the network. Benefits are expected to include reducing medical errors, increasing office efficiencies and improving patient satisfaction.

AND OF O UTRE ACH AND ADVO C ACY

Provides $34.6 million8.3% of hospital operating expenses in community benefit, using national Catholic Health Association guidelines. Funded by a $100,000 allocation from the state legislature, Saint Raphaels opens a school-based clinic at neighboring Barnard Environmental Studies Magnet Elementary School. Hospital clinics at nearby Timothy Dwight Elementary and Troup Magnet Academy of Sciences have been in place for 15 years. The Hospital Pediatric Primary Care Center and New Haven Legal Assistance Association establish HeLP (Health Law Partnership for Families). Clinic children and their families receive direct, confidential legal assistance and representation on safe housing, access to healthcare, and appropriate education services.

1906 Catholic Hospital Association founded 1907 Catholic Hospital Association and Sisters of Charity of Saint Elizabeth agree that the Sisters will administer the new hospital, Association accepts the Sisters recommended name: Saint Raphael Sisters Irmina McDonough, Mary Eustelle Kivlehan, Rose Ulrica Farley, and Alice Veronica Flynn arrive in New Haven and began the work to convert a residence at 1442 Chapel Street into the new hospital State Senate Joint Resolution No. 166 incorporates the Hospital of Saint Raphael 1908 New staff took possession of the 12 bed hospital (converted Barnes residence) Mrs. Winifred Dugan admitted as the first patient Ladies Aid Society organized with 205 women Hospital of Saint Raphael Training School enrolls Mary Agnes Smith as its first student. It was later renamed the School of Nursing 1909 Saint Marys Building completed

1910 Fully equipped pharmacy is established 1911 A modern laboratory was added 1912 Hospital installs its first x-ray machine William Verdi, M.D., named surgeon-in-chief Nursing school graduates its first class with diplomas 1915 10% of all Saint Raphael patients admitted are given free care 1916 At Saint Raphaels, general ward fees increase to $1.25/day, private ward fees increase to $1.75/day 1919 Establish Urology Department under Israel Kleiner, M.D.

1923 Saint Ritas Building opens 1923 A 651 George Street house is purchased for $22,500, moved to the middle of the Hospital campus, and renamed Saint Vincents Pavilion. Initially housing nursing students, it eventually housesat separate timesthe Pediatrics Department, dietitians who lived on-campus and interns. It was razed in 1962. 1924 Truman Lewis donates $100,000 to construct the Selina Lewis Building to house the School of Nursing 1925 Selina Lewis Building opens, accommodates 100 nurses 1928 A $10,000 gift from one of Dr.Verdis patients enables planning for a new Pathology Departmentincluding an autopsy departmenton the ground floor of the Saint Ritas Building.

Ford introduces the Model-T First electronic washing machine Kelloggs starts selling corn flakes New York subway opens First World Series

The Tango catches on The Titanic sinks Daylight savings time introduced U.S. introduces personal income tax First traffic light

Women get the right to vote in the U.S. New York Stock market crashes First Winter Olympics Penicillin discovered Babe Ruth makes home-run record

WORLD WAR I

MOMENTS OF

The Hospital of Saint Ra

1932 Dr. Nesbit hired as first full time pathologist 1933 Dental and maternity clinics organized 1936 Dining room of Arnold College renovated into a modern pediatric section, subsidized largely by Raynham Townsend, M.D. 1938 Hospital has 220 beds and 40 bassinets, with 57 extra beds crowded in. Patient census is regularly 260-290, turns many patients away for lack of room 1939 Deal struck to purchase the land and buildings of Arnold College for $110,000. College gym moved to George Street. Clears the way for the construction of the Main and Private buildings

1940 Dr. Mario Garofalo joins the Hospital. He is the 75th anesthesiologist licensed in Connecticut. 1942 Private and Main buildings open. Dr Verdi performs the first operation in the new surgical suite. All patients are transferred to these building, with the older buildings converted to other uses, such as dining rooms for nurses and doctors and quarters for animal research. 1946 Enrollment in School of Nursing hits its peak of 151 students. WWII and US Cadet Nurse Corps account for the jump in enrollment. 1948 School of Medical Technology founded, closes in 1975

1951 School of Radiologic Technology founded 1955 Quadruplets born at Saint Raphaels to Mr. & Mrs. Kenneth Barnesonly 4th set in Connecticut history since record-keeping started in 1893 1956 Volunteers launch Cheerio gift cart 1957 $350,000 Radiation Therapy Center opens The Hospital celebrates its 50th birthday, has 370 beds, 60 bassinets, 800+ staff Volunteer Department forms 1958 Max Carter, M.D., uses a heart-lung machine to perform open heart surgery at Saint Raphaels, said to be the first community hospital in the state, possibly New England, to do this revolutionary procedure

Empire State Building completed FDR Launches New Deal First commercial flight over the Atlantic Golden Gate Bridge opens

Nylons are sold Mount Rushmore completed Slinky toy hits shelves Bikinis introduced State of Irael founded

Hawaii admitted as 50th state Color TV introduced Polio vaccine created DNA discovered Disneyland opens

WORLD WAR II

KOREAN WAR

aphael

1962 Saint Raphaels dedicates the Saint Josephs Pavilion LPN program is instituted 1963 Saint Raphaels opens its first intensive care unit with 13 beds. Each patient unit is completely equipped and in full view of the nurses station. 1965 Opens the first acute coronary care unit in Connecticut, second in New England and among the first in the U.S. 1966 8,000 square foot Emergency Department opens on Sherman Avenueexpanding its size by 7,000 square feet! Cost per visit: $7.50. 1968 Department of Pastoral Care established and is among the first at a U.S. Catholic hospital

1972 Sister Louise Anthony signs letter creating formal affiliation with Yale University School of Medicine 1975 Saint Raphael Foundation established 1976 $30 million William F.Verdi Memorial Building opens, adding 60% more space and increasing bed capacity to 482 1977 School of Nursing graduates last class Cardiac Diagnostic Unit opens, heralded as the only one of its kind in U.S. as it combines disciplines of nuclear medicine, cardiovascular radiology, echocardiography, and cardiology in one location Childrens Psychiatric Emergency Service inpatient unit opens for children 11 and younger Eight hour surgery program starts to reduce costs and length of hospitalizations, offered on Mondays, Tuesdays and Thursdays. Patients have their lab or other tests in the morning, procedure in the afternoon and then go home. Average charge = $310

1981 After a 10-year battle to get regulatory approval, Saint Raphaels performs its first CT scan. Critics had described it as an expensive gadget and doctors new toy. Philip Fazzone, M.D., and John Chandler, M.D., perform Saint Raphaels and New Havens first coronary angioplasty. By 1985, Saint Raphaels is doing 37% of all these procedures in the state and by 1986, its first in the state to reach 1,000 procedures 1982 Designated as a Regional Center for the Correction of Dento-Facial Abnormalities in Southern Connecticut, is among the northeasts top oral surgery centers 1983 Laser Surgery Center opens, with Saint Raphaels doing more laser procedures than any Connecticut hospital. Lasers used for ENT, facial and plastic surgery, obstetrics, neurosurgery, ophthalmology, general surgery Auxiliary starts mens golf tournament 1985 Ground is broken for the $33 million expansion and renovation program resulting in the Luca E. Celentano, M.D., Sister Louise Anthony, and Sisters of Charity Center for Caring buildings, increasing hospital capacity to 491 beds 1989 Open the states largest cardiothoracic intensive care unit

19 N c c

19 D a O r

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Neil Armstrong becomes the Lasers invented first man to walk on the moon Berlin Wall built President Kennedy is assassinated Medicare signed into law

Nuclear power plant Computer floppy disks introduced accident at Three Mile Island VCRs introduced Ella Grasso is first woman elected Governor of Connecticut Star Wars released

Challenger space Ted Turner establishes CNN shuttle explodes AIDS is identified E.T. movie released Berlin wall falls Sally Ride first woman in space

Wo

GULF W VIETNAM WAR

90 New Havens first, Connecticuts second, laparascopic cholecystectomy performed as a new alternative to conventional gallbladder surgery

2000 Hamden Surgery Center opens 2001 Terrorist attack on the U.S. Connecticut hospitals initially asked to prepare for potentially thousands of persons injured at the World Trade Center. Staff respond immediately: 114 patients discharged, double the daily average. Celentano 5 patient care unitclosed due to nursing shortageis made ready. Pastoral Care and Psychiatry available for counseling. Nurses and other staff volunteer to help in New York City. First in New England to use a zirconium knee prosthesis Interventional neuroradiologists among first in Connecticut to perform vertebroplasty, using a special cement to strengthen broken bones and treat spinal injuries/problems. 2002 Early adopter in the U.S. of computerized physician order entry for medications, with new computerized medication carts introduced to enhance patient safety One of the first in the state to offer IMRT (intensity modulated radiation therapy) which targets radiation to tumors, reduces exposure of other tissue, and has fewer side effects. 2003 First in southern Connecticut, second is the state to begin using a PET/CT scanner; it helps with diagnosis and treatment staging of oncology, cardiology, and neurology disorders

2004 Orthopedic surgeons begin performing minimally invasive hip replacements First in Connecticut to offer catheter cyroablation to treat irregular heart beats 2005 One of first in the state to implant biventricular defibrillators to better manage congestive heart failure First in New England to offer mini-maze surgery as a less invasive way to correct atrial fibrillation First in New England, second in the U.S., to perform fully robotic gastric bypass surgery using the daVinci robotic surgical system. First Connecticut hospital to offer minimally invasive laparoscopic vertical banded gastroplasty Among first in New England to perform minimally invasive surgery for esophagus removal, treating malignant and benign disease 2006 State approves Hamden cancer center satellite Newborn Intensive Care Unit expands its services, treating women reaching their 32nd week of pregnancy (previously was 34th week) 2007 Verdi South opens (Bone & Joint Center, Scheduled Admissions Unit) MRI Center first in the U.S. to receive cardiac imaging accreditation IGRT (image guided radiation therapy) added to the cancerfighting arsenal, enabling cancer to be attacked with unprecedented accuracy while minimizing impact on surrounding tissue.

91 Drs. Mark Marieb and Mark Schoenfeld perform a cardiac ablation, considered a major breakthrough in cardiac medicine Occupational Health & Treatment Center opens (later renamed Occupational Health Plus)

94 Father Michael J. McGivney Center for Cancer Care opens

96 HOPE (Having an Opportunity to Prepare for Employment) program begins, providing skills, practical experience and mentoring to help people transition from welfare to work. First Connecticut hospital to use a new vein harvesting technique n vascular surgery.

97 Saint Josephs Pavilion closes to make way for $25 million ambulatory services building, which will include an expanded Emergency Department and new Short-Term Surgery Unit, auditorium, and outpatient Radiology area when it opens n 1999

orld Wide Web debuts Official end of the Cold War Oklahoma City bombing Fear of Y2K bug

Terrorist attack on the U.S. Hurricane Katrina strikes 11 Asian countries devastated by the tsunami

WAR SECOND GULF WAR

H OS PI TAL A D MI NI S TR ATO RS
Sister Mary Irmina McDonough Sister Rose Vincent Sister Immaculata Sister Catherine Regina Reverend Mother Elenita Sister Rose Alexis Sister Louise Anthony Sister Anne Viginie Robert Beeman Dan Rissing James J. Cullen David W. Benfer