Johns Hopkins Hospital

The Johns Hopkins Hospital (JHH) is the teaching hospital and biomedical research facility of Johns Hopkins School of Medicine in Baltimore, Maryland. Founded in 1889, Johns Hopkins Hospital and its school of medicine are considered to be the founding institutions of modern American medicine and the birthplace of numerous famed medical traditions, including rounds, residents, and house staff.[5] Several medical specialties were founded at the hospital, including neurosurgery by Harvey Williams Cushing and Walter Dandy, cardiac surgery by Alfred Blalock,[6] and child psychiatry by Leo Kanner.[7][8] Johns Hopkins Children's Center which serves infants, children, teens, and young adults aged 0–21, is attached to the hospital.

Johns Hopkins Hospital
Johns Hopkins Medicine
The hospital's Bloomberg Pavilion, hosting the Johns Hopkins Children's Center
Geography
Location1800 Orleans Street[1], Baltimore, Maryland, U.S.
Coordinates39°17′46″N 76°35′30″W
Organisation
Fundingfederal and private
TypeTeaching
Affiliated universityJohns Hopkins School of Medicine
Services
Emergency departmentI
Beds1,091[2]
Helipads
HelipadFAA LID: 0MD3 and 17MD
Number Length Surface
ft m
1 rooftop
(concrete)
2 rooftop
(concrete)
History
Opened1889
Links
Websitehopkinsmedicine.org
ListsHospitals in U.S.
Other linksJohns Hopkins Bayview Medical Center
Johns Hopkins Hospital Complex
Location601 North Broadway,[3] Baltimore, Maryland, U.S.
Area8 acres (3.2 ha)
Built1889
ArchitectCabot & Chandler, and others
Architectural styleQueen Anne style
NRHP reference No.75002094[4]
Added to NRHPFebruary 24, 1975

Johns Hopkins Hospital is widely regarded as one of the world's greatest hospitals and medical institutions.[9] For 21 consecutive years from 1991 to 2020, it was ranked as the best overall hospital in the United States by U.S. News & World Report. In its 2019–2020 edition, U.S. News & World Report ranked the hospital on 15 adult specialties and 10 children's specialties; the hospital came in 1st in Maryland and third nationally behind the Mayo Clinic in Rochester, Minnesota and Massachusetts General Hospital in Boston. In 2021, the hospital marked 32 consecutive years of placing in the top five hospitals in the nation.[10]

The hospital's founding in 1889 was made possible from a philanthropic bequest of over $7 million by city merchant, banker, financier, civic leader, and philanthropist Johns Hopkins, which at the time was the largest bequest in the history of the United States. The hospital is located at 600 North Broadway in Baltimore.

History

Johns Hopkins, the Baltimore merchant and banker whose philanthropic gift launched the hospital
Johns Hopkins Hospital
Johns Hopkins Hospital, c.1890–1910
The interior of the Octagon Ward at Johns Hopkins Hospital
10-foot high statue of "Christ, the Divine Healer" at the hospital's administration building
Christus, an 1833 Carrara marble statue in the hospital's rotunda of the resurrected Jesus, based on Bertel Thorvaldsen's original in 1833

Founding

Johns Hopkins (1795–1873), a Baltimore merchant and banker, left an estate of approximately $7 million (US$173.84 million in 2022[11]) when he died on December 24, 1873, in his city mansion on West Saratoga Street, just west of North Charles Street, at the age of 78. In his will, he asked that his fortune be used to found two institutions that would bear his name: "Johns Hopkins University" and "The Johns Hopkins Hospital." At the time that it was made, Hopkins' gift was the largest philanthropic bequest in the history of the nation.[12]

Toward the end of his life, Hopkins selected 12 prominent Baltimore residents as trustees for the project. A year prior to his death, he sent each a letter telling them that he was giving "thirteen acres of land, situated in the city of Baltimore, and bounded by Broadway, Wolfe, Monument, and Jefferson streets upon which I desire you to erect a hospital." He wished for a hospital that "shall, in construction and arrangement, compare favorably with any other institution of like character in this country or in Europe" and directed his trustees to "secure for the service of the Hospital, physicians and surgeons of the highest character and greatest skill."[12]

Hopkins instructed the trustees to "bear constantly in mind that it is my wish and purpose that the hospital shall ultimately form a part of the Medical School of that university for which I have made ample provision in my will." By calling for this integral relationship between patient care, as embodied in the hospital, and teaching and research, as embodied in the university, Hopkins laid the groundwork for a revolution in American medicine. Johns Hopkins' vision, of two institutions in which the practice of medicine would be wedded to medical research and medical education was revolutionary.

19th century

Initial plans for the hospital were drafted by surgeon John Shaw Billings, and the architecture designed by John Rudolph Niernsee and completed by Edward Clarke Cabot of the Boston firm of Cabot and Chandler in a Queen Anne style.[13] When completed in 1889 at a cost of $2,050,000 (US$50.8 million in 2022[11]), the hospital included what was then state-of-the-art concepts in heating and ventilation to check the spread of disease.

The trustees obtained the services of four outstanding physicians, known as the "Big Four," to serve as the founding staff of the hospital when it opened on May 7, 1889. They were pathologist William Henry Welch, surgeon William Stewart Halsted, internist William Osler, and gynecologist Howard Atwood Kelly.[14]

In 1893, Johns Hopkins University was one of the first medical schools to admit women.[15] The decision to begin coeducation was a result of a shortage of funds, as the Baltimore and Ohio Railroad stock that was supposed to cover cost was used up in building the hospital in 1889 and the medical school had not yet been built. Four of the original trustees' daughters offered to raise the money needed to open the school, but only if the school agreed to admit qualified women to the university. After several discussions, the trustees agreed to their terms and accepted the financial help of these four women with only one of the doctors, William H. Welch, resisting. Eventually, even Welch changed his views on coeducation, "The necessity for coeducation in some form," he wrote later, "becomes more evident the higher the character of the education. In no form of education is this more evident than in that of medicine ... we regard coeducation a success; those of us who were not enthusiastic at the beginning are now sympathetic and friendly."[16]

Osler, the first chief of the Department of Medicine, is credited with originating the idea of a residency, in which recently graduated physicians receive advanced training in their specialty while treating patients under supervision; then, as now, residents comprise most of the medical staff of the hospital. He also introduced the idea of bringing medical students into actual patient care early in their training; at the time medical school consisted almost entirely of lectures. Osler's contribution to practical education extends to the creation of "grand rounds", the practice of leading physicians discussing the most difficult cases in front of assembled medical students, for the benefit of patients and students.[17] The term “rounds” derives from the circular ward where bedside teaching occurred.[18] He once said he hoped his tombstone would say only, "He brought medical students into the wards for bedside teaching."[14]

Halsted, the first chief of the Department of Surgery, established many other medical and surgical achievements at Johns Hopkins including modern surgical principles of control of bleeding, accurate anatomical dissection, complete sterility, and the first radical mastectomy for breast cancer (before this time, such a diagnosis was a virtual death sentence). His other achievements included the introduction of the surgical glove and advances in thyroid, biliary tree, hernia, intestinal and arterial aneurysm surgeries. Halsted also established the first formal surgical residency training program in the United States.

Kelly is credited with establishing gynecology as a true medical specialty. He created new surgical approaches to women's diseases and invented numerous medical devices, including a urinary cystoscope. He was one of the first to use radium to treat cancer.[14]

Welch was responsible for training many of the outstanding physicians of the day, such as Walter Reed. He also founded at Hopkins the nation's first Public Health school, now known as the Johns Hopkins Bloomberg School of Public Health.[14]

A notable sight at the hospital is the marble statue Christus, a Carrara marble statue in the Billings Administration Building rotunda of the resurrected Jesus based on the 1833 original by Bertel Thorvaldsen, which was a gift by Baltimore merchant William Wallace Spence; it is a replica of the original by Danish sculptor Bertel Thorwaldsen in Copenhagen. Unveiled in 1896, the statue brings comfort to many, the hospital has said.[19][20]

20th century

Original hospital, the Billings Building, in 2019

In 1903, Harriet Lane Johnston left a sum of over $400,000 at her death in 1903 to establish the Harriet Lane Home for Invalid Children as a memorial to two sons who had died in childhood. In October 1912 the Harriet Lane Home officially opened. It was the first children's clinic in the United States that was associated with a medical school, first run by John Howland. Eventually treating over 60,000 children a year, the Harriet Lane Home became a pioneer treatment, teaching, and research clinic, and the first to have subspecialties in pediatrics as created by Edwards A. Park.

Between 1930 and 1963, Helen B. Taussig, who helped to develop the blue baby operation, headed the pediatric cardiac clinic. Child psychiatrist Leo Kanner did studies of autistic children. Lawson Wilkins established an endocrine clinic that developed procedures used universally to treat children with certain glandular disorders, including dwarfism. John E. Bordley and William G. Hardy made strides in detecting hearing impairments in very young children.[21]

In 1912, Diamond Jim Brady donated $220,000 to the hospital, which created the James Buchanan Brady Urological Institute.[22] Ophthalmologist William Holland Wilmer opened the Wilmer Eye Institute at the hospital in 1925, and its building was completed four years later. Wilmer received a medical degree from the University of Virginia School of Medicine in 1885 and later worked in New York City, Washington D.C., and Baltimore, where he established the institute.[23]

Achievements

Medical achievements at Johns Hopkins include the first male-to-female sex reassignment surgery in the United States that took place in 1966 at the Hopkins Gender Identity Clinic.[24]

Two of the most far-reaching advances in medicine during the last 25 years were also made at Hopkins. First, the Nobel Prize-winning discovery of restriction enzymes gave birth to the genetic engineering industry. Second, the discovery of the brain's natural opiates has triggered an explosion of interest in neurotransmitter pathways and functions. Other accomplishments of the hospital include the development of HeLa by George Otto Gey, head of tissue culture research in 1951,[25] the first and arguably most important line of human cells grown in culture, identification of the three types of polio virus, and the first "blue baby" operation, which was done by surgeon Alfred Blalock in collaboration with Helen Taussig, a Hopkins graduate specializing in pediatric cardiology and surgical technician Vivien Thomas that opened the way to modern cardiac surgery.[16][26]

Contributions to heart surgery were brought on by the discovery of heparin and the Blalock-Thomas-Taussig Shunt.[27] Johns Hopkins has also published The Harriet Lane Handbook, an indispensable tool for pediatricians, for over 60 years.

Operations

Johns Hopkins Medicine's campus at Green Spring Station in Brooklandville, Maryland

The hospital occupies approximately 20 of the 60 buildings on the Johns Hopkins Medical Campus. The complex has over 80 entrances and receives 80,000 visitors weekly. It houses over 1,000 beds and has a staff of over 1,700 doctors with over 30,000 total employees.[28]

From 1982 to 1992, then CEO Robert Heyssel established the hospital's first Oncology Center, the Nelson Patient Tower, the Clayton Heart Center and the Johns Hopkins Outpatient Center which bears Heyssel's name.[29] In May 2012, the Johns Hopkins Hospital opened two new towers as part of a major campus redevelopment effort. The opening of the new $1.1 billion Charlotte R. Bloomberg Children's Center tower and the new Sheikh Zayed Tower marked the highpoint of this effort. In addition to the main hospital, the system operates four other hospitals and several outpatient care facilities in the Baltimore and Washington metro areas and All Children's Hospital in St. Petersburg, Florida.[30] In May, 2019, the hospital completed an $80 million expansion project at its Green Spring Station campus in Brooklandville, Maryland, offering out-patient surgery, imaging, and oncology treatment at the 3-story, 100,000-square-foot (9,300 m2) Pavilion III.[31]

Johns Hopkins also provides remote consultations worldwide through the Grand Round platform, and uses the same platform to help patients find the ideal specialist for their unique needs.[32]

Johns Hopkins Children's Center

Johns Hopkins Children's Center (JHCC) is a nationally ranked, pediatric acute care children's teaching hospital located in Baltimore, Maryland, adjacent to Johns Hopkins Hospital. The hospital has 196 pediatric beds[33] and is affiliated with the Johns Hopkins School of Medicine.[34] The hospital is the flagship pediatric member of Johns Hopkins Medicine and is 1 of 2 children's hospital in the network. The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21[35][36][37] throughout Baltimore and the wider United States. Johns Hopkins Children's Center also sometimes treats adults that require pediatric care.[38]

Johns Hopkins Children's Center also features one of the only ACS verified Level 1 Pediatric Trauma Centers in the state.[39] The hospital is directly attached to Johns Hopkins Hospital and is situated near the Ronald McDonald House of Maryland.[40]

Rankings

Johns Hopkins Hospital was ranked as the top overall hospital in the United States for 21 consecutive years by U.S. News & World Report until 2012, when it moved to second place behind Massachusetts General Hospital in Boston. In 2013, it was reinstated as the top hospital in the United States.[41] In the 2016-2017 Best Hospitals edition, Johns Hopkins ranks 3rd nationally.[42]

U.S. News & World Report – 2016–2017 rankings by medical specialty[43]
US rankingMD rankingSpecialty
31Ear, nose & throat
11Radiology
41Geriatrics
21Neurology and neurosurgery
41Urology
11Rheumatology
41Psychiatry
31Ophthalmology
51Gastroenterology and GI surgery
41Diabetes and endocrinology
91Cardiology & heart surgery
91Oncology
71Gynecology
131Pulmonology
91Orthopedics
5 1 Nephrology

Concern over ethics and research methodologies

Johns Hopkins School of Medicine and Johns Hopkins Hospital have faced criticism over ethics and research methodologies.[44][45][46][47]

See also

References

  1. "Getting to The Johns Hopkins Hospital". HopkinsMedicine.org. Retrieved December 20, 2014.
  2. "Licensed Acute Care Hospital Beds Fiscal Year 2018" (PDF). mhcc.maryland.gov. Retrieved Jan 9, 2018.
  3. "Johns Hopkins Hospital Complex". National Park Service. Retrieved December 20, 2014.
  4. "National Register Information System  (#75002094)". National Register of Historic Places. National Park Service. March 13, 2009.
  5. "General Psychiatry Residency Program at The Johns Hopkins University School of Medicine". Johns Hopkins Medicine. Archived from the original on September 23, 2009. Retrieved January 8, 2011.
  6. "Something the Lord Made - an HBO Film". Johns Hopkins Medicine. 2004. Retrieved 2012-03-09.
  7. "The History of Johns Hopkins Medicine". Johns Hopkins Medicine. Retrieved 2012-03-09.
  8. "Division of Child and Adolescent Psychiatry". Johns Hopkins Medicine. Retrieved 2012-03-09.
  9. Randi Henderson; Richard Marek (20 March 2001). Here is My Hope: A Book of Healing and Prayer: Inspirational Stories of Johns Hopkins Hospital. Doubleday. ISBN 978-0-385-50032-6.
  10. "2019-20 Best Hospitals Honor Roll and Overview".
  11. Inflation Calculator
  12. A. McGehee Harvey; Victor A. McKusick (1 May 1989). A Model of Its Kind: Volume 1 - A Centennial History of Medicine at Johns Hopkins. Baltimore: Johns Hopkins University Press. ISBN 978-0-8018-3794-4.
  13. Dorsey, John & Dilts, James D., Guide to Baltimore Architecture (1997) p. 203-4. Tidewater Publishers, Centreville, Maryland ISBN 0-87033-477-8
  14. "The Four Founding Physicians". Johns Hopkins Medicine. Retrieved 2012-03-09.
  15. Gerard N. Burrow, MD; Nora L. Burgess, MD (February 2001), "The evolution of women as physicians and surgeons", The Annals of Thoracic Surgery, archived from the original on 2003-07-22, retrieved 2013-04-10
  16. "Women -- Or the Female Factor". Johns Hopkins Medicine. Retrieved 2013-04-10.
  17. History of Grand Rounds
  18. "Rounds: Are we spinning our wheels?". Retrieved 2020-08-25.
  19. Rasmussen, Fred (October 13, 1996). "'The Divine Healer' Hospital: The representation of Christ the Consoler in the Hopkins lobby still offers hope". Baltimore Sun. Retrieved September 25, 2019.
  20. Roylance, Lindsay (December 2003), "A Provocative Icon", Dome, Johns Hopkins Medicine, 54 (10): 1, archived from the original on 2013-12-03
  21. "The Harriet Lane Home for Invalid Children". www.medicalarchives.jhmi.edu. Archived from the original on 2016-07-31. Retrieved 2017-02-09.
  22. "'Diamond Jim' gives $220,000 to Hospital" (PDF). The New York Times. 13 August 1912. Retrieved 2012-03-09.
  23. Parker, Walter R. (1936). "Dr. William Holland Wilmer". Transactions of the American Ophthalmological Society. 34: 20–23. PMC 1315552.
  24. Laura Wexler (January–February 2007). "Identity Crisis". Style Magazine. Baltimorestyle.com. Archived from the original on 2012-02-19. Retrieved 2012-03-09.
  25. Rebecca Skloot (2 February 2010). The Immortal Life of Henrietta Lacks. Random House Digital, Inc. ISBN 978-0-307-58938-5. Retrieved 9 April 2013.
  26. "Johns Hopkins Medical Milestones". Johns Hopkins Medicine. Archived from the original on 2011-12-01. Retrieved 2012-03-09.
  27. Patel, Nishant D.; Alejo, Diane E.; Cameron, Duke E. (2015-01-01). "The History of Heart Surgery at The Johns Hopkins Hospital". Seminars in Thoracic and Cardiovascular Surgery. 27 (4): 341–352. doi:10.1053/j.semtcvs.2015.11.001. ISSN 1532-9488. PMID 26811040.
  28. Alex Dominguez (16 September 2010). "Gunman kills self, mother at Johns Hopkins Hospital". WPVI-TV. Archived from the original on 19 September 2010. Retrieved 2012-03-09.
  29. "Dr. Robert Heyssel, former CEO of Hopkins, dies at 72". Retrieved 16 August 2018.
  30. "Patient Care Locations". Johns Hopkins Medicine. Retrieved 2012-03-09.
  31. Boteler, Cody (September 25, 2019). "Johns Hopkins Medicine to debut Green Spring Station expansion". Towson Times. p. 10.
  32. "Grand Rounds Announces New Collaboration with Johns Hopkins Medicine to Enhance Access to World-Class Health Care".
  33. "Johns Hopkins Children's Center". www.childrenshospitals.org. Retrieved 2020-07-11.
  34. Fisher, Andy. "Johns Hopkins Medicine: Patient Care Locations". www.hopkinsmedicine.org. Retrieved 2020-07-11.
  35. "Pediatric Clinical Research Unit (PCRU) | Johns Hopkins Children's Center". www.hopkinsmedicine.org. Retrieved 2020-07-12.
  36. "Fellowship Positions | American Pediatric Surgical Association". eapsa.org. Retrieved 2020-07-12.
  37. Se_Support1. "Pediatric Emergency Department: Johns Hopkins Nursing". www.hopkinsmedicine.org. Retrieved 2020-07-12.
  38. "CHD Clinic - Johns Hopkins Adult Congenital Heart Disease Program". ACHA. Retrieved 2020-07-11.
  39. "Trauma Centers". www.miemss.org. Retrieved 2020-07-11.
  40. "Our New Neighborhood". rmhcmaryland.org. Retrieved 2020-07-11.
  41. "Honor Roll of Best Hospitals 2013-2013". U.S. News & World Report. Retrieved July 16, 2013.
  42. "2016-17 Best Hospitals Honor Roll and Overview". Archived from the original on 2016-08-02. Retrieved 2016-08-02.
  43. "Best Hospitals Honor Roll 2016-2017". U.S. News & World Report. usnews.com. 1 August 2016. Retrieved 2016-02-08.
  44. Josefson, D. (2001-09-08). "Johns Hopkins faces further criticism over experiments". BMJ (Clinical Research Ed.). 323 (7312): 531. doi:10.1136/bmj.323.7312.531. ISSN 0959-8138. PMC 1121125. PMID 11546691.
  45. "Johns Hopkins Hospital Faces Backlash for Suing Low-Income Patients". WAMU. Retrieved 2023-04-26.
  46. "Johns Hopkins Univ. Faces $1 Billion Lawsuit Over STD Study". www.cbsnews.com. April 2015. Retrieved 2023-04-26.
  47. Kolata, Gina (2001-07-17). "Johns Hopkins Admits Fault in Fatal Experiment". The New York Times. ISSN 0362-4331. Retrieved 2023-04-26.

Further reading

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