This short history of one of the great medical centers in the United States, the NewYork-Presbyterian Hospital / Weill Cornell Medical Center, also documents the important contributions of its Department of Radiology.
The New York Hospital is the second oldest hospital in the United States and was created by a royal charter from King George III in 1771. Its opening, however, was delayed for 20 years because of the Revolutionary War. During the British occupation of New York City, the newly finished hospital building was converted into barracks for the British soldiers.
After the occupation, the building was converted back to its original purpose, providing New York with its first hospital. Samuel Bard, a famous physician of the era, was appointed the first attending physician at The New York Hospital. In June 1789, Dr. Bard operated on George Washington, who had been President for only 1 month. The operation was performed in the executive mansion, then located in New York City. A large carbuncle in the left thigh, which Dr. Bard thought was a symptom of anthrax, was excised, but an uncomplicated recovery made this diagnosis dubious. By the early part of the 19th century, the Old Hospital, as it was then called, was no longer adequate and was demolished.
The second New York Hospital was located between 15th Street and 16th Street, west of Fifth Avenue. Over the entrance, there was a stained glass medallion measuring 2.5 ft (76.2 cm) in diameter, which represented the seal of the hospital, the Good Samaritan and his motto: "Go and Do Thou Likewise." In The Benevolent and Necessary Institution (1), Eric Larrabee states: "Among American surgeons of the first half of the 19th Century one of the most distinguished and by far the most famous to operate in The New York Hospital was Dr. Valentine Mott, a pioneer in vascular surgery."
Cornell University Medical College was established in 1898 and was located on First Avenue between 27th Street and 28th Street. The original building was designed by the famous architect Sanford White. In l908, Cornell University Medical College made a daring innovation by requiring a 4-year college degree for admission (1), becoming the first medical school to establish what would become a universally accepted pre-admission requirement.
In 1927, The New York Hospital and Cornell University Medical College joined to become The New York Hospital-Cornell Medical Center and moved to the present location along the East River, between 68th Street and 70th Street. The architectural design of the hospital, particularly the Gothic arches forming the facades, was inspired by the Pope's Palace in Avignon, France. The architect, Henry R. Shapley, was awarded the gold medal of the Architectural League of New York.
Over time affiliations with neighboring world class institutions were begun including Memorial Hospital, Memorial Sloan Kettering Cancer Center, and The Hospital for Special Surgery. A distinguished institution with which The New York Hospital-Cornell Medical Center has a combined MD-PhD program is The Rockefeller University. This large and complex medical community extends north to south along the East River from 63rd Street to 72nd Street and west to First Avenue.
Among the distinguished faculty in the formative years of The New York Hospital-Cornell Medical Center was Lewis Gregory Cole (1874-1954), professor of radiology. Dr. Cole was one of the pioneers in this new specialty. He was a brilliant clinical radiologist, an accomplished teacher, and an innovator in equipment design. Although Dr. Cole had a broad range of clinical interests, his major contributions were in gastrointestinal radiology (2), a field in which he made many important and original observations. The quality of his work was universally recognized, and he was published in Acta Radiologica and other prestigious foreign journals. His most provocative and controversial article was entitled "The Pathological Yardstick" (3). In this article, he presented to a group of world-renowned pathologists microscopic sections of organic gastric lesions and asked the pathologists to answer the following questions.
The diversity of the answers was surprising. For example, for about one-fourth of the gastric lesions, there was a difference of opinion among the pathologists as to whether a lesion was malignant and an even greater difference of opinion as to type of neoplasm. The published findings drew considerable criticism and some ill-will from the pathologists. However, the article represents one of the first studies of observer performance in medicine.
In 1932, John Russell Carty was appointed chairman of radiology. Dr. Carty's father was General John J. Carty, a celebrated inventor and electrical engineer credited with perfecting long-distance telephone operation. Dr. Carty was a regular participant in the meetings of the New York Roentgen Society and was a frequent contributor to the radiologic literature. He was particularly interested in soft-tissue radiography and wrote a number of articles on this subject. Dr. Carty was forced to resign in 1943 because of poor health and died shortly thereafter at an early age. Harold L. Temple was appointed acting radiologist-in-chief in June 1943 and radiologist-in-chief in July 1946. He resigned in September 1948 to enter private practice.
Robert P. Ball, who had been an associate of Ross Golden at Columbia Presbyterian Medical Center, held the position of radiologist-in-chief and professor of radiology from 1948 to 1951. Sydney Weintraub, who had been in charge of gastrointestinal radiology, served as acting radiologist-in-chief from March 15, 1951, to December 31, 1951.
In 1952, John A. Evans was appointed radiologist-in-chief, professor of radiology, and chairman of radiology, positions he held until his retirement in1976. In these two decades, the department of radiology expanded and differentiated, and its academic programs were strengthened. Dr. Evans was a strong advocate of separating radiology into diagnosis and therapy and, during his tenure on the American Board of Radiology, Dr. Evans was instrumental in implementing this separation. This issue provoked considerable controversy in the field of radiology and at times much emotional discussion. However, the decision proved to be the right one. Dr. Evans delivered the annual oration of the Radiological Society of North America (RSNA) in 1963 (4). He was also the recipient of the RSNA's Gold Medal, the society's highest honor, in 1967. He served as president of the American Board of Radiology from 1967 to 1969 and was chairman of the committee that organized the board's first written examination. Dr. Evans was a chancellor of the American College of Radiology from 1958 to 1962 and was a recipient of its Gold Medal in 1985. A significant part of Dr. Evans' time also was spent in postgraduate education.
It is during this period that the Robb-Steinberg method of visualizing the four chambers of the heart, the aorta, and the major pulmonary vessels (5) was developed; this remarkable achievement ranks with the major medical accomplishments of the 20th century. During the 1950s, Israel Steinberg and Charles Dotter gained wide recognition and fame for their work in angiocardiography. Their studies of congenital and acquired heart diseases (6) contributed to the successful surgical treatment of these diseases. They aggressively and successfully applied this technique to many medical and surgical diagnostic problems. Their studies had a major impact on the management of heart disease, aneurysms, lung, mediastinal and abdominal tumors, vascular anomalies, and vascular degenerative disease. Their busy angiographic suite in the department of radiology hosted visitors from radiology departments all over the world, a situation that added to its frenetic atmosphere. Dr. Dotter left in 1953 to become chairman of radiology at the University of Oregon. While there, Dr. Dotter continued to bring enthusiasm, brilliance, and innovation to vascular radiology. Dr. Steinberg, although an internist by training, spent his professional career performing angiocardiography in the The New York Hospital's department of radiology. Drs. Dotter and Steinberg will take their place among the great names of radiology.
After the Dotter-Steinberg era, important clinical, teaching and research contributions in radiology were made by Harry Stein, Richard J. Fleming, Harold Baltaxe, Robin Watson, and Thomas A. Sos.
In 1957, Robert Freiberger was appointed director of radiology at The Hospital for Special Surgery, professor of radiology at Cornell University Medical College and attending radiologist at The New York Hospital. Dr. Freiberger and his associates were influential in popularizing arthrography as an important diagnostic tool through publications and postgraduate courses with live demonstrations of the technique. Their contributions to the field of orthopedic and rheumatic diseases helped define musculoskeletal radiology as a distinct subspecialty. Dr. Freiberger resigned as director of radiology at The Hospital for Special Surgery in 1988 and retired in 1997.
In 1957, David Baker initiated a pediatric radiology service at The New York Hospital after completing both pediatric and radiology residencies. However, after only 1 year, he left to replace the distinguished pediatric radiologist John Caffey as director of radiology at Babies' Hospital, Columbia Presbyterian Medical Center. Before 1957, Dr. Caffey had been a consulant and visiting professor in the department of radiology at The New York Hospital. His weekly conferences undoubtedly influenced Dr. Baker in his decision to become a pediatric radiologist. Dr. Baker's appointment as Dr. Caffey's successor was also probably influenced by Dr. Caffey's opinion that a pediatric radiologist should have received training in pediatrics.
In the 1960s, the department of radiology was involved in the development and introduction of a number of new radiographic and interventional diagnostic techniques; these included nephrotomography for the differential diagnosis of renal masses, percutaneous splenoportography for use in patients with portal hypertension, percutaneous transhepatic cholangiography for the diagnosis of obstructive bile duct disease, percutaneous lung biopsy (a technique that, although used extensively in Sweden, was not being used in the United States), and the Seldinger technique of percutaneous transfemoral arteriography.
In 1967, D. Gordon Potts was appointed professor of radiology and chief of the section of neuroradiology. Dr. Potts quickly established strong clinical, teaching, and research programs. His fellowship program was highly regarded, and many of his former fellows are now in charge of academic neuroradiology programs. Dr. Potts implemented a well-funded research program whose major emphasis was the study of the basic anatomic and physiologic mechanisms involved in the production and absorption of cerebral spinal fluid. In support of such studies, Dr. Potts obtained an electron microscope, the first of its kind to be used in the hospital. His publications have been substantial, and his five-volume text on neuroradiology, coedited by Hans Newton (7), was considered the definitive work in this field. Dr. Potts left The New York Hospital-Cornell Medical Center in March 1985 to accept the chairmanship of radiology at the University of Toronto.
Elias Kazam, professor of radiology, organized the section of ultrasound in 1967 and later organized sections of body CT and MR imaging. Dr. Kazam's early cross-sectional CT and MR imaging studies are classical clinical contributions. His clinical work and writings are distinguished by their high quality. Dr. Kazam resigned from the faculty in October 2001 to enter private practice. He is now Professor Emeritus of Radiology at Weill Cornell Medical College.
Morton A. Meyers was in charge of gastrointest.inal radiology from 1970 to 1978. His clinical skills resulted in several important anatomic and physiologic radiologic observations for several gastrointestinal disorders. His monograph entitled "Dynamic Radiology of the Abdomen: Normal and Pathologic Anatomy" (8) is a popular reference source for medical students and radiology residents. In 1978, Dr. Meyers became chairman of radiology at the State University of New York at Stony Brook.
On July 1, 1976, Joseph P. Whalen was appointed radiologist-in-chief and chairman of radiology and continued in these capacities for the next 16 years. During Dr. Whalen's tenure and under his guidance and planning, new space was acquired in the C.V. Starr Building, permitting more centralization of diagnostic radiology facilities. In addition, all sections of the department of radiology were given new equipment. Additional staff, resident, and fellowship positions were added; these additions strengthened the clinical, teaching, and research programs. In the 1980's the department became the first MRI demonstration site in New York. It is generally recognized that Dr. Whalen's cross-sectional anatomic-radiologic correlations laid the basis for the interpretation of CT scans and MR images. He gave the New Horizons Lecture at the annual meeting of the Radiological Society of North America in 1972 and the Caldwell Lecture at the annual meeting of the American Roentgen Ray Society in 1979. In 1989, the State University of New York Health Science Center, Syracuse, awarded him the honorary degree of doctor of science.
H. Dirk Sostman was appointed radiologist-in-chief and chairman of radiology on July 1, 1995, positions he held until August 2005. During this decade, many changes occurred in the medical center and in the department of radiology.
In the summer of 1996, The New York Hospital announced its intention to merge with the renowned Presbyterian Hospital in the City of New York to form a single corporation, the NewYork-Presbyterian Hospital and this merger was completed on the last day of 1997. This exciting initiative created one of the most distinguished academic health centers and one of the largest not-for-profit health care networks in the United States. The New York Hospital opened an entirely new patient bed tower in mid-1997. Rising above the FDR Drive / East River Drive, the Greenberg Pavillion houses all patient beds and inpatient operating rooms; it is part of the commitment by The New York Hospital to remain at the forefront of health care delivery into the twenty-first century. The department of radiology again acquired new and more functionally organized clinical space, and completely renewed its equipment, with new MRI, CT, PET, Ultrasound, etc.
Many outstanding new clinical and research faculty were added to the radiology department staff. In addition, new initiatives in information technology and clinical organization were implemented. NewYork-Presbyterian/Weill Cornell Radiology was an early adaptor of the film-less revolution and, in 1995, was one of the first Hospitals in the country to install a PACS (Picture Archiving and Communications System).
The Department and the Medical College made significant investments in imaging research with the July 2002 opening of the new Citigroup Biomedical Imaging Center (CBIC) with a 3.0 T high-field MRI/MRS, a Discovery LS PET/CT, NMR, and a cyclotron. The Department greatly expanded its women's imaging and CT capacity with the March 2001 opening of Cornell Medical Imaging at 61st Street and York Avenue. Dr. Sostman led the Medical College's strategic planning for its new Ambulatory Care Building. This state-of-the-art and modern thirteen story, 300,000 Square Feet building, the Weill Greenberg Center (WGC), located on the south-west corner of 70th Street and York Avenue opened in early 2007 and signifcantly expanded the Medical College's clinical footprint. Radiology's outpatient imaging practice is located on the third floor of the new Weill Greenberg Center and its opening greatly expanded the department's capacity to provide comprehensive imaging services (CT, MRI, PET/CT, Ultrasound and X-ray) in a modern and beautiful setting with state-of-the-art equipment.
During his tenure as chairman, Dr. Sostman also served the Medical College and the Hospital as Senior Associate Dean for Clinical Affairs (2001-2005), Executive Vice Dean (2003-2005), President of the NYPH Medical Board (2004-2005), and as a Trustee of NYPH (2003-2005). In June 2001, Dr. Sostman was elected President of the Association of University Radiologists (AUR); he is a founding member of the Society for Cardiovascular Magnetic Resonance and the Society of Thoracic Radiology. He was a member of the New York State Board for Medicine. His scientific advisory panels have included the Radiology and Nuclear Medicine Study Section of the National Institutes of Health, the Diagnostic Imaging Special Emphasis Panel (Chair) of the NIH, and the NIH Commission of the Academy of Radiology Research.
In 2005 Dr. Sostman stepped down to assume leadership roles, as Chief Academic Officer and Executive Vice President, at The Methodist Hospital System in Houston which had recently become an affiliate of the Medical College. Dr. Sostman retired in August 2012 and is now Professor Emeritus of Radiology at Weill Cornell Medical College.
Robert J. Min was appointed interim chairman of radiology at Weill Cornell Medicine and interim radiologist-in-chief at New York-Presbyterian Hospital/Weill Cornell on August 1, 2005 after serving as vice chairman of radiology. Dr. Min was named chairman of radiology and radiologist-in-chief on April 1, 2008. Dr. Min is a leader in the development of minimally invasive techniques to treat varicose veins, including transcatheter duplex-guided sclerotherapy and endovenous laser. Dr. Min has served in several leadership roles including president of the American College of Phlebology, vice president of the American Board of Venous and Lymphatic Medicine, president of the New York Roentgen Society, secretary of the New York State Roentgen Society, president of the NewYork-Presbyterian Medical Board, executive committee of the Weill Cornell Physician Organization, and editor-in-chief of Clinical Imaging.
During his tenure, the department has undergone unprecedented growth including a doubling of the number of clinical faculty and dramatic expansion of the clinical programs. In order to provide patients and referring physicians with unmatched customer service combined with the expertise of academic radiologists, Dr. Min launched Weill Cornell Imaging at NewYork Presbyterian, in January 2008, as a joint venture between The NewYork-Presbyterian Hospital and Weill Cornell Medicine. Weill Cornell Imaging at NYP continues to fluorish with its fifth outpatient imaging center opening in January 2013 on the upper west side (84th and Broadway).
The department of radiology has become a leader in providing not only the highest quality but also the safest care to patients becoming nationally known in areas such as radiation dose monitoring. Health care reform has also necessitated a focus on value. The department of radiology has made providing the highest value to our patients, referring physicians, and the healthcare system a priority by starting initiatives such as automated decision support and a radiology consultation service.
In addition to fostering clinical growth, Dr. Min has focused on the expansion of radiology research programs with the recruitment of outstanding scientists. Significant investments have been made in research laboratories, space, equipment, and seeding of junior faculty and investigators. The Molecular Imaging Innovations Institute (MI3) and the Dalio Institute of Cardiovascular Imaging (Dailo ICI), both interdisciplinary programs based in the department of radiology, were launched in July 2013.
The future chapters of this illustrious department of radiology are yet to be recorded, but it is clear that they will depend upon the efforts and creativity of the many dedicated faculty, trainees and staff who have succeeded their distinguished predecessors.