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A History of the Division of Pulmonary and Critical Care Medicine of Jefferson Medical College of Thomas Jefferson University

In 1913 the Department of the Diseases of the Chest was established at 236-38 Pine Street with Elmer H. Funk (JMC 1908) as Medical Director.  The facility, identified as  “Little Jeff” was organized as a hospital with medical, nursing and social service personnel to provide care for patients with active tuberculosis. A major mandate was to provide teaching in physical and clinical diagnosis as well as the management and treatment of tuberculosis.  This institution reflected the activities of Lawrence F. Flick (JMC 1879)  who founded in 1892 the 1st State Society for Prevention of Tuberculosis. In 1895, the Free Hospital for Poor Consumptives, in 1901 the White Haven Sanatorium, and in 1903 the Henry Phipps Institute came into being. Dr. Flick was described as the “White Knight fighting the White Plague”  by his colleagues and was an early proponent of the contagiousness of tuberculosis.

In 1927 Burgess L. Gordon (JMC 1919) was appointed to the Directorship of the Department of the Diseases of the Chest and was succeeded in 1951 by Martin J. Sokoloff (JMC 1920) who concurrently was an Attending Physician at White Haven Sanatorium and the Chief of the Division of Tuberculosis Control of the Philadelphia Department of Health.

In 1946, White Haven Sanatorium merged with Jefferson Medical College while concurrently the Barton Memorial Division of Jefferson Medical College Hospital opened at Broad and Fitzwater Streets for the treatment of tuberculosis. In 1956, the Department of the Diseases of the Chest became the Barton Memorial Division of the Department of Medicine.

The Anthracite Health and Welfare Funded a pulmonary physiology laboratory under the directorship of Hurley L. Motley M.D. The effects of bronchodilator aerosol therapy on “Miner’s Asthma” was an early example of clinical investigation. In 1953, Richard T. Cathcart M.D. became the Director of the Pulmonary Physiology Laboratory and in 1962 succeeded Dr. Michael J. Sokoloff as the Director of the Barton Division of Diseases of the Chest

G. William Atkinson (’70 PG) became the director of the Pulmonary Laboratory in 1970 and Director of the Barton  Division in 1974. During his tenure a Respiratory Intensive Care Unit was established in 1977.  James Wilson became the Chief of the Barton Memorial Division in 1983 but his tenure was shortened by his sudden demise. Subsequently, the Division was directed by acting co-chiefs, J. Denise Moylan (PGA ’78) and Edward Schulman (JMC ’75) from 1983-85.

In 1985, James E. Fish M.D. became the Chief of the Division of Pulmonary and Critical Care Medicine. During his directorship there was a major expansion of the training program with an increased number of fellowship positions and the development of numerous basic research protocols. This was period wherein the division became recognized for asthma translational research, Asthma Clinical Research Networks, and extramural NIH-level funded laboratories. The successful group included Drs. Fish, Stephen Peters, Shaver, Ray Penn, Zangrilli and others who conducted investigational bronchoscopy research studies in patients with asthma.  Dr. Fish departed Jefferson in 2002 (after a brief period where he was the acting chair of the department of medicine).  Stephen Peters M.D. served briefly as Acting Director 2002-03 and Frank T. Leone M.D (PGA’97). 2003-05.  The “old guard” of the Fish era all departed largely to go to Wake Forest.   In 2005,  Paul E Marik M.D. was recruited from Univ of Pittsburgh by the new chair of medicine Art Feldman to largely develop medical critical care at TJUH.  He, as an intensivist with a prolific CV was the Director of the Division of Pulmonary and Critical Care Medicine until 2008.  Gregory C. Kane M.D. (JMC’90), a highly respected clinician educator (director of the residency program for over 15 years)  assumed the position of Acting Director until the appointment of  Dr. Mani Kavuru in 2010.  Dr. Kavuru joined Jefferson in September 2010, after a tenure as division director for 4 years at East Carolina University in NC.  Dr. Kavuru is a clinician scientist who trained at the Cleveland Clinic and was on faculty there for 14 years (1991-2005).  He established a reputation in several lung disorders including asthma, sarcoidosis, and pulmonary alveolar proteinosis.  He has an extensive track record of grant funding, clinical trials, and publications.

The position of directorship of the Division of Pulmonary and Critical Care Medicine reflects the evolution of the subspecialty of pulmonary medicine from the treatment of tuberculosis described as “phthisiology” to the current broad-based specialty that encompasses pulmonary physiology, critical care medicine, interventional & procedural medicine, immunology and the diagnosis and management of allergy & sleep disorders. During the initial 50 years,  the focus was not only the management of tuberculosis but also the public health aspects and of control of this disease. During the post World War II period, there was an increased interest in occupational respiratory disorders, asbestosis and anthraco-silicosis, emphysema and lung cancer. Concurrently, the development of spirometry and arterial blood gas analysis in the pulmonary physiology laboratory led to increased applications. Invasive diagnostic procedures, including flexible fiberoptic bronchoscopy, percutaneous needle aspiration of the pleura and lung biopsy were incorporated in the practice of pulmonary medicine. This was rapidly followed by the development of acute and chronic ventilatory support and respiratory care units that progressed to the identification of critical care medicine as an integral component of pulmonary practice Today,  both clinical and basic science investigations have led to new management techniques and previously undiagnosed respiratory disorders.