- Genealogy of the California Pacific Medical Center and its Department of Opthalmology
- Chairs of the Department of Ophthalmology at California Pacific and its Ancestral Organizations
by William H. Spencer, M.D., Emeritus Director, Ocular Pathology
Forty-seven years have passed since Dr. Hans Barkan published his well-researched and lively historical sketch of the Cooper Medical College. It draws fine portraits of physicians who laid the foundations of medical education in San Francisco and is especially valuable for anyone interested in the early history of the Departments of Ophthalmology at the California Pacific Medical Center and Stanford University Medical School. His interwoven personal recollections say much about his strength of character and scholarly bent.
My intent is to update Dr. Barkan's chronicle with respect to organizational changes at California Pacific and its eye department after Stanford University Medical School moved to Palo Alto in 1959. (see Genealogy) I also acknowledge the seminal role played by Dr. Elias Samuel Cooper, an early eye, ear and general surgeon who inaugurated Dr. Cooper's Eye, Ear, and Orthopaedic Infirmary in 1855 and was the prime mover in establishing the Medical Department of the University of the Pacific in 1859, the first medical school in the Far West and the forerunner of California Pacific and Stanford medical school.
The San Francisco Scene in the 1850's | San Francisco Ophthalmic Practice in the 1850's | Affiliation with Stanford University | The Lions Eye Foundation | Renaissance of the Medical Center | References
The San Francisco Scene in the 1850's
Since California Pacific's heritage goes back to the decade after the gold rush began in 1849, it seems appropriate to set the stage with respect to the remarkably brisk growth and general ambience of San Francisco at the time. There were only 165,000 people in California in 1848 and no more than 15,000 of them were of European descent (half were Spanish-speaking former Mexican citizens who called themselves Californios. Ten years later, California's rapidly expanding population was recorded at 380,000, and that of San Francisco 56,800. Many of its new citizens arrived by sailing from the East Coast to Panama, where they traversed the isthmus and then sailed north to San Francisco. Others sailed around the horn or came overland. An entrepreneurial spirit prevailed and continued for some time. As late as the 1870's - almost a quarter century after the onset of the gold rush - the city was described as "... still a rough and tough community, a seaport of which the Barbary Coast was known the world over, the Mother Lode days and Sutter's Fort not far in the past, and the duel between Terry and Broderick fought only a few years previously. No symphony or art gallery existed; no museum of natural science, but two medical schools." It is rather remarkable that these schools - the predecessors of Stanford and the University of California medical schools as well as the California Pacific Medical Center - had already been formed in 1859 and 1864 respectively.
Absence of Medical Regulation
The medical environment in which these schools were formed was unregulated and chaotic. Henry Harris commented that San Francisco in the 1850's had - "a plethora of doctors and near doctors, as variegated in quality as Jacob's coat was in colors, [who] glutted the market with their offerings. Within their broken ranks/migration verging on vagrancy, desperate charlatanism and economic strangulation prevailed".
Anyone could practice medicine in California without a license until 1876. The medical profession was not recognized legally by the State before this date and it was common for medical practitioners to advertise (and exaggerate) their medical skills in the newspapers. After 1876, medical licensing was done by the State Medical Society until 1901 when a State Board of Medical Examiners was finally created.
Unenlightened Medical Practices/Inadequate Instrumentation and Anesthesia
The therapeutic armamentarium in the 1850's was quite limited and the importance of antisepsis was not generally recognized. Lister's first paper on antisepsis would not be published until 1867 and surgeons routinely performed operations without masks while wearing street clothes. Cellular pathology had just been described by Virchow, and bacteriology would not have its practical beginnings until 1880 when solid culture media was announced to the world by Robert Koch.
Like their brethren elsewhere, early San Francisco eye doctors were handicapped by the lack of proper instruments and had limited understanding of diseases affecting the posterior portion of the eye. Helmholtz had invented the ophthalmoscope in late 1850, but it did not arrive in the United States until May, 1855 when Dr. Elkanah Williams of Cincinnati, Ohio brought one with him on his return from a European study trip and stressed its potential importance. It did not come into general use for several more years, and only a few who did possess an ophthalmoscope were sufficiently trained to use it properly or understand the implications of the changes they saw. It is unlikely that pioneering San Francisco oculists were aware of Von Graefe's 1855 observation of optic disc cupping in glaucomatous eyes, or his 1857 report of the curative effects of iridectomy in some glaucoma patients. The measurement of refractive errors would not be placed on a scientific footing until Donders published his treatise on anomalies of refraction and accommodation in 1864.
The slit-lamp would not be developed until the 1920's, and external eye problems encountered by early San Francisco oculists had to be examined by direct inspection or with the aid of a loupe using available illumination. Daylight was preferred over the dim illumination provided by candles or gas light. Although Thomas Edison had invented the incandescent lamp in 1879, San Francisco would not have a central lighting system until the late 1890's. The need for adequate lighting during surgery may have influenced Dr. Lane and the architects who designed the Lane hospital (which opened in 1895) to install glass enclosed bay windows in its operating rooms.
The reliance on flammable sources of indoor lighting also influenced the choice of general anesthesia. Ether had first been used as a general anesthetic in the 1840's, but its use was limited to large well-ventilated spaces because of its combustibility. Many early San Francisco physicians preferred to use chloroform (introduced in 1851); it was non-flammable and had a more rapid action than ether. Adequate local ocular anesthesia would not be available until Carl Koller discovered the topical anesthetic properties of cocaine in 1884 and described its subconjunctival use in ophthalmic surgery in 1892.
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San Francisco Ophthalmic Practice in the 1850's
Economics and Competition
San Francisco has long had a reputation for being an attractive and expensive place to live and practice medicine. It was already so in the 1850's. Early San Francisco doctors had ample competition from others and new members encountered opposition from those who had arrived even earlier. Lane commented on the situation in 1855 - "... those who first came founded - on the mere fact of prior arrival and earlier residence - a claim to precedence almost equal to superior caste and prerogative; whence sprung a feeling which viewed with cold distrust, if not positive enmity, any attempt to enter the self-privileged ranks"
The expense of running a medical practice was quite high. The private papers of Dr. Enoch Pardee, who began practice as an oculist in San Francisco in February 1853, are illuminating in this regard. At the end of his first year of practice he wrote to his fiancée Mary in Ohio stating he had treated 1065 patients and received $5320 in gross income. He went on to say: "My expenses have been very large [and] perhaps seem almost incredible to you in that part of the continent. They are little rising of $3000 for the past year - a very good little fortune in some parts of the world. At times my expenses have exceeded $600 per month. You may ask what it was that caused my expenses to run so high - my principal accounts were for advertising, office rent and board." - Dr. Pardee wanted to go east to visit Mary, but noted "...it would be a great sacrifice for me to leave the country. Men are constantly trying to work into my practice and obtain a reputation as an oculist, which would give them a chance by [my] being absent for a few months. I will send you the cards of 2 or 3 who are now making great pretensions to the treatment of the eye - but get very little if any practice. Therefore, you see the opportunity they would have if I should leave the city. I now stand at the head of the profession on the Pacific Coast and it is the height of my ambition to remain there - which I feel confident of doing by a steady and persevering application of my time. My friends all tell me that I have the best prospect of any man in California. One thing, I am positive that I give general satisfaction to all of my patients ... and that I am doing better in a pecuniary point of view then what I ever was before." Indeed, Dr. Pardee did do well in California, perhaps to a greater degree as a politician than as an oculist. He later became Mayor of Oakland, and his son George Cooper Pardee - also an ophthalmologist - became Governor of California (1902-1908).
Elias Samuel Cooper. M.D.
Let me now turn to the colorful medical career of Dr. Elias Samuel Cooper who was 33 years old when he arrived in San Francisco in 1855, 37 when he founded the first medical school in the Far West in 1859, and 40 when he died in 1862. Born, in Butler County, Ohio in 1822, Cooper began his medical studies at age 16 under the tutelage of his older brother Esaias; he subsequently pursued formal college training in Cincinnati, and received his M.D. from the University of St. Louis in 1841 at age 19.
Cooper initially practiced in Danville, Ohio, where he gained recognition as a highly competent surgeon, said to be particularly adept in the eye operations of that period and in the rectification of clubfoot. He was fascinated by surgery and was reputed to have "allowed no day to pass without using his scalpel". He also had a passion for studying anatomy and was accused by Danville officials of being a grave-digger in order to obtain tissues for study. He was prosecuted, but was honorably acquitted. Nevertheless, he left town as a result of adverse publicity. In 1844 he set up a new practice in Peoria, Illinois, where he successfully established a surgical infirmary "for the treatment of the eyes, ears, and club feet".
A decade later (1854), Cooper's health began to fail and he developed a facial paralysis, apparently of central origin, which he disguised by growing a beard. He left Peoria and traveled to Europe where he visited leading general and eye surgeons in London and Paris. Upon his return to America in 1855, he set up Cooper's Eye, Ear, and Orthopaedic Infirmary in San Francisco. Cooper claimed to specialize in treatment of the blind, the deaf and the lame, but he did not limit his practice to treatment of these problems. He is also credited with removing goiters and parotid tumors, as well as performing successful thoracotomies and hernia repairs.
Cooper also had the dubious distinction of being the defendant in the first malpractice suit in California history. He had performed the first successful caesarean delivery in the west, but the child was still-born. The patient was urged to sue by Cooper's disgruntled surgical assistant (Dr. David Wooster) who felt he should have received equal credit for the success of the surgery. The jury could not come to a verdict, and the case was dropped. Thereafter, Wooster remained a bitter enemy of Cooper and castigated him in print whenever he could.
Cooper's short seven-year tenure in San Francisco was marked by impressive productivity, but he apparently had a somewhat exasperating personality. As Barkan noted, "...he was disliked; he was not trusted and many of his characteristics and doings offended men who later became violently opposed to him in every respect. But there was no denying his great ability and tremendous working power." Henry Harris also described Cooper as difficult, but acknowledged his exceptional capabilities. He described Cooper as "... a scheming, busy, ambition-tortured man sufficient of audacity and creativeness to mark him as superior. And while no one described him as prepossessing, yet he succeeded through an ability approaching greatness in holding the loyalties of Rowell and Cole and, in a lesser way, winning the regard of his fellow Quaker, the unimpeachable Gibbons".
The negative aspects of Cooper's personality and his lack of charm may have been somewhat overstated by Barkan and Harris, since much of their information was based upon scathing editorials written by Wooster in his own publication the Pacific Medical and Surgical Journal. The following (unpunctuated) letter from Cooper to Enoch Pardee, in which Cooper proposes a possible partnership arrangement, provides a somewhat softer version of Cooper's relations with his colleagues. It also says much about Cooper's fondness for surgery. In many ways the letter could have been written by a current San Francisco ophthalmologist.
San Francisco June 3/57
Dr E H Pardee
Yours of 26th came duly to hand and should have been answered sooner but for excess in engagements growing out of my preparing papers for our Medical Society
My knowledge of your method of treating the eyes is derived solely from results and as a candid man I have always been disposed to accord you success relying on the reports of patients who have been with you and others
I have little taste for treating long standing eye cases and should my surgical sphere become sufficiently extensive to occupy my time otherwise I would abandon ophthalmic medicine almost entirely and as I always please patients best in the departments of practice most suited my last it will not I think be very difficult to get rid of my chronic eye patients at any time
So far as I know patients who have become dissatisfied with my treatment almost invariably apply to you
As you doubtless have an opportunity of seeing many cases of cataract strabismus and other afflictions of the eye requiring surgical treatment which I believe you have not much taste for attending to might it not be profitable to us both to share the fees equally which I would willingly do You secure the cases and I operate on them
Please call at 1 or 1 1/4 o'clock PM any day and we can talk over the matter I should be pleased to see you and at that hour I am usually at home and disengaged
E. S. Cooper
Cooper and Pardee did not become partners, but they seem to have had respect for each other. An unconfirmed report in Enoch Pardee's archives suggests that Pardee's son, George Cooper Pardee, who was born one month after the above letter was written, was delivered by - and named for - Cooper.
The Medical Department of the University of the Pacific
In addition to his private practice, Cooper was one of the prime organizers of the California State Medical Society. From the perspective of California Pacific Medical Center and Stanford, his most important achievement was founding the Medical Department of the University of the Pacific (chartered by the University of the Pacific - a Methodist Episcopalian college founded in 1851 and located at the time in Santa Clara. It is now in Stockton). The school's faculty consisted of six physicians and a professor of medical jurisprudence. Medical students worked in Cooper's office, which was renamed The Pacific Clinical Infirmary. Cooper also started The San Francisco Medical Press as the official publication of the school (1862).
Levi Cooper Lane, M.D.
During the school's first year (1859) Levi Cooper Lane (Elias Cooper's nephew) sailed into San Francisco Bay as a naval surgeon aboard the sloop of war Decatur. Lane was a true scholar and by every account a bright, competent, and well respected physician. Cooper invited Lane to join his medical practice and also offered him a faculty position in the Medical Department of the University of the Pacific as professor of physiology. Lane agreed to accept these offers, but was already committed to spend the next year (1860) studying abroad at Goettingen and Paris. Lane honored his promise in 1861 when he returned to San Francisco to work in Cooper's busy office, teach medical students, edit the San Francisco Medical Press, and write medical papers. Cooper's health was quite poor by this time. He could no longer lecture and was plagued by increasing visual loss and deafness.
After Cooper's death in October, 1862, Lane helped maintain the school and faculty. It was difficult to meet expenses owing, in part, to the financial slump of the early 1860's brought about by the Civil War. In 1864, six years after its inauguration, the school suspended operations; it had graduated 28 students in this interval including Henry Gibbons Jr., the future dean of the reorganized Medical Department of the University of the Pacific.
The Toland Medical College, the Reorganized Medical College of the Pacific, and the Cooper Medical College
In 1864, Dr. Hugh H. Toland, a successful surgeon, founded the Toland Medical College at Stockton and Chestnut streets. The faculty included three from the recently suspended Medical Department of the University of the Pacific (including Lane). The Pacific group was uneasy in this setting and never felt they really belonged. Consequently, they seceded from Toland's faculty in 1870 and reestablished the Medical College of the Pacific as the Medical Department of the University (City) College. Toland's school was later deeded to the University of California (March, 1873) and became the forerunner of the University of California Medical School in San Francisco - now UCSF.
The reorganized Medical College of the University of the Pacific prospered, as did Lane. In 1882 he donated a new personally funded building for the school at Sacramento and Webster Streets and changed the school's name to Cooper Medical School in honor of Elias Cooper. Lane also funded an addition to the building in 1892. In 1895 Lane Hospital was opened.
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Affiliation with Stanford University
By 1900 Lane and his faculty recognized that mounting expenses necessary to maintain a first rate medical school would require a merger of Cooper Medical College with a local university. After Lane died on February 18, 1902, negotiations with Stanford University began and on January 13, 1908, Stanford University accepted Cooper Medical College as its Department of Medicine. Complete control did not pass from the directors of Cooper Medical College to the Trustees of Stanford University until 1912 when the last Cooper student graduated.
Origins and Growth of the Departments of Ophthalmology at California Pacific Medical Center and Stanford
Despite Elias Cooper's interest in treating diseases of the eye and ear, the original 1859 faculty of the Medical Department of the University of the Pacific did not include a professor of ophthalmology and otology (Cooper was designated Professor of Anatomy and Surgery). When the reorganized Medical College of the Pacific (City) College was formed in 1870, Levi Cooper Lane assumed the acting professorship of ophthalmology and otolaryngology. Lane recognized the interim nature of the appointment, and was undoubtedly pleased when Dr. Adolph Barkan accepted appointment as the first professor of ophthalmology and otolaryngology in the Far West in 1872. Dr. Barkan was a native of Eperies, Hungary (near Budapest) who had received a classical European general and medical education at the universities of Vienna and Zurich (where he studied under Billroth). He immigrated to San Francisco in 1869 and soon established a thriving practice as a specialist in diseases of the eye, ear, nose, and throat. He was the first in San Francisco to remove intraocular foreign bodies with the aid of a magnet, and was also one of the first to perform mastoid operations. Dr. Barkan was a fine teacher and accounted to be an excellent lecturer. He soon became a mainstay of the faculty of the Medical College of the Pacific as well as the Cooper Medical College where he founded the Barkan Library of the History of Medicine and served as the last president of the college. In 1908 he was one of the first professors to be appointed by Stanford University Medical School. Dr. Barkan retired from active practice in 1910; when he also retired from teaching in 1912, he had served Stanford and its precedent institutions for 40 years.
The Residency Training Program
The precise origins of ophthalmology training at Cooper Medical College and Stanford Medical School are unrecorded. It was, apparently, started in an informal fashion by Dr. Adolph Barkan. Dr. Hans Barkan commented that his father's teaching of ophthalmology had "... established a definite school of men trained as highly in this specialty as was possible in this country". Unfortunately, the names and dates of service of Adolph Barkan's trainees are not recorded.
Informal training of future ophthalmologists apparently waned during the early years of Dr. Adolph Barkan's successor as chairman, Dr. Albert McKee. However, shortly before McKee retired, Drs. Wilbur Swett and Frank Rodin jointly trained for two years (1924-1926). Their appointment likely reflects the influence and devotion to teaching of Dr. Hans Barkan, who had been a member of the Stanford faculty since 1915. Within a year of Hans Barkan's succession to the departmental chair in 1928, he formally established a residency training program of two years duration. The program's length was expanded to three years in 1945. It is interesting to note the early presence of woman residents during Dr. Barkan's departmental chairmanship.
During Stanford Medical School's 47-year tenure in San Francisco, Albert McKee, Hans Barkan, A. Edward Maumenee, Dohrmann Pischel and Jerome Bettman successively followed Adolph Barkan as department chairmen (see Department Chairs).
Effects of Stanford Medical School's move to Palo Alto upon the Department of Ophthalmology at California Pacific Medical Center
When Dr. Jerome Bettman assumed the eye department chair in 1958, Stanford medical school's move to Palo Alto was already well under way and the facility was transiently known as San Francisco Stanford (to distinguish it from Palo Alto Stanford). Within a year, all of its San Francisco buildings, remaining equipment, and land were legally transferred to a not-for-profit corporation sponsored by the Presbytery of San Francisco.
The medical school's move coincided with the initiation of a new national trend toward staffing American medical schools with employed full and/or part-time physicians. Consequently, relatively few members of the San Francisco based medical community moved to Palo Alto. Many who did not, including most of the former eye department faculty, had developed well-established medical practices in San Francisco, had long voluntarily participated in clinical teaching activities on a part-time basis, and had admitted most of their patients to the Stanford-Lane hospital. As a result, the San Francisco faculty had much clinical expertise to offer residents wishing to train in ophthalmology at the renamed Presbyterian Medical Center (PMC); they had also developed a loyalty to the existing facility. But, in order to maintain the quality of residency education, they were faced with the need to institute a basic science teaching program without the financial backing of a university endowment.
They were assisted in this regard by Dr. Michael Hogan, chairman of the department of ophthalmology at the University of California Medical School. An interim joint basic science lecture series was initiated with the university ophthalmology faculty. UC residents also shared a resident rotation with PMC residents at San Francisco General and the Southern Pacific Hospitals, and PMC eye pathology specimens were processed and evaluated gratis at UC by Drs. Michael Hogan and William Spencer. Within a few years, PMC's basic science program strengthened and these joint activities were no longer needed.
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The Lions Eye Foundation
A great boost occurred when Lions Joseph Giuffre, Leonardo S. Bacci, and A. Bud Mason met with Dr. Bettman in 1966-1967 to explore a mutual patient care relationship between the eye department and the Lions Eye Foundation for Children, Inc. (established in 1959). The organization's title was changed to the Lions Eye Foundation of California/Nevada, Inc. shortly after agreement was reached for the Lions to help provide support for the eye care of needy patients. Barbara Anger was appointed Director of Operations April 8, 1968 and served with grace and distinction for the next 27 years. When she retired on September 9, 1995, she was succeeded by Mark Paskvan, who now has the title Program Coordinator. Between 1970 and 1983, Maurice Perstein, the Executive Director of the Lions Eye Foundation, greatly expanded the number of participating Lions clubs. Since 1983, Don Stanaway has continued to oversee this very successful collaboration.
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Renaissance of the Medical Center
Between 1958 and 1966 the medical aspects of the newly renamed Presbyterian Medical Center (PMC) were coordinated by an executive committee composed of all department heads and chaired by Dr. Henry Gibbons IV. The committee sought affiliations with several organizations and solicited financial aid from a variety of sources. When Dr. Jerome Bettman retired in 1966, he was succeeded by Dr. Arthur Jampolsky who continued to assist the committee in these efforts.
The College of Physicians and Surgeons and the University of the Pacific in Stockton (UOP) had provided funds for building a new dental school building at the corner of Webster and Sacramento streets, and it appeared, for a while, that UOP would also fund a graduate school of medical sciences on this campus. Financial support to build a new Presbyterian Hospital had been acquired by a group spearheaded by Mr. Fred Merrill (then President of Fireman's Fund Insurance Company). He was ably assisted by Drs. Frank Gerbode, John Niebauer, David Rogers and Arthur Jampolsky as well as other physicians who helped plan the space and also establish the Institutes of Medical Science (now the Medical Research Institutes). The Smith-Kettlewell Institute of Visual Sciences (SKIVS), under the direction of Dr. Jampolsky, formed a major initial component of these research institutes. SKIVS has maintained a collaborative association with the Department of Ophthalmology since its inception.
In 1971 Dr. Jampolsky recruited Dr. Bruce Spivey (formerly at the Department of Ophthalmology of the University of Iowa) as eye department chair and dean of the proposed UOP school of medical sciences. The department flowered under Dr. Spivey's strong leadership. It's format combined part-time clinically experienced voluntary faculty with full-time teachers, basic scientists and researchers. Dr. Spivey also facilitated establishment of the Pacific Vision Foundation in 1977. This important step has since eventuated in the provision of on-going financial support for the department's research and teaching activities; it has also supported the development of improved patient care. Endowment funds for ophthalmology chairs have been donated to PVF through the generosity of the Fred Gellert Foundation, the Wayne Valley Foundation, and by friends and admirers of Dr. Spivey.
In 1976, Presbyterian Hospital found itself in severe financial distress. The hospital's board was aware of the need for administrative revitalization and, in recognition of Dr. Spivey's effective leadership of the eye department, Dr. Spivey was asked to accept the dual positions of President and Chief Executive Officer of the entire facility. Dr. Spivey was concerned about the future of the residency program, as well as the viability of the hospital, and agreed to accept the appointment for eighteen months. The hospital flourished under his direction, which stretched to over fifteen years.
In 1979, Dr. Spivey's strong administrative skills also led to his appointment as Executive Vice President of the American Academy of Ophthalmology. He retained the hospital and Academy positions when he was succeeded by Dr. Robert Stamper as departmental chair in 1986.
Substantial structural and organizational changes occurred in the Medical Center beginning with the opening of the Pan Med medical office building in 1976. Constructed at the former site of the Cooper/Lane facility, it has since provided convenient office space for the private practice of clinicians affiliated with PMC. During the same year, with managed care looming on the horizon, California Healthcare System (CHS) was formed under the directorship of Dr. Spivey. CHS enabled PMC, Mills-Peninsula and Marin General hospitals to improve their patient contracting arrangements and purchasing power. Alta Bates hospital was added to CHS in 1990. Two years later, PMC merged with Children's Hospital of San Francisco and the name of the facility was changed to California Pacific Medical Center. The new arrangement greatly increased medical staff size and the hospital's patient base. Similar hospital mergers began to occur throughout the country and, in 1992, Dr. Spivey moved to Chicago to become head of the Northwestern Healthcare Network.
During Dr. Stamper's tenure as eye department chair (1986-1995) the hospital underwent a difficult financial retrenchment brought about by its need to undergo a rapid transition from a facility emphasizing fee-for-service medicine with free patient access to subspecialty care, to one stressing constrained patient access to specialists under managed care. Procedurally oriented surgical subspecialty teaching departments, such as ophthalmology, were particularly effected by the resultant cut-back in hospital financial support. The consequences of managed care have also been felt nationally by many university-affiliated departments of ophthalmology.
In 1995 Dr. Stamper stepped down as chairman and the transition to a new form of academically oriented eye department began; one committed to maintaining the integrity and quality of the residency training program without a university endowment, while functioning within the lean financial constraints of managed care. They successfully accomplished this goal with the aid of community ophthalmologists, volunteer clinical faculty, the Lions Eye Foundation - which has financially supported a steady stream of patients requiring medical and surgical care - and the Pacific Vision Foundation, which continues to bolster departmental education, research, and clinical activities. Dr. William Stewart resigned the eye department chairmanship in the fall of 1999, when he was selected to become Medical Director of the Institute for Health and Healing at California Pacific Medical Center. In January 2000, Dr. Susan Day was appointed to chair the Department of Ophthalmology.
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- Barkan, H: Cooper Medical College Founded by Levi Cooper Lane: An Historical Sketch. Stanford Med Bull 1954;12:145-184
- Nolte, C: The San Francisco ‘48ers. San Francisco Chronicle June 21, 1998.
- Harris, H: California's Medical Story. Grabhorn Press, San Francisco 1932:131-141, 167
- California Statutes 1875-76: 792
- California Statutes 1901: 56
- Asbury, T: The History of Ophthalmology in Cincinnati (1827-1996): 3
- Blaisdell, FW: The Civil War. Bull Am Col Surg 9198; 83:38-39
- Lane LC: Elias S. Cooper. In Representative Men of the Pacific; Shuck, O: The Occidental Printing House, San Francisco
- O'Malley, CD: The Barkan Library of the History of Medicine and Natural Science books: An Account of its Development. Stanford M. Bull 1951;9: 145
- Parkinson, RH. Eye, Ear, Nose and Throat Practitioners in San Francisco Previous to 1900 (cited by Bar,an, H. ref#1)
- Bacci, LS, Lions Eye Foundation of California-Nevada - History: 1959-1989
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