Alfred Worcester

Alfred Worcester (1855-1951) was a general practitioner in Waltham, Massachusetts known for pioneering work in patient care, the treatment of appendicitis, and the use of Caesarean section.

Biography

Alfred Worcester was born in Waltham on June 22, 1855. He earned AB at Harvard College, Phi Beta Kappa, in 1878 and MD at Harvard Medical School in 1883. He entered practice in Waltham in 1884 and founded the Waltham Hospital and Training School for Nurses the following year.[1] He married Elizabeth Joy Hill (1854-1951), the daughter of a former president of Harvard College, in 1886. They had no children. Other accomplishments included: founded the Rutland Sanitarium (for care of tuberculosis), 1895; admonished the physicians of eastern Canada to allow the founding of the Victorian Order of Nurses, 1897; president of the Obstetrical Society of Boston, 1899; founded Waltham Baby Hospital, 1902; Major in American Red Cross, Switzerland, 1918-1919; president of the Massachusetts Medical Society 1919-1921; professor of hygiene, Harvard College, 1925-1935. He died August 28, 1951 and his wife died six days later at their home in Waltham.

Accomplishments

He was called a pioneer in the organization, practice, training, and science of medical and nursing care.[2][3][4] He originated the concept of teaching about the care of the patient that would be applicable to all medical specialties.[5] He was an early adopter of appendectomy for appendicitis and of Caesarean section for complicated labor. He advocated for compassionate medical care and counseling for college students and was Harvard College's first Professor of Hygiene. He was a prolific writer and speaker and was deeply religious. He gave lectures and sermons in New England and Eastern Canada. This quote from his collection of lectures, The Care of the Aged, the Dying, and the Dead,[6] demonstrates his eloquence and humanity.

“The relief and comfort of our aged patients should be our aim, rather than the prolongation of their lives. But this is hardly a true distinction, for the relief and comfort given to an aged patient often effect the prolongation of life if only by restoring the willingness to live."[7]

Because of his innovations, he was often involved in controversy. He suffered several life-threatening illnesses, including appendicitis, which informed his approach to patient care. Scientific medicine was on the rise while he advocated preserving humanistic medicine.[8] In the 1880s, appendicitis was treated expectantly, sometimes leading to incision and drainage via anterior or posterior approach, and was often fatal. The reports of his cases and the controversy between him and the surgeons of Boston demonstrate the evolution of medical and surgical practice and the contribution of generalists to specialty care.[9] Including practical experience in home care during nurses' training, which he organized at the Waltham Training School for Nurses, was frowned upon by hospital-based nursing school administrators of the day.

Dr. Francis Peabody’s famous statement, “the secret of the care of the patient is in caring for the patient,”[10] was delivered in a series of lectures initiated by Dr. Worcester. Some of the lectures, including Dr. Worcester’s on the care of the aged and the care of the dying, were published in a collection in 1929.[11] Dr. Worcester’s lectures were then published on their own in 1935, together with a third lecture on the care of the dead. This book went into a second edition and several printings, the last being in 1977. Dame Cicely Saunders, the leader of the palliative care movement in the United Kingdom, was inspired by Dr. Worcester’s book during her training.[12]

References

  1. ↑ O’Hara D and Gallupe HQ, eds. Alfred Worcester: A Tribute to a Physician of Massachusetts. Boston, The Four Seas Company, 1925.
  2. ↑ Obituary: Alfred Worcester. NEJM. 1951:245(13):510-511.
  3. ↑ Kerr D. Profiles in Caring: Alfred Worcester: A pioneer in palliative care. AM J HOSP PALLIAT CARE. 1992;9(3):13-14,36-38.
  4. ↑ Freeman JT. Dr. Alfred Worcester: Early Exponent of Modern Geriatrics. Bull NY Acad Med. 1988;64(3):246-251.
  5. ↑ Reminiscences of Alfred Worcester 1938, http://thegardencottage.files.wordpress.com/2012/08/dr-alfred-worcester-reminiscences.pdf. Accessed November 7, 2014. Manuscripts preserved at the Harvard University Archives and the Francis A. Countway Library of Medicine
  6. ↑ Worcester A. The Care of the Aged, the Dying, and the Dead. Springfield, IL: Charles C Thomas; 1935. Read online at http://babel.hathitrust.org/cgi/pt?id=mdp.39015012537695;view=1up;seq=7.
  7. ↑ quoted also in Geriatrics--The Care of the Aged. JAMA. 1937;109(26):2143-2144. reprinted JAMA. 2014;312(11):1159.
  8. ↑ Crenner C. Private Practice: In the Early Twentieth-Century Medical Office of Dr. Richard Cabot. (Richard Clarke Cabot) Baltimore: Johns Hopkins University Press; 2005.
  9. ↑ Worcester A. The Treatment of Appendicitis. BMSJ. 1892:127(5):101 and ff.The Boston Medical and Surgical Journal as published by The New England Journal of Medicine.
  10. ↑ Peabody FW. The Care of the Patient. JAMA. 1927;88(12):877-882.
  11. ↑ Emerson LE, ed. Physician and Patient: Personal Care. Cambridge, MA: Harvard University Press; 1929.
  12. ↑ Saunders C. Letter. AM J HOSP PALLIAT CARE. 1992;9(4):2.

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