Beacon of Hope: Founding Years
Laying the Groundwork
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Founding Years 1944-1953
Growth Years 1953-1969
Years of Change and Renewal 1969-1993
About the Author

The Clinical Center first appeared in PHS building plans in October 1944. Heading the 10-year PHS prospectus for postwar construction were proposals for a 500-bed Medical Center hospital and a 200-bed Neuropsychiatric Institute and hospital on the Bethesda reservation.11 The 79th Congress was averse to President Franklin D. Roosevelt’s domestic spending programs and preferred to locate postwar research authority in a private body, which would contract clinical research to leading medical schools and university centers.12 Temporarily blocked, Parran and NIH Director Rolla G. Dyer enlisted the services of Mary E. Switzer, Parran’s superior in the Federal Security Agency, to write legislation authorizing the mental health clinical unit as well as a nationwide hospital building program, which Congress readily funded in August 1946.13 The administration froze public works spending before considering the $18 million PHS proposal to start the Bethesda expansion, but Parran managed to get the Bureau of the Budget to approve $2.6 million for land purchasing and architectural services in December 1946. A building committee was hastily set up within the PHS, and in January Parran’s staff submitted the first comprehensive plan for expanding the Bethesda reservation.14

Preparations for a dozen new buildings began in earnest in April 1947, after Parran established a symbiotic relationship with the new Republican chair of the House Appropriations Subcommittee, Frank B. Keefe of Wisconsin. With only a promise of $22 million for construction expenses in 1948, an NIH research facilities committee chaired by Norman Topping plunged ahead with a 30-line site agenda projected to cost $116,246,765.15

The catalyst of this new, full-speed-ahead political environment was extramural research. Requests for research funding from medical schools, academic departments, and hospital centers surged at the end of the war, but philanthropies and drug companies proved unwilling to invest enough capital to sustain the research boom. Moreover, the proposed National Science Foundation became mired in congressional debates complicated by the insistence of leading academic scientists that basic research be kept separate from agencies controlling research applications. Keefe and other key members of Congress decided that spring that the study sections and advisory councils Parran and Dyer had organized in 1945 and 1946 were the only effective instruments available to fund the wave of emergent medical technology.16 In October, President Harry S Truman joined this consensus by accepting the Steelman Committee’s recommendation that medical research spending be tripled quickly. The upshot was a resolution by the Federal Bureau of Hospitalization on November 4, 1947, authorizing construction of a “research hospital, together with ancillary structures,” which would combine mental health and chronic/infectious disease research.17

After a whirlwind of planning activity between the NIH Director’s Office and the Public Building Service, Representative Keefe on March 5 accepted a special appropriation request for $31,830,000 to construct the main building.18 The substructure contract was let in July, and in the fall steam shovels excavated the hillock behind Top Cottage, creating a mountain of spoil dirt, which dwarfed existing buildings. Behind the scenes the planning focus slipped, reflecting the abrupt dismissal of Surgeon General Parran in February and the need to accommodate within the organization two more categorical institutes, Heart and Dental Research, which Congress chartered at mid-year.19

Dr. Jack Masur, assistant director at Montefiore Hospital and a specialist in chronic care administration, was appointed director of the embryonic hospital staff on April 1, 1948. One of 55 consulting specialists to the planning committee, Dr. Masur used New York’s Goldwater and Memorial Hospitals as institutional models in designing the Clinical Center. His leadership of the later planning phases diminished the importance of PHS traditions in both clinic and laboratory. Impatient with the lack of training and professional development in the Marine Hospital clinical service, which after 1944 was barred from using patients for research,20 Masur set out to create new professional standards and to optimize patient care in the emerging world of scientific medicine.

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