James Burns Amberson Jr., Head of the Chest Service 1938-55FOUNDED in 1831, New York University is the largest private university in the United States, with more than 40,000 students. The School of Medicine has been part of the university from the earliest planning sessions more than a century ago. Organized by a faculty of six instructors and called the University Medical College, it admitted its first class of 239 students in 1841. In 1898, the University Medical College merged with Bellevue Hospital Medical College, which subsequently became the New York University School of Medicine. The School of Medicine included approximately 650 medical students, 1200 residents and fellows, 45 M.D./Ph.D. candidates, and 5,000 postgraduate registrants. The faculty numbers over 3,000, of which 1,165 are full-time and 2,024 are part-time.
Bellevue Hospital Center, this country’s first municipal hospital, began in 1730 as a single-room infirmary in the public almshouse located at what is now City Hall Park in lower Manhattan. Recurrent outbreaks of Yellow Fever led within 20 years to a new building for the infirmary at the same location, but ultimately public demands that fever victims be isolated in a more remote section prompted the common council to lease a part of a Kips Bay farm, called Bellevue, bordering the East River. A new facility was opened there in 1816, with beds for 200 patients under the care of two visiting and two house physicians. In 1825 a new “fever” hospital building was added at the same site, which was finally named Bellevue Hospital.
Bellevue was also one of the first teaching hospitals in the country. In 1750, anatomy was taught there; by 1787 Columbia University’s College of Physicians and Surgeons, and by 1841 New York University, had assigned faculty and medical students to Bellevue.
he Chest Service at Bellevue, first designated the Tuberculosis Service, was founded by Dr. James Alexander Miller in 1903. Only four years out of medical school, Dr. Miller was assigned to Bellevue by the Department of Medicine of the College of Physicians and Surgeons. He found hundreds of cases of tuberculosis in the medical clinic of the outpatient department who were being treated essentially with a cough mixture. Within the hospital, there were male and female wards for tuberculosis with a total capacity of 80 beds. He also used an outmoded ferryboat moored in the East River near Bellevue as a day-care facility for both children and adults with tuberculosis. The universal high esteem given Dr. Miller was evidenced when he was able, singlehandedly, to raise funds for a new large hospital building (C & D Building) for tuberculosis patients in 1936. Dr. Miller attracted Dr. James Burns Amberson to his staff in early 1930. Dr. Amberson, a Johns Hopkins graduate, became interested in tuberculosis when he contracted the disease and was treated at Trudeau Sanatorium. Dr. Amberson proved to be a brilliant clinician with remarkable insight into basic pathophysiologic mechanisms. He was a pioneer in clinical research in tuberculosis and other respiratory diseases and became visiting physician in charge of the Chest Service in 1938.
For the next 40 years, graduates of this program filled many prestigious academic posts as well as clinical positions in the United States and throughout the world. Together with a strong department of pathology at Bellevue Hospital, the Chest Service staff contributed a great deal of new knowledge about the pathophysiology, clinical behavior, and treatment of tuberculosis and other pulmonary diseases. When Dr. Amberson retired in 1955, the alumni of the Bellevue Hospital Chest Service honored him by creating the Amberson Lecture series given at annual meetings of the American Thoracic Society.
In 1932, Dr. Miller recruited Dr. Dickinson Richards and Dr. André Cournand to organize and direct research in cardiopulmonary physiology. These brilliant investigators endorsed the concept that the heart, lungs, and circulation are a single system for the transport of gas between the environment and the tissue, and that no part of it can be studied without regard to the others. Their most famous contribution was their pioneering development of cardiac catheterization as a means for studying the heart, lungs, and circulation. In 1941, they placed a catheter in the right atrium of a human being, and by 1944 they were sampling blood and measuring pressure in the right ventricle and pulmonary artery. In 1956, Drs. Richards and Cournand received the Nobel Prize in medicine and physiology in recognition of their application of physiologic concepts, methods, and techniques to the study of respiratory and cardiocirculatory diseases. During this period, they trained more than 150 research fellows in cardiopulmonary physiology.
These second generation cardiopulmonary physiologists occupied academic, clinical, and research positions throughout the world, and have contributed greatly to our current concepts of cardiopulmonary function in health and disease.
In 1955, Dr. John McClement succeeded Dr. Amberson as director of the Chest Service. Under his able leadership, the Chest Service maintained an active research program and provided strong clinical and research training. In 1970, Dr. H. William Harris was named director of the Graduate Training Program, and the fellowship added a second year and expanded from three to twelve positions. In 1975, the Chest Service moved to the new Bellevue Hospital building, containing an inpatient service, a large and active outpatient department, and a new well equipped and staffed pulmonary physiology laboratory. The annual John McClement Lecture at Grand Rounds serves to honor his stewardship. Previous speakers have included Ralph Steinman, MD, Arnold Levine, PhD, Peter Barnes, MD, John West, MD, Barry Bloom, PhD, Carl Nathan, MD, John Minna, MD, Jack Gouldie, PhD, and Margaret Becklake, MD. From 1983 to 1989, Dr. Harris directed the Chest Service and maintained its clinical excellence.