Em. Med. Annual Report 2011 - Hennepin County Medical Center

Part 2: A Thumbnail History of
Emergency Medicine at
Hennepin County Medical Center
by Ernest Ruiz, MD, FACEP
Hennepin County Medical Center (HCMC) evolved
from Minneapolis City Hospital (1887-1901),
Minneapolis General Hospital (1901-1964), and
Hennepin County General Hospital (1964-1974.)
In 1955, Professor Owen Wangensteen, Chair of
the Department of Surgery at the University of
Minnesota (UM), assigned one of his surgeons,
Claude R. Hitchcock (1920-1994), to the
Minneapolis General Hospital (MGH) to be Chief
of the Department of Surgery. The ER was already
run by a surgery department that consisted of
academically inclined community surgeons who
donated their time to teach and supervise. The ER
was usually staffed by interns and one first year
surgery resident. Hitchcock's arrival enlivened the
hospital with his energy and his love for teaching
and research. Like his mentor, he was a stern
administrator and believed that medicine was a
24/7 occupation. The hospital became well known
for its surgical expertise, especially for trauma and
cancer surgery.
In 1965, hospital and nursing administrations
selected Hildred Prose, RN, an ER staff nurse
since 1951, to become Director of Emergency
Services, answering directly to Hitchcock. The ER
had become very busy, overcrowded, and
understaffed. She was a strong advocate for the
ER patient. She became a thorn in the side of
administration and that of Hitchcock with her
admonitions about staffing and space needs. In
the late sixties, the ER was remodeled and
8 | Department of Emergency Medicine Activities Report | 2009-2010
enlarged, expanding into space that had been the
ambulance garage. Hitchcock also encouraged
the ambulance service to train its "drivers" with
basic emergency skills. Interns were no longer
required to ride ambulances. Still, the ER
remained overcrowded. The sixties saw the advent
of Cardio Pulmonary Resuscitation (CPR) that
could be initiated pre-hospital. Ambulance
personnel and fire fighters applied this new skill
enthusiastically. Persons previously pronounced
dead in the community were now rushed, CPR in
progress, to the ER already teeming with patients.
Although attempts were made to resuscitate them
in ER cubicle space, monitoring equipment and
other tools were lacking. Prose wrote long memos
to Hitchcock about problems. He was already
extremely busy leading his department in vital
areas, such as renal transplantation and wound
infection treatment with hyperbaric oxygenation.
In 1971, Hitchcock called Ernest Ruiz, a general
surgeon on his staff, to his office and asked him to
"run the ER." Ruiz was four years out of his
surgery residency. He had experience in trauma
surgery and knew that improvements could be
made. After conferring with his wife about the
consequences of this new assignment, they
agreed that it was the right thing to do. He met
with Hitchcock to accept the offer. Ruiz specified
that it was on condition that the ER was to be
under his control without interference from
Hitchcock or the other departments – it was to be
an Emergency Department (ED) instead of an ER.