Em. Med. Annual Report 2011 - Hennepin County Medical Center
Em. Med. Annual Report 2011 - Hennepin County Medical Center
Em. Med. Annual Report 2011 - Hennepin County Medical Center
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Part 2: A Thumbnail History of<br />
<strong>Em</strong>ergency <strong>Med</strong>icine at<br />
<strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong><br />
by Ernest Ruiz, MD, FACEP<br />
<strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong> (HCMC) evolved<br />
from Minneapolis City Hospital (1887-1901),<br />
Minneapolis General Hospital (1901-1964), and<br />
<strong>Hennepin</strong> <strong>County</strong> General Hospital (1964-1974.)<br />
In 1955, Professor Owen Wangensteen, Chair of<br />
the Department of Surgery at the University of<br />
Minnesota (UM), assigned one of his surgeons,<br />
Claude R. Hitchcock (1920-1994), to the<br />
Minneapolis General Hospital (MGH) to be Chief<br />
of the Department of Surgery. The ER was already<br />
run by a surgery department that consisted of<br />
academically inclined community surgeons who<br />
donated their time to teach and supervise. The ER<br />
was usually staffed by interns and one first year<br />
surgery resident. Hitchcock's arrival enlivened the<br />
hospital with his energy and his love for teaching<br />
and research. Like his mentor, he was a stern<br />
administrator and believed that medicine was a<br />
24/7 occupation. The hospital became well known<br />
for its surgical expertise, especially for trauma and<br />
cancer surgery.<br />
In 1965, hospital and nursing administrations<br />
selected Hildred Prose, RN, an ER staff nurse<br />
since 1951, to become Director of <strong>Em</strong>ergency<br />
Services, answering directly to Hitchcock. The ER<br />
had become very busy, overcrowded, and<br />
understaffed. She was a strong advocate for the<br />
ER patient. She became a thorn in the side of<br />
administration and that of Hitchcock with her<br />
admonitions about staffing and space needs. In<br />
the late sixties, the ER was remodeled and<br />
8 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />
enlarged, expanding into space that had been the<br />
ambulance garage. Hitchcock also encouraged<br />
the ambulance service to train its "drivers" with<br />
basic emergency skills. Interns were no longer<br />
required to ride ambulances. Still, the ER<br />
remained overcrowded. The sixties saw the advent<br />
of Cardio Pulmonary Resuscitation (CPR) that<br />
could be initiated pre-hospital. Ambulance<br />
personnel and fire fighters applied this new skill<br />
enthusiastically. Persons previously pronounced<br />
dead in the community were now rushed, CPR in<br />
progress, to the ER already teeming with patients.<br />
Although attempts were made to resuscitate them<br />
in ER cubicle space, monitoring equipment and<br />
other tools were lacking. Prose wrote long memos<br />
to Hitchcock about problems. He was already<br />
extremely busy leading his department in vital<br />
areas, such as renal transplantation and wound<br />
infection treatment with hyperbaric oxygenation.<br />
In 1971, Hitchcock called Ernest Ruiz, a general<br />
surgeon on his staff, to his office and asked him to<br />
"run the ER." Ruiz was four years out of his<br />
surgery residency. He had experience in trauma<br />
surgery and knew that improvements could be<br />
made. After conferring with his wife about the<br />
consequences of this new assignment, they<br />
agreed that it was the right thing to do. He met<br />
with Hitchcock to accept the offer. Ruiz specified<br />
that it was on condition that the ER was to be<br />
under his control without interference from<br />
Hitchcock or the other departments – it was to be<br />
an <strong>Em</strong>ergency Department (ED) instead of an ER.