Features and Information:
Medical History of San Luis Obispo County
following piece was written as background text for the San Luis Obispo
County Medical Society and San Luis Obispo County Health Foundation's
video presentation entitled "Champions in Health: San Luis Obispo
County 1930-1950." The video is available through the SLO
County Medical Society, tel. 805/544-3020.]
Health Services in San Luis Obispo County 1930-1950
The 1930s: Hard Times
In the 1930s, people all across the U.S. experienced hard times-the 1929 stock market crash led to an era of bank failures, bread lines, and tent cities called Hoovervilles. Thousands lost their farms and homesteads to the Dust Bowl which engulfed the South and Midwest, and many of these people, desperate to find work or refuge, headed for the Golden State.
Some of them came to San Luis Obispo County. Near Oceano, the Dunite population of artists and eccentrics swelled as people realized they could take refuge in the dunes and live on the still-plentiful Pismo clams and on vegetables gleaned from the nearby fields tended by Japanese farmers.
The Dunites' serious medical problems were treated by Dr. Rudy Gerber of Oceano. Money was always a problem-often Dr. Gerber was paid in fish or clams, and he brought more than one baby into the world in exchange for a pig or a calf. And when times were really tough, the doctor worked for nothing.
The labor-intensive crops of southern San Luis Obispo County attracted thousands of the Dust Bowl nomads-people so desperate that sometimes their most urgent medical need was actually the need for nourishment. As one worker recalled,
"If you didn't work, you didn't eat…. So, if you found a tomato field to work at for a while, you ate tomatoes. If you found a lettuce farm, you ate lettuce, because no one had any money."
Medical problems connected with this influx of migrants were addressed by the public health departments of the state and county. Campgrounds were provided specifically for migrant workers, and the State Health Board required every necessary convenience:
"Please be advised that the [camp] site situated on the mesa west of Nipomo is the only one…satisfactory for this purpose….The gum trees afford shelter, drainage is good, and an ample water supply is available. The site is well isolated and, if proper toilet facilities and garbage pits are provided, this location would be ideal for a free camp."
Ebba Anderson, a registered nurse sent by the Council of Women for Home Missions, reported on the situation in the Nipomo pea-pickers' camps:
"[The] camps were watched very carefully for communicable diseases….In one case where I was uncertain being measles or scarlet [fever], Dr. Bingham, the County Health Officer, checked on the case immediately. All measures were taken to avoid any serious epidemics in the camps…All of the children in the migrant school as well as in other schools were vaccinated. Mothers were urged to have pre-school children vaccinated also…."
Nurse Anderson treated mumps, measles, whooping cough, food poisoning, colds and sore throats, boils, infections, poison oak, weed poisoning, scabies, and impetigo. She supplied booklets on prenatal care as needed, and referred all serious illnesses to the County Hospital or the County's Medical Panel.
Nurse Andersen ended her report by praising the County's efforts: "The County seemed to recognize their responsibility in helping these less fortunate people as they passed through….There was wonderful cooperation from all agencies interested in the migrants' well-fare."
Heavy rains in February of 1936 blighted 2000 acres of the county's pea crop and left hundreds of migrants with no work, no money, and no food. The crisis was burned forever into the consciousness of Americans by the work of Farm Security Administration photographer Dorothea Lange. Her photos of 32-year-old Florence Thompson and her children had the most impact. When the national press published the "Migrant Mother" image, 20,000 pounds of relief supplies, including beans, oatmeal, and flour, were shipped to Nipomo. And beyond the local crisis, this unforgettable image out of a pea-pickers' camp on the Nipomo mesa became an enduring symbol of the ravages of the Great Depression.
The County's physicians, meanwhile, were doing their best to handle the difficult conditions. They urged the establishment of a new TB sanitarium on the hill behind General Hospital, and they recommended that the County provide clinics for the indigent at the hospital. Apparently, some of the physicians had personal concerns about the effects of the Depression, as the County Medical Society sent a letter to State Senator Chris Jespersen urging that state law prohibit a physician's automobile being attached in cases of debt.
The automobile of San Miguel's Dr. Leo Stanley, Jr. was never threatened in this way. Rather, in 1938, it was distinguished by its faithful service on a 5,000-mile round trip undertaken by Dr. and Mrs. Stanley and their friends Dr. and Mrs. Frank Lowe.
Dr. Stanley explained later that "The purpose of our trip was to observe the workings of Rochester, Minnesota's Mayo Clinic-a multi-specialty group practice, and to share what we learned with our colleagues back in California…."
A few years later, San Luis physicians Joseph Middleton and George Dunklee formed a partnership which embraced the Mayo brothers' multi-specialty clinic concept and evolved into the San Luis Medical Clinic.
Towards the end of the '30s, the benefits of President Roosevelt's New Deal were felt as WPA labor worked on a
sea-wall between the beach and Front Street in Avila, and on the first stages of the new County Courthouse. Federal measures such as Social Security brought people some degree of financial relief, but these programs stopped short of a national health insurance effort.
Regional and state health plans were implemented instead. California workers, including those on the Central Coast, were offered a plan by California Physicians Service; eligibility was extended to all workers with family incomes under $3,000 a year, and in 1939, that was 90% of the state's population.
As the 1930s ended, news of the conflicts in Europe and the Far East became increasingly grim. And in the city of San Luis Obispo, not even the newly-installed electric lights on Higuera Street could dispel the darkness of the gathering clouds of war.
The 1940s: War and Recovery
The 1941 attack on Pearl Harbor brought the U.S.
into World War II. In San Luis Obispo County, black-outs became routine, residents of Japanese descent were re-located to inland camps in California or Arizona, a Japanese submarine sank the Union Oil tanker Montebello off the coast of Cambria, and local boys left for military service as their families and neighbors supported the war bonds effort.
When U.S. participation in the war had become imminent, the federal government had ordered massive construction and expansion at Camp Roberts and Camp San Luis. Lands that cattle had grazed became training grounds for war. Construction of the camps was completed in early 1941; over the next four years, almost three-quarters of a million men would come to the County to prepare for combat in Europe, Africa, and the Pacific.
Healthcare at the camps was provided by members of the Medical Corps-physicians, nurses, lab technicians--all of whom had either volunteered or been drafted, just like the patients they served. One such physician was Major Elmer Goooel. A Clevelander by birth and a surgeon by training and experience, he served for three years at Camp San Luis Obispo's Station Hospital. The camp newspaper described him as:
"Genial, energetic, and a most devoted physician…The words 'genial and energetic' will be attested by hundreds of GIs who have become acquainted with Dr. Goooel at those unique military functions that are always scheduled for the chilly hour just before dawn."
Patients in the camp hospitals were entertained by the American Red Cross recreation staff-there were movies, variety shows, jazz concerts, educational talks, and a regular Sunday afternoon "Open House" for relatives and friends.
The influx of soldiers and staff for the two camps created a housing crisis, as many wives, children, and girlfriends moved to the area. The population of the City of San Luis Obispo went from 9,000 to 12,000 in just five months. The presence of so many military dependents kept the area's civilian physicians busy. North County physician Fred Ragsdale found that his general practice began to feel more like an OB/Gyn specialty practice, as he delivered scores of military wives who had come to be near their soldier husbands:
"I did a lot of obstetrics, especially during the 1940s when Camp Roberts was open. So I delivered a lot of those Army wives. The U.S. Government paid us twenty-five dollars to deliver an Army wife, just for the delivery, and if we gave prenatal care, the Army would pay us thirty-five dollars."
Joyce Mathison Carscaden was employed by the County Health Department during the war years. She recalled that:
"The influx of so many men into the community caused County Health to create a section for venereal disease investigation, treatment, and control….The number of staff was doubled from two to four to cover this work and the maternity programs."
Penicillin, which had been discovered in the late 1920s, had remained in perilously short supply until its mass production for wartime military use. The new "wonder drug" was invaluable to the armed services for treating men wounded in battle, while supplies of the drug at Camp San Luis and Camp Roberts were used to treat serious infections among the men. And on at least two occasions, although the miracle of penicillin was not yet generally available to non-military, local physicians used it for treating seriously ill civilians, once for Jenny Hiltel, in a case of blood poisoning, once for Barbara Mugler in a case of strep throat.
By December of 1945, most of the troops been discharged, and Camp San Luis and Camp Roberts leased land back to local ranchers. Some Japanese American
families--including the Etos, the Naganos, and the Hayashis--returned to the area, and County residents resumed peacetime pursuits, such as Pismo Beach's staging of its first Clam Festival. Wartime buildings and facilities were converted to other purposes-the Navy property at Morro Bay became the site of the new PG&E power plant, and the infirmary used to treat personnel at Cal Poly's Naval Flight Preparatory School became the nucleus of the college's peacetime health center. Much later, some of the Army buildings at Camp San Luis would become classrooms for San Luis Junior College, later to become Cuesta College.
Wartime advances in surgery paid peacetime dividends on operating tables at home. Progress on the battlefield in the handling and transport of blood and plasma was applied when the National Red Cross organized blood donor services for civilians in 1948. Several years later, in San Luis Obispo, mobile units operated by the County Blood Bank would conduct regular blood drives at the Monday Club and the new Veterans Memorial Building. Yet another development in post-war medical care was the establishment of Jones Ambulance Service, which, 55 years later, is still with us as San Luis Ambulance Service.
In the post-war years, penicillin became widely available, tuberculosis patients were being cured by the streptomycin, and cortisone was used to treat rheumatoid arthritis. This progress in treatment options was paralleled by major healthcare support from the federal government. In 1946, Congress passed the Hospital Survey and Construction Act, better known as the Hill-Burton Act. The bill was designed to provide federal monies to build new hospitals or to modernize those which had not been upgraded since before the Great Depression. In return for federal funds, facilities agreed to provide free or reduced-fee medical services to persons unable to pay.
Dr. Fred Ragsdale tells how Paso Robles was able to use this funding to build its own hospital:
"This was in 1946; some of us cast about trying to figure some way that we could improve the hospital situation and have a hospital in Paso Robles. Previous to all of that we had to go to the branch of the General Hospital in Atascadero.
"Dr. Wilmar developed the idea that we could form hospital districts, as there were sanitation districts, irrigation districts, and cemetery districts, so he figured why couldn't there be hospital district? He approached his local state senator, Chris Jespersen of Atascadero, about the idea, and Chris Jespersen…introduced legislation to establish hospital districts, and the legislature approved it.
"In 1948 Paso Robles outlined a proposed hospital district and had a vote to form the district, also with a bond issue of $200,000 with which to build a new hospital. Along with this we got $200,000 from the State Department of Health,…and also $200,000 from a branch of the United States Government, which was promoting such ideas at those times.
"And so, with the $600,000, we were able to build a hospital on what they called Terrace Hill."
The Paso Robles Veterans Memorial Hospital on Terrace Hill opened its doors on January 2,
1950. Its first patient, Kenneth Burke, was a Templeton dairy worker, had been injured when a cow fell off a truck onto his back. He was treated by Dr. Ragsdale, who made sure the event was recorded in the local newspaper.
The medical advances in the closing years of the 1940s would be multiplied in the 1950s. This decade, sometimes referred to by healthcare practitioners as "The Golden Years," would see healthcare standards in the County of San Luis Obispo keep pace with those taking place nationally.
The 1950s: "The
Some people think of the 1950s as a complacent time of poodle skirts, big-finned cars, and the "I Love Lucy" show. In truth, the decade began in turmoil. After a brief postwar calm, the nation's attention turned to Russian aggression in Eastern Europe, to the Soviet's development of the A-bomb
and--later-of Sputnik, to the Communist take-over in China and the Chinese attack on South Korea. These events inspired fears which led to the witch-hunts of Senator Joseph McCarthy, blacklists, spying scandals and executions, and other Cold War concerns of the Truman and Eisenhower years.
The new suburbias looked tranquil, but schoolchildren practiced "duck-and-cover" drills, backyard barbecue areas were converted to fallout shelters, and nuclear bombs were routinely tested just an hour's drive from Las Vegas. With all this for people to worry about, it's small wonder that the U.S. Public Health Service designated mental illness as "America's No. 1 public health problem." San Luis Obispo County was not exempt from concerns about mental illness, as in 1954 the County Supervisors budgeted $121,648 for a new psychiatric ward at the General Hospital.
Health problems other than mental illness were more easily treated. The most publicized-and probably the most welcomed-healthcare victory in those years was Dr. Jonas Salk's successful development and testing, in 1954, of a vaccine against polio. The March of Dimes, founded by President Franklin D. Roosevelt in 1938, had been instrumental in funding that research effort.
Before the vaccine breakthrough, polio outbreaks were frequent, and dreaded, and the only help for the victims had been hot packs, physical therapy, and the iron lung. Juanita Tolle, R.N., former Director of Nursing Services for the County Health Department, describes her experiences working with hospitalized polio patients in the early '50s:
"Most of them were in respirators and iron lungs, as they were called then, with their heads out of the respirator and mirrors to connect them with the outside world and communicate with the nurses and friends that came to see them. We did hot packs and physical therapy treatment for them - we also did, of course, personal care because it was particularly important for them not to develop bedsores or skin breakdown. We did this through portholes in the iron lung, and we used isolation techniques with gowns and masks."
Dr. Salk's vaccine meant that fear of polio would become a thing of the past. A lesser fear, but one all too common, was fear of tooth decay, which could be treated, but at considerable trouble and expense. Then, a study in Flint, Michigan, confirmed that fluoridation could significantly reduce tooth decay, and in 1953, San Luis Obispo dentists and doctors banded together to support a local fluoridation measure, which passed with 56% of voters approving.
Beyond the polio vaccine and fluoridation, progress included vaccinations against many childhood diseases, development of the heart-lung machine, the ultrasound scanning of pregnant women, the use of the Apgar score for newborns, and the discovery of the structure of DNA. These and other breakthroughs in healthcare led to increasing medical specialization, and the County, with a population of over 50,000, was ready to support the arrival of specialist physicians.
One such specialist was Dr. Edison French. After wartime service in the Navy Medical Corps, Dr. French had settled in San Luis Obispo, purchased the San Luis Sanitarium on Marsh Street, renamed it the French Hospital, and begun to practice state-of-the art medicine. He claimed to be the first surgeon in San Luis Obispo to use intravenous anesthesia, the first to perform a lung resection, and the first to do a collapsed lung therapy. He was also the first specialist to actively encourage other specialists to settle in the area.
One of Dr. French's recruits was Dr. Lou Tedone, who served at Camp Roberts during the Korean years. As recalled by Dr. Tedone, Dr. French's recruiting techniques were effective and gentlemanly:
"I think I can best describe Dr. Edison French as a man of high energy and of great vision. Apparently his main goal was to provide good medical care to San Luis Obispo and to do that by bringing in specialists. As a matter-of-fact, the reason that I remained in San Luis Obispo was because of Dr. Edison French.
"Originally I was planning on going back to Brooklyn, New York, practicing there as a first-generation Italian American…But at the last minute, I decided to check the opportunities here, and since there was no pediatrician, Edison give me a very, very good offer that made me change my mind and remain here.
It's interesting that when I did accept his offer, there was no signed contract. We merely shook hands and went to work. And that's the way he conducted the hiring of all the other people at the French Clinic."
In addition to Dr. Tedone, other board-certified specialists, in order of arrival, included:
Ernie Werbel, General Surgery and Trauma
Al Gazin, Radiologist;
Tibor Beresky, Ophthalmology
Tony Keese, Orthopedic Surgery
Tom McKellar, Pathology
Gene Petrick, Anesthesiology
Bramwell Anthony, OB/Gyn
Bernie Tannenbaum, Psychiatry.
Some of the physicians of these times helped to create special places for patients with special needs. Dr. Joseph Middleton worked to establish a halfway house for alcoholics, and Dr. Keese participated in a program for disabled children run by the San Luis Medical Clinic. Dr. Keese recalls the creation of a school for these children:
"Chris Jespersen was a state senator, and somehow or other he developed a cerebral-palsy school here in town, which is unusual for an area this small….It was actually a school, in addition to the medical aspect."
Later, to extend training and opportunities to disabled adults, Dr. Keese and Dr. Harry Fryer found a site at Camp San Luis where they helped create a sheltered workshop that would evolve into Achievement House.
Juanita Tolle, another champion of the underserved in those years, describes the services of the County Health Department:
"We added family planning. We added child health and disability prevention as a federal program that provides early examination, diagnosis and treatment of children before they get into school, and also through their school years…. We had more prenatal programs…along with health education for not smoking and not drinking and avoiding those things that would perhaps damage their baby or bring on premature births…."
These social concerns at the local level reflected a growth in the nation's conscience: the decade of the '50s saw the U.S. military complete its desegregation policy and the Supreme Court reject the doctrine of "separate but equal," and Rosa Parks made history when she refused to give up her bus seat to a white passenger in Montgomery, Alabama.
By 1958, rock 'n' roll had swept the country, and Elvis had gyrated his way through the Ed Sullivan Show and been drafted into the Army. A growing prosperity brought new leisure pursuits: Disneyland opened, as did Hearst Castle, and Alex and Phyllis Madonna began construction of their pink palace beside Highway 101. A few miles from the Madonna Inn, another large building was under construction-less distinctive in appearance, but crucial to the community's continuing development. That building was Sierra Vista Hospital, which grew, phoenix-like, out of the demise of the old Mountain View Hospital at the upper end of Marsh Street.
Dr. Anthony Keese recalls this transition as follows: "When I first came to San Luis Obispo, there were two hospitals in town, Mountain View and French Hospital…. Mountain View…was owned by [R.N.] Emma Righter, who was an elderly lady. She took care of seeing that everything went well, and if she didn't like it she'd tell you about it. They had a kitchen that was just below the operating room and they always baked something good there…. Of course, when you were operating, the smells were wafting up to the surgery. It made you work a little faster.
"Emma Righter died and…we [doctors] thought it would be nice if we could buy Mountain View and maybe refurbish it and make it into a better hospital. But when we were all sitting around talking about it, Ed French came along and bought the hospital, and so we sat around someplace else and decided we'd like to build another hospital….
"There was a lot of discussion on what to call it. Somebody wanted to call it Doctors' Hospital, and I thought that was a bad idea to have doctors involved in naming it, especially since they owned it. Then it was the Murray Street Clinic. Then we finally decided on Sierra Vista, which is Spanish for Mountain View."
On December 7, 1959, Sierra Vista Hospital opened its doors. This was a fitting end to a decade of expansion of healthcare services in San Luis Obispo County.
In the forty years since that time, the medical community has witnessed countless changes and dealt with numerous challenges. Medicine continues to evolve as a science, while its practitioners struggle with the ancillary issues of reimbursement rates, liability, insurance dictates, and increasing regulation. Many of the issues from the past are still with us: the effectiveness of the "wonder drugs" is challenged by ever-faster mutations of virus and bacteria, new strains of tuberculosis are emerging, the post-polio syndrome troubles patients 40 years later, supplies of donor blood must be screened ever more closely, and the need for pre-natal programs is greater than ever. Our society, increasingly affluent at the upper levels, has yet to fully address the needs of the homeless and uninsured whose only access to medical care is the hospital emergency room, of mental patients who formerly would have been institutionalized, and of low-income workers who haven't the option of paying for their medical care with fish and clams, a calf, or a pig.
Senior physicians, having witnessed the cycles of change, can provide a seasoned viewpoint. Dr. Lou Tedone, when asked what would be his advice to today's pre-med students, replied:
"I would like to pass this on to anyone else who wants to become a physician: I know there are some negative thoughts going on right now about how difficult it is, but I feel that as long as you want to be a doctor and enjoy helping people, it is a very rewarding profession and to stick with it.
"As far as being successful, I think of the three A's. If you do become a physician, No. 1 [is] Ability. Make sure you keep current and are able to treat conditions successfully. No. 2, that you are Available …make yourself available so that the patient can get to you. And then, finally, for success, Affability, the third A, meaning: Develop a good bedside manner, and be nice to people."
© 2002 Lynne Landwehr. All rights reserved.
Credits and Sources:
Anderson, Ebba, R.N., Council of Women for Home
Missions: Narrative report entitled "Peas: March 15 - May 1, 1939."
Anthony, Bramwell M.D., interviewed by Dr. Billy Mounts.
Bailey, Jane H., and Dorothy L. Gates. Morro Bay's
Yesterdays. Morro Bay: El Moro Publications/Central Coast Press, 1982; second printing 1993, third printing 2001.
Benn, Lesley Gerber. Daughter of Rudy Gerber, M.D.
Davis, Al. Curator, Camp Roberts Military Museum.
Five Cities Times-Press-Recorder.
Hall-Patton, Mark: South County Tribune, column, December 19, 1991.
Hammond, Norm. The Dunites. Arroyo Grande, California: South County Historical Society, 1992.
Henderson, Gary: Water Division Manager, Utilities Department, City of San Luis Obispo.
Keese, Anthony, M.D., interviewed by Dr. Billy Mounts.
Kennedy Library, California Polytechnic State University: Special Collections Department, Catherine Trujillo.
Kennedy, Robert E.: Learn by Doing: Memoirs of a University
President. San Luis Obispo, California: California Polytechnic State University, 2001.
Krieger, Dan; Liz Krieger; and Stan Harth. War Comes to the Middle
Kingdom. San Luis Obispo: San Luis Obispo County Historical Society, 1991.
Library of Congress/National Archives: Photos taken in Nipomo peapickers' camp by Dorothea Lange for the Farm Security Administration.
Loe, Nancy; Dan Howard-Greene; and others. Cal Poly: The First Hundred
Years. San Luis Obispo: Robert E. Kennedy Library, California Polytechnic State University, 2001.
March of Dimes National Office, White Plains, NY: David W. Rose, Archivist.
Mayer-Harnisch, Guenther, M.D., interviewed by Dr. Billy Mounts.
Medical History Subcommittee members: Rick Cohen, Lynne Landwehr, Kathy Laster, Jenny Mathis, Kaye Mickelson, Billy Mounts, M.D., Mary Parker, R.M., Ed.D., Nancy Rosen, Lou Tedone, M.D.
Mounts, Billy, M.D. Interviews with
healthcare providers; columns for the newsletter of San Luis Obispo
County Medical Society.
Mugler, Fred, Jr., M.D., and Barbara Mugler: Correspondence.
Peoria (Illinois) Public Library/Downtown Library: Elaine Pichaske Sokolowski, Reference Department
Ragsdale, Fred, M.D., interviewed by Dr. Billy Mounts.
San Luis Obispo County Medical Society: Minutes
San Luis Obispo Daily Telegram: Selected articles.
San Luis Obispo Telegram-Tribune: Selected articles.
Shot 'n' Shell (Camp San Luis newspaper): Selected articles.
Stanley, Leo L., M.D. "Across the Plains in 1938 (Volumes I and II)." Private memoir and scrapbook.
State of California Public Health Department: Letter to County Public Health Department Officer Allen F. Gillihan.
Tedone, Lou, M.D., interviewed by Dr. Billy Mounts.
The Cambrian, article from December 25, 1941.
Tolle, Juanita, R.N., Former Director of Nursing Services for San Luis Obispo County Public Health Department; interviewed by Dr. Billy Mounts.
Tri-Counties Blood Bank: Mona Kleman, Community Relations Representative.
United States Department of Agriculture: Northern Regional Research Center, Peoria, Illinois: Joyce Blumenshine, Librarian.
Young, Naomi B. "The History and Development of San Luis Obispo County Hospital System, 1874-1970." Private typescript, San Luis Obispo, 1971.