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A heroic contribution to medicine

Yale Medicine Magazine, 2018 - Autumn


Joseph Marshall Flint’s genius for wartime surgery.

Because Joseph Marshall Flint, MD, was trained as a research anatomist, many at Yale did not see him as their top choice for professor of surgery at the School of Medicine. When the administration offered Flint the position, other faculty and physicians complained: the doctor’s only former surgical experience was during a sabbatical year in Germany and Austria in 1906, right before he arrived at Yale. Despite the controversy, Flint would prove his value to Yale during his 14-year career there, leading its mobile hospital unit in World War I and reforming surgical education.

Before he accepted the position as professor of surgery, Flint had conditions. He wanted laboratories, classrooms, and offices “in close contiguity with the hospital and dispensary,” wrote Flint’s Yale colleague, Samuel Clark Harvey, PhB 1907, MD 1911. In the early 20th century, medical schools did not usually have full-time faculty or resources dedicated to research and student training.

Around this time, however, a movement to institute these changes in medical schools was beginning. Flint joined the movement and helped restore Yale’s waning reputation as a top medical school. For example, to make up for the fact that medical students could not work with patients, Flint instituted a dog surgery course modeled after the one Harvey Cushing, MD, had pioneered at Johns Hopkins.

European conflicts interrupted Flint’s practice as a professor. During the Greco-Bulgarian War in 1913, a precursor to World War I, Flint served as a surgeon in an Athens hospital. Once World War I began, Flint started volunteering on behalf of the French before the United States joined. He worked as a surgeon in a French military hospital in 1915 and wrote papers on military medicine. He also developed an X-ray photography method to locate foreign bodies and refined suspension methods used to treat fractures.

Flint took particular interest in French military hospital design. After five months volunteering there, Flint told the Yale Daily News, “Not the least interesting feature of military surgery is the organization of a military hospital.”

In fact, according to an article in the Yale Daily News, Flint had pushed for Yale to join the war and provide a Yale Hospital for wounded European soldiers as early as 1914.

In 1917, a few weeks after the U.S. declared war on imperial Germany, Flint was asked to head the efforts to design and implement a mobile hospital for American soldiers in France. Flint’s work with the French resumed as he studied their mobile hospitals to perfect the American counterpart.

From 1917 to 1919, Flint served as the commanding officer of Mobile Hospital Unit No. 39, the Yale Unit, of the American Expeditionary Forces. He designed the Yale Unit for maximum efficiency, modeling it after both French hospitals and Ford’s factory assembly lines. If soldiers were the product along the assembly line, the staff members were the factory workers, staying in place to perform their assigned duty as the belt rolled along to maximize hospital efficiency.

According to Melissa Grafe, PhD, the John R. Bumstead Librarian for Medical History and head of the Medical Historical Library, Flint’s design was efficient not only on paper but also in practice, lowering the average operating time per patient.

Because of the hospital’s success, Flint was awarded the Distinguished Service Medal with a citation that, according to Harvey, read: “When placed in a position of great responsibility as commanding officer of Mobile Hospital No. 39 at Aulnois-sous-Vertuzey, France, he used extraordinary skill and sound judgment in the organization and operation of that unit, the first of its kind in the American Expeditionary Forces.”

During his service as commanding officer, Flint contracted the Spanish Flu and never fully recovered. Throughout the rest of his life he experienced persistent pulmonary problems. In Yale’s collection of his writings, several books are filled with hand-drawn medical charts, colored pencils and red ink tracing the trajectory of his health. Flint died in 1944, living long enough to see Mobile Hospital Unit No. 39 reinstituted in World War II.

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