“A steam engine in pants”

Milton C. Winternitz, M.D., was the catalyst behind the Yale School of Medicine’s rise to elite status in the years between the two world wars and one of the most colorful and forceful personalities to emerge from the school’s 192-year history. Invoked frequently as the originator of the Yale System of medical education, which took shape during his first term as dean, Winternitz was also a terror to faculty and students alike, an intimidating presence who inspired awe as well as furious devotion. He was, as former Dean Gerard N. Burrow, M.D. ’58, HS ’66, writes in his new history of the school (quoting former Yale President James Rowland Angell), “a steam engine in pants.”

Winternitz, who served as dean from 1920 to 1935, occupies a central chapter in the book, A History of Yale’s School of Medicine: Passing Torches to Others, published in October by Yale University Press. The article that follows is adapted from the book and focuses on Winternitz’s role in establishing the Yale System. The entire chapter, which reveals a great deal more about Winternitz’s character and personality, can be read online in PDF format.

Burrow, who started the book after stepping down as dean in 1997, began his medical studies at Yale in 1954. After a residency in medicine at Yale, he was asked by Chair Paul Beeson, M.D., to stay on as an assistant professor, and he spent another decade in New Haven before joining the faculty at the University of Toronto in 1976, where he eventually led the Department of Medicine. In 1991, when a search began at Yale to find the successor to then-Dean Leon E. Rosenberg, M.D., HS ’63, Burrow was a dean himself, at the University of California, San Diego. He made a trip to New Haven to lobby the search committee for the preservation of the Yale System. Not long after he was named the school’s 14th dean.

Burrow’s history of the school was commissioned for the university’s Tercentennial in 2001. Writing it “was incredibly painful,” Burrow said, laughing, during an interview in late July. “I’ve done six or seven textbooks: a couple I’ve written, a number of them I’ve edited. Writing this history was infinitely harder. In a textbook, you kind of know what you want to say. But with this book the history unfolds and then you find another letter, and that changes it. You get to a certain place and you say, ‘Gee, I wonder why that happened?’ And you realize that would add another five years to the book.”

Once he finished writing, Burrow’s career path took an unusual turn. After nearly 10 years on the board of the Sea Research Foundation in Mystic, Conn., he was asked in 2001 to step in as interim CEO; he was already heading the board and indulging a lifelong fascination with the sea, marine mammals in particular. In January of this year, he became chief executive on a permanent basis. “I spend my time now trying to decide whether we bring in three 10-foot alligators or 15 two-foot alligators. We decided on the 15. … I decide how we’re going to spread our advertising and marketing money, because we are virtually entirely dependent on attendance. And I end up talking with bankers about how to refinance bond issues. I’m doing things that are very different from medicine and very challenging and interesting.”

The former dean is now directing a breeding program designed to save an imperiled population of beluga whales. “I’m actually working with people at Yale to see if we can do artificial insemination.” As the foundation’s CEO, Burrow oversees both the Mystic Aquarium and the Institute for Exploration, directed by Robert Ballard. Three years ago, he accompanied Ballard 3,000 feet below the surface of the Mediterranean Sea to uncover ancient Roman ships. Next August he plans to join the explorer on a Black Sea expedition to look for evidence of civilization at the time of the Great Flood. He admires Ballard for his ability to simultaneously pursue good science, educate and entertain. “At times he’s like a cardiothoracic surgeon [in his intensity], but he’s got incredible vision and enormous amounts of energy.”

In exploring the origins of the medical school, Burrow focused on its relationship to the university, to Connecticut’s medical establishment and to the hospitals with which it has been affiliated. Chronic underfunding by the university in earlier days, he writes, led many times to the school’s near-demise, and it was hampered by a lack of control over the clinical facilities in which its faculty members practiced. The arrival of Winternitz was preceded by a long period of decline in the mid-1800s, followed by a slow revival that began with the establishment of the Sheffield Scientific School at Yale in 1861. By 1910, when Abraham Flexner reported to the Carnegie Foundation that Yale and Harvard were the only medical schools in New England worth saving, the school was on a much more stable course. Flexner later held out the promise of financial support from the Rockefeller Foundation if Yale would move to a full-time clinical system, which he felt was a solution to medicine’s woes.

Burrow sees Winternitz as one of the driving forces in the medical school’s evolution from a tiny school with a faculty of five in 1813 to one of the world’s pre-eminent biomedical institutions today. Winternitz was, Burrow writes, “a complex personality who was either loved or hated [but] involved in everything.”