"Reallocation" at the University of
Kansas School of Medicine: a
Pathological Case History

 Fred Whitehead
1. For most of the history of medicine, its professional
education has been proprietary.  The apprenticeship engaged a
novice in the service of a seasoned veteran physician, for a set
term of years, during which he "read medicine," i.e. memorized
anatomy and other texts, learned how to suture wounds, deliver
babies, and the like.

2. In addition to this traditional one-on-one method, there
developed from time to time what amounted to medical schools,
where groups of doctors might practice their art at a temple
complex dedicated to healing, as came to be the case in ancient
Greece.  It is often forgotten now, but during the Middle Ages,
medical education and practice in many Islamic countries was far
in advance of that in Europe.  But eventually, in the
Renaissance, medical schools were founded in university towns,
such as Padua and Oxford, thus establishing a paradigm for
linking medicine to higher learning in general.  In other
European cities, especially the large metropolitan ones like
Paris and London, those who aspired to become doctors went to the
charity hospitals, where there were abundant desperately ill poor

3. When the University of Kansas was established just after the
Civil War, the old traditional apprenticeship method of medical
education still prevailed, though private proprietary schools in
cities like Topeka and Kansas City soon attracted students.  But
there was no publicly-supported Medical School in the State.

4. By the mid-1890s, KU leaders began to argue that the
University and the State needed its own medical school.  One
problem was that the University was in Lawrence, a small
community, which, it was argued, could not support a full-scale
clinical enterprise.  However, Kansas City was nearby, and like
medieval London or Paris, furnished a large supply of "clinical
material," i.e. numerous poor people who were sick.  Venereal
diseases, tuberculosis, and so forth were common there, along
with gunshot and knife trauma, and thus students would be able to
learn their trade. 

5. Notably, one of Kansas' most eminent and energetic physicians,
the Halstead surgeon, Arthur Hertzler, had himself experienced
the apprenticeship by "reading medicine" under a rural preceptor,
but had gone on to earn a formal M.D. degree at Northwestern
University.  That was followed by advanced post-graduate
education in Berlin, under the famous Virchow.  Hertzler became
Professor of Surgery at the new University of Kansas School of
Medicine after it was founded in 1905.  Curiously, Hertzler
maintained his growing clinic in Halstead, taking a Pullman car
to and from Kansas City, where he taught for nearly forty years. 

6. Other Kansas City physicians, in private practice, became
professors at KU, more or less on a volunteer basis.  But a small
nucleus of full-time faculty was formed as well.  The growth of
KU's medical school was given a powerful impetus by the Flexner
Report of 1910, which argued that all medical education should
become university-based.  In part, the argument was that such a
basis would ensure that medicine would become firmly scientific. 
Soon afterwards, in Kansas City as elsewhere around the United
States, the small proprietary schools closed up shop. 
Henceforward, while a few private schools continued to exist,
most young doctors got their training at the new university

7. However, even in the political discussions leading up to the
founding of KU's medical school, there was vocal concern in the
state legislature that the school's proximity to Kansas City
would mean that it would in fact serve and be controlled by
Kansas City, Missouri physicians.  How, it was demanded, would
the need for physicians in the many small towns of Kansas be
met?  This was an important question, because rural communities
were being asked to support the school (always an expensive
proposition, then as now), without receiving any clear benefit. 
That is, the "split" of interests between "Eastern" and "Western"
Kansas was operative in those days, just as it is in our own

8. The system that prevailed up into the early 1960s was that the
basic sciences such as anatomy, physiology and so forth, would be
taught on the main campus in Lawrence, and the clinical years
would be in Kansas City.  Eventually, under the leadership of Dr.
Franklin Murphy, the whole enterprise was consolidated on the
Kansas City campus.  Perhaps symbolically, that campus was
located right on the border with Missouri, on State Line Road; it
could not have been more "eastern" in its placement. 

9. Murphy is regarded as a legendary leader of the University of
Kansas, first as Dean of the Medical School, and then as
Chancellor.  Certainly he was one of the rare persons who served
in either position whose credentials as an intellectual were not
in doubt.  Murphy strongly supported the growth of the KU
libraries on both campuses, and was himself something of a
bibliophile and art connoisseur.  Coinciding with his own
expansive vision for the University and its medical school were
two trends.  First, the G.I. Bill enabled hundreds of young
people in Kansas who had served in World War II to secure
advanced education.  During the War, many older physicians in
rural communities had been prevailed upon to remain in practice. 
When the War ended, there was a wave of retirements, and the
"Murphy Plan" aimed to meet the needs of these small towns by
introducing young doctors to opportunities there.  The second
trend was the huge flow of federal money into hospitals for
clinical education and for research.  The funding rationale was
that basic scientific research and education of young people,
especially for underserved rural communities, justified the
commitment.  There were also significantly increased State
expenditures as well. 

10. One of the unusual features of the KU Medical School was its
Clendening Library, which focused on the History of Medicine. 
Before joining the KU faculty, Logan Clendening had been a Kansas
City, Missouri physician, with a successful private practice in
Internal Medicine.  He was also a Freethinker (so defining
himself in Who's Who), a friend of the iconoclastic novelist
Sinclair Lewis (who did the "research" for Elmer Gantry from
his suite in the Ambassador Hotel on Broadway in Kansas City,
Missouri), and a popular author of newspaper medical advice
columns.  An enthusiastic bibliophile, he began amassing a
substantial collection, which included first editions of
Vesalius, Harvey, and other great pioneers of medicine.  Today
the Clendening Library is among the top ten Medical History
libraries in the United States.  Clendening published numerous
books, both popular clinical "guides," and medical history.  His
successors, Drs. Ralph Major and Robert Hudson, insured that
through their own teaching and through invited lectures by
distinguished scholars, KU's medical education would be strongly
founded in the classic medical humanities.

11. During Hudson's decades of leadership, every freshman medical
student attended a required course, which was called The Clinical
Process.  This course aimed to introduce students to social and
ethical issues, such as sexual identity, abortion, health care
economics, death and dying, etc.  In addition, Hudson annually
gave a popular elective course on the History of Medicine.  I
served as a discussion leader for The Clinical Process, and
because of my additional reputation as a humanities scholar, I
received a joint appointment as a faculty member in that

12.  The University of Kansas has a long and perhaps rather
romanticized connection to New England and its tradition of
distinguished colleges.  KU's Crimson and Blue colors are those
of Harvard, and indeed, KU is colloquially known as "Harvard on
the Kaw."  But institutions like the Clendening Library and its
affiliated History and Philosophy of Medicine Department in part
justified the comparison. 

13. My own connection to the University of Kansas began when I
enrolled as a freshman in 1962, just in time for the Cuban
Missile Crisis.  Every visitor to the Lawrence campus is
impressed by its dramatic natural setting.  Situated along the
crest of Mount Oread, KU has a panoramic view of the Kansas River
valley.  Coming as I and many others did from provincial Kansas
towns, the University provided both an Enlightenment and a
Liberation.  By 1978, after I completed my Ph.D. at Columbia
University, more or less by accident I was informed of a position
at the Medical School, as Assistant Director of the Preceptorship
Program, which sent senior students to work with physicians in
rural Kansas.  The Director was Dr. Ralph Reed, like Murphy, a
well-read physician and humanist, who volunteered as an
instructor in KU's Western Civilization course.  Reed was active
in Republican party politics, but was a civilized man, i.e. he
did not automatically recoil at radical ideas, though he rarely
found them believable.  While we were very different in
temperament, he and I enjoyed our work for the Preceptorship,
especially the long expeditions through Kansas to meet doctors
and their students.  I think he hired me because he wanted to
have someone he could talk with about books and ideas on these

14. Not all KU administrators were as enlightened as Reed.  For
some years in the 1980s, the Preceptorship was in the Department
of Family Medicine, under the Chairmanship of James Price.  I had
gotten interested in writing a book about Mad Scientists, and
therefore had my office shelves filled with books on science
fiction, Nazi history, medical experiments gone wrong, and the
like.  Price had a habit of abusing his staff, and one day he
called me into his office and demanded: "Why do you have all
those books in your office?!"  Amazed, I could only reply: "Jim,
I'm writing a book; I thought universities liked people who had
books, and write books."  Price later became Dean of the Medical

15. Not long after that, with a small but enthusiastic group of
professors and community physicians, I co-founded the da Vinci
Society, which provided a monthly forum for topics combining
themes in science, medicine, and the humanities.  This was
outside the formal curriculum, but again, was in the spirit of
advanced Higher Education.  At places like Harvard, Berkeley or
Stanford, such a Society would be supported and encouraged.  At
KU it was tolerated at best. 

16. By 1991, the Preceptorship Program was under the leadership
of Dr. Jane Murray, a newly appointed Chair of Family Medicine.
Murray was a graduate of the UCLA Medical School, where she had
earlier majored in the History of Science.  She strongly believed
that medicine should not be reductive, that it had to become
personal, emotional, and spiritual.  She readily agreed to a
proposal I made, to commence a monthly Humanities Conference,
based in our Department, but open to all faculty, students and
staff at the Medical Center.  In the course of the next several
years, I organized some 80 of these sessions, which took the form
of lunch-time seminars.  Topics ranged widely, from the history
of various diseases, to the lives and works of graphic artists,
and poetry readings.  According to Murray, KU's Department of
Family Medicine was unique in the United States for its
sponsorship of a regular Humanities event. 

17. Under Murray's leadership, KU obtained a $15 million grant
from the Kansas Health Foundation, to support Primary Care
Physician Education.  Awarded in 1995, the grant was for a term
of five years, and at the time was one of the largest ever given
to an American medical school.  This project was intended to
support revision of the curriculum and expansion of medical
education into the "real world" community outside the walls of
the campus on State Line.  Like Franklin Murphy before her,
Murray was a young, optimistic and progressive physician who
believed that the University should serve the State and its
people.  The goal was that KU's medical school should become the
top national model for producing primary care doctors. 

18. Beginning in 1995 the University itself had new leadership in
the person of Chancellor Robert Hemenway, who had a scholarly
record of achievement, especially in the field of African- 
American literature.  Also soon coming on board was Dr.
Donald Hagen, who had recently retired after a long career in the
Navy, where he had become Surgeon General.  While not an
academic, Hagen quickly sized up KU Medical Center as a hotbed of conflicting fiefdoms.  With weekly messages via e-mail, Hagen
proclaimed a day of renewal was at hand for KU.  He even put his
top leadership through a course of Covey training, which aims at
developing cooperative ways of functioning in large

19. For a variety of reasons, these efforts at renewal failed. 
One reason was the arrival of a new Dean of the Medical School,
Dr. Deborah Powell.  A graduate of Radcliffe and of Tufts, she
had the requisite New England pedigree traditionally esteemed at
KU.  However, because she was a Pathologist, there was some
concern whether she understood or supported the Primary Care
Physician Education project and its ambitious goals.  We were all
assured that, though she was not in a "people-oriented"
specialty, she did support P.C.P.E.  As it turned out, Powell was
urged by none other than Hagen himself to begin cutting the
budget of the Family Medicine Department, which was supposed 
to be the linchpin of the whole Primary Care project.  In
frustration Murray resigned as Chair, though she continued to
teach residents in Family Medicine on a part-time basis.  Dr.
Cynda Johnson, who then became Interim Chair, supported the
continuation of the Humanities Conferences, and otherwise was a
dedicated and progressive educator. 

20. By the Summer of 1999, various candidates for permanent Chair
of Family Medicine had been interviewed, and the consensus of the
faculty was that Johnson should be appointed to the post. 
Powell, however, refused to do so, saying "the chemistry is not
right."  Exasperated, Johnson announced she was leaving KU, where
she had spent twenty years, to take the position of Chair of
Family Medicine at the University of Iowa Medical School.  The
Dean was developing an alarming penchant for authoritative but
mysterious statements such as her judgment about "the chemistry."

21. On October 6, 1999 I was summoned to Dr. Powell's office and
given a letter stating that my contract would not be renewed
after June 30, 2000.  In a brief discussion, she stated: (1) "Your Department is in a budget deficit, and I have to make
cuts," and (2) "Your research does not fit the mission of the
Medical School."  The latter statement was especially amazing,
since I had just recently earned promotion, via rigorous peer
review, to Associate Professor, a senior faculty rank, effective
July 1, 1999.  Subsequently, I learned that Powell told the new
Interim Co-Chairs of Family Medicine: "I cannot justify having an
English major in a Family Medicine Department."  Powell's
statement about my research dismissed in one sentence my record
of 80 scholarly publications, plus 100 lectures and seminars I
had given all around the United States and in Europe, on topics
of medical, intellectual and cultural history. 

22. Naive people customarily take such things personally.  Some
even come to agree with those who dismiss them, that their work
is insignificant.  However, I resolved at once to contest this
dismissal.  Some 400 letters and messages from around the United
States and from several other nations went to Dr. Hagen.  The
American Association of University Professors conducted an
investigation of my case and of others on the main campus in
Lawrence.  Their investigating committee prepared a report, which
however, had no effect on the administration.  After a
perfunctory exchange of letters with a KU attorney, Robert
Kreiser of the AAUP's national office said there was nothing more
they could do.  Proceeding to a formal censure of KU would not be
possible, Kreiser said, for reasons that remain obscure.

23. A bizarre atmosphere began to develop on the State Line
campus.  In August 1999, a majority of the Kansas State Board of
Education voted to remove key concepts of the theory of evolution
from tests given to high school students in the state.  This
prompted intense international publicity, projecting an image of
Kansas in 1999 as backward as Tennessee in 1925.  In response, I
personally agreed to sponsor a scholarly conference, "Monkey
Business in Kansas," to be held at the Medical Center November
5-6, 1999.  Two days before the conference, Linda Davies,
Director of Academic Support, telephoned me and directly charged
me with falsely representing that the Department of Family
Medicine had sponsored the event.  I replied that I was
personally sponsoring it as a faculty member.  The next day, Ed
Phillips, Vice Chancellor for Administration, telephoned and
similarly berated me: "You have been," he charged, "less than
forthcoming about the sponsorship of this event."  He added: "The
University cannot support events like this."  When I demanded
that he put his objections in writing, Phillips perhaps realized
that his bullying tactics would not prevail with me and refused
to do so.  The conference took place as planned.  Phillips,
recently hired by Hagen, was a pal from Navy days, and obviously
knew nothing of the concept of academic freedom.  Phillips' next
move was to proclaim a new policy at the Medical Center, that
faculty had to obtain the approval of their Department Chairs
before scheduling any space for "outside events."  I protested
this to Dr. Robert Trueworthy, chair of the Faculty Council, but
he never replied, nor did the AAUP take any action on this clear
abrogation of traditional faculty rights and privileges.

24. I filed a formal complaint against Dr. Powell, for violating
my academic freedom when she made the statement dismissing me
because of my research.  On June 27, 2000, four days before my
dismissal took effect, the mandated hearing finally was held. 
The faculty member I originally wanted to represent me was not
allowed to serve on the committee.  Dr. Mark Fey, a professor of
hearing and speech, chaired the hearing, and among other
irregularities, attempted to prevent my son from making a
tape-recording of the hearing.  Fey even attempted to prevent my
citation of Sir William Osler, the distinguished Professor at
Hopkins, concerning the importance of the humanities in medical
education and practice.  I persisted, and got into the record
Osler's denunciation of those whose only standard of value was
"the tape-measure of utility."  At the hearing, Dean Powell
testified she could not remember making the statement about my
research.  Dr. Dolores Furtado, a long-time AAUP officer at KU
Medical School and the head of the AAUP's Task Force on Medical
Schools, "represented" me on the Committee, but as I learned only
much later, did not support me in the decision that was made in
favor of the Dean.  The Committee made no finding of facts, nor
did it issue any kind of explanation for its decision, nor did it
actually have a formal vote.  In short, the whole hearing took on
the character of a Star Chamber proceeding such as occurred in
17th Century England.  To this day, Furtado has never explained
to me her strange role in this proceeding. 

25. My dismissal occurred as the Dean ordered, on June 30, 2000. 
The University refused to pay me several thousands of dollars for
unused sick leave accrued, on the grounds that I had been
terminated, and had not retired.  I did not even receive any
formal written notice of the Committee's adverse decision until
the middle of July. 

26. There are other aspects of this case too complicated to enter
into here.  It must, however, be said, that other faculty were
told the same thing, that their research did not fit the mission
of the School, and were dismissed.  In the summer of 2000, after
I had been forced out, Dr. Jane Murray, my former Chair and
supporter of the Humanities Conferences, learned that her
part-time appointment as a Professor of Family Medicine had been
terminated when her paychecks simply stopped coming.  Justifiably
infuriated at this treatment, Murray reported these attacks on
Family Medicine to the press, resulting in several articles. 

27. Difficult as it is to retain one's perspective during such
disturbing events, it is important to try to grasp trends which
underly what might otherwise be considered personality disputes.
I had often remarked to Murray that KU's departments resembled
the atavistic combatants of the Balkans, who glare out from their
battlements, prepared to pour boiling tar on all who approach. 
These are people, I said, who are not educated or civilized, but
are content to remain mercantilists of the provincial sort. 

28. The reason Family Medicine found itself in "deficits" was
that the other "rich" departments starved it for resources. 
Faculty salaries in Surgery or Anesthesiology, for example, were
often several multiples of those for Family doctors on the
faculty.  Similarly, administrative expenses grew out of
control.  Powell herself made a salary of $270,000 the year she
dismissed me (while I made $37,000).  Her husband, also a
pathologist, made a salary almost as much as the Dean: hence,
these two exacted a sum in the neighborhood of Half a Million a
year.  For the sake of comparison, we may note that United States
Senators make $140,000 per year, and United States Supreme Court
Justices make $170,000.  Furthermore, through the Kansas Open
Records Act, I obtained records that showed the Dean's office
spent $190,000 in one year for "social activities," such as
receptions and dinners.  Almost $300,000 was spent for
consultants on a project to collect information on the kinds of
work done by the faculty, at the same time faculty with a proven
record of scholarly research and publication were being harassed,
driven out, and dismissed.

29. Aside from this gross waste of money, which alone gives the
lie to "deficit" claims of any kind, the entire context became
clearer in the summer of 2000, when suddenly a Life Sciences
Initiative was announced in the Kansas City media.  An ambitious
and complex project, this scheme joined the University of Kansas,
the University of Missouri-Kansas City, and the newly established
Stowers Institute in Kansas City, Missouri in a plan to make
Kansas City one of the largest national centers for basic
biomedical research.  Hundreds of millions of dollars were to be
sought from a combination of public and private sources, for an
initiative which proclaimed as its goal "an aggressive and
comprehensive commercialization system."  In his annual
Convocation address in September 2000, Chancellor Hemenway, a
member of the Board of Directors of the Life Sciences Initiative,
supported this effort, saying almost incidentally that
"reallocations" at the Medical Center would have to be made. 
Thus, without any faculty advice or consent, it was revealed
exactly how "the mission" had changed.  If you did not bring in
big federal or private dollars, you were dispensable.

30. At KU Medical Center, the Department of Family Medicine was
dislodged from its easily accessible position at the entrance to
the Hospital, to make room for a large group of cardiologists
from St. Luke's Hospital in Kansas City, Missouri.  Just as
legislators a hundred years ago had feared, Kansas City, Missouri
interests were taking over the KU Medical School.  This
transition was facilitated by the newly privatized KU Hospital
Authority, created by act of the State Legislature.  For the
first year or two, a community and legislative-based oversight
committee was required by law, but that was soon quietly
eliminated.  Food and custodial services were privatized, with
more long-term employees terminated.  The administration's
"reallocation" became the workers' unemployment.

31. One thing that is common to Powell, Hagen and Hemenway is
that none of them are native Kansans.  Conversely, many of those
they have attacked and fired were either born in Kansas or have
long years of service to the state and to the university.  The
approach of this troika is quite clearly to support outsiders
whose objective is to make as much money as possible from us. 
They also support high rollers within Kansas who have the same

32. One might have expected Chancellor Hemenway to make a stand in defense of the humanities in medical education, such as he did on November 14, 1997, when he gave a seminar in our Family Medicine Humanities Conference series, and publicly stated: "I'm really glad that Fred Whitehead is drawing together the humanities and medicine."  By 1999, he and others had determined that mere English majors were an impediment to the Life Sciences.  KU would go backward in time, to become a proprietary trade school like those which vanished ninety years before.  As Osler foresaw, its standard of value would be, indeed, "the tape-measure of utility."

Fred Whitehead (fredwh@swbell.net) is former Associate Professor
of Family Medicine, University of Kansas School of Medicine. 
This article is a chapter from his new book, KU Confidential,
which is available free via e-mail from the author as an attached
MS Word document, or in printed form postpaid for $15 (PO Box
5224, Kansas City, KS  66119).












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