After several consultations as to how this approach might be made, I was allowed a trial experiment. The closing of schools in June would mean that the thirty-odd nurses on school inspection duty would be at liberty. June also meant the beginning of the diarrhoeal season which, if this summer of 1908 was going to be anything like its predecessors, would kill its 1500 babies each week all through the hot weather. The Commissioner and Dr. Bensel let me have those nurses to use in an experiment in preventive child hygiene.
In order to make our experiment count for something, the scheme had to be tried out first in a district with a very high baby death rate. So I selected a complicated, filthy, sunless and stifling nest of tenements on the lower east side of the city. If we could accomplish anything in the face of living conditions like these, we would go far toward proving our point. This neighborhood was largely populated by recently landed Italians, willing to learn new things in a new country. Mrs. Capozzi might be puzzled to find a perfect stranger dropping in to tell her how to take care of her perfectly well baby, but there was probably as much point in learning the American way of caring for babies as there was in learning the American way of talking.
How to reach the newborn babies without any waste effort was a problem. But it was not too difficult to solve. The Registrar of Records in the Department was cooperative and used to each day send me the name and address on the birth certificate of every baby whose birth had been reported on the previous day. It was essential to reach these babies while they were still very young and this proved to be the ideal way to find them; it is still the ideal way. Within a few hours, a graduate nurse, thoroughly instructed in the way to keep a well baby well, visited the address to get acquainted with the mother and her baby and go into the last fine detail of just how that baby should be cared for. Nothing revolutionary; just insistence on breast-feeding, efficient ventilation, frequent bathing, the right kind of thin summer clothes, out-of-door airing in the little strip of park around the corner—all of it commonplace enough for the modern baby, but all of it completely new to Mrs. Capozzi and all of it new in public health. Many of these mothers were a little flattered to have an American lady take all that trouble about little Giovanni, and were likely to go out of their way to learn and to cooperate. If the mothers were sulky or apprehensive, the nurses went again and again, wearing down their resistance, establishing friendly contact, until they were ready and willing to cooperate. In my experience, nearly all mothers are fine when they are given half a chance to know how to be. As soon as they saw that their babies were flourishing, despite the cruelly hot weather, they became our most efficient aides.
From the first I was pretty sure that we were getting results. I was not prepared, however, for the impressiveness of the facts when the results of the summer’s campaign in that corner of the east side were tabulated. During that summer there were 1200 fewer deaths in that district than there had been the previous summer; we had saved more babies than there were men in a regiment of soldiers and I had learned one certain thing: heat did not necessarily kill babies. Everywhere else in town the summer death rate of babies had been quite as bad as ever. We had found out how to save babies on a large scale. But it was far more important that we had proved that prevention paid far beyond our wildest hopes. There, if we have to be dramatic about it, was the actual beginning of my life work.
Early in August the Department officially created the Division of Child Hygiene with me as its Chief. Money came from the Board of Estimate and Apportionment in fairly generous amounts. It did very nicely as a beginning. Before I left the Department, however, our annual appropriation was well over twelve hundred thousand dollars a year. The first Bureau of Child Hygiene in the world was on its way.
CHAPTER V
IT WAS NEVER QUITE CLEAR IN MY MIND whether in pioneering in child hygiene being a woman was more of an asset than a liability. There were many times when a man might bury himself under the anonymity of his sex in such a position and thus contrive to get many things done without comment or criticism. But for a woman, this was more difficult. There were many stumbling blocks and the first one came early. It is difficult to realize now, but at that time the appointment of a woman as an executive was an upturning of procedure that brought out trouble all along the way. On the other hand, it had its compensations. From the point of view of publicity, it was superb. I have a well-defined feeling that if a man had been given this position, it would have been just another bureau; but for a woman to get this job, well, that was news. The Bureau needed publicity; my sex offered a challenge that provided good copy for the reporters and one of my real problems was how to avoid publicity instead of seeking it. That challenge was met immediately.
The start came when I was assigned a staff. Naturally they were all men. I had previously worked with all of them; we were good friends in our lowly capacity of inspectors. The picked few who were to help me form the Bureau were doctors; all splendid men, able, conscientious and adjustable. But evidently not adjustable enough to take kindly to the idea of working for a woman. They had hardly received notice of their appointments when all six of them walked solemnly into my office and told me that they had submitted their resignations. It was nothing personal, they assured me, but they could not reconcile themselves to the idea of taking orders from a woman. This was an impasse that I had not thought about but it was a serious one. I had to think quickly. I needed those particular doctors; I wanted them to work with me. It was a rather tense moment and I asked them to sit down and talk it over with me. “See here,” I said; “you are really crying before you are hurt. I quite realize that you may not like the idea of working under me as a woman. But isn’t there another side of this question? I do not know whether I am going to like working with you. None of us know how this is going to turn out. But if I am willing to take the responsibility of our success or failure, I think you might take a sporting chance with me.”
They looked thoughtful for a long moment but no one said anything. I had to go on. “Let’s try it this way. Give the arrangement a month’s trial. If at the end of a month you still do not like it, go ahead and resign, and I will not say anything about it. But, if all goes well and you want to stay, I shall be glad. Is that agreed?”
They pondered again for a few moments and then, not too enthusiastically, said they would stay and hold up their resignations for a month. That month went by and I reminded them that the time had come for their decision. All of them told me that they had withdrawn their resignations. They had completely recovered from their distressful doubts and sensibilities. By that time we were all in the midst of an interesting and enthralling job and, as I had hoped, they were much too keen about its possibilities to leave it for a moment. Besides, with what now seems almost like Machiavellian subtlety, I had given each one a title and placed him at the head of a division in the Bureau. All six of those men stayed with me during the critical years of organization. Dr. John J. Cronin, Dr. Royall Willis, Dr. Jacob Sobel and Dr. Robert Fowler were with the Bureau until I retired. Dr. William Weber died in harness as chief of the baby health stations. Dr. Clarence Smith eventually retired to look after his thriving practice, but not until the spadework of experiment and organization was finished. I owe a tremendous debt of gratitude to all of them. They were at my right hand for many years and no one could have had a more loyal, a more efficient or a finer set of co-workers. For Superintendent of Nurses, I had Miss Anna Kerr, an able and effective administrator. They were all splendid friends.
There were other places where being a woman was useful. In politics, for instance. I still knew no more about politics than I had learned from the famous Job Hedges, the celebrated wit and after-dinner speaker. I met him one day when he was running for the office of Governor of New York State. I knew him very well from the old days when he was a very young man and I was a little girl in Dansville, so I asked him if he thought he was going to be elected. “No, I can’t be elected,” he said. “People think I am a funny man. An
d the first rule of politics is that, if you are funny, you can be popular and you will be laughed at but you cannot be elected because no one will ever take you seriously.” He was right. He was not elected and I think that was the reason. Anyway, I did not forget that piece of advice and it was many years before I dared tell a funny story before an audience. But I was still anything but a professional politician. I had gone into the Department of Health solely because it promised to pay a salary for very little work and I spent my entire career there fighting shy of politics.
But the Department was part of the political set-up of a politics-ridden big city and on many and many an occasion not even an apprehensive innocent like myself could avoid becoming a part of this game. When as head of this new Bureau I was endowed with the right to suggest or influence appointments, the trouble began and never stopped until I retired. And here, being a woman was an enlightening asset in dealing with the old-time Tammany crew of chieftains and hangers-on. No one has ever been quite able to define Tammany Hall in its old days; indeed it would present its difficulties today. They well knew how to make men knuckle down and obey orders, but they had no previous experience of women in a political office. Between their bewilderment over that anomaly and their natural Irish politeness, I could often find my right way out. What is more, I came to like the Tammany groups that I met. I liked them and I liked to work with them. That is heresy, I know, but I couldn’t help it. There was “The” McManus, a quiet and gentlemanly sort when I saw him, whatever he may have been on the outside. “Big Tim” Sullivan was another man who always was courteous and charming to me, and Senator Pat McCarren who had the richest brogue of them all and the greatest sense of what was due to “a lady.” There were many more but these are the men who stand out in my memory. I was not innocent enough not to know their background. Fundamentally, I was opposed to Tammany and all it stood for. But given an individual contact with its leading lights, I learned to know the game and could still like the men who played it.
They had a curious honesty in their approach. They knew what they wanted and asked for it. But, because I was a woman, they were very polite about it and the effect was that they were asking a favor of me instead of giving me orders. They were always sending me incredible women to be appointed as nurses; this had happened many times when I was still assistant to the Commissioner. Our nurses were not under civil service at first, so candidates had no examination to pass and, theoretically, we could appoint anyone who had the wit to say she was a nurse, whether or not she had ever seen so much as the entrance door to a hospital. Up to a point, I had played ball with Tammany in the interests of a quiet life. In the very early days, if the woman was fit for children to be with and had had any reasonable experience, she was appointed. But in those days, many of them were not only distinctly not nurses but, having become the cast-off sweethearts of Tammany ward-heelers, were not to be endowed with city jobs. One day Senator McCarren sent me a fine specimen of that type, who had, no doubt, started life in a sailors’ dance hall on the Brooklyn waterfront. I listened to her for two minutes, asked her to step outside, and then got the Senator on the telephone.
“I’m sorry,” I told him, “but it just can’t be done. You know as well as I do that this woman is not the sort of person who should associate with children.”
“You mean,” he said, “you don’t think the lady and children would mix?”
“I do not,” I said, “and what is more, she isn’t a nurse. I am not even sure she knows what the word means.”
“Well,” he said, “no doubt you’re right. I haven’t seen her myself. I’ll just tell Senator Blank his girl will have to get a job somewheres else.” Then I heard him chuckle at the other end of the wire. “Ye’re a true lady,” he said, “and I like to see such a broth of a girl standing up to Tammany. I’ll stand by you, doctor.”
The fact that the politicians and I mutually liked one another helped a great deal, of course. At bottom they were thoroughly corrupt and cynical, a sort of government cancer, but my occasional half-hour chats with these bosses were almost invariably very pleasant occasions. They all seemed to like me, all except the great McCooey of Brooklyn. He and I fell out because, when he called me up and ordered me to send him the list of nurses who had then passed the civil service examinations so he could tell me which ones were to be appointed, I refused. By that time the whole matter of the nursing staff had been settled by making them civil service employees. Their appointment was covered by the civil service rules, for which I was profoundly grateful. I had no desire, nor in fact any authority, to pass this over to any politician, no matter how great he might be. But from that time on, I faced almost overwhelming resistance to anything I wanted to do in his kingdom of Brooklyn. His power was very great there and woe betide anyone who dared oppose him.
Sometimes I went to Tammany for the help I could not get from the city government. We would often find a baby in a family completely on the ragged edge, starving and freezing. Organized charity acted too slowly in such cases. So here was the cue for dropping in on the local Tammany district leader, who kept up his political fences by handing out help wherever it was needed. Two minutes of description, then: “Sure, ma’am, he’ll get a sack of coal and enough money to eat on right away.” Naturally the family so assisted meant another vote for the Tammany candidate in the next election, but that was not my business in such an emergency. If the head of the family played his cards right, Tammany would probably see that he got a job. All of which does count on the credit side for Tammany.
To be quite honest, I must confess that I would rather work with a Tammany administration than with a reform administration. I know, and knew then, that the organization meant graft and wholesale corruption. In the shameful conditions in the Health Department in my early days I had seen at close range where that sort of thing led. But, as the head of a Bureau trying to get things done, I inevitably had to depend upon the administration in power, and Tammany’s methods, in my case, were a comfort. When I took a new idea to a reform administration, they were always very gentlemanly about it. But it was a long and arduous road to follow. They would, of course, ask how much it would cost and then, after they had studied my carefully worked out statement which went into meticulous detail, they would send me word that it would be considered in due course. Months later, they would let me know that although the idea was fundamentally sound, the state of the city’s finances made it inadvisable at the moment. I did not want things considered; I wanted them done. Their caution appeared to be in the taxpayers’ interest, of course, but from my point of view it was not the way to get things accomplished, and in the long run the taxpayers were bound to suffer too. I knew my work was important and I knew that it would always be an up-hill fight to put it over. It would have been far the easier way to rest upon these vague promises and sink back into inertia. There were brilliant exceptions, of course. George McAneny, who was at one time President of the Board of Aldermen, and Paul Wilson, who was secretary to Mayor John Purroy Mitchel, were men of social vision and gave me great help as well as moral support, but on the whole reform administrations were hard sledding for reformers.
When a Tammany administration was in power there was no such hanging fire. The Mayor and other heads at City Hall were too exalted and busy to be approached directly but there was always another and less direct route to follow. Always an eminent Tammanyite who could be approached and told what was on my mind and how great the need was. He rarely asked questions; just, “So you’re sure it’s a good idea, Doctor. But then it’s always a good idea to help the babies;” and when I had said yes, he would say, “And why not? I’ll let the right people know and you’ll get your appropriation.” And that was that. In ways that might be devious, the plan I wanted to follow would be financed in the next budget for the Health Department. There was never any question of a quid pro quo. And this baffling mixture of official incompetence explained to me, in part at least, Tammany’s hold on the people: large spending
and innate humanity. Incidentally, it is interesting to look back today upon the “wild orgy of spending” of the Tammany regimes, and reflect upon the mounting budgets of the present.
I took only one piece of graft while I worked for the Department. I still have it somewhere. One morning while I was assistant to Dr. Darlington, the Department doorman came in and said there was a man outside who had a present for me. With the Department’s shy evasion of the woman question, I was then officially “Dr. S. J. Baker,” on the letterheads at least. The man said he was a barber. I did not want any presents from barbers or from anyone else and told the doorman to send him away. In ten minutes he returned, saying the man had left but that he had insisted on leaving the present as his “thank you” for a letter I had written him. I opened it out of curiosity and found a gorgeous shaving mug tastefully inscribed “Dr. S. J. Baker” in large gold letters. It was the kind of shaving mug that barber shops used to present to steady patrons and keep in special shelves by the mirror. I have another which belonged to my father; they make a noble pair. I could not resist keeping it.
I had few opportunities to be tempted. Only once in a very long while some woman looking for a permit to board a baby would try to buy herself what she wanted. To their credit, I know of no midwife who ever tried to buy her permit. And we had nothing else to sell. So graft did not rear its ugly head in the Bureau of Child Hygiene. But, throughout the Department, it would come out into the open often enough. There was the periodic scandal in a few of the Bureaus at regular intervals; generally at the beginning of each new administration. It was usually concerned with food: just a quiet slipping the inspector a hundred dollar bill and suggesting that he might prefer to look at this car of vegetables instead of the shipment four cars down the line. A certain number of inspectors were dismissed and sometimes a jail sentence waited for them but after the cleaning-up was over and everything quiet again, the same graft crept in once more. The same conditions occurred in the milk division at one time and that resulted in sending a highly placed official of the Department to Sing Sing prison for a five-year sentence. Later, one of the most important officials in the Department decided to clean up this situation for good and all. He did it too but when things became too warm to be pleasant, he was offered a large salary to resign and go over to a certain large milk concern to reorganize that business so that such conditions could not occur any longer. He went, and was left in solitary grandeur in an office of his own until after a year or two he found himself out of a job. But the purpose had been accomplished; he had been taken out of the Department. Whether such conditions hold now, I do not know. I can only speak of my time.
Fighting for Life Page 10