The Skeleton Outline

Health Officer Albert E. Austen MD looked out the window of his office in the Old Town Hall.  He could see the Post Office across the street with its obelisk dedicated “To the Greenwich Men and Women Who Died During the World War”, a war in which he himself had served.  He could see down the slope of Greenwich Avenue, with the tree line of Long Island visible across the Sound in the distance.  It was rush hour, and the avenue was crowded.  Trolley cars made their way up the hill among crowds of people on foot and a swarm of black automobiles, including many Model-T’s and a sprinkling of fancier ones like the Locomobiles made in Bridgeport.  There were even some horse-drawn carts still around.

The practice of public health was becoming more professional and systematic in the 1920s, and Dr. Austen wanted the Greenwich Department of Health to fully participate in this movement.  He had already

 had a hand in creating the first Code of Public Health for the State of Connecticut, one of the first in the country.  He had recently become aware of the work of Dr. Ira Hiscock of Yale University, whose research focused on the practice of public health within the state and nationally. Dr. Hiscock based his research on extensive interviews with local health directors, and Dr. Austen had read the reports he wrote about the health departments of New Canaan and Fairfield.  So he had invited Dr. Hiscock to investigate public health in Greenwich, and today he was waiting for Dr. Hiscock to come and discuss his latest findings.

Through his window Dr. Austen could see Dr. Hiscock getting out of the taxi that had brought him from the train station at the bottom of Greenwich Avenue.  When he arrived at the office a few minutes later, he sat down and after a few pleasantries, began:

Greenwich Health Department Lab, from Hiscock's 1925 Report

“Albert, today I wanted to discuss with you the state of your laboratory.  I have reviewed the lab reports and interviewed the lab director.  You know, Greenwich is unusual for a town of this size to have such excellent local facilities- only Manchester and Middletown have similar labs.  Of course all the larger cities have health departments with their own laboratories.  Your laboratory performs diagnostic tests for infectious diseases, and tests milk and water for bacteria contamination. I did a study of public health laboratories nationally, and described the work of an idealized “well-rounded” laboratory.  The Greenwich Health Department laboratory pretty much follows this pattern.  Its equipment and methods are modern.  I do think a fuller use of a laboratory of this type might well be made in a community of 25,000 people.”

“Greenwich is, overall, a progressive town in terms of public health.  Its strong points are that it has good control of its milk and food supplies, it handles communicable disease well, and it has a nursing service of unusual enterprise.  Gaps that I see concern sewerage and garbage issues, and the situation regarding tuberculosis and venereal disease.” 

Dr. Hiscock wrote up his findings and prepared a report for Dr. Austen, who used the 1925 Hiscock report as a basis for developing the Greenwich Department of Health.  In a later report, Dr. Austen presented a “skeleton outline” of the Department’s organization, describing the interlocking divisions that composed it and the work of each one, so that the Greenwich community would appreciate this resource that the Town had available to it.  There would be other evaluations of the Department in the future; for example, Yale would return in 1975, and pave the way for the hiring of a director who would introduce the conceptual changes in public health that would bring it into the 21^st century. The Greenwich Department of Health and its laboratory have always sought outside advice and resources for creative ideas to improve the quality of service they provide to the community.

Sources:

Sanitary Code, 1918

Greenwich Health Department Annual Reports: 1918, 1925

Hiscock, “Public Health Practice” 1924

Hiscock, “Survey of Greenwich”, 1925

Hiscock, ”Public Health Laboratories”, 1925

Hiscock, “20-Point Program”, 1937

Photo retrieved from: http://www.hmdb.org/marker.asp?marker=38427