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received his degree. Dr. Dever, who had charge of the immediate details of the hospital from its opening to November 19, 1893, was a man whom I had known for ten years, who not only had experience gained in private practice, but who had been connected with the old hospital at Rainsford and Long islands for two years, whom I knew to be conscientious, capable, and trustworthy; and he would tell you that I never felt obliged to interfere with him in any way whatsoever, nor did I. Our arrangement for the classification and location in the wards of diseases was complete and well carried out under him. When Dr. Dever left us I considered that Dr. Parker was entitled to a trial as first assistant, so he was appointed. Fearing, however, after some little observation, that, even as my critics say, "He has a heart which is greater than his talent," I took unto myself some duties. for a while which previously had not been considered necessary. And, gentlemen, if you read over certain portions of this testimony carefully, with reference to dates, you will not wonder that at about this time I pursued such a course; and I should like to have Mrs. Evans recall to her mind a certain conversation I had with her relative to Dr. Parker on her third visit to Long Island. Since this hearing has been in progress, though for obvious reasons I should much preferred not to have done so at this time, I have felt compelled, in order to protect myself, to assume the entire charge and responsibilities of the hospital treatment of patients included.

The CHAIRMAN. The committee will now take a recess until 8 o'clock this evening.

EVENING SESSION.

The hearing was resumed in the Aldermanic chamber at 8 P.M., Chairman Hallstram presiding.

STATEMENT OF DR. CHARLES H. COGswell

Dr. Cogswell continued his statement as follows:

Continued.

All this talk about an average number of patients to a nurse is nonsense unless you know the character of the cases to be nursed. In some cases five patients to a nurse would be too many, while in other instances fifty would not. For example, April 28, Mr. Murphy, our nurse in Ward A, reported thirty-one patients under his care. Mrs. Lincoln and her friends would at once exclaim, "Overworked nurse, neglected patients." Some facts: At 8 A.M that day I visited the ward, found two patients asleep in bed, the nurse playing checkers with a third, and the other twenty-eight not in evidence anywhere, out around the island for a walk or over at Loafers' Hall for a smoke, I presume. Nor is this an isolated instance. For the past year our daily average of patients confined to their beds has not been over thirty. They say we correspond to Tewksbury in the class of cases treated. I say we do not, any more

than that all large general hospitals treat about the same diseases. I say that we are much below Tewksbury in the proportion of acute diseases and diseases requiring nursing; and to prove my statement, I offer the following statistics compiled from the last annual report of each institution :

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But it is said it is not merely a question of the number of nurses, it is what their occupation has been; what has been required of them; what their character has been. A great deal of time has been occupied on this subject. Witnesses have testified who knew little or nothing about the facts. To put it mildly and charitably, many misstatements have been made.

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The term floating population," as used in regard to our hospital nurses, certainly cannot apply to our female nurses, as we had the same four September 1, 1894, that we had when the hospital opened, and notwithstanding all statements to the contrary they were all thoroughly competent to fill the positions which they occupied, nor have 1 ever known anything derogatory to their personal character. Now, as to the male nurses, when the hospital opened April 2, Mr. Morphy was the day nurse and Mr. Bowden night nurse. May 16, Mr. Bourse came as night nurse, Bowden going on as second day nurse. As much has been said about Bourse's drunkenness I wish to preface my remarks on him by the statement that he came to me from Tewksbury, where he had been a nurse, with an excellent letter of recommendation. He resigned August 2, because he thought he ought to receive more pay. He was reëngaged August 31, and resigned October 3, under the following circumstances: He had returned that afternoon from leave of absence. What his condition was on arrival I do not know, for I did not see him, but some time afterwards he came into the office at the hospital, for what I do not remember, but he was unmistakably under the influence of liquor. Commissioners Jenks and Pillsbury were there at the time. Both told me they would not keep such a man on the island and to discharge him. I said I intended to do so. That was the first and only time I ever saw him under the influence of liquor. He never was reported to me by any one previously, and up to that time I never suspected that he

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was a drinking man. I considered him as good a nurse as we ever had, and in view of what I considered his previous good conduct he was allowed to resign. Bowden left June 30, and Michael Barrett went on as night nurse July 14, and remained until August 27, when he was transferred to Marcella-street Home. H. W. Hall, who has figured quite extensively in the testimony, about whom McCaffrey and Parker knew so much and so little, depending on circumstances, came September 5, and the best evidence did not show, as counsel promised, that "at least one death was due to his administering medicine to one who should not have received it." About the 10th of November Dr. Parker told me that more whiskey was going out at night than he had ordered. I told him to measure it and make sure. He said he had done so once or twice. I told him to measure it every night and keep a record. I asked him if he had any evidence to prove that Hall took it, as I knew it was possible for others besides Hall to take it, and he said "No." Meantime on Thursday, November 16, Hall came down from the city intoxicated, for which he was discharged. McCaffrey and Parker have not told the truth about this man. I will not say they have made deliberate misstatements. I prefer to think that, not expecting ever to be called on to testify in regard to this case, and having no reason to keep memorandum of dates, they have forgotten and got a little mixed. Up to Friday morning, November 17, no one had ever reported Hall to me as being under the influence of liquor, nor had I seen him in such a condition. On that morning Mr. Doran, an inmate, came to me and said that the night before at about half-past seven he had found Hall asleep in the hallway near his room and had assisted him into it. On the same night McCaffrey reported the same thing, and in addition the fact that that morning he had found Hall asleep in his room with the gas lighted. On Sunday, November 19, Hall was discharged, without any investigation by me, as he acknowledged being intoxicated. He denied, however, ever having taken any liquor for personal use from the ward medicine closet. We had but one other nurse at that time, so I told Hall he could remain a few days until another was secured. November 22 I engaged a Mr. Raymond, but owing to the fatal illness of a relative he did not come until November 27, on which day Hall took his departure. Hall was not discharged, as you see, because Mrs. Lincoln made his drunkenness publicly known. She never has made it known, and I doubt that at the time she knew we had such a man there. Nor did he remain five or six weeks after he was reported for drunkenness and then leave before a nurse came to take his place. The only conversation that I ever bad with Dr. Parker about this man, excepting when he reported the disappearance of the whiskey, was some few days after your committee visited Long Island and Mr. Doran testified that he had seen Hall repeatedly drunk. I thought I would investigate the matter, find out the truth, and see why it was that, if these and other cases were true and all so well known, I had been kept in ignorance, and if any one knew it who would be responsible to report them to me, I wanted to know it. Dr. Parker then told me, for the first time,

that one night he and McCaffrey saw Hall when they thought he he was under the influence of liquor. He has testified here under what circumstances? Neither of them seemed to have thought it of enough consequence to have reported the fact to me.

Raymond remained on as night nurse up to February 13, when Mr. Finnerty came to take the position, Raymond going on as day nurse. Raymond was discharged June 7, 1894, and Lewis N. Connors engaged to fill his place; he with Finnerty and Mr. Morphy constituted our staff of male nurses up to Nov. 1, 1894. If you will examine the dates given here, you will see how little truth there is in Mr. McCaffrey's statements that we were ever dependent on inmates for night nurses any length of time. That we have been without a second day nurse in the male wards a portion of the time is true, but not through any fault of mine nor the commissioners. When the hospital opened I asked authority to engage two day nurses and it was granted, and I have done my best to keep the places filled, but the law has not been passed yet to enable me to go up town and take a desirable man by the collar and say, Here, you come down to Long Island and work at nursing."

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Now, as to trained nurses and a training school at Long Island, Mrs. Lincoln forgot to mention that I told her last fall it was my ambition to have some such system at no distant day, though I have not seen my way clear to it as yet. Our nurses are most of them what would be termed experienced nurses, capable of performing any duty which is expected of them. By having a training school attached to a hospital, you secure a high grade of nursing at a small cost. The treatment of nurses at Tewksbury and their training school has been mentioned. I wonder if they know how long ago that school was started, and if it was within eight months of the time the hospital opened.

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Early in the investigation this statement was made: same false economy and disregard of the welfare of the people under the charge of the institution resulted in denying to the physician the most necessary instruments which they recommended and demanded." On examination what has this dwindled into? Dr. Parker, under cross examination, stated that the only instruments he ever asked for that he did not get immediately were an ether cone, surgical sponges, and applicators. The applicators he would have gotten immediately if he had written for a hard rubber uterine applicator, which was what he wanted; but the clerk at the office not being a medical man did not know where to send for an applicator, and waited to see me, which delayed their arrival. This was no fault of mine. The ether cone, such as was wanted by Dr. Parker at first, or the one we eventually got, I do not approve of. It is not necessary, nor is it used by the best surgeons. I ordered one which was a simple affair, something like a straw sleeve protector, such as are used at the City Hospital. The jar of surgical sponges I have not ordered nor shall I, as I do not approve of them for general use; wads of absorbent cotton are much better. A director, the absence or want of which has occasioned so much talk, was on the island at the time Dr. Parker felt the

need of it, in the instrument case, and had been since a year ago last June. I should not be blamed for the fact that the young man did not recognize it as such when he saw it combined with an artery needle. The idea that I told Mr. McCaffrey Dr. Parker ought to have made one out of a piece of paper was so preposterous that it could not be left without an explanation, so it was offered by Dr. Parker; namely, that Mr. McCaffrey probably got it mixed up with the ether cone which could be made out of paper. That might have gone if it had not been for the fact that Mr. McCaffrey knew nothing at all about the ether cone. Dr. Putnam has said that our supply of instruments was small. I have not any doubt that the instruments he was shown were few in number, and with a purpose. When he was there we did not have them in a case, and what assurance has he that he saw them. Our instruments are not as numerous as those at the City Hospital, but are quite sufficient to do any operation we are ever likely to be called upon to perform, and were decided upon after careful consideration by Drs. Dever, Sullivan, and myself. This purchase was not intended to be final. We have added to our stock from time to time as we found instruments were needed, and it will probably continue for years to come. We do not differ in this respect from the best hospitals in the country.

Again, these statements are made: "That same economy, so called, which presented itself in connection with surgical instruments, also found expression with regard to medicines." "Medicines which would serve the purpose better than anything known, could not be had because they were expensive." To support these statements a witness has been produced who does not know anything about the subject, and a second, whose evident intent and purpose was to mislead - McCaffrey — says he has seen me scratch, scratch, scratch, and so on, cutting off drugs which he and others would have you believe might have saved lives, grinding down the doctors, interfering with their proper treatment, and all sorts of dreadful things. Now, let us get down to facts. I have the original requisitions as made on me by Doctors Dever and Parker up to January 1, 1894 (since that date they say they have gotten everything they asked for), also the requisitions made by me on the Commissioners of Public Institutions. It is fair to presume that if an article appears on the former but not on the latter, it was cut or changed by me, though in one or two instances it was a mistake of the clerk in copying.

Let me tell you what you will find: On March 31, 1893, you will find one-half dozen boxes of belladonna plasters cut down to one-fourth dozen, the latter a three weeks' supply or a month's supply, and we order every two weeks. One-half dozen bottles syrup hydriodic acid cut down to one-fourth dozen, a month's supply. One dozen eye-shades cut off because they could be made at the institution. Five hundred Trinitrin tablets cut off, because, as I told the physician, I preferred them to use a solution of nitroglycerine. I am not to blame if Mr. McCaffrey or any one else did not know that it was the same drug under a different name in a different form. April 15, 1893, you will find 300 five-grain

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