THE EVOLUTION OF A MEDICAL CENTER: A HISTORY OF MEDICINE AT DUKE UNIVERSITY TO 1941.

Bylames F. Gifford Jr. '61. Durham: DukeUniversity Press, 1972. 249 pp. $8.75.

This first of two projected volumes tells interestingly of the origin and early history of the Duke University Medical Center through the first operating decade of the Center, ending at the outset of World War II. Additionally, the first part of the volume in fact is a partial history of the Duke family and of the tobacco industry.

The book will be of special interest to those in any way connected with Duke University and its predecessor, Trinity College, and particularly to those who have allegiances of whatever sort to Duke Medical School, Hospital, and related health interests. There will also be more than parochial appeal, for the story can be related directly to an important era in the history of American medical and health-related education. North Carolinians can enjoy the revelation that their state, largely through the influence of the Duke Endowment and as prescribed by lames B. Duke when the Endowment was established, was early involved with planning and systematizing health education, services, and facilities. This was 30 years ahead of the earliest national evidence that this sort of thing was not only desirable but also downright essential.

The early struggles, trials, and tribulations of those who believed in the wisdom of establishing a full-blown medical center in Durham, North Carolina, seemed finally rewarded when terms of the Duke benevolence permitted the founding of the medical center. Ironically, the timing of the opening of the center in 1931 coincided with the start of the depression years. This circumstance simply changed the nature of the earlier problems and trials. However, the affairs of the center were by then in the hands of a sufficient number of dedicated able leaders believing utterly in their mission, so the various obstacles were finally overcome and the viability of the center clearly established.

The story of the Duke Medical Center recognizes the accomplishments of people who believed in an ideal and who were not dissuaded in their pursuit of the ideal by political difficulties and parochial problems. Often their thinking was well ahead of their time. The final advantage of adequate financing permitted Duke to take its eminent place as a medical center within a private university.

As histories of this sort go, the book is good reading. The second volume may be awaited with interest by those eager to hear the rest of the story.

Active in health administration for the past37 years, Mr. Wilson is Clinical Professor ofHospital Administration, Dartmouth College,and also since 1948 Executive Director ofthe Mary Hitchcock Memorial Hospital,Hanover.