As president of the RIMR board, Welch wooed as its first director his protégé Simon Flexner, whom he had considered his most gifted pupil and America’s best young pathologist. Of German-Jewish ancestry, raised in Louisville, Kentucky, Flexner neatly fitted into the Rockefeller mold of disciplined, self-made men.
Though highly respected in the medical world, Flexner was not a luminary when Welch approached him in early 1902. At thirty-nine, he faced an excruciating decision: whether to surrender a lifetime appointment as a pathology professor at the University of Pennsylvania to leap into the vortex of “an institution devoted exclusively to discovery of something new,” as he put it.12 When Flexner asked Gates why he was certain they would find something new, Gates smirked and replied that he had the faith of fools. The whole thing seemed so shadowy and insubstantial that Flexner hesitated for several months to accept the post. He bargained hard for the ability to offer high salaries to prospective researchers as well as for a promise that the institute would have a small, adjoining hospital in which diseases under study could be tracked in a clinical setting.
Flexner—spare, lean, ascetic, bespectacled—had features as sharp and precise as his mind. He was the sort of fair but tough-minded administrator who appealed to Rockefeller. Many people saw warmth beneath his businesslike exterior, but he was not a bluff clubman. “Flexner was competent,” said H. L. Mencken, “but he was a precise and somewhat pompous fellow.”13 More than one scientist quaked at his exacting expectations and incisive criticisms. Evidently heartened by this perfectionist director, Rockefeller pledged another one million dollars to the RIMR that June. Recalling how quickly Harper had burned up money, he stipulated that Flexner should receive the payments staggered over a ten-year period, slowing the pace of development.
Simon Flexner came to symbolize the institute, and his high-minded tone of scientific rigor established its enduring character. (Sinclair Lewis patterned the character of A. DeWitt Tubbs, the worldly director of the McGurk Institute of Biology in Arrowsmith, after him.) He exhibited a shrewd talent for exciting the public about the RIMR’s work. Soon after his appointment, a reporter tracked him down at his Philadelphia lab amid “the gruesome cans and jars of his work, busy as a hornet,” and he conveyed the audacious nature of the nascent institute, which he called “an extensive scheme, embracing the whole field of study of the cause and prevention of disease.”14 He had a missionary ardor for pure research, then rare in scientific circles. “There is no such thing as useless knowledge in medical research,” he said. “Ideas may come to us out of order in point of time. We may discover a detail of the facade before we know too much about the foundation. But in the end all knowledge has its place.”15
With Flexner signed up, a search committee surveyed Manhattan for a permanent home, and in 1903 bought thirteen acres of farmland on a stony bluff overlooking the East River between Sixty-fourth and Sixty-eighth Streets. When Junior first spotted this site, it was a bleak, treeless slope with cows browsing on the grass. The district was still so poor that the steam-heat company had not run lines there, and it attracted unsavory industries, such as breweries and slaughterhouses. For this so-called Schermerhorn tract, the Rockefellers paid $660,000. After an interim period of eighteen months spent in two brownstone houses at Lexington Avenue and Fiftieth Street, the RIMR moved into its new home on York Avenue in May 1906. Photos show a solid six-story brick building standing on a bare, windswept hill, flanked by a tiny copse of trees and a few sheds, with the Queensborough Bridge being constructed in the background. It is hard to match up this picture with today’s Rockefeller University, the pampered home of Nobel laureates, with its lushly landscaped grounds, screened from the city by magnificent gates and lofty trees.
As at Standard Oil, Rockefeller played the grand ventriloquist, operating at arm’s length. In pithy notes, he transmitted his wishes to subordinates, reserving the right to approve all major commitments of money. Having learned in business to rely on experts, he could seem remote from his own philanthropies. In 1910, Charles W. Eliot, the former Harvard president, lamented to Gates, “Mr. Rockefeller’s method of giving away money impersonally on the basis of investigation by others was careful and conscientious; but it must have cut him off almost completely from the real happiness which good deeds brought to the doer.”16
Rockefeller refrained from interfering with the medical institute’s autonomy and for a long time did not even visit it. While appreciating this restraint, Simon Flexner repeatedly invited him to tour the premises. “Very graciously he said that he could not take the valuable time of the workers,” said Flexner, “and when I said we had many visitors he remarked that made it more important that he should not consume my time.”17 Several years after the main building’s dedication, Rockefeller père and fils were in the vicinity one day when Junior suggested, “Father, you have never been at the Institute. Let us take a taxi up there and look at it.”18 Rockefeller agreed reluctantly. When they pulled up outside the institute, he just sat in the car and stared at it. “Father,” Junior gently prodded, “don’t you want to go in and look at it?” “No,” said Rockefeller, “I can see the outside.”19 After more coaxing, he finally went inside. A staff member gave them a brief tour. Rockefeller expressed his gratitude then left, never to return. His craving for anonymity, such a controversial feature of his business career, seemed noble in his benefactions, and his respectful diffidence before scientific expertise won him praise as an exemplary donor.
However enlightened, Rockefeller’s detachment was also self-protective, for he feared that face-to-face encounters would generate fresh pleas for funds. One reason he did not visit the RIMR sooner was almost certainly that he wished to keep Flexner guessing about his intentions. As late as 1911, he advised his son, “I think it better that no intimation shall reach the Institute representatives of any purpose to increase the endowment in the near future. Let us hold the Institute to the strictest administration and observe for a further time how they get along and delay committal, as long as we can, to be confirmed as to the wisdom of such additional endowment.” 20 This slow development of the RIMR was a classic Rockefeller move.
In retirement, he devoted about one hour per day to philanthropy. Yet he managed to preside over this charitable universe in deed as well as name, demanding that his administrators have the exactitude of scientists, the sound economy of businessmen, and the passion of preachers. It was not the case, as Charles Eliot feared, that Rockefeller derived no pleasure from his good works, for he was engrossed in the RIMR. “If in all our giving, we had never done more than has been achieved by the fine, able, honest men of the Medical Institute,” he once remarked, “it would have justified all the money and all the effort we have spent.”21 Doc Rockefeller’s son took more pride in the RIMR than in any of his creations other than Standard Oil. In response to Eliot’s letter, Gates explained that Rockefeller stayed abreast of developments there:
I make it my business to keep Mr. Rockefeller personally informed of every important thing done and every promising line of inquiry at the Institute. He knows the lines of experiment trembling on the verge of success and their thrilling promise for humanity. I have seen the tears of joy course down his cheeks as he contemplated the past achievement and future possibilities of the Institute. He is a man of very quick and tender sympathies just as he is a man of a keen and lively sense of humor.22
Allowing for a certain hyperbole, the portrait is essentially just.
While Flexner paid social calls on Rockefeller and always found him cordial, he and Welch dealt mostly with the nonmedical trustees—Gates, Junior, and Starr Murphy—on policy matters. They made presentations that evoked the high drama of their medical sleuthing, holding their auditors rapt. As president of the trustees, Gates sat at the head of the table, his tie askew, shaggy hair falling over his forehead, flaming with enthusiasm at each new discovery, while the self-contained Junior posed well-chosen questions. Both Gates and Junior brought an almost mystical
intensity to these meetings, as if their spirituality was finding a new home in scientific research. Gates likened the RIMR to a “theological seminary” and described Flexner’s work as a kind of prayer. He told Flexner, “To you He is whispering His secrets. To you He is opening up the mysterious depths of His Being. There have been times when, as I looked through your microscopes, I have been stricken with speechless awe. I felt that I was gazing with unhallowed eyes into the secret places of the Most High.” 23 For many of the men associated with the early Rockefeller philanthropies, science seemed to beckon as a new secular religion as the old spiritual verities waned.
Since cynics thought the RIMR would be relegated to ivory-tower irrelevance, Gates tried to shelter Flexner from any anxiety about immediate results. Then a sudden opportunity for heroism arose during the winter of 1904–1905, when three thousand New Yorkers died in a cerebrospinal meningitis epidemic. In response, Flexner developed a serum in horses to treat the disease. During monkey trials in 1907, he found that if injected at the proper spot in the spinal canal, the serum would treat the disease effectively. Rockefeller eagerly followed developments, telling a friend on January 17, 1908, “Only two days ago I was called on the telephone to speak with a German doctor, who had given it to a patient, and he reported that in four hours after the first application, the temperature became normal and so continued, and he was very hopeful at that time of the recovery of the patient.” 24 Until early 1911, when the New York City Board of Health took up the slack, the RIMR distributed the Flexner serum free as a public service. Later, the disease was treated with sulfa drugs and then antibiotics, but in the meantime Flexner’s serum mercifully spared hundreds, perhaps thousands, of lives. The press lionized him as a miracle worker, redounding to the lab’s benefit.
In a turbulent season of antitrust suits, Flexner’s triumph generated goodwill for Rockefeller, and this loosened the master’s purse strings. In early 1907, the institute directors asked Rockefeller for a $6 million endowment; eager to dampen starry-eyed hopes, he consented to $2.6 million, or less than half the desired amount. That same year, Junior advised him that the time was ripe to build the small adjoining hospital that had been promised to Flexner; the combined cost of endowment and hospital would be $8 million. As Rockefeller pondered this, the triumph of Flexner’s serum tipped the scales, and in May 1908 Junior notified the board that his father, in homage to this feat, would create a sixty-bed hospital and a nine-bed isolation pavilion. As blueprints were rolled out, Rockefeller tempered his generosity with his usual pinchpenny pleas for economy. “It is easy for these institutions to ask for money,” he told his son. “We have not one farthing to expend injudiciously.”25 When it opened in 1910, the hospital treated, free of charge, patients afflicted with any one of five priority diseases under study: polio, lobar pneumonia, syphilis, heart disease, and intestinal infantilism. Four rooms on the top floor were reserved for the Rockefeller family, but Senior never took advantage of this privilege, despite Gates’s constant urging: “The physicians are extremely polite, gentle, and courteous, and the nurses the very paragons of their tribe,” he assured him.26 But Rockefeller stubbornly preferred his osteopaths and homeopaths, whom he could also more easily control.
Now an independent foundation established in perpetuity, the RIMR adopted bylaws creating a board of scientific directors with unlimited control over research—a declaration of faith in science unprecedented in American philanthropic annals. (A separate board of trustees saw to fiscal matters.) In the estimation of one periodical, the RIMR was now “probably the best equipped institution for the study of the causes and cure of disease to be found anywhere in the world”—high tribute for an outfit less than ten years old.27 It was becoming the most richly endowed institute of its kind on earth, cranking out an enduring catalog of medical wonders.
More than a laboratory wizard, Flexner was a master talent scout. He collected brilliant strays, loners, and eccentrics who found the relaxed atmosphere of the institute congenial to their creative work. On his East River bluff, he marshaled an outstanding stable of scientific talent—he proudly dubbed them his prima donnas—including Paul Ehrlich and Jacques Loeb. Another inspired hire was a Japanese lab worker, Hideyo Noguchi, who would perform pathbreaking work in the study of syphilis. Flexner turned the institute into a series of autonomous departments, with each fiefdom shaped around a resident genius, while he kept close tabs on the central budget.
Flexner’s most prescient decision was to recruit the French-born surgeon Dr. Alexis Carrel from Chicago. Short and thickset, with an erect, military bearing, Carrel was a Catholic mystic and diehard royalist. His future medical agenda was defined in 1894 when President Sadi Carnot of France was stabbed by an assassin and died from the hemorrhaging of a severed blood vessel. Then only twenty-one, Carrel turned to the puzzle of rejoining severed vessels and devised solutions that would facilitate blood transfusions, organ transplants, and other advanced surgical procedures. Rockefeller frequently told dinner guests the dramatic tale of how Dr. Carrel, in 1909, saved the life of a premature infant who developed melena neonatorum, a condition in which blood oozes from the digestive tract. In a wondrous operation, Carrel resuscitated the pallid infant by attaching a vein in its leg to the artery of its father, a New York physician; within minutes, a rosy flush suffused the baby’s face. In 1912, Carrel won the Nobel Prize for medicine, the first ever awarded to a researcher in America.
Rockefeller was fortunate to have applied his money at the precise moment that medical research matured as a discipline and offered unbounded opportunities. None of the titan’s other philanthropies was perhaps such an unqualified success. Bowing to a serviceable division of labor, Andrew Carnegie ceded medicine to Rockefeller. Once approached about building medical facilities, he smiled shrewdly and said, “That is Mr. Rockefeller’s specialty. Go see him.”28
After decades spent warding off abuse, Rockefeller and his entourage were delighted, perhaps even mildly surprised, by the unalloyed praise heaped upon the RIMR. Gates fairly glowed with pleasure: “The nicest ear can scarcely detect a single discordant note.”29 In pleading for money for the RIMR, Junior observed to his father that “none of the Foundations which you have established are so popular with the public generally or so free from criticism as the Institute. I feel, therefore, that large sums of money are, in a sense, safer there than in other fields.” 30 Gates expanded on the theme that through medical research Rockefeller money touched everyone on earth and that “the values of medical research are the most universal values on earth, and they are the most intimate and important values to every human being that lives.”31 How could Rockefeller, long the target of almost universal obloquy, not embrace this new role of benefactor of all humanity? His gifts also reflected his own obsessive concern with longevity. When Carl Jung, the Swiss psychoanalyst, met Rockefeller in 1912, he recorded this impression: “He is almost exclusively preoccupied with his bodily health, thinking of different medicines, new diets and possibly new doctors!”32
In his inner circle, Rockefeller faced one boisterous critic of the RIMR: his golfing pal and crony Dr. Hamilton F. Biggar, a champion of homeopathy. A small-town doctor of the old school, Biggar was wont to pontificate: “We have too much laboratory and not enough bedside practice.”33 It was partly at Biggar’s behest that Rockefeller had balked at the merger of the University of Chicago with the allopathic Rush Medical College. Under Biggar’s influence, Rockefeller nearly refused to provide a $500,000 check to repair the Johns Hopkins Medical School after it was partially destroyed by fire in 1904—simply because the school refused to recognize homeopathy. Gates dismissed the work of Samuel Hahnemann, the German founder of homeopathy, as “the wild imaginings of a natural fool turned lunatic,” and found it hard to endure Rockefeller’s vestigial faith in what he saw as outdated medicine.34 Although he often muzzled his strong views on the subject, Gates’s real aim was to deliver a mortal blow to homeopaths—to shut their medical schools, expel them from
medical societies, and strip them of hospital privileges—so as to clear the field for scientific medicine. Gates considered Biggar, if not a charlatan, at least a fossil and feared his rearguard attempts to undermine the RIMR.
At one point, antivivisection activists created an uproar about experiments at the RIMR, and Biggar leaped into the fray, complaining to Rockefeller about the cruelty inflicted on the lab animals. At this point, Gates decided to wipe out Biggar’s influence forever. In several caustic memos to Rockefeller, he lashed out at the homeopaths: “Neither Dr. Biggar nor any of his Homeopathic friends have told you, so I think it in hand to tell you, this fact—that Homeopathy is rapidly dying out in this country”—ditto for allopathy. “Both are fading away as schools of medicine with the dawn of scientific inquiry. Both were wrong. The theories of both have been completely exploded in the last twenty-five years.”35 In an early version of the letter, never sent, Gates was even more outspoken. “Dr. Biggar has not kept up with the progress of medicine and is still living in the twilight of two or three generations ago.”36 In deference to his golfing partner, Rockefeller did not acknowledge these memos.
It was deeply ironic that Rockefeller retained such residual faith in homeopathy even as he financed the world’s most sophisticated medical-research operation. Periodically, he had spasms of irritation, firing off letters on the need to save homeopathy, but these outbursts quickly passed. Through his philanthropies, Rockefeller did more than anyone else to destroy homeopathy in America, and in the end he seemed powerless to stop the scientific revolution that he himself had so largely set in motion.