The ‘Lost Oration’ — Flashback: March 1917

March 29, 2017

Intense changes roiled the world in March 1917. World War I had been underway for more than two-and-a-half years. In Russia, the 300-year-old Romanov dynasty collapsed at the start of what became an unfolding revolution and civil war. The U.S. was technically neutral, but German attacks on American shipping would lead President Woodrow Wilson and Congress to declare war against Germany and its allies the next month.

Mayo Clinic was on a precipice of its own.

For several years, the Mayo brothers had seen the need to create formal programs in advanced education for physicians. At the time, this field was essentially unregulated. Practitioners — after only a few weeks of “study” — could frame a certificate and claim to be a “specialist.”

The Minnesota State Capitol Building as it looked in the 1910s.

In response, William J. Mayo, M.D., and Charles Mayo, M.D., took a series of steps that created a separate entity called Mayo Foundation for Medical Education and Research. Starting in June 1915, in affiliation with the Graduate School of the University of Minnesota, the foundation provided academically sound training in a range of specialties. As a sign of their commitment, the brothers gave $1.5 million (equivalent to more than $36 million today) to fund the program.

To the brothers’ dismay, the affiliation sparked a storm of protest. Critics included county medical societies and individual physicians throughout the state. Perhaps the idea was too new and innovative. Possibly the critics could not fathom the Mayos’ spirit of altruism. Rhetoric became heated: “Barbarians at the gates” and “a phantom gift and a trial marriage” were some of the printable charges. Biographer Helen Clapesattle described “the personal spite and malice, the disgraceful misrepresentation and abuse.”

Although the program flourished from the start, attacks continued and, in early 1917, a bill was introduced into the Minnesota State Legislature. It sought to dissolve the affiliation between Mayo and the university.

According to Clapesattle: “When a public committee hearing on the pending bill was announced, some of the university officials considered the situation serious enough that they asked Dr. W.J. Mayo to appear for the Foundation. It was an amazing request to make – to ask a man to defend himself for being magnificently generous! But after a minute’s thought Dr. Will replied, ‘I’m a good soldier. If you … think it’s necessary, I’ll do it.’ ”

The crowded, fractious chamber hushed as Dr. Will began to speak. Clapesattle said “He talked … simply, earnestly, colloquially.”

“So that you may understand what my brother and I desire to do, let me go back to our boyhood days.

My father, Dr. W.W. Mayo, was recognized as the leading physician and surgeon of Southeastern Minnesota. When we were small boys we assisted him as much as we could, gradually growing into the profession much as a farmer boy learns by working with his father. …

Now my father had certain ideals. He believed that any man who had physical strength, intellectual capacity or unusual opportunity held such endowments in trust to with them for others in proportion to his gifts. …

I have always thought a good deal of Lincoln’s Gettysburg Address. There’s a line in it which explains why we want to do this thing. It is ‘that these dead shall not have died in vain.’ We know how hard it is for those who have had the misfortune of deaths in their families, of deaths that might have been avoided. What better could we do than take young (colleagues) and help them become proficient in the profession so as to prevent needless deaths?”

Helen Clapesattle wrote that a quarter-century later, people who had heard the speech “were still referring to it as the greatest, most eloquent speech they had ever listened to.”

And yet it almost disappeared from the historical record. Dr. Will spoke without notes or manuscript. In that era of silent movies, it was not possible to capture a live speech on film. Fortunately, a few journalists in the crowd took notes – shorthand then being a common business skill – and jotted down some of Dr. Will’s words. His transformative speech is known in the annals of Mayo Clinic as the “Lost Oration.”

The bill failed, but the ideals expressed in Dr. Will’s impromptu remarks still guide the mission of Mayo Clinic, in which medical education and research advance the ultimate goal of serving patients.

The affiliation with the University of Minnesota continued in the decades that followed. The opening of the Mayo Memorial Building on the university’s campus in 1954 symbolized the relationship. Starting in 1983, Mayo Clinic became an independent, degree-granting institution, and collaboration with the University of Minnesota continues in other avenues.

Mayo Clinic has undergone several changes in corporate structure and governance over the years, but the priorities of patient care, research and education remain central to our mission, as symbolized by the three shields of the Mayo Clinic logo.

TRANSCRIPT OF “THE LOST ORATION”

Remarks of William J. Mayo, M.D., to the Senate Committee on Education, Minnesota State Legislature, March 22, 1917.

Source: Aphorisms of Dr. Charles Horace Mayo, 1865-1939, and Dr. William James Mayo, 1861-1939, Collected by Fredrick A. Willius, M.D. Rochester, Minnesota: Mayo Foundation for Medical Education and Research, 1990. Appendix I, pages 85-92

In 1917 a bill was introduced into the Minnesota State Legislature for an act to instruct the Board of Regents of the University of Minnesota to dissolve the affiliation of the Graduate School of the university with the Mayo Foundation for Medical Education and Research. This affiliation had been established by the Board of Regents on June 9, 1915. On the night of March 22, 1917, Dr. Mayo appeared before the Senate Committee on Education which was conducting public hearings on the bill. His extemporaneous remarks, set down only by the newspaper reporters present, were so powerful and so eloquent that support for the bill subsided rapidly, and it never became an act. Dr. Mayo used no manuscript. The version which follows is reproduced from the Minneapolis Morning Tribune, March 23, 1917, by special permission of the Minneapolis Star and Tribune Company.

I had some hesitancy in appearing at this meeting. There has been much misunderstanding and misapprehension about the whole plan. So that you may understand just what my brother and I desire to do, let me go back to our boyhood days.

My father, Dr. W.W. Mayo, was recognized as the leading physician and surgeon of Southeastern Minnesota. When we were small boys we assisted him as much as we could, gradually growing into the profession much as a farmer boy learns by working with his father.

Now my father had certain ideals. He believed that any man who had physical strength, intellectual capacity or unusual opportunity held such endowments in trust to do with them for others in proportion to his gifts.

As our business grew, my brother and I added men to the staff, not as hired men but as co-workers. We have had our ideals. Everyone who came into the clinic and hung up his hat was to get treatment regardless of the cost and no one was asked if he had the price.

Because erroneous statements have been made in this regard, I will say that we have never charged a physician or a clergyman or any dependent member of the family of either.

As we grew larger, we took in young men and finally built up a school and provided fellowships to enable students of exceptional ability to work and study in connection with the clinic. We had 26 of those fellowship students in 1914, before the arrangement with the University.

In 1898 my father retired and we took what money we had and turned it over to Burt W. Eaton, a fellow townsman, with instructions to look after it and such additions as we might make. Last year it totaled about $1,500,000. It is the basis of the endowment of the foundation.

We have never taken notes at the clinic. No mortgage has ever been given on a home to pay a bill there. We never sue. Thirty percent of our patients are charity cases. About 25 percent pay barely the cost of treatment.

I can’t understand why all this opposition should have been aroused over the affiliation with the University. It seems to be the idea of some persons that no one can want to do anything for anybody without having some sinister motive back of it.

If we wanted money, we have it. That can’t be the reason for our offer. We want the money to go back to the people who gave it to us. The proposal for this affiliation came from the University to us and did not originate with us. We want to serve the state that has given us so much and we think the best way we can serve it is through medical education.

The offer of the endowment fund of the foundation when the affiliation becomes permanent is an outright tender despite the talk of a “phantom gift” which has been heard throughout the state. I know that doctors of Minnesota two years ago were appealed to in letters containing misrepresentations.

Now let’s call a spade a spade. This money belongs to the 2,500,000 people in this state. I don’t care two raps whether the medical profession of the state like the way this money has been offered for use. It wasn’t their money. Discussions against the affiliation have been in the past of just such petty and trivial detail as we have heard tonight.

I have always thought a good deal of Lincoln’s Gettysburg address. There’s a line in it which explains why we want to do this thing. It is “that these dead shall not have died in vain.” We know how hard it is for those who have had the misfortune of deaths in their families, of deaths that might have been avoided. What better could we do than take young men and help them to become proficient in the profession so as to prevent needless deaths?

We are willing to change the contract at the end of the trial period, if that is thought wise. If our committee will come to Rochester, we will show you what is being done and what the arrangement means. My brother and I are over 50 years old. What better can we do than devote our remaining years to this work?

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The ‘Lost Oration’ — Flashback: March 1917

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