Early Hospital Social Work Practice

Abstract

Janet Thornton (1881–1963) was the director of social services at Columbia-Presbyterian Medical Center in New York City from 1924 to 1947. Drawing on previously unexamined archival letters and documents, this article presents a professional and personal perspective on Thornton’s life. Restoring her to the historical record on hospital social work brings into focus the foundations of present-day social work practice in health care settings and adds new insights into the role of women in the burgeoning profession.

In 2003, as a social work manager at New York City’s Columbia–Presbyterian Medical Center and the editor of the department’s newsletter, I was researching the history of the hospital’s social work department in preparation for its 2004 centennial when I rediscovered a forgotten but truly remarkable woman. Janet Thornton (or JT as she was called) was the director of social services at Columbia–Presbyterian from 1924 to 1947. Nine boxes of archival materials in the University of Virginia (UVA) Library (consisting of correspondence among eight members of the Thornton family on topics ranging from Civil War veterans, to the building of the Panama Canal, to World War I, and to the evolution of hospital social work) and an oral history from JT’s 92-year-old nephew provided a prolific chronicle of this important American family. The materials in these archives give us a unique opportunity to remember and honor a captivating life that brings into focus the beginnings of health care social work. Little information has been published on this social work pioneer; without the discovery of the family archives at UVA, much of this rich history would have remained buried in archival boxes in a library basement.

Reviewing JT’s life opens up a period in hospital social work that has rarely been written about. The model of medical social work practice that she developed in the middle years of the 20th century remains germane to and consistent with contemporary standards of social work practice. JT was also influential in the larger field of social work, holding local and national offices and working diligently to raise professional standards and promote social work education, including being active in organizing the American Association of Medical Social Workers and the National Association of Social Workers (Albert and Shirley Small Special Collections Library Archives, Thornton Family Papers, 1886–1962, box 6, hereafter Thornton Family Papers). At the same time, her life and work offer a fascinating glimpse into the network of progressive women who played a key role in the development of social work in this period. Compared to most American women, JT was atypical of her time. Yet, she was typical of politically progressive women who were active in movements to effect social change in the late 19th and early 20th centuries. This article serves to reintroduce JT, highlight her contributions to hospital social work, and lay the foundations for future scholarship on her life and work.

Foundational Experiences

Janet Thornton was born in 1881 to a well-established Virginia family with ties to prerevolutionary America. Higher education was important to the Thornton family, partly because of the family’s connection to UVA where JT’s father was the first dean of the School of Engineering (Thornton Family Papers, box 1). JT attended St. Timothy’s, an Episcopal girl’s boarding school outside Baltimore and then Bryn Mawr (1901–1906). Her choice of college was due, in part, to her admiration of M. Carey Thomas, Bryn Mawr’s first dean (1894–1922; Thornton Family Papers, box 6). The formative years that JT spent at Bryn Mawr were during the time that Thomas dominated the college. A staunch representative of women and higher education (Horowitz, 1994), Thomas advocated for women to be treated on equal grounds to men (Bryn Mawr College, 1935; Cross, 1965; Horowitz, 1994,). During JT’s time at the college, for example, Thomas eliminated classes that were seen as feminine, such as piano, cooking, and parenthood (Cross, 1965).

Attending boarding school from a young age and JT’s exposure while at Bryn Mawr to Thomas and to fellow-minded students fueled an independent spirit at a time when most women occupied a subjugated role in society; for example, women did not have the right to vote until JT was 39 years old. While at Bryn Mawr, JT met women like Mary Antoinette Cannon (who was called Antoinette), who later became her life companion. Antoinette became a prominent social worker who was influential in hospital social work practice (holding important positions in Boston, Philadelphia, and New York) and serving as a faculty member at the New York School of Social Work (since 1963 Columbia University School of Social Work) from 1921 to 1945. Political activist Anna Louise Strong was also at Bryn Mawr during the time that JT attended. Strong became a communist, a proponent of social service and child welfare, and a journalist reporting from the Soviet Union and China. Independent-minded and progressive women, such as Cannon and Strong, undoubtedly influenced JT. After graduating from Bryn Mawr in 1906 with an AB in Latin and German, JT followed a route that was common to social workers in training at that time, joining the staff of the Philadelphia Society for Organizing Charity, first as an intern and then in 1907 as a staff member. She was supervised by the prominent social work practitioner, teacher, and theoretician Mary E. Richmond, author of the 1899 social work classic, Friendly Visiting Among the Poor, a Handbook for Charity Workers and, later, the seminal text, Social Diagnosis (1917). Richmond believed in “immersion” as training for future social workers, saying that the “friendly visitor must largely be educated in the work as the child learns to swim in water” (Agnew, 2004, p. 62). JT’s personal correspondence indicates a great fondness and respect for Richmond. In a 1907 letter to her father, JT proclaimed that “Miss Richmond has the understanding heart . . . her [weekly lectures] are illuminating, very free from pedantries, preacher and psychologist attitudes” (Thornton Family Papers, box 4). A letter the following year shows clearly the influence of Richmond’s study, diagnosis, and treatment framework in JT’s work:

A case is reported by some neighbor or someone who hears of its need, then we visit the home and try to take a full picture of the present situation, past history, and their future plans if they have any. We try to make a thorough investigation in order to know the case and what is really the right treatment . . . Diagnosis follows after examination, and after that treatment. Real difficulty comes at the beginning and the end. . . . After a decision is reached we have to carry out the plan if possible. Half the time we can’t because we can’t change people’s state of mind (February 1908 letter to her sister Rose, Thornton Family Papers, box 4).

In these early professional years, JT displayed the apprehension of a 24-year-old student who was learning to diagnose the “social ills” of the poor. In the same letter, she described the sheer magnitude of the work:

Miss Richmond says she has not known a year like this in all the time of her connection with the Society. There are simply thousands of unemployed men, not only the usual lot of tramps and thieffers but steady, hard working fathers of large, respectable families. I don’t see myself that we are doing much good. It takes too long to develop the really efficient resources to meet such emergencies. But then I know next to nothing about it all and ought not form opinions yet (Thornton Family Papers, box 4).

Despite these insecurities, JT went on to become “superintendent” of the Philadelphia Society for Organizing Charity and a proponent of Richmond’s “social diagnosis” approach (Thornton Family Papers, box 4). In a March 23, 1908, letter to her father, JT discussed her promotion and her expanding interest in social work:

I am very much gratified at having the Superintendent’s position given me, for it proves I must have been somewhat successful—the opportunity to do good work for me, and I had to try. I doubt if I should ever get another chance like it, and after all I believe my happiness like most other people’s depends on working at something I am interested in. (Thornton Family Papers, box 4)

Nonetheless, JT was restless. In February 1909, she told her sister Rose that she was considering a move to Boston:

I am about on the point of applying for a position in the Boston Society and also one in Dr. Cabot’s hospital social work service. Indeed, I don’t know why I have been waiting, for I certainly do want to be in Boston next winter . . .. I feel just a little dread of starting in a new place. Miss Richmond here has certainly been kind and I can hardly find anyone in Boston I shall like more. (Thornton Family Papers, box 4)

By 1911, JT had taken herself farther along the training route to Boston and an internship and then paid position at the Boston Dispensary. Founded at the end of the 18th century to provide medical relief for the poor, the Boston Dispensary was at the forefront of considering the social conditions of patients. For example, individuals were permitted to make regular payments as a type of “insurance,” allowing them to receive medical treatment when needed. Many aspiring social workers trained at the Boston Dispensary; in 1960, it merged with Tufts Medical Center.

From Charitable Casework to Medical Social Work

JT was to become prominent in the burgeoning profession of hospital social work. As the 1921 proceedings of the American Hospital Association’s (AHA) 23rd annual convention in West Baden Springs, Indiana, where a “service bureau” for hospital social services was first recommended and ratified, make clear, she was part of an interconnected community of leading hospital social service advocates—most notably Ida Cannon, Michael Davis, and Antoinette Cannon ( What Happened at the Convention, 1921 ). By 1921, involving social services had become the standard of good medical care, and individuals, such as Ida Cannon, Davis, Antoinette Cannon, and JT, continued to learn from one another and, through their various interrelated professional activities, promoted consideration of the social component in medical care.

Ida Cannon, founding mother of medical social work (and no relation to Antoinette Cannon), established the country’s first hospital social service department at Massachusetts General Hospital in 1905, in collaboration with Dr. Richard Cabot (Rehr & Rosenberg, 2006). In March 1913, JT wrote to her father saying that she had paid $5 to enroll in Extension Lectures in Connection with Special Course in Medical Social Service, taught by Ida Cannon and Cabot and a number of prominent physicians at Simmons College (Thornton Family Papers, box 5). At the 1921 convention, Ida Cannon, then director of Massachusetts General Hospital’s social service department, was appointed the first director of the AHA’s service bureau for social services (of which JT and Antoinette were important participants) and presented a report on the status of the country’s then estimated 370 hospital social service departments.

Michael Davis, a PhD in sociology who played a prominent role in the study of “dispensary treatment” and health care administration and policy (Mullner, 2009), was JT’s supervisor when she started work at the dispensary in 1911. Initially, JT found dispensary work difficult and her supervisor unsatisfactory. Writing to her mother in March 1914, she described Davis as someone “I neither like nor trust.” Furthermore, she continued, “the place is in a state of disorganization and unrest, inharmonious relations between doctors and Board to director, inadequate funds, etc.” (Thornton Family Papers, box 5). However, JT went on to become one of the pioneers of dispensary/hospital social service and to develop a lifelong professional relationship with Davis. (Reflecting the interlocking nature of the relationships in this group, Davis and Antoinette Cannon also formed a close professional bond while working together at the New York School of Social Work, where they taught the course, Problems of Hospital Social Work.) Davis was a major participant at the 1921 convention as director of the AHA’s service bureau for dispensary care.

It was important to JT that social work be afforded respect as an integrated but specialized part of a hospital’s medical services. When Davis left the Boston Dispensary in 1920, JT became the director, writing confidently about successful “dispensary treatment” and the need for patients to understand the plan of treatment. In her view, “the great failure on the part of the hospital is the failure to understand the psychology of the patient, a failure which is not medical, but social” (Thornton, 1919, p. 278). At the 1921 convention of the AHA, JT prepared a presentation entitled, “The Place of Social Service in the Administration of Hospitals and Dispensaries, or the Relationship of Hospital Social Service to other Hospital Services” ( What Happened at the Convention, 1921 , p. 302), which was delivered by her professional and personal confidant Antoinette Cannon. JT concluded: “Social services rightly understood and practiced is an integral and specialized part of the hospital’s medical services. It is not a generalized hospital service; neither is it a generalized community service interjected from without, nor a graciousness contributed by a ladies committee” ( What Happened at the Convention, 1921 , p. 302).

Also in 1921, JT was appointed to the United Hospital Fund’s (UHF) Committee on Dispensary Development; the committee was headed by Michael Davis. This position took her around the country advising on the development of multidisciplinary medical clinics. In 1924, while completing her responsibilities with the UHF Dispensary Committee, she was recruited by Columbia–Presbyterian Medical Center in New York City and was soon appointed director (Thornton Family Papers, box 5).

Practice and Research Leadership at Columbia-Presbyterian Medical Center

In 1904, Presbyterian Hospital (now Columbia–Presbyterian Medical Center) placed a social worker in the Neurological Institute to assist patients with the “social component” of illness. This “social worker” was a nurse, who focused on prevention and community organization efforts to promote public health (Lamb, 1955). Poverty, chronic disease, unsanitary conditions, and substance abuse were all recognized as contributing to a patient’s overall health and ability for recovery. Affirming the importance of social services, the medical center subsequently hired more social workers and decided to organize an official department in the 1920s. JT was to become this department’s first director.

At Columbia–Presbyterian, JT received support and guidance from Dr. Hugh Auchincloss, who served as the social service representative to the hospital’s medical board. Mirroring the relationship between Ida Cannon and Dr. Richard Cabot in Boston, the doctor and the “social worker” collaborated; JT and Auchincloss designed a program that integrated social service with the medical work of the hospital. Unit-based social workers became part of the medical team and were responsible for identifying social factors, contributing relevant information, and advising on treatment. Foreshadowing modern-day hospital-based social service departments (Lamb, 1955), JT created a strong centralized department with the dual responsibility of attending to the psychosocial needs of patients and the training and credentialing of new social workers. Since JT did not have a formal degree in social work, the department turned to faculty of the New York School of Social Work to provide training and instruct staff workers on the supervision of students. The faculty representative was her close friend Antoinette Cannon.

JT also broke new ground in her support for practice-based research. In 1930, the Auxiliary of Vanderbilt Clinic at Columbia–Presbyterian gave a grant of $10,000 to be used “not for current expenses but for some undertaking to improve the work of the Social Service Department” (Lamb, 1955, p. 279). This grant sponsored a major research study, organized by JT, to investigate the connection between social disorders and medical problems. The result was The Social Component in Medical Care, A Study of One Hundred Cases From the Presbyterian Hospital in the City of New York (Thornton & Knauth, 1937). This study brought forth a taxonomy of social problems that have an impact on health. In her preface, JT stated that she saw the book as a way to promote social work departments in other hospitals across the country and noted that she hoped to communicate “the social factors affecting medical issues and applying measures that highlight the patient’s strengths” (Thornton & Knauth, 1937, Preface, n.p.). Thornton’s objectives and hypotheses for the study were consistent with her training in “social diagnosis” by Richmond, Ida Cannon, and Cabot. Thornton concluded that “disability can be decreased by controlling adverse social factors affecting individual patients.” (Thornton & Knauth, p. 282)

The book received favorable reviews. In The American Journal of Nursing, Carter (1938) concluded that the authors were successful in presenting the impact of social factors on a patient’s recovery and that the case studies would be particularly helpful to public health nurses. In The Milbank Memorial Fund Quarterly, Hiscock (1937, p. 393) wrote that “Conclusions drawn . . . are highly valuable as additions to the knowledge from medical social work and from considerations of the various causes of depletion of body substance, fatigue and emotional tension.” The editors of the British Medical Journal were similarly positive, noting that, “We have a great task to correlate the physical and mental welfare of mankind with social states” ( Social Background of Ill Health, 1937 , p. 22).

In his 1955 book on the history of Presbyterian Hospital and Columbia–Presbyterian Medical Center, Lamb concluded that the work of the social service department had proved invaluable to ushering in “modern medical practice,” in which patients are required to take an active part in their diagnosis and treatment, and that it was “necessary therefore that the doctor know their way of life in order to instruct them in their part and insure the means to carry it out” (Lamb, 1955, p. 275). He went on to say that there are patients who derive little benefit from medical attention unless they are assisted by social service “to regulate their lives and alter their environments in prescribed ways” (p. 280). Although not as clinical as Lamb in his description, JT clearly promoted a diagnostic approach to social work intervention, believing that identifying and improving a patient’s social factors would decrease the impact of disabilities. This important work continues to form the nucleus of present-day health care social work.

On a Personal Note

With her move to New York City in 1924, we learn more about JT’s personal life. At Bryn Mawr, JT met Antoinette Cannon, who went on to become an influential social worker in New York City, receiving her master’s degree in social work at the New York School of Social Work and later becoming an instructor at the school. Antoinette became JT’s professional colleague and personal companion. In 1921, she moved from Philadelphia, where she had been the director of social work at the University of Pennsylvania Hospital, to New York City, where she joined the faculty of the New York School of Social Work. While at the Bryn Mawr Club in the city, Antoinette met up with her old friend JT, and the two decided to take an apartment together. In 1923, with an investment of $1,000 each, the two women purchased a house at 84 Macdougal Street in Greenwich Village (Thornton Family Papers, box 4). They occupied this home together until Antoinette’s death in 1962.

When interviewed in 2004, JT’s 92-year-old nephew, John T. Thornton, Jr., recalled her as a “very nice, very well educated and well spoken, somewhat homely woman.” He described her as “avant-garde “ and “unconventional,” noting that his first memory of her was when he was very young and his family traveled from West Virginia to New York City for the first time. They stayed at the house on Macdougal Street, and John recalled being “shocked” to see that JT smoked and drank alcohol, behavior he had never seen in a woman. John’s mother assured him that this “was how ladies lived in the North.” He fondly remembered many trips to New York City and time spent with his aunt and Antoinette (lovely woman) at the house on Macdougal Street (personal communication with John T. Thornton, Jr., nephew of Janet Thornton. Charlottesville, VA. July 1, 2004).

As a student and during her professional life, JT was exposed to and nurtured by women-centered institutions and organizations, places where women could experience “unity and continuity between public and private, work and politics, friends and companions” (Frazen, 1996, p. 107). Many of the women who undeniably influenced JT also had female companions: educator and feminist M. Carey Thomas with Mamie Gwinn and then Mary Garrett (Horowitz, 1994); New York School of Social Work professor and social work researcher Florence Hollis and Rosemary Reynolds (Five Colleges Archives and Manuscripts Collections, Sophia Smith Collection, Hollis-Reynolds Papers, 1863–1987); settlement house leader Jane Addams and Ellen Gates Starr and then Mary Rozet Smith; Thornton’s associate director of social work at Presbyterian and later New York School of Social Work professor Gordon Hamilton and Anna Kempshall and then Ruby McKay; and, perhaps most significant, JT’s early mentor Mary Richmond with Zilpha Smith and then Louisa Eyre (Fredriksen-Goldsen, Lindhorst, Kemp, & Walters, 2009).

Frazen (1996) noted that these relationships (sometimes referred to as Boston Marriages) cannot be fully understood within contemporary understandings of intimacy and sexuality. Nonetheless, acknowledging the existence and nature of JT and Antoinette’s relationship provides another dimension when considering their professional significance and accomplishments. JT and Antoinette had a personal life that nurtured and supported their work—they were not, in Franzen’s words, “lonely spinsters or married to their work” (p. 120).

Whether or not JT and Antoinette were what could be referred to by the contemporary understanding of the term lesbian, it is clear that the women had a passionate relationship. The archives hold many letters from JT to Antoinette. Unfortunately, there are few reciprocal letters from Antoinette; however, it could be seen as significant that so many of JT’s letters were preserved (by Antoinette?) and later added to the Thornton Family Papers (by JT?). Either Antoinette was not as prolific a writer as JT, or JT did not save all Antoinette’s letters, but the letters from JT were obviously important to both women, who took steps to save them for perpetuity.

Both women were involved in their work; JT had only 2 weeks’ annual vacation, and Antoinette traveled frequently. In a note to Antoinette, who was in St. Louis in 1931, JT wrote, “I miss you so much always—as if a piece of me was stretched away far. Our bedroom is peaceful and full of you.” From a train to Boston in 1929, JT wrote, “A ne dites vous or dis tu, ma Cherie, Antonie, Babie wish I were home listening to our radio—us walking around the garden. Wish I had some vodka and snuff and cigarettes and lemonade. If you were here the train wouldn’t sway so much from side to side.” In 1931, JT wrote to Antoinette who was going by ship to Cuba and then on to Panama, “how I wish I were going along with you through those tropical waters and romantic scene—my love is ever with you.” In May 1931, JT was in Indianapolis, Indiana, consulting with social worker Edith Eikhoff on starting a social services department at the Indiana University hospital and wrote to Antoinette, “My great aim now is to finish and get home to you—everything else seems wasting an opportunity.” In another 1931 letter, JT signed off, “Your partner in all things—J.” JT and Antoinette supported one another financially and emotionally, and this undoubtedly supported their professional endeavors (all excerpts from Thornton Family Papers, box 5).

According to the UVA archives, JT and Antoinette’s Greenwich Village townhouse became a center for social and political discourse. The women hosted lively discussion groups focusing on social issues of the time. It is unclear who attended these discussion groups, but, at different times, JT’s letters mention visits by Gordon and Anna and Gordon’s Effie (presumed to be Gordon Hamilton and Anna Kempshall—it is unclear who “Effie” was) and Florence and Rose or Rosemary (presumed to be Florence Hollis and Rosemary Reynolds (Thornton Family Papers, boxes 5 and 6).

Another frequent guest at these forums was JT and Antoinette’s friend and colleague Ida Pruitt. Pruitt, the daughter of American missionaries, was born in China and lived there for most of her life. Educated at Columbia University Teacher’s College and trained as a social worker in Philadelphia and Boston, she was hired in 1921 by the Rockefeller Foundation to head the newly formed Department of Social Work at the Peking Union Medical College in Beijing ( Ida Pruitt and a Changing China, 2002 ). Pruitt would forward manuscripts and articles to the house on Macdougal Street for advance reading in preparation for her visits to New York and subsequent discussion groups organized at the house (Thornton Family Papers, box 6). Among them was an article by radical journalist Anna Louise Strong. Entitled, “An Evil Fraud on the American People,” it describes what was being kept from the American public about life in Communist China. There were also excerpts of “An Chuang Diary” by David and Isabel Crook, self-proclaimed Marxists living in a commune in China (Thornton Family Papers, box 6). Finally, there was a letter from Talitha Gerlach, a social worker who was persuaded to move to China by Pruitt to become the YWCA foreign secretary. Gerlach, who wrote about her experiences in China, was also known to be a communist (Thornton Family Papers, box 6).

Given these connections, it is not surprising that during their New York period, JT and Antoinette were considered to be political radicals, and perhaps even communists. In 1949, Antoinette was investigated by the House Committee on Un-American Activities (HUAC) because she was one of the sponsors for the Scientific and Cultural Conference for World Peace—a conference in New York City that was purportedly arranged by the Communist Party (Committee on Un-American Activities, 1949). Prior to Antoinette’s investigation, there was an array of references to both women’s progressive political involvement in articles and political advertisements in the New York Times. In 1929, JT was a member of the New York County Advisory Council of the Women’s Organization for National Prohibition Reform, established to advocate ending prohibition (“Noted Women Join in Fight on Dry Act,” 1929, p. 6). In 1934, both women were referenced in articles about the American Association of Hospital Social Workers Conference held in New York. At this conference, a social worker on staff at Presbyterian Hospital had her remarks undoubtedly embellished by the newspaper in an article, “Radicalism Held Cure for Disease, Miss Gilbert of Presbyterian Hospital Cites Efficacy of Joining the Reds: An Outlet for Spleen” (1934, p. N1). Both JT and Antoinette were identified as supporters of Miss Gilbert’s position. In a letter to the editor of the New York Times, Antoinette wrote, “It would be misleading to say that radicalism could be used for the purpose of curing disease. We can say, however, that the provision of opportunity for the expression of real interests makes for good health” (Cannon, Expression and Health, 1934, p. 12).

In 1936, JT’s name appeared in an article about “leading social workers of the state” endorsing progressive Democrat Herbert Lehman (who also ran on the Liberal and American Labor tickets) for governor (Social Workers United for Lehman, 1936). Lehman, who was elected, was known as a “New Deal” supporter and as being close to the Roosevelts. In a 1944 political advertisement in the New York Times, both women are named on a petition to Governor Thomas E. Dewey asking for him to pardon Communist Party member Morris Schappes. Schappes, employed by the City University of New York, was fired and sent to prison for refusing to name other City College personnel as Communists (Open Letter to Governor Thomas E. Dewey, 1944 , p. 12). In 1953, JT is listed among “Educators, Psychiatrists, and Social Workers” endorsing African American Liberal Party candidate James H. Robinson for Manhattan borough president. Robinson was also investigated by HUAC. These wide-ranging references offer an indication of JT and Antoinette’s undoubtedly progressive, perhaps even radical, politics. It is unknown whether the women were actual members of the Communist Party, but they did study some form of Marxism in the previously mentioned discussion groups on life in the Soviet Union and China.

Conclusion

JT retired in 1947. According to letters in the archives, she remained active in the field of social work and traveled with Antoinette. When Antoinette died at age 78 in 1962, JT sold the house on Macdougal Street and moved back to a house on the UVA campus that she shared with her two sisters. She died in March 1963, at age 81. A 1963 press release by Elizabeth G. Gardiner, past president of the American Association of Medical Social Workers, memorializing JT said the following:

Colleagues and students alike benefited from JT’s startling questions that brushing away superficial things went to the heart of the matter. Slow of speech and quick of understanding, she encouraged questions at every step of the way. Those who worked with her became more appreciative of what she taught them as they themselves matured. They remember with particular warmth her kindness and generosity, her wit and equanimity, her imagination and gentleness, her insight and realistic approach. (Thornton Family Papers, box 6)

Former Columbia-Presbyterian staff member Frances Evans was similarly eloquent:

We who worked with her for so many years—at old Cornell and at Presbyterian—were deeply influenced by her love of mankind, her understanding of their needs and her belief in their own powers of recovery. She came of a staunch American background and she expected that staunchness in others. She had a penetrating mind and accurate judgment. . . her outstanding characteristics were humility and quiet serenity, which bespoke great faith. One went to her overwhelmed with one’s problems—one never came away without a clearer knowledge of oneself. (Thornton Family Papers, box 6)

Questioning, kind, generous, presenting with wit and equanimity, imaginative but realistic, staunch, accurate judgment, humility and serenity—all are words that are characteristic of a good social worker. Reviewing JT’s life allows us a clearer understanding of the professional foundation of health care social work and the relevance of social workers in a hospital setting. The discoveries made about the strong, interconnected women who played key roles in the early days of social work and who were very much participants in the changing social and political winds of the era, provide an important personal context to understanding the vital profession of social work.