As the United States was on the brink of a world war in 1940, University of Missouri Health Care's Ellis Fischel Cancer Center opened its doors in Columbia, Mo., to wage a war on cancer. Our center was the first state cancer hospital west of the Mississippi River and only the second one in the nation.
Setting the Foundation
In the 1930s, the state of Missouri spent $2 million a year on fighting tuberculosis but nothing on cancer — a disease that was killing twice as many Missourians as TB. Governor Lloyd C. Stark set about to change that. He had the backing of members and physicians in various organizations, including the Missouri State Medical Association’s Committee on Cancer, the Barnard Free Skin and Cancer Hospital in St. Louis and the American Society for the Control of Cancer.
Stark began his term as governor in 1937, the same year the federal government established the National Cancer Institute. In his inaugural speech in January 1937, Stark stressed the importance of offering a cancer hospital available to “the humblest citizen.” In May of that year he signed a bill to establish this hospital and a state cancer commission.
Ellis Fischel, MD, was appointed chair of the state’s Cancer Commission. A prominent St. Louis physician, Fischel had dedicated his career to the study and treatment of cancer and voiced his concern about the lack of cancer care in rural Missouri. The commission was charged with supervising the maintenance of the state’s cancer program.
The original bill called for the hospital to be built in Columbia under the authority of the University of Missouri, but legislators from other parts of the state suggested various locations. Columbia was eventually selected due to its central location in Missouri and the City of Columbia’s donation of 40 acres of land for the hospital.
The 40-acre tract of land was previously farmland owned by Leslie T. and Nellie Proctor. The land was originally located beyond Columbia’s city limits, so the city limits were extended for use of Columbia’s utilities for the hospital. The site is located on I-70, which was at that time Highway 40, Missouri’s major east-west highway.
Construction was funded by an appropriation of $500,000 from the legislature and $409,000 from the Public Works Administration. Jamieson and Spearl, St. Louis architects, designed the building.
Tragically, Ellis Fischel was killed in a vehicle accident in May 1938 en route to Jefferson City on Cancer Commission business. Four months later, construction crews began groundwork for the state cancer hospital that would ultimately bear his name and laid the cornerstone for the facility in December of that year.
Missouri Governor Lloyd C. Stark was influential in passing a bill to create Ellis Fischel State Cancer Hospital. When he signed the bill in May 1937, he sent a telegram to Ellis Fischel, MD, concluding with the words, “Many precious lives will be saved by the prompt treatment made possible by this law.”
Opening Our Doors
The Ellis Fischel State Cancer Hospital was dedicated on April 26, 1940.
The seven-story building resembled a layered chocolate cake, with each successive story of cream-colored brick a smaller “layer.”
The 85-bed hospital was equipped with the latest technology of the time for combating cancer. Surgery, radiation and X-ray therapy were the main methods of the day. Few hospitals met the National Cancer Institute’s strict standards for stocking radium like Ellis Fischel, which housed one of the Midwest’s largest supplies of radium.
The hospital’s first floor housed the main waiting room, outpatient clinics and an X-ray treatment unit. The second, third and fourth floors each contained nearly 30 patient beds. Patients received cared in two-bed rooms or on four-bed wards with windows overlooking landscaped grounds. Patients could step out of their rooms and onto one of the hospital’s balconies to take in sunlight. Living quarters for resident physicians, along with educational facilities, were found on the fifth floor. Operating rooms, a diagnostic X-ray lab and a 2,300-pound led safe containing radium occupied the sixth floor. The seventh floor was dedicated to clinical and research laboratories.
The first three physicians at the hospital were Lauren Vedder Ackerman, MD, pathologist; Eugene Bricker, MD, surgeon; and Theodore Eberhard, MD, medical director and radiotherapist. The staff included a part-time radiologist (then called a roentgenologist), a part-time dentist, a chief resident physician, three resident physicians, nurses and social workers. Bernice Huffman was the hospital’s first superintendent of nurses. Harry Seekman served as the hospital’s administrator and lived in an apartment on the top floor. More than 50 physicians throughout the state volunteered as consultants. The consultant physicians were reimbursed for travel to and from the hospital but received no other compensation from Ellis Fischel.
During its first full year of operation, more than 1,000 patients were treated at the hospital in keeping with the original intent of treating only Missouri residents unable to pay for their care. In able to receive treatment at Ellis Fischel, patients would go before their county courts and prove that they were unable to pay for any of their medical costs. Each county court paid $5 per month per hospitalized patient as well as transportation costs to and from the hospital for patients from that county. The General Assembly paid the hospital a provision for administrative costs. The patients themselves were not charged for their care.
Much forethought went into the process the staff followed for patient care at the hospital. A new patient’s appointment would go something like this: The patient reported to the hospital on his appointment date. A clinic charge nurse seated near the entrance greeted him as well as all returning patients. The nurse recorded the new patient’s attendance and sent him to the social service department. A social service worker interviewed the patient to determine any home, family or traveling obligations or obstacles that could interfere with his treatment. The social worker then worked with local groups, county courts, the Social Security Commission and the state’s health board to best meet the patient’s needs so that he could receive proper medical care.
After the social worker’s interview, a resident physician examined the patient. The resident physician then called in the attending physicians on staff. The resident presented the patient’s medical history and his findings to the group of doctors. Working together, they determined if the patient needed any further tests and then determined a course of treatment for the patient. There were generally three scenarios: First, the patient might be discharged home with a letter to his primary doctor and no follow-up appointment set. Second, the patient might be discharged home and given an appointment to return for testing or treatment. Third, the patient might be admitted to the hospital. If he were admitted, he would be bathed and issued hospital clothing. Upon his discharge, the staff would return his personal clothing, make a follow-up appointment and send a letter detailing his diagnosis, treatment and follow-up care to his primary doctor.
Ellis Fischel quickly attained a national reputation during its first decade. Employees were instrumental in studying the effectiveness of radiation therapy. Two Ellis Fischel physicians — Lauren Ackerman, MD, and Juan Del Regato, MD — wrote a definitive book on cancer care. The book, “Ackerman and Del Regato’s Cancer: Diagnosis, Treatment, and Prognosis,” was used as a textbook in medical schools throughout the nation for decades.
1950s and 1960s
As the 1950s began, Ellis Fischel remained only one of five state cancer hospitals in the United States. A new form of treatment for cancers, chemotherapy, was being researched throughout the nation. In 1955, Congress created the National Cancer Chemotherapy Service Center. Ellis Fischel would become one of 30 teaching hospitals participating in this program to test various chemotherapy drugs in the 1960s.
The 1950s brought some new landscaping and technology to Ellis Fischel. In 1952, the Columbia Garden Club planted a therapy garden on the hospital’s grounds. Local Kiwanis members financed it and delivered flowers from the garden to hospitalized patients.
In 1957, Ellis Fischel added a $100,000 cobalt therapy wing. The area included a three-ton stationary cobalt machine and a smaller, rotating model to provide radiation treatments to patients.
By the end of the decade, the employees at Ellis Fischel had cared for approximately 26,000 patients since the hospital opened in 1940. In the 1960s, the staff cared for approximately 2,000 hospital patients and 8,500 clinic patients each year.
With the introduction of Medicare in 1966, Missouri’s legislature changed the law governing admissions to Ellis Fischel to include patients who could afford part of their costs in addition to patients who were unable to pay any costs. To keep with the original mission of our cancer center, the poorest Missouri citizens — those who could not afford any of the costs for their cancer care — were still given first priority.
While our staff was getting used to the changes that Medicare brought to Ellis Fischel, history was happening a few miles away on the University of Missouri campus. In 1966, MU’s nuclear reactor — the world’s most powerful university reactor — began producing radioisotopes for research and clinical application. To this day, the University of Missouri Research Reactor is the nation’s highest-powered university reactor and a leader in radiopharmaceutical research and other areas of research.
The Ellis Fischel State Cancer Hospital opened in Columbia, Mo., in 1940, one year before MD Anderson Cancer Center opened in Houston. Both hospitals were trailblazers in cancer care – using a multidisciplinary team to care for patients and offering a hospital with the singular mission of caring for cancer patients.
Renilda Hilkemeyer, the director of nursing at MD Anderson from 1955 to 1978, is credited with revolutionizing the specialty care of patients with cancer and is recognized as the “pioneer of oncology nursing.” R. Lee Clark, the director of MD Anderson, recruited her from Ellis Fischel.
“I was hired at M.D. Anderson based on the work I did in Missouri,” she said.
In 1950, Hilkemeyer was hired to set up a continuing education program for nurses at the Ellis Fischel State Cancer Hospital. It was the overwhelming success of the program that drew the attention of MD Anderson’s director.
In the book, “Building A Legacy: Voices of Oncology Nurses,” by Brenda Nevidjon, Hilkemeyer said:
“I had some excellent physician mentors at EFSCH, who spent much time helping me learn through new patient multidisciplinary conferences, patient rounds, follow-up clinics, time in surgery, and radiotherapy, where I could actually see what was going on. Then I could determine the nursing care needed.”
Changing Cancer Care Landscape
1970s and 1980s
The admissions requirements for patients were expanded in 1972 to include any Missourian with cancer who was referred by a doctor or dentist to Ellis Fischel.
Also in 1972, state officials created the Missouri Cancer Registry to collect patient information used for cancer prevention, treatment and research. The registry is now operated by the University of Missouri.
In 1973, the Missouri legislature appropriated $7.6 million to build a new wing onto Ellis Fischel. The three-story addition opened in 1975, expanding the hospital’s outpatient clinics and laboratory space and adding a new operating room suite. The hospital’s exterior dramatically changed at this time. Instead of a striped painting scheme, the entire building exterior was painted with a tan weather coating to give the original facility and new addition a cohesive look.
The 1980s was perhaps the saddest decade for our cancer center in its 70-plus years of existence. Forty years after Ellis Fischel opened with three physicians, the cancer hospital once again had only three doctors on staff. The hospital also faced a nursing shortage and a yearly budget deficit of approximately $100,000. To reduce expenses while continuing to care for cancer patients, the Ellis Fischel instituted a hiring freeze, reduced its supply purchases and closed an inpatient floor.
Local community members hoping to keep Ellis Fischel open and return it to better times formed a grassroots group, “Citizens to Save Ellis Fischel State Cancer Hospital.”
Mohammed Akhter, MD, then director of the Missouri State Department of Health, was appointed by the state to lead a five-member advisory board to assess the hospital and make recommendations. The board members considered moving oversight of Ellis Fischel from the state of Missouri to the University of Missouri.
In 1982, Gov. Christopher Bond signed a bill to make Ellis Fischel the state cancer center, changing the facility’s name to Ellis Fischel State Cancer Center.
A few miles across town, researchers at MU’s research reactor continued to make strides. In 1988, the reactor was awarded approval for Ceretec, its first commercial radiopharmaceutical to fight cancer.
Joining Our Strengths
In 1990, Ellis Fischel merged with the University of Missouri, combining strengths in cancer research and treatment into a comprehensive cancer program. Ellis Fischel became the flagship for most of the University’s cancer-related programs in patient care, education, administration and research.
Following the merger, several facility improvements were made to the cancer center. A dual-beam linear accelerator and other high-tech devices were installed. Patient rooms and clinics were renovated. Upgrades to patient rooms included telephones, televisions and electrically operated beds. A short-stay center was added for patients requiring chemotherapy or blood transfusions. Patients could focus on recovery at a new rehabilitative services area that featured a beauty shop and offered wig fitting, breast prostheses, cosmetology, speech therapy and physical therapy.
In the early nineties, MU physicians who had cared for cancer patients at University Hospital and Clinics moved to the Ellis Fischel facility located on the Business Loop, along with more oncology nurses and administrative staff. Among those moving was Michael Perry, MD, a renowned cancer clinician, educator, researcher and administrator at the University of Missouri for more than 35 years. In 1991, Perry stepped down from his role as chair of the Department of Medicine at the MU School of Medicine and became interim medical director of Ellis Fischel.
Various community Rotary clubs combined efforts to create a $50,000 Rotary Garden project outside the cancer center in 1994. The new garden was designed to provide a peaceful haven to patients, visitors and employees.
Ellis Fischel began offering mobile mammography services via a rented van in 1992. Five years later, the cancer center purchased its first mobile mammography van to bring cancer screenings and education to rural areas. The program continues today, as the van travels to more than 20 Missouri counties each year.
Joining forces with the University of Missouri strengthened Ellis Fischel’s research efforts. MU offers unmatched opportunities for collaboration in animal and human health, with the state’s only College of Veterinary Medicine, as well as colleges of agriculture, food and natural resources, engineering and human environmental sciences; the Bond Life Sciences Center; and academic partners in the schools of medicine, nursing and health professions; and the nation’s most powerful university research reactor.
During the decade, Ellis Fischel researchers played a leading role in the first nationwide breast cancer prevention study of Tamoxifen. In 1997, MU’s research reactor received approval by the Food and Drug Administration for its second radiopharmaceutical, Quadramet, a drug to relieve pain caused by bone cancer.
Care in the 21st Century
At the dawn of a new millennium, University of Missouri’s research reactor made headlines with its release of TheraSphere, a drug that used microscopic ceramic spheres to carry radiation to liver tumors. The university received a $10 million grant from the National Cancer Institute to establish a premier center for developing radiopharmaceuticals.
Clinical services throughout MU Health Care were consolidated to reduce financial strain in the early 2000s. Ellis Fischel’s inpatient services were moved from the cancer center’s location on the Business Loop to University Hospital in 2000. The cancer center’s inpatient units, symptom evaluation unit, intensive care unit, post-anesthesia care unit and operating rooms were moved to University Hospital. Outpatient services, clinics, faculty and administrative offices, and research space remained at Ellis Fischel Cancer Center.
This was a challenging time for Ellis Fischel, but the financial turnaround was successful. The cancer center grew following the move of inpatient units and developed in the two locations with good cooperation between the teams at Ellis Fischel and University Hospital.
Thanks to the generosity of donors and the cancer center’s auxiliary members, the Ernest and Eugenia Wyatt Guest House opened in 2001, just footsteps away from Ellis Fischel’s location on the Business Loop. The guest house provides lodging and a place of respite for patients and families who live more than 50 miles away and must travel for their care. The guest house is named in honor of the late Ernest Wyatt and his wife, Eugenia, a lifelong central Missouri resident whose sister was treated by the cancer center’s namesake, Ellis Fischel, MD.
In 2004, Missouri designated Ellis Fischel as the state’s official cancer center. At the end of the year, the center opened new laboratory space at MU’s School of Medicine. The highly advanced labs were created with $3.4 million in federal funds and another $150,000 in private gifts raised by an annual gala for Ellis Fischel, “A Summer Celebration,” held at The Lodge of Four Seasons at the Lake of the Ozarks.
In 2005, MU Health Care embarked on a strategic planning process. A facility review of the Ellis Fischel building on the Business Loop found that the 70-year-old building needed to be replaced. During the coming years, plans were developed to design and build a state-of-the-art facility for Ellis Fischel.
Researchers throughout the University of Missouri collaborated on cancer studies funded by the National Institutes of Cancer, including nanotechnology and comparative oncology studies with Ellis Fischel and College of Veterinary Medicine researchers.
Ellis Fischel’s experts continued to use new technology in the fight against cancer, adding a Trilogy Tx linear accelerator in 2008 to deliver targeted radiation to tumors and digital mammography in 2012 to screen for breast cancer.
A genetic counselor and dietitian were added to the care team. The staff developed programs to help survivors address their health and emotional and needs following a life-changing cancer experience.
Over its 70-plus years, Ellis Fischel has played a significant role in making vast improvements in cancer care. Patients are surviving cancer like never before, and new research holds the potential for detecting cancer at its earliest stages and developing better ways to treat it.
In March 2013, Ellis Fischel relocated to a new patient care tower located on the University Hospital campus. The first two floors provide state-of-the-art facilities for all of Ellis Fischel’s outpatient care. Patients requiring hospitalization receive care in one of the all-private rooms located on the eighth floor. Turn the page to read more about our new home.
Ellis Fischel - The Man Behind the Mission
Ellis Fischel is named in honor of a St. Louis surgeon who devoted most of his life to ensuring all cancer patients received early and proper treatment. Missourians were so inspired by his work that they built the first state cancer hospital west of the Mississippi River.
Ellis Fischel was born July 3, 1883, in St. Louis to parents Martha and Washington Emil Fischel. His mother gave him her maiden name, Ellis, for his first name. Ellis’ father was a founding member and physician at the Barnard Free Skin and Cancer Hospital and a leading internal medicine physician at St. Luke’s Hospital in St. Louis. Ellis’ brother, Walter, became a physician. His sister, Edna Gellhorn, marched with suffragists seeking the right to vote and organized the St. Louis League of Women Voters three months before the 19th Amendment was ratified. Ellis’ niece, Martha Gellhorn, has been described as one of the greatest war correspondents of the 20thcentury. She also was briefly married to Ernest Hemingway.
Ellis’ sister described him as having thick, black hair, a firm mouth and chin, a large nose, and large eyes and ears. The tip of one of his ears accidently was snipped off by a barber when he was young. As an adult, Ellis stood six feet tall and fellow surgeons noted his large and capable surgical hands. Like other pioneers, Fischel worked too closely to radium before modern precautions were discovered, and the radioactive material used in early radiation therapy created precancerous warts that blistered his fingertips.
The path to medicine and family life
Ellis Fischel enrolled at Harvard University in 1900, where he played on the university’s baseball team and was classmates with Franklin Delano Roosevelt.
After graduating from Harvard in 1904, Ellis moved to Newark, N.J., and worked as a molder at a factory owned by a cousin. His mother was not pleased with Ellis’ career choice. After only four months of factory work, Ellis was persuaded by his mother to attend medical school and follow in the footsteps of his father and brother.
Ellis also met his wife, Marguerite Kauffman, in 1904. They wed in May 1913 after dating for nine years. Marguerite composed music and wrote a book, “The Spastic Child,” which was published through three editions. The Fischels had two sons, Ellis Jr., who was paralyzed from birth, and John.
In 1908, Ellis received his medical degree from Washington University in St. Louis and then completed a two-year internship at St. Louis City Hospital. He proceeded to study abroad in Berlin and London where he studied surgical methods.
Ellis began treating cancer patients at a charity hospital in St. Louis during World War I. Many physicians at the hospital had left to serve in the war, and Ellis stepped in for them while he cared for his paralyzed son.
“Chance led to the surgical service at a charity cancer hospital — service which has given me the greatest individual satisfaction and stimulation to greater endeavor,” he wrote.
The surgeon attacked cancer in every part of the body — even the brain — and was among the first to use radium as a weapon against the disease. As a member of the Missouri Medical Association’s Cancer Committee, Ellis persuaded the American Cancer Society to conduct a statewide cancer survey. The results showed that poor Missourians were in critical need of cancer care.
Armed with the survey and his experiences caring for cancer patients, Ellis asked elected officials to support his plan for a state cancer hospital. The plan was approved and construction of the building began in January 1938. Ellis was named the first chair of Missouri’s Cancer Commission.
Leaving a legacy
Tragically, Ellis did not live to see the hospital completed. He died May 14, 1938, in an automobile wreck in Useful, Mo., on his way to a Cancer Commission meeting. He was 53 and died only 13 days before his 25th wedding anniversary to Marguerite. He was laid to rest in Bellefontaine Cemetery in St. Louis.
Missouri Governor Lloyd C. Stark insisted on naming the state cancer hospital for Ellis Fischel.
Stark told a reporter, “I will appreciate very much your mentioning the fact that after Dr. Fischel’s death I asked that the name be changed from mine to his because, in my opinion, there never would have been a state cancer hospital except for Dr. Fischel’s untiring efforts.”
During his 25 years in private practice, Ellis cared for 1,208 cancer patients. Of those patients, 519 reached the milestone of surviving five or more years after being diagnosed with cancer. He cared for countless more charity patients — perhaps as many as 10,000 patients who were unable to pay for their care. He wrote extensively on cancer treatment and taught at St. Louis University and Washington University in St. Louis.
In biographies, Ellis is described as disciplined, highly trained, rugged, tireless, reticent, reserved, dignified, courageous, frank, honest and fair.
Ellis once wrote, “The greatest interest in life, as I have found it, is my daily contact with my fellow man, both in health and in disease. The greatest rewards come through what we personally mean to a few obscure individuals. The greatest thrill is from public recognition of work well done. It appears to me that it is this same thrill that stimulates the football player to go through the punishing weeks of training for the ‘big game,’ and stimulates most of us to go through the biggest game of all, the game of living.”
Our New Home
Ellis Fischel has always been committed to providing the best cancer care to patients. In March 2013, the center’s caring and compassionate team moved into the new facility.
Ellis Fischel encompasses 100,000 square feet on the first and second floors of University Hospital’s new patient care tower. Ellis Fischel’s unit for hospitalized patients is located on the eighth floor of the new building.
The Ellis Fischel Gala and the Brown Family Healing Garden gives patients and visitors a chance to enjoy nature. The cancer center’s waiting areas look into the healing garden.
The latest technology for detecting and treating cancer patients is available at Ellis Fischel, such as radiology equipment, shown here, digital mammography and a linear accelerator for precisely delivering radiation to targeted areas.
The facility was built as an environmentally-friendly building, with features such as recycled building materials, green roofs with live plants and plenty of natural sunlight, including a two-story skylight at Ellis Fischel.
In the ambulatory infusion unit, patients can choose to undergo chemotherapy treatment at a station or in a private room.
The clinic rooms are painted with accent colors that are earth tones, designed for their natural look and calming effect. Many have quotes on the walls, such as this quote: “In this life, we cannot always do great things, but we can do small things with great love.”
All patient rooms are private, with a private bathroom, sleeper sofa for loved ones and large windows letting in natural light. The rooms are equipped with automated hospital “smart room” technology.
Patients can view the University of Missouri campus and miles of Columbia from their patient rooms on the eighth floor. This photo, taken from a patient room, shows the tower of MU’s iconic Jesse Hall in the center and the original Ellis Fischel building in the distant left.
The new home reflects Ellis Fischel’s focus on caring for patients every step of the way, from diagnosis to survivorship. The rehabilitation center features not only exercise equipment but also a kitchen for healthy cooking demonstrations.