Alfred Worcester

Alfred Worcester (1855–1951) was a general practitioner in Waltham, Massachusetts. He is known for pioneering work in patient care, the treatment of appendicitis, and the use of the Caesarean section.

Biography Alfred Worcester was born in Waltham, Massachusetts on June 22, 1855. He earned his Bachelor's degree (A.B.) at Harvard College in 1878 and was a member of Phi Beta Kappa. He received his M.D. at Harvard Medical School in 1883. He entered practice in Waltham in 1884 and founded the Waltham Hospital and Training School for Nurses the following year. He married Elizabeth Joy Hill (1854–1951), the daughter of Thomas Hill, former president of Harvard College, Worcester died August 28, 1951. His wife died six days later at their home in Waltham.

Accomplishments Worcester is considered a pioneer in the organization, practice, training, and science of medical and nursing care. He began the practice of focusing on the care of the patient, which would be applicable to all medical specialties. He was an early adopter of appendectomy for appendicitis and of Caesarean section for complicated labor. He advocated for compassionate medical care and counseling for college students and was Harvard College's second Professor of Hygiene. He suffered several life-threatening illnesses, including appendicitis, which informed his approach to patient care. Including practical experience in home care in nurses' training, which he organized at the Waltham Training School for Nurses, was frowned upon by hospital-based nursing school administrators of the day.

Appendectomy In the 1880s, appendicitis was treated expectantly, by waiting for a walled-off abscess to form, with incision and drainage via anterior or posterior approach. This treatment was often fatal. Worcester improved on this by operating earlier in the course of the disease, entering the peritoneum to do so. At first, this was by open lavage of the peritoneal cavity and removal of what was left of the ruptured appendix. Later, he found that he could operate before the appendix had ruptured and prevent generalized peritonitis and abscess formation, which greatly reduced morbidity and mortality. The reports of his cases and the disagreement between him and the other surgeons of Boston demonstrate the evolution of medical and surgical practice and the contribution of generalists to specialty care.

Geriatrics, palliative care, and patient care Dr. Francis Peabody's noted statement, "the secret of the care of the patient is in caring for the patient," was delivered in a series of lectures initiated by Worcester. Some of the lectures, including Worcester's on the care of the aged and the care of the dying, were published in a collection in 1929. Worcester's lectures were then published on their own in 1935, together with a third lecture on the care of the dead. This book received a second edition and several printings, the last being in 1977. Dame Cicely Saunders, the leader of the palliative care movement in the United Kingdom, was inspired by Worcester's book during her training. In this book, Worcester states:

Worcester's consult on a case in a memoir of turn-of-the-century Malden, Massachusetts, includes this observation: