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“Being There”: Fact-Finding and Policymaking: The Rockefeller Foundation's Division of Medical Education and the “Russian Matter,” 1925–1927

Published online by Cambridge University Press:  27 April 2009

Susan Gross Solomon
Susan Gross Solomon
Affiliation:
University of Toronto
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Extract

The last quarter century has witnessed a rising tide of skepticism among scholars about the link between information-gathering and policymaking. Drawing on several decades of research and rethinking, students of organizational behavior concluded that organizations collect information for reasons that have more to do with organizational dynamics than with the making of choice. Students of public policy found high-stakes policy controversies deeply resistant to recourse to “the facts.”

Type
Articles
Information
Journal of Policy History , Volume 14 , Issue 4 , October 2002 , pp. 384 - 416
Copyright
Copyright © The Pennsylvania State University, University Park, PA. 2002

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References

Notes

1. Green, Donald P. and Shapiro, Ian, Pathologies of Rational Choice Theory (New Haven, 1994), 19.Google Scholar

2. For the clerical imagery, see James G. March, “Introduction: A Chronicle of Speculations about Decision-Making in Organizations,” in March, James G., Decisions and Organizations (Oxford, 1988), 1–21Google Scholar. March characterized as “retrogressive” the evolution of rational choice theory from a simple and elegant to a complex theory. Ibid. 15.

3. Martha S. Feldman and James G. March, “Information in Organizations as Signal and Symbol,” in ibid., 409–28. This piece was originally published in Administrative Science Quarterly in 1981.

4. Ibid., 418.

5. James G. March, “Ambiguity and Accounting: The Elusive Link Between Information and Decision-making,” in ibid. 395.

6. March, James G. and Olsen, Johan P., Ambiguity and Choice in Organizations (Bergen, Norway, 1976), 340.Google Scholar

7. Ibid., 349.

8. Ibid., 59–61.

9. Feldman and March, “Information in Organizations as Signal and Symbol.”

10. Feldman, Martha S., Order Without Design: Information Production and Policy-Making (Stanford, 1989), 6, 145.Google Scholar

11. Ibid., 4–5. It was easier for adherents of rational choice to deal with missing or inaccessible information than with the fact that future preferences and tastes were unknown. March, James G., “Bounded Rationality, Ambiguity, and the Engineering of Choice,” Bell Journal of Economics 9 (1975): 598.Google Scholar

12. Students of policymaking made scant reference to studies of organizational behavior that had come to the same conclusions.

13. Stone, Deborah A., Policy Paradox and Political Reason (Glenview, Ill., 1988), 4Google Scholar. A second edition appeared in print in 1996. Unless otherwise noted, references are to the first edition.

14. Ibid., 252–53.

15. Ibid., 264.

16. Schon, Donald A. and Rein, Martin, Frame Reflection: Toward Resolution of Intractable Policy Controversies (New York, 1994), 22.Google Scholar

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18. Stone, Policy Paradox, 123–25.

19. Geertz, Clifford, Local Knowledge (New York, 1983), 5.Google Scholar

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22. Weiss, Carol Hirschon, “Policy Research: Data, Ideas or Arguments,” in Wagner, Peter, Weiss, Carol Hirschon, Wittrock, Bjorn, and Wollman, Hellmut, eds., Social Sciences and Modern States (Cambridge, 1991), 307–332.CrossRefGoogle Scholar

23. Martin Rein and Donald Schon, “Frame-Reflective Policy Discourse,” in ibid., 275

24. Clifford, James, “Travelling Culture,” in Grossberg, Lawrence et al. , Cultural Studies (New York, 1992), 96–116.Google Scholar

25. Smith, James A., The Idea Brokers: Think Tanks and the Rise of the New Policy Elite (New York, 1991), 41.Google Scholar

26. Cueto, Marcos, “Visions of Science and Development: The Rockefeller Foundation's Latin American Surveys of the 1920s,” in Cueto, Marcos, ed., Missionaries of Science: The Rockefeller Foundation and Latin America (Bloomington, 1994), 1–22Google Scholar. In 1914, a few months before the establishment of the China Medical Board at the end of that same year, the Rockefeller Foundation mandated a survey of public health and medical education in Peking. Ferguson, Mary E., China Medical Board and Peking Union Medical College: A Chronicle of Fruitful Collaboration, 1914–1951 (New York, 1970), 19–20Google Scholar. The survey did not cover the history and social structure of China.

27. Penfield, Wilder, The Difficult Art of Giving: The Epic of Alan Gregg (New York, 1967), 158.Google Scholar

28. For the complex relations of giving and taking between the Rockefeller philanthropies and Russia, see Solomon, Susan Gross and Krementsov, Nikolai, “Giving and Taking Across Borders: The Rockefeller Foundation in Russia, 1921–1927,” Minerva 3 (2001): 265–298.Google Scholar

29. Weissman, Benjamin M., Herbert Hoover and Famine Relief in Soviet Russia, 1921–1923 (Stanford, 1974)Google Scholar. In the period before June 1923, the Laura Spelman Rockefeller Memorial alone gave over a million dollars to the ARA for emergency relief in Russia. Rockefeller Archive Center (hereafter RAC), Laura Spelman Rockefeller Memorial (hereafter LSRM), III, 3/105, John D. Rockefeller Jr. to Arthur Woods, 6 February 1923.

30. All assistance not defined as emergency aid was classed as constructive. “Emergency type of work … refers to aid we think necessary to prevent regression in countries where local authorities cannot put up funds to meet ours—all low exchange countries. This program will drop out as soon as a country can join us in financing projects; then the program becomes constructive (constructive probably not a good term in contrast with emergency).” RAC RF 12.1 Gregg diary, 25 August 1924, communiqué signed by R. M. Pearce.

31. Kennan, George F., Soviet-American Relations, 1917–1920 (Princeton, 1956)Google Scholar; McFadden, David W., Alternative Paths: Soviets and Americans, 1917–1920 (Oxford, 1993).Google Scholar

32. Although the worst of the “Red Scare” had abated by 1920, there remained deep unease in America about Bolshevism. Murray, Robert, Red Scare: A Study in National Hysteria, 1919–1920 (Minneapolis, 1955).Google Scholar

33. For the reorganization, see Schneider, William, “The Men Who Followed Flexner: Richard Pearce, Alan Gregg, and the Rockefeller Foundation Medical Divisions, 1919–1951,” in Schneider, William, ed., Rockefeller Philanthropy and Modern Biomedicine (Bloomington, 2002)Google Scholar. The author is grateful to Schneider for allowing her to see and cite the manuscript.

34. Farley, John, “To Cast Out Disease: A History of the International Health Division of the Rockefeller Foundation (1913–1951),” unpublished manuscriptGoogle Scholar. The author is grateful to Farley for allowing her to consult a portion of this manuscript.

35. The Memorial was established by John D. Rockefeller Sr. in memory of his wife. A comprehensive history of this agency remains to be written.

36. For the DME in this period, see Solomon, Susan Gross, “The Power of Dichotomies: The Rockefeller Foundation, the Medical Literature Program, and Russia, 1921–1925,” in Gemelli, Giuliana and MacLeod, Roy, eds., American Foundations in Europe: Scientific Policies, Cultural Diplomacy, and Trans-Atlantic Relations, 1920–1980 (New York, 2002).Google Scholar

37. RAC IEB Minutes and Dockets, 30 April 1923. For a general history of the IEB, see Gray, George W., Education on an International Scale: A History of the International Education Board, 1923–1938 (New York, 1941).Google Scholar

38. The IEB relied on leading scientists all over the world to propose young colleagues for fellowships in their laboratories or departments; the Laura Spelman Rockefeller Memorial trusted aid agencies such as the YMCA and the Student Feeding Fund to identify and transmit information about worthy causes. For the programs extended by the IEB and the LSRM to Russia, see Solomon and Krementsov, “Giving and Taking.”

39. Fosdick, Raymond, The Story of the Rockefeller Foundation (New York, 1952), 106.Google Scholar

40. RAC RF 1.1/785 USSR/1/1, Russell to Gunn, 10 March 1924. The relevant meeting was held on 27 February 1924.

41. Colonel Frederick Fuller Russell (b. 1870) graduated from Columbia College of Physicians and Surgeons in 1893. In 1898, he was commissioned in the U.S. Army Medical Corps. In 1913, he became Professor of Bacteriology in the Army Medical School. During World War I, he directed the Division of Laboratories and Infectious Disease of the U.S. Army. In 1920, Russell resigned from the Army to become a full-time member of the Rockefeller Foundation's International Health Board. In 1923, he was named director of the IHB, a post that he retained until his retirement in 1935. For Russell's biography, see Farley, , “To Cast Out Disease,” unpublished manuscriptGoogle Scholar. Russell was consistently hostile to the Bolshevik regime; indeed, internal Foundation histories picture him as “the spoiler” in the Rockefeller relationship with Russia. Fosdick, The Story of the Rockefeller Foundation, 286.

42. Richard Mills Pearce Jr. (b. 1874) graduated from Harvard Medical School in 1897. In 1908, he became professor of pathology and research medicine at the University of Pennsylvania. In 1916, he was appointed adviser to the International Health Board. In that capacity he made three trips to South America. In 1919 he was named director of the newly created Division of Medical Education, a post he retained until his death in 1930. Schneider, “The Men Who Followed Flexner.” See also Gregg, Alan, “The Work of the Rockefeller Foundation in Medical Education and the Medical Sciences, 1920–1929 inclusive, under the direction of Richard Mills Pearce, Jr., M.D.,” Rockefeller Foundation Quarterly Bulletin 5 (10 1931): 358–374Google Scholar. See also Fosdick, The Story of the Rockefeller Foundation.

43. The DME introduced its medical literature program in 1920. See Solomon, “The Power of Dichotomies.”

44. Alan Gregg (b. 1890) was educated at Harvard Medical School. During World War I, he served in France in the Harvard Medical Unit. From 1919 to 1922, he went to study malaria and hookworm in Brazil. Penfield, The Difficult Art of Giving: The Epic of Alan Gregg, 111. Gregg's rise in the Foundation was rapid. In 1922, Gregg became the assistant to Richard Pearce, director of the DME. In 1924, after two hectic years in the New York office of the Foundation, Gregg set off for Paris as Pearce's representative, charged with surveying education in the medical centers of Europe. At the end of 1926, Gregg was promoted to associate director of the DME, becoming the ranking DME officer in Paris.

45. In 1926, the American Society for Cultural Relations with Russia was created; within three years, that Society boasted more than 1,000 members from every state in the union. Parks, J. D., Culture, Conflict, and Coexistence: American-Soviet Cultural Relations, 1917–1958 (Jefferson, N.C., 1983), 22–23Google Scholar. In the mid-1920s, many Americans traveled to Russia; in fact, by far the largest number of foreign visitors to Russia during these years were American. Gosudarstvennyi Arkhiv Rossiiskoi Federatsii (hereafter GARF), Moscow, f. 5283, op. 3, dd. 25, 37, 38, 40; ibid. op. 2, d. 301.

46. United States National Archives, 861.42/86. Arthur Woods to Joseph C. Grew, 20 October 1925.

47. Ibid., Inter-Office Correspondence.

48. Before he assumed the directorship of the International Education Board in 1923, Wickliffe Rose had been director of the IHB.

49. Selskar Michael Gunn (b. 1883) received his Bachelor of Science degree at M.I.T. (1905) and an advanced degree in public health at Harvard Technology School of Public Health (1917). He was associate director of the International Health Division's Commission for the Prevention of Tuberculosis in France (1917–20), representative of the IHB in Czechoslovakia (1920–22), special member of the IHB staff, 1921–25, associate regional director of the IHB, based in Paris, (1926–27); and vice president of the Rockefeller Foundation in Europe (1927–41). RAC, 8 bio files.

50. RAC RF 1.1 785 USSR/1/1, Rose to Gunn, 24 February 1923.

51. For the yo-yo effect, see ibid., Russell to Gunn, 16 April 1923; ibid. Russell to Gunn, 18 January 1924.

52. Ibid., Russell to Gunn, 19 August 1924.

53. Ibid.

54. RAC RF 5 IHB/ D 1.2 (Corr. Prog.) 785 Russia. Pearce to Gregg, 2 September 1924.

55. Ibid.

56. RAC RF 12.1 Pearce diary, 9 December 1924.

57. Pearce asked Russell what he knew about Russia. RAC RF 12.1, Russell diary, 2 January 1924.

58. In April 1925, Rose recorded in his diary that the Foundation “expected to have Dr. Gregg go into Russia to survey the needs of medical literature.” RAC RF 12.1, Vincent diary, 27 April 1925.

59. Helms, Mary, Ulysses' Sail: An Ethnographic Odyssey of Power, Knowledge, and Geographical Distance. (Princeton, 1988), 66–67; 74.Google Scholar

60. For Gantt's biography as the Foundation knew it, see RAC RF 5, IHB/D 1.2 (Corr), 785 Russia, Pearce to Taylor, 16 December 1925; RAC RF 1.1 785 USSR/2/16, Galpin to Pearce, 11 January 1926.

61. The article, “A Review of Medical Education in Soviet Russia,” appeared in the British Medical Journal, 14 June 1924. It was followed by two additional articles in the same journal, the first on hospitals and health conditions in Russia (23 August 1924), the second on scientific work in Russia (20 September 1924). These articles were later included in a book of Gantt's writings on Russia. Gantt, William Andrew Horsley, A Medical Review of Soviet Russia (London, 1928).Google Scholar

62. RAC RF 5/IHB/D 1.2 (Corr.) 785 Russia. Gantt to Pearce, 26 April 1924.

63. Ibid., Pearce to Gantt, 16 December 1925.

64. Ibid., Pearce to Flexner, 16 December 1925.

65. Ibid., Pearce to Gregg, 16 December 1925.

66. RAC RF 12.1 Gregg diary, 28 December 1925.

67. RAC RF 5 IHB/ D 1.2 (Corr. Prog.) 785 Russia, Pearce to Gregg, 31 December 1925. For the role of the questionnaires in the production of the survey, see Schneider, “The Men Who Followed Flexner.”

68. RAC RF 1.1/700A/16/116.Gregg to Pearce, 28 December 1925.

69. As of April 1923, Henry Eversole, who was based in the Paris office, was given charge of emergency work (laboratory supplies, medical literature, resident and traveling fellowships) for low-exchange countries. RAC RF 1.2/700/1/2, Summary of Conference, 2–11 April 1923.

70. RAC RF 12.1, Gregg diary, 29 December 1925.

71. RAC RF 1.1 785 USSR/2/16. Horsley Gantt, “Moscow Trip, January 1925.”

72. The report was forwarded to the Foundation by Stephen Duggan of the Institute of International Education. RAC RF 1.1 785 USSR/2/16. Duggan to Vincent, 4 January 1926. Rockefeller President George Vincent agreed with Duggan's positive assessment of the report. Ibid., Vincent to Duggan, 6 January 1926.

73. Gantt had requested the meeting to secure information on the work of the Commissariat for an article he was writing for the British Medical Journal.

74. RAC RF 5 1.2/ 272/3450. Interoffice correspondence, circulated by Pearce, 5 June 1926.

75. RAC RF 1.1 785 USSR/2/16. Pearce to Gregg, 9 January 1926. Acting as Gantt's patron, Pearce sent him a fellowship application to the National Research Council. RAC RF 1/1 785 USSR/2/16. Pearce to Gantt, 15 February 1926.

76. Ibid., Gregg to Pearce, 12 January 1926.

77. Ibid., Pearce to Gregg, 25 February 1926.

78. Ibid., Gregg to Pearce, 6 March 1926.

79. Ibid.

80. Ibid.

81. Ibid., Pearce to Gregg, 16 March 1926.

82. Ibid., Gregg to Russell, 26 January 1928.

83. RAC RF 1.1 700 Europe/17/126, 27 May 1925. Minutes of the Rockefeller Foundation, Topic: DME Emergency Program. For the mandate, see RAC RF 12.1. Vincent diary, 1 May 1925, interview with Richard Pearce.

84. RAC RF 1.1/ 700/17/128.

85. National Library of Medicine (hereafter NLM), Gregg materials, box 24. Gregg to Pearce, 6 May 1925.

86. Dr. Philip Miller, who at one time was associated with the Rockefeller Institute, had just returned from a trip to Russia. For Miller's report, see RAC RF 1.1 785 USSR 2/18, Philip C. Miller, “Notes on My Visit to Soviet Russia, 1926.” For Gregg's rendition of Miller's observations, see RAC RF 1.1 785 USSR/2/6, Gregg to Pearce, 30 October 1926.

87. RAC RF 1.1 785 USSR 2/16, Gregg to Pearce, November 1926.

88. RAC RF 1.1 700A/16/116, Pearce to Gregg and Carter, 17 November 1925.

89. RAC RF 1.1 785 USSR/2/16, Thompson to Gregg, 19 May 1926.

90. RAC RF 12.1 Pearce diary. Conference on Russian Problems, 7 January 1927.

91. In a meeting in May 1927, Russell urged his fellow officers to discourage an invitation from the Soviets. RAC RF 1.1 785 USSR/2/16, Thompson to Gregg, 19 May 1926.

92. The original invitation was received in May 1924. RAC RF 5 1.2 (Corr. Projects) Russia, Read to Gunn, 27 May 1924.

93. RAC RF 12.1, Gregg diary, 23 June 1927. Interview with Roubakine and Selskar Gunn.

94. RAC RF 12.1, Pearce diary, 7 January 1927. For the formal authorization to Gregg to explore the possible grant of fellowships, see RAC RF 1.1 700/16/117, 20 January 1927.

95. RAC RF 12.1, Gregg diary, 23 June 1927.

96. New York Times, 3 June 1926, 37; ibid., 6 December 1926, 2; ibid., 6 July 1927, 34; ibid., 21 July 1927.

97. For the briefing book, see RAC 785 A Rus, Medical Education in Russia, vol. 2; for the 1928 report, see ibid., vol. 1; for Gregg's travel diary, see ibid., vol. 1.

98. The Foundation's Information Office often prepared briefing books of this type in advance of the visit of an officer to a region. Schneider, “The Men Who Followed Flexner.” Loftus probably worked for the Information Office.

99. Surveys conducted by the International Health Board from 1917 to 1922 followed a standard format. There was a substantial background section on a country's location, natural resources, form of government, and history. To this was added data on its public health agencies and medical practice, prevalent diseases, ratio of doctors to population, conditions of medical licensing, and regulations regarding foreign physicians. Primary, secondary, and university education was described, with special attention to medical schools. The main section of the report focused on medical education: its academic and administrative organization, admission requirements, student fees, degree and course offerings, and physical plant. In 1922, the surveys became shorter. Cueto, Missionaries of Science, 4–7.

100. RAC 785 A Rus, Medical Education in Russia, vol. 2, 109.

101. Ibid., 134. Here Loftus quoted Gantt directly.

102. The Russian Commissariat of Public Health, created in 1918, was responsible for “nearly all of the medical work in Russia,” ibid., 154.

103. RAC 785 A Rus, Medical Education in Russia, vol. 2, 129.

104. Ibid., 108.

105. Ibid., 103.

106. Ibid., 128. Solomon, Susan Gross, “Social Hygiene in Soviet Medical Schools, 1922–1930,” Journal of the History of Medicine and Allied Sciences (10 1990): 153–221.Google Scholar

107. RAC RF 785 A Rus, Medical Education in Russia, vol. 2, 71.

108. Schneider, “The Men Who Followed Flexner.”

109. RAC RF 12.1, Gregg diary, 8 June 1927.

110. Within the field of ethnography, the coexistence of personal narrative (“subjective”) and description (“objective”) has sometimes been treated as uneasy. Pratt, Mary Louise, “Fieldwork in Common Places,” in Clifford, James and Marcus, George, eds., Writing Culture: The Poetics and Politics of Ethnography (Berkeley and Los Angeles, 1986), 27–50.Google Scholar

111. RAC RF 12.1 Gregg diary, 6 December 1927.

112. Ibid.

113. Ibid.

114. Ibid., 8 December 1927.

115. Ibid., 19 December 1927.

116. Ibid., 6 December 1927.

117. Ibid., 10 December 1927. The venereologist Volf Moiseevich Bronner was the head of medical education in the Russian Ministry of Education.

118. Ibid., 12 December 1927.

119. Solomon, Susan Gross, “Through a Glass Darkly: The Rockefeller Foundation's International Health Board and Soviet Public Health,” Studies in History and Philosophy of Biological and Biomedical Sciences, 09 2000, 409–419.Google Scholar

120. RAC RF 12.1, Gregg diary, 15 December 1927. Petr Lazarev was a leading biophysicist.

121. Ibid., 10, 11 December 1927.

122. Ibid., 19 December 1927.

123. For the handwritten notes, see NLM, Gregg papers, box 25, Rockefeller Foundation 1927–29, “Russian Report.” For the finished report, see RAC RF 785 A Rus, Gregg, Alan, “Report on Medical Education in Russia,” Medical Education in Russia, vol. 1 (1927), 1Google Scholar. Dated 1927, the report was actually completed in May 1928.

124. Gregg's final report followed the template he had developed for the DME in 1925. Reports contained a background section, a description of medical facilities and personnel, and recommendations. Additional materials appeared in the appendices. Schneider, “The Men Who Followed Flexner.”

125. Ibid., 3.

126. Ibid., 10.

127. Ibid., 90–81.

128. Ibid., 2.

129. Ibid., 2.

130. Ibid., 22.

131. Ibid., 21.

132. Ibid., 30–35.

133. Ibid., 34.

134. Ibid., 36.

135. Ibid., 37.

136. Ibid., 20.

137. Ibid., 103. Gregg reported that the serious dearth of properly trained men … is one of the principal concerns of the Russian authorities.” Ibid., 48.

138. RAC RF 12.1, Gregg diary, 13 December 1927.

139. Apparently the DME officers used their diaries as a way of communicating with their director, Richard Pearce. As Gregg explained, “I could tuck into anything I wanted him to know but could not tell him formally.” Penfield, The Difficult Art of Giving, 172.

140. Alan Gregg to Philip Miller, 14 January 1928. Quoted in Penfield, The Difficult Art of Giving, 193.

141. NLM, Gregg papers, box 21. Miller to Gregg, 6 February 1928.

142. RAC, Minutes of the Board Meeting of the Rockefeller Foundation, 10 February 1928.

143. Pratt, “Fieldwork in Uncommon Places,” 32.

144. RAC RF 1.1/700A/16/17, DME Programs in Europe, 5.

145. RAC RF 12.1, Russell diary, 7 May 1928.

146. RAC RF 12.1, Gunn diary, 21 June 1928. See also RAC RF 2—1928/650/12/ 97, Pearce to Gunn, 7 August 1928.