New Hand at HEW

A soft-spoken Hoosier settled down in an incompletely furnished office in Washington's Health, Education and Welfare Department last week to tackle a big job. As special assistant (to Secretary Marion Folsom) for health and medical affairs, Dr. Lowell Thelwell Coggeshall, 55, has a roving commission, but his special concerns are improving research, financing medical education and making hospital care simpler and cheaper.

Career & Training. Born and raised on a farm near Saratoga in eastern Indiana, "Cog" was one of two in the local high school's senior class. At Indiana University he waited on tables to help pay for his tuition in zoology, then got a Rockefeller Foundation job in malaria research. This gave him the idea that he needed an M.D. Back at Indiana U. he helped pay tuition by teaching physiology to prospective embalmers.

In World War II Coggeshall put his earlier research to practical use by helping fight malaria at African air bases. Then he moved on to the Navy as consultant, fought a similar campaign against mumu, the filariasis that South Pacific G.I.s dreaded because they feared it would lead to elephantiasis or perhaps sterility. Coggeshall boosted their morale by showing that it did not. Since 1947 he has been head of the University of Chicago's division of the biological sciences, which embraces a medical school and nine hospitals.

Ideas and Plans. Coggeshall's agenda for HEW include getting some money from voluntary health organizations (e.g., the American Cancer Society. National Foundation for Infantile Paralysis) for improving medical schools. But his most interesting project is a revolutionary plan for American hospitals. As Coggeshall sees it, there are two kinds of hospital patients: the seriously ill, who need all the services that a hospital can afford, and those who are in for less serious ailments or mere diagnosis. But, he points out, most modern hospital rooms are designed for the first type. They are rigged for all kinds of emergencies, with such fixtures as oxygen outlets, and this makes them expensive. With every room a sick room, hospital design also leads to big staffs--so many trained people to give injections, nurses to answer the buzzer, orderlies to give baths and serve meals.

Says Coggeshall: "I should like to see a self-service wing set up in a hospital, for patients who don't need all this expensive special equipment and service. Those who are in for diagnosis or convalescing may well be able to go to a cafeteria and service themselves--and enjoy company at their meals. Some of them might go home at night. I believe that those who are not incapacitated should not be treated--and charged--as though they were."

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