Richard Clarke Cabot

• Richard C. Cabot
• Born: May 21, 1868
• Died: May 8, 1939

Physician and educator who synthesized medical science and social work, was born in Brookline, Massachusetts, one of three sons of James Elliott Cabot and Elizabeth (Dwight) Cabot. On completing Harvard College in 1889, he entered Harvard Medical School, which granted him the Doctor of Medicine degree three years later. He began his teaching career as an assistant in medicine at his alma mater in 1899 and became an instructor in 1903, an assistant professor in 1908, and a full professor in 1918. In 1933 he was named professor emeritus.

After taking his medical degree, Cabot began to work in the outpatient clinic at Massachusetts General Hospital. There he concerned himself chiefly with perfecting methods of diagnosis. In his book Medicine and Social Work, which describes his early years in the outpatient clinic, Cabot told how in trying to arrive at a complete and exact diagnosis he found he needed more information about patients than he could obtain from them in the clinic. He recognized that treatment in more than half the cases he saw during his years in the clinic involved an understanding of the patients’ economic situation and economic means, but still more of their mentality, their character, their previous mental and industrial history—all that brought them to their present condition, in which sickness, fear, worry, and poverty were inextricably mixed.

But as a clinic physician he had no time for searching out this information by visiting each patient’s home. What was needed, he believed, was a home visitor or social worker to complete the diagnosis through more careful study of the patient’s illness and economic situation and to carry out the physician’s treatment by means of organized community resources.

In 1905 Cabot established a full-time, paid social worker at Massachusetts General Hospital to work with the physicians in the clinic, “first, in deepening and broadening our comprehensions of the patients, and second in helping to meet their needs, economic, mental or moral, either by her own efforts, or through calling to her aid the group of allies already organized in the city for the relief of the unfortunate.” In the next thirteen years, 200 other hospitals in the United States started social work programs, some of them employing forty or fifty social workers for the needs of a single hospital.

Cabot became a visiting lecturer in Professor Josiah Royce’s Harvard course in logic in 1903, serving later on a committee that scrutinized the university’s philosophy department for the Board of Overseers. Owing to his concerns over the societal effects of medicine, he was appointed a professor of social ethics at Harvard, a post he filled from 1920 to 1934. In his teaching, he elaborated and elucidated the argument that the public good is the proper justification for good conduct; this was the ethic of the Progressive Era, although, for Cabot, it also stemmed from his conception of the morality of medicine in an urban and polycultural society, in which the underprivileged were among the responsibilities of the more talented and better-educated men and women.

A zealous crusader for the public good, Cabot argued as early as 1913 for group medical services, suggesting that “group medicine is one hundred times better for the patient and for the doctor than the ordinary, usual practice.” In his books and in his short-lived Boston Herald column (1915-16), he was sharply critical of the medical profession, charging that the system was “absurdly expensive and absurdly inefficient” and was responsible for “an enormous number of unnecessary surgical operations.” He asserted also that three-fourths of all illnesses were cured without the victims’ ever knowing that they had these ailments. “Proof,” he added, “is found in postmortem examinations which time after time reveal indelible and unmistakable traces of disease which the subject had conquered unknowingly.”

During World War I Cabot served in France with various medical facilities, notably as chief of medical service in Bordeaux in a hospital of more than 4,000 beds. Before his discharge from the Army, he had been promoted to the rank of lieutenant colonel.

As chief of the medical staff at Massachusetts General Hospital, a post he obtained in 1912, Cabot served as a consultant to other nearby institutions: the New England Hospital for Women, the Westboro School for Boys, the Lancaster School for Girls, the Brockton Hospital, and the Sturdy Memorial Hospital of Attleboro. In addition, he was a visiting physician at the Channing Home, consulting physician to the Massachusetts Eye and Ear Infirmary and, for a period, chief of staff at Mount Sinai Hospital.

He was elected president of the National Conference of Social Work in 1930 and a year later received the gold medal of the National Institute of Social Sciences. From 1931 to 1935 he was president of the Massachusetts Anti-Saloon League.

His wife, the former Ella Lyman, whom he married in 1894, died in 1934. They had no children.

A year before his death at the age of seventy, Cabot advocated that theological students should spend one year in a hospital or an institution for the poor and homeless, saying that “what theological students learn in the seminary should be tested and applied before they are let loose in a parish.”

The Cabot concept of wedding medicine to social work in hospital practice energized both professions and gave them explicit goals in dealing with patients and their families. A practical reformer and a humanitarian, he pressed for wide-ranging health care in an enlightened society.

Principal sources are Cabot’s Social Science and the Art of Healing (1909; 1928); What Men Live By (1914); Medicine and Social Work (1919); Adventures on the Borderlands of Ethics (1926); The Meaning of Right and Wrong (1933); The Art of Ministering to the Sick (with R. L. Dicks) (1936); Christianity and Sex (1937). The New York Academy of Medicine library has ninety references dealing with Cabot’s ethical and medical ideas. See also the Dictionary of American Biography, supplement 2 (1958). An obituary was published in The New York Times, May 9, 1939.