A Clear Vision: The History of the Doheny Eye Institute 1947 – 2017

Lighting the Darkness

On August 2, 1944, the day of her sixty-ninth birthday, Carrie Estelle Doheny, one of Los Angeles' most prominent philanthropists and the second wife of oil magnate Edward Laurence Doheny, climbed the stairs to the private third-floor chapel of her 8 Chester Place mansion in the city’s West Adams district. A devout Catholic, Mrs. Doheny knelt to pray. During those contemplative moments, she probably suffered a vascular event in her left eye, blinding it instantly. What remained of her partial vision was at dire risk. For her already-impaired right eye was, most likely, affected by an advanced stage of glaucoma, the “sneak thief of vision.” Back then, few treatment options existed for such a condition and it often progressed to total blindness. As Mrs. Doheny would quickly learn, the quality and scope of ophthalmological services on the west coast fell far below those available at top eastern universities such as Harvard and Johns Hopkins—long-standing centers of medical education and research excellence.

At the time, no California medical school or affiliated hospital enjoyed the academic or scientific traditions, reputation, or prestige of these venerable eastern institutions. And glaringly, Los Angeles and Mrs. Doheny had few ophthalmological resources to draw on. The medical school at UCLA had yet to be established, let alone built; and the USC School of Medicine, founded in 1885 and the first accredited medical school in Southern California, was considered little more than an appendage of Los Angeles County General Hospital. The latter’s decades-long focus on public service and indigent care, as well as its tight budget, lent USC’s medical faculty and students scant support to develop a truly academic or research environment. The Department of Ophthalmology’s lowly position on the funding totem pole didn’t help either, delaying its National Accreditation Council for Graduate Medical Education (ACGME) residency training status until 1955. While Los Angeles was home to many skilled ophthalmologists and scattered small clinics, not one local eye pathology laboratory existed. Doctors commonly sent difficult eye specimens to Washington, D.C.’s Army Medical Museum, subsequently renamed the Armed Forces Institute of Pathology, for analysis and then waited months for the results.

Almost as inconveniently, the nearest eye bank was located in San Francisco. By circumstance and necessity, Mrs. Doheny had no recourse but to cast her net wide for the best ophthalmological resources she could find.

For most people a personal loss of this magnitude would lead to their undoing. But Mrs. Doheny was not like most people. A woman of uncommon determination and courage, she spoke of her sight loss as “...a gift from God,” if she mentioned it at all. From the private depths of her adversity she pledged to find out all she could about her condition; and she threw herself into the task as soon as her trusted ophthalmologist, Dr. A. Ray Irvine Sr., had fitted her with a prosthetic shell that covered her wasting eye. Described as a masterful executive in her own right, Mrs. Doheny was no stranger to managing large scale enterprises. Her business acumen had long been honed by years of active involvement alongside her husband, Edward Doheny. Upon Edward’s death in 1935, Mrs. Doheny became the executor of his will and president and chairman of his holding firm, Pan American Petroleum and Transport Company. Equally significant was the breadth of her open heart. Not only was she a hands-on philanthropist—the Los Angeles Orphanage, now Maryvale, and St. Vincent’s Hospital were chief among her scores of largely Catholic charities—she was also an avid rare book collector and bibliophile with a shrewd, discerning eye. The sum of her skills, talents, and unfailing generosity equaled a formidable force for good in the world.

Undaunted, even though her remaining sight was fading, Mrs. Doheny proceeded. Sometime in 1944 she visited the pathology lab at St. Vincent’s Hospital to meet Mary Daily Irvine, not coincidentally the daughter-in-law of Dr. A. Ray Irvine Sr. and the wife of his son, Dr. S. Rodman Irvine, also an ophthalmologist. Mrs. Irvine, a trained chemist, volunteered in the lab, cutting and staining eyes as part of Dr. John Budd’s pathology research on the eye’s aqueous humor. Mrs. Doheny took a liking to Mrs. Irvine, and within a short period, the two women began spending time together once a week. Part trusted confidant, part advisor, Mrs. Irvine urged Mrs. Doheny to consider expanding her original idea for an eye infirmary to include an eye laboratory as well. The elder Dr. Irvine endorsed the suggestion, adding that doing so would considerably enhance the services and reputation of St. Vincent’s Hospital, a modest community hospital.

Mrs. Doheny astutely agreed. Within months, a committee was assembled at her behest to systematically assess the needs and requirements for future action. The members of this first advisory panel included Dr. A. Ray Irvine Sr. and Sister Fidelis, the administrator of St. Vincent’s Hospital, as well as two nationally respected ophthalmologists, Dr. Alan C. Woods, director of Johns Hopkins’ Wilmer Ophthalmological Institute, as it was then called, and Dr. Phillips Thygeson, director of the Proctor Eye Institute in San Francisco. Meanwhile, at the suggestion of Dr. S. Rodman Irvine, Mrs. Doheny dispatched her attorney, Mr. Olin Wellborn III, on a fact-finding mission to the best eye institutions across the country.

Lest momentum be lost, Mrs. Doheny also took the advice of the Doctors Irvine to retain Mr. Glenn Martineau, a young attorney fresh out of Harvard Law School. It was he who ultimately drafted the irrevocable trust, funded by a $227,000 endowment, to establish the Estelle Doheny Eye Foundation at St. Vincent’s Hospital. By August 1, 1947, only one day shy of the third anniversary of her catastrophic vision loss, Mrs. Doheny and seven original trustees assembled in the Doheny offices located in Room 1100 of the Petroleum Building on West Olympic Blvd. in Los Angeles to sign the official documents. The Eye Foundation’s mission was short but sweeping: “To further the conservation, improvement, and restoration of human eyesight.” Ambitious, too, was the plan to create an eye laboratory to offer specialized services to local ophthalmologists, an eye bank to provide surgeons with legally willed eyes, and an eye infirmary to care for the immediate and practical needs of the community.

Big ideas often have humble beginnings, and the Estelle Doheny Eye Foundation was no exception. Dr. A. Ray Irvine Jr., also an ophthalmologist, and his brother, Dr. S. Rodman Irvine, were authorized to buy and install the necessary equipment and supplies to get the Eye Foundation up and running. According to an accounting dated August 7, 1947, the initial costs for equipment, including the 3% sales tax, totaled $976.45. The Surgical Optical Company donated photo equipment valued at $1,835 and Dr. A. Ray Irvine Sr. gifted his Bausch & Lomb microscope to the fledgling enterprise. Soon thereafter, the principals gathered quietly on the first floor of St. Vincent’s Hospital to inaugurate two small rooms—one, a pathology lab; the other, a photography lab—occupying scarcely 1000 square feet. Even though the lab’s equipment would be considered bare-bones by today’s standards, the virological, immunological, and bacteriological ocular studies its staff produced were timely and invaluable. Los Angeles’ ophthalmologists were treated to a menu of heretofore unavailable but critical services, such as eye photography, tests for uveitis, Sabin blue dye tests for oxoplasmosis, and microbiology tests for external eye diseases. Upon the completion of testing, a written report was sent to the referring doctor without charge, at least initially. Equally priceless was the new no-fee eye bank—a much-needed, dependable source of donated eyes for cornea transplant surgery.

In November 1947, twenty-six members of the Eye Foundation’s rotating Advisory Committee gathered for an informal celebration at the Los Angeles Country Club; and scarcely one month later, on December 16, 1947, Dr. Alan C. Woods delivered the first formal Estelle Doheny Eye Foundation Lecture to the Eye Section of the Los Angeles County Medical Association. Describing the new laboratory he observed, “It’s like a beautiful little Japanese garden, so compact, so complete, with so much growing and blossoming.” “Compact” was a complementary way of describing it: space was at such a premium that the lab rabbits, routinely caged in sterile environments inside, were kept on the hospital roof!

But what the start-up facility lacked in square footage, its three-person staff more than made up for in medical expertise and enthusiasm. Each enjoyed a flourishing private practice, yet still made time to nurture Mrs. Doheny’s dream. Dr. A. Ray Irvine Jr., for example, dedicated nights, weekends, and days off without pay to the Eye Foundation “...for the love of the game”—until he was finally awarded a half-time appointment and stipend in 1960. According to his son, Dr. John Irvine, “In the early days, before Dad joined the Eye Foundation Board—I remember him coming home at night for dinner, after having worked all day in private practice, and then leaving for the eye lab for a couple of hours. He was like a hired hand doing pathology, and research as well. Other nights, he’d bring work home and go into his study that was equipped with a microscope and a dictation machine so that his reports could be transcribed as part of the service the Eye Foundation was providing to the community, for free!” Equally devoted were the other members of the widely respected Irvine family, whose various roles shaped the Estelle Doheny Eye Foundation from its beginning. Dr. A. Ray Irvine Sr. and Dr. S. Rodman Irvine initially shared co-director roles. Then, in time, Dr. A. Ray Irvine Jr. replaced his father and served with his brother in the same capacity. Later, Dr. A. Ray Irvine Jr. became the laboratory director and, ultimately, its medical director. Mary Daily Irvine, Dr. S. Rodman Irvine’s wife, who volunteered her time as the Eye Foundation’s lab technician, was soon joined by her husband’s cousin, Dr. Wendell C. Irvine, ophthalmologist, researcher, and future Trustee.

Aware that the small organization might easily be regarded as a family affair, the leadership actively recruited members from the wider Los Angeles medical community and beyond. The directors invited the officers of the eye section of the Los Angeles County Medical Association to serve on various committees, and chiefs of eye staff from area hospitals were asked to join an Advisory Committee. One early recruit was the colorful Dr. Peter Soudakoff, reputedly the former eye specialist to the Russian czar and later an Associate Professor of Ophthalmology at the University of Peking Medical School years before signing on as the laboratory’s first full-time Ocular Pathologist. With the assistance of eye residents on 2- to 3-month rotations from Los Angeles County General Hospital Resident Eye Service, these initial training opportunities were soon expanded to include medical residents from Wadsworth Veteran’s Hospital, Birmingham Veteran’s Hospital, and White Memorial Hospital. As the Eye Foundation’s professional associations widened, so did its repository of ophthalmic pathology slides. From the onset, Drs. Irvine, Soudakoff, and others contributed and pooled their extensive personal collections with the intention of establishing a comprehensive reference and lending library for the purposes of diagnosis, research, and teaching.

A Vision Takes Wing

By 1949, Mrs. Doheny, despite her nearly complete blindness and increasing social isolation, was still very much in command of her business and philanthropic affairs. Ever the realist, she began to consider ways to carry on her lifelong devotion to philanthropy in perpetuity and, on June 17 of that year, created the Carrie Estelle Doheny Foundation (CEDF). By the end of its first fiscal year, CEDF reported approximately $555,000 in assets and had made grants totaling just over $35,000—all to benefit the advancement of education, medicine, religion, and the health and welfare of children and the needy. As part of Mrs. Doheny’s long-range plan to target, but not limit, donations to Roman Catholic charities after her death, she named two additional Trustees: Sister Fidelis Klein, then Superintendent of St. Vincent’s Hospital, and The Very Reverend William Goodman Ward, pastor of St. Vincent de Paul Church, her private chaplain at Chester Place, trusted philanthropic advisor, and spiritual counselor. Father Ward, who would come to play a key role in the Eye Foundation’s future, staunchly represented Mrs. Doheny’s wishes to the letter for decades.

Shortly after its opening, the Eye Laboratory was processing approximately thirty pathological specimens per month, a turnover that had doubled by September 1948 and increased to 100 by the first twenty-four days of February 1949. No small achievement given the intricacy of the work conducted within such cramped quarters. The Eye Foundation’s Eye Bank, too, was growing by leaps and bounds. Having received approximately 988 eye donations during its first two years of operation, it was authorized to develop an even more extensive community-wide service, exchanging available eyes or corneal tissue with all of the hospitals in the County of Los Angeles system. The need for additional space was obvious, and by April 1949 the Eye Foundation’s Trustees petitioned St. Vincent’s Hospital for two large rooms “on the seventh floor, across the hall from the Eye Laboratory, instead of four smaller rooms on the first floor of the East Wing.” But three years later, the Eye Foundation was asked to surrender a portion of these more spacious quarters and the photographic section was downsized to room #15 on the first floor. Clearly, “blossoming” had given way to bursting at the seams, and no amount of shuffling could change that.

Making do gave way to great anticipation in 1954 when Mrs. Doheny established a $1,638,000 trust fund to build, equip, and furnish a much-needed addition to St. Vincent’s Hospital, ultimately known as the Doheny Pavilion. In what must have been perceived as a lavish upgrade, the Eye Laboratory and Eye Bank were slated to occupy the entire first floor, with the remaining four floors dedicated to the 60-bed maternity department and the radiology department. The architectural firm of Austin Field & Fry was hired to design the nearly 57,000-square-foot addition, and James I. Barnes Construction Company was retained to build it. Mrs. Doheny’s astonishing gift crowned a history of giving to the hospital that had begun during the Depression, when, at the urging of her husband, she had become involved with St. Vincent’s. During those desperate years, Mrs. Doheny had paid all of the utility and food bills that Sister Fidelis Klein, then Treasurer, was unable to meet

For the Eye Foundation’s devoted staff, the promise of larger facilities buoyed hopes and stirred aspirations. The two Irvine brothers, both having spent significant time at the prestigious and forward-looking Johns Hopkins’ Wilmer Ophthalmological Institute and the Massachusetts Eye and Ear Infirmary, were strong proponents of incorporating pathology and microbiology into the Foundation’s research capabilities. To this end, Dr. A. Ray Irvine Jr. and G. W. Johnson Jr., Secretary to the Board, attended a California Institute of Technology course on innovative laboratory design hoping to incorporate these ideas into the new layout. Members of the Irvine family also visited the recently completed Proctor Foundation Laboratory at the School of Medicine at the University of California, San Francisco, one of many site visits to the fast-evolving specialty eye laboratories springing up in association with prominent medical schools and hospitals in other parts of the country.

On May 1, 1956, a crisp spring day, the Doheny Pavilion and Estelle Doheny Eye Foundation officially opened its doors. Located at 272 S. Lake Street, adjoining St. Vincent’s Hospital, the building stood out by virtue of its highly functional architecture. According to newspaper accounts, its interior, influenced by findings from a Mayo Clinic study, was designed with the “patient’s relaxation and comfort in mind...[based on] scientifically selected color schemes, photo murals, piped-in music, and air conditioning” to create “the most complete and modern laboratories for human eye research and treatment in the world.” Decidedly a step up compared to other local facilities. The 10,000 square feet of sleek terrazzo and tile floors, acoustical ceilings, and windows dressed with venetian blinds softened by drapery valences were a far cry from the meager two-room lab. In no time, the hallways were humming with activity, and Dunkirk 7-2371, the Eye Foundation’s new telephone number, was ringing off the hook.

Grateful as the staff was for more breathing room, the expansion didn’t solve all of the Eye Foundation’s growing pains. Paradoxically, more space meant more demand for services and programs that had been usurping limited resources and sidelining prevention and treatment research for several years. Acutely aware of their laboratory’s limitations, the staff frequently discussed the advantages of collaborating with researchers off-site and moved to discontinue uveitis workups to free up on-site space. As early as 1950, Dr. S. Rodman Irvine had suggested teaming with St. Vincent’s Dr. Edward W. Boland to explore using cortisone treatment for eye diseases. Two years later, he proposed a two-year joint investigation at the newly established University of California, Los Angeles’ School of Medicine related to the vitreous humor and basic research on the causes and treatment for glaucoma—a $21,000 project that the Eye Foundation ultimately funded in 1954. Confident that UCLA would shortly eclipse other southland medical facilities, Dr. S. Rodman Irvine also advocated teaming with UCLA on a long-range training program for Eye Laboratory technical personnel in advanced techniques for uveitis and herpes disease, as well as a toxoplasmosis research project to be transferred back to the Eye Foundation’s facility upon its completion.

Meanwhile, Dr. A. Ray Irvine Sr., serving as Chairman of the Los Angeles County General Hospital’s Department of Ophthalmology half a day a month, was also actively cultivating projects and close ties with his UCLA colleagues. Along with the unspoken invitation to bring the Eye Foundation with him, he was offered the position of Acting Chairman of the Department of Ophthalmology a full two years before the department accepted its first official ophthalmology student. An opportunity he respectfully declined. Boosting the Eye Foundation’s fledgling research capabilities came first and, by 1954, he had secured a federal grant, #B-1648, from the Extramural Program of the National Institute of Neurological Diseases and Blindness. Other federal grant projects, based at the Eye Foundation but held in cooperation with UCLA, soon followed, creating the demand for more sophisticated laboratory equipment, such as an electron microscope and light coagulating machine, not to mention a much-needed Underwood electric typewriter.

During the same period, the facility’s staffing requirements also escalated as Los Angeles County General Hospital residents began rotating through the Eye Foundation, calling for instruction in eye pathology and the basic sciences. By the late 1950s, the organization’s Trustees dealt increasingly with budget requests for administrator, technician, postgraduate fellow, and affiliated doctor salaries. Overtime compensation was on the table, too, and for the first time, so were publicity services. Each issue was worthy of attention. Overshadowing them all, however, was Mrs. Doheny’s ever more pressing mandate to support eye research. But how? Would a university affiliation better advance her clear objectives? If so, could this alliance be forged without jeopardizing the Eye Foundation’s highly-prized autonomy?

The Greatest Good for the Greatest Number of People

Mrs. Doheny’s death on October 30, 1958, and her $250,000 gift to the Eye Foundation represented a signal moment. Four months later, Father Ward, her devoted steward, convened the Committee on the Future to clarify and chart the Foundation’s course. Under his firm guidance, the Committee agreed to:

place more emphasis on basic research to prevent eye disease.
continue to offer essential services otherwise unavailable in the area, focusing on those with specific research potential.
appoint a director and develop associations with one or all of the medical schools in Los Angeles.
maintain the eye laboratory at St. Vincent’s Hospital for the time being with the understanding that too many university projects related to basic research might strain its limited resources.
diversify and increase the board’s membership, and possibly reactivate the original medical advisory committees to revise laboratory policies.

With the groundwork laid, the tasks of appointing a director and choosing a university affiliation took center stage. By this time Los Angeles’ two primary medical schools—UCLA and USC—were openly wooing the Eye Foundation. A special committee began to scrutinize each institution. The investigation was augmented by Father Ward and Sister Fidelis’ site-visit to the Proctor Foundation and a written request to the Howe Laboratory at the Massachusetts Eye and Ear Infirmary for a copy of its organizational chart. The Trustees then met with Dr. Stafford L. Warren, the first Dean of UCLA’s newly opened facility, and USC’s Dean Loosli, requesting they submit their respective plans for building their eye departments as well as details defining the Eye Foundation’s role. All the while, the board’s cautious deliberations were guided by Mrs. Doheny’s prescient admonition that the shifting priorities of all universities could easily eclipse those of the Eye Foundation.

Fortunately, Father Ward, a soft-spoken but tenacious man with strong convictions, was able to shepherd the Trustees and the Eye Foundation through this uncertain and volatile period. Reaching consensus was a struggle; but differing Board Members shared one unifying starting point: the Eye Foundation’s autonomy was non-negotiable. Beyond this, there were plusses and minuses on both sides to account for. On the one hand, the Doheny family held long-standing ties with USC. Mrs. Doheny’s stepson, Edward “Ned” Laurence Doheny Jr. had received his B.A. from USC in 1916, had been elected President of the General Alumni Association from 1923-1925, and had served on the USC Board of Trustees from 1919-1929. Upon his untimely death, Mrs. Doheny had donated over $3 million to construct USC’s Edward Laurence Doheny Jr. Memorial Library in his honor. Even so, Mrs. Doheny, and subsequently Father Ward, was wary that the service relationship between the USC School of Medicine and the Los Angeles County General Hospital might “turn the Eye Foundation into classrooms,” thereby relegating research to second place.

On the other hand, and in stark contrast to Los Angeles County General Hospital and USC’s noble but hobbling emphasis on public service, UCLA Medical School’s burgeoning importance and vibrant research environment seemed to offer more potential and meshed more closely with the Eye Foundation’s investigative mission. But, unlike the private USC, UCLA was part of a large, state-supported system with a massive administration that might just as easily “gobble up” the tiny Eye Foundation.

By April 7, 1961, the board was poised to make a decision, and seven of the nine Trustees voted in favor of USC. Absent documentation, it is reasonable to conjecture that USC, a smaller, private institution with plans to expand, and the only serious contender other than UCLA, seemed a more familiar and safer fit. Nevertheless, the two trustees who cast their ballots in favor of UCLA— Drs. S. Rodman Irvine and A. Ray Irvine Jr.—reasoned otherwise. Requesting that their comments be appended to that day’s board meeting minutes, both argued that the decision “should depend primarily on where the funds can be most effectively used to accomplish the greatest good for the greatest number of people over the longest period of time.” Moreover, Dr. S. Rodman Irvine maintained, "...we have at the University of California at Los Angeles, a ‘top-flight’ Eye Department, administered by vigorous, young, accomplished full-time professional administration and research personnel. This is not the situation at the University of Southern California at the present time and I believe it more prudent and sensible to associate with a going concern than with one that has yet to be developed."

With the negotiations scheduled to commence promptly, the wheels of affiliation were finally in motion. Or almost. On May 22, 1961, Dr. S. Rodman Irvine submitted a letter of resignation to the board to free his seat for a USC representative. Dr. Hugh A. Edmondson belatedly filled this position a decade later, in 1971, concurrent with the creation of the USC Department of Ophthalmology. Within seven months of Dr. S. Rodman Irvine’s leave-taking, in January, 1962, the trustees unanimously endorsed Father Ward’s proposal to appoint Dr. A. Ray Irvine Jr. as Laboratory Director. Now formally in charge, he took the reins and mapped a comprehensive program for the laboratory’s operation that would lead the Estelle Doheny Eye Foundation through unforeseen roadblocks, detours, and dead ends—all in the service of fulfilling Mrs. Doheny’s dream.