By Lee Manchester
Claire Fagin showed from an early age that she had a mind of her own. In 1943, she was 16 years old, the daughter of immigrants in New York City. Her parents had decided that she was going to become a physician like her aunt, Dr. Ida Mintzer, the director of dermatology at Queens General Hospital. They had even taken to calling their daughter “Clarence” to steel her for the very male world of medicine.
After enrolling at Hunter College, however, something became clear to Claire.
“I had a vision of myself, and that vision did not include going to medical school,” she recalls. “It was not a role model I could accept.”
With the help of a friend, behind her parents' backs, Fagin conducted her own research on nursing careers. After determining that she wanted a baccalaureate nursing program, not just hospital training, there were only three choices open to her — one of which was Wagner. The dean of the College's brand-new nursing program was Mary Burr.
“She was teaching in the evenings at Hunter, and I made an appointment to see her,” Fagin says. “I fell in love with her right away; she was so warm and motherly. … She told us she would take us at the beginning of the term in January, and that was wonderful to us; I wanted to get out of Hunter in the worst way.”
Claire enrolled at Wagner College.
Then, she went home and told her mother.
“She went berserk,” Fagin recalls. “She telephoned my father at his grocery store across the street, and for the first time ever he closed the store in the middle of the day and came home.”
Not knowing what else to do, Harry Mintzer called his sister Ida, the doctor, for advice.
“Ida said, 'Harry, stop worrying. When she goes through the nursing program at Wagner College, she'll get her bachelor's degree. After that, she'll be able to decide whether to become a doctor.'
“That calmed my father down,” Fagin says. “I was so grateful five years later when everyone, including Aunt Ida, came to my graduation.”
For all of her long and productive life, Claire Mintzer Fagin '48 H'93 has made up her own mind and led by her own lights, no matter what others have thought. That fearlessness helped her spearhead reforms in healthcare, change the direction of nurses' training, build the top-rated nursing school in America, and become the first woman to lead an Ivy League university. All along the way, she drew on her early decision to become an R.N. — which, as she once told a reporter, to her means “real nurse.”
Defying Doctor's Orders
After all of the family turmoil, Fagin's defiant choice turned out to have been a good one. “The picture that I have of Wagner College during that time is very fine,” she recalls. “And the gorgeous alma mater — I've remembered the words to this day: 'Beautiful upon a hill, looking out to sea.' It was so perfect; the place and the song went together so wonderfully.”
She began her nursing career at Sea View, a tuberculosis hospital on Staten Island, but her real passion was for psychiatric nursing. After about a year, she joined the staff at New York's famous Bellevue Hospital, and she soon discovered that she needed to deepen the theoretical side of her education. She enrolled in the graduate nursing program at Columbia University's Teachers College, earning her master's degree in 1951.
Her next step took her farther away — to Bethesda, Maryland. “I don't know that I would ever have left New York, because I was very, very homebound,” Fagin says, “except that I had met this incredible woman while I was getting my master's, Gwen Tudor, and she was going to start up the Clinical Center at NIH,” the National Institutes of Health, one of the world's foremost medical research centers.
Fagin joined her mentor at the NIH Clinical Center. It was during this period that she met Sam Fagin, an engineer living in suburban D.C. The two were married in 1952.
At Clinical Center, an important seed was planted for her professional future as well.
“Everybody came through Clinical Center — and I mean everybody, from all over the world,” Fagin recalls. One of those people was filmmaker James Robertson, who screened a documentary on the common practice of separating parents from their children in hospitals. Robertson's film touched a special chord with Fagin.
As an infant, Fagin's mother had been quite ill. “I was taken care of by my darling aunt and uncle,” Fagin says. “Then my mother came back when I was 11 months old.” Fagin believes that the separation from her mother, followed by the separation from her aunt and uncle, traumatized her, creating psychological challenges for her as she grew up.
That's why, when Robertson showed his film at Clinical Center, “naturally, it went splung,” she says, like an arrow piercing her heart.
“They tried to get rid of us, but we refused to leave.”
A few years later, Fagin had an encounter of her own with parent-child separation in hospitals. The Fagins had returned to New York and adopted their first son, Joshua. When Josh underwent surgery for a hernia, Claire and Sam wanted to stay with him while he recovered.
“They tried to get rid of us, but we refused to leave, because by that time I had seen that film [by James Robertson], had read everything there was to read about separation, had read Anna Freud [the prominent child psychologist], had read everything imaginable, and they were not getting us to leave,” she says.
A hospital guard threatened to remove the Fagins by force. “All you're going to be doing is exacerbating his separation,” warned the pediatrician.
“Doctor, you obviously don't read the literature,” was Claire's reply. “And I left her and that hospital.”
Shortly thereafter, Fagin enrolled in the Ph.D. program at New York University, where she chose for her dissertation topic the issue of “rooming in” versus separating children from parents during hospitalization.
It was that dissertation, completed in 1964 and published in 1966, that first brought Fagin into the national limelight. According to biographer Susan M. Reverby, “[Fagin's] groundbreaking study … demonstrated the critical importance to patients and nurses of allowing parents of hospitalized children to room together. Her published monograph and articles in the mid-1960s, as well as her television appearances and media visibility, were highly influential in transforming hospital practices across the country.”
The next stage of Claire Fagin's career involved a series of administrative appointments where she made big waves that lifted each program to a new level of excellence.
Fagin joined the faculty at NYU, directing the graduate program in psychiatric nursing. In 1969, when NYU nursing moved to eliminate specialty programs like hers, she made her own move, to lead the Department of Nursing at Herbert Lehman College in the Bronx.
There, she developed a new baccalaureate program that prepared nurses for primary care practice, a new concept at the time.
“Nobody else was doing this then,” she says, “and all I had was a concept. I had to gather people around me who could put meat on the bare bones I gave them. I loved my faculty — I called them 'my jewels,' and I brought some of them with me to Penn.”
The University of Pennsylvania recruited Claire Fagin in 1977 to become dean of its troubled School of Nursing — and, because they had sought her out as a known innovator, she was well positioned to institute the changes necessary to build the school up.
“I would always throw out challenges,” she says. “I would meet with one group and tell them that we had to double the master's program, that we couldn't survive with a master's program that size. A faculty member looked at me and said, 'How on earth do you expect us to do that?' I said, 'I expect it — and we're going to do it.'”
Under Fagin's leadership, the entire nursing faculty at Penn had to get doctorates. To go along with the extra training, Fagin secured grant funding to support their work, and she saw through the completion of a new building and the creation of a new doctoral program for the school.
By the time Fagin left the dean's office at the end of 1991, Penn had the top-rated nursing program in the country — and her faculty loved her for what she'd done to pull them into the top tier.
Ivy League President
Claire Fagin stayed on at Penn Nursing as the Leadership Professor, an endowed seat. The next spring, taking a break in Paris with her husband, they read the news that Sheldon Hackney, Penn's president, had been nominated by newly inaugurated President Bill Clinton to head the National Endowment for the Humanities. Until that moment, Fagin says, she hadn't given a thought to becoming the next president of the University of Pennsylvania — but, suddenly, the idea intrigued her.
When she and her husband returned to Philadelphia a few days later, they saw a front-page article in the Daily Pennsylvanian that listed her name toward the bottom of a roster of possible candidates for acting president.
As she was soon to learn, however, Fagin was anything but a long shot for the job. She received a call that night asking her to meet with Allen Shoemaker, the chair of Penn's board of trustees, later in the week.
“When I met with Al, I came prepared to convince him that I was the right person for the job,” Fagin recalled in an autobiographical essay. “From the beginning of the interview, it was clear that my 'sales' pitch would be unnecessary and that I was being offered the position then and there.”
Fagin says that she was “thrilled … to be the first woman chief executive officer of Penn. I knew that the success or failure of my presidency would cast a long shadow on the future, but despite the possible outcomes, the appointment sent a message that Penn was ready for a non-traditional appointment. For this 254-year-old university, the message for women was hailed with enthusiasm.”
Claire Fagin took over the interim presidency of the University of Pennsylvania on April 14, 1993.
The very next day, nine members of the Black Student League confiscated an entire issue of the Daily Pennsylvanian, which had been running a conservative column they considered inflammatory. Racial tensions immediately rose.
The following week, another race-related story hit the papers, adding to the tensions at Penn.
“It dealt with an event that had occurred in January involving a group of black women students and a white male freshman,” Fagin recalls. “Close to midnight on a school night, the women were celebrating the founding of their sorority with traditional chants outside a high-rise dormitory. Many students yelled out of the windows, and one student was identified who allegedly called the women 'black water buffalos' and told them to go to the zoo if they were looking for a party.”
News stories about the Daily Penn confiscation and the “water buffalo” incident drew national interest because of former president Sheldon Hackney's upcoming NIH confirmation hearings.
“I had dealt with issues of diversity, race relations and political correctness before,” Fagin says, “but never at the level of intensity that we were experiencing at Penn. … After I was in that job for two weeks, I was walking around with tears behind my eyes, it was so horrible.”
To deal with the immediate crises, Fagin found herself doing double duty as both president and press representative, making connections with editors at the Philadelphia Inquirer and the Washington Post. And it helped. “They toned down a bit,” she says.
But Fagin's real agenda for her year as interim president was not to improve Penn's media relations — it was to rebuild the university community itself.
“I had been at Penn 17 years by the time I became president, and I had seen the sense of community erode. To me, it had been the most warm and embracing campus you could possibly be on, and somehow it had lost that,” she says. “What I wanted to do was rebuild that sense of community. It wasn't like some kind of myth I was trying to recreate — I was there, I know what happened, I don't know why, but I had that capability.”
“I’m a nurse, and I’m a healer — so I healed.”
Throughout her presidency, she focused on the work of a special Commission on Strengthening the Community, completing its goals before she left office.
Fagin believes that the challenges of that time in the university's history called for the unique strengths associated with a female approach to leadership.
In an autobiographical essay, she cited several studies of the differences between male and female leadership styles that had “focused on the more interpersonal strategies women are comfortable with and use, on the reduction in hierarchical methods of administration and management, on the increased focus on communication-listening as well as speaking and sharing information, and on consensus building. Those strategies and styles describe much of my own management. … The climate at Penn when I became interim president called for this interpersonal style.”
“At that time, nobody could have handled it but me, and I knew it,” Fagin says. “I'm a nurse, and I'm a healer — so I healed.”
Working Like a Dog
Though Fagin's term as interim president of the University of Pennsylvania ended on June 30, 1994, she by no means retired from her career as a scholar and leader in the nursing profession. She continued her study of nursing home reform, examined the economic pressures that were forcing the healthcare system to abandon patients, and developed a nationwide program to build nursing capacity for geriatric care.
In 2006, the former dean was given a rare honor: The building that housed the Penn Nursing program she had led for 15 years was renamed Claire M. Fagin Hall.
Today, Fagin consults for several nursing schools and research projects, serves on corporate boards, and “works like a dog” with her fellow board members of the Visiting Nurse Service of New York to improve home nursing care in New York City. And she continues to provide career advice to colleagues in the fields of nursing practice, research and education.
She has been widely recognized and much honored: former president of the National League for Nursing, winner of the American Nurses Foundation's First Distinguished Scholar Award and the Lillian D. Wald Spirit of Nursing Award, a Fellow of the American Academy of Arts and Sciences, an Honorary Fellow of the (U.K.) Royal College of Nursing, a Living Legend in the American Academy of Nursing, and recipient of 15 honorary doctoral degrees and counting — including one from Wagner College in 1993.
“Whatever I have achieved, the awards I have gotten, the personal rewards I have felt, would not have come my way were I not a nurse,” Fagin says. “I feel I have given a lot to the profession, but I am not even near to repaying what it has given me. I shall always be grateful for the stroke of fortune that brought me to choose this wonderful field.”