Winter 2019

The Unstoppable Frances Stern

How Stern’s first-of-its-kind nutrition center became a model for other clinics and a training ground for generations of dietitians devoted to the cause.

By Monica Jimenez

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Illustration: Pierre Mornet

When social worker and educator Frances Stern helped create the Boston Dispensary Food Clinic in 1918, she knew she needed to teach the most vulnerable members of society—including poor women, children, and immigrants with nutrition-related problems—about what to eat to stay healthy. What she didn’t know was that her small clinic, the first of its kind anywhere, would inspire food clinics around the world and send hundreds of expert dietitians onto the front lines of nutrition science.

One hundred years after its founding, and seventy-five years after being renamed after its founder, the Frances Stern Nutrition Center is known for its top-notch inpatient and outpatient services at Tufts Medical Center, and beloved by alumni of its combined dietetic internship/master’s degree program, offered in partnership with Tufts’ Friedman School of Nutrition Science and Policy.

Here, a dozen voices—alumni, staff, past and present directors, and Stern herself via a 1944 essay—tell the story of the center, from its early days as a food clinic to its vital work today.

Cooking instruction at the food clinic in 1924. Photo: photos: Tufts University digital collections and archives

Born to German immigrants in 1873, Frances Stern taught immigrant children when she was a teenager and founded a club to mentor poor young women in her early twenties. Her interest in promoting better nutrition came later, as she studied chemistry and food sanitation at MIT and earned her degree from Simmons College, wrote her book Food for the Worker in 1917, and become an industrial health inspector. Then she decided to unite these passions—and a lifelong mission of nutrition-focused social work was born.

Johanna Dwyer, Frances Stern Nutrition Center Director: She was a teacher and social worker beloved by her students and patients who was very much involved with immigrants, the poor, and social welfare programs.

Kelly Kane, Dietetic Internship Director: She had a vision of nutrition being part of the whole person, which back in the early 1900s was not the standard of care. There was no established standard.

Frances Stern, in a 1944 essay: [Hospitals at the time were] feeding the bed patient according to the physician’s prescription but hardly with the thought of the social and economic conditions that would face the patient on his discharge.

Kane: Frances created the standard. She identified that by improving the nutrition status of the patients, she would improve their health.

Stern: [The food clinic] develops in patients a knowledge of their body requirements, an understanding of their own needs, so that they are not passive but become active in their own behalf.

Carole Palmer, N69, Master’s Program Director: She was not even a nutritionist, but she was smart enough to realize the problem and find the solution. She was able to put the bite on people for money and support because of her social prestige—she came from a wealthy family and she was politically very savvy. That’s how she was able to get the hospital to start the first ambulatory nutrition clinic in the country.

The clinic started with one desk, two chairs, and maybe four patients a week referred from the Massachusetts social services department. But it grew quickly, as the late Janice Feffer (read her obituary on page 34), who worked at the center for decades, once described in notes and an interview. The clinic looked like no other, according to a memorial book on Stern’s life.

Frances Stern (far right) teaching diabetic patients to weigh foods.

Janice Feffer, former staff member: The food clinic in the Boston dispensary grew from very small beginnings to a very important facility providing care for the large influx of immigrants who came to Boston in the early 1900s. Frances recognized the benefits that would be derived by treating each patient as an individual and relating his treatment to his particular medical, social, economic, and cultural background.

Stern memorial book: [H]er idea of a clinic was a startling departure from the usual. The shining brass of the samovar and candelabra, the colorful posters, the books and toys, the comfortable chairs from Miss Stern’s home created an atmosphere which was part of herself. In this warm setting, it was easier for friendly workers to get cooperation from patients.

Dwyer: She was focused on health promotion and disease prevention, as well as medical nutrition therapy for diet- related problems, and making things accessible to people. In that sense, she was ahead of her time.

Kane: She physically showed patients the first food models. She was famous for saying, “Someone should show them.”

Stern memorial book: ‘Visual aid’ is a common expression today. In 1925, it was unknown even to Frances Stern. She knew only that it was useless to tell a patient he needed ‘so many’ grams of protein. It was easier to show him a wax model of a piece of meat and say, ‘You may have this much,’ and it was far more likely that, so taught, he would follow his diet.

Janice Feffer: It was exciting. It was interesting. It was all new, and it all came out of her head.

As time went on, the food clinic only grew in influence. Along the way, Stern didn’t let up in her quest to improve health through diet, even as her hearing and eyesight declined, and Paget’s Disease confined her to a wheelchair. She remained as sharp as ever.

Janice Feffer: I remember very clearly Frances sitting at her desk in a wheelchair. She looked to me like a very old woman, but in that condition, she carried out tremendous things.

Patients in the food clinic’s waiting room in 1935.

Stern memorial book: Frances Stern was unflagging in her quest for improvement, and she demanded the utmost in effort from her students, friends, and fellow workers. To meet her standards was not easy, for she was intolerant of anything less than the best.

Richard Feffer, Janice’s widower: She was very stern. She had a crude hearing aid and she would hold it up and say, ‘Speak up!’ People with hearing disabilities do everything to conceal it, but with her it was up there front and center.

Janice Feffer: She outwardly appeared aggressive, demanding, extremely independent. But she had a heart of gold and tremendous insight, and was very giving and concerned for her associates, family, and fellow men. She was a remarkable woman.

Dwyer: She was also a consummate matchmaker. She took a shine to Richard and encouraged him and Janice to link up, which they did!

Stern died in 1947, but her legacy of helping those who needed nutrition most continued, sometimes at personal risk. The center partnered with Tufts University, established the Mass. Nutrition Resource Center at the Department of Public Health, took part in several national clinical trials, and hired a series of directors who grew its reputation and enhanced its impact: Clare Forbes, Madge Myers, and current director Johanna Dwyer.

Madge Myers, former center director: My goal was to advertise the fact that we were a singular internship program in public health and nutrition, to emphasize to the dietetic world the fact that we were unique.

Palmer: Even when Frances was long gone, we had several famous people come in for outpatient care. One was the anthropologist Margaret Mead.

Dwyer: Our dietitians staffed the nutrition service at the Columbia Point low-income housing project. In the late seventies, there were all sorts of civil disturbances, and on one occasion, the bus the dietitian was riding in was shot at. I consulted with our dietitian, Mary Curry, about pulling out at that point, but she wasn’t concerned and continued to serve the project until it closed.

Kane: I think the sense of mission really comes down from Johanna. It trickles down and lays the groundwork for the unique environment we have here.

Dwyer: No, it’s really thanks to the many fine directors and staff we have been blessed with over the years. Today, the Stern Center also benefits from the leadership of Kelly Kane and Carole Palmer, who are also faculty members at Tufts.

Beth Winthrop, N83: Early in our program we all went to a joint intern class day at a Harvard teaching hospital. Dr. Dwyer told us we didn’t have to dress up, so we were all in jeans, sweaters, and sneakers. We get there and all the other interns have on stockings, heels, lab coats, everything ironed, pressed, and pleated. And Dr. Dwyer comes in the back of the auditorium, and instead of saying, “Frances Stern interns, please stand up,” she runs down to the front and tells an off-the-cuff story about each of us. It takes like twenty minutes. Did we feel like the most special interns there? Yes.

Kane: Johanna sees the students not as students, but as future colleagues, and she treats them that way.

Dwyer: What we expect of students is that they be professionals. If they don’t want to be in the human-service profession, they need to get out and do something else. If they do want to do that, they’re colleagues.

Today, the Frances Stern Nutrition Center is known for its focus on disease prevention and treatment; its rotations in Tufts’ nutrition, medical, and dental schools; and its alumni’s wide range of careers—and their fierce loyalty.

Abby Usen Berner, N03, former Friedman School alumni association president: The strength of Frances Stern is giving students experience in so many specialized areas to determine what they want to do.

Mary Kay Crepinsek, N84: I did a rotation at the State House in Massachusetts and learned about how legislation comes about. And then I spent two weeks on an Indian reservation in Machias, Maine, one of the poorest places in the country at the time. We were able to provide a range of educational and counseling services for residents of the reservation.

Usen Berner: I had a pediatric rotation where I was exposed to inborn errors in metabolism, and that experience gave me a strong start. Now I’m a pediatric dietitian in an outpatient setting at Spaulding Rehabilitation, helping infants and children get a good start using nutrition.

Grace Phelan, N05, Friedman School alumni association president: During our rotations in the ICU, we were interacting with doctors, nurses, pharmacists. We were integrated into the care team and asked for our opinions. It helped us not only increase our knowledge, but also understand how physicians think.

Palmer: The dietetic interns have had clinical rotations at the dental school since 1965. Although those rotations have been ongoing for more than fifty years, the practice has suddenly achieved new recognition as other schools scramble to develop interdisciplinary models for the future. Ours has been there all along.

Dwyer: Over the years, we have contributed a thousand or more first-class dietitians, and they have generally been at the forefront of treating the current problems of the country. The center carries on the tradition of excellent patient care, scholarship, research, and community service today.

Phelan: If you meet someone who graduated from Frances Stern, you automatically have this connection. Everyone is very proud of our program, particularly the history behind it.

Palmer: We tell the students as much as we can about Frances Stern. Her picture is on the wall and on a T-shirt. We say we are a family—the Frances family.

Kane: Though so much time has gone by, we still face the same challenges identified so many years ago, and are still trying to incorporate nutrition as part of good health. We are still serving immigrant populations as Frances Stern did, and I think we can learn a lot from her—like not letting what always has been in place stop us. As wonderful work as she did in the 1900s, we still need to continue that work now.

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