By Paul Sisson | [email protected] | The San Diego Union-Tribune

Today, Scripps Health runs five hospitals and 19 outpatient centers, employing more than 13,000 people across San Diego County. And Scripps Research has produced six Nobel laureates and numerous FDA-approved drugs.

Not bad for an organization that started in 1924 with a 57-bed hospital and adjacent medical clinic on Prospect Street in La Jolla, decades later joining with Mercy Hospital in Hillcrest, which opened that very same year.

Leaders will commemorate a century of care Tuesday, their speeches to be followed by refreshments -- pineapple punch and cake -- just what Ellen Browning Scripps served 10 decades ago to celebrate inaugurating Scripps Memorial Hospital.

Two strong women, both with decades of experience taking care of people, laid the foundations for what has become a household name across the region and in scientific circles that span the globe.

Mother Mary Michael Cummings, the daughter of Irish immigrants born in Illinois arrived first, starting what would be called St. Joseph's Dispensary above a men's clothing store downtown in 1890 with only a $50 gift from the church to get started. Within a year, she and her sisters had secured a 10-acre site in Hillcrest for a larger building, gradually raising the funds to build the six-story Mercy Hospital where it still stands today, in a much-expanded form, on Washington Street.

Unfortunately, Cummings died of a heart attack in 1922, never getting to walk through the front doors of the facility she spent decades pulling together, one charitable donation at a time.

Ellen Browning Scripps arrived in San Diego a multimillionaire with a fortune estimated to be the equivalent of $3 billion today. But she came from equally humble roots, caring for relations on the family farm in Illinois after emigrating from London with her family in 1844.

While Cummings followed her faith to the Sisters of Mercy, working westward from St. Louis tending the sick and needy, Scripps saved up and sent herself to Knox College in Illinois at a time when higher education was unattainable for most women. Studying science and mathematics, she graduated with a "ladies diploma" in 1859. At that time, the school issued full diplomas only to men.

She followed her half brother into the newspaper business. Ellen, who never married, worked in a wide range of roles from copy editor to travel reporter, also building equity in and helping run the business which gradually amassed a nationwide collection of mastheads and was a pioneer in syndication of content.

Following her half-sister Julia Anne Scripps west to California, Ellen Browning Scripps championed a wide range of philanthropic efforts, from providing funds to create Scripps College in Pomona to working with her brother, E.W. Scripps, to float what is now known as the Scripps Institution of Oceanography.

By 1926, her philanthropic works were extensive enough to gain the attention of Time Magazine, which put her on its cover.

It is easy to think, at the 100-year mark, that Ellen Browning Scripps would have been amazed by how those seeds she planted on Prospect Street have grown. But then again, maybe not. This was a woman, notes Dr. Sarita Eastman, a San Diego pediatrician and author, who lived through the Civil War and witnessed the accelerating pace of change that occurred at the turn of the century.

Having researched Scripps' progenitor for her book, Good Company, Eastman said Scripps probably expected very big things from her charitable investments in health care and research.

"I believe Miss Ellen was building for both the present and the future and fully expected that a century would bring exponential growth and change," Eastman said. "She knew she was setting the wheels in motion for a tremendous journey."

Today, Chris Van Gorder, chief executive officer of Scripps Health for the past 25 years, references Ellen Browning Scripps and Mother Mary Michael Cummings frequently. Though these names were not constant touchstones when he got the top job, he said learning their stories simply make him want to remind employees whence their organization came.

"Mercy joined us in 1995, and I think maybe I'm a little sensitive to our Mercy colleagues," Van Gorder said. "Because we have her name, it would have been very easy for the organization to just focus on Ellen Browning Scripps, and not Mother Mary Michael Cummings, and I think that would be wrong."

"It's important that we remember that these were both remarkable women in their time, and a big part of what we have to do every day is sustain their legacy which has always been taking care of the community."

And there has been a fair bit of that. Scripps' 2024 community benefit report for fiscal 2023 estimates $768 million in uncompensated care, including more than $600 million in reimbursement shortfalls from Medicare and Medicaid, and $18 million in charity care.

Scripps cited those shortfalls in 2023 when it decided to pull its most popular medical groups out of Medicare Advantage plans, causing about 32,000 beneficiaries to find new doctors or switch to original Medicare coverage, which is generally significantly more expensive.

What would Mary Michael Cummings and Ellen Browning Scripps have made of this situation?

While she said she was not familiar enough with the ins and outs of the Medicare Advantage decision to comment, Eastman said there is plenty of evidence in the historical record of both Cummings and Scripps being rather tight budgeters. They were, she said, focused on serving the community, but also were willing to cut programs to bare bones if they felt like an initiative could lose so much money that it threatened their organization's overall mission.

"The reason they didn't go under is because they watched every penny," Eastman said.

Frugality did not mean zero tolerance for betting big on the future. Funding for research was regularly available. The reason a metabolic clinic was built next to that first hospital on Prospect Street was to make a new wonder drug called insulin available to the community, and it wasn't long before care merged with curiosity. It was not enough to use new drugs. Scripps also wanted to provide space for researchers exploring new frontiers.

Dr. Eric Topol, executive vice president of Scripps Research and head of the Scripps Research Translational Institute, said that though research and health care have been separate entities for many years, there is still plenty of cross pollination.

"It's pretty amazing that, a century ago, Ellen Browning Scripps made this combined entity that was unique at the time, both the beginning of a health care system and also what turned out to be the largest biomedical institute in the country," Topol said. "While they have grown apart over time, there is still some interdependency, some of our researchers fully collaborate deeply with the people at Scripps Health."

Scripps Health also continues to do its own research, especially in areas such as diabetes, and offers training programs for physicians. One of the standouts has been Scripps' micrographic and dermatologic fellowship in oncology.

Dr. Hubert Greenway has run the program since 1984, training physicians in the surgical removal of skin cancers using methods pioneered by Dr. Frederic Mohs who he studied under at the University of Wisconsin.

Having personally performed more than 40,000 such surgeries, Greenway has long been a sought-after speaker at scientific conferences worldwide. He also helped pioneer the use of interferon in treating skin cancer, making Scripps, he said, the first to do so in the nation.

Health systems are known to compete fiercely for top talent, and yet Greenway has remained at Scripps for 40 years, one of its longest-serving affiliated physicians.

Over the years, he said, offers have come from all over. Once, a good friend tried to get him to come to Winston, Salem, N.C., while he simultaneously tried to pull his counterpart west to San Diego. Both ended up staying put.

"There are great places to practice medicine throughout the country, but each time I would look, if I took out a piece of paper and wrote down the plusses and minuses, it always came out that Scripps offered the best and had the best," Greenway said.

At the end of the day, he added, what most doctors want is to be at a place where they feel they are able to focus first on their patients. And that extends to the business side of the house.

Sandra Garbiso, 75, is Scripps' longest-serving employee, starting at Scripps Clinic and Research institute, originally called the Scripps Metabolic Clinic, in 1967 as a high school senior, later moving to an office job at Mercy Hospital handling revenue management, then rejoining Scripps in 1995, when Mercy entered the organization.

Her job today, oddly enough, is doing battle with health insurance companies to get bills for services paid. Though she once managed the whole department, she made room for the next generation to take the helm and went back to handling accounts, 56 years into the job.

So much has changed. She recalled the days of handling billing before computers when every service provided at the bedside was noted on a paper charge slip, gradually pulled together in file folders organized by date. Today, with electronic medical records, she can see everything going on with an individual patient with a few keystrokes.

She said that even working in business operations there is an awareness of the organization's founders. It's fitting, she said, that Mercy and Scripps came together long after their founders passed away.

"You know, they both had this vision, that was meant to marry up at some point," Garbiso said. "They both had the really sincere desire to help people ... and I see that going on forever."