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Tue January 8, 2013
RI Hospital marking 150 years of caring for the sick
(PROVIDENCE, RI) This year marks the 150th anniversary of Rhode Island Hospital. Founded in 1863 as the state's first general hospital, it remains the largest hospital in the state and the state's only level one trauma center. Here’s a look back on a hospital that was founded on a commitment to care for the indigent.Providence doctors had been agitating for a general purpose hospital as early as 1851 but it wasn't until wounded Civil War veterans started returning home in 1863 that the General Assembly chartered the Rhode Island Hospital Corporation. The City of Providence donated a 12 acre site on Eddy Street where a seamen’s hospital once stood. It took five years to raise funds and erect a 400-thousand dollar red brick turreted building that overlooked pastoral grounds with the Providence River in the distance. A cobbler with a tooth abscess became the first patient on October 6th, 1868.
Medicine was in its infancy. Doctors knew nothing of the germ theory but cleanliness, fresh air and nutrition were emphasized. Lacking most modern medicines, nurses kept patients comfortable until the illness passed ... or didn't. At Rhode Island Hospital the average stay in 1868 was 47 days. George Wunderlich, director of the National Museum of Civil War Medicine, says nurses -- more than doctors -- would have saved patients' lives in the hospital's earliest years.
"Quite frankly, it was the nurses in the 19th century who saved a lot of patients simply by making sure that things like hydration, sanitation and diet were properly delivered,” said Wunderlich. “But there were also a lot of operations being performed at that time and, in fact, for some conditions they actually had pretty decent medications, depending on what it was for certain types of illness and those would have been administered there."
Wunderlich says your chances of surviving a stay at Rhode Island Hospital in those early years were pretty good.
"General hospitals we find in the Civil War have mortality rates under eight percent, some under six percent, which when you consider many hospitals today are at four and five percent it's really quite good."
From the beginning to the present, Rhode Island Hospital has been a refuge for the poor. According to a history of the hospital called "To Meet These Wants" by Joseph Garland, it charged no fee at all until 1933. Then it was a modest 10 cents a visit but laboratory services and drugs remained free.
How did it survive? Well the city of Providence paid for the care of some of its indigent citizens. And a bank called the Rhode Island Hospital Trust Company was created. It funneled a portion of its profits to the fledgling hospital building, in time, a healthy endowment.
State historian laureate Patrick Conley notes that Rhode Island lagged behind Boston, Hartford and New Haven, Connecticut in the establishment of a general hospital.
"Rhode Island lagged behind and Providence lagged behind despite the urging of a number of doctors,” Conley said. “In 1811 Brown University established a medical school. The medical school lasted until 1827. Had that medical school stayed in operation, Rhode Island Hospital might have been founded a couple of decades before it eventually was founded."
From the start, Rhode Island Hospital has been growing.
Here are some highlights:
In 1879 the first telephone was installed, a five party line at an annual cost of $22.
In 1882 a nursing school was formed. It would disband in 1973.
In 1892 the marriage of an old city vehicle and a hired horse formed the nucleus of an ambulance service.
The dawn of the 20th century brought anesthesia and X-ray departments.
In 1914 Rhode Island Hospital became one of the first hospitals in the country to have an electrocardiograph machine.
During the 1918 influenza pandemic it was inundated with close to 1400 patients in a four month period.
The 1920's were a period of robust expansion, with the additions of dormitories for male and female employees, a laboratory, library and auditorium.
But the 1931 opening of a dental clinic marked a Depression-induced lull in the building boom. In 1932 the hospital board ordered wages and salaries cut by 10 percent. Ward rates were $21 a week but most patients were admitted free. They simply had no money to pay.
During World War II nearly half the hospital's doctors entered the military. Retired doctors were recalled to active duty and volunteer groups were formed to carry on the work of the absent.
By war's end the lack of an affiliation with a medical school was taking its toll. Virtually no research was being done and a Boston inferiority complex gripped the hospital staff.
In 1948 the hospital added the word "research" to its mission. A decade later it was celebrating that commitment with the opening of the George Building, dedicated to cancer research.
But its biggest break happened in 1963 when Brown resurrected its medical school. Rhode Island Hospital president Timothy Babineau says Brown has affiliations with seven hospitals, but none that rise to the level of its relationship with his.
"It is the principle teaching hospital for Brown medical school, our academic partner,” said Babineau from his spacious office on the first floor of the hospital. “We received that designation a couple of years ago. Brown recognized that although it has many teaching hospitals, Rhode Island Hospital plays a unique role in its academic mission. We are the level 1 trauma center for the city and the region. We are the burn center for the city and region. We have the only children's hospital here. The open heart surgery program is located here. And we have the tripartite mission of not only providing superb clinical care but also creating new knowledge through research and educating the next generation of caregivers. That's really a unique tripartite mission. Layer on top of that for 150 years we have never turned away anybody irrespective of their ability to pay for the services and we never will. That also makes us unique in the community."
Through the years, Rhode Island Hospital has trained thousands of doctors. They include William P. Murphy, a 1920 intern who received the Nobel Prize in Medicine and Physiology for work on pernicious anemia and William McDonald, who served as President Franklin Roosevelt's neurologist for treatment of polio.
Dr. Walter Thayer, a semi-retired gastroenterologist, interned at Rhode Island Hospital starting in 1954.
"There was [sic] only a few antibiotics available then,” Thayer recalls. “There was penicillin, sulfa, isonide, streptomycin and tetracycline. That's all we had. Now we have over a couple hundred antibiotics. All these cardiac medicines we use today like beta blockers and calcium channel blockers hadn't even existed. We used digitalis and morphine for patients in heart failure."
He lived in a men's dormitory which provided unique access to the nurses.
"We had tunnels. We knew how to get nurses into the nurses’ dorm through the tunnel.”
Tending patients wasn’t their only job.
“One of the jobs was to get rid of bats. At night bats used to fly around there and patients would get all upset and we had these huge bat nets.... And we'd try to catch the bats and let them out. Of course they'd just come right back in."
Nurse Kathleen Mezzanotte recalls the spirit of cooperation after the Station nightclub fire in 2003.
"It would give you chills. It was just unbelievable how the doctors, everybody pitched in. Whether you were a doctor, housekeeping, nursing, dietary, anybody ... Doctors were emptying laundry bins. We all just chipped in. It was just incredible."
So what's the future of Rhode Island Hospital as it marks its sesquicentennial year? Hospital president and CEO Timothy Babineau has concerns about the implementation of the Affordable Care Act but is confident the hospital will carry on.
"Health care reform is a real hurricane out there,” says Babineau. “The ability of Rhode Island Hospital to continue to fulfill its tripartite mission even as the number of folks who can't pay for our services increases. Last year we provided tens of millions of dollars in charity care which again is part of our mission but we need an operating margin to be able to fund the research and teaching. Although sometimes I lie awake at night worrying about these things I also take great comfort in the fact that Rhode Island Hospital has survived much bigger challenges over the last 150 years and it's still here and I suspect it will be here for another 150 years."
Thousands of poor Rhode Islanders past and present would say "Amen" to that.
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