Chapter I: Frontier Hospital

Beginnings

St. Augustine Church and St. Joseph's Academy  [AHS #13,927 H17]
St. Augustine Church and St. Joseph's Academy 
[AHS #13,927 H17]

 

It was not always so -- this humming, organic reality that we know today, pulsating round the clock in its shell of mortar and steel. This microcosm of modern, technological society where dozens of sciences converge to serve the talents and energies of hundreds of professionals engaged in a single pursuit: the welfare of their fellow humans -- this hospital that is St. Mary's does have its story. Its beginnings already go back beyond the memory of living men. Yet, it is a story of continuous living that reaches back to yesterday, touches today, and leaps toward the unknown tomorrow. This, perhaps, is the fascination of history -- the realization that the humdrum, taken-for-granted today was someone else's completely unpredictable tomorrow.

Without a doubt, the tomorrow on the minds of seven determined women who were approaching Picacho Peak from the north on the evening of May 25, 1870, must have been the twenty-four hours that lay immediately ahead. These women, all of them Sisters of St. Joseph of Carondelet, Missouri, had left their motherhouse over a month before. They had been traveling to Tucson on a circuitous route that had taken them from St. Louis to San Francisco by rail, thence to San Diego by sea. After a brief rest, they had set out once again, this time by wagon for Arizona. The trail cut south through the mountain passes in Baja California, eastward through the ranges along the border and north again into the sand dunes west of Yuma. Finally, it took them across the Colorado to Fort Yuma one week after they left San Diego. Eleven days later, they had passed through the worst of the desert, following the course of the Gila River as far as the ruins of Casa Grande where they had turned south for the final leg of the journey to Tucson.

If the rigors of the journey itself had not been enough to have the Sisters thirsting for an end to it, then certainly a new sense of danger must have had them praying for a quick arrival in Tucson, as the little party of seven nuns, a driver, and the Vicar-General of the Vicariate of Arizona, Father Jouvenceau, who met them at Yuma, had by now come well within the range of an Apache sweep. Ranchers had warned of the dangers along the way and told of the depredations of Cochise and his marauding bands. Even more threatening were the very vivid memories of the fresh graves marking the final resting place of isolated pioneer families which they had seen along the trail from Yuma. Apache terror was a reality, not a newspaper headline.

By then, however, the party was no longer traveling alone having been met the previous evening by a mounted escort of sixteen troopers from Ft. Lowell. On the morning of the 25th, a party of miners heading for Tucson eagerly sought the protection of the same military escort. Paradoxically, the tension increased as the party grew in numbers because each addition brought with it the implied likelihood of a large band of hostiles in the area. Nor was this sense of an imminent attack dispelled in any way by the arrival of a large body of armed Tucson citizenry which had met the group about noon. By the time darkness fell, the sisters' wagon was surrounded by what must have been the largest armed company to approach Picacho Pass since the notorious battle of Picacho during the Civil War. Whether or not any Apaches were in the neighborhood is not known, but by midnight, the entire throng was galloping past the truncated silhouette of Picacho Peak to the accompaniment of fierce yelling on all sides and the thunder of hundreds of hooves.

Fortunately, the night itself and the last lap of the trek continued without any violence. By the evening of the 26th of May, the Sisters were welcomed into Tucson with cheers and fireworks. They were in their new home.

What was it that impelled these seven women who began the story of St. Mary's Hospital and Health Center to set out upon this long trip to an isolated and unknown corner of the American Southwest? Obviously, it was a sense of mission, and that sense of mission can be understood only in light of the religious community to which they had bound their individual lives. These women, and they should be named -- Emerentia Bonnefoy, Monica Corrigan, Euphrasia Suchet, Hyacinth Blanc, Martha Peters, Ambrosia Arnichaud, and Maxime Croisat -- had separately chosen a religious society that emphasized individual conviction and inner strength dedicated to the service of God and of the neighbor.

The Sisters of St. Joseph date their beginnings as a religious community in the year 1650 when the society was organized in Le Puy in the Upper Loire Valley of France. The first institutes of the new group consisted of small secret clusters of three sisters living among the people and ready to undertake anything within their abilities, so long as it was for the benefit of the "dear neighbor." Mediocrity was unwelcome, and each candidate was measured by whether or not she had the quality that would enable her to be chosen as Superior of the entire Congregation. Only a crystal clear perception of life bonded to great humility and charity could possibly hold such a group of women together.

The society grew along these lines during its first century, but, as with all religious orders, it was cruelly suppressed at the time of the French Revolution. The Sisters were dispersed, and during the Reign of Terror, five of them sent to the guillotine. It was a temporary roadblock, however, for once the nation tired of the Terror and the anti-religious laws were relaxed, the Sisters of St. Joseph reappeared and spread all over France. They also looked beyond the borders of France, and by 1836, they had crossed the Atlantic Ocean and had reached as far inland as St. Louis where they opened a school at Carondelet in answer to the prayers of Bishop Rosati. Less than forty years later, Carondelet was the hub of the Congregation's American efforts and the Sisters were just as ready to answer the plea of the newly appointed Vicar Apostolic of Arizona, Jean Baptiste Salpointe, when he called for help. .

On Ascension Thursday, May 26,1870, the Bishop had been granted his Sisters and Tucson had its first school. The Sisters began their teaching duties without delay. They learned to speak Spanish quickly because of their desire to gain the goodwill and confidence of those they served, and to be the good neighbor" made it imperative that every barrier be removed as soon as possible. In rapid succession, their efforts were extended beyond the confines of the "Old Pueblo" an Indian school at San Xavier, a hospital in Prescott for men injured in mining operations, a school in Yuma. The original Tucson school grew and divided into a secondary school, St. Joseph's Academy, and an elementary school, St. Augustine's, for the children of the Tucson parish, and within six years, the Sisters' efforts were capped by the opening of a novitiate for local girls who expressed an interest in joining the society. By 1880, the Sisters of St. Joseph were an established factor in the life of Tucson. The Old Pueblo was finally being tied into the arterial system of the United States, and a retrospective sweep of the decade of the 1870's offers a better perspective, perhaps, than does a detailed chronological narrative of the changes that had occurred.

The Federal Territory of Arizona had been established only in 1864, but the terrible exigencies of the Civil War then raging the East limited that establishment to the simple legal reality. A Federal presence, in the form of an effective civil administration was non-existent, and an operative military presence simply a bureaucratic fiction. As a result, a real vacuum of legal authority was filled by a crude and often cruel amalgam of frontier justice and outright injustice. The first to suffer were the Indian tribes, especially those who had accepted the guarantees of the Federal Government in the form of treaties. Then, when individual chiefs among them -- and Cochise was one -- could no longer tolerate the absurdity, there was no way that Federal forces could contain the Indian desire for revenge. Violence spawned violence, and, as late as August of 1873, a drumhead court tried, convicted, and executed four murderers in the space of twenty four hours. The sentence was carried out just moments before the arrival of a military attachment dispatched from Fort Lowell to prevent its implementation.

Such extremes of civil disorder were soon to disappear. The growth of military camps in Southern Arizona and the garrisons stationed in them -- Forts Lowell, Grant, Crittenden, Bowie and others -- created a commerce in stores and supplies that rapidly increased the status of Tucson as a hub of military transport. Mining was becoming an organized industry, pushing the image of the solitary, self-reliant prospector further and further into the realm of fiction and fantasy. More than anything else, though, it was the coming of the railroad that changed the role and destiny of Tucson. The tracks of the Southern Pacific reached the city in 1880, and the first train arrived at 11:00 a.m. on the 20th of March. Charles Crocker, the President of the Company, was on board the train, and his presence, while delighting the citizenry of Tucson, symbolized much more. It signaled that Tucson had really been connected to the rest of the nation and that the industrial revolution had arrived in the southwest. For the Sisters of St. Joseph, too, the new era would dramatic effects on their mission in Tucson and in Arizona.

One of the first trains in Arizona, 1880 [AHS #14,991 H18]
One of the first trains in Arizona, 1880
[AHS #14,991 H18]

The evolution of mission that began to unfold with the advent of the "Iron Horse" was not a change of heart on the part of the Sisters. It was simply a case of their attention being called to a new and desperate need of their "dear neighbor."

Standing about midway in the lonely expanse between El Paso to the east and the Pacific Coast to the west, Tucson was a natural staging area for the railroad. For all its marvels, this new phenomenon was far from self-sufficient. Regional repair facilities and machine shops were badly needed; major fuel depots were an obvious part of the system; food and rest areas for crews and passengers, homes for railroad workers -- all these must have given Tucson the aura of a heaven-sent metropolis whatever its frontier limitations might be. Most of all, Crocker and his lieutenants knew, the railroad needed help in handling the daily toll of painful injuries that plagued train crews and track gangs. A hospital was needed in Tucson. They put their case to Bishop Salpointe.

 

The Hospital

Bishop Salpointe who founded St. Mary's Hospital in 1880 sold it to the Sisters in 1882 with the provision that it always be called St. Mary's and that it be used as a hospital for 99 years.  [AHS-BC #B93,421 H19]
Bishop Salpointe who founded St. Mary's Hospital in 1880 sold it to the Sisters in 1882 with the provision that it always be called St. Mary's and that it be used as a hospital for 99 years. 
[AHS-BC #B93,421 H19]

 

The plea posed a cruel dilemma for the missionary prelate. In 1877, he had purchased a tract of ground about one-and-one-half miles west of the city, adjoining the grounds of the Sisters' novitiate. Here, he was erecting a trade school for the Indian youth of the area, and, with their help, the building was almost completed; however there was no questioning the need for a hospital -- not only for the railroaders but for the welfare of the entire community. Given the circumstances of time, there was no way by which he could open the trade school and also establish a hospital. The painful decision was made -- the trade school was postponed, the building was turned into a hospital, and the Sisters of St. Joseph accepted the responsibility of staffing it. Deeply disappointed and hurt, the Indians nonetheless returned to help finish the building when they saw the nuns laboring to carry the heavy rocks. St. Mary's Hospital was dedicated on April 24, 1880, and received its first eleven patients on May 1st.

The sudden turn of events was no easier for the Sisters than it had been for the Bishop. Even though their numbers had increased in the intervening decade, the demand for their services had far outstripped their capacity to meet the needs. Additionally, sickness and death had touched them as well as it had visited all who faced the rigors of the life on the frontier. Sister Emerentia, the first Superior, had succumbed as early as 1874. More than anything else, though, those who were assigned to the new hospital -- Sister Basil Morris, the new superior, Sister St. Martin Dunn, Sister Julia Ford, and Sister Mary John Noli -- each sensed a terrible inadequacy in their preparation for the new work. Even in a day when nursing education, in general, was primitive compared to the present day, they were not satisfied with mediocrity. Only the twofold determination to help the sick and injured and to learn how to do it as quickly as possible made up for what they felt they lacked in professional preparation.

Portrait of St. Mary's first physician Dr. John C. Handy [AHS #1,484 H20]
Portrait of St. Mary's first physician Dr. John C. Handy
[AHS #1,484 H20]

 

Dr. Handy standing with his rig in front of his office on Camp Street (now Broadway) [AHS #28,383 H21]
Dr. Handy standing with his rig in front of his office on Camp Street (now Broadway)
[AHS #28,383 H21]

 

Fortunately, they were not entirely alone in the venture, for there was a doctor in Tucson, John C. Handy, who had served alternately and often simultaneously, as contract surgeon for the army, as the railroad doctor, as county physician, and as private practitioner to the inhabitants of Tucson. Dr. Handy had graduated from Cooper College near San Francisco at the age of nineteen and had received his medical diploma from Toland Medical School in 1865. Army medical service had brought him to Southern Arizona in 1871, with responsibility for medical work at Fort Grant, Camp Thomas, Camp Goodwin, and probably at Fort Lowell. He had seen the gamut of military injuries and illnesses, both those arising from the perpetual conflict with outlaw Apaches and those stemming from workaday injuries and illnesses in garrison duty -- battle wounds, broken bones, pneumonia, typhoid fever, and other less well-defined epidemic diseases. Civilian afflictions were much the same, adding the expected range of childhood diseases and gynecological cases, with "general debility" ranking high among the listed diagnoses. Contemporary accounts depict him as a man, kind and gentle with the poor and ill, but a man not to be questioned. The promise of daily care for his patients that the new hospital offered motivated him to pitch in and instruct the four sister-nurses in the basic techniques of health care. The reality of the hospital, moreover, helped him lure his brother-in-law, Dr. William Holbrook, to join him before the year was out. Organized health care was underway in Tucson.

With but two doctors and four nurses to care for the patients of a twelve-bed hospital, it is obvious why we have no detailed descriptions of the daily hardships involved. There was a constant, twenty-four-hour a day job to be done, and that was the care of the sick and the dying. The nursing, bathing, feeding, the cooking and scrubbing, the tending of the physical plant, the repair, supplies, equipment, the bills -- all this and more were part of each and every day. There were no handy spigots to draw water for drinking, for bathing, for cooking or cleaning. Every drop had to be carried from a well, and late in 1880, the Daily Citizen mounted a public campaign to provide a windmill for pumping water.

With each passing month Tucson was growing. The Federal Government had moved to end the dreary and cruel Indian campaigns once and for all. Before the troops were able to subdue Geronimo, however, upwards of five thousand soldiers were in and about the Southwest at one time. It was no longer a matter of teamsters and traders passing through Tucson. They had come to stay, centralizing their operations, and they were being joined by mining companies, by merchants and businessmen of all kinds. A telephone exchange had come into operation in 1881. A few years later, in 1885, the Territorial Legislature established a university -- with the curious proviso that the town had to provide the land for a campus. It is worth noting that, when the land was finally donated, it was because of the generosity of two gamblers and a saloon-keeper who pooled their resources to give a forty-acre tract east of town!

 

Sister St. Martin and Mrs. Spencer in front of St. Mary's Hospital [AHS #30.074 H22]
Sister St. Martin and Mrs. Spencer in front of St. Mary's Hospital
[AHS #30.074 H22]

 

Almost from the start, Bishop Salpointe, together with the Sisters and the doctors knew that St. Mary's had to grow with the city. A second floor, opened in 1882, had doubled the capacity, but even as that floor was put into operation, another addition was underway to the north of the first. In order to raise funds for the expansion, the gentle, scholarly Bishop wrote a booklet on the history of San Xavier del Bac which was published in San Francisco. The book was priced at fifty cents; we don't know how much income it provided, but we do know that a larger building was functioning in 1884, and the original twelve-bed hospital had, by then, grown to accommodate up to fifty patients. The names of the new doctors began to appear alongside those of Handy and Holbrook. Drs. Michael Spencer, Hiram Fenner, Henri Matas, and Pierre Guiot all came on the scene during the 1880's. These new arrivals -- some from Europe, some from eastern states -- constituted a reinforcement that allowed not only more time for diagnosis and treatment but also time for better recordkeeping, opportunities for consultation, experience-sharing and mutual assistance. Early in the decade, the Sisters of St. Joseph acquired complete ownership of the hospital from the Bishop, paying him $20,000, thus all operations under one administrative organization.

For St. Mary's Hospital, the decade from 1880 to 1890 was a period of great transition that was to blossom out in the next nine decades with a startling complexity. The personnel who came, and those who were to come, came with training, perspective, and ability to transform the whole institution.

In a tragic way, the death of Dr. Handy in 1891 from complications following a gunshot wound signaled an end of a pioneer era both socially and scientifically. Dr. Handy typified, in a unique manner, the thousands who had come to the frontier of the Southwest to make their lives. Only a few of them, like himself, brought any kind of special training with them. But all those who endured had to have a remarkable combination of talents and personal qualities that enabled them to survive -- strength, resourcefulness, initiative, and indeed, a quality of daring. Some of them have been enshrined as heroes; others, by one accident of circumstance or another, have been tagged as outlaws or desperadoes. Most of the pioneers left no individual mark in history; they are part of a common record of human development, and their lives are part of the goodly heritage we all possess. As a physician, Dr. Handy had to be resourceful. He was counted on as a diagnostician, practitioner, obstetrician, surgeon, pediatrician, pathologist -- he was the doctor on whom Tucson counted for many years.

 

Dr. George Goodfellow hurried from Tombstone to Tucson to treat Dr. Handy after he was shot. Dr. Goodfellow later took Dr. Handy's position as Southern Pacific Railroad surgeon.  [AHS-BC #13.278 H23]
Dr. George Goodfellow hurried from Tombstone to Tucson to treat Dr. Handy after he was shot. Dr. Goodfellow later took Dr. Handy's position as Southern Pacific Railroad surgeon. 
[AHS-BC #13.278 H23]

 

The other doctors who joined him in the annals of St. Mary's were generalists, too, though we find them beginning to focus on one area of medicine or another as time and conditions permitted. Handy's successor as Southern Pacific doctor -- and at St. Mary's -- was Dr. George Goodfellow who had begun to specialize in abdominal surgery at a time when few men would attempt such operations. He came to Tucson from Tombstone where he had built an enviable practice and reputation. With Goodfellow's arrival, surgery began to move forward at St. Mary's. A special room was set aside for operations, and Lister's methods were followed in their entirety.

 

Early Expansion

Hospital around 1895 -- Convent, left, North Wing, center and Isolation Cottage right [AHS #2,134 H24]
Hospital around 1895 -- Convent, left, North Wing, center and Isolation Cottage right
[AHS #2,134 H24]

 

Almost at the same time, in 1893, Sister Fidelia McMahon was appointed as Superior of the hospital sisters and Superintendent of the hospital itself. She was to remain as the leader and chief executive of St. Mary's until 1920. In her long tenure office St. Mary's grew from a frontier hospital to a full-fledge medical institution. Though we have no written plan of action that she might have developed, we can judge from her accomplishments that from the start, she plunged in with all the talents of her quick and perceptive mind, First of all, she started immediate construction of a residence convent for the hospital sisters. With their growing numbers and round-the-clock schedules, it was neither practical nor reasonable for them to have to shuttle back and forth between the hospital building and whatever quarters were improvised for them in the hospital basement and in the adobe convent across the road which had recently been renovated to serve as an orphanage. Within the year, a two-story convent building joined the cluster of structure on the hospital grounds. It was a simple and sturdy building with a chapel and parlor along with several smaller rooms on the first floor, dormitories and washrooms on the second. Although city water for out side irrigation purposes had reached the hospital in 1892, there was no inside running water. The hospital's own well was serving for drinking and bathing needs. Although utility lines had not yet reached the hospital, the older buildings and the convent were wired for electricity when the convent was erected.

Sister Fidelia envisioned a modern and separate surgical area, too, and despite the impossibility of providing one immediately it is apparent that she did set aside a temporary space. Kitchen, dining, laundry and storage areas occupied the basement of the hospital itself; the Southern Pacific Wards and the count wards filled most of the first floor. It is conceivable floor where a maternity ward and nursery had been set up.

The demands for expansion and development were obvious and inescapable. One after another, plans and contracts flowed from Sister Fidelia's desk.

Foremost among the needs she faced. with a priority even more urgent than a surgical arena, was the proper care of patients with communicable diseases. Sometime between 1893 and 1900, an Isolation Cottage took its place in the complex -- a one-story structure of four large rooms, each of which had its own doorway to a broad veranda that extended around the perimeter. The capacity of this building was twenty-four beds. Gallons of lysol were consumed daily, and clothing, bedding, and bathing materials were often burned in severe cases, and along with them even some record charts were summarily deposited in the same fires, so great was the stress on antiseptic purity.

Doctor Hiram W. Fenner [AHS #29,346 H25]
Doctor Hiram W. Fenner
[AHS #29,346 H25]

 

An isolation area was essential in a general hospital, but it was no more than a small part of the financial burden assumed by Sister Fidelia. As railroad passenger service from the east and north became more comfortable and more regular, Tucson had begun to receive a large number of tubercular patients seeking the benefits of the climate and the clean air. It was becoming a problem to accommodate those who sought the medical facilities of the hospital. So the Isolation Cottage was built in the shadow, figuratively, of a much larger component, the Sanatorium. This building, a two-story circular structure surrounding an inner patio, was designed by Dr. Fenner to take continuous advantage of the sunshine. It had a shaded porch on the inside and outside circumference of each level. The individual patient rooms opened onto these porches and the doorways were large enough to allow the beds to be wheeled out for those patients who were not ambulatory. The facilities were coordinated to supply the best in current therapy for the widespread disease.

Operating Room in the New Surgery Suite [AHS-BC #BD24,627 H26]
Operating Room in the New Surgery Suite
[AHS-BC #BD24,627 H26]

 

Once these needs were met, the next order of business was the long-awaited surgical unit or suite, as it came to be called. Since it was to include an emergency room, it was decided that it must be at ground level. In order to best serve all areas of the hospital, it was situated at the westward extremity of the original building and the North Wing. On either side of an interior hallway were the various operating rooms, sterilizing rooms, preparation rooms and a large emergency room. It was, according to contemporary descriptions, furnished with the most modern equipment available, "making it all the most exacting surgeon could demand."

The surgery suite was in operation in 1903, and Sister Fidelia then turned her attention to more prosaic matters. As delightful as the Tucson climate was and is, no one can ignore or deny the rigors of the summer heat -- certainly not a health care facility. Being a consummate realist, Sister Fidelia set about excavating a large chunk of hillside in order to build an ice-storage area that would take advantage of the terrain and be as impervious as possible to the rays of the summer sun. It was ingeniously designed with pipes running under the huge blocks of ice to provide a source of readily available icewater. Not only did this save the daily need for delivered ice, but it was a blessing for the patients.

To attack the other extreme of temperature, the next major outlay of funds was for the construction and installation of a steam heating system in 1906. The original heating plant installed at the time included cast iron radiators in the rooms of the three buildings that were served. Over the next twenty-five years, the needs and growth of the hospital complex led to a situation where there were five separate sources of heat scattered among the various buildings. Electric wiring, too, brought added efficiency as soon as electricity had reached the west side of town. The first electric bill, for the month of September, 1907, was $19.40.

View of hospital, farm buildings and fields about 1920 [AHS #51,403 H27]
View of hospital, farm buildings and fields about 1920
[AHS #51,403 H27]

 

The School of Nursing

None of these basic needs came cheaply, even in those days when the economy was still beautifully simple. Sister Fidelia, by this time, was coping with a debt of some $12,000, but the health needs of the growing community were many and medical science and technology were beginning to present new challenges each year. The demand for trained and efficient nurses was already outstripping the abilities of the Sisters to fill the gaps from their own ranks.

The problem of securing trained nurses was not easily solved. To begin with, nursing education was then largely a matter of "on-the-job" training -- a situation that was neither attractive to the young beginner nor beneficial to either trainee or patient in the long run. Nursing schools, as such, were relatively non-existent except as adjuncts to a general hospital. Such annexes were springing up by the hundreds in the East and Midwest, yet few of their graduates -- and they numbered only a few thousand in the whole country -- were coming to the Southwest.

There was but one obvious solution to the local need. Together with the doctors, Sister Fidelia made her plans for a School of Nursing to be attached to the hospital. Early in 1911, she engaged a contractor to begin working on a building that would provide student living quarters and classrooms for the newest project. Even as the building started, plans for its operation were also underway. Sister Francis de Sales Fuller and Sister Mary Evangelista Weyand were transferred to Tucson from St. Joseph's Hospital School of Nursing in Kansas City, Missouri. Their assignment was to prepare a curriculum and organize a teaching faculty. The doctors who were practicing in the hospital were enthusiastic and cooperative on both counts so that by the time the school opened and admitted its first students in December of 1914, curriculum and faculty were ready.

When one considers that the first national norms -- The Standard Curriculum for Schools of Nursing -- were not published until 1917, the following tabulation of course and hour content of the initial curriculum seems impressive still:

COURSE

1st YR

2nd YR.

3rd YR.

INSTRUCTOR

Anatomy & Physiology

30 hrs.

30 hrs.

30 hrs.

Srs. Francis & Evangelista
 

 

 

20 hrs.

Dr. Schnabel
Methods of Nursing

30 hrs

 

30 hrs

Srs. Francis & Evangelista
Materia Medica

 

30 hrs.

30 hrs.

Sr. Evangelista
 

 

 

15 hrs.

Dr. Pratt
Ethics

10 hrs.

 

 

Sr. Francis
Dietetics

 

30 hrs.

30 hrs.

Sr. Evangelista
Obstetrics & Gyn

 

39 hrs.

19 hrs.

Dr. Schnabel & Walls
Hygiene

 

 

20 hrs.

Dr. Schnabel
Bacteriology

 

 

20 hrs.

Drs. Pratt & Gotthelf
Urinalysis

 

 

20 hrs.

Dr. Pratt
Pediatrics

 

 

6 hrs.

Dr. Rogers
Orthopedics

 

 

6 hrs.

Dr. Rogers
Contagious Diseases

 

 

30 hrs.

Dr. Olcott
Surgical Nursing

 

 

15 hrs.

Dr. Rogers
Surgical Nursing

 

 

15 hrs.

Drs. Thomas & Rogers
First Aid

 

Demonstrations

15 hrs.

Dr. Rogers & Mr. Conover

Class hours from this record total 511 hours.

Professional Standards

The participation of the doctors, both in the planning and academic standards of the school, indicates a great degree of professional idealism on the part of the local physicians in these early years of the twentieth century. They were just as concerned, too, about their own competency as they were about nursing standards. Concurrently with the inauguration of the Nursing School, the doctors began the preliminaries of establishing the rules and standards of a modern medical staff. It would have come sooner or later in the ordinary course of events, but a near disaster probably provided a practical impetus to its realization. Barely three weeks after the Nursing School opened, there was a major flood in Tucson. The Santa Cruz River was transformed into a torrent that rampaged the West side of town and cut it off from the rest of the city. As far as St. Mary's Hospital was concerned, only the foresight of one of the local physicians, Dr. Charles Schrader, prevented what might have become a desperate situation. As the flood waters rose during the day of December 23, he all but ordered his associate, Dr. Samuel Townsend, to get across the river to the hospital so that there would be at least one doctor on hand should the hospital be cut off. The St. Mary's Road Bridge was already gone, and the Congress Street Bridge was going. Dr. Townsend made his way across a 1' X 12' plank serving as a bridge to begin a three-day stay as the "house" doctor!

It is safe to assume, certainly, that the near-miss was among the motivating factors that galvanized formal planning for normal procedures and for unexpected contingencies. At any rate, the medical staff was officially constituted in its first meeting on February 16, 1917, and among the items discussed was the question of "hiring a laboratory worker." The subject of, a clinical laboratory was brought up again on February 23, and this time, a committee was appointed -- Eye, Ear, Nose, Throat and Lab -- with Drs. Schnabel and Thomas on the working end of the study assignment. At the third meeting on March 9, Credentials Committee was established to govern the admission of newcomers to the staff.

The recurrence of the laboratory question in these early meetings of the staff was due not only to the desirability of having a facility for whatever pathological techniques were available in the contemporary state of the art but to the fact that the doctors knew there was someone on hand who could do the testing. That individual was Sister Evangelista, the Assistant Director of the Nursing School. She was a progressive perfectionist not only in regard to technical excellence of nursing education but in regard to hospital procedures as well. It is not surprising that she responded eagerly to the idea of a clinical lab -- and she found space in the school to set one up. The increasing importance of pathological investigation in diagnosis directly benefited doctors and patients. The additional training for student nurses was an obvious by-product.

Sister Evangelista's influence in Arizona quickly reached out beyond the confines of the institution she served in Tucson. She knew the essential ingredient that nursing care added to the practice of medicine. She was convinced, too, that pride in one's profession and the sense of dignity accorded to that profession by society were equally necessary to maintaining standards of efficiency and that, without them, the best academic training in the world would not sustain the profession with the passage of time. She had a personal, as well as professional, interest in fostering this recognition; her first graduates -- she had become Director of Nursing School on the untimely death of Sister Francis de Sales in June of 1917 - began their nursing careers without the benefit or protection of licensing or registration of any kind by the young State of Arizona. The lack of recognition was a situation she set out to correct.

Although administration of the School, teaching duties, and laboratory work occupied her days, she nonetheless found time to be an activist for professionalism. In December of 1918, she called a meeting of all graduate nurses in the Tucson area to discuss the matter of a professional organization. Within a year the Arizona State Nurses Association was a reality and Sister Evangelista joined actively in the campaign to establish a statewide certifying board. The Fifth Arizona Legislature, on June 9, 1921, passed an act empowering the Governor to appoint a State Board of Nursing Examiners. The Governor, Thomas Campbell, appointed Sister Evangelista as a charter member of the Board. She was further honored by being licensed as R.N. No. 1 of the State of Arizona. During her repeated terms of office on the State Board, she had the added pleasure of seeing registration numbers in the hundreds given to graduates of St. Mary's.

Meanwhile, Sister Fidelia McMahon continued the unending work of maintaining and upgrading the physical plant and patient care at the hospital. Medical Staff records show that a motion to buy a "Wrappler Table and Hydrogen Tube" was carried at a meeting on October 12, 1917. In a few months, the X-ray Department was established in a little room off the lobby in the North Wing. Sister Fidelia had seen an amazing quarter century at St. Mary's -- from a frontier hospital to a modern institution serving a growing community that was a major center of a new state of the Union. The nation itself had joined the circle of "world powers" and was engaged in a miserable war that engulfed all of Europe. Though few realized it at the time, the era of political isolation for the nation, the state, and the city had come to an end. So, too, had Sister Fidelia's tenure of leadership at St. Mary's. Her successive reappointments as head of the hospital ended in 1920, and she departed for an assignment in Los Angeles where she died in 1923. Tucson had lost a valuable executive and a "good neighbor".

Progress never occurs "cost free." There is an inevitable toll that must be paid. It may be financial; it is always human -- in terms of exhaustion, sacrifice, bruised sensibilities -- a score of possibilities. The unceasing expansion of physical plant, the additional support services, both technical and prosaic, left St. Mary's in an uncomfortable degree of debt as the decade of the 1920's began. Sister Vincentia (1920-1923), Sister Fidelia's immediate successor, bent her efforts toward maintaining liquidity, but even she, in her short three-year term, had to spend several thousand dollars for a new laundry facility -- outside the basement of the North Wing where it had been housed -- in a new building adjacent to the boiler house. The significance of this improvement lies not so much in the improvement itself as in the realization that it had long been postponed in favor of other needs. It could be postponed only because the Sisters, both of the nursing and service staffs, had long been rising extra early on "laundry" days to do the job before the regular hospital day began!

The Convent

The sacrifices of the Sisters to care for their sick were brought home to Tucsonans in a dramatic way in March of 1925. A fire in the chapel of the convent revealed to the public how sacrificial the nuns had been when it came to their own comfort. Firemen and public officials who toured the building after the flames were extinguished suddenly realized that, while the nuns had been seeing to patient comforts through the years, there had been little chance or money to add amenities to their own quarters in the thirty years since the convent was built. Not only that, the number of Sisters living in the building was far greater than the structure had originally been designed to house. Happily, a public subscription fund was begun, and a sum of $25,000 was eventually raised to build a new convent which was occupied in 1927. It was a wholehearted community project with Herbert Drachman, a Jewish civic leader, Harold Bell Wright, a Protestant writer, and Bishop Daniel Gercke sharing the spotlight on the day the new home was dedicated.

The new convent did not contain a chapel, but it was soon to have one. Shortly after the fire, Bishop Gercke, who was traveling in the East, had a chance meeting with Thomas E. Murray, Jr., the young industrial engineering genius. Murray wanted to build a chapel in some mission field in memory of his mother, Catherine. He asked Bishop Gercke if he could recommend a likely place for the memorial. The Bishop lost no time in telling the story of the Sisters of St. Joseph at St. Mary's Hospital in Tucson. The result of that meeting was St. Catherine's Chapel. Alone of all the buildings on the grounds in 1928, it stands today and is in the process of restoration.

Hospital Development

Hospital development during the decade was internal and organizational rather than physical. As early as 1921, three members of the Medical Staff had been certified as Fellows of the American College of Surgeons: Drs. Mead Clyne, Joel Butler, and George Dodge. Within a few years, they were joined in that circle by Drs. Monte Comer, Victor Gore, Charles Patterson, and Charles Thomas. The Nursing School gained accreditation in 1922, paralleling the increasing recognition of the Medical Staff.

The number of annual patient admissions, too, grew apace with all the other indices of expansion. The archives of St. Mary's are evidence that good patient records were kept in the old bound ledgers, But as diagnostic services increased and therapeutic systems mushroomed, the amount of information necessary to record quickly outgrew the limitations of hand-written ledgers. In the mid-twenties, a formal Medical Records Department was organized to ensure consistency of entries, adequate cross-referencing and indexing vital to the medical history of an individual patient. The advent of this procedural change was a contributing factor in the accreditation of St. Mary's by the American College of Surgeons in 1928. Sister Victoria, who was at the helm of the hospital from 1923 through 1929, had, of course, the experience of the fire, the new convent, the chapel, an infirmary for sick and elderly nuns, remodeling of the old convent building, which was joined to the hospital proper for additional patient services -- all of these added to the duties of administration. Retrospectively, it is amazing that she was also able to guide the complex through the maze of internal reorganization and restructuring. Events proved that her course of action left the hospital in much better shape to face the ravages of the Great Depression of the thirties. Her aim had been to keep the capital debt of the hospital within manageable limits -- and this in a decade of easy credit that was the undoing of a multitude of enterprises during the ensuing upheaval of the national economy. This prudence allowed her successor, Sister Mary Charles McIver, to pursue a similar course of moderation. There was no backtracking; there was steady forward progress without dramatic innovations.

Organization and Growth

The scenario that greeted Sister Mary Charles (1929-1935) was by no means one that allowed for complacency. For one thing, there was an understandable growth in the number of indigent patients coming to the hospital with nothing approaching the modern concept of governmental or societal responsibility to provide adequate medical care at public expense. Coupled with that was the gradual withdrawal of the Southern Pacific patients to the Southern Pacific Hospital on Congress Street. The move hurt the cash flow of the hospital even though it did provide more room for patient care. The remodeling of the vacated wards was carried out as best as was possible. Far better functional space was found, moreover, for the Clinical Laboratory and X-ray services and for expanded maternity and infant care -- providentially, too, because more mothers were looking to a hospital confinement for delivery than had been the case in the past.

Sister M. Charles, as the new Superintendent, was the first R.N. to serve as Chief Executive Officer at St. Mary's, and Depression or no, there were definite changes to be made in routines as she saw them from her perspective. Foremost was a reduction in the amount of time that nursing personnel had to give to housekeeping tasks, ranging from room cleaning to food preparation. Non-professional people were hired to take over those duties -- with R.N. supervision where necessary. For the more physically demanding janitorial and maintenance jobs, more male personnel was another requirement. There was an added problem here, for as anyone knows, equipment breakdown, power failure, plumbing back-ups, and the like seem to choose nighttime hours rather than daytime to make themselves known. In order to solve this "on call" need for twenty-four hour maintenance help in those early days in the Southwest, Sister Mary Charles built a structure that contained ten sleeping rooms for maintenance personnel directly north of the laundry building. Years later, when better transportation and living accommodations on the west side dispensed with the need for these rooms, they were turned into storage use. Indicative, too, of constant maintenance needs was the erection of a paint shop and a carpentry shop south of the boiler room.

Again, in spite of the financial problems of the economic depression, two stories were added to the North Wing. This increased the capacity of the hospital to 185 beds and 20 bassinets. Two automatic passenger elevators were also installed, as well as a system of silent electric call signals.

Technical proficiency was not being bypassed either. Specialization was spreading to many areas of medicine, and, in the early thirties, both the Clinical Laboratory and the X-ray Department (the term "Radiology" was just coming into general use ) were put under the direction of physicians who had chosen these respective fields as their areas of concentration. Perhaps it was of equal significance that the year l931 saw the first intern launch his medical career at St. Mary's. He was Dr. Chester Reynolds who later went on to a practice in child psychiatry in El Paso. An oxygen tent was purchased in 1933, although as Sister Aloysia noted in The St. Mary's I Knew, oxygen inhalation therapy by use of individual face masks had been in use for some time. Additionally, a full-fledged Laboratory Technician was added to the Clinical Lab staff.

Shortly before she left in 1935, Sister Mary Charles commissioned a technical study of the fuel needs at the hospital. The statistics are most interesting when one looks back on the beginnings a half century earlier. By 1934, the hospital plant was making annual purchases of 62,000 gallons of fuel oil, tons of coal, and about $1,000 worth of gas! The study recommended a total conversion to natural gas -- a recommendation the hospital accepted, although it was four years before the transformation was complete. The fuel needs are interesting to repeat, because they demonstrate in one expense area alone what it took to run a hospital whose records for 1935 show 3,036 patient admissions, 169 births, and, 688 operations. That was St. Mary's at the mid-point of its history!

An observer of the present day, looking backwards fifty years to the Tucson of the 1930's, can very easily assume that what we take for granted today in the matter of basic utilities and services was also available then. This is not so, of course. Waterlines, gas lines, electric power, and sewer systems are related closely to political boundaries. Tucson's eastward and northward expansion had already begun. Even though, for all practical purposes, St. Mary's was Tucson's only community hospital, the west side neighborhood where it was located had not yet been formally made part of Tucson. Technically, the hospital was not entitled to something so basic as fire protection -- although the city had been farsighted enough to see that it was always given. The conversion to natural gas heat was due as much to the availability of gas on the westside as it was to the decision at the hospital to use it. Sister Ildephonse, who became Administrator in 1935, arrived in time to see that project to completion, but she had also to face the sewage problem. Ever since its founding, the hospital had depended on its land area to provide ample room for septic tanks. The expansion over five decades had finally exhausted any further reliance on that system. In 1938, a sewer line was finally extended from Grande Avenue to the hospital -- without complications, fortunately, thereby removing a growing threat to the daily operations of the complex.

While the two utility problems were being solved, Sister Ildephonse (1935-1941), a registered nurse like her predecessor, turned her attention to securing further recognition of St. Mary's in the hospital field. Her goal was full accreditation according to the latest standards of the American Medical Association. It was not a search for paper credentials, either, because it was connected with the intent to have a first class intern/resident education program. The two features that the hospital lacked among the list of standards were a medical library facility and an acceptable autopsy procedures program. These were essential to a continuing medical education program. A library building was erected at about the site of the present central tower, and it was in operation by 1933 with a certified librarian in charge. In addition to shelving and reading areas, the building contained a large conference room to which a morgue and autopsy room was joined. The Medical Staff cooperated enthusiastically in both aspects of the project, and in the same year, the American Medical Association granted full approval for a mixed residency program at St. Mary's. Within a short time, the program was alive and blooming in the desert.

The world was closing in on Tucson as the decade of the thirties ended, although few saw it at the time. Events associated with World War II would work fantastic changes in the then small but growing southwestern city. One last hospital addition appeared just before the tragedy of Pearl Harbor and that was the four-story South Annex along Silverbell Road (the road has since been relocated several hundred yards to the east). This was a magnificent structure and a major component of a hospital that would continue to serve the city and the nation during the demanding years of the war.

Understandably, the health professionals in Tucson were heavily dependent on the advances and trends emanating from the northern and eastern research centers. Indeed, Tucsonans were still on the geographical and political frontier; transportation and communication were still a world away from the instantaneous age we live in today, and resources were not available either financially or technically to allow research and experimentation. Yet they were not without the capability of attempting to do what was necessary to help their patients.

Many sufferers of lung diseases and arthritis were attracted to Tucson for its climate alone. While they benefited from the climate, they were still desperately ill, and many of them needed medical/surgical treatment. It was in this area of care that notable advances were made here in Tucson.

 

Southern Methodist Hospital [ AHS #44,277 H28]
Southern Methodist Hospital
[ AHS #44,277 H28]

Such is the picture -- in kaleidoscopic form at St. Mary's and at the other hospitals that had joined St. Mary's on the local scene. Southern Methodist, the Southern Pacific Hospital, the County Hospital, and several sanatoria for treatment of tuberculosis and arthritis shared the responsibility for health care in the early thirties, and they all had an important role to play as the city grew. Unfortunately, the Great Depression played havoc with the newer institutions, and before the decade was out, Southern Methodist had closed its doors, while most of Southern Pacific's surgery cases were sent to California. By 1939, for all practical purposes, St. Mary's was the only general hospital functioning in the area.

 

World War II

Such were the conditions when the fury of World War II burst upon the United States at the beginning of the forties.

St. Mary's Hospital shared in the upheaval. Within a very short time after Pearl Harbor, 32 doctors had left for military duty, 35 alumnae of the Nursing School were in service by 1943, and a score of registered nurses who were not products of the Nursing School also enlisted for the duration. To offset this drastic loss of skilled people, retired and semi-retired doctors resumed full-time service while many retired nurses and nurses who had left the active field as mothers of families or for other reasons returned to full or part-time professional activity. In other areas, older men and women worked and volunteered wherever they could help.

The national will to survive and endure prevented panic and despair. Those who remained to serve the general public had to double and triple their responsibilities. In the area of maintenance and repair, improvisation became the order of the day as the needs of a nation at war took priority in the acquisition and utilization of material. Moreover, areas such as Tucson well suited to training vast numbers of men were suddenly engulfed with people: servicemen in training, construction workers building and expanding bases, dependents who came with them, and family members who came to visit. The changes were sudden, confusing and overwhelming, problematic for those who had the obligation to care for the medical needs of the new arrivals.

Formal action by the Federal Government and by the American Red Cross was quick in coming. Nationally, the Red Cross urged inactive nurses to return, and in 1942, St. Mary's became a center for refresher courses with the ready assistance of the staff doctors and the University of Arizona. Similarly, the Red Cross inaugurated a Volunteer Nurses' Aide Program at St. Mary's in 1943 with fifty women in the first class. This was the beginning of a program that continued after the war and eventually evolved into the LPN programs that have led many women and men into full-fledged nursing careers. In the same year, the Federal Government organized the Cadet Nursing Corps. A unit was established at St. Mary's School of Nursing, and during the first six months, 54 students were enrolled. All during the war new classes were enrolled each January and June. The number of enrollees overtaxed the facilities of the school, and the University of Arizona jumped in to help. Students were transported to the University's Chemistry courses in cars driven by the Auxiliary of the Pima County Medical Society. A side benefit for these students during the war years, however, was the large number of young men assigned to the Davis-Monthan Air Force Base, and the student nurses and young airmen enjoyed the frequent dances and social activities that all needed so much.

The civilian population of Tucson doubled during these years. Wartime weddings established many family units and others moved to the city -- many of them making it their permanent home. Predictably, the number of births at St. Mary's also doubled, and the Obstetrics Department had to look for bed space all through the hospital.

Once the war-generated movement of Americans to the Southwest started, it never stopped. Tucson continued to grow after the war both because of continuing uncertainty in the international situation and because of the desire of thousands to escape the blight and dreariness of the older population centers. By 1946 it was painfully evident that the cycle of remodeling and expanding had to begin anew. Plans and projects had to await the availability of materials, the switch of construction companies from a war economy to a civilian economy, and a return to whatever normalcy might ensue. Sister Mary Eileen Coady, Administrator from 1941 - 1947, guided the hospital through the period of the war and made ready for the next phase of growth. Plans included alteration of routine, as well as physical enlargement of the plant.

 

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