THE EVER-WHIRLING WINDS OF CHANGE
The Ever-Whirling Winds of Change The Story of Saint Luke’s Hospital, 1894 - 2014
Photography and Text by Lauren R. Pacini Forword by Denise San Antonio Zeman Preface by John J. Grabowski, Ph. D. 2014
Copyright Š 2014 by Lauren R. Pacini All rights reserved. Published in the United States of America The Western Reserve Historical Society With the cooperation of Artography Press The Western Reserve Historical Society Publication Number 197 ISBN 0 911-704-63-9 Printed in Northeast Ohio on acid-free paper
Front Cover - Saint Luke’s Hospital Shaker Boulevard Elevation, 2012. Back Cover - Statue of Saint Luke, Walter Sinz, sculptor. Saint Lukes Archives, Western Reserve Historical Society. Frontispiece - Statue of Saint Luke, Walter Sinz, sculptor. Saint Lukes Archives, Western Reserve Historical Society. Unless otherwise indicated, all photographs are property of Artography Studios, Lauren R. Pacini, Photographer. All rights Reserved.
The Story of Saint Luke’s Hospital, 1894-2014
FOREWORD “The most important thing to remember is this: To be ready at any moment to give up what you are for what you might become.” - W. E. B. Du Bois This gentle reminder from W. E. B. Du Bois crystallizes my reflections on this wonderful chronicle, in photography and prose, of the renaissance of Saint Luke’s. This is the second published work for photographer and author Lauren Pacini, whose Shattered Dreams Revisited examines the death and rebirth of the Midwest industrial city. In Shattered Dreams, Pacini captures a city’s decay, but he also celebrates its rich history, traditions and culture alongside definite signs of rebirth. While Shattered Dreams tells a story of a whole city, The Ever-Whirling Winds of Change provides a more in-depth “case study” approach, documenting in real time the process of giving up what was, and moving toward what might become for Saint Luke’s. In many ways, this book reflects the decision of Saint Luke’s Foundation to return to this place in order to pay tribute our past, rejoice in our present and imagine our future. Saint Luke’s has stood on its present site since 1927. Over the years, it housed the medical center as well as a school of nursing, resident training programs, nursing staff residence and support buildings. Many new lives were welcomed into the world on this site, and scores of patients were restored to good health. New healthcare professionals were trained in the latest medical techniques while always being guided to care as well as cure. The clock tower marked the passing of time with chimes that were heard throughout the community. A larger-than-life statue of Saint Luke the Evangelist, a physician by profession and recognized by Christians as the patron saint of artists, physicians, surgeons, students and butchers, has stood with a watchful eye over those who come and go from the building. The statue depicts Saint Luke flanked by a nurse to his right and a mother holding her infant to his left. One cannot help but be struck by the significance of these individuals, for they represent the marriage between healthcare delivery (the nurse) and health of the community (the healthy mother and child), all interwoven with a sense of faith and hope (Saint Luke). In 1997, Saint Luke’s became part of a for-profit partnership, with the proceeds being used to seed Saint Luke’s Foundation to ensure that the medical center’s charitable mission would continue. The building changed ownership several times after the initial sale, and closed its doors in 1999. A chain link fence provided little security from vandals who stripped it of much of its infrastructure, making it a symbol of disinvestment Page iii
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and decay to hundreds of close neighbors and riders who take the “Shaker Rapid” to and from downtown Cleveland on a daily basis. The clock tower had stopped ringing. The Foundation, with a mission to support the improvement and transformation of health and well- being of individuals, families and communities of Greater Cleveland, took a special interest in the neighborhoods previously served by the medical center and jumped at the opportunity to support a truly transformational project to redevelop the site into a place where people would live, work and play. This was more than bricks and mortar…this was truly “place making” at its best. As the many moving pieces came together, Cleveland Neighborhood Progress and partners effectively leveraged a combination of New Market and Historic Preservation tax credits with generous support of other public, private and foundation allies to fund the $78 million redevelopment. On the pages that follow, the reader will first come to understand the intriguing story of Saint Luke’s, and its unique place in the history of healthcare in Cleveland, and then experience the laborious process of literally bringing Saint Luke’s into a new life. Brick by brick, window by window, floor by floor, Saint Luke’s was transformed from a place that had perished into a beautiful, vibrant place where people live, learn, work and thrive. The impact of place on health outcomes is well documented, and today’s Saint Luke’s stands as an iconic symbol of hope for the emergence of the surrounding neighborhood as a healthy community. The Ever-Whirling Winds of Change reveals the renaissance of Saint Luke’s, and Saint Luke’s Foundation could not be more proud to have played a part in this initiative. In many ways, the project parallels the evolution of the Foundation, from a traditional grant-maker to a catalyst for healthy people, strong communities and resilient families. With our offices happily settled on the sixth floor of the east wing, we have quite literally come “full circle,” returning to this place, but in a much different form. It is my sincere hope that Saint Luke’s continues to be a positive force in this community, offering leadership and support for the improvement and transformation of health and well-being of individuals, communities and families. It is also my lasting wish that those who read this book or cross this threshold be “ready at any moment to give up what you are for what you might become.” Thank you for the privilege of walking this journey of transformation with you. It has been my greatest joy and culminating achievement to have played a small role in bringing this story to you. Denise San Antonio Zeman, President and CEO Saint Luke’s Foundation 2000-2014
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PREFACE The word “landmark” sees frequent usage in many contexts in contemporary America. A state legislature may pass a landmark law; the Supreme Court considers what could be a landmark decision; or someone speaks of an event that was a landmark in his or her life. Then too, many structures are considered landmarks because of their historical connections and or architecture. These uses of the word, although correct, tend to obscure its primary meaning: A landmark is a feature on the land that helps someone know where they are or where a boundary lies. The clock tower on the Saint Luke’s Hospital building on Shaker Boulevard is a landmark in all senses of the word. For nearly nine decades it has helped people of various backgrounds know where they were and it represented and still represents an institution that has been significant in many respects. Sited near the western edge of the Appalachian plateau on Cleveland’s east side, Saint Luke’s stands well above the level of the Cuyahoga river valley and a good portion of the city. The clock tower can easily be seen from multiple vantage points. It not only marks the boundary of an important geological feature, but also that of the city’s residential “heights.” From a closer perspective the tower has come to mark “home” for those who live in the adjacent communities and neighborhoods on the heights. Built in 1927, its construction paralleled the period of major growth in nearby Shaker Heights, as well as the rise of adjacent ethnic neighborhoods. It was landmark for the Italians who lived near Our Lady of Mt. Carmel East parish and the Hungarians who settled in upper Buckeye. It also served as a reminder for those who remained below, whether Hungarians in lower Buckeye or Italians in Big Italy, that they too might figuratively and literally rise in the world. Coming to the heights was part of the American dream. When African Americans came to the heights around Saint Luke’s in the 1960s they too sought the American dream and, perhaps, the tower reminded them that they had arrived. But whether they could escape bias and prejudice still remained an open issue despite the upward move. What occurred in the buildings arrayed below the clock tower was also a landmark -- one based on significance. As the hospital grew and prospered in the decades after the 1920s, it became a major factor in local, regional, and national medical developments. Whether in the field of surgery, research, invention (such as the first heart-lung machine) or the education of nurses, Saint Luke’s built a reputation of quality and innovation. It was an institution that could not only been seen from many parts of the city, but one that was known throughout the community and beyond. The clock tower marked not only location, but excellence. Page v
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Yet, by the early 2000s the clock tower stood in shabby disrepair and the hospital buildings empty and vandalized. Surrounding neighborhoods that once symbolized individual and group aspiration were beginning to be viewed as less than ideal; indeed, they became, for some, the antithesis of what they promised to be. It became tempting at that time to see the clock tower a as a marker for one of the epicenters for what was wrong with urban America. But today, the clock tower, newly refurbished, is again a positive landmark. It rises above a set of buildings that have been repurposed as schools, residences and offices for agencies, including Cleveland Neighborhood Progress and the Saint Luke’s Foundation, focused on reclaiming and rebuilding not only the adjacent neighborhoods, but others throughout the city of Cleveland. The tower and the structures below are now central to a community that has not abandoned its dreams and aspirations for a good life on the heights. This volume is the history of Saint Luke’s – a landmark that was almost lost, but which – thanks to the innovative support of the Saint Luke’s Foundation and multiple participants from the city of Cleveland and the surrounding neighborhoods – is again a landmark. Whether viewed as an exemplar of adaptive reuse; community cooperation; or social justice, the repurposing and rehabilitation of the Saint Luke’s complex is hugely significant, not only locally, but nationally. The Ever-Whirling Winds of Change is both an institutional history and a story of contemporary urban America. Lauren Pacini’s images and words chronicle a landmark which now has come to serve as a marker for those who seek solutions to the challenges facing urban America in the twenty-first century. John J. Grabowski, Ph.D. Krieger-Mueller Associate Professor of Applied History Case Western Reserve University Historian and Senior Vice President for Research and Publications Western Reserve Historical Society Editor, Encyclopedia of Cleveland History
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PROLOGUE On September 3, 2013, the corridors of Breakthrough Charter Schools’ Intergenerational School were filled with happy voices. The move into the school’s new home signaled the completion of the third and final phase of the historic renovation of Saint Luke’s Hospital and its transformation into Saint Luke’s Manor. Although the project had begun nearly three years earlier, the story of Saint Luke’s began nearly 120 years earlier with the founding of Cleveland General Hospital in 1894 and the emergence of Saint Luke’s Hospital in 1906. Two and one-half years earlier, The Plain Dealer had announced “Old Saint Luke’s hospital in Cleveland set for rebirth; developers to start construction on seventy-two apartments.” Having grown up on Cleveland’s East Side, Saint Luke’s was our family’s hospital until its closing in 1999. It was where I went to have my tonsils removed and where I took my children when they were in need of emergency room services. Saint Luke’s had stood vacant for more than a decade, and now it was to be repurposed. The story of Saint Luke’s is a story that has been repeated throughout America’s industrial heartland. It is the story of a city, an industry and an iconic institution, each struggling to reinvent itself. It is the story of Elisabeth Severance Allen Prentiss and her love for her city and the two men in her life – Dr. Dudley P. Allen, MD, and Francis F. Prentiss. Above all, the story of Saint Luke’s, like that of Cleveland, is one of perseverance and determination in the face of gale-force winds of change. Where possible, I have elected to tell Saint Luke’s story through the voice of those who lived it, through original source documents. These documents convey authenticity and deep insight into the person and the time. What began for me as a several year journey through the renovation of a remarkable historic building has become a nearly 120 year historical journey through the life of an even more remarkable institution, offering an understanding of the evolution of healthcare in Cleveland, and beyond. Lauren R. Pacini
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The choice of the title of this work deserves some explanation. For the title of the last chapter of her book, Saint Luke’s Hospital 1894-1980, Josephine Robertson drew inspiration from the 16th century English poet, Edmund Spenser. In his poem “The Faerie Queene, Spenser wrote, “What Man that sees the ever-whirling Wheel of Change, the which all mortal things doth sway . . .” Although “wheel of change” might better suit a history of transportation, it was clear to me that the story of Saint Luke’s is a story of an institution and an industry constantly affected and sometimes buffeted by “Ever-Whirling Winds of Change.” Lauren R. Pacini
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CONTENTS Acknowledgements Foreword Preface Prologue Cleveland in the 19th Century The Early Years – 1894-1906 The Carnegie Avenue Years – 1908-1927 The Gift of a New Hospital The Times that Tried Men’s Souls Another World War From Depression and War to Expansion And Exploration The Nursing Situation Intensifies The Changing Tide in Nurse Education Developing a Master Plan The Matter of Affiliation The Quickening Pace of Change The Legacy Continues Transformation: The Birth of Saint Luke’s Manor Epilogue Appendix I – Population of Cleveland and Cuyahoga County, 1800 - 2010 Appendix II - Saint Luke’s Leadership, 1894 – 2013 End Notes and Citations Bibliography
i iii v vii 1 7 19 35 47 57 67 83 89 95 101 107 117 121 215 217 219 221 223 Page ix
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“Unfortunately, the men who make history do not usually write records; hence it happens that the story of the beginnings of Saint Luke’s is somewhat hazy, although of comparatively recent origin.”1 The Reverand Ward Beecher Pickard, D.D. Superintendent, Saint Luke’s Hospital ca 1922
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THE CARNEGIE AVENUE YEARS – 1908-1927 Beginning on Tuesday, July 14, 1908, three days of public inspections were held at Saint Luke’s magnificent new facility on the grounds that had once belonged to the Van Gorder’s. It was reported that thousands visited the new hospital, arriving on foot, on the electric street car lines on Euclid or Cedar Avenues, by horse and buggy, or by automobile. Visitors were greeted by Dr. Ward Beecher Pickard, D.D., the hospital’s new superintendent and chaplain, and Miss Elizabeth Maude Smythe, assistant superintendent and directress of nursing. The twenty-five students of Saint Luke’s Hospital Training School for Nurses led tours for the guests. A reception committee included ministers, doctors, trustees, and members of the Methodist community. Mrs. E. J. Blee, who was a member of the reception committee, became the first patient of the new hospital. As she arrived, she fell from the street car, breaking her hip. No detail had been overlooked in the design of the hospital. No detail that is, but one. Worcester R. Warner, co-founder and president of the Warner & Swasey Company, exited the hospital’s elevator on the third floor and climbed the stairs to the fourth floor to inspect the roof garden that had been developed for the use of convalescing patients. Realizing the difficulty that some patients would have accessing the garden, Warner offered to pay the $1,200 it would cost to extend the elevator to the garden level. The hospital’s air conditioning and water filtration systems were the best that money could buy. Louis Pasteur, Robert Koch and Joseph Lister, pioneers in medical microbiology, modern bacteriology and antiseptic surgery respectively, were all pioneers in the “germ theory” in the 19th century. Saint Luke’s was a pioneer the early 20th century. The air conditioning system was described as follows: … the air which is forced into every part of the building is drawn through a room filled with a continuous rain shower and then passes through 60,000 square feet of perforated baffle plates which extract the soot and dirt with their accompanying bacteria. This device also increases the humidity of the air in a dry time and decreases it when the proportion of moisture is too high. Three conduits enter every room in the building, one for hot air, one for cold air and one for the escape of foul air. The flow of warm or cool air is regulated by a damper operated in each room. The ventilating flues are always open and in service, each one rising independently to the attic where the impure air passes out of the building. The boilers, engine and fan are sufficient in capacity to provide for the change of the entire volume of air every eight or ten minutes. The water for the hospital is filtered and treated by both mechanical and chemical processes, said to make it “equal in clarity and healthfulness to the best spring water.” Page 19
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Patients and staff moved from Woodland Avenue and on October 18, 1908, the Guy Buttles Case Memorial Wing (the west wing) was dedicated. Dr. Pickard described the event as follows: On Sunday, October 18th, 1908, Saint Luke’s Day in the Church Calendar, the Guy Buttles Case Memorial Wing was formally dedicated as a Christian Hospital for the blessing of suffering humanity and the Glory of God our Father, according to the usages of the Methodist Episcopal Church. After the dedicatory services at the Hospital, exercises were held at Epworth Memorial Church, the following persons participating: F.F. Prentiss, Rev, R.M. Freshwater, D.D., Rev. A.B. Meldrum, D.D., Rev. H.F. Stilwell, D.D., Rev. Chas. Galimore, D.D., Rev. W.R. Stearley, D.D., Rev. W.B. Pickard, D.D., beautifully illustrating the genuine catholicity of the new enterprise. The dedication of only that part of the building actually paid for avoided the too common practice of dedicating debts to Almighty God.7 Two years earlier, with $65,500 in hand, the building committee had set about their work. After reviewing the plan that called for the construction of two structures, one on either side of the Van Gorder house, it was decided to build an entirely new building. New plans were drawn, and the cost was estimated at $110,000. The lot immediately to the east was purchased, and the Van Gorder’s frame house was moved to that location. Ground for the new hospital was broken and Prentiss placed a spade full of soil into a box that was to be placed in the cornerstone. The cornerstone was set in place on April 13, 1907. Following a prayer by the Rev. Mr. Freshwater, he went on to say, “It must be clearly understood that this is not a sectarian or denominational institution. The Methodist people have not entered on this enterprise for Methodist glory but to help carry on a needed philanthropic work.” Shortly after the groundbreaking, it was realized that no provisions had been made for nursing quarters. The former Van Gorder residence was modified to meet that need. The house and lot behind the hospital – facing Cedar Avenue – was purchased in order to allow for future growth. Additional property was acquired as the opportunity was presented. Unforeseen expenses continued to mount as changes were made to the plans. When the Guy Buttles Case wing of Saint Luke’s Hospital was dedicated, the debt had climbed to more than $150,000. But for the leadership and credit worthiness of Francis Fleury Prentiss, the story of Saint Luke’s would have come to an end on Woodland Avenue. The year 1910 was a turning point in medical education and a turning point for Saint Luke’s as well. Medical education was being revolutionized as the result of a survey conducted by Dr. Abram Flexner on behalf of the Carnegie Foundation for Advancement of Teaching. Dr. Flexner met with Drs. Roland E. Skeel and Benjamin L. Millikin, the deans of the medical schools of Ohio Wesleyan University and Western Reserve University respectively, suggesting that the two medical schools should be merged. Both parties were receptive to the idea of a merger. Dr. Frederick Clayton Waite represented Western Reserve and Dr. Skeel represented Ohio Wesleyan. At a meeting on May 17, 1910, the academic aspects of the merger were satisfactory to both sides, but Dr. Herbert Welch, president of Ohio Wesleyan University, inquired as to what the plans were to purchase the university’s medical school building and other property in Cleveland, valued at $40,000. Dr. Charles F. Thwing, president of Western Reserve University responded that he lacked the authority to enter into a financial agreement. Dr. Waite had apparently anticipated this and produced a certified check in an amount close to that of the price, which Ohio Wesleyan officials accepted. Dr. Waite owned the property until the Western Reserve school of pharmacy purchased it from him four months later. In 1914, the last class of Ohio Wesleyan medical students was graduated and the medical school founded by Dr. Weber ceased to exist. Page 20
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The consolidation of the two medical schools served to eliminate a competitor. Now Dr. Waite launched another campaign. This time it was against Dr. Weber’s successor as professor of surgery, Dr. Dudley P. Allen. And as had been the case with Dr. Weber, the campaign played out while Dr. and Mrs. Allen were in Europe. Dr. Weber had returned from Europe to find that his position had been eliminated. Dr. Allen returned to find that a mandatory retirement had been instituted, although there was no record of the policy in any minutes and the “policy” was not formally adopted until 1921 when the retirement age was set at seventy. When Dr. Allen was notified of the action, which would have required his retirement nearly two years later at age sixty, he immediately resigned. In his history, Dr. Waite’s account was as follows: Dr. Dudley P. Allen resigned his professorship of surgery in June, 1910, after 17 years of successful teaching. He had been one of the leaders in the development of the medical school since 1893. He was active in faculty matters and an excellent teacher. His resignation brought the question of finding as good a teacher. . . . 8 The next meeting of the medical faculty was held on September 22, at which time it was moved and seconded that a letter for the record be prepared thanking Dr. Allen for his service. No such letter is known to exist, but a resolution passed by the executive committee of the university along with the formal acceptance of his resignation read as follows: In accepting the resignation of Dr. Allen, which, notwithstanding the request of the president, has not been withdrawn, we desire to place on record our respect for the character and our gratitude for the service of our associate. Dr. Allen was elected to the professorship of surgery, July 28, 1893. To this chair, already renowned, he brought rare professional skill and fine enthusiasm. Upon the medical school of the university to which his father and his grandfather gave their labor, he conferred a distinction as well as gave professional and personal devotion. The world has recognized him as one of its eminent surgeons and his profession in America has paid him highest honors. As a token of our respect and regard, we beg leave to ask Dr. Allen to accept the place of professor emeritus.9 Dr. George W. Crile was elected professor of surgery and head of the department of surgery on December 19, 1910. At a dinner in his honor on November 25, 1911, given by the Cleveland Medical Library, of which he was a founder, Dr. Allen said: So long as the history of medicine in Cleveland is remembered, I think three names will stand out as most prominent of all. That is, those of Dr. Delamater, Dr. Ackley and Dr. Weber. We have had from Dr. Weber tonight a most kindly letter, which I am sure has touched us all, and I think it would be fitting that we send him a message saying that the profession of northern Ohio, assembled in the banquet room of the Union Club sends him a kindly greeting, that he may the better understand the affection and honor in which his name is still held by the public and the profession of this city.10 Dr, Allen concluded his remarks by saying, “Gentlemen, I raise my glass to the profession which I have loved so well and which has honored me.” Saint Luke’s fifteen man board of trustees had initiated a comprehensive study of the hospital in 1913. Six years earlier, the founders, leaders in their fields of industry, banking, ministry and the law, had known nothing about health care. The running of the hospital had been left to Dr. Pickard, a Methodist clergyman, and the staff that had come to Saint Luke’s from Cleveland General Hospital. With Dr. Pickard’s retirement at hand, the board set their sights on the new concepts of scientific management. Page 21
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Frederick Winslow Taylor, a mechanical engineer and America’s father of scientific management was reorganizing industry through organizational structure and standardization of methods in order to achieve maximum efficiency. “Efficiency” was the by-word of the day. With this new focus the trustees began their study of the needs and future of Saint Luke’s Hospital. It was understood that it was going to cost money to implement the needed efficiencies that would result in reduced costs to the hospital. It was also recognized that the hospital needed to be expanded. An average of 112 sick patients were turned away each week for lack of available bed space. To meet the growing need, it was necessary to double the bed capacity, build a new nurses’ residence and an administration building; and establish an outpatient department, a children’s pavilion and a maternity ward. It was also necessary to install heating, lighting and refrigeration plants, and to purchase equipment for the x-ray and pathology departments. It was estimated that it would cost $500,000 to make those additions and improvements and to pay down the hospital’s debt. Edward F. Stevens, a noted Boston architect specializing in the design of hospitals, was hired to draw plans for additions and modifications, with utmost efficiency in mind. In order to finance the project, an eight day fund raising campaign was designed and headed by Charles E. Adams, a prominent Baptist and civic leader. Fifty 10-man teams and fifty 10-woman teams were organized, and a list of 75,000 names was compiled. Just before the campaign began, Prentiss said, “Saint Luke’s . . . was not built for a few, but for all, and I am anxious that this $500,000 shall be raised from all the people of our city and not just a few.” Gifts of cash, checks or pledges came from 9,233 individual solicitations, along with many unlisted donations that were collected by flower girls on the streets and in theaters, by women in the ball park, and by men who passed their hat in various public and private places. Major gifts included $50,000 from John D. Rockefeller whose donation was the largest in the campaign, followed by a $25,000 gift from Mr. Prentiss. Other prominent Clevelanders, including Samuel Mather, Mr. and Mrs. John L. Severance, Ambrose Swasey, Mr. and Mrs. W.S. Tyler, Mrs. George F. Gund, Mr. and Mrs. Worcester R. Warner, Lucretia Prentiss Bailey, Mr. and Mrs. Lyman H. Treadway, and Samuel L. Prentiss, each contributed generously.. After eight days only $274,811.95 had been collected. It seems that Saint Vincent’s, Saint John’s, Saint Alexis and Saint Ann’s hospitals were all having fund raising campaigns. The timing could not have been worse. It was decided to continue the campaign until at least $200,000 more had been raised. In December 1915, Hunt had announced that it seemed to the trustees “an exercise in good judgment and foresight to hold temporarily in abeyance the proposed improvements.” With the funds raised in the initial eight days, the trustees first paid off the existing debt. Instead of building the new home for the nurses, an old apartment building on Cedar Avenue was purchased and improved. Although further construction was put off, W.D.B. Alexander donated $2,098 for the advancement of work in serology. Drs. Charles Teter, a dentist and anesthetist, and Willard C. Stoner, a generalist and diagnostician, donated $2,013 for a plant in which to produce nitrous oxide. The laboratory facilities were improved, including the purchase of up-to-date X-ray equipment, making it possible to detect tuberculosis, diphtheria, cancer and other diseases microscopically. In 1916 the hospital served 6,336 patients, more than triple number served in 1909. However, more than half of these paid less than the actual cost of the services they received, and nearly $38,000 was given in free care that year. Without an endowment or government subsidy, the hospital could not break even. Dr. Allen had died of pneumonia on January 6, 1915. On September 19, 1917, after an appropriate period of mourning, the marriage of two multi-millionaire philanthropists quietly signaled a new chapter in the life of Saint Luke’s Hospital. The bride was the widow of the late Dr. Dudley P. Allen; the groom was Francis F. Prentiss. Elisabeth Severance Allen was the daughter of Louis H. and Fannie Benedict Severance. She Page 22
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was born in Titusville, Pennsylvania, on November 16, 1865. Her father, a pioneer in the oil industry, was associated with John D. Rockefeller, and was a prominent figure in Standard Oil Company. For the second time, strategies designed to benefit Western Reserve’s medical school would benefit Saint Luke’s – first in its founding and again in its course for the future. Only months earlier, President Woodrow Wilson had asked for and received from congress a declaration of war. The United States entered World War I on April 16, 1917, and Saint Luke’s plans for expansion remained on hold. Within a few days of the declaration of war, Dr. Skeel, Saint Luke’s surgeon and chief of staff, had joined the British Medical Corps. Shortly thereafter, Dr. Stoner, diagnostician and generalist, left to organize the medical unit of U.S. Base Hospital No. 52 and to serve as its chief of staff. The next to leave was Dr. C.V. Davis, resident in charge of Saint Luke’s interns. Those who remained behind fought another war on the home front – the great influenza pandemic of 1918-20 – fought by an army that was depleted, as doctors and nurses answered the call to war. More Americans died as a result of the pandemic than all those who died in World War I. Between October 1918 and June 1919, Cleveland saw 30,000 reported cases and 5,474 deaths from influenza. Nationwide, an estimated 675,000 lost their lives to the pandemic, as compared with 116,156 American deaths on the battlefields of World War I. Worldwide the death toll is estimated to have been between thirty and fifty million. In the meantime, Dr. Skeel had seen service on virtually all of the important fronts of the war. He had been gassed. He had saved lives. He left no record of his experiences. One story is known, coming to light in a letter to Dr. Skeel’s widow, sixteen years after the doctor’s death. It was the twenty-third annual “thank you” letter from Charles F. Rafferty of San Francisco, in which he wrote: When I was rolled onto Dr. Skeel’s operating table at Evacuation Hospital 108, I concluded from the large practice he seemed to enjoy that he was competent, and I was not otherwise interested. When, however, during the first dressing, he adroitly emptied the hot ashes from his big pipe on my bare abdomen and stood there smiling while I feebly and futilely tried to brush off the coals, I do recall that I expressed certain convictions as to his probable genealogy. Had I used my imagination, if any, I would have realized that he did this trick deliberately as a counter irritant to the agonizing pain on unavoidably touching the sciatic nerve which was exposed for about seven inches. Afterwards, as more and more doctors, army and civilian (in France, Virginia, New Jersey and New York), continued to express amazement over my operation and the astonishing results obtained, I became more and more anxious to meet “Dr. Steel.” Every person I met always had the same question put to him, “Do you know Major Steel, a surgeon?”11 Rafferty had been hit twenty times in the abdomen and lower part of his body by a machine gun. After being discharged, he returned to Buffalo. He was still suffering from pain and sleeplessness but could not find a doctor able to help him. Continuing to search for “Dr. Steel,” he asked a stranger on a street car his standard question. The stranger was an employee of the Federal Reserve Bank in Cleveland. After further conversation, in which the stranger asked Rafferty some questions, he said, “I think I know this man. His name is Skeel, not Steel. I believe he has moved from Cleveland, but he has a brother living there. I’ll get the address for you.” Rafferty went to San Francisco to meet the army surgeon and stayed for treatment. His letter continued: My thrice weekly visits to Dr. Skeel warped me back into a normal groove. I began to sleep regularly and improvement was immediate and progressive. Page 23
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They had said I couldn’t live, could never walk again, could not be married, but I do walk, also run; and I think my M.D. wife is the greatest wife, mother and pal in the world. I’ll not bore you about the four living Rafferty children. . . . Everything I have I owe to Major Skeel, and I think I get more pure fun out of being alive than anyone else I know. To him I send my thanks and gratitude in my prayers every morning and every night.12 Yet another campaign was being waged on the home front that would have a profound effect on Saint Luke’s and hospitals everywhere; this, the fight for gender equity and professional recognition. As early as January 1904, the Ohio State Association of Graduate Nurses had driven to regulate the practice of nursing through state legislation. A bill was introduced requiring that in order to practice, a nurse must be at least twenty-three years old and of good moral character; she must be a graduate of a recognized training school providing three years of instruction; and she must have passed an examination by the nurse examining board. Under the law of the State of Ohio, only male electors could serve on the Ohio Board of Examiners. The legislation would have put the all-woman profession of nursing under the control of an all-male board. The nurses set their sights on changing the law. With the help of Cleveland attorney John S. Clark, a supporter of liberal mayor Tom L. Johnson, the bill was redrafted in 1906 to provide for an examining committee of five graduate nurses. Although the bill was defeated, the nurses developed some powerful allies, including leaders of the Cleveland Chamber of Commerce and the president of the Ohio State Medical Association, Dr. George H. Matson, who appointed a committee to help the nurses. The nurses working for state registration concentrated on an educational campaign for the next six or seven years. Their goal was to win the support of the voters. In 1912, the Nurses’ Auxiliary of the Woman’s Suffrage Party of Cuyahoga County was organized. In 1914, the president of the state nurses’ association, Mary Gladwin, had the nurse registration bill revised one more time, and it was approved by the association’s executive committee on January 29, 1915. On February 17, 1915, the revised bill, providing for the Ohio Medical Board of Examiners to be the official registering body, with a committee of three nurses and the secretary of the board as the examining body, was presented to the Ohio general assembly. It was referred to the house Committee on Universities, Colleges and Normal Schools, where it was recommended for approval on its first hearing; however the bill’s content caused dissention among the nurses because it gave control of nursing to men. The bill was tabled on March 10, in order to give the nurses an opportunity to resolve their differences. The bill’s proponents argued that it could be amended to give nurses complete control of their profession if woman suffrage became law. The bill was signed into law on April 27, 1915. With the approval of Ohio nurses, the state medical board announced new standards for training in October of the same year. The requirements included a three-year course and eight-month terms, with classes and lectures during day-time hours. The curriculum consisted of “experience and instruction in medical, surgical, pediatric and obstetric nursing, diet cooking for the sick, and instruction in theoretical courses, such as physiology, anatomy, hygiene, bacteriology, chemistry, and material medica.” Notwithstanding the fact that seventy-four of the eighty Ohio hospitals with nurses’ training schools approved the standards, opposing bills were introduced to lower the requirements. The status of nurses in Ohio was steadily improving by the end of 1918. The public was impressed by the legislative battle they waged, as well as with their contributions during World War I, both on the front and at home. On August 19, 1920, Tennessee became the thirty-sixth state to approve woman’s suffrage. The following year the Ohio legislature passed the Bing Act, making education compulsory for both girls and boys between the ages of six and eighteen. Opportunities were opening to women in areas that had previously been closed. Although equal pay was Page 24
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rarely received, women were satisfied by the gains that they had made. On June 4, 1923, Saint Luke’s adopted the eight-hour work day. The first women interns were appointed the following year. The Eight Day Campaign that was conducted in 1914 to raise funds for capital expansion left the hospital with $275,000, no debt, and big dreams. Having thoroughly considered expansion of the existing facility as well as an entirely new hospital on the Carnegie Avenue grounds, the board of trustees then turned to consideration of relocation to an entirely new site. In 1923, the first property that was considered, and actually purchased, was on the high grounds overlooking Doan Brook Gorge and Ambler Heights to the east and Cleveland to the north. Before they could proceed further, the City of Cleveland notified the hospital that the land was needed for the adjoining Fairmount Reservoir, nullifying the purchase by Saint Luke’s. The next site that the trustees considered was on East Boulevard. Preparation was being made to close on that property when the Cleveland Board of Education stepped in – this time the property was wanted for Rainbow School for Crippled Children. It was now time to consider another option.
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THE GIFT OF A NEW HOSPITAL Having outgrown the Carnegie Avenue facility, Francis F. Prentiss called a special meeting of the Board of Trustees on December 26, 1923. Mr. Prentiss began the meeting with a discussion of the purchase of a new 16-acre site located on Shaker Boulevard, with immediate access by Rapid Transit and within two blocks of trolley car lines. The Van Sweringen Company held this property at a price of $640,000 and had concluded a sale for it at that price, but a problem arose and the transaction had not been consummated. After several meetings, in which Mr. Prentiss had made every effort to have the parcel of land donated to the hospital, the land was offered to Saint Luke’s for $250,000. Mr. Prentiss then continued the meeting with the second purpose – the anonymous offer of one million dollars toward a new building and an additional one million dollars for an endowment, on condition that the Trustees purchase a site satisfactory to the donors and secure pledges in the amount of one million dollars within one calendar year. Prentiss went on to say that he was not at liberty to give the names of the donors, but that the gift had been included in their wills, assuring that the offer would be carried through by their executors in the event of their deaths. He added that it was the wish of the donors that construction of the hospital might begin within a year. Elisabeth Severance Prentiss After a brief discussion, in which it was pointed out that the gift would elevate Cleveland to one of the three great medical centers in the country, the Board approved the acceptance of the gift, the purchase of the land, and the formation of a campaign committee. Shortly thereafter, the Board received a letter from Elisabeth Severance Prentiss, confirming her gift in memory of her late husband, Dr. Dudley P. Allen, and laying out the conditions of the gift. Included in the conditions was the stipulation that Saint Luke’s Hospital be renamed The Dudley Allen Memorial Hospital of Cleveland, Ohio, of the Methodist-Episcopal Church. Some of the Hospital’s staunchest supporters objected to this stipulation. At a special meeting of the Board of Trustees on April 12, 1924, after much discussion, a cable was sent to Mr. Prentiss, who was vacationing in Europe with his wife. The purpose of the cable was to advise the Prentiss’ of the Board’s decision to delay the campaign until July in hopes of reaching a unanimous decision regarding changing the name of the Hospital. On May 12, 1924, the Board of Trustees convened again in a special meeting, recorded in the minutes as follows: Page 35
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Mr. Watkins announced that since the last formal meeting of the trustees, Mr. W.H. Hunt, actuated solely by his personal relations with Mr. Prentiss, had felt it incumbent upon him, in loyalty to Mr. Prentiss, to go to Florence and acquaint Mr. Prentiss by word of mouth just what the hospital’s situation has been. Mr. Watkins asked Mr. Hunt to tell the trustees whatever he might care to as to his conversations with Mr. and Mrs. Prentiss, and, with the omission of certain more intimate details, Mr. Hunt outlined in a general way his talks with Mr. and Mrs. Prentiss in Florence on April 17th and 18th. Mr. Hunt submitted for the records of the trustees a copy of his cablegram from Florence dated April 28th, in which the offer of Mrs. Prentiss was amended and also submitted communication from Mrs. Elisabeth S. Prentiss of the same date. The campaign to raise the $1,000,000, as required by Mrs. Prentiss’ gift, was successfully completed well before the one year deadline. Having met the terms of the fundraising challenge, final plans were completed by Hubbell and Benes, Architects. In June 1926, Lundoff-Bicknell Company, General Contractors, was awarded a $2,500,000 contract to build the hospital. It was clear that additional funds would be needed to complete the job. Mr. Prentiss pledged $400,000 provided that the trustees would raise an additional $200,000. On June 22, 1926, the board of trustees passed a resolution saying that it would “do its utmost to execute the plan for development and completion of the hospital.” It also passed a resolution stating that, “since Prentiss Francis Fleury Prentiss had previously given the hospital $372,931.56 for the capital account during the history of the institution, a like amount would be taken from the proceeds of the Carnegie Avenue property, when sold, and would be placed in the Francis F. Prentiss Fund.” On December 5, 1927, the architects and builders inspected the new hospital which had been built at a cost in excess of $3,000,000. Dedication Exercises were held on the evening of December 7. An address by Dr. Samuel W. Kelley, M.D., a member of the Senior Staff, began as follows: Mr. Chairman, Colleagues, Ladies and Gentlemen: I have never heard of an important enterprise being completed in a very short space of time – except in one instance. That was when a quite considerable piece of work was done in six days, and the Artisan inspected it, pronounced it a good job, and rested on the Seventh Day. But now many persons do not believe even that account of construction rushed through. They say that it was by a long series of progressive changes that the present structure was evolved, and that the process is still going on. I believe they are right. As to the amount of effort put forth in large undertakings, the novelist Black somewhere says “Every great work was done easily,” and then he adds an important qualification – “but it was with the same kind of ease with which the tree blossoms, after long years of preparation,” and I think he is right. Now we have here at hand a modern instance, and as briefly as possible, shall I try to trace for you the process of preparation and some of the stages of development that have led up to the blossoming of this fine institution which we are here to install in its splendid new home and scene of future activities. A volume could be written upon the labors and sacrifices of the medical staff, another upon the work of the Woman’s Board Page 36
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and the Maternity Dispensary, and still another upon the generosity of the friends of the hospital, especially of our honored President Mr. F.F. Prentiss and of Mrs. Prentiss. Without them we certainly would not be celebrating here today and tonight. I hope they will reap their reward not merely in words of praise but in observing for many, many years the results of their philanthropy. Mr. William H. Hunt has been Treasurer and earnest friend of St. Luke’s from its very beginning, and if I were President of the United States and looking for a Secretary of the Treasury, I would know where to look. Volumes would be needed to chronicle the vicissitudes and triumphs of the hospital’s career and of the good deeds it has done for the people. Since I have been accorded the privilege of addressing you, an honor which I greatly appreciate, perhaps you will permit me to add a few words to the members of the staff and the internes and to all the physicians who join with us in the use of the Hospital. Let us remember that no priest in a temple has a more sacred office to perform than has the physician at the bedside of his patient or the surgeon at the operating table. While we reverence the established rites of our cult and adhere to the best known methods of procedure, let us ever be expectant and eager to recognize new revelations of Science and to apply them in our art. Every hospital, whether connected with a medical college or not, is a school. It is a school where consultants, staff, and all visiting physicians, while endeavoring to instruct the internes and nurses, should themselves be students. Each physician should be keen to learn from his own experience and from his associates, and should also endeavor to contribute something to the common knowledge. The advantages for learning like the facilities of the hospital, should not be selfishly monopolized by our own personnel. Non-staff physicians who have patients here, should be invited to our medical conferences and discussions. That is not all. A hospital should disseminate knowledge of how to get well, how to keep well and to prolong life, to the entire public coming within the sphere of its influence. This opportunity is greater with the phenomenal increase in the use of hospitals by the people. We should always bear in mind that even as it is not buildings that make a school, it is not equipment alone that makes a hospital. It is the devotion, the assiduity, the knowledge, the skill, the courage, kindness and helpfulness of the physicians and surgeons. In brief, it is for us to maintain and to advance our scientific and professional standards, for us to justify the expenditure of these great sums of money and immense labors of preparation, development and construction, and to vindicate our worthiness to have these facilities placed in our hands, and to minister within these walls.13
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TRANSFORMATION: THE BIRTH OF SAINT LUKE’S MANOR The headlines in the newspaper, that cold February morning in 2011, announced the coming rebirth of Cleveland’s long-closed hospital. In 2006, Neighborhood Progress, Inc., purchased the vandalized complex and began the process of restoring it to its original configuration by demolishing the newer construction. The Nurses’ Residence had been demolished in 2000, and the land had remained vacant for years. On June 7, 2010, the new Harvey Rice Elementary School, named for the founder of public education in Ohio, was dedicated on the spot where the Nurses’ Residence once stood. Immediately to its east is the new Rice Branch of the Cleveland Public Library. Since its closure in 1999, many uses were considered for the hospital building. The Cleveland Job Corps, a no-cost education and career technical training program administered by the U.S. Department of Labor, considered the property, but opposition from within the neighborhood led to their selection of a different site. In an effort to stem the tide of vandalism, Cleveland Neighborhood Progress purchased the abandoned hospital and began to invest in the neighborhood. A plan was developed to build new homes on abandoned parking lots to the north of the hospital. No sooner was the first phase completed when the economy suffered the effects of the mortgage crisis Harvey Rice School and Library with Saint Lukes in the in 2008. Distance By February 2011, vandalism and neglect had taken their toll on the building. Anything of value, from the hands of the clocks and the copper urns that adorned the clock tower above the main pavilion and the tower above the East Wing, to gutters and down spouts, and copper piping and plumbing fixtures were gone. Melting snow found its way from the roofs down to the tunnels beneath the building, where water was ankle-deep. Many of the rooms were strewn with tiles from the ceilings and plaster from the walls. The once-magnificent structure was in ruin. The three-phase plan called for apartments in the Main Pavilion and the West Wing and commercial space in the East Wing. The plans for the first phase included seventy-two apartments and abundant common space including lounges, an exercise room, a computer room and laundry facilities. In February, 2011, there appeared to be no way that Phase I could possibly be completed by the end of December. Soon the entire complex was alive with activity. Crews demolished what needed to be, either to create the individual apartment suites or to make needed repairs. A large percentage of the tradesmen and laborers had their own Saint Luke’s stories to tell, remembering now-gone relatives who had worked there Page 121
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or had been cared for there. Others recounted their own experiences as patients, or the trips to the Emergency Room with their children. On April 29, the official Ground-breaking ceremony took place. Despite the bitter cold, it was held in front of what had once been the hospital’s main entrance. Guests were offered tours, as they would be again on June 7 of the following year when the Grand Opening and Ribbon Cutting Ceremony took place. There was a great deal to be done in order to meet the deadline for the completion of Phase I. The copper on the tops of the two towers was replaced. New hands were made for the four faces of the clock and a new electronic chime mechanism was installed. The urns, eight on the Clock Tower and four on the cupola above the East Wing, were replaced by molded fiberglass replicas. Metal lathe, rusted and crumbling from years of water damage and neglect, was replaced with aluminum framing. No detail had been overlooked in the design and construction of Saint Luke’s Hospital on Shaker Boulevard, and no detail was overlooked in its renovation. Many of the rooms had originally included fireplaces. Over the years the hospital was reconfigured to support the changing needs, and by the time that the renovation of the hospital was underway, only two of the original fireplaces remained. They were restored as the centerpiece of two of the apartments. The December 30 deadline for an occupancy permit for Phase I was met and the Main Pavilion was nearly fully leased. Applications were being accepted for suites in the West Wing as Phase II was approaching completion. The look of joy and excitement as prospective tenants came to tour the available spaces was intensified on the faces of residents as they attended the June ceremony. In her remarks during the Ribbon Cutting, Brooke King, the Executive Director of Breakthrough Charter School’s Intergenerational School, made the official announcement that the Intergenerational School would be moving to the East Wing in time for the beginning of the 2013-14 school year. Completion of the space for the Intergenerational School became a labor of love as workers put in extra effort to assure its readiness for the first day of school on September 3, 2013. On August 29, with work still going on around them, teachers were busily organizing their classrooms. The excited chatter as boxes were emptied and materials organized was a harbinger of things to come. The look of anticipation on the faces of parents and students as they arrived for the first day of school turned to amazement that morning as they entered their new space. Bright colors and daylight replaced the drab, windowless space of the school’s former location. In addition to the Intergenerational School, the Centers for Families and Children Services’ Debra Ann November Early Learning Center, and a Boys & Girls Club occupy the first four floors. The Saint Luke’s Foundation has returned to the place that it first called home, and Cleveland Neighborhood Progress, one of the driving forces behind the Saint Luke’s project, occupies the upper two floors of the East Wing. It seems somehow significant that the final step in the long journey is the completion of the repurposing of the Prentiss Auditorium. When the work is completed, the auditorium will be transformed to an active learning center - flexible auditorium space that will serve as a gymnasium, lunchroom, performance space and community meeting room. Saint Luke’s Manor now anchors a 20-acre revitalization effort in the Buckeye-Shaker neighborhood. Financial support for the project came from the City of Cleveland, the Ohio Housing Finance Agency, the Ohio Department of Development, Enterprise Community Investment, and PNC Bank. The project also utilized both low income and federal and state historic tax credits, and serves as excellent testimony to the importance of tax credits is the renovation, restoration and repurposing of legacy properties. What began on Woodland Avenue in 1894 now celebrates 120 years of service to the community. It is appropriate that the legacy of Francis Fleury and Elisabeth Severance Prentiss remains embodied in Saint Luke’s Manor and the Saint Luke’s Foundation. Page 122
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South and West Elevations, March 18, 2011. The Long Process of the Renovation of Saint Luke’s Begins. Page 124
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North Elevation, March 18, 2011. The Long Process of the Renovation of Saint Luke’s Begins. Page 125
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Clock Tower, March 18, 2011. Page 126
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One of Two Remaining Fireplaces in a Private Room in the Main Pavilion, March 18, 2011. Page 134
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Residents’ Lobby, Saint Luke’s Manor, January 4, 2012. Page 176
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Residents’ Lounge, Saint Luke’s Manor, January 4, 2012. Page 179
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Resident’s Livingroom, Saint Luke’s Manor. Page 185
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Saint Luke’s Manor Grand Opening Ribbon Cutting, June 7, 2012. Page 188