A History of Children’s Hospitals in Utah

A History of Children’s Hospitals in Utah

By BARBARA MANDLECO AND CARMA MILLER

Children’s hospitals have a long history, both in England and the United States. The first children’s hospital in the English-speaking world, the Hospital for Sick Children at 49 Great Ormond Street in London, England,was founded by Dr. Charles West on Valentine’s Day, 1852, and within three years, children’s hospitals were established in America. In 1855 Dr. Francis West Lewis founded the first American pediatric hospital, Children’s Hospital of Philadelphia, dedicated to finding cures and treating illnesses and injuries specific to young people. The Children’s Hospital of Boston was founded in 1869, and a year later the Children’s Hospital National Medical Center in Washington, D.C., opened.The effort to establish children’s hospitals moved westward and the St. Louis Children’s Hospital, the seventh oldest pediatric hospital in the United Statesand the first west of the Mississippi was founded in 1879. The Children’s Hospital in Denver began as a “tent hospital” in the summer of 1897. On the West Coast children’s hospitals were established in Los Angeles in 1901, Seattle in 1907, and Oakland in 1912.1

Children’s hospitals were needed in the Patients on the sunny south side of Primary Childrenʼs Hospital in the 1950s.

PRIMARY CHILDREN’S MEDICAL CENTER

Intermountain West as well, and two such hospitals, Primary Children’s Medical Center (earlier known as Primary Children’s Hospital) and Shriners Hospital for Children Intermountain (earlier recognized as Shriners Hospital for Crippled Children), founded in Utah during the first quarter of the twentieth century, met this need. Although pediatric units were found in Utah hospitals, and a third children’s hospital for children with polio was planned and built in the mid-1940s on the University of Utah campus, it was never occupied.2

Five major themes are important in an examination of the history of children’s hospitals in Utah.First,the steadfast commitment to caring for children; second,providing charity care as not-for-profit organizations; third,the leadership of strong, dedicated women (many of whom were nurses); fourth, the role the hospitals fill in furthering treatment, research, and education; and fifth, the child-centeredenvironmentprovided for patients.

Until 1911, children in Utah were cared for in the general wards of hospitals. After witnessing a crippled child’s struggle on a Salt Lake City street, Louie B. Felt, the president of the Primary Association of The Church of Jesus Christ of Latter-day Saints and her counselor, May Anderson, asked Primary Association volunteers to sponsor a children’s department at the Groves LDS Hospital. 3 Consequently, LDS church President Joseph F. Smith approved the Primary Association’splansto secure donations to furnish and maintain “two rooms, one for boys and one for girls, each to contain at least three cots and other necessary furnishings” at Groves LDS Hospital,and between 1911 and 1921, the Primary Association received $4,871.48 to care for forty-six children.4

However, Felt and Anderson, concerned that children were not receiving care specific to their age in the adult hospitals, believed a hospital dedicated solely to the care of children was needed. President Heber J. Grant shared their concerns and in June 1921 he sent the two Primary Association leaders to study children’s convalescent and day care centers in the eastern United States. After visiting the New York Graduate School and Hospital, they concludedthat, with significant financial support, a similar hospital could be built in Salt Lake City. Consequently, upon their return, Felt and Anderson met with President Grant and proposed thata children’s convalescent hospital be built in Salt Lake City.5

In response to Felt and Anderson’s request, LDS church authorities made available two homes on North Temple Street in Salt Lake City. One home was remodeled as a thirty-five-bed facility and named the LDS Children’s Convalescent Home and Day Nursery. The other home was used as a residence for nurses who worked at the hospital. The facility opened on May12, 1922, the 102nd anniversary of Florence Nightingale’s birth. Children who had undergone surgery at the Groves LDS Hospital now received extended convalescent care that was more child-centered and provided more freedom than found in a regular hospital routine.6 The new facility also provided childcare during the day for children whose mothers worked at the hospital.

Louie B. Felt, President of the LDS Church Primary Association, (right) and her counselor, May Anderson, (left).

PRIMARY CHILDREN’S MEDICAL CENTER

In 1923, the name of the hospital changed, and “Day Nursery” was removed, becoming “LDS Children’s Convalescent Hospital.“ In 1934,the year the hospital was officially incorporated, the name was changed to “Primary Children’s Hospital” to reflect the type of care that had evolved over the past decade.7

Prior to World War II,care delivery in the hospital was similar to other pediatric hospitals throughout the United States and Canada. Parents and families often were viewed as a hindranceand as possible sources of infection. Therefore, parental visits were limited to two afternoons a month and siblings rarely visited at all. However, a fresh air porch was located in the hospital and children’s beds were often moved there. Since many hospitalized children lived outside the Salt Lake City area, family visits were difficult and scarce; the average stay was lengthy—158 days. In fact, some children remained in the hospital for one to two years and one child with osteogenesis imperfecta was hospitalized for thirteen years.8

During the first thirty years of the hospital’s operation,5,907 inpatient and 3,498 outpatient children from all over the world, regardless of ethnicity, religion, or nationality, were treated at this hospital. In 1938,the need for an updated facility and more space became apparent.9 That year local business leaders presented LDS church President Heber J. Grant with one thousand silver dollars in commemoration of his eighty-second birthday. He donated the money for construction ofa new children’s hospital and each of the silver dollars was made into a paperweight and sold for one hundred dollars. However, the challenge of President Grant’s subsequent illness and death in 1945 and the shortage of building materials and labor during World War II, slowed construction on the new building.10

Ground was broken on April 1, 1949, during the annual Primary Association Conference. On April 5, a year later, the cornerstone was laid by LDS church President George Albert Smith. The cornerstone contained the names of financial contributors, a Heber J. Grant souvenir paperweight, as well as historical pictures and files. The new seventy-bed facility, designed by Utahn George Cannon Young and located on two and one-half acres overlooking the Salt Lake Valley at 11th Avenue and E Street, was dedicated in March 1952. President David O. McKay of The Church of Jesus Christ of Latter-day Saints addressed the five hundred invited guests who attended the ceremony conducted by LaVern W. Parmley, general president of the church’s Primary Association. Other participants included Frances G. Bennett, a member of the church’s Primary general board and vice president of the hospital board of trustees, as well as LeGrand Richards, the Presiding Bishop of the church, and Harold B. Lee of the Council of the Twelve Apostles and an advisor to the Primary Association.11

The new $1.25 million building was equipped with a library, occupational therapy department, playrooms, and a physical therapy and outpatient clinic as well patient rooms, operating rooms, and an X-ray department. All patient rooms were located on the sunny south side, and sun porches and a playground were located on the flat part of the roof.12 The interior was decorated with murals painted by Utahns Jane Swensen andArnold Freiberg.

During the next several years, Primary Children’s Hospital was challenged by increasing numbers of patients who needed medical services. In addition, the focus of care at the hospital gradually changed from care of children with chronic conditions (often the result of polio)to acute care requiring updated services and equipment. In 1961, when acute care was added, the hospital size increased from seventy to eighty-four beds. In 1966, a two million dollar expansion on the west side of the building doubled the bed capacity and created several new departments, including an emergency room. In 1969, Primary Children’s Hospital began its preadmission orientation for children with its “Lemonade Party,” the first, or among the first such orientation program for children in the country. At the party, children scheduled for surgery went to the hospital to watch a film, dress in scrubs, sniff anesthesia “scents” and tour the post operative area.

In 1973, the name was changed to Primary Children’s Medical Center to reflect the broader care and services provided patients and families. LDS church leaders later announced the operation of its many hospitals was no longer central to its mission, and consequently all hospital interests were divested. As a result, in 1975Primary Children’s Medical Center became part of Intermountain Health Care, a newly created, independent, nonprofit corporation.13

As new services were added, a larger facility was needed and plans for a new hospital were announced in 1986. Four years later, on April 23,1990, the new Primary Children’s Medical Center opened on the University of Utah campus adjacent to the School of Medicine. Within one year of opening, a thirty-bed infant unit was opened; additional beds were also added to the rehabilitation and newborn intensive care units. In 1999, the emergency department increased by ten beds, and a twenty-six-bed rapid treatment area for children needing to be in the hospital for less than twenty-four hours wasopened.14

Children were invited to submit drawings to brighten the inside of the hospital. Of the more than fifty thousand drawings submitted, one hundred and fifty were enlarged and framed, ten were rendered into large murals, and twenty-six were selected to represent the letters of the alphabet. Utah artist Dennis Smith created a large whimsical sculpture that was part boat, part machine, part city, and included thirty-five inch high sculptures of children. The focal point of the sculpture was a large water wheel that turned as water flowed over it.15

While Primary Children’s Hospital grew from three rooms located in the Groves LDS Hospital to a modern 235 bed facility, the Salt Lake City Shriners Hospital for Children also became an important institution for providing health care to children. The Ancient Arabic Order of the Nobles of the Mystic Shrine (Shriners) was founded in 1872 for the purpose of fraternal fun and fellowship. In time, charitable endeavors, especially providing free medical care to needy children became a hallmark of the organization. This philanthropic endeavor was the direct result of a 1919 reminder by the imperial potentate that “our order will never find its soul until it unites in some great humanitarian project and erects a living monument as evidence of a worthy purpose underlying the organization.” 16 Consequently, the Shriners Hospitals system was established to treat orthopedic injuries and birth defects in children. Support came from a yearly two dollar assessment from each Shriner.

The LDS Childrenʼs Convalescent Home and Day Nursery opened May 12, 1922.

PRIMARY CHILDREN’S MEDICAL CENTER

Today, there are twenty-two Shriners Hospitals located throughout the United States. The first hospital opened September 16, 1922,in Shreveport, Louisiana, and the eighth, located in Salt Lake City, opened January 22, 1925. The national board of the Shrine believed the Salt Lake City area needed children’s care focusing on musculoskeletal problems including congenital hip, tuberculosis of the spine, and rheumatoid arthritis.17

Initially, the Shriners rented space in the south wing of Salt Lake City’s St. Mark’s Hospital for a twenty-bed temporary mobile unit “. . . where all special services, such as laboratory, x-ray, operating room, anesthesia and dietary are provided.”18 The mobile unit was divided into boys and girls sections with a long, wide, windowed veranda providing a sunny, bright environment.

As requests for treatment increased, the Shriners National Board of Trustees authorized construction of a new hospital in Salt Lake City in 1945.The authorization reversed a trustee vote in January of that year to close the Salt Lake City facility and transfer the patients to Amarillo, Texas, where a new hospital was to be built to serve the southwestern states. Pressure to build the Salt Lake City hospital came from community leaders such as Dr. John Edward Carver, pastor of the First Presbyterian Church in Ogden, Milton E. Lyman, Salt Lake City Treasurer, Christian H. Fischer, a local coal merchant, Salt Lake City physician Dr. H. P. Kirtley, and Lincoln G. Kelly, chairman of the local Shriners board of governors.Property for the new hospital was obtained in 1946 through an act of Congress when President Harry S. Truman, himself a Shriner, signed the document deeding approximately seven acres of land from the Fort Douglas military reservation to the Shrine. A provision was included requiring the land revert to the government upon sale or relocation of the hospital.

A ground-breaking ceremony for the new 1.2 million dollar building took place on May 3, 1947, under the supervision of Lincoln Kelly. Five thousand people attended the ceremony that included a parade of Shrine temple members from the intermountain area and a presentation of the history and legends of the Mystic Shrine by actors from the El Korah temple. Other participants included John D. McGilvray, vice chairman of the national hospital board of trustees, and Mrs. Gertrude R. Folendorf, national hospital administrator. 19 Two years later on June 18, 1949, the cornerstone was laid on the northeast corner of the building.

During the cornerstone ceremony, a sealed metal casket containing the days’ memorials was placed inside the three thousand pound Colorado granite cornerstone, a gift from Orion, Clyde, and George Watson, nobles of the El Jebel Temple in Denver. Following an old Masonic ceremony, wine, corn and oil (symbols of plenty, joy and peace) were poured, and Grand Master Newell Dayton and Deputy Grand Master John Stark leveled the mortar over the upper surface of the cornerstone. Dr. John Edward Carver, a senior member of the Intermountain Hospital’s board of governors, delivered an address. Others attending the ceremony included Utah’s Secretary of State Heber Bennion, Jr., Salt Lake City Mayor Earl J. Glade, Ogden Mayor Harmon W. Peery, Dr. A. L. Huether, chief surgeon for more than twenty years, vice-chairman of the national hospital board of trustees John McGilvray from San Francisco, and Mrs. Frances Simpson from Limon, Colorado, who had donated more than fifty thousand dollars in support of the hospital’s policy of treating children without restrictions to their race, creed or color.20

The Shriners Hospital for Crippled Children, Intermountain Unit, opened May 26, 1951.

SHRINER’S HOSPITAL FOR CHILDREN, INTERMOUNTAIN UNIT

Construction was completed on December 1, 1950, and the hospital opened March 1, 1951,when twenty children were transferred from the mobile unit at St. Mark’s hospital to the new forty-bed hospital.21 Regarded as one of the finest children’s units in the United States, the building was dedicated debt free on May 26, 1951,and officially named Shriners Hospital for Crippled Children, Intermountain Unit. The new hospital contained two large wards, one for boys and one for girls, as well as two isolation rooms, a kitchen, a school room, occupational and physiotherapy rooms, sun rooms and playrooms, offices for the medical staff, living quarters for eighteen nurses, treatment rooms and cubicles, as well as a sewing room with an outside entrance for the women who mended and sewed for the children. The top floor contained an apartment, typical of all Shriners hospitals at the time, where the hospital administrator lived.22 The interior included three clear plastic carved bas-reliefs of a circus parade in the outpatient reception room, large murals of well-known fairy tales, including the Ugly Duckling, Cinderella, Sleeping Beauty, Jack and the Beanstalk, Hansel and Gretel, and Snow White and the Seven Dwarfs on the second floor, and floor tiles, which depicted nursery rhyme characters such as Humpty Dumpty and Peter Rabbit.

By the 1980s, the building was no longer adequate. Officials considered several plans: moving the hospital to the University of Utah campus, remodeling and expanding the existing building, or demolishing the 1951 hospital and constructing a new one. Each option presented challenges. According to the original deed granting the hospital property to the Shriners, if they vacated the property, it would revert to Salt Lake City. Senator Jake Garn successfully sponsored a congressional bill removing the reversion clause, which would then allow proceeds from the sale of the property to be used for a new facility. However, local homeowners in the neighborhood objected to an expanded facility. Ultimately, Shriner authorities decided to demolish the old hospital and construct a new forty-bed hospital on the same site. The thirty-three million dollar new hospital, designed in consultation with the Greater Avenues Community Council, was completed in 1995,and featured private and semi-private rooms, an in-house prosthetics and orthotics department, a hydrotherapy pool, a movement analysis laboratory, a three thousand square foot indoor play area, operating rooms and four apartments for parents and other family members.23 The lobby and second floor activity room areas are decorated with a large five-section mural entitled, “Love of Work, Gift of Health,” created by Kenneth Gore. In 1996, the Salt Lake City hospital became known as Shriners Hospital for Children Intermountain Unit when all Shriner hospitals were given the same name.24

Charity care remains a vital part of both Primary Children’s Medical Center and the Shriners Hospital for Children. Since its founding in1922, charity care at Primary Children’s Medical Center has been available to children whose families live in the surrounding states and who are unable to pay for care. When the hospital was founded the only restrictions for admission were that boys be under the age of twelve and girls be under the age of fourteen and had financial needs. Now, children from other states or countries can apply for and receive charity care on a case-by-case basis. In 2007, the hospital provided more than eight million dollars in charity care services, although most children receiving treatment are from families who have medical insurance or who are able to pay for hospitalization.25

The Boyʼs Ward at Shriners Hospital c. 1952.

SHRINER’S HOSPITAL

Shriners Hospitals for Children accept patients free of charge. However, they must beeighteen years of age or younger, require orthopedic or reconstructive burn care, and benefit from the hospital services. Care is also limited to those for whom “treatments at another facility would pose a financial hardship.”26

Both hospitals demonstrate creative methods of raising funds to meet the challenge of supporting charitable care. Initially, funds for charity care came from the local area, and the methods of obtaining these funds were rather traditional. However, today, charity funds for both hospitals come through regional, national and international initiatives that often utilize modern technology in their efforts.

For example, from 1911 to 1921 the children’s ward at the Groves LDS Hospital was funded by the Primary Association of The Church of Jesus Christ of Latter-day Saints with voluntary contributions from the officers and members of the Primary. In 1922, contributions were expanded and became more creative when Primary leaders encouraged children between four and twelve years of age to contribute “Birthday Pennies”—one penny for each year of age on their birthday—in support of the hospital. Also during these early years, donations of clothing, bottled fruit, bed furnishings, table linens, dolls, stuffed animals, night gowns and pajamas were made. Gifts of food from various LDS wards and stakes also helped support the hospital, as did donations of underclothing, socks, diapers, dresses, boys’ white shirts, slacks, overalls, hair ribbons, bibs, bath and hand towels, and laundry and hand soap. In addition, influential clubs, individuals, and organizations made donations to support the hospital.27

In 1934,as hospital costs mounted, the yearly “Penny Parade” fund raising drive began. Primary Association volunteers called at church members’ homes in February to ask for contributions equal to one penny for each year of age of all family members. In 1948, the “Dimes for Bricks” campaign was launched to raise money for a new hospital building. During this campaign,distinctive coin cards that each held five dimes were created with an architect’s sketch of the 1950s-era hospital on the flap. One dime bought one brick for the new building. More than twenty thousand dollars were raised in this effort with the purchase of 203,303 bricks.28 In 1958, with increased hospitalization costs and the additional services offered, donations of two or more pennies for each birthday were requested.29

During the 1970s various funds and fundraising campaigns were instituted, including remembrance and memorial funds, an endowment program, and the “Festival of Trees,” a popular and financially successful annual event where Christmas trees are decorated, displayed, and sold to support the hospital. Other fundraising campaigns have included telethons supported by KSL Radio and Television stations. Revenue from the hospital’s gift shop and espresso cart and countless hours by volunteers also support the charitable work.30

Shriners Hospital for Children refuses assistance from federal, state or other governmental agencies, nor does the hospital accept insurance payments for the cost of a child’s care provided by the hospitals. Financial support comes from an annual contribution from all Shrine members, an endowment fund, and various fund raising efforts.31 Shrine members and volunteer groups also provide and mend clothing, donate food, and give special parties. Daughters of the Nile, Junior League, Grey Ladies, Ladies of the Oriental Shrine, Order of the Eastern Star, DeMolay, Job’s Daughters and students from area colleges and universities read and tell stories, supervise play, crafts, and recreational activities, and provide other help as needed. In addition, Shrine members often act as hospital hosts, guides, skilled laborers, or help transport patients to and from the hospital. Most Shrine temples also sponsor fund-raising events for the hospital in their area, which may include horse shows, miscellaneous sport and social events, newspaper drives, and the Shrine circus which began in Michigan in 1906.32

The Shriners Hospital for Children also benefits from wider reaching fund raising efforts, including the annual collegiate East West Shrine Football Game, played since 1925, which to date has raised more than fourteen million dollars. In addition to this football game, many other high school and college football games are played throughout the country including the Potato Bowl, the Maine Lobster Bowl, the Pretzel Bowl, and the Maple Sugar Bowl to benefit Shriners Hospitals for Children.33

Over time the Shrine organization has been challenged as members have aged and died while the cost of care for children has increased. Beginning in 1983, donations to the hospitals were accepted from members of the community at large. Gifts and bequests from citizens interested in the philanthropy and designated charitable fund raising events administered by the Shrine, such as “Children . . . The Heart of It All” poetry book, men’s ties and lady’s pins, as well as the “Reaching Out for Medical Miracles” campaigns have also become important to the organization in supporting charity care.34

The success of the children’s hospitals over many decades is due, in large part, to the outstanding leadership of many women. Louie B. Felt, the first president of the LDS Church Primary Association, and her counselor and successor, May Anderson, conceived the idea of a Utah hospital for children. Their vision included a two-fold plan to benefit children by giving compassionate service to children suffering from physical handicap, and providing young LDS children the opportunity to receive joy and satisfaction by giving to those less fortunate.35 Their efforts resulted in the first children’s ward being opened at the Groves LDS Hospital and later, the establishment of the LDS Children’s Convalescent Home and Day Nursery.

Anna Rosenkilde, a graduate of the LDS Hospital nurses training program and a former army nurse was another early, dedicated, and strong leader. Miss Rosenkilde began her career in Salt Lake City at the LDS Children’s Convalescent Home and Day Nursery in April 1922 (just prior to its opening on May 11) and retired in 1946.36 Known as “Mama Rose” to the young patients, she supervised graduate nurses, nurses’ aides, cooks, janitors, orderlies and medical students. Because few parents were able to visit their hospitalized children frequently, she wrote personal notes to the parents of each patient every month, reporting on the child’s general health, medical progress, schoolwork, and social interaction. In fact, nurse Rosenkilde’s eloquent plea to LDS church President Heber J. Grant in November 1937 led to his prompt and generous pledge of a thousand dollars to launch the funding drive for a new hospital.37 Even though nurse Rosenkilde retired from Primary Children’s Hospita lin 1946, she did not end her mission of caring

Anna Rosenkilde, first superintendent of LDS Childrens Convalescent Home and Day Center. After her retirement, she worked at Shrinerʼs Hospital.

PRIMARY CHILDRENS MEDICAL CENTER

The length of patient stays at both hospitals has decreased dramatically over time. In 1955 the average length of stay at Primary Children’s was fifty-five days while at Shriners in the late 1970s, the average stay was forty-five days. Today, the length of stay at both hospitals is similar—4.5 days at Shriners and 5.4 days at Primary Children’s.47

Since their founding, both hospitals have demonstrated a tradition of devoted attention and care to create a welcoming atmosphere for children with illnesses and disability. Both have successfully met challenges inherent in funding ever-increasing numbers of patients needing services, providing services to wide geographic areas, altering care according to treatment advances and changing populations, and designing child-friendly buildings. Such caring is gratefully acknowledged by generations of children and their parents.

Indeed, both Primary Children’s Medical Center and Shriners Hospital for Children have played an important role in the history and culture of children’s health care, not only in Utah, but in the Intermountain West as well. Early Utah leaders were dedicated to caring for the needs of ill children, and made significant efforts to ensure national trends were studied and then implemented in Utah. Over time, each hospital has remained current with national healthcare trends while not losing focus of their original vision to provide “…health care for children in an atmosphere of love and concern.”48

NOTES

Barbara Mandleco is a professor in the College of Nursing, Brigham Young University. Carma Miller is an assistant professor of nursing at Salt Lake Community College. The authors would like to thank the Charles Redd Center for Western Studies, Brigham Young University, for funding their study.

1 National Association of Children’s Hospitals and Related Institutions, “History of Children’s Hospitals” (2008), http://www. childrenshospitals.net/AM/Template.cfm?Section=Facts_and_Trends& TEMPLATE=/CM/ContentDisplay.cfm&CONTENTOE=12693 (accessed April 29, 2008).

2 The hospital was to be called “Utah Crippled Children’s Hospital.” The project never came to fruition due to cost overruns. The building was instead used to house the Utah State Health Department. See “Polio hospital building cost up 50%,” The Salt Lake Tribune, February 13, 1947.

3 Louie B. Felt, “An Appreciation,” The Children’s Friend, 11 (June 1912):192.

4 “The Hospital Movement,” The Children’s Friend 10 (July 1911):366; “Hospital movement in behalf of children,” The Children’s Friend 21 (February1922): 65-69.

5 Marba C. Josephson, “…Of Such Is The Kingdom of Heaven. The Primary Children’s Hospital,” The Improvement Era 55 (October 1952): 714-17, 734, 736, 738, 740, 742, 744-45.

6 Conrad A. Harward“A history of the growth and development of the Primary Association of the LDS Church from 1878 to 1928,” (Master’s thesis, Brigham Young University, 1976), 122.

7 Laura Winder to Carma Miller, March 16, 2007, in possession of authors.

8 “A Few Moments from the History of Primary Children’s Medical Center” (1997), Unpublished document, Primary Children’s Medical Center Public Relations Department copy in possession of authors; Laura Winder, Primary Children Medical Center public relations, to Carma Miller, September 16, 2002, in possession of authors; Osteogenesis Imperfecta isa condition causing extremely fragile bones.

9 Josephson, “Of Such Is the Kingdom of Heaven”; Harward, “A history of the growth and development of the Primary Association.”

10 “LDS president breaks ground for new children’s hospital,” The Salt Lake Tribune,April 2, 1949.

11 “Any pennies to spare?” The Salt Lake Tribune Magazine, January 30, 1949; “A Few Moments from the History of Primary Children’s Medical Center”; Harward, “A history of the growth and development of the Primary Association”; “The Primary Children’s Hospital,” [Souvenir booklet] (1952), Special Collections, Brigham Young University Library; Carol Cornwall Madsen and Susan Staker Oman, Sisters and Little Saints (Salt Lake City: Deseret Book, 1979) 170, 172; “New hospital is dedicated,” The Deseret News, March 3, 1952.

12 “Workers start to equip S. L. hospital,” The Salt Lake Tribune, June 5, 1951.

13 In 1974 the First Presidency announced that the LDS church’s fifteen hospitals would be donated and turned over to a new nonprofit organization so that the church could devote “the full effort of [its] Health Services…to the health needs of the worldwide church.” While noting that the hospitals were “a vigorous and financially viable enterprise,” the First Presidency emphasized that “the operation of hospitals is not central to the mission of the Church.” The First Presidency further indicated that with the expansion of the church in many nations it was “difficult to justify the provision of curative services in a single, affluent, geographical locality,” news release, September 6, 1974, http://www.lightplanet.com/mormons/ daily/health/Hospital_EOM.htm (accessed August 2, 2007).Laura Winder to Carma Miller, September 17, 2002; Madsen and Oman, Sisters and Little Saints, 172-73; “Primary Children’s Medical Center History and Statistics” (2008), www.intermountainhealthcare.org/ xp/primary/aboutus/ history. xml (accessed April 29, 2008).

14 L. George Veasy in Henry P. Plenk, Medicine in the Beehive State (Salt Lake City: University of Utah Press1992), 393-415; “A Few Moments from the History of Primary Children’s Medical Center”; “Primary Children’s Medical Center History and Statistics.”

15 “Art brightens children’s hospital,” The Salt Lake Tribune, January 28, 1990.

16 Lottie Felkner, The St. Mark’s Hospital School of Nursing Story. (Salt Lake City: unpublished manuscript sponsored by the St. Mark’s Hospital Nurses’ Alumni Association, 1970), copy in possession of Lottie Felkner; “Added help, hope and health assured intermountain crippled children,” The Salt Lake Tribune, May 3, 1947; “Shriners Hospitals: Improving the Lives of Children,” http://www.shrinershq. org/Hospitals/_Hospitals_for_Children/history/ (accessed June 3, 2008).

17 A Short History of the Shrine and Shriners Hospitals (Tampa.: Shriners International Headquarters, 2001). Shriners International Headquarters,and in possession of authors;Charles Swindler, MD, former Assistant Chief of Staff (Shriners) to Barbara Mandleco and Carma Miller, December 11, 2003.

18 Ralph T. Richards, “The Shriners’ hospitals for crippled children” in The Story of the Shriners’ Hospitals forCrippled Children [Souvenir booklet] (Salt Lake City:The Sahara Club, 1949); “Shriners open hospital unit in Salt Lake today,” The Salt Lake Tribune, January 21, 1925. During the early years of the mobile hospital, several prominent physicians and nurses provided care to children. Dr. A. L. Huether of Toronto, Canada, an orthopedic surgeon, was the first chief surgeon, and held that post until the 1940s. Mrs. Laura Tolander Bishop was the first superintendent (administrator) of the mobile unit. Mrs. Gertrude R. Folendorf, superintendent of the San Francisco hospital, was “loaned” to assist in organizing and opening the Salt Lake unit. Miss Mary E. Hale was the first superintendent of nurses, Miss Mabel Torgerson the supervisor during the day shift, and Miss Nina Williamson the night shift supervisor. Felkner and Larsen, The St. Mark’s Hospital School of Nursing Story; “Lame children will be helped,” The Salt Lake Tribune, January 20, 1925.

19 The Salt Lake Tribune—“Shriners map May 3 rites for hospital,”, February 13, 1947; “Shriners to break ground for hospital on May 3,” April 3, 1947; “Shrine pledges handicapped ‘best hospital,’”and “Shriners go on parade in S. L. today,”May 3, 1947; and“40,000 cheer Shriners in S. L. parade,”, May 4, 1947.

20 “Grand master to conduct hospital rites,” The Salt Lake Tribune , May 19, 1949; “For crippled children. Colorado nobles send stone for Shriners’ new hospital,” June 3, 1949; “Masons lay child hospital’s cornerstone,” June 19, 1949; “Shriners chart S. L. hospital service today,” June 18, 1949; and “For crippled children. Masonic rites scheduled at Shriners Hospital,”June 14, 1949.

21 “Shriners open new hospital March 1,” The Salt Lake Tribune, February 2, 1951.

22 “Shrine Hospital, a children’s wonderland, monument to humanitarian organization,” The Salt Lake Tribune, February 26, 1951, and “Shrine Hospital construction now getting finishing touches,” January 8, 1951; Charles Swindler to Barbara Mandleco and Carma Miller, December 11, 2003; Sherman Coleman to Barbara Mandleco and Carma Miller, August 8, 2002.

23 “Garn boosts S.L. Shriners’ effort to get new crippled children’s unit,”and“Shriners to Build BrandNew Hospital,” The Salt Lake Tribune, December 5, 1992; “Shriner’s Hospital is Talking to University About Building New Facility on Campus,” The Salt Lake Tribune, June 25, 1987; During a conversation with the author on August 6, 2007, Jake Garn stated that he became involved in securing the property because he had a special place in his heart for children’s hospitals, and because he was on a Senate subcommittee that had jurisdiction over public lands.

24 “A Short History of the Shrine and Shriners Hospitals, ” 17.

25 “Work begins on convalescent home,” The Deseret News,October 22, 1921; “Primary Children’s Medical Center: The Child, First and Always,” Primary Children’s Medical Center Public Relations Department, 1999, in possession of the authors; “Primary Children’s Medical Center Mission and Commitment to Charity Care,” inhttp://intermountainhealthcare.org/xp/public/ primary/aboutus/mission.xml (accessed June 3, 2008); “Primary Children’s Medical Center History and Statistics.”

26 “The Minaret,” (1996): 6, in possession of the authors.

27 “A Few Moments from the History of Primary Children’s Medical Center”; Ralph T. Richards, Of Medicine, Hospitals and Doctors. (Salt Lake City: Utah Medical Association and LDS Hospital – Deseret Foundation and University of Utah Health Sciences Center, 1953); Selma Miller,“Primary children support hospital “Love Pennies” provide ample fund kiddies are happy tho suffering,” The Salt Lake Telegram, March 9, 1924; Isabelle S. Ross, The L.D.S. Children’s Hospital. Radio Services, Auspices of the Primary Association General BoardFebruary 12, 1933; “Primary urges donations for Children’s Hospital,” The Salt Lake Tribune, April 9, 1949.

28 “LDS Primary to send out ‘dimes’ card,” The Salt Lake Tribune, April 30, 1949; MadsenandOman, Sisters and Little Saints, 130.

29 “The How of the Primary Children’s Hospital,” (no date), in possession of the authors.

30 “The How of Primary Children’s Hospital”; “$10 million drive started at hospital,” The Deseret News Church News, January 10, 1970; Laura Winder to Carma Miller, February 4, 2005; “A Few Moments from the History of Primary Children’s Medical Center”; Children’s Miracle Network, “About Us,” http://www.childrensmiraclenetwork.org/web/aboutus.htm (accessed June 3, 2008); “Primary Children’s Medical Center; History and Statistics.”

31 Elaine F. Shimberg, A Heritage of Helping: Shriners Hospitals, (Tampa: Shriners Hospitals for Children, 1996); “The Story of Shriners Hospitals,” (Tampa: Shriners International Headquarters, 2001).

32 “A Short History of the Shrine and Shriners Hospitals.”

33 “The East West Shrine Game: About the Game” http://www.shrinegame.com/about.php (accessed March 5, 2007); “A Short History of the Shrine and Shriners Hospitals.”

34 “Shriners plan special day,” The Salt Lake Tribune, October 1, 1983; “Children….The Heart of It All Fundraising program introduced,” http://www.shrinershq.org/whatsnewarch/archives02/heartofitall602.html (accessed August 10, 2005); “First Lady Elaine’s program will benefit research efforts:Reaching out for medical miracles,”http://support.shrinershospitals.org/site/PageServer?pagename=FirstLady (accessed March 5, 2007).

35 Harward, “A history of the growth and development of the Primary Association.”

36 Laura Winder to Carma Miller, September 19, 2005, in possession of the authors.

37 MaryJack, “Pres. Grant pledged support of erection of Primary Hospital,” The Deseret News Church Section January 23, 1952.

38 “Shrine pledges handicapped ‘best hospital’”; Correspondence to the authors from Gloria Larsen,

39 Statistics;” Laura Winder to Carma Miller, July 14, 2005; “Salt Lake Shriners fest marks hospital day,” The Salt Lake Tribune, June 6, 1977.

40 Primary Children’s Medical Center, “Mission and Commitment to Charity Care,” http://intermountainhealthcare.org/xp/public/primary/aboutus/mission.xml (accessed March 5, 2007).