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Beds of Innovations
The legacy of its hospitals made New Haven a center for excellence in the evloving science of medicine
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Business New Haven
3/4/2002
By: Priscilla Searles
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Going to the hospital is a prospect most of us would prefer to avoid. But today's hospitals have little in common with early facilities. Hospitals as we know them today didn't really exist until the 19th century, which makes one shudder at the lot of the seriously ill in previous eons.
Connecticut's first hospital, the fifth general hospital in the United States, now Yale-New Haven Hospital, opened in 1833. Early hospitals were generally charity institutions, intended for the poor. Physicians worked in hospitals on a rotating basis without pay. They supported themselves treating wealthier patients at home, rather than in the hospital.
Opening a hospital in New Haven wasn't easy. In 1826 the New Haven County Medical Association discussed the possibility of a New Haven hospital, later petitioning the Connecticut General Assembly. The charter, approved by legislators on May 26, 1826, established the General Hospital Society of Connecticut for the purpose of “establishing and maintaining a general Hospital in the city of New Haven.” Ten incorporators were listed: four professors at the medical school, five community physicians and one layman.
The hospital was managed by a board of directors, some selected because of their financial contribution to the new facility. A “prudential committee” of three handled financial matters while a visiting committee of six made frequent visits to the hospital, reporting any problems they encountered to the prudential committee. As an incentive to donate money to the hospital, those who gave $100 or more could nominate one person for a free bed in the hospital for six weeks each year.
The primary motivation for opening a hospital in New Haven was not necessarily concern for the poor but to provide clinical experience for students at the Medical Institution of Yale College, now the Yale School of Medicine. Chartered in 1810 and opened in 1813, the medical school had no formal arrangement with the hospital, and clinical training was not part of the curriculum. However, most of the school's professors were attending physicians at the hospital. Students gained practical experience by doing an apprenticeship with a preceptor.
Raising money to open the first facility, known as the State Hospital, took a number of years. New Haven was a small port town of less than 10,000 residents. It took some pleading, but the state legislature finally came through with $5,000. Yale medical school faculty members each pledged ten percent of their annual income, or a minimum of $100 a year for five years. In addition, the Connecticut Medical Society donated examination fees collected for medical graduates. And the federal government agreed to pay the hospital the port fees paid by sailors in New Haven in return for free medical care in the hospital.
The first hospital was located on a seven-acre plot on Grove Street. Ithiel Town designed the building, which was constructed for approximately $13,000. Facing Cedar Street, the three-story building was made of stone covered with stucco. In early years there weren't enough patients to fill the 75-bed hospital, so rooms were let out to lodgers. It would take almost 20 years before demand increased to the point that all the space was needed for patients.
Money to keep the hospital going continued to be a problem. Unable to provide free services, the hospital charged most patients $3 a week for board, medical attendance and medicines. In the 1850s the state provided $2,000 a year for “the support of indigent patients from every part of the state.” In order to accommodate such patients State Hospital had to invest in furniture and other conveniences for the hospital.
The Civil War placed a strain on all existing hospitals. In 1862 the State Hospital building was leased to the Union government for use as a military hospital. Regular hospital functions were carried out in rented quarters in Whalley Avenue.
The military hospital became known as Knight Hospital, named after Jonathan Knight, president of the board of directors of the General Hospital of Connecticut and professor at the Medical School at Yale College. With temporary quarters built on the property, Knight Hospital could accommodate 1,500 patients. Between 1862 and 25,340 soldiers were treated at the facility, with only 185 deaths.
Following the Civil War the hospital entered an era of unprecedented growth. In 1873 two wings were added, providing room for an additional 126 patients as well as housing for nurses. In 1903 the facility recorded 1,721 admissions with an average length of stay of 30 days. In 1906 the main entrance was located on Cedar Street, with a stable on Howard Avenue to provide housing for the horse-drawn vehicles and motor ambulances.
Although the hospital and Yale had worked together from the outset, the first formal affiliation agreement between the two wasn't signed until 1913. The agreement was based on “the belief that a closer alliance between them will render the Hospital more useful to its patients and to the community, and will benefit said University by enabling it to give the best clinical instruction to its students, and afford the best opportunities for advanced study and scientific research.”
The hospital also agreed to permit the faculty of the School of Medicine to nominate, as vacancies occurred, people for the position of attending physicians, surgeons and other staff, assuring “that the hospital shall secure for the treatment of its patients the greatest degree of medical and surgical skill that can be furnished by said Medical School.”
The 20th century brought sweeping changes to the State Hospital, including name changes. Many firsts were recorded, including the first artificial heart pump. In 1965 an affiliation agreement with Yale University created Yale-New Haven Hospital.
New Haven's second major hospital appeared on the scene in 1907 when the Sisters of Charity of Saint Elizabeth in New Jersey responded to a request by 14 physicians to come to New Haven and found a hospital. On February 2, 1907 the sisters moved into a site at 1442 Chapel Street, converting a Victorian home into a 12-bed hospital. The hospital was incorporated on March 14, 1907. Three years later a new, larger building was constructed.
One of the hospital's founding physicians was William F. Verdi, a Yale Medical School graduate. Forced to operate in private houses in the early days of his career, Verdi commented in 1913 that “The worst drawback we had in this city and which is now entirely overcome was the lack of hospital facilities.” At the time of Verdi's comments, New Haven's hospitals were handling surgery in their own facilities, not in someone's front parlor.
Diseases that we no longer consider major threats led to the opening of a number of specialized hospitals, while others arrived on the scene as profit-making enterprises.
The Newhope Private Sanitarium opened in 1900. Begun as the Newhope Hot Air Sanitarium, its treatment regimen focusing on “thermotherapy,” the institution soon expanded to accept all patients “except those suffering from pulmonary tuberculosis, contagious and metal afflictions and drug or alcoholic addiction.”
Newhope had a permanent staff, rather than the visiting physicians and rotating house officers of a public hospital. In 1907 it became the Elm City Private Hospital. Located on Park Street in New Haven, the building was sold to Yale University in 1918. It was used by the Department of Public Health and later as a dormitory for the Yale School of Nursing.
In 1902 the New Haven County Anti-Tuberculosis Association was founded. Soon to become the Gaylord Farm Association, the group was one of the first public health organizations in the nation. On September 20, 1904, Gaylord Sanatorium opened its doors to its first six patients. The plant was valued at $86,000 and with $99.20 cash in hand, the facility was off and running.
Located in Wallingford, 200 of the 600 acres owned by Gaylord were originally purchased in 1793 by Moses Gaylord, a country doctor from Branford. The property remained in the Gaylord family until the New Haven County Anti-Tuberculosis Association purchased it.
The mission of the association was “to establish and maintain a sanatorium and hospital in New Haven County, on a non-profit basis, for the care and treatment of cases of pulmonary tuberculosis susceptible to amelioration.” David Russell Lyman became the first director of Gaylord Farm Sanatorium.
The “cure” for tuberculosis a century involved plenty of fresh air, good food and rest. Patients often stayed in tents until they were moved into cottages. Gaylord was also a self-sufficient community with its own working farm.
But staying at Gaylord wasn't exactly a resort vacation, as Ethel Stevens, a former patient, wrote:
“The early days of Gaylord were much different. I was here in the middle 1920s when it was like a big farm with two buildings - Wheeler and Tuttle - together with several mere shacks, where patients lived when ready for exercise. These shacks, or cottages as they were called, had long porches with 12 or 15 beds on each one. All our time was spent on these porches and, believe me, it was often very cold and unpleasant. The “pigs” or hot jugs that kept our beds warm were often unsatisfactory, especially when the corks came out as mine did several times.”
Such notables as famed Yale athlete Albie Booth recuperated at Gaylord. One of Gaylord's most famous patients was Eugene O'Neill, who came to the sanatorium 1912 and stayed for several months.
Unlike Stevens, O'Neill appears to have considered his stay a positive one. Following his discharge he wrote to Dr. Lyman:
“I am looking forward to some fine spring day when I shall be able to pay the farm a visit… although I trust all the patients I knew are halely and heartily bucking the world, I still hope to find, among those attached to the San, some familiar face to remind me of the time I should have been cast down by my fate - and wasn't. If, as they say, it is sweet to visit the place one was born in, then it will be doubly sweet for me to visit the place I was reborn in - for my second birth was the only one that has my full approval.”
In 1922 Gaylord closed the year with a “comfortable” balance of $13.54. The average length of stay was 51 days; the average cost to patients, $23.71 a month. Taking advantage of its geographical location near the best of Connecticut's silversmiths, in 1923 crafting silver was introduced to provide patients with an occupational skill after treatment. In 1926 Gaylord became the first sanatorium in the country to offer its facilities to the U.S. Public Health Laboratory National Research Committee.
In 1948 Gaylord Farm Sanatorium became Gaylord Hospital to reflect its evolving focus on patients with chronic illnesses of all kinds. By the 1950s, with the discovery of medications that successfully treated tuberculosis, Gaylord turned its expertise to other forms of rehabilitation, beginning with chronic pulmonary disorders, then stroke, brain injury and spinal-cord injury.
The hospital's programs grew over the years and Gaylord established itself as the premier rehabilitation hospital in the state.
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