Monday, August 6, 2012

Boston City Hospital-

In my up-coming Victorian, holiday novella, Another Waltz, my hero ends up in a hospital in Boston.  While doing the research I became engrossed in a fascinating book, A History OF The Boston City Hospital From Its Foundation Until 1904, by David Williams Cheever, George Washington Gay, Amos Lawrence Mason, Johns Bapst Blake, Boston City Hospital

Built to provide comfort and care to the poor patients of the city, construction of Boston City Hospital was begun in 1861, on Harrison Avenue in the South End of Boston, north east of Roxbury.

In the 1830’s a project was begun in which fill was brought in by trains to fill in a large portion of Boston’s Back Bay and it was on the former Tidal Marsh that the hospital was built.

The four buildings of the original group were designed in the French Renaissance style.  The administration building was an imposing structure of brick, with tall wooden columns, balustrades and porches with a large dome at the very top, 148 ft. above the street. The first floor was used for general administrative purposes, with a reception room for visitors and offices and apartments for the superintendent and trustees. The second floor contained private rooms for patients and the third floor, flooded with light from the great dome, was used for operating rooms. Two stairways and a hand elevator were used to move patients. The basement rooms were 13 ft. high with another sub basement. These lower stories contained a kitchen, storerooms, a dispensary, a laboratory, and a dining room for the employees, with rooms for clerks and stewards.

To the left and right of the administration building were Pavilion’s I and II.  One hundred feet away, they were connected by a cover colonnade. Each building was 180 ft. X 48 ft. and had three stories with a basement 3 ½ ft. below the grade of the ground. Pavilion I, the surgical side, contained Wards, A, B, C, & D, and Pavilion II, the medical side held Wards, E, F, G, & H.

Because of the surgical and antiseptic methods of the day, hospital gangrene and general sepsis were common. In 1866, Pavilion III, known as the “Foul Ward,” was built where the old Roxbury canal had channeled its sewage into the old marsh. The main ward was for men and the second story for women.

The original boiler room was located on Albany Street, parallel with the Administration building. Steam was generated from three tubular boilers at thirty pounds of pressure. Steam was carried to a large battery of steam coils, and fresh air, drawn through a latticed window was forced by a large propulsion fan 15 ft. in diameter, through a large sub basement conduit. From here the heated air was distributed by smaller ducts, to the various wards.  A secondary system of ducts admitted cold air and by mixing the valves the correct portion of hot/cold air could be maintained.

The problem was that the conduits, which in some places were 10 ft. wide and 12 ft. high, had too many leaks to properly achieve this.  Then rats, which soon burrowed between the sewers and the imperfectly constructed conduits, caused sewer gas to be mixed with the heated air and pushed into to the wards. All patients in beds near the air inlets invariably ended up with septic complications, many of whom died.

Then because the hospital was built on such a low grade, the flow of tides caused seepage of ooze into some areas of the buildings.

In these early days sewage was removed by barrel sewers, but the sluggish flow caused solids to settle and form deposits that gradually became obstructive.

The original medical and surgical staff consisted of eighteen members. One third was consulting physicians and surgeons. The rest were house officers, (interns) who roomed in various parts of the hospital and were equally divided between the buildings.

Patients slept on beds with horse hair mattresses of blue and white striped ticking.  They were covered with a coarse linen sheet and beige wool blankets. In the wards of the hospital, there were seven windows on each side of the ward with two beds to each window.  It had also been voted that except for emergency cases, no one could be admitted to the hospital without a satisfactory character reference.



Above her loomed a wide porch with four Corinthian columns and balustrades. She blew her runny nose and pushed her spectacles tight to the bridge of her nose. After stuffing her handkerchief into her coat pocket, she grasped the fabric of her skirt and carefully limped up each snowy step one at time, eighteen times.

Inside, the ceiling soared above her head even higher than twelve foot ceilings in Payton’s house. On either side two large staircases stretched toward the second floor. A door snapped shut somewhere; the sound echoed through the building. Across the width

of the room she spotted a sign over a door of a room marked Visitors. Her heels clicked loudly against the tile, their cadence out of time. After all these years, she could still hear the sing-song chants of the girls from boarding school ringing in her head. “Gimpygirl! Gimpy-girl!” Even her brother had mimicked their taunts.

“Excuse me?”

The woman seated behind the desk raised her head. Her shrewd gaze silently appraised Madeline from the bonnet which protected her head to the kid gloves which covered her hands.

Madeline continued. “I’m looking for a man—”

The woman interrupted with a quick bark of laughter, flashing rows of crooked, yellowed teeth. “Dearie, ain’t likely anyone of your quality would be here.”

Madeline shuddered at the limp strands of salt and pepper hair, which had fallen from the woman’s bun to frame her face and sagging throat. The fingernails of her hands, as they dealt a game of solitaire, were rimmed with black.

Adjusting her spectacles Madeline repeated her question. “Do you have a patient here by the name of Sean MacAuley?”

“An Irishman, eh? Well, we got lots a them here, but none by that name.”

Madeline glanced beyond the desk, to the file cabinets, tables, and shelves, stacked with ledgers and piles of papers. How could this person remember the name of every patient?

“Could you please check your records? He would have been admitted the night before last.”

The matron heaved a sigh, which strained the bosom of her too-tight blouse, as she half-heartedly sifted through the piles of papers littering her desk. After a couple of minutes, she looked up and shook her head.

Madeline’s shoulder’s drooped. Where else could he be? This had to be the right hospital. Unless he’d gone back to where he’d been staying. With all the hotels in the city, it would be like hunting for a needle in a haystack. Maybe she should just forget the whole idea and let him go.

“There was a man—” the woman added, startling Madeline from her musing. “—the police brought him in. Don’t know his name.” The wooden chair creaked under her cumbersome weight as she flipped open the book beside her. “He was listed as an accident patient. That would put him in North Pavilion,” she pointed toward a side door on the right.

Madeline murmured her thanks and once outside walked beneath the covered colonnade, which spanned the curved distance between the administration building and the entrance to the Pavilion.

Once inside, the nurse in Ward A informed her that the beds were filled to capacity, but some of the male patients were being tended to in the basement, and Sean might be with them.

Stale sweat, urine, and vomit blended together with an assortment of noxious odors, forcing

Madeline to swallow an urge to gag.

Though less than half of the wall was actually below ground level, she still wondered how these poor souls could survive in such damp conditions. The nurse on duty indicated the bed at the end of the row as the one, which held the nameless patient.

As she started down the wide aisle separating about twenty beds, for the first time she prayed that Sean wouldn’t be here. She pictured him on a train, heading back to Texas, his wide grin in place as he seemingly laughed at the world like it was all some secret joke.

She passed through a pocket of cold air, into a wave of heat blowing from a large ventilation duct, then shivered as she moved back into the cold. A few more steps and she was forced to detour around a pile of soiled linens and dirty bandages which littered the aisle like flotsam in a stream, all while maintaining her focus on that last bed. She glanced around, certain every eye was on her as she limped through the ward, relieved to find most of the men were either asleep or watching her with vacant eyes.

As she came to a stop at the end of the iron bed, a gasp that was part relief and part horror escaped her lips. For although she was relieved to have finally found the man, who, until Thursday night had been known to her as James Sullivan, she barely recognized the battered visage of the man sleeping restlessly before her.

Another Waltz is scheduled for release October 10th  from The Wild Rose Press.


  1. Good morning, all. Today is the first time in a few months I haven't had to work on my blog day. Yay! I'll been around to answer any comments or questions. Hope you enjoy this glimpse into this Victorian era hospital.

  2. I find it so interesting how so many businesses, including hospitals, housed the people that worked there. If you lost your job, you really lost your 'house' back then.

  3. I love Victorian Era Books! My brother had a Victorian house before he died! I would love to read and review this book.
    Thanks Kathy!

  4. Hi Lauri,
    I was surprised too, when I learned that everyone who worked in the hospital, lived there as well. I was also surprised that the doctors were called house officers. I debated about using the term, but my critique partners thought it worked, and my editor had no problem with it, so I used it in place of doctor.

  5. Hi Rebecca,
    A good deal of this story features an old Beacon Hill mansion, in which the heroine lives. The house I based it on was actually built in 1818. It has four stories with the kitchen in the basement and the servants on the fourth floor. There's a marble foyer with a wide spiral staircase and a ballroom on the second floor. I wish I could have lived in it.

  6. Rebecca,
    I would love it, if you wanted to review this book. It's a holiday novella, coming out in October, from The Wild Rose Press.

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  8. Kathy, your excerpt hooked me and I definitely have to read the book! although hospitals are much better today, it's not uncommon to catch a cold, virus, or staph in them. A friend caught a debillitating gastrointestinal problem while visiting someone in the hospital, as did her husband and mother. They recovered quickly, but my friend battled the problem for over a year before she was rid of it. Good post.

  9. Sounds like a lovely place. I might say, thank goodness we have much better facilities, and lord knows we do. But like Caroline, our hospital routinely has patients--especially those with any kind of abdominal surgery--to contract staph and also the kind that comes from damaged organs leaking inside the body cavity. Two years for two different women I know. It's hell.
    And yet, it's mere speck when compared to the Victorian hospitals.
    Your novel sounds so good, and it seems as though you've done a fantastic job of research.

  10. Hi Caroline,
    When my daughter was in the hospital years ago, they asked it I would let her be part of a study where some kids were given antibiotics immediately and some were not. I agreed, but had no idea which group she was in.

  11. Hi Celia,
    Part of the reason I write historicals is because of the research journeys. The breif scene in the hospital of this novella gave me so much information that I'm hoping I get to use it in another story.

  12. Wonderful research and a great excerpt. Looking forward to this story.

  13. Hi Paty,
    Thanks for stopping by. This one is a holiday novella that takes place in Boston. Not my usual western, but the same time period so it was still fun to write.

  14. I doesn't seem like a great place to go for medical care, especially the wards close to the septic areas. Sure am glad we've come such a long way to insure better care.

    Your story sounds great, Kathy.

  15. Hi Paisley,
    Thanks for stopping by and taking the time to leave a comment. Hospitals back then weren't the best. They tried, but they had no idea about so many things, especially how bacteria was spread. To many people hospitals were nothing more than places people went to and didn't return.


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