PACEMAKER: Centennial 1998

The early years

University Hospital opened its doors to the public in January 1898. But the beginnings of patient service at the University of Iowa date to about 1873, when the fledgling Medical Department opened a hospital operated jointly with the Sisters of Mercy Catholic religious order.

The eight-member medical faculty, headed by Davenport surgeon Washington Freeman Peck, had raised some $5,000 to refurbish an 1842-vintage school building known as the Mechanics Academy into a 20-bed hospital with two open wards--one each for men and women--four private rooms and a surgical amphitheater.

To run the hospital, Peck persuaded the mother superior of the Sisters' Davenport house to send a group of nuns to Iowa City to feed and care for patients at the hospital at no cost to the university. The medical faculty, for its part, provided medical services to patients and served as the hospital's board.

Most patients at the hospital were drawn from the ranks of the poor, for at that time hospitals were understood to be charitable institutions serving unfortunate "paupers" without means or family of their own. Counties paid for such care out of charity funds, and indeed, the Medical Department had a standing agreement by which Johnson County (where Iowa City is located) paid for six patients a week throughout the year at the rate of $4 per patient.

Medical care and medical education at that time were rudimentary by modern standards, as one can well imagine. Medical sects such as homeopathy, herbalism and spiritualism flourished, while many "regular" physicians still subscribed to the so-called "heroic" medicine of "bleeding, blistering and purging."

Few if any states required a medical degree or license to practice medicine, and Iowa's Medical Department didn't even require entering students to have a high school diploma. Since the two-year curriculum essentially repeated the same lectures and demonstrations each year, many students abandoned their studies after the first year to work under the tutelage of an established physician before striking out on their own.

Joint operation of the Mechanics Academy hospital met the needs of both the Sisters of Mercy and the Medical Department. The Sisters' mission, after all, was to care for the sick and poor, and the hospital allowed them to do just that; it also served as the resident nuns' convent. The Medical Department, meanwhile, used patients to provide clinical instruction to medical students, and those patients needed the nursing care given by the Sisters.

But the somewhat different missions of the Sisters and the Medical Department generated misunderstanding between the hospital partners. This difficulty, combined with the deteriorating condition of the Mechanics Academy hospital, prompted the Sisters of Mercy in 1885 to relocate to a vacant mansion a few blocks away. Renovating the mansion and turning its carriage house into a surgical theater, the Sisters opened an independent Mercy Hospital in 1886.

The medical faculty continued to treat patients, conduct clinical instruction and serve as the board of Mercy Hospital. Faculty members and other officials realized, however, that this arrangement would not meet the long-term needs of the Medical Department.

For one thing, while it was an improvement over the Mechanics Academy, Mercy Hospital still left something to be desired as a clinical facility. Doctors complained, for example, that the surgical theater and a makeshift passageway between it and the main building were dangerously cold and drafty in wintertime.

Also, standards of medical practice and education were improving, such that by 1890 the state required physicians to be licensed and the Medical Department had raised admission requirements and replaced its two-year course with a graded three-year curriculum. Scientific medicine, with its increasingly sophisticated understanding of diseases (the germ theory was by then commonly accepted), had gained ascendancy over other medical sects and was fast outgrowing its own antiquated beginnings.

Given all this, officials reached a clear understanding of what needed to be done: The university must build its own hospital.

Charles A. Schaeffer, president of the university from 1887 to 1898, led the protracted effort to gain legislative approval for the necessary appropriation. Proposing a millage tax to support construction of a new hospital and other buildings at the university, Schaeffer argued the hospital would serve hundreds of indigent Iowans who could not afford the medical and surgical care they needed.

The tax finally gained approval in 1896, and in less than two years the new 65-bed University Hospital stood at the site the Mechanics Academy had previously occupied. Designed with clinical instruction in mind, the hospital boasted a 200-seat amphitheater in addition to its wards, clinics and private rooms; steam heat and electric lights made it thoroughly modern.

University Hospital as it existed then would appear quite modest today, but it truly represented a new era of patient service and medical education for Iowa.