Saturday, July 27, 2013


What made a frontier town grow into a city?

Bet most people would answer, “churches and schools, banks and newspapers.” Oh, and commerce, of course. It does take those things, but that’s not the complete picture. According to local historians in my neck of the woods, a town was just a town until it had a staffed hospital. At that point, the frontier town became a metropolis--a real city, and a real point of pride. After all, every new town’s aim was to grow and prosper and become the next San Francisco or Denver.

Medical care has been on my mind lately, partly because of a recent surgical procedure of my own. The bill for the out-patient operating room nearly put me into intensive care with a heart attack! (Not really. Just a simple case of sticker shock.) How, I wondered, did people in the the 1880’s cope, which is when Spokane, Washington got its first hospital and became, in the resident’s eyes, a metropolis? A small metropolis, at least. More, what kind of care did they receive? And what did it cost? This first hospital, by the way, evolved into the same one where I received care last month.

As was often the case, especially in the west, this hospital was first opened by two Sisters of Providence nuns. It began in a shed while the hospital building was being built. Can’t you just see it? A brick edifice rising out of dusty and rocky open land? When the city burned in 1889, the hospital was spared, helped out by its brick exterior and landscaped grounds.

In 1887, the first year Sacred Heart hospital was open, 354 patients were treated. The first patient, a transient found sick and alone in a shack down by the railroad tracks, died.

Ladies in the throes of bearing a child usually avoided the hospital, preferring to give birth at home with a midwife in attendance. Hospitals, after all, were mostly utilized only in desperate circumstances. They were known as place to go to die, perhaps a self-fulfilling prophecy. However, in this hospital, even in those times, the doctors preformed surgeries not only for severed limbs and bullet wounds, but for appendicitis, and even cosmetic type surgery, for instance, creating and appending a prosthetic ear onto a small boy. History tells us the latter was a great success. Hospital care, complete with skilled nursing, ran about $4.00 a day. I expect those patients thought it horribly expensive.

This is not to say doctors saw patients only in the hospital or their offices. Even in the metropolis they made house calls, just as when the town had been wide open and wild and woolly--on the other hand, by most accounts it still was wild and woolly. One doctor’s horse knew the streets so well the doctor slept on the way home.

As an item of interest--or maybe curiosity--I don’t remember ever reading a Western novel that included any of this sort of information. There’s tons of stuff written about the worn old frontier doctor with a heart of gold who takes chickens in trade for childbirthing, and digs out bullets with utter aplomb while the outlaw holds a six-shooter on him. Mostly he goes days without sleep and drives his horse through rain and blizzards and blazing sun far distances to serve his fellow man. The hospital is usually one room in his own house.

If anyone knows of a Western novel that includes a real hospital in the plot, please let me know. I want to read it. Just think, Coma or Contagion, set in the old West.

Alternate care came not only from mid-wives, but druggists who prescribed medicines for maladies that today would require a whole team of doctors. Further on the fringes were traveling medicine shows, where anyone who wanted could put “Doctor” in front of his name. In a word, the quacks. The self-proclaimed doctor’s stock in trade were balms and elixirs made up of who knows what. Often they contained opium or other dangerous and habit-forming drugs, which was good business for the quack, insuring repeat customers.

Patent medicines were freely advertised in every newspaper and magazine. Lydia Pinkhams for women’s ailments is a well-known example. It was after the turn of the twentieth century before that changed. On the other hand, look in any magazine or newspaper today. Chances are you’ll see medicines, both patent and prescription, advertised as widely, if not as colorfully, today.

Lifestyle advice, although doctors of the day didn’t use that term, might seem very modern to us today. Local doctors shared their recommendations for a long life with the local newspaper:
•Take pride in your hair and dress
•Think pleasant thoughts
•Take regular exercise, especially for “stiff” portions of the body (go ahead, laugh)
•Avoid overeating and careless living
•Mix regularly with the young
•Exercise sanity with regard to tobacco

What I find most interesting about the towns scattered across the west is that so few of the then acquired metropolis status, regardless of their high hopes. And sadly, I believe there are fewer all the time as the West disappears into urban sprawl.

Born and raised in North Idaho on the Coeur d’Alene Indian Reservation, C.K. Crigger lives with her husband and three feisty little dogs in Spokane Valley, Washington. She is a member of Western Writers of America and reviews books and writes occasional articles for Roundup magazine.

Imbued with an abiding love of western traditions and wide-open spaces, Ms. Crigger writes of free-spirited people who break from their standard roles. In her books, whether westerns, mysteries, or fantasy, the locales are real places. All of her books are set the Inland Northwest, the westerns with a historical background. Her short story, Aldy Neal’s Ghost, was a 2007 Spur finalist. Her western novel, Black Crossing, won the 2008 Eppie. Letter of the Law was a 2009 Spur finalist in the audio category.


  1. Carol, you're just a hop, skip, and a jump away--I'm in Seattle. :) You're question of whether anyone has read a western set in a hospital--no, I haven't. Hadn't even thought of it until you mentioned it.

    I was surprised to find that there was a hospital in Silver City, Idaho. Only 2,500 residents lived there, but then most of those were miners, so lots of accidents. What I find interesting when I read the newspapers of the time is that most of the recuperation was done in hotel rooms or friends' houses. Not one baby was born in the hospital that I've found. So a very different place than today.

  2. Hi, Jackie...waving. I believe Spokane had 3000 residents when it became a "metropolis."

    I know of other smaller towns that had hospitals, too, although not on the scale of Sacred Heart.

    By the way, gotta correct a spelling. Performed--not preformed. Ish!

  3. Interesting. Never thought of that either. Though not a Catholic, I know it was a Catholic priest who started the first school in my coal-mining community. He was also an ardent supporter of the first hospital, opened by the state for those accident-prone miners.
    We never made it to metropolis-status.

  4. Carol,
    Thanks so much for being our guest here at the Western Fictioneers Blog today! I never really thought about this, I suppose, and it's a very interesting topic, for sure! My great great great grandfather was one of those doctors that rode a horse and made house calls. He was a full blood Choctaw (we believe) and was taken from his real parents and given to a Presbyterian minister to raise. That family did send him to medical school. This would have been in the 1850's 1860's or so, here in Indian Territory. I remember talk of "the hospital" in Durant, OK (where both sides of my family were from) back during the early 1900's, but don't know when it was built. Very interesting post!

  5. A fascinating post, Carol! Plenty of interesting information here! We still have 'free' healthcare here in Wales though I'm not sure how long it will last. A lot of people take it for granted but would miss it if it disappeared.
    I love reading all about the history of the West! Thanks again!
    Molly :-)

  6. Thanks for that very interesting post, Carol.

    I have an interest in Dr George Goodfellow, often referred to as the 'Gunfighter's Surgeon.' He was a pioneering surgeon, not just in drama and gunshot surgery, but in abdominal surgery and even reconstructive surgery.

    There were 12 doctors in Tombstone when he moved there, although only he and two others had a bona fide diploma. There was a pest house (infectious disease 'hospital') and in 1881 a proper hospital was opened. (Dr Goodfellow had opened a temporary one the year before in New Boston). It was called the Cochise County Hospital, and sometimes also was referred to as the Sisters Hospital, since it was staffed by the Sisters of St Joseph. Dr Goodfellow became its director and he instituted procedures for instrument sterilisation.

    I am writing a novel about Dr Goodfellow at the moment for our West of the Big River series and the hospital plays a part.


  7. What an interesting article. I have wondered so much about hospitals in the old west so this was great information.
    About medicine shows and opium, odd to realize there were drug dealers even way back then.
    The Sisters of Mercy from Ireland started the hospital where I worked for 47 years. It was bought out by a huge mediacl center a few years back and everything about it changed...and not for the good. The nuns actually cared about the patients and the kind of care they received.
    Very informative article, Carol

  8. One of the greatest losses in Health Care is the disappearance of Catholic Hospitals that are still run by religious orders. Most of the so-called "Catholic" hospitals are now run by for-profit organizations, and no longer charity-based. St. Raphael's in New Haven, CT, where I was born, used to be the hospital to go to for quality and compassionate care, while Grace-New Haven, later Yale-New Haven, was to be avoided if at all possible. Then, the nuns left St. Raphael's and it became just another big-city hospital, and was finally taken over by YNHH, which had become the hospital of choice for the area. Very sad.

    One of my Jim Blawcyzk stories had a private hospital in Austin run by a doctor. Had to be that way, since the first real hospital in Austin didn't open until well into the 1880s.

    Jim Griffni

    Jim Griffin

  9. I'll be waiting to read your Dr. Goodfellow book, Keith.

    And thanks for all the other comments. I believe Sacred Heart is still a non-profit, but we have a couple other pre-20th century hospitals here that,while starting out as charity institutions, have changed. Still here, though, and good hospitals, too.

    Those "quack" doctors were something else! Such characters!

  10. Wow, really interesting stuff. My husband's grandfather was a horse and buggy doctor, but in the East. He did take strange things in trade for services. The comment about the hospital being a place to go and die, well, in some places, unfortunately that is true. My grandmother used to use Lydia Pinkham's! LOL! I like that the hospital was the sign of a metropolis!

  11. Donna, I hope you had a chance to actually talk with your grandfather about those days.

  12. Fascinating. Colorado Springs had a Sisters of Charity hospital. It became necessary due to all the people who were arriving here for 'the cure' for consumption. In fact there were three liscensed female doctors here prior to 1880. Loved the post, and like you have been doing a lot of research on early female doctors and medical practices.

  13. What great insight, Carol - as usual, you put your finger on it. Why would women trust a hospital when they could birth a baby at home with a caring midwife? LOL... I know I put in Lydia Pinkham's in Double Crossing and how much alcohol it contained. Medicine in the Old West is sure a fascinating subject.

  14. Spokane had a "real" female doctor,too, a Dr. Mary A. Latham. What a character! I wondered if she had full-fledged hospital privileges, or if she may have been barred. So far, I haven't found that info.

    Meg, the quacks, and their persuasive powers at retail selling, is especially fascinating. How could those customers be so credulous?