St. Luke's Hospital Complex, Chicago Illinois
Reverend Clinton E. Locke founded St. Luke's Hospital in 1864 as one of the charitable activities of the Grace Episcopal parish. The hospital originally occupied a cottage with seven beds. As the city grew and Locke appealed to other Episcopal parishes for contributions, the hospital expanded. In 1871 it moved to the present Indiana Avenue site and occupied an old boarding house with fifty beds. Between 1882 and 1890 St. Luke's constructed five hospital building pavilions designed by Treat & Foltz which gave the hospital "beautiful and well arranged buildings," and increased the capacity of the hospital to 152 beds. In 1884 the Vestry of the Grace Episcopal Church passed a resolution of thanks on the twenty-fifth anniversary of Clinton Locke's rectorship which singled out the St. Luke's Hospital as a monument to charity and philanthropy. The resolution stated: "In opposition to the fears and misgivings of many he at an early day persisted in organizing the great charity known as St. Luke's Hospital, a work that had its beginnings in humble and obscure rooms but which, through faith and work and broad and liberal management, has reached out so as to include the whole diocese making the charity now the grand work of all the parishes of the state and of the liberally disposed of all good people of the city." In appealing for charitable contributions to the hospital, Locke and the St. Luke's Hospital gained the support of leading Chicagoans and many Prairie Avenue residents, including the Armours, Fields, Pullmans, Crerars, Ryersons, Pecks, Doanes, and Fairbanks. The charitable association accounts for some of this site's historical significance.
In order to understand the innovations represented by the extant St. Luke's Hospital buildings, it is necessary to take account of the substantial transitions in late-nineteenth-century hospital practice. Through much of the nineteenth-century nearly all hospitals were charity hospitals. The poor received medical care in the hospital while middle and upper class patients were privately treated in their homes. In the 1880's with major progress in the fields of bacteriology and hygiene, and advances in medical and surgical techniques, the hospital slowly became a more attractive facility for the wealthy. The replacement of private residence with hospital treatment for all classes awaited the development of buildings which provided a degree of social segregation and more amenities than customary in the older charity hospital designs.
In 1886 the St. Luke's Annual Report stated, "Until quite recently [hospital] use has been restricted to the absolutely poor, and hence [the] great prejudice against them on the part of that very large class, who, while health continues, enjoy the use of many of the luxuries as well as the necessities of life... . Another source of prejudice arose from the fact that most of the older hospitals, having been built with little regard for hygienic principles or sanitary laws, exhibited a most disastrous mortality in their statistics. A better understanding of these laws and principles has gone far to disabuse the public mind of this prejudice as it has led to the construction and care of hospital buildings which in sanitary results really far surpass the majority of private dwellings." The transition from home to hospital delivery of babies in the twentieth-century dramatically illustrates this changing perception and use of the hospital. Despite the new hospital buildings constructed at St. Luke's in the 1880s, which included forty private rooms, in 1889 only thirty-three percent of the 819 patients treated were "pay patients." The rest were free patients paid for by private charitable contributions. Twenty years later this figure had reversed itself; in 1909 when 6,596 patients were treated at St. Luke's Hospital nearly two-thirds of both the patients treated and the days of treatment provided went to pay patients. The statistics suggest what the twentieth-century buildings reflect; first, hospitals were no longer the medical facility of last resort, and, second, larger numbers of patients were being treated. These changes both at St. Luke's and across the United States led to the construction of entirely different, modern, hospital complexes.
The 1880s St. Luke's Hospital buildings provided some private rooms, but not nearly enough to keep pace with changing medical and public attitudes about hospitalization and Chicago's rapidly expanding population. In the early 1900s patients paid for beds both in the Hospital's large open wards and in private and semi-private rooms. Private nursing care cost between $15 and $25 per week. In the early 1900s the growing demand for more private accommodations led the Hospital to seek money for additional hospital buildings. As part of the Hospital's plans the analogy to hotel construction frequently arose. In 1904 the Annual Report stated, "The demand for better hospital conditions is becoming more and more urgently apparent. The best accommodations are in the greatest demand. . . . Everyone who can at all afford it will gladly pay for greater privacy, and the tendency of the demand is strongly for smaller wards and better private rooms. Hospital management in certain branches is conducting a hotel for the sick .... It is reasonable that a public, accustomed to a high class of accommodations when they are in good health, should expect and be willing to pay for at least as good conditions when they are ill. Hospital buildings have not improved, during the period mentioned, in the same degree as hotels. This is plainly true of Chicago." The emphasis on privacy, higher standards of accommodation, and the attention to architectural models, like the hotel, represented a new direction in hospital design, one in which the St. Luke's Hospital assumed a leading role.
The George Smith Memorial Building is the oldest extant hospital building in the St. Luke's complex. In 1906 James Henry Smith gave St. Luke's cash and land worth over $500,000 for the construction of a building intended exclusively for the treatment of private patients. The building was a memorial to Smith's cousin, George, an early resident and businessman in Chicago. The architectural firm of Frost & Granger designed the six-story U-shaped building in 1906. The building with a frontage of 140 feet on Michigan Avenue and a depth of 161 feet provided private rooms for 125 patients and opened in October 1908. The building is Chicago's earliest hospital building entirely devoted to private room accommodations.
Charles S. Frost worked closely with Louis R. Curtis, the Hospital Superintendent, and designed a building very close to the small luxury hotel model the Hospital had sought. Frost, an M.I.T. trained architect, had been a partner in the firm of Cobb & Frost from 1882-1898. With Henry Ives Cobb he had designed the Union and Calumet Clubs, the Newberry Library, the O1d Chicago Historical Society Building and several early buildings for the University of Chicago campus. Frost later designed the La Salle Street and Northwestern stations, the Northern Trust Building, the Durand Memorial Hospital for Infectious Disease, the Borland Building, and the office building for the Chicago & Northwestern Railroad Company. One person observed of the Smith Building, "Perhaps the most noticeable feature is the lack of what might be termed the hospital atmosphere. The building has the appearance of a quiet modern hotel."
A 1908 description of the Smith Memorial Building records its innovative departure from existing hospital design: "Today it stands as a radical departure from all accepted forms. Precedent has had little influence, except as a danger signal from which to turn in the construction of . . . the new building . . . the aspect is that of a luxurious modern apartment hotel. Pass the-portal and you find yourself in a spacious, cheerful hotel-like lobby with . . . a handsome large marble fireplace, massive marble pillars and a mosaic floor . . . the rooms are such as you will find in the homes of well-to-do people." The private rooms could be occupied separately or combined as suites for patients who wished to be attended by friends, relatives, or personal servants during their hospitalization. A large number of private bathrooms connected with the rooms. The corridors were lined with marble and mosaic, special air filters and ventilators assured clean air, and double hung windows protected against noise and dirt. Operating rooms on the north side of the sixth floor took advantage of the natural lighting available from large windows and skylights. In 1912 the Helen L. Carter Solarium was constructed on the roof of the Smith Building.
The Smith Building responded in an innovative manner to the problems and possibilities of its urban, streetscape, context. Part of the Michigan Avenue site was donated to the Hospital in 1881 by St. Luke's trustee, N. K. Fairbanks, who lived three blocks south in a Michigan Avenue mansion. From its early acquisition the Hospital planned to build a building here which would serve as the "principal front" of the hospital and became "an ornament to that fine street." Despite the growing commercialization of Michigan Avenue in the early twentieth-century, the Hospital still constructed a building appealing to the tastes of the residents of the earlier wealthy residential section. Nevertheless, the Hospital's attempts to stay in close proximity to a burgeoning downtown, for the convenience of doctors, patients and visitors and to serve in medical emergencies, caused some design problems. The traditional imagery of a quiet, sanctuary-like, place for physical restoration seemed challenged by the bustle and commerce at the doorstep. The Smith Building design met these problems by orienting nearly all patient rooms toward the building's courtyard. By turning inward the building attempted to escape the noise, dirt, dust, and smoke of the surrounding neighborhood. The plan insured that as other buildings were constructed adjacent to the Smith Memorial only auxiliary rooms and offices would be deprived of light. The response to the street was in many ways similar to that found in Richardson's Glessner House constructed twenty years earlier, a few blocks south of the St. Luke's Hospital. In 1909 the Hospital Annual Report concluded that the Smith Building "overcame, in large measure, all the objections such as noise and smoke incident to a location near the center of the city. The building has been the subject of much favorable comment, not only in this country, but abroad." Some interior partitions have been removed, some added, yet the Smith Memorial Building retains its historical character and integrity.
In the context of the "charity" hospital, many viewed the Smith Memorial design as extravagant. The Hospital trustees countered this view by maintaining that the Building and its wealthy patients provided a substantial endowment for the charity work of the Hospital. The Smith Building did provide support for the Hospital's charity wards and also established a standard of patient care, privacy, and amenity toward which the entire Hospital soon aspired. In 1910 the trustees declared the necessity of replacing the 1880s Indiana Avenue buildings with larger buildings permitting greater bed space and increased segregation of patients both by class and according to a more vigorous medical specialization of wards. In 1912 the trustees declared the need for more open wards and also recognized the needs of a new class of middle-income patients: "There is . .. an insistent demand for accommodations which may be best described as one grade above the open wards. Space divided into very small single rooms and others to accommodate two or three patients conducted on a parity with the open wards except as to privacy and visiting privileges is needed to meet the wants of the class who are ill fitted for the open wards, but are unable to pay the usual private room rates. No hospital in the city meets this demand."
The only other hospital in Chicago to construct a separate building for private patient care during the early 1900s was Presbyterian Hospital. The Private Pavilion at Presbyterian Hospital emerged under the same circumstances as the Smith Building did at St. Luke's. In November, 1908 Presbyterian Hospital opened its new brick, six-story Private Pavilion to serve well-to-do patients in private rooms. The building was expanded in 1916, and more recently, the sixth floor sun parlor and surgical section were substantially altered and a seventh floor has been added. In comparing the two buildings there is no question that the Smith Building is a finer design which is more significant in its use of luxurious models, and retains greater integrity. The only other extant private patient building in Chicago in the mode of the Smith Building is Meyer House of Michael Reese Hospital designed by Schmidt, Garden, & Erickson two decades after the design for the Smith Building.
Surprisingly, the St. Luke's Smith Building is one of only a handful of hospital buildings surviving in Chicago from the late nineteenth and early twentieth centuries. The main tendency of Chicago hospital development has been the demolition of older hospital buildings in the search for land to build new hospital buildings. The St. Luke's complex is unusual in retaining an intact early structure, which represented a departure in hospital design, and is still surrounded by buildings which complement it in scale rather than overshadowing it.
When the Smith Building opened in 1908 its 125 bed capacity exceeded the size of every private hospital in the State outside of Chicago. The medical centers of Chicago thus appear to form an architectural group of their own. The Smith Building is significant in the history of Chicago Hospital Development and probably precedent setting in the state.
The three-story brick Kirkwood Building, completed in 1916 between the Smith Memorial and the Indiana Avenue buildings, was constructed to provide "a continuity of service" between the anticipated destruction of the old hospital buildings and the construction of a new building. The first floor served as a central hospital laundry.
World War I stalled the St. Luke's Building Fund drive and at the same time pointed out the difficulties and costliness of operating a nineteenth-century hospital building under prevailing, twentieth-century, theories of hospital management and nursing care. In 1919 the new building was viewed as the Hospital's "most pressing need." The Hospital trustees worried that the lack of a new building would threaten the "prestige and position" of the Hospital and its standing among Chicago's "three best hospitals." The rising standards of patient care and demands for further classification of patients lay behind the plans for a new building. In 1920 the trustees declared "without question greater comfort and better service could be rendered ward patients in small, sanitary wards, instead of large, antiquated ones now in use. Again there is a continued demand for lower priced rooms and small wards for the men and women in moderate circumstances who refuse to enter the Hospital as free patients and yet cannot afford to pay the excessive prices necessary to maintain the present private rooms." The trend toward smaller wards, greater privacy, and more efficient plan and operation, introduced in the Smith Memorial, served as a model for St. Luke's later buildings and characterized modern hospital development in general.
In the twentieth-century as modern hospitals came to serve larger numbers of patients with greater numbers of beds, economy and efficiency of operation, tempered by- patient and medical needs, became leading considerations in hospital design. In 1909 just after the completion of the Smith Memorial St. Luke's treated 4,620 patients who stayed in the hospital a total of 71,966 days. In 1923 just prior to the construction of a new Main Hospital building the patient census had risen to 10,014, accounting for 112,040 hospital days. Confronted with this rising scale of hospital operations, hospital administrators and architects paid increasingly close attention to hospital plan and layout. In 1927 Edward F. Stevens, a leading hospital architect, declared, "The well-functioning hospital must be planned from the stand-point of efficiency in management and comfort of patients, and should be an architectural design at once pleasing and practical." The chief objects to be obtained in modern hospital design were "first-- efficiency; second--economy in construction; third--economy in maintenance; fourth--absolutely fireproof hospitals." Increased attention paid to efficiency and economy combined with new sanitary theories and hygienic practice to give the modern hospital a higher density form. The modern, high-density, hospital building of the twentieth-century increasingly eclipsed the sprawling nineteenth-century hospital plan which placed separate wards in widely separated pavilion buildings connected by a central corridor system, a form which proved to require greater labor and supervision to operate.
When St. Luke's Hospital vacated its older 1880s hospital buildings in 1924 to make way for a new building, it literally and figuratively carried to new heights the strictures for modern, economic, efficient and high density hospital design. The Hospital replaced its five old separate, pavilion, buildings with a single nineteen-story building. Upon its completion in 1925 the building was the tallest hospital building in the United States. With the exception of the inclusion of some larger wards that are familiar today, the 1925 Main St. Luke's Hospital Building captured and codified nearly all of the design trends underlying the modern hospital of today. In 1916, announcing early plans for the building the trustees stated, "The new building will be operated on the most economical lines and its up-keep will be cared for through the lowered cost of administration and the increased income of the part-pay wards. The key-note of our thinking today is efficiency." Even prior to the construction of the Main Building St. Luke's administrators had inaugurated an "Efficiency Committee" to monitor closely the cost and care of patients.
As in the Smith Memorial Building the Main Building design resulted from the close collaboration of the architect Charles S. Frost and the Hospital Superintendent, Louis R. Curtis. The steel, reinforced concrete building with a stone and brick exterior, has a 200 foot frontage on Indiana Avenue; the north two-thirds of the building is 58 feet in width, the south third is 35 feet in width. The most striking and significant aspect of the Main Building is the unusual application of the skyscraper form to hospital design, a plan which originated from the new emphasis on-economy and efficiency. In 1926 the trustees succinctly outlined the considerations underlying their design: "The tall structure was selected after very careful consideration, for the following reasons; the high cost of land; lower construction cost; economy in operation." Without adding any land to the hospital site the Hospital's bed capacity increased from 400 to 600 with room to expand to nearly 800 beds. This increased capacity was achieved at the same time that patients were afforded more space and privacy. The hospital promoted efficiency by incorporating many of the mechanical systems which had led to the popularity and development of high-rise office and hotel structures. Elevators, dumb-waiters, pneumatic tubes, linen chutes, mail chutes, telephone systems, in-building libraries, kitchens, all expedited hospital operation and made the skyscraper form adaptable for hospital use.
The functions of the hospital were segregated by floor. A physiotherapy room occupied the basement along with supply department, records room, and receiving wards. The hospital offices, emergency, out-patient, and social work services were located on the first floor. The St. Luke's Hospital School of Nursing occupied the second floor and the third through fifth floors served as nurses residences which were designed to be converted to patient rooms as the hospital expanded. The sixth and seventh floors were devoted to the small private and semi-private rooms, accommodating sixty-four patients of "modest means" which the hospital had sought since shortly after the completion of the Smith Memorial Building. The eighth, ninth and tenth floors were devoted to specialize children's wards, and the eleventh through seventeenth floors housed general medical and surgical wards. Research laboratories were located on the eighteenth floor; x-ray and operating rooms were on the nineteenth floor. The north end of the building included a twentieth story with an amphitheatre for the main surgical unit and a machine room. On the ward floors, instead of the older very large wards, rooms accommodated variously one, two, four, five, or fifteen patients. Bed assignments were now made according to medical need of the patient rather than ability to pay. Thus while nearly twenty-five percent of the patients were still in the free charity category, they received the same treatment and space as paying patients, a modern conception of hospital administration. The enameled white interior of many of the wards placed a higher degree of emphasis on sanitary facilities than the home-like rooms in the Smith Memorial Building. The Main Building cost approximately $2,300,000 to build.
In many ways the Main Building represented as much of an innovation in its orientation to its immediate urban context as the Smith Building had earlier; however, rather than turning inward the new Main Building turned upward and eastward.
Incorporating arguments made earlier in favor of commercial skyscrapers, the trustees argued that the skyscraper hospital promised to deliver patients located on the upper floors from the noise, dust, and dirty air of the streets and urban neighborhood surrounding the Hospital. The sixth floor was the lowest floor occupied by patients when the building first opened which guaranteed a degree of separation from the street. More importantly, the design took advantage of major urban improvement projects in the vicinity, to the east. The long narrow form of the Main Building provided the greatest number of windows facing east that were possible on the Hospital site. Earlier these windows would have faced out over the sheds, buildings, noise, smoke, and dirt of the Illinois Central Railroad; however, by the time the building was built the anticipated electrification of the railroad promised a cleaner, less noisy district. The plans for Indiana Avenue also called for its widening and improvement, changing the street from a "back street" into a main avenue. Of central importance in determining the final design for the hospital was the anticipated improvements along the Outer Lake Shore Drive directly east of the Hospital. The Main Hospital Building at St. Luke's Hospital rose to nineteen stories, taking advantage of the anticipated views of the Lake Michigan Shore improvements, in particular the Soldier Field Stadium and the Field Museum of Natural History.
In the years following the completion of the Hospital the Shedd Aquarium and the Adler Planetarium were added to this grand architectural ensemble. Reviewing the Hospital plan one critic observed, "Nothing will interrupt the inspiring view of the broad stretches of Lake Michigan over these classical structures."
No other building in Chicago enjoyed a grander view of these Chicago Plan improvements. The interior layout of the Hospital also took advantage of the view to the east. All rooms for patients faced east; the toilets, kitchens, cafeterias, nursing stations, elevators, utility rooms, storage rooms all used the space on the west side of the building. Faced with the problem of building a modern hospital on a difficult central-city site, the Main Building designers responded by removing patients as far as possible from the ground-level and by framing a dramatic birds-eye view of natural scenery and classical architecture.
Irony characterizes the twentieth-century relationship between Grace Episcopal Church and the St. Luke's Hospital. The Hospital originated as one of the many charitable activities of the church. In the 1920s this relationship reversed itself as the Hospital trustees merged with the Church Vestry in an attempt to sustain, support and give life to the parish. In 1913 William Otis Harris described the conditions he found in the parish and surrounding the Church when he assumed its rectorship in 1902: "Once standing on a beautiful residence avenue, surrounded by the comfortable homes of prosperous families, its neighborhood had completely changed to a district of cheap boarding houses, lodging and tenements, with all their accompanying misery, squalor, vice and wretchedness. Its parishioners had fled... . Its losses by death or removal of those who had been its pi}lars and chief supporters were heavy. Business was rapidly forcing its way in." The Hospital shared these neighborhood changes since its site was only one block east of the Church. The Church increasingly served as an institutional focus for its tenement neighborhood and attempted to serve as a parish for downtown businessmen and visitors, an endowment raised from older wealthy parishioners permitted such a redefinition of the Church's role. When a 1915 fire destroyed the Church building and delays plagued the efforts to rebuild the structure the congregation and church mission shrank further. Increasingly the Church defined its mission as ministering to the sick at St. Luke's Hospital. In the early 1920s it actually took over the Hospital chapel as its main place of worship.
As St. Luke's expanded in the twentieth-century the hopes of successive Hospital chaplains was for the construction of a chapel "to comport in dignity with the Smith Memorial and proposed new buildings." As plans for reconstruction of the old Grace Church Building faded, plans developed to construct the parish's main Church on a site adjacent to the Hospital, to serve Hospital needs. In 1923 David Evans, a member of the Church Vestry, wrote to Edward L. Ryerson, a Hospital trustee, "By combining the work of the two institutions, therefore, St. Luke's would be enabled to concentrate on the operation of a large modern hospital, while Grace Church would find employment for its funds and its energies, as planned by present and former members of its parish. Working together they would cure, not alone the bodily ills, but quicken the spiritual life of the community."
In 1926 with the Church Vestry dominated by key figures in St. Luke's Hospital, Charles H. Schweppe, Edward L. Ryerson, Louis R. Curtis and Frank Hibbard, plans were finally undertaken for construction of a new Church building just south of the Main Hospital building on Indiana Avenue. Earlier buildings for the Grace Episcopal parish were designed by distinguished architects. William Le Baron Jenney designed the 1875 church building. A 1906 Church chapel was designed by Cram, Goodhue and Ferguson who also designed a new building for the old site after the 1915 fire, which was never built. In 1926 Edward L. Ryerson asked Thomas Eddy, Tallmadge, a leading Chicago architect, to design the new Grace Episcopal Church.
Tallmadge was educated at M.I.T. and after his graduation in 1898 worked for Daniel H. Burnham & Company until 1905 when he organized a firm, Tallmadge & Watson, with Vernon S. Watson. Among the firm's best known church designs are Chicago's First Presbyterian, Elgin's First Methodist, the Union Church in Hinsdale, the Grace Lutheran in River Forest, and the First Methodist Episcopal, First Baptist and First Congregational Churches in Evanston.
Supplementing the funds for the Church available from the insurance on the old building, Edward L. Ryerson contributed $25,000 to the building fund and took an active part in its design. A member of the Vestry reported to a contributor: "It was Mr. Ryerson's idea, and concurred in by all the rest of the Vestry, that as much as Grace Church will be devoted principally to institutional work in connection with the Hospital, . . . the note of simplicity should be observed throughout. I do not mean by this that the interior should be so plain as to create a feeling of coldness or austerity but plain in a way which will reflect the very finest taste and dignity. All the materials and designs so far have been of the very best, but we have had to fight with the architects to avoid over-ornamentation [of the interior]." The Vestry felt their design adhered to the best trends in modern ecclesiastical style. The building was compared favorably with Bertram Goodhue's design for Rockefeller Chapel at the University of Chicago which was "large and handsome," with a "beautiful interior," and yet was "simplicity itself," and considered "by far the finest ecclesiastical structure in the city."
Aside from participating in a modern evaluation of ecclesiastical architecture, the Church Vestry and Bishop Charles P. Anderson envisioned the new Church building as taking an important stand in the center of the Lakefront improvements. Most importantly the Church structure evoked the religious and charitable origins of the St. Luke's Hospital. The Church's cornerstone was laid on April 29, 1928 and the building was dedicated May 5, 1929.
In 1940, echoing plans conceived in the 1920s and delayed by the Depression, Charles H. Schweppe, President of the St. Luke's Board of Trustees, declared, "One of the greatest immediate needs in St. Luke's proposed long-range building program is an enlarged School of Nursing, of which the most urgently needed unit is a new Nurses' Residence . . . provid[ing] housing, educational and recreational accommodations for our students and graduate nurses. Upon its completion, two floors of Main Building now housing students would be available 98 much needed additional ward space to accommodate patients unable to pay more. Schweppe did not live to see his plan realized; however, his proposal and his long philanthropic association with the Hospital was memorialized when Charles and Laura Schweppe Memorial Nurses Home was dedicated May 21, 1943.
The Schweppe Building, with the Morton Clinic Building, complete the medical center character of St. Luke's Hospitals. They are comparable with each other, providing closure to the complex by placing a white stone classically pedimented entry at its northern and southern ends.
St. Luke's merged with Presbyterian Hospital to form Presbyterian-St. Luke's Hospital in 1956. Their nursing schools also united to create the Presbyterian-St. Luke's Hospital School of Nursing.
Rush Medical College was affiliated with the University of Chicago from 1898 to 1941. Following the end of this affiliation, Rush Medical College closed its doors in 1942 for the next 27 years.
In 1969, Rush Medical College reactivated its charter and merged with Presbyterian-St. Luke's Hospital to form Rush-Presbyterian-St. Luke's Medical Center.
The St. Luke's Hospital Complex was abandoned sometime in the 1970s and moved to the modern Rush hospital complex.