It's April, 1892. At a meeting of the King's Daughters, Mrs. David Flenniken moves that the organization "undertake the building of a hospital in Columbia." Around the table there is little enthusiasm for the suggestion. In fact, the presiding officer, Miss Isabel Martin, looked at Mrs. Flenniken as if she were crazy. At the time, the treasury contained $6, maybe $12.
But the idea persisted.
In May, the Columbia Hospital Association was organized. Throughout the summer, the association worked to secure funds for the first general hospital in central South Carolina.
On Sept. 17, 1892, a charter was issued to Columbia Hospital. At that time, Columbia was a city of 15,000.
Columbia Hospital originated in the city almshouse which provided medical attention to the poor. The city of Columbia assisted by leasing the land to the hospital for 99 years, and agreeing to provide $1,000 per year for five years.
By 1893, the first brick building had been built on land described as "near the electric railway, the view beautiful, forest trees standing and fine residences near. Nowhere can better well water be found, without surroundings to endanger it."
The first patient was admitted to the new hospital on Nov. 2, 1893, and the first operation was performed soon after by Dr. B. W. Taylor.
For many years, physicians were required to provide all of their own surgical supplies. Rooms were furnished by various individuals and organizations. The founders of the Hospital Association worked hard to raise funds to build and operate the hospital, including the grandmothers of Dr. Foster Marshall, and Dr. Victor Murdaugh, who currently practice medicine at Richland Memorial. The ladies sought donations to the hospital as well as raising money from hot suppers and entertainment.
The opera "The Mikado", performed by "home talent," raised $321.90. They also increased their membership to 137 and charged 50 cents in annual dues. For many years, Columbia churches donated funds on an annual basis on Hospital Day. In the early days, it was hard to get patients to agree to be admitted to the hospital.
Until this time, most people were cared for in their homes.
Hospital care was a new idea, except to the poor who could not afford to be cared for at home. People had no idea what might happen to them if they entered the hospital. A newspaper article written by Dr. R. W. Gibbes, soon after the hospital opened, convinced people that the hospital offered improved care with lower risks.
Physicians were also beginning to think that it was too dangerous to operate on patients in their homes. After all, at times, the best operating table to be found was a door taken off its hinges. A hospital lighting committee was formed to try and get electricity installed, but were unable to get the Electric Company to give a cost estimate.
The Gas Company, more responsive and offering better terms, got the job.
It was announced that "for certain reasons gas is preferable in a hospital to electricity." However, after a nurse's cap caught fire in a gas jet, Dr. Taylor requested and got electric lights for the operating room. In the beginning, only those doctors who were staff members could practice medicine in the hospital.
Other doctors in the community who had patients that needed to be admitted to the hospital were required to refer them to staff physicians. After much wrangling, all Columbia doctors, in good standing, were given permission to practice in Columbia Hospital. The Columbia Hospital Training School for Nurses was started in 1897.
Nursing duties were extensive. Not only did they provide medical care for their patients, but they also made out bills, ordered supplies and cooked for their patients. The 1903 annual report of the Columbia Hospital Association states that "there is much to contend with in trying to provide food for a transient and sick public. Families send dainties which the nurses have to cook and serve." Prospective student nurses were required to arrive in Columbia with enough money to pay their way home, in case they were not accepted.
In addition, they needed to bring sewing and mending materials, writing materials, a match safe (wooden matches were stored in small metal containers and carried in a pocket), measuring tape, 10 aprons, a pen knife, four linen collars and one table napkin ring. A full uniform was a blue gingham dress, linen collar, cambric cuffs, white apron and a linen cap.
Nurses were first housed in the hospital, but when more space was needed it was found to be less expensive to rent rooms for them in neighborhood homes. This had the additional advantage of allowing the nurses to enjoy an uninterrupted night of sleep.
The first separate building to house nurses opened in 1907 and was partially built of wood taken from the old almshouse. Nurses had good reasons for needing a restful night of sleep. In the winter, there was a problem keeping patients warm because blankets frequently disappeared.
They often used their own coats to make the patients more comfortable or went down to the boiler room "to awaken some fireman who had poured spirits down to keep spirits up," in an effort to get more heat. Unfortunately, when the heat was turned up, the radiators made so much noise they awakened the patients who, in turn, called for service from the nurses. Nurses also had to carry deceased patients, on a litter, to a small out-building where they would be picked up by a local undertaker.
The hospital rules stated that "free beds are reserved for the sick poor of Columbia, indigent accident cases, and emergency cases of the city. To other needy patients, a rate of $5-7 per week is charged." Rates in private rooms, depending on location, ranged from $10-15 a week, payable in advance. Extra fees were charged for laundry, a massage, liquor, medical and surgical expenses or a private nurse.
The hospital was thriving and continually growing. In 1910, it expanded to 115 beds when the roof of the main building was raised, and a second story added as well as white columns. Two brick wings were also added.
It eventually grew to be too cumbersome for the ladies to handle. An effort to get the county to take over its administration failed. In 1909, the then 70-bed hospital was turned over to 26 doctors. Amazingly, it was debt-free and had money in the treasury. This didn't last long. In 1921, deeply in debt because the physicians were "not richly gifted in management," the hospital was turned over to Richland County.
At the turn of this century, Columbia Hospital was rapidly becoming a center for the diagnosis and treatment of disease. The hospital was still under the direction of its original founders, the King's Daughters. But as the hospital continued to grow, it soon became too cumbersome for the ladies to handle.
In 1909, the then 70-bed hospital was turned over to 26 doctors. At the time, it was debt-free and had money in the treasury. In 1910, Columbia Hospital expanded to 115 beds when the roof of the new building was raised, and a second story added, as well as white columns.
Although they soon proved to be poor business managers, the physicians who ran Columbia Hospital made major organizational improvements.
Gone were the early days of "making do," as was the case in a 1912 abdominal operation that took place in the patient's home. In that instance, the physician was accompanied by a surgical nurse and anesthetist. Lightwood knots were used for lights, and catheters were boiled in tomato cans in front of an open fire. The nurse, who remained behind after the surgery, had a choice of sleeping on the bed with the patient or on the floor.
In addition to more surgeries being performed in the hospital under more controlled conditions, individual departments within the hospital became more organized and began offering more scientific and professional care to their patients. A rotating hospital staff was in place, with each physician becoming familiar with all of the patients and their needs. As a result, "no patients was allowed to languish, forgotten, in the hospital."
Physicians put in long days. In addition to caring for patients, they gave their time to teach nurses as well as provide them with free medical and surgical care. During this time, the hospital continued to expand to meet the growing demands of the community. The first resident physician, Dr. T. K. Fairey, was employed in 1920.
In 1921 control of the hospital was turned over to the Richland County delegation. The county administered the hospital through a board of trustees whose members it selected for approval and appointment by the governor of the state. This method of governance remains in place today. The hospital's continued growth was financed through taxes and and a $300,000 bond issue that was used to retire indebtedness, provide maintenance and meet the need for new buildings. Also in 1921, the public donated $65,000 toward the cost of building the William Weston Home for Nurses. Dr. Weston is one of the oldest Columbia Hospital physicians living today, and his son and grandson currently practice medicine at Richland Memorial.
1924 brought the first intern physicians to the hospital, and this, combined with improvements in the nursing school, changed the character of the hospital's service. Full-time, trained instructors were used in the nursing school, and nursing supervisors were assigned to the floors. Nurses were no longer required to work as many hours each day, and clinics were established to meet the growing medical needs of the poor.
The hospital's influence was felt throughout the state. In the early years, physicians frequently traveled to Anderson and other northwestern communities to tend to the sick. With the assistance of Columbia Hospital's nurses and physicians, the Anderson Hospital opened in 1908. Miss Jean Kay, directress of Columbia Hospital in 1907, moved to the new hospital as did Miss Mary Stelling, a Columbia Hospital nursing graduate, who became Anderson's first directress of nurses. In addition, Columbia Hospital was influential in the establishment of the South Carolina State Nurses Association.
By 1933 the hospital had expanded to 275 beds, and clinics were open every weekday. In 1934, 5,060 patients were admitted with about half of them receiving free care. At this time, hospital beds cost between $2 and $4 a day for wards and semiprivate rooms, and $3 to $8 per day for private rooms. A writer for The State, upon reviewing these rates, recommended that rooms costing $4 or more should not be charged extra for an electric fan, and that no more than $3 should be charged for lab fees. It was also recommended that not more than $1.50 be charged for the board of special nurses.
Other changes were being made in 1934 as well. On January 10, the first black patient was admitted to Columbia Hospital's 75-bed West Wing--a separate brick building that faced Hampton street. Prior to this time, black patients were cared for in both Good Samaritan Hospital and Waverly Hospital, which later merged and, eventually, closed. Black nurses staffed and trained in the West Wing, which was the most modern of the hospital's facilities. Nine years later, in 1943, a new, 165-bed Black unit was built on Harden Street at a cost of $330,000.
About this same time, the oldest section of hospital, known as the East Wing, changed as well. Gone were the charming verandas and open fireplaces. Operating rooms were moved to the interior of the building. Self-operating elevators were installed, and the tall white columns that graced the front of the building removed. The first patient to be admitted to the renovated wing was Mrs. D. R. Flenniken, the King's Daughter who was instrumental in founding the hospital.
As the storm clouds of World War II gathered over Europe, Columbia Hospital again prepared for change. As it had during the Spanish-American War, the hospital made preparation to care for the sick and wounded. In 1943, the hospital was designated as an official casualty station.
Columbia Hospital had a history of adapting to change by the outbreak of World War II. The hospital had been through three methods of administration while expanding to meet the needs of the community and striving to keep pace with the latest technology.
Through the 1920s and 30s, with the exception of the Depression years, there was a greater demand for nurses than ever before. By the time World War II broke out, it was harder to find enough nurses to meet that demand. In 1943, the hospital participated in the Cadet Nurses Program. This program, used to recruit nurses, offered federal scholarships to cover all student expenses. As an additional attraction, uniforms were designed by well known popular designers. The program was advertised nationally and locally and used the slogan "The Proud Career." Until its end in 1945, all student nurses at Columbia Hospital came under the Cadet Program. Many other nurses and physicians from Columbia either served in the military or provided care for returning soldiers.
The 1940s brought a period of great growth in both hospital facilities and services.
In 1941, plans were made for the construction of units to meet the specific needs of children. This was not a new idea. In the hospital's 1905 annual report it was written that "we hope soon to have a children's ward." The first space set aside specifically for the purpose of treating children came about in 1910, when Dr. William Weston Sr. became the first physician in the state to limit his practice to pediatrics. However, it wasn't until 1941 that plans were made for the construction of units to meet the specific needs of children. Nurses were urged to take post graduate courses in pediatric nursing in order to offer the very best care. In 1943 a new pediatric department for black patients opened its doors. When a new white pediatric department opened in 1944, the superintendent of the hospital, J. B. K. DeLoach, asked the charge nurse, "What in the world are you going to do with all of this space?" Less than nine months later additional space had to be added. Then, as now, children with special needs came from throughout South Carolina to be treated at the hospital.
Columbia Hospital had offered medical clinics since 1923. However, by 1942 the clinics, crowded from the day they first opened, had to expand as well. A rheumatic fever clinic was added in 1947. In that year, the clinics of Columbia Hospital served 17,835 patients. In addition to treating those who were ill, the clinic staff worked hard to educate patients on the prevention of disease.
Other departments in the hospital made major changes over the years as well. One of the most dramatic changes took place in the laboratory. The first laboratory in the hospital was started in 1907 by Dr. Asbury Coward. Dr. Coward, who felt it was important to run some routine tests before a patient underwent surgery, furnished the lab at his own expense. It was set up in a bathroom, and one person observed that with the bathtub removed and the floor tiled "it served its purpose nicely." By the end of the 1940s, the lab had made several moves, been divided into specialized departments, and was running over 88,000 tests a year.
Among the construction projects during this time was a chapel built at the request of the King's Daughters, founders of the hospital. They felt a chapel would be a proper memorial to commemorate their involvement with the hospital and promised to furnish it. During the chapel dedication the hospital's superintendent noted that both spiritual and physical healing were closely related "in relieving the suffering of humanity."
Columbia Hospital had come a long way in spite of some financial problems. The expansions and modernization of the hospital, as well as treating patients who did not have the ability pay, did not come easily. But progress was necessary. In spite of the tight cash flow, the 1947 audit showed assets of the hospital were valued at $1,519,199,32.
The next year, 1948, brought the enactment of a licensing law for South Carolina hospitals. The law generally addressed the physical conditions of hospitals, especially the issue of fire safety. A bond issue was approved in the amount of $1.5 million, and the renovations and improvements to existing buildings began anew. A new nurses home was also built for white students and an addition made to the home for black students. At the completion of this project, the original nurses' home, William Weston Hall, built in 1921 and 1922, was condemned for housing of students. Newer parts of the Hall were renovated for classroom space. The ever increasing patient load made additions and improvements to the laundry necessary as well. During this time the hospital converted its heating system from coal to natural gas.
In 1958, the hospital could boast that its newly completed wing on Hampton Street (built between two existing wings) was completely airconditioned and was the first in the Midlands to have electrically operated patient beds. Until this time, not even operating rooms were airconditioned on a year-round basis.
Although new additions had been made, by the early 1960s many parts of the hospital were still very old. Some elevators had been in use for 28 years. The kitchen did not have the capacity to handle the increased load of patients and staff. The emergency room needed to be expanded and modernized, and the clinics were in need of a new building.
The hospital had just about outgrown its site on Harden St. at a time when Columbia was beginning a period of rapid population growth. It was becoming increasingly difficult to find an available patient room and bed. It was not unusual to find a patient in a bed in the hall or a lounge. Plans began to be made for a new building at a new location.
It seemed that Columbia Hospital was always undergoing some form of change to meet the medical demands of the community, but by the 1960s it was meeting the social demands as well.
What had started out as one hospital had eventually evolved into two separate units for black and white patients. Civil rights legislation of the 1960s effected many institutions, not just hospitals, and Columbia Hospital quickly reassessed and changed its staffing and admissions policies to reflect that change. Columbia Hospital already had many proud "firsts" to its credit and, not surprisingly, it became the first hospital in the city to end a dual system of health care. And, in 1966, it became one of the first hospitals to admit patients under the Medicare program.
Also during this time, the health care needs of the city of Columbia were being reassessed. Due to the rapid population growth, it was recommended that Columbia Hospital begin long range planning programs on how to best meet those needs. The goal was 700-800 acute general hospital beds with necessary ancillary and service facilities.
An editorial in The Columbia Record on Nov. 2, 1964, cited the shortage of beds in the Columbia area and noted the advanced age of the buildings of Columbia Hospital. The editorial stated that there were "beds in halls, lounges, solariums and waiting rooms. Positive steps need to be taken to correct the situation. Vote yes on the hospital bond issue Tuesday."
Richland County voters approved a $6 million bond issue for the construction of a 300-bed hospital to supplement Columbia Hospital's existing facilities which would then be renovated. A 50-acre tract of land was purchased in 1965 for the new construction. However, after careful consideration of the needs of the community and the costs involved with both new construction and extensive renovations, the Board of Trustees recommended that an all new 600-bed hospital be built.
The plan met with the approval of the voters. With additional financial help from federal funds, the Duke Endowment and private business, a new hospital was completed in 1972 and renamed Richland Memorial Hospital.
The hospital's proud and excited staff opened its new doors on March 4, 1972, and Sophie Starling, R.N., greeted every patient that entered.
The move, which could have been a logistical nightmare, went smoothly. It involved hospital staff, family members, volunteers, South Carolina Electric and Gas buses and the National Guard. 163 patients were moved and more than 2,000 pieces of furniture. The move begin at 8 a.m., and, almost unbelievably, the hospital was operating by lunchtime. The first new patient was admitted the next day. Dr. Tom Austin, director of neonatology both then and now, said that everyone's role was not clear, but "everyone simply pitched in to get the job done." In 1972, the hospital had 1,400 employees.
The new hospital had about 14 acres of floor space and enough plumbing and electricity to serve a city of 15,000 people. It had a cooling capacity of 2,500 tons, considered enough to cool 1,200 average homes. The building contained 95 miles of electrical conduit, 316 miles of electric wiring, 36 miles of plumbing and 25,000 light bulbs and fluorescent tubes! The pride in this new facility probably matched the pride of the King's Daughters and the Ladies Hospital Association at the completion of their first new building in 1893.
During this decade, an Ambulatory Care Center to house the hospital's outpatient clinics, the Family Practice Center and a dental clinic, sponsored by the Medical University of South Carolina was built. A second Ambulatory Care Center followed in 1975 to accommodate full-time faculty members of the University of South Carolina School of Medicine who combine private practice with work in the Richland Memorial teaching clinics.
By 1982, Richland Memorial Hospital employed 2,500 people. It was another memorable year for the hospital that marked the opening of The Heart Center and the groundbreaking for the Ronald McDonald House which was completed in May, 1983, a few months before the opening of Children's Hospital.
Today, Palmetto Health Richland is a nationally recognized, regional community teaching hospital. It's healthcare team seeks to provide the highest quality care possible for patients and to assure the best resources and support available for physicians. Hence, the latest new facility, the Center for Cancer Treatment and Research which continues Columbia Hospital's proud tradition of "firsts", the latest being the only place in South Carolina and one of the few in the nation to perform mis-matched bone marrow transplantations.
The hospital serves as a major referral center for physicians across South Carolina as well as neighboring states and handles about 275,000 patient visits each year. It now employs 4,300 people, making it one of the largest employers in the area. Palmetto Health Richland continues to be a statewide center for prenatal diagnoses and management of high-risk pregnancies.
Columbia Hospital has come a long way from its roots in three shabby wooden buildings. On the occasion of it's 100th anniversary there is every reason to be proud. In a March 4, 1982, article in The State marking the 10th anniversary of the new building, nurse Tommie Shuler is quoted as saying, "Columbia Hospital could do anything and so can Richland Memorial." And so it continues...
— by Monya F. Havekost