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Not the Traditional Institution: CATHOLIC SISTERS IN THE HOSPITAL MARKETPLACE, 1853–1880 Many a man who differed from the Roman Church widely in dogma, had nothing but admiring consent and approval for this self-abnegating and practical Christian work of the sisters at Santa Rosa Infirmary.1 San Antonio Weekly Express, 1869 This newspaper quotation reflected the views of many non-Catholics of that era who, while suspicious of Catholicism itself, greatly admired the work and character of the sister-nurses. The statement serves as a starting point to examine the sisters’ place among their constituents as they established hospitals in the Midwest, Texas, and Utah. To explore this issue further, seven hospitals that developed before 1880 will be analyzed. Not all had the support of the local community that Santa Rosa Infirmary received. Four successful hospital ventures and three unsuccessful ones will be the focus of this chapter. The story is particularly worthy of attention because it shows the importance of an established market, physicians’ support, and public and governmental backing in the determination of a hospital’s success or failure. The 1850s through the 1870s saw an expansion of hospitals resulting from a secular pious activism, traditional stewardship, and religious and 51 3 Wall_CH3_3rd.qxd 4/11/2005 2:52 PM Page 51 ethnic responses to a growing immigrant population. Regional variations in hospital development reflected economic disparities. Particularly in the South and West, less private capital was available for private philanthropy, and this hindered the creation of voluntary hospitals.2 In some cities in the latter half of the nineteenth century, no hospitals existed to handle the burden of sickness. Sisters took advantage of this opportunity to care for the sick, and many of their institutions often were the earliest ones built. When nuns established their facilities, they had to compete with multiple types of hospitals, each dedicated to caring for patients from certain social groups. Privately supported voluntary hospitals, products of Protestant patronage and stewardship for the poor, were managed by lay trustees and funded by public subscriptions, bequests, and philanthropic donations . Because of the status and influence those hospitals could give them, physicians treated patients without charge. Public or tax-supported municipal hospitals accepted charity patients, including the aged, orphaned, sick, or debilitated. For most of the nineteenth century, only the socially marginal, poor, or isolated received care in institutions. Inside the hospitals, patients had to recognize themselves as a dependent class. Hospital personnel sought to develop in the poor patients habits of proper behavior, speech, cleanliness, and Protestantism, all of which translated into a program of moral uplift. On the other hand, when middle- or upper-class persons fell ill, their family members nursed them at home.3 Catholic hospitals were not primarily started to provide wealthy benefactors a means of patronage. While some collaborative teaching ventures between sisters and medical schools existed, a Catholic hospital’s main purpose was to heal and comfort the infirm, the sick, and the dying and to afford them the opportunity for repentance and spiritual solace. And in the wake of new threats, Catholic hospitals could not only manage unprecedented health problems of a growing population but also revitalize Catholicism itself. Functions of Catholic Hospitals Other historians have analyzed the public/private ambiguities of hospitals that were dedicated to the public welfare while eventually depending on private-paying patients and governmental funding. These institutions developed exclusionary policies based not only on social class and race but also on diagnosis, as they prohibited admissions of those with chronic or contagious disease, mental disorders, alcoholism, and venereal disease.4 52 Chapter 3 Wall_CH3_3rd.qxd 4/11/2005 2:52 PM Page 52 Catholic hospitals had some of these same elements as well. But because of their religious functions, nuns expanded the kinds of patients they admitted. Although official notices stated otherwise, many of the sisters’ general hospitals admitted patients with contagious diseases such as typhoid fever, diarrhea, syphilis, pneumonia, and tuberculosis.5 Sisters also accepted persons experiencing delirium tremens. And nuns attended some individuals for as long as they lived. While this strategy certainly enlarged a hospital’s financial base, it also allowed persons a comfortable place not only to die but also to live.This kind of service involved providing for basic needs and also for medical care. Furthermore, it was possible for a person to purchase a permanent place in the hospital. Thus, with Catholic hospitals, exclusionary claims were not so crucial, and functional boundaries appear to have...


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