Introduction
The history of
Tulane University School of Medicine’s involvement with
Charity Hospital is long and storied. Tulane, originally founded
as the Medical College of Louisiana in 1834, has long played
a role in both caring for the poor and shaping the future
of the hospital.
In reading the
history of both, two themes emerge. First, Charity has been
destroyed or on the brink of closing many times before, due
to both natural disasters and political neglect. Hurricane
Katrina may simply be the latest incarnation of a recurring
theme in New Orleans—that of destruction and rebirth.
Second, what captivates people about Charity is not so much
the building itself, which is already the sixth building to
carry that name, but rather what Charity stands for. The ideals
of humanism and caring for the most vulnerable in our society
has long been a driving force in both medicine as a whole
and Tulane University School of Medicine specifically. How
these laudable goals emerge in the changing political and
economic landscape of the twenty-first century is a story
that is still unfolding.
The Early Years:
French Colonialism
In 1699, France established
its first permanent colony in the Gulf Coast. Based first
in Mobile, the colony sought to exploit the area around the
Mississippi River for trade and natural resources. In 1718,
Bienville founded the city of New Orleans on a small crescent-shaped
area of land in a bend of the Mississippi, in order to better
take advantage of trading with the area the mighty river traversed.
Health of the nascent
city soon became a primary concern. Early on Bienville noted
“the inclemency of the air” surrounding New Orleans,
and soon colonists were dying of tropical diseases such as
malaria and yellow fever. In 1731, the private company that
had been granted rights to the resources of the city failed.
Bienville, the city’s founder, was blamed for the company’s
financial failure and returned to France disgraced. The colony
returned to control of the French king.
The first record of any medical facility in the city comes
in 1722, with the founding a small military hospital known
as the Royal Hospital, located on Ursuline Street in what
is now the French Quarter. Early medicine was ill-prepared
to face the realities of living in a tropical climate: infectious
diseases and nutritional deficiencies were rampant. In 1726,
some much needed relief arrived in the city, with the arrival
of Ursuline nuns and the founding of a convent. They also
contracted to run the hospital and provide care. The nuns
were dissatisfied with running a hospital and convent in the
same small building, and continually pressed the colonial
government to build a larger hospital. In perhaps an example
of foreshadowing, in August 1732 a fierce hurricane struck
the city and completely destroyed the existing Royal Hospital.
A new hospital was built and completed in 1734.
In spite of poor conditions
and limited medical knowledge, Royal Hospital still provided
better care than that received by the city’s poor and
indigent. By decree, Royal Hospital could only care for French
military personnel and those in the King’s service.
Appalled by the plight of the poor in trying to obtain care,
a well-off shipbuilder named Jean Louis bequeathed his estate
to the founding of a Charity Hospital for the poor. He died
in January 1736, and on May 10, 1736, the first Charity Hospital
opened its doors in a house at Chartres and Bienville Streets.
Charity Hospital has taken
the form of many buildings in different locations. The second
hospital, built in 1743, and the third, in 1785, were located
near a ship-turn basin at the edge of the French Quarter.
At that time, boats entering the port of New Orleans did not
sail up the Mississippi; rather, they came through an inlet
from the Mississippi sound to Lake Pontchartrain, sailed down
Bayou St. John and the now-defunct Carondelet Canal to a large
basin where the ships could turn around and proceed back to
the lake after discharging passengers and cargo. The location
of this ship-turn basin is the present-day Basin Street. The
fourth building, built in 1815, was on Canal Street at the
present location of the Fairmont Hotel. The fifth, built in
1832, and the sixth and current hospital, built in 1939, were
located in the same location on Tulane Avenue.
In 1763, at the conclusion
of the Seven Years’ War, Spain took control of New Orleans
and all of Louisiana west of the Mississippi. Spanish control
resulted in few changes for the French inhabitants, who naturally
felt tension towards their new government. In 1779, Charity
Hospital was again reduced to rubble by a hurricane, resulting
in much suffering among the poor of the city. However the
Cabildo, or Spanish town council, took no steps to rebuild
the hospital. Only in 1782, after a full three years with
minimal care for the poor in the city, did a wealthy Spanish
patron named Almonester donate a then-fortune of 114,000 pesos
for the construction of a new Charity Hospital. Almonester
also set in motion plans to have a hospital generate some
form of revenue, as up until this point it had relied entirely
on donations. Plans included a cattle ranch, a lime factory,
a brick factory, and slaves he donated to the hospital, including
a mulatto named Domingo who was learned in surgery and given
authority to “exercise the function of head of the surgery
ward.”
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