The St. Louis City Hospital was founded on July 10, 1845 to serve the indigent of a cholera-infested city. Located at the head of Soulard Street, now the infamous corner of 14th Street and Lafayette Avenue, the first building was partly finished by June, 1846, when patients started to move in. Only 90 patients could be admitted at the time. This portion of the building cost $17,068.57, and the annual cost of maintenance at the time was about $18,000.00. Over the next ten years, additions were made costing the city about $40,000.00.

Despite the initial expenditures and the enthusiasm of Mayor Bernard Pratte, City Hospital did not have the money it needed to effectively address the health problems of the what was becoming one of the nation’s largest cities. The nurses were City Hall charwomen or women recommended by the policeman on the beat, and could only tend patients during the day. At night, the night watchman was left to attend the patients, give out medication, and give the babies their bottles. Only in 1847 did the city government hire Doctor David Glassock as first resident physician. He was given the handsome sum of $200.00 a year plus room and board. Nurses and bedside care did not come until the Civil War, when thousands of wounded soldiers came for medical attention.

In Thoughts About the City of St. Louis by John Hogan, the author paraphrases a report from the early 1850s: "(because of) the rapid increase in population, and the flood of emigration, it (City Hospital) has been found inadequate." Strangely, on May 15, 1856, the hospital was totally destroyed by fire. The fire broke out at 3:00 a.m. in the lecture room. All patients and staff survived, except an insane Italian, who was rescued only to run back into the blaze.

Awaiting the construction of a new hospital, patients were taken to the new United States Marine Hospital and the County Farm (basically a "poor house"). In May 1857, a new $62,000.00 hospital was completed at the old site. Large additions were made in later years so that eventually 450 patients could occupy beds there.

In 1872, plans were developed contemplating Mansard style buildings facing Lafayette Avenue, and calling for the removal of all original structures. However, only one new wing was built on vacant land to the west of the hospital. Not long after came yet another problem, the "Cyclone of '96," which wrecked all the buildings along with most of the surrounding Lafayette Square and Soulard neighborhoods. In the words of Doctor Samuel Smith Stewart, "scarce one brick was left upon another."

Patients were transferred to Emergency Hospital 1, also known as the Convent of the House of Good Shepherd, at the block bounded by 17th, 18th, Pine, and Chestnut Streets. Doctor Stewart wrote of this building, "some of the rooms had no windows at all, and were as dark and close as must have been the Black Hole of Calcutta." He also wrote that "(Emergency Hospital 1) was plentiful [sic] populated by large rats which nightly gamboled in the cubicle where we were lying." These rats even ate his medical books.

After the St. Louis Post-Dispatch released a scathing investigation of the hospital conditions in 1898, City Building Commissioner J. Harry Randall called the building a "fire trap and disease-breeder." The Post-Dispatch had sent reporter Joseph M. Adams into the hospital for 36 hours. When he emerged, "he was so ill he could scarcely write the account of his observations."

The city continued planning for a new public hospital, but did little to remedy the problems at Emergency Hospital 1. By 1901, the hospital became so overcrowded that immediate means of relief became necessary. The city purchased the Pius Hospital, at 14th and O'Fallon to be Emergency Hospital 2; communicable diseases were housed here.

A construction program began in 1898 led to the completion of the long-awaited new hospital at the old site. Moving day was August 10, 1905. At this point, the hospital had been housed in the convent for nine years. The new hospital complex consisted of a group of bay-ended buildings along Carroll Street with a planned addition facing Lafayette Avenue, which was finished in 1910. Albert Groves designed the addition, which included the landmark Administration (Main) Building and its Ward Buildings. The completion of the addition gave St. Louis a beautiful group of functional buildings in the Georgian Revival style. For once, the public hospital corresponded in appearance to the dignity of the mission of public health care. To accompany the move and to foster an efficient and clean operation, the Department of Health began a new system of management at City Hospital. This management system was used for years afterward.

Of course, at this point, "the system" was strongly segregated and City Hospital only accepted white patients; the city sent patients of color to the crude City Hospital 2 in north city, which would be replaced by the magnificent art deco buildings of Homer G. Phillips Hospital in 1937. The story of that much-loved hospital and the city’s callous abandonment of it deserves another essay.

Unfortunately, the new City Hospital wouldn’t thrive for very long. Many dedicated physicians, nurses and employees had to face low funding even after the great bond issue passage of 1923, which gave the city tens of millions of dollars. The new City Hospital became outdated within two decades of completion -- just in time for the Great Depression.

Still, starting in 1933, the city began a $5.5 million modernization project at the hospital. The Federal Works Progress Administration provided much funding for new construction and renovation at the site. The noted St. Louis public works architect Albert Osburg, who was also designing the Homer G. Phillips Hospital in north city, designed the master plan for the City Hospital renovation. Most prominent of the new buildings was the 13-story Tower building, added in 1942. The Tower replaced two of the old Carroll Street buildings. One of these buildings, the "E" Building (the 1905 buildings were lettered rather than named), became a dormitory for male interns. The Commissioner's Building, on 14th Street, was renovated and turned into the women’s' dormitory after serving a long career as the Hospital Division Headquarters Building (it was later used as this again from the 1960s until 1985). Other new buildings included the Clinic Building, the new Laundry Building and Power Plant, and the Kitchen and Services Building -- all given their respective functions more space than the older buildings had.

In fact, the hospital now had space to offer new services. For instance, the hospital’s laundry had been sent to City Hospital 2 before the Laundry Building was complete in 1937. The largest newly-developed service was the treatment of psychiatric patients. In 1939, the city opened the Psychiatric Building (later named for Malcolm Bliss) on a lot north of Carroll Street across from City Hospital. This building was a large, X-shaped building with a slightly different style than the other new buildings, which carried over Georgian Revival hallmarks -- keystones above windows, red brick, symmetry, stone courses -- from the older buildings on the site.

Building continued with the spare-looking Snodgras Laboratory of 1961, a $725,000 modern lab designed to catch up the City Hospital's outdated Pathological Department facilities, located in one of the old buildings demolished for the new lab. The modernization project appeared to be successful, even if City Hospital employees still complained about the daily operations.

Yet, in 1967, a panel of medical experts released a report stating that the hospital had conditions "which could only be described as unbelievable and terrible for modern America." Again, the city’s Department of Health attempted to modernize the complex; the buildings seemed to age fast with the overload given to them. The hospital expanded into the Ancillary Services Building, a one-story catch-all structure taking up the whole interior courtyard between the Tower and the older buildings along Fourteenth and Lafayette avenues. Included in this building was a larger emergency room than the one in the Tower.

Problems at the hospital, such as a rape in the clinic in 1984, seemed to come one after another so that the hospital’s reputation perpetually declined. The actual state of the hospital was certainly poor, but not unworkable. While inefficient, the hospital was succeeding in providing basic patient care to indigent patients for over 100 years, which is certainly not easy. Yet America was heading toward managed care even for the poor, and few public policy makers would defend the idea of health care as welfare any longer. Now, it was a "service" provided to those eligible.

The outrageous closure of Homer G. Phillips Hospital in 1979, along with gradually cutbacks in Saint Louis and Washington University medical student interns, only increased the burden on City Hospital. Still, Mayor (and now School Board marauder) Vincent C. Schoemehl, Jr. set up an Acute Care Task Force to study the hospital in 1983, with his strong hint that he wanted to see the hospital closed. Frustrated, they soon voted themselves out of existence. In 1983, Schoemehl told the Saint Louis Globe-Democrat that "We are shooting for a November 1st (1983) close date. City Hospital is finally so far out of repair that it cannot continue to operate." But others, especially African-American members of the board of aldermen, balked at the idea of shutting down the city’s last public hospital -- the last place where even someone who could not pay a dime would not get turned away. as then-Alderman Virvus Jones said "I think the city cannot afford not to be in the hospital business."

Though the hospital didn't close until June 1985, Schoemehl got his way. The city and county became partners in a new hospital, St. Louis Regional Medical Center (now the sad ConnectCare) at 5535 Delmar Boulevard. For a year after City Hospital's closure, the clinic at the old hospital operated during working hours on weekdays.

In June 1986, the city opened bids for the hospital. Pantheon Corporation, the flagship of Fox Theater developer Leon Strauss, bought the hospital by beating out other offers, including one from homeless advocate Reverend Larry Rice, who wanted to turn the complex into a center for the homeless. Pantheon planned a mixed-use development with condominiums as the main use of the property, but had difficulty getting their project started. For the next few years, the buildings sat empty as trespassers made entrances into the building. Vandals began sacking the hospital for all of its valuable copper: pipes, wiring and, of course, the decorative cupolas on the roofs of the Administration and Ward buildings. By late 1988, most of the copper was missing from the cupolas, which stood on the roofs of five-story buildings.

Some people suspected that the daring copper thieves were pulling an inside job, but it’s possible that no one was looking. After all, so many people went inside to steal or squat at this point that no one paid much attention. Since the buildings were privately owned, the police made some effort to keep people out, but mainly failed due to the size of the complex. The press barely covered City Hospital's deterioration, so noticeable due to its site at the south entrance to downtown. Only one story of the problems at City Hospital made it into the Post-Dispatch in the few years after the hospital closed: In September 1989, a police dog, Bert, fell three stories and was injured while he and an officer were chasing a trespasser inside one of the older buildings.

Reverend Larry Rice, who wanted to use the buildings for a massive homeless center, continued making the reasonable assertion that the buildings should be used for their intended purpose of providing a public good. In an October 17, 1989 St. Louis Sun article, he said "that property could help a lot of people who need help." Rice decided to take action in early 1990 by breaking in the hospital's Main Building and cleaning up rooms. Twenty-five homeless men were preparing to move in when Police Lt. Anton Wagner arrested Rice, Rev. T. Matthew Carter, and several others. Rice then set up tents on the front lawn, and was arrested again. He also led public tours through the hospital.

Rev. Rice then collected over 1,000 signatures for his petition drive to put an item on the ballot that would let voters decide whether he or Mills should be the owner. When the petition was submitted, Judge Robert H. Dierker, Jr. turned it down saying that laws in the state prevented such an item to be determined by voters.

Rice and others accused the city and Mills Group of letting the hospital deteriorate so badly that it would have to be demolished. Mills Group denied this, and then, as if to silently conceded the point, stopped paying real estate taxes on the property. Pantheon President John Roach said to the Post-Dispatch in 1993, "It didn't make sense to pay them. The penalty for not paying taxes is losing the property." Later, Collector of Revenue Ronald Leggett filed suit against Mills Group, successor to Pantheon, for the missing taxes. But largely City Hall under Schoemehl didn’t bat an eye or move a muscle. By 1992, when the city once again held title to the building, Rice no longer wanted to use the buildings, recognizing that they were too deteriorated for a volunteer renovation project like the one he had proposed.

The Pantheon plan, of course, had been a dismal failure. No one wanted to use the complex, due in part to the overwhelming amount of work the buildings needed just to adapt them to a new use. Other factors contributed: federal tax credits that had fueled a downtown historic real estate mini-boom in the 1980’s had dried up by 1986, when Congress passed a tax bill revoking most of them. Also, the City Hospital stood at the juncture of the Soulard and Lafayette Square neighborhoods in a dead zone; both neighborhoods were improving steadily but their edges were still very rough. The dead zone here was contained by the impenetrable I-44/I-55 interchange and the dreary Darst-Webbe and Clinton-Peabody housing complexes.

In October 1992, Mills Group President Bruce Mills, elected that City Hospital be returned to the city of St. Louis. The Land Reutilization Authority (LRA) took the title from Mills but did little else. What could be done with these aging, decaying, vacant buildings? The city lacked the imagination to think about saving City Hospital, and it lacked the money to even demolish them. LRA director Michele Duffe speculated that various underground storage tanks full of hazardous materials, lead paint and asbestos problems made the building an impossibly difficult restoration project. Around 1992, Schoemehl said that possibly the main building on Lafayette Avenue could be saved.

As Rice said, "It is a vacant eyesore, slowly rotting in the shadow of a once humble, but proud neighborhood." Of course, it was not truly vacant. Many people visited the spectacular complex, attracted by the scale of its decay and the beauty of the rusty-brick buildings and their colorful interiors. Photographers, architects, historians, and thrill-seekers prowled the complex at all hours of the day, mostly just taking away photographs and memories. When I visited in late 2001 for my first full exploration (I had been inside the Power Plant earlier), many papers, clocks and signs remained. Despite some people's destructive energy, most visitors respected the buildings too much to damage them -- that was what the professional and amateur thieves had done earlier.

In early 1995, the Department of Housing and Urban Development unveiled a plan under the HOPE VI initiative to spend $46.7 million on the redevelopment of the Darst-Webbe housing project and the City Hospital site. HUD, working with architect Rod Hemni and the quasi-public St. Louis Development Corporation, initially made a decision to demolish the entire hospital complex (along with Darst Webbe's outdated concrete towers) with replacement by townhouses and businesses. At first it seemed as though renovation was never even considered. However, as pressure mounted to get the project initialized, and after two failed efforts to attract developers for the plan, the St. Louis Housing Authority said in July 1996 that the ultimate fate of the hospital buildings rested entirely on the choice of a developer.

The difficulties of renovating Darst-Webbe alone -- no easy task -- gave the hospital more time to live. This time proved to be enough for a renovation plan to emerge, although this plan has yet to prove itself feasible. A group of Lafayette Square residents formed a group called the St. Louis City Hospital Redevelopment Corporation in 1997 and began building support for renovating the buildings. Their plan called for demolishing only Malcolm Bliss, the Tower and Snodgras Laboratory, while using the rest of the buildings for a luxury hotel, apartments and office space. They would develop the rest of the site with new construction of shops and houses.

As HUD was entangled in the logistics of rebuilding Darst-Webbe, the city of St. Louis’s Community Development Agency took the initiative to work on a plan for City Hospital. In 1999, the city finally a request for proposals for the site -- the first formal effort in 13 years to do something with the hospital. The city chose the plans of St. Louis City Hospital Redevelopment Corporation, but something stalled and nothing happened on the site until late 2001, when the buildings were fenced off -- much to the dismay of the average trespassing hospital visitors (more adventuresome sorts still found ways in).

The city paid for site preparation, including demolition and asbestos abatement. Throughout 2002, Spirtas Wrecking Company worked on basic demolition projects: the Malcolm Bliss building in March and April, the old Nurses’ Building foundation, left behind since 1985, and the Snodgras Laboratory and Ancillary Services buildings in the fall. Unfortunately, the "E" Building proved to have not withstood abandonment very well, and its concrete-reinforced structure had disintegrated fatally. In October 2002, the "E" Building fell to wreckers much to the surprise of this observer.

The relatively mammoth Tower fell in the winter months of 2002 and early 2004, enduring a slow wrecking ball that took the building apart piece by piece. Parts disappeared in late 2002 -- the rooftop structures, then the lower wings -- before more drastic chunks began to disappear. Slowly, the rear elevation of the Administration and Ward buildings became visible again for the first time in 60 years. By the beginning of March 2003, nothing remained of the Tower except its foundation, and the visible entrances of tunnels leading to and from the missing building.

The St. Louis City Hospital Redevelopment Corporation still does not hold title to the site, however. Legal complications of untold detail bogged down their efforts to actually buy the buildings, but supposedly the city will transfer the title sometime in 2003 and the developers will reopen the Administration Building as condominium units by the end of 2004. We will see what comes to pass. One doesn’t have to think too far back in City Hospital’s life to pause and consider how odd it is that the buildings will become housing for people who can afford to buy condominiums. What a strange reversal, one that mirrors the devastating transformation of the St. Louis inner city well.

Copyright 1995 & 2003 Michael R. Allen.