By Andre Sobocinski, historian, U.S. Navy Bureau of Medicine and Surgery
Two hundred and ten years ago, Navy Surgeon Edward Cutbush established Naval Syracuse, Sicily to provide medical support for the Mediterranean Fleet then engaged in war with the Barbary States (1). Although other medical facilities did exist around this time, Naval Hospital Syracuse was the first hospital to be established by order of the Secretary of the Navy.
In the early years of Navy Medicine, our “hospitals” were often located on or near Navy yards along the Eastern seaboard (2). At best they were makeshift facilities offering a modicum of care; at worse they were simply shelters from the elements (3). Navy Surgeon William P.C. Barton, an early proponent for upgrading hospital would describe one such hovel, “I have myself seen a number of sick seamen with whom I was left in charge at the Navy Yard, Philadelphia, where they were necessarily huddled into a miserable house, scarcely large enough to accommodate the eight part of their number—a spirit of impatience and even of revolt…so wretched was the hovel and so destitute every necessary comfort for sick persons…[that] every man who gathered sufficient strength and was successful in getting an opportunity to effect his escape, absconded immediately.” (4)
The Navy took its first giant leap forward in the cause of hospitalization, Feb. 26, 1811. On this day, Congress approved an act establishing the first permanent Navy hospitals. The Act directed that the Secretaries of the Navy, the Treasury, and War (Army) serve as “Commissioners of Navy Hospitals” and the unexpended balance of the Marine Hospital Fund (5) — would be placed at their disposal for construction of permanent Navy medical facilities (6). In addition, contributions of 20 cents a month by each naval officer and Sailor would be used to bolster the fund now known as the “Navy Hospital Fund.”
Ten years lapsed before the Commissioners selected the first hospital site in Washington, D.C. (1821). This was followed by the purchase of other sites in Chelsea, Mass. (1823); Brooklyn, N.Y.; Philadelphia, Penn. (1826); and Norfolk/Portsmouth, Va. (1827). Some of America’s greatest architects including William Strickland and America’s preeminent prison designer John Haviland were hired to design these new symbols of the Medical Department. The first hospital opened in 1830 in Portsmouth, Va. followed soon after by Naval Hospital Philadelphia (aka, the “Naval Asylum.”) Although no longer hospitals, both Haviland’s Portsmouth (now Naval Medical Center Portsmouth’s “Building 1”) and Strickland’s Asylum (Now the centerpiece of a luxury condominium development called “Naval Square”) still exist as testaments to the grandeur of the original facilities.It is little surprise that many hospital “firsts” in the Navy would
follow the Act of 1811 including: the first uniforms for Navy hospital personnel (1813), Navy hospital administration book (1814) (7), joint medical facility (1862) (8), floating hospitals (1863) (9), West Coast hospital (1870) (10), permanent overseas hospital (1872) (11), teaching hospital (1878) (12), base hospitals (1917), medical center (1935) (13), development of deployable mobile/fleet hospital (1940) (14) and convalescent facilities (1943) .
World War II precipitated the largest growth of Navy hospitals in history. By war’s end, the Navy boasted 114 hospitals (52 regular, 20 base hospitals, 19 convalescent hospitals, 16 mobile/fleet hospitals and seven special augmented hospitals). The war may have been the biggest test for Navy Hospitals, but other challenges have followed most notably base realignment and closure. Since the end of World War II the Navy has closed three of the original hospital sites Brooklyn (1948), Chelsea (1974), Philadelphia (1995), as well as major medical facilities that existed in Oakland, Calif. (1995), and St. Albans, N.Y. (1974).
Today Navy hospitals are flagships of executive medicine and leaders in warrior care. They are advanced research centers, and pioneering institutions in the fields of trauma, mental health, and rehabilitation. As budget constraints and “reinvention” continue to redirect the concept of hospital care, the tenet of patient-centered care at Navy Hospitals is destined to remain a constant.
(1) In operation from 1804 to 1806, the building used as a naval hospital was at least two stories high contained between six and ten rooms. It was approximately 90 feet long and 50 feet wide. As are most of the structures, past and present, on the Island of Sicily the building was constructed of stone.
(2) From Charlestown, S.C. to Boston, Mass.
(3) The original hospital at the Norfolk Navy Yard was a former gunner’s store room and patients shared the two-story building with rigging, a storekeeper’s office and a purser’s issuing room. In 1815, Surgeon Lewis Heerman rented his own house for use as a hospital in lieu of the dilapidated quarters that were available.
(4) Holcomb, Richard C. A Century With Norfolk Naval Hospital, 1830-1930. Portsmouth, Va: Printcraft Publishing Company, 1930. p120.
(5) In a time before permanent Navy Hospitals, sick and disabled Sailors and Marines could use Marine Hospital facilities (later Public Health Service). Each month 20 cents would be collected from every officer, seaman, and Marine and placed in a “Marine Hospital Fund” to pay for hospital services.
(6) Langley, Harold. A History of Medicine in the Early Navy. Baltimore, Md: The Johns Hopkins University Press. 1995.
(7) Barton, William P.C. A Treatise Containing a Plan for the Internal Organization and Government of Marine Hospitals in the United States: Together with A Scheme for Amending and Systematizing the Medical Department of the United States Navy (1814)
(8) Naval Hospital Mound City, Il. (1862-1870s) is long considered the first to employ both Army and Navy medical personnel.
(9) USS Red Rover (1863-1865)
(10) Naval Hospital Mare Island, Calif.
(11) Naval Hospital Yokohama, Japan
(12) Navy Hospital Brooklyn, N.Y.
(13) Naval Medical Center Washington, D.C.
(14) Mobile Hospital No. 1, Guantanamo Bay, Cuba