Provident Hospital – the first Black owned and operated medical institution in the United States

Raymond H. Curry
University of Illinois, Chicago, United States

VeeLa Sengstacke Gonzales
Chicago, Illinois, United States

 Nurses tending to a patient at Provident Hospital

Prior to 1891 there was not in this country a single hospital or training school for nurses owned and managed by colored people … there are now twelve! … and not a single failure in the effort!
– Daniel Hale Williams, 19001

Emma Reynolds, a young Chicago woman in the late 1880s, had been denied admission by each of the city’s nursing schools on account of her race.  Her brother, pastor of St. Stephen’s African Methodist Episcopal Church, approached Dr. Daniel Hale Williams, a young black surgeon, for help.  Dr. Williams himself, despite his degree from Chicago Medical College (now Northwestern University Feinberg School of Medicine), had been unable to obtain clinical privileges at any Chicago hospital, and was forced to operate in patients’ homes.  He also obtained work as surgeon to the City Railway Company and by securing an appointment as a teacher of anatomy at his alma mater.2

With the support of a few prominent white citizens (Philip Armour, George Pullman, and Marshall Field among them) as well as many black individuals and organizations, Williams worked for two years to develop plans for a hospital accessible to black patients and medical practitioners, and incorporating a nursing school.   In 1890 the Reverend Jenkins Jones secured a commitment from the Armour Meat Packing Company for the down payment on a three-story brick house at 29th and Dearborn Streets.  In 1891 a board of trustees, an executive committee, and a finance committee were named, a community advisory board and a women’s auxiliary board were assembled, and Provident Hospital and Training School Association opened as a twelve-bed facility.  Dr. Williams was appointed hospital chief of staff.  It was the first black-owned and operated medical institution in the country and the first interracial hospital in Chicago — the staff and patients were both black and white.3, 4

The initial priority had been to secure an adequate hospital building. But the founders also considered community needs and the hospital’s overall mission.  When the legal papers were drawn up in 1891, the charter of the “Provident Hospital and Training School Association” stated that “The object for which it is formed is to maintain a hospital and training school for nurses in the City of Chicago, Illinois, for the gratuitous treatment of the medical and surgical diseases of the sick poor.”3  In 1892 seven women, including Emma Reynolds, enrolled in the first nursing class. The first physician in surgical training, Dr. Austin Curtis (later surgeon-in-chief at Freedmen’s Hospital in Washington, DC) studied under Dr. Williams from 1891 through 1893.  Dr. Williams meanwhile brought renown to himself and to Provident when he performed a thoracotomy to oversew a stab wound to the pericardium and left ventricle of a young man’s heart – thought at the time to be the first operation ever performed directly on the human heart.5

Over the next few years, demand for medical care in the community grew, and despite a national economic depression the Provident board initiated expansion plans.  An 1896 funding campaign raised sufficient funds to construct a new building at 36th and Dearborn. The effort was joined by abolitionist Frederick Douglass, who gave a public lecture in Chicago and presented a donation to Dr. Williams at the new hospital site.  The hospital moved to its new 65-bed location in 1898.

Although the hospital’s formation was dependent on wealthy donors, and such people stepped in at key moments in Provident’s history, the generosity of community residents was also a critical factor; and community support was not restricted to financial contributions. The strong appeal of a hospital responsive to the black community elicited repeated waves of community volunteerism.

Like any institution that endures for a century, Provident experienced many changes in its medical and administrative leadership. In 1894, President Cleveland appointed Dr. Williams Surgeon-in-Chief at Freedmen’s Hospital in Washington, DC.  Williams transformed that institution by organizing the medical staff into seven departments and creating an academic affiliation with Howard University.  He returned to Chicago and Provident Hospital in 1898.  In the interim, however, Dr. George Cleveland Hall, an opponent of Dr. Williams, had been named medical director and his supporters had assumed control of the Provident board of trustees.  The resulting tensions led Williams to secure appointment at other Chicago hospitals – his national reputation now able to overcome the prejudice that stood in the way of these same opportunities only a decade earlier – and he gradually distanced himself from Provident, finally resigning in 1912.  His last decade of practice was as associate attending staff surgeon at St. Luke’s Hospital.  On his retirement, St. Luke’s offered to name a patient ward in his honor but he declined, fearing it would become a segregated ward.2

Following his return from Washington  Dr. Williams also began working to facilitate the establishment of other black-owned hospitals around the country.  Most notably, he served as visiting professor at Meharry Medical College in Nashville, and guided the development of its hospital.  The model he had started at Provident, and now brought to Meharry, was soon recapitulated at Knoxville, Kansas City, St Louis, Birmingham, Louisville, Atlanta, and Dallas.2, 4

In 1933 Provident established an educational affiliation with the University of Chicago, and as part of the agreement purchased a building on East 51st Street, near the university and previously occupied by the Chicago Lying-in Hospital. The newly refurbished, seven-story facility added considerable space for patient care, education, and administrative functions. A four-story outpatient building was constructed and two apartment buildings at 50th and Vincennes were purchased to house student nurses. As evidence of its support, the University of Chicago established a one million dollar fund for teaching and research at Provident Hospital.  This became the most productive period of Provident’s history as an academic medical center, for the rise of specialization in medicine began to make postgraduate training obligatory for physicians, and Provident was one of few places in the country where African-American medical school graduates could train.  In 1938 Provident became one of only nine institutions in Illinois approved by the American College of Surgeons for graduate training in surgery, and by the early 1940s the hospital also boasted programs in internal medicine, pediatrics, obstetrics, pathology, ophthalmology, and otolaryngology.3

During the Great Depression Provident struggled financially.  But unlike other institutions who then recovered in the post-war economic expansion, Provident’s challenges only increased as black migration to Chicago swelled the population in the hospital’s Bronzeville neighborhood. The hospital narrowly averted bankruptcy in the late 1940’s, then remained reasonably stable financially over the next two decades.  The Civil Rights Act of 1964 and the 1965 enactment of Medicare and Medicaid, however, with their non-discrimination clauses applicable to any institution receiving federal funding, had ironic consequences for institutions like Provident. As it became more common for black physicians to be granted privileges at larger hospitals, and for black patients, particularly those newly insured by Medicare or Medicaid, to receive care at other institutions, the financial condition of Provident worsened.  Other trends, such as a shift of nursing education from hospitals to colleges of nursing, also led to a diminution of Provident’s role as an educational institution.  The Provident nursing school closed in 1966.

In order to compete and continue to serve its community effectively, Provident needed to expand further and upgrade its facilities.  Through the efforts of John H. Sengstacke, publisher of the Chicago Defender and longtime advocate for Provident, an alliance with Cook County Hospital, and federal grants through the Departments of Health, Education and Welfare and Housing and Urban Development, the hospital was able to open a new 300-bed pavilion adjacent to the existing 51st Street site in 1982.  But the new facilities did not turn around the hospital’s fortunes, and debt only increased through the 1970s and 1980s.  After declaring bankruptcy in July 1987, the hospital closed its doors that September.

The community’s devotion to the hospital remained, and various groups attempted to garner funding and political support toward its reopening.  These efforts coincided with a plan by the Cook County’s Bureau of Health Services to improve service provision to residents on the south side of Chicago, and the Cook County Board of Commissioners acquired the hospital in 1991.  After considerable investment in upgrading the physical plant, the Bureau reopened the facility as Provident Hospital of Cook County in August 1993.

While no longer considered a black-run hospital, Provident continues to serve the health needs of the community under the auspices of the Cook County Bureau of Health Services.  Its legacy as America’s first black owned and operated hospital survives through the Provident Foundation,6 established in 1995 by Ed Gardner, a prominent businessman and the chair the hospital board at the time of its transfer to the County, and James W. Myles, a longtime union leader.  The Foundation honors the legacy of Provident Hospital and Dr. Daniel Hale Williams by providing scholarship support and mentorship to aspiring doctors, nurses, and other health professionals from Chicago.

A less tangible, but more deeply embedded legacy lives on in the many people the hospital served for nearly a century.  There are those whose forbearers first entered professional ranks through training as a nurse or physician at Provident, or did so themselves.  There are the many Chicago natives proud to be “Provident Babies.”  One, born Michelle LaVaughn Robinson in 1964, has become First Lady of the United States. Most of all there are those whose families benefitted from the care they received; it was, as noted by the venerable Chicago historian Timuel Black, “often the safest – and sometimes the only – place to go.”3

 

References

  1. Williams DH.  The need of hospitals and training schools for the colored people of the south.  Read before the Phillis Wheatley Club at Nashville, TN, Jan 23, 1900.  Manuscript Department, Moorland-Spingarn Research Center, Howard University, Washington, D.C.
  2. Buckler H.  Daniel Hale Williams, Negro Surgeon.  New York: Pitman Publishing Corporation, 1954 (2nd Ed 1968).
  3. Krieg RM, Cooksey JA.  Provident Hospital: A Living Legacy.  Chicago: The Provident Foundation, 1997.
  4. Wesley, Nathaniel.  Black Hospitals in America: History, Contributions and Demise.  Tallahassee, FL: NRW Associates Publications, 2010
  5. Williams DH.  Stab wound of the heart and pericardium – suture of the pericardium – recovery – patient alive three years afterward.  Med Rec 1897;51:439.
  6. The Provident Foundation, accessed January 19, 2015, www.providentfoundation.org

 


 

RAYMOND H. CURRY is senior associate dean for educational affairs at the University of Illinois College of Medicine, and clinical professor of medicine and medical education at the University of Illinois at Chicago.  A native of Lexington, Kentucky, he is a graduate of the University of Kentucky and of Washington University School of Medicine in St Louis, and completed internal medicine residency at Northwestern University/McGaw Medical Center.   Dr. Curry is a member of the board of directors of The Provident Foundation.

VEELA SENGSTACKE GONZALES is former program director for the Provident Foundation, where she helped initiate community outreach programs, coordinated and served as artistic director for exhibitions of the Foundation’s historical collection, and assisted in developing the Future Nurses, Future Doctors program.  VeeLa learned of the importance of Provident Hospital and its history from her father-in-law, the late John H. Sengstacke, who passionately championed its cause dating back to the 1940s.  In 1972 VeeLa began her study of tai chi chuan with Master Hubert H. Lui at Columbia College, Chicago; she has continued to study, practice, and teach tai chi for over four decades.