How Sanitariums Became Hospitals, and Why

How glorious is the past! How we love to burn incense to it! With what longing and regret we look back on the "good old days" and somehow, perhaps in blissful for­getfulness, we attribute to them the piety, vir­tue, holiness, and dedi­cation that we feel is so sadly lacking in our day. Fervent saints with nostalgic inclina­tions look backward to the days before cake mixes, automobiles, airplanes, television, and safety razors; before automatic toasters, frozen strawberries, and packaged mashed potatoes; the days of sanitariums, before they evolved into hospitals, and count those days as better, less filled with evil, and closer to God. A newer generation that never wore button shoes or detachable collars, in­nocently takes the word of the stooping and the bald, and so they too believe in the piousness of antiquity. I wonder what it is in human nature that prompts us to be­lieve that hay is more conducive to holi­ness than gasoline, and that buggies con­tributed more to righteousness than auto­mobiles; or for that matter that sanitariums were right and chosen of God, while hospi­tals were basically departures from God's chosen pattern for reaching mankind with the love of God?

What Is or Was a Sanitarium?

It is high time that we investigated this nostalgic superiority of the one over the other. First, let us define the terms. Just what is, or was, a sanitarium? It was a house of healing primarily for the ambulatory, and usually located in rural surroundings. It had its own Seventh-day Adventist closed salaried staff of physicians. It specialized in modalities of treatment familiar to every Adventist mind: hydrotherapy, diet, exer­cise, sunshine, fresh air, and an out­stretched hand to touch the hand of the Great Physician. In fact, our church and our sanitariums, thanks to divine revela­tion, were among the first to emphasize these simple, but nearly overlooked heal­ing agencies and to bring them to the fore­front. Thus, emphasis was placed on pre­ventive medicine and recognizing the laws of health as but another version of the laws of God. Patients came from far and near to these fine institutions. They knew of and understood their unique programs, and ap­preciated them and desired to conform their lives to this system of treatment and re-creation. They benefited thereby im­mensely. Most of the guests stayed for a period of weeks, and memory goes back to the time when the average length of stay was well over twenty-one days.

Rubbed—Steamed—Fomented

Worship was conducted in the parlor each evening. The physicians frequently lectured on health, and once a week there was a "Question Box," at which time the doctor opened the box and took out these questions and answered them to the satis­faction, and I hope to the healing, of the people. Occasionally, just before the time for the parlor meeting, it would be discov­ered that the box was empty, or nearly so, and this scribe at times helped to write a few questions just to make the evening worth while. Those were the glorious days! The obese came and were reduced. They left and got fat again, and returned and lost the same poundage over and over again. People were rubbed, and steamed, and fomented—and they were helped!

These institutions were calculated more to teach people how to live and to develop proper habits of diet, than to the treatment of the acutely ill. This was good. These fine institutions were tools to reach the hearts of people, and somewhat successful tools used of God. The occasions were few and very far between when patients actu­ally joined our church, but certainly preju­dice was broken down, a spirit of inquiry was awakened, and the laws of health were popularized as the laws of God. The eating habits of America were altered, and for this to a large measure the country is debtor to the church.

It should be noted and remembered that these institutions were tools and not objec­tives in themselves. How easy it is to con­fuse the method with the objective! The sober facts are that every instrument of the church—the sanitarium, the hospital, the church school, the academy, the college, the publishing house, the Voice of Prophecy, and Faith for Today—are tools to reach the hearts and minds of people. None are ends in themselves. All are but methods and none final objectives.

As time went on, seriously ill people came to the hospital sections that were ap­pended to our sanitariums. This came about with a half guilty feeling, for there was uncertainty that it was right for us to operate hospitals.

However, these sick ones needed treatment, and their hearts appeared to be just as open to the gospel and the love of God when they were horizontal in bed; in fact, just as open as were the hearts of the verti­cal and ambulatory. Also, a new genera­tion of physicians was appearing, most of whom were more interested in treating acute cases and in doing surgery, than in devoting their professional interests to the tired, the fat, and those without acute medi­cal problems.

Salaried and Un-salaried Doctors

There developed a growing difficulty to staff our sanitariums with dedicated and competent physicians on a salaried basis. At one time it was thought that our insti­tutions would suffer bankruptcy„ unless they were endowed by the professional earnings of our salaried Seventh-day Ad­ventist closed staffs. Time proved this to be incorrect in conclusion. Again, as our medi­cal school graduated more and more skillful and dedicated men, it was impossible for all of them to be employed in the limited number of closed-staff institutions we oper­ated. Many had no choice but to enter pri­vate practice. This they did, and their wives purchased newer coats as their husbands bought longer and shinier cars. The wives of the institutional salaried physicians looked on and wondered. More and more of our own Seventh-day Adventist physi­cians entered into private practice, disasso­ciated from the sanitarium as salaried em­ployees. Organized medicine vociferously proclaimed that it was unethical for any physician to be salaried to a lay organiza­tion, and thus be subject to exploitation by the laity. No one should make a. profit from the physician's service except the phy­sician himself. Good and dedicated men sometimes defied these professional edicts. Fewer and fewer became willing to do so for, frequently, it meant to live under the shadow of disapproval of their colleagues of the profession. In honesty, it must be stated that no army of physicians rose up to oppose these edicts. In equal honesty, it should be stated that dedication was not necessarily measured by salary arrange­ments, and that the pious and fervent and sincere prayers of the godly physicians in private practice were probably just as well received in heaven as were the prayers of the salaried. The influence of a physician's life upon the open heart of a patient seemed to be quite unrelated to arithmetic.

Speed Enters Picture

Exit the buggy—enter the automobile—and then the airplane. The bubble of pros­perity expanded and burst into the depres­sion. Born in Dallas, Texas, as a child of the depression, was Blue Cross, and from this seed sprouted the total program of pre­paid hospitalization, and prepaid medical care. The more affluent segment of society, which hailed Teddy Roosevelt, and came to our sanitariums with their wives for summer vacations, grew fat, retired from business; eventually they developed coro­naries and were carried to the quiet church­yard for their final rest. Their children re­turned home to weep, but not often to come to the sanitariums, as did their fa­thers and their mothers, for three weeks of summer vacation. Instead, they got into their even newer and even shinier cars and took their vacations, staying at a different city every night. Those who did come to the sanitarium for rest, relaxation, and phys­ical refurbishing, turned in their claims to Blue Cross or to some comparable insur­ance company, and were told that their in­surance policies did not cover such vaca­tions. Their policies covered care only in hospitals and then when they were sent there by a physician for the treatment of a specific disorder requiring hospitalization for treatment. Patients became more and more reluctant to come to sanitariums on their own expense when they were paying perfectly good hospital insurance.

During all of this slow transition some­thing else was happening in the medical world. A different type of staff organization was evolving. Hospital staffs became organ­ized bodies of physicians, living in the area adjacent to the hospital and using its facili­ties. The purpose of their organization was to better the level of the practice of medi­cine, to curb the unscrupulous, and to limit the privileges of the incompetent. These were scientific organizations, and not bod­ies charged with the responsibility, or given the authority, to operate the institu­tion, or to make policies binding or direct­ing its activities. Unnecessary surgery was curbed by the sheer weight of professional acceptance. Incompetent men were limited in their hospital privileges by the staff or­ganizations to which they belonged and al­lowed to do only those procedures for which they had demonstrated an ability to safely attempt. Hospitals became safer places for humanity.

"Came" or "Sent"

Our Seventh-day Adventist physicians in the areas of our institutions became mem­bers of these staffs, not because of their creed, but because of their professional competence. These staffs comprised both Seventh-day Adventist and non-Seventh­day Adventist physicians. The institution's influence became the influence of its staff of nurses and workers, separate and apart from the influence of the attending physician. Patients no longer came to our institutions, but rather were sent by their physicians. They did not choose our hos­pital because they were wanting to subject themselves to a particular regime or pro­gram, but because their physician desired to use the facilities which the hospital of­fered for their care. Nurses prayed at their bedsides, and watched little cribs with anxious mothers, and prayed with weepingfathers... Chaplains opened the Word of God to frightened souls, who were afraid of an uncertain future. The principles of healthful living were taught, but in different ways. The parlor lecture was gone; the pillow speaker took its place as a tool of teaching. Good hospitals every­where developed physical medicine depart­ments. That which was once obtainable only in our sanitariums as a modality of healing, became available in every well-run hospital.

You Be the Judge

Thus, our institutions evolved into hos­pitals treating the acutely ill, the horizon­tal rather than the vertical patient. Was it wrong, a departure from the pattern? No. A hospital, like a sanitarium, is but a tool to reach the hearts of people with the love of God. Its objective is just the same as was the objective of the sanitarium, that is to set salvation in the midst of the multi­tude, and to minister to the souls of men, recognizing that it just so happens that God has chosen to send souls wrapped in bodies. It is true that a hospital reaches a different segment of society than did the sanitarium of other years. It reaches its segment of society when the door of the heart is widest open. Doubtless, there is no time when the soul is more susceptible to the love of God and the comfort of faith in the Divine, than the night before surgery. No one ever takes an anesthetic without wondering whether he will wake again to greet an­other morn. Our nurses, physicians in pri­vate practice, and total staffs are using these opportunities to bring the message of love and hope to many more people than were ever reached through our sani­tariums. Baptisms are not infrequent, and are much more common than in other days. Let us then understand both the sanitar­iums and hospitals for what they are—tools to touch the lives of people and to pour the love of God into hurting hearts. Both are, and were, good. Neither is an objective or an end. When one tool be­comes dull with changing conditions and altered programs, it is time to go to the woodshed and get a new and sharper tool, better fitted to the needs of the day. This is what happened, and how sanitariums be­came hospitals. Let us thank God for them, support them, help staff them with quali­fied dedicated Christian nurses and work­ers, and rejoice that they bring the gospel to many who could never be reached in any other way, not even by a sanitarium.