At Pennsylvania Hospital, 250 years of care.

Abstract

PHILADELPHIA—On a full city block in Society Hill, a short walk from Independence Hall, surrounded by azaleas and wisteria and overseen by a statue of state founder William Penn, sits the original Pennsylvania Hospital, the first hospital in this country. Established on May 11, 1751, by a charter granted by the Pennsylvania legislature through the efforts of Benjamin Franklin and Thomas Bond, MD, the hospital this week celebrates 250 years of caring for the community. Originally intendedtobeaplaceof refuge and cure for “the sick-poor and insane” of what was by 1776 the second largest English-speaking city in the British empire, the now greatly expanded Philadelphia facility uniquely combines the architectural and archival treasures of its colonial past with the mission of a 21st-century tertiary care hospital. A recent visit with Pennsylvania Hospital physicians revealed their intense pride in being part of this institution and their determination to carry forward and augment its distinguished heritage. According to R. Michael Buckley, Jr, MD, chief medical officer of the hospital and chair of its Department of Medicine (and also a professor at University of Pennsylvania School of Medicine), an outstanding feature of the place is the culture of collegiality fostered by its historic surroundings. Patients now come from a much wider area than did the 18th-century clientele who arrived on foot or by horse and carriage—Buckley estimated they comprise in equal part people from the neighborhood, the rest of the city, the suburbs, and a 100-mile radius including adjacent states—but physicians run across each other routinely in the beautifully preserved Pine Building, which is a National Registered Landmark. The Pine Building, facing Pine Street between Eighth and Ninth, was designed by colonial carpenter Samuel Rhoads, who also had a hand in Independence National Historical Park’s showplace Carpenter’s Hall. It was built in three parts: the East Wing (opened in 1756, it originally housed both physically and mentally ill patients), the West Wing (to which the mentally ill were moved when it opened in 1796), and the center section, which was opened in 1804 as a buffer between the two and contained the apothecary, library, offices, staff quarters, and surgical amphitheater. All now house administrative and physicians’ offices, as well as the Historic Library and contemporary libraries and meeting rooms. Two and a half centuries of expansion have added a number of more modern inpatient and outpatient facilities nearby. Somewhat unusually for a metropolitan hospital, said Buckley, “almost everyone who practices here practices only here.” He emphasized that the daily on-site presence of most staff makes possible a type of personal care much appreciated by patients. For example, he said, the response to a re-