The History of Long Island College Hospital: From Dispensary to Modern Medical Complex
The Long Island College Hospital (LICH), an institution with a rich and complex history, played a significant role in shaping medical care and education in Brooklyn, New York. From its humble beginnings as a dispensary for German immigrants to its evolution into a multifaceted hospital and teaching facility, LICH's journey reflects the changing landscape of healthcare in America. This article explores the hospital's origins, growth, challenges, and eventual closure, shedding light on its lasting impact on the community it served.
Origins and Early Development
In March 1856, the Brooklyn German General Dispensary was established by German doctors concerned about providing medical care to the growing number of German immigrants in the neighborhood. A dispensary in the mid-19th century was similar to what is now known as a clinic, offering diagnosis and dispensing medicines. The Brooklyn German General Dispensary also had wards for in-patient treatment.
The Dispensary quickly outgrew its original quarters due to the high demand for its services, treating 850 patients in its first 19 months. In 1857, the doctors partnered with prominent Brooklyn businessmen to develop a hospital and medical school. Briefly named The St. John's Hospital, this new institution aimed to improve medical care in Brooklyn and challenge Manhattan's dominance in medical education.
At the time, aspiring practitioners learned through apprenticeships, with limited access to formal lectures, especially outside city centers. The founding fathers saw the medical school as an opportunity to elevate Brooklyn's status, lamenting the city's neglect in establishing its own "temples of science" due to its proximity to Manhattan. This ambition fueled a sense of rivalry between Brooklyn and Manhattan.
Financial Challenges and Early Growth
The organizers, including financier Daniel Chauncey and railroad magnate Samuel Sloan, contributed financially and sought outside funding. They sent out solicitation letters appealing to the community's charitable instincts and civic pride. These efforts allowed them to purchase the "Perry Property" on Henry Street for $31,250, and a Charter was granted by the State Legislature on March 6, 1858.
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The medical school faced initial setbacks, closing in 1859 but reopening the following year through the generosity of Dr. William Henry Dudley. Despite financial adversity, the hospital continued to develop, receiving wounded soldiers during the Civil War in 1862. The medical school initiated a course in military surgery to address the need for competent doctors on the battlefield.
By 1873, the hospital was treating over 10,000 patients annually and expanded with a new wing in 1882, adding classrooms, wards, a museum, and steam heat. New buildings were also added, including the Hoagland Laboratory, which opened in 1888 as one of the first bacteriological labs in the country, reflecting the growing acceptance of germ theory.
In 1897, the Polhemus Memorial Clinic, considered the world’s first high-rise medical facility, was constructed. Continuing the founders' legacy, two floors were reserved for outpatient clinics to treat the local poor. By the turn of the 20th century, the Long Island College Hospital had surpassed its founders' expectations.
The 20th Century: Advancements and Scrutiny
The Polhemus Memorial Clinic added laboratories and spacious amphitheaters to the medical school. In 1900, the hospital adopted the 4-year medical curriculum pioneered at Johns Hopkins, a pedagogically innovative medical school in Baltimore.
As medical standards evolved, hospitals and medical schools faced increasing scrutiny. In 1909, the Carnegie Foundation began reviewing medical schools nationwide. The Foundation’s report in 1910 led to the closure of nearly half the medical schools in the country. LICH received a relatively favorable B grade, but the report highlighted deficiencies such as a lack of full-time teachers, a library, and physiology and pharmacology labs.
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LICH addressed these issues by hiring full-time professors and building laboratories. However, oversight agencies continued to proliferate. In 1918, the American College of Surgeons cited LICH for poor record keeping, lax supervision of interns and residents, inadequate surgical follow-up procedures, and indifferent quality control.
During World War I, the hospital operated in crisis mode, facing a shortage of nurses and annual deficits. Despite these challenges, the educational arm of the hospital continued to improve, with 28 of the 108 students entering the medical school in 1922 holding B.A. degrees.
Evolving Demographics and Financial Pressures
The population served by LICH continued to evolve. While the institution's founders initially aimed to serve the area’s German population, Irish immigrants were already present in the 1850s, followed by Italians, Syrians, Lebanese, and German and Russian Jews. Later, Puerto Ricans, Central Americans, and smaller numbers of African Americans and Asians arrived.
As these immigrants' socio-economic status improved, their demands for social services also increased. Employer-sponsored insurance programs made it easier for patients to pay for hospital stays and specialist treatments. Hospitals attracted middle- and upper-class patients by developing private and semi-private rooms. During World War II, LICH raised its rates for such rooms, achieving profitability for the first time.
Patient/staff relations also changed, with LICH advising its staff in the 1950s to "maintain courteous relationships with their patients," indicating that paying clients expected better treatment than charity patients.
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However, technological advancements and payment changes led to escalating hospital costs. New machines were expensive to purchase and maintain, requiring special housing conditions and trained technicians. LICH, like other hospitals, faced these pressures, leading to a significant shift in its identity and mission.
Merger and Transformation
In 1931, the Hospital's medical school became independent of the Hospital and was incorporated as the Long Island College of Medicine. Then in 1950, the medical school merged with the new State University of New York to become SUNY Downstate. Offices, staff, students, and professors moved to Clarkson Avenue, the site of the SUNY Downstate Medical Center. Known for a time as the Health Science Center of Brooklyn, it was the only medical school on all of Long Island until 1971.
After the merger, the Henry St. institution became one of many Brooklyn hospitals where interns and residents rotated. Financial and social challenges persisted, reflecting broader cultural changes.
Nurses won a 5-day work week in 1950, improving their working conditions. Also in 1950, following an accusation of discrimination by the Association of Colored Graduate Nurses, the Board announced a nondiscrimination policy. However, the Board also announced that nurses who married or became pregnant would be immediately dismissed.
Despite these challenges, the hospital celebrated its 100th anniversary on March 6, 1958, with a fund-raiser at the Hotel St. George. New buildings increased the density of the existing campus. In the 1980s, the hospital expanded its geographical reach, buying St. Peter’s church on Hicks St and moving its nursing staff into it, and receiving permission to build a parking structure on Hicks St.’s upper Van Vorhees Park in exchange for three Henry St. buildings.
Closure and Redevelopment
The story of LICH’s demise is part of a larger narrative about the restructuring of healthcare in New York City. Over the past 20 years, there have been countless accusations of mismanagement, political double-dealing, and community betrayal. LICH's history reflects the evolution of healthcare in America, with rising standards for doctors, shifting patient populations, and increasing technological and scientific breakthroughs.
The 20th century brought even more profound changes, including the rise of the American Medical Association, private and employer-sponsored insurance companies, state and federal oversight, and programs like Medicare and Medicaid. The disparity between those who could afford private insurance and those who couldn't also increased.
By 2008, the hospital was affiliated with the Continuum Health Partners and had been in financial trouble due, in part, to capital debt. On May 27, 2011, Long Island College Hospital became part of SUNY Downstate’s University Hospital of Brooklyn, renamed as University Hospital of Brooklyn at Long Island College Hospital, serving as a clinical campus for medical students in the Downstate College of Medicine.
The state helped facilitate the merger to help avoid the closures that were facing other New York City hospitals. It was losing $15 million per month as of July 2013. As a way of maintaining the hospital, SUNY issued an RFP on July 17, 2013, to seek bids from developers who could turn the property into a profitable venture through mixed-use real estate projects while maintaining medical services for the community.
On July 19, 2013, the New York State Department of Health approved SUNY Downstate Medical Center’s plan to close the hospital, which called for all remaining patients to be transferred or discharged on or before July 28. On August 20, 2013, a Brooklyn Supreme Court Justice ordered the closure of the hospital to be stalled.
Once the lawsuits were settled and the hospital closed, bidding ensued, and Louis Kestenbaum’s Fortis Property Group won the bid. In January 2014, SUNY called for revamped bids to reflect the wants of the community and expectations of SUNY. The winning bidder of the 2014 bidding process was Brooklyn Health Partners, which said it would operate a 300- to 400-bed hospital on the site.
A new development of seven towers was revealed in 2015, to be constructed by Fortis Property Group and known as River Park. Construction started in 2017, with expected completion through 2023.
The School of Nursing
The Long Island College Hospital School of Nursing opened in 1883. In 1860 the Hospital introduced bedside teaching but it wasn’t until 1883 that the School of Nursing opened. The school enjoyed a long tradition of educating nurses for 130 years before the last graduation in May, 2013 when the school closed.
In 1883 the nurses made their own uniforms which were not really “uniform” by any means. Each was made to suit the wearer’s fashion sense. One nurse tells of her uniform shrinking and she inserted a fedora in the front of the waist, and wore this as her uniform. Her next uniform sported a ruffle on the ends of the sleeves and on bottom of the skirt. By 1893, the dress of the uniform was made of a striped blue and white seersucker, a cap and an apron.
The uniform also had a fichu, which was a light triangular scarf that was draped over the shoulders and fastened in front or worn to fill in a low neckline. The nurse would receive her cap at the end of the probationary period. The fichu was added at the end of the first year, and the cap was awarded to graduates. The graduate cap was designed by Miss Ida Sutliffe, the first director of the school and also an alumnus, and closely resembles the New York Hospital cap. The cap is made slightly higher and fuller by the addition of pleats in the back.
In approximately 1935, the seersucker uniform was replaced by the blue and white gingham. The uniform changed again in 1942 when the sleeves were shortened.
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