Old Main hospital in 1924


It’s Not the First Time Hospital Construction Has Stopped Because of a Pandemic

By Joel Howell

Fall 2020
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The COVID-19 pandemic continues to wreak havoc on the economy throughout the world, and Ann Arbor has not been spared. As part of an urgent plan to reduce expenditures, Michigan Medicine has halted construction on the new inpatient hospital. Construction on the $920 million, 12-story, 690,000-square-foot tower started in late October 2019, with hopes that it would be open for patient care in 2024. However, it was announced on May 5 that construction on the new hospital would be halted. For how long remains uncertain.

As disappointing as this decision is, it may provide some perspective to realize that this is not the first time that construction on a new University of Michigan hospital has been suspended indefinitely in the face of an economic catastrophe and a pandemic.

U-M hospitals have led the country for over 150 years. In 1869 U-M became the first U.S. university to own and operate its own hospital, creating a model for medical education that has been emulated by hundreds of medical schools. The first hospital was a 20-bed converted professor’s house on North University Avenue. But this space was soon outgrown, and in 1876 a new Pavilion Hospital was built. Other additions followed, and the Pavilion Hospital was eventually replaced with a structure known simply as the Catherine Street Hospital.

By the turn of the 20th century, it was becoming apparent that the Catherine Street Hospital was unsuited for modern medicine. A set of scattered buildings along Catherine Street, housing about 200 beds in four separate structures, with winding corridors said to resemble “rabbit warrens,” the hospital was crowded, leaky, and lacked adequate spaces for either education or modern laboratories.

Plans were made for a grand new hospital building that would once again set the standard for university hospitals. First, in 1915, the Board of Regents appropriated $1,500 (nearly $40,000 in 2020 dollars), and then in the spring of 1917 the Michigan legislature agreed to provide $1.05 million (about $21 million in 2020 dollars) in equal payments over six years. A site was identified on Ann Street, overlooking the Huron River valley. The architect was Albert Kahn, the leading American industrial architect of the time, who had designed many of the Ford Motor Co. plants as well as Hill Auditorium on the U-M campus.

But the new hospital was envisioned during turbulent times. Even as the plans were being drawn, the U.S. was about to enter World War I. The U.S. joined the Allied Powers in 1917, eventually sending around 2 million people to fight in Europe. And then a different catastrophe swept around the globe. The first cases of a new form of viral influenza arrived in Ann Arbor near the end of September 1918. Before the pandemic subsided, more than 15,000 people died in Michigan, among 650,000 in the United States. More people worldwide died in the pandemic than had died during the recently ended war. In 1920, with both the war and the epidemic over, U-M finally broke ground on the new hospital.

The war and the pandemic, however, had taken their toll on the economy, in part because the pandemic had been especially lethal for working-age adults. Both the effects of the war’s end and of the influenza pandemic led to a worldwide depression. As in 2020, this economic downturn was characterized by extreme deflation and a sharp rise in unemployment.

Architectural rendering of the new hospital tower.
Architectural rendering by HOK of the proposed new inpatient hospital. Construction on the 12-story tower began October 2019 and was halted May 5, 2020.

But plans had been made and hopes were high. Construction on the new hospital started early in 1920. All did not go smoothly. Construction was marked by labor disputes, and delays were costing the state some $100,000 by October 1921. As the depression took its toll on the economy, the state treasury was rapidly depleted. By the middle of November 1921, the state simply did not have funds to continue work at the site, causing construction to come to a complete standstill. The Ann Street site was boarded up and would remain so for several years.

As the economy started to recover, leaders fought to resume work on the partially built hospital. In his inaugural message to the legislature in 1923, Michigan Governor Alex Groesbeck pleaded for additional funds to finish the building, labeling it an “urgent need.” In March, U-M President Marion Burton adopted a relatively unusual approach to searching for funds, inviting 100 members of the legislature to a “junket” via a train from Lansing to Ann Arbor, where they would meet with him on campus in the Michigan Union (some members of the legislature chose to take the ride in the cab of the Michigan Central locomotive to marvel at what was then the incredibly rapid pace of more than 60 miles per hour). Lawmakers toured the old hospital and noted the “almost intolerable conditions.” In what newspapers called a “magnetic presentation,” Burton said resuming construction was essential for building the “university of tomorrow.”  

His presentation did not have an immediate effect. In August 1924, with the shell of the giant unfinished building still sitting useless atop the hill on Ann Street overlooking the Huron River valley, and the old hospital crowded with more patients than could be cared for, Burton characterized the story of the building as one of “delays and disappointments.”

However, the effects of the depression finally abated. Funds were made available later in 1924, and, on August 12, 1925, patients were finally moved into the new hospital. Triple the size of the Pavilion Hospital at 434,445 square feet, it was not only the largest publicly financed structure in the state, but also the largest university hospital in the entire U.S. When it was built, it was nine stories tall, but it was designed to allow for additional stories to be built (and they were). With 823 beds, it could accommodate more than 15,000 people per year with an average length of stay of 17 days (far longer than the typical patient stay in 2020).

It also was modern, a model for other hospitals to emulate. Every room had natural light. There were 26 sun rooms, 11 operating rooms, and an auditorium for teaching. Not only was there ample space for scientific laboratory work, but also, in a striking innovation, the building both housed laboratories and was itself a laboratory. Electrocardiogram (ECG) machines of the time were large and immovable, so the entire building was wired to allow ECG tracings to be taken without having to move the patient to the machine. Work using this wiring led to discoveries that are part of every ECG taken today.

Moreover, the hospital was built with connections to the community firmly in mind. Medical School Dean Hugh Cabot proclaimed that a central goal of the hospital was aiding in the “economic difficulties of sick people.”  As a state hospital, funded by the people of the state, it was thought that decisions about what to do ought to be guided to a significant extent by what would be good for the people of the state, and especially Ann Arbor, since the city had given major financial support for several of the earlier hospitals. All of this was accomplished for around $4.4 million (a bit over $65 million in 2020 dollars).

The hospital was formally inaugurated in a three-day gala celebration in November 1925. Affectionately known as Old Main, it served the state and university well for 61 years. But it eventually needed to be replaced, and, in 1986, the current University Hospital opened. Old Main was demolished in 1989; the Frankel Cardiovascular Center now occupies much of the land on which it stood.

Today, just as was the case for Old Main, a viral pandemic and an economic depression have forced a pause in hospital construction. Just as was the case about a century ago, we wait for construction to resume.

Top photo: Old Main, 1924. Courtesy of the U-M Bentley Historical Library