Once upon a time, in Canada, people thought we didn’t need hospitals. It’s hard to believe, but they thought that hospitals were for poor people who couldn’t afford to pay a doctor to come to their house. Or for those people who didn’t have a house for the doctor to come to. People confused hospitals with the poor house, or insane asylums, or with temporary quarantine stations when there was an outbreak of an infectious disease. It was hard to argue for building a special, permanent, expensive structure just for health care.

Hospitals built in the early 1900s had a large central administration block, with long narrow wings for medicine and surgery. Long narrow wings facilitated the Nightengale principles of lots of fresh air and natural light. This layout also served to keep different kinds of patients separate—keeping surgery away from the maternity wing, and isolating people with infectious diseases from other patients to help prevent spreading disease.

In the 1930s and 1940s Canadian hospitals were designed with special facilities for labs and x-rays, and were becoming large enough to have record keeping and laundry facilitie Read More
Once upon a time, in Canada, people thought we didn’t need hospitals. It’s hard to believe, but they thought that hospitals were for poor people who couldn’t afford to pay a doctor to come to their house. Or for those people who didn’t have a house for the doctor to come to. People confused hospitals with the poor house, or insane asylums, or with temporary quarantine stations when there was an outbreak of an infectious disease. It was hard to argue for building a special, permanent, expensive structure just for health care.

Hospitals built in the early 1900s had a large central administration block, with long narrow wings for medicine and surgery. Long narrow wings facilitated the Nightengale principles of lots of fresh air and natural light. This layout also served to keep different kinds of patients separate—keeping surgery away from the maternity wing, and isolating people with infectious diseases from other patients to help prevent spreading disease.

In the 1930s and 1940s Canadian hospitals were designed with special facilities for labs and x-rays, and were becoming large enough to have record keeping and laundry facilities. Though the modernist movement in architecture was happening elsewhere, the look of hospitals (like other public buildings in Canada) was conservative, keeping historic, decorative features like peaked roofs and ornamental details in the stone or brick façade.

In the 1950s, new hospitals built in urban Canada took the form of tall towers, usually surrounded by parking lots. These had flat roofs and a modern look. The decorative features were gone. They looked like big rectangular blocks meeting at right angles, sometimes forming a T or an X shape when viewed from above.

As hospitals got bigger and more complex, they required new systems to keep everything running smoothly. Hospitals built their own utilities, like central heating plants, incinerators for hospital waste, and industrial-sized laundries and kitchens.

When you see a large hospital, look for a big smoke stack. It could be attached to the central heating plant, or, in older hospitals, waste incinerators.

© CSTM & UHN 2002. All Rights Reserved.

Vancouver General Hospital

Vancouver General Hospital

Photo courtesy of British Columbia Archives
c. 1910
© British Columbia Archives


Hôpital Notre-Dame Montreal

Hôpital Notre-Dame Montreal

Photo copyright of Blackader Lauterman Library, McGill University
1924
© Blackader Lauterman Library, McGill University


Calgary General Hospital

Calgary General Hospital, built in 1953.

Photo courtesy of Calgary Hleath Region Archives

© Calgary Hleath Region Archives


Royal Jubilee Hospital Laundry

Royal Jubilee Hospital laundry Victoria, B.C., 1949

Photo courtesy of British Columbia Archives
1949
© British Columbia Archives


What happens if you are dependent on a ventilation machine to breathe, and there's a power blackout? Or if you are confined to a hospital bed, unable to walk, and there's a fire?

Hospitals have well-developed security and communication systems. For electricity backup, there are usually on-site generators that kick in when the main power supply fails. For fire and other emergencies, there is a communication system that uses specified “codes” to indicate what kind of emergency is at hand, and all staff are trained in what to do for the particular codes.

For instance, “Code Red” often means “Fire in the building.”

Big-city hospitals have doctors and nurses who specialize in different kinds of health problems. In contrast, clinics in remote communities have very few specialists.

So what happens when you have a medical problem that requires a specialist?

One solution is to travel to the city, but this can be expensive and disruptive. The emergence of satellite communications in the 1970s suggested a better way. One of the first trials of “telemedicine” in Canada linked doctors and nu Read More
What happens if you are dependent on a ventilation machine to breathe, and there's a power blackout? Or if you are confined to a hospital bed, unable to walk, and there's a fire?

Hospitals have well-developed security and communication systems. For electricity backup, there are usually on-site generators that kick in when the main power supply fails. For fire and other emergencies, there is a communication system that uses specified “codes” to indicate what kind of emergency is at hand, and all staff are trained in what to do for the particular codes.

For instance, “Code Red” often means “Fire in the building.”

Big-city hospitals have doctors and nurses who specialize in different kinds of health problems. In contrast, clinics in remote communities have very few specialists.

So what happens when you have a medical problem that requires a specialist?

One solution is to travel to the city, but this can be expensive and disruptive. The emergence of satellite communications in the 1970s suggested a better way. One of the first trials of “telemedicine” in Canada linked doctors and nurses in Labrador with specialists in Toronto and Ottawa. A Canadian company, CIFRA Medical, developed a system that allows a local doctor examining a patient to send data (like heart rate) and digital images (like x-rays) to a specialist in a larger hospital, all by satellite. The specialist can then help determine the best treatment for the patient.

Do hospitals make you healthy, or do they make you sick? Since their beginnings, hospitals have had the unfortunate potential to make people sicker than they were coming in.

Think about it: Hospitals put people carrying disease-causing bacteria and viruses in the same institution as people who are very old or very young or very weak: all of whom can be more susceptible to infection.

The building itself can facilitate the transmission of infection. Disease-causing organisms can travel through the hospital in ventilation systems, or on food dishes, or linens. Infection can be transmitted by medical equipment, like surgical instruments, catheters, and bedpans. Today there are systems in place to keep hospital infections in check (like strict sterilization procedures), but there still are occasional serious outbreaks.

“Patient seems comfortable. Leg is healing well.” This might have been noted in a patient record in 1900. At this time, patient records contained the handwritten impressions of doctors and nurses. By 1925, patient records were becoming more important, partly because the hospital was becoming larger and more complex, with different specialists doing different things with the patient. The patient record helped keep track of what was done, when, by whom, and the results. There were now reports from the x-ray department, from blood analysis lab, from nurses taking temperature.

By the 1970s, the look of patient records had changed considerably. You're not likely to find “Patient seems cranky” in your patient record now. Rather, it will mainly contain numbers and graphs on standardized forms.

© CSTM & UHN 2002. All Rights Reserved.

Hospital Safety Codes

Hospital safety codes from University Health Network, Toronto

Canada Science and Technology Museum, University Health Network Artifact Collection
2001
© CSTM & UHN 2002. All Rights Reserved.


Prototype Telemedicine Unit

Prototype telemedicine unit around 1998

Illustration by Mozhgan Kernanshahy
c. 1998
© Mozhgan Kernanshahy


Hand-washing

Hand-washing (a basic necessity in preventing hospital infections) at Toronto General Hospital, 1982.

Canada Science and Technology Museum, University Health Network Artifact Collection
1982
© CSTM & UHN 2002. All Rights Reserved.


Record-keeping

Record-keeping at Toronto General Hospital

Canada Science and Technology Museum, University Health Network Artifact Collection
c. 1985
© CSTM & UHN 2002. All Rights Reserved.


War means casualties. Injured men and women have to receive medical care. But how are they to receive care so far from home?

During the Second World War, injured soldiers received immediate treatment at mobile hospitals erected near the battlefield. There were also temporary Canadian hospitals set up in European cities.

Often injured personnel were sent home to recover.

Canada's first medical ship, the Lady Nelson, was outfitted with beds for patients, medical equipment, and medical staff to take care of these patients while they were transported home to Canada.

At Halifax harbour, patients were loaded onto specially-outfitted hospital train cars and transported to their home towns.

People tend to think of Canadians as polite, patient and conservative. Dr. Norman Bethune (1890-1939) was none of these. He was passionate, bold, and impatient with the more conservative members of his profession. In the 1930s he decided to fight fascism in the Spanish Civil War. In Spain, he organized a blood transfusion service that collected blood in the cities, and transported it out to the wounded near the front. This service was the first of Read More
War means casualties. Injured men and women have to receive medical care. But how are they to receive care so far from home?

During the Second World War, injured soldiers received immediate treatment at mobile hospitals erected near the battlefield. There were also temporary Canadian hospitals set up in European cities.

Often injured personnel were sent home to recover.

Canada's first medical ship, the Lady Nelson, was outfitted with beds for patients, medical equipment, and medical staff to take care of these patients while they were transported home to Canada.

At Halifax harbour, patients were loaded onto specially-outfitted hospital train cars and transported to their home towns.

People tend to think of Canadians as polite, patient and conservative. Dr. Norman Bethune (1890-1939) was none of these. He was passionate, bold, and impatient with the more conservative members of his profession. In the 1930s he decided to fight fascism in the Spanish Civil War. In Spain, he organized a blood transfusion service that collected blood in the cities, and transported it out to the wounded near the front. This service was the first of its kind, and enabled transfusions to be performed on soldiers soon after injury, reducing the shock caused by blood loss.

© CSTM & UHN 2002. All Rights Reserved.

Moving the Sick

Moving the Sick

Photo by Alexander n. Stirton, DND
Courtesy of National Archives of Canada
1944
© National Archives of Canada


Collecting Blood

Collecting Blood

Canada Science and Technology Museum, University Health Network Artifact Collection

© CSTM & UHN 2002. All Rights Reserved.


Learning Objectives

The learner will:
  • Observe evolution of hospitals, tools and treatments throughout the twentieth century;
  • Identify the evolution of medical technology and discuss its contribution to treatment and medical care;
  • Illustrate concepts in biology, identify specific diseases and treatments offered (past and present).

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