March 6, 2011

19th century Fabiola ladies championed health care for all

Fabiola Hospital in its heyday.

Kaiser Permanente Oakland stands today on one of the busiest intersections in the city, destined to bustle even more with the new medical center rising in place of the MacArthur-Broadway indoor mall.

What many may not realize is that the groundwork for the Kaiser Permanente complex was laid — both literally and figuratively — in Oakland’s early years by a group of high society women of the Fabiola Association.

In 1887, it was at that same corner, then New Broadway and Moss Avenue, on 2 ½ acres of land covered with oak, eucalyptus and locust trees donated by Anthony Chabot, that the Oakland Homeopathic Hospital and Dispensary constructed a splendid turreted Victorian building. They named it the Fabiola Hospital after a wealthy woman who built a public hospital in 4th century Rome.

It looked more like a railroad baron’s mansion than what we might think of as a medical building, but it was in line with what those 19th century matrons thought was best for sick people — an environment that was home-like and comforting.

Privileged women strive for underprivileged

The group had been organized by Kate Kirkham 10 years before. She witnessed a carriage accident and was horrified to learn the victims would be taken 10 miles to a San Leandro hospital, the nearest hospital at the time. She collected $50 donations from 18 women of her circle — local water developer Chabot was a friend of hers — and opened the group’s first facility on Market Street.

Fabiola hospital building

Bucolic setting of original Fabiola hospital

They formed the Fabiola Association to support their work, which focused on providing medical care to anyone who needed it. In its early years, the association members were proponents of homeopathic care.

Once the hospital went up, the association members established a nursing school that accepted men (an oddity at the time), a diet kitchen, and a visiting nurse service. They began a program of expansion that didn’t abate until the Great Depression hit in the 1930s.

Fabiola grew to meet community needs

Fabiola’s expansion was much like the evolution of the modern-day Kaiser Permanente’s complex. Before 1900, Fabiola annexed a Queen Anne-style cottage to the main building for the nurses’ quarters, and then added a facility for children and a maternity “cottage.” Over the following 20-plus years, the hospital spread across Broadway with the takeover of a Red Cross facility and the building of a graceful Spanish-style nursing home designed by Julia Morgan.

inside of maternity hospital room

Interior of maternity cottage late 19th century

A new surgical building went up in 1907 along Moss Avenue and Howe Street. The final spate came in 1923, accompanying a building boom across the city, when the Fabiola ladies built another nurses residence at 3797 Piedmont Ave., with a tennis court.

The year ended with the completion of a modern 50-bed maternity hospital at the corner of Moss Avenue and Broadway appointed with, according to the Oakland Tribune, “antique walnut, rich rugs and cretonne hangings.”

The much-touted maternity building, you may realize, became home to the first Kaiser Permanente hospital in 1942. But there’s more to this story.

Both Kirkham and Kaiser dreamed of better access to care

The Kaiser Foundation Health Plan’s mission is built upon the work of earlier generations that saw providing adequate health care as a duty of the society. And people of means often took it on as their personal mission. Henry J. Kaiser was inspired to set up the Kaiser health plan by his mother’s untimely death, much as Kate Kirkham was prompted by the suffering she witnessed in the accident.

In the progressive era, women across the country started hospitals and clinics for women, children and the poor. The Fabiola Association was part of the trend. Members insisted in their by-laws that the hospital be managed by women and that the staff doctor always be a woman.

Black and white photo of exterior of hospital

Fabiola maternity hospital circa 1924

Society ladies took care of working nurses

The Fabiola women were fiercely devoted to the welfare of the nurses. In 1902, they were encouraged by the board president to take turns sending their carriages out “at 8 o’clock in the morning to take the night nurses out for an hour or two driving in the quieter parts of our suburbs” to help them relax before going to bed.

There were power struggles among the ladies who served on the Fabiola board and at least one strike by nurses which necessitated the matrons' heading over to the hospital to hoist the bed trays up from the kitchen. They were also taken to task by local ministers who berated them for raising money through gambling, with the Fabiola Derby Day at the Oakland Trotting Park.

Again, owing to their social status, such criticism didn’t stop them. “Oakland’s most exclusive dames are members of Fabiola and they are indignant over Rev. Baker’s strictures,” reported the Tribune in June 1904.

Each year, the Fabiola Association issued their service statistics. In 1900, they saw 871 patients of which 619 were hospitalized. Of those, only 131 paid the full hospital charges, the rest paid nothing or just what they could afford. By 1930, the hospital saw 4,753 patients, of which 517 received free care.

Unfortunately, the good works wrought by the Fabiola ladies soon came to a crashing halt. Hard times reduced paying customers and donations dried up. The hospital closed in October 1932. The Tribune’s headline was “Fabiola Ends Experiment in Feminism” and editorialized that the regret felt by Oaklanders for its loss “was akin to grief.”

Original architectural beauties demolished

Early the following year, the glorious original hospital — a building that would qualify for landmark status had it survived — as well as the children’s annex, nurses home, and the surgical building were all razed. The new maternity hospital was saved in hopes the operation could be resurrected.

Instead, the Fabiola Association turned over all its assets to Samuel Merritt Hospital in 1940 with the stipulation that it be used for those unable to afford hospital care, and the women went to work for another decade to aid that effort. The real estate, including the hospital, was estimated at a $75,000 value.

black and white photo of hospital post renovation

Fabiola maternity hospital renovated and reopened as the first Permanente Foundation Hospital circa 1942

The hospital was considered still quite modern with its reinforced concrete construction, and Henry Kaiser and Dr. Sidney Garfield were quite pleased to find it in 1942 when they were running out of room to treat shipyard workers at the Richmond Field Hospital. They paid $333,000 for the land and renovations and reopened it in August.

The Fabiola building served as the core of the original Kaiser Permanente complex during the war and early days of the public health plan. Many additions and renovations on the site characterized Oakland’s flagship facility’s growth over the past 65 years.

At one time, the Fabiola was painted pink, Henry Kaiser’s favorite color, and in its last iteration was encased in aluminum, one of Kaiser Industries’ main industrial products. The 1923-built, four-story building was torn down in 2005 as part of the Oakland Medical Center rebuild project currently underway.

Kaiser Permanente carries on Fabiola’s original mission

Few Oaklanders remember the old hospital now, though scores were born in the homey maternity cottage, including my father in 1920. The new Fabiola building on Howe Street is the last reminder of that “institution of real Christian socialism” — as defined by its president Mrs. J.P.H. (Catherine) Dunn at its closing — that was the original Fabiola.

If in later years Henry Kaiser was accused of being a “socialist” for putting forth a prepaid, group health plan, he stands shoulder to shoulder with Kate Kirkham and her successors in realizing his shared humanity with those in need but without means.

Over a century separates the pastoral beauty that surrounded the 19th century Fabiola Hospital from the current scene: pavement, numerous traffic signals and striped crosswalks that knit together Kaiser Permanente’s modern complex. But the legacy of thoughtful health care and community benefit is what abides.