Note: This article was originally published in 2013 and republished in 2025 for the University of Michigan Medical School’s 175th anniversary.

By the late 1880s, the temporary wooden Pavilion Hospital had survived on the north side of the Diag for nearly 15 years. That was long enough, insisted President James B. Angell, for the university to be housing contagious patients so close to a growing population of students.

A new home was needed for the university hospital, and 10 acres were acquired on the northeastern outskirts of town, near the Detroit Observatory. There the sprawling compound called the Catherine Street Hospital arose, and the medical campus was born.

A planning committee visited new hospitals in the East and came back with a grand scheme that would cost more than $200,000. But nothing like that amount could be raised, and the planners had to settle for an economy version — much to the despair of a generation of doctors, students, and patients.

The legislature gave $50,000 for two buildings — one for the allopathic Department of Medicine and Surgery, the other for the Homeopathic Medical College — and the citizens of Ann Arbor donated $25,000 more. The buildings opened with 104 beds on December 1, 1891.

“The heating, ventilating, lighting, and draining of the wards have received the most careful attention,” the university bragged in its publicity materials. “The laboratories are equipped with all necessary apparatus for the scientific investigation of disease, and the most perfect instruments for the use of the X-rays in diagnosis are provided.”

Of all these innovations, the ventilation system may have been the most welcome, at least at first. Inspectors had been saying the smell inside the Pavilion Hospital took them right back to the pestilential field hospitals of the Civil War.

Whatever the new buildings’ advantages over the old Pavilion Hospital, they were still inadequate to a growing city and a diversifying medical profession. New specialties demanded new facilities, and the new hospital had hardly opened its doors before additions began to sprout. Old structures were picked up and moved. The buildings were connected by ramshackle passageways, some of them exposed to the weather. Bewildered visitors studied signs and maps to find the Surgical Pavilion, the Palmer Ward for pediatrics, the Contagious Hospital, the Otolaryngology Ward, the Psychopathic Hospital, and others. The Maternity Hospital occupied one rambling frame house, the Maternity Cottage another. The U-M Dental School moved in. In 1900 the Homeopathic Department moved to new quarters on North University (the building now called North Hall), whereupon its vacated building on Catherine became the new Surgical Ward. Eventually, the compound comprised some 20 buildings with 400 beds.

More beds meant the ability to treat more patients, of course, but it also meant increased demand. Patients now came to Ann Arbor from outside of Washtenaw County, and if the wards were full, the overflow patients had to find quarters in the neighbor- hood’s boarding houses.

The hospital’s fees will strike 21st-century readers with wonder. For in-state patients, the cost of “all ordinary care and medicine” was $1.50 per day in the wards, $2.10 per day in a private room. Out-of-staters paid half a dollar more. A patient paid $35-50 for a “minor” operation, $80 for abdominal surgery.

Pregnant women entering their “confinement” paid $2.50 per week in the Maternity Cottage. But regulations specified that they must “assist with the housework, care for their own rooms, help with plain sewing, prepare vegetables, fruits, etc. ...” And any woman who required surgery was expected to bring a letter of consent signed by her husband. What a single woman was to do about this, or a woman whose husband withheld his permission for surgery, hospital authorities did not say.

By the early years of the 20th century, wrote Reuben Peterson, M.D., a faculty member and early historian of the hospital, “the old Catherine Street Hospital group … had become one of the great teaching hospitals of the country.” But this reputation was due to faculty stars such as the pathologist George Dock and the bacteriologist Frederick Novy. The buildings themselves had deteriorated into “a most shocking condition,” thanks largely to a non-medical hospital superintendent who valued thrift above all other virtues. The food was unbearable. “Piles of dirt [were] allowed to accumulate in corridors, wards and private rooms,” Peterson wrote, and preventable infections were rampant among patients and staff. Odors from the dog laboratory pervaded the lecture rooms.

In the face of outright scandal, a committee of the medical faculty overthrew the hospital’s non-medical managers and waged a massive clean-up campaign. They replaced the appallingly poor food service with a new kitchen and bakery; hired a hospital usher to establish an efficient system of admitting patients; and covered dingy, dark walls with sparkling white paint.

But the improvements couldn’t untangle the hodge-podge of the buildings themselves. Hospital stores were crammed in a labyrinth of basement rooms. Patients were prepared for surgery in bathrooms. There were no laboratories designed for teaching. Students in the West Medical Building sat on tiers of rock-hard benches to watch operations that could be seen only from the front rows. (When the administration later appealed to alumni for donations to save the building, one replied: “Sure, I will give 10 dollars to preserve the old Medical Building. However, if you tear it down, I will donate 25 for I have distinct recollections of sitting on those damn old seats.”)

By World War I, the inadequacy of the facilities on Catherine Street had become painfully obvious to all. The automobile industry was turning Michigan into a prosperous center of industry, and it was no longer necessary to pinch pennies. The expenditure for the original Catherine Street buildings had been $75,000. Now, nearly 30 years later, plans took shape for a world-class hospital that would be built for roughly $4 million. It would open its doors in 1925.

“To the members of the teaching staff and the medical alumni who had to put up with the inconveniences of the old Catherine Street Hospital,” Peterson later wrote, “the new hospital is still hardly believable.”

Sources include the papers of University Hospital and Reuben Peterson’s unpublished history of the hospital, both held by the Bentley Historical Library; and Victor C. Vaughan, A Doctor’s Memories (1926).