The Carter Hospital (Part 1)

As tuberculosis became the leading cause of death in the United States during the turn of the twentieth century, the Office of Indian Affairs began to pay increasing attention to health concerns, finding staggeringly high rates of morbidity and mortality due to the disease among the tribes (Godfrey 2017, also see Murphy 1910). Whole Native families were dying from tuberculosis as many individuals stayed sick for extended periods of time. On October 14, 1911, the Choctaw Nation General Council passed an act, providing that a sanitorium be created for Choctaw and Chickasaw tuberculosis patients. The bill was signed by G.W. Dukes, President of the Senate, and Osborne Anderson, Recording Secretary. The House passed the bill the same day and was immediately signed by Victor M. Locke, Principal Chief. On May 7, 1912, the U.S. Senate passed an act (concurred by the U.S. House of Representatives on May 8, 1912) authorizing the Secretary of the Interior to set aside funds to purchase land for the sanatorium not to exceed four sections of unallotted tribal lands.

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis that usually affects the lungs but can also affect other parts of the body. Typical symptoms of TB include chronic cough with mucus containing blood, fever, night sweats, and weight loss. Tuberculosis called “Hichushi-ililli” in Choctaw, was also commonly referred to as consumption or the “Great White Plague,” due to the progressive deterioration or wasting condition of the sufferer’s overall health and extreme anemic pallor or paleness of those afflicted (Frith 2014: 32). TB is highly contagious and spreads through the air from person to person.

Following the discovery of the tubercule baccilum – bacteria that causes tuberculosis – in 1882, the United States launched several massive health campaigns to educate the public on tuberculosis prevention and treatment. During the early twentieth century, educational pamphlets were widely advertised in local newspapers, including the Talihina Democrat, which emphasized the disease’s contagious nature and recommended preventative measures such as sleeping in the open air (Talihina Democrat, July 29, 1910:3). As the annual financial cost of the disease rose dramatically across the United States, the Red Cross partnered with the National Tuberculosis Association to sell Christmas mail stamps to help fund educational outreach and treatment. In 1912, the United States Public Health Service examined the prevalence of tuberculosis and other infectious diseases on reservations and boarding schools and found several factors contributing to the spread of tuberculosis, including unsanitary conditions, overcrowding, and poor food (Commissioner of Indian Affairs 1912: 19-21). During the early twentieth century, Choctaws and Chickasaws were still largely suffering from the lingering and continued effects of Removal and the distruption to their communities because of allotment. According to Swanton (2001 [1931]: 238), tuberculosis became especially rampant among the Choctaw community when people moved from traditional homes to poorly ventilated log cabins that were sealed with chinking.

Sanatoria were developed in the mid-nineteenth century to treat TB. These were specialized hospitals where persons with TB were sent to be cured with the aid of fresh air, nutritious food, and exercise in the form of “mountain walks.” Patients spent part of the day reclined outside on wide sun porches taking in the fresh air. This method, called “the rest cure,” was sometimes beneficial for patients with minimal disease, but many with severe infection never recovered.

Situated at the foot of the Buffalo and Winding Stair Mountains, approximately three and a half miles northwest of the town of Talihina, a more idyllic place for a sanatorium in the eastern portion of the state could not be found. Nestled among the tall pines, the future site of the Choctaw-Chickasaw Hospital was selected for its picturesque location as well as its proximity to several large springs (Choctaw Herald, April 1, 1915: 2, also see Talihina Tribune, November 24, 1916: 1). Gabe E. Parker, Superintendent of the Five Civilized Tribes (1915-1921) and an enrolled Choctaw, approved an expenditure of $50,000 for the hospital to serve the two tribes and began advertising in the spring of 1915 for bids to construct a frame hospital building (Daily Ardmoreite, April 20, 1915: 3). The contract to construct the original sanatorium and related buildings was awarded to Horton Smith (Des Moines Register, May 29, 1915: 7). The initial appropriation was secured, and the actual work began that year. Improvements included a frame hospital, powerhouse, water, sewer, and lighting systems at a total cost of $48,954. The property was placed in the care of W.M. Donner, who, under the Indian Department (which later became the Bureau of Indian Affairs), supervised various stages in the hospital’s construction. The institution was officially named the Carter Sanatorium. With 10 years of experience in government work, Special Physician W. E. Van Cleave was placed in charge of the sanatorium to help finalize and set up the hospital. Ten to twelve full-time personnel were anticipated. Construction of a road from Talihina to the hospital, a laundry building, and a barn were also completed.

During the hospital’s dedication banquet, Parker declared the newly completed sanatorium “the only one exclusively for Indian patients in the world” (Muskogee County Democrat, November 16, 1916). G.W. Dukes also spoke at the dedication, asserting the great need for the institution among the Choctaws and Chickasaws who were rapidly suffering and dying from the disease with little to no medical attention (Talihina Tribune, November 24, 1916: 1).

Dr. Van Cleave was temporarily relieved in July 1917 by Dr. Walter S. Stevens but returned to manage the facility shortly thereafter. The Carter Hospital, built to accommodate about 60 patients, officially opened on November 17, 1916. Its first patient was Miss Ida James of Whitesboro (Talihina Tribune, November 10, 1916: 1). By the following year, the hospital had 20 patients, mostly youth.
William H. Ketchum, a member of the Board of Indian Commissioners and a Catholic missionary, sent several updates to the Hon. George Vaux, Jr., Chairman of the Board of Indian Commissioners, during and after the hospital’s construction, strongly advocating for additional resources and funds.  Plans were made to erect a tent colony in the neighborhood to treat patients while the building was being equipped (Muskogee Times Democrat, March 14, 1916: 3).

In 1917, Ketchum reported additional plans to construct cottages for older patients and hospital staff. He also urged the Commission to appoint a Choctaw official who could act as an interpreter for the physicians and nurses to help the patients feel more at home, which would hopefully encourage them to stay for the duration of their treatment. Ketchum envisioned the hospital less as a treatment facility and more as a “colony,” or self-contained village, so he advocated for provisions to improve the well-being of the patients, such as religious services and open-air classes for the children. Ketchum also participated in a vigorous educational campaign, which took the form of local health drives and community outreach. At Ketchum’s insistence, the Department of the Interior’s Office of Indian Affairs, printed an informational pamphlet on tuberculosis in the Choctaw language in 1917. The pamphlet explained the transmission of the disease, encouraged clean and sanitary living conditions, and included instructions on how to use and dispose of sputum or spit cups (Department of the Interior Office of Indian Affairs 1917).

Regular newspaper updates from the hospital included the comings and goings of visitors and patients and the procurement of a dedicated vehicle for the sanatorium. Life at the sanatorium followed a regular schedule. The Delphian Club entertained at the Sanatorium and classes began to be taught to the younger patients (Talihina American, May 17, 1918: 1, also see July 2, 1920: 8). As the demand for hospital beds increased, the complex grew to include a superintendent’s cottage, employee housing, a commissary, a school, and a working farm that included a dairy barn, a hog shed, cow shed, poultry house, hay storage, and feed storage.

By 1921, there were still no Choctaws or Chickasaws on staff at the hospital. The facilities were also frequently overcrowded and being used to treat non-TB patients without any separation. In 1928, the Institute for Government Research released the Meriam Report, which severely criticized the Department of the Interior’s implementation of the Dawes Act and subsequent healthcare services, finding a general lack of personnel, equipment, management, and design. Following the inauguration of President Franklin D. Roosevelt in 1933, Indian policy changed significantly in place of governmental policies aimed toward assimilation and reformist policies centered on the preservation and improvement of Indian health conditions. With additional funding opportunities made available through New Deal public works programs, improvements to the facilities at Talihina began immediately (Godfrey 2017: 7). By the end of 1935, plans were being made to construct a 225-bed addition on the campus at an estimated cost of $862,500. In 1939, the Carter Hospital was converted into an employee’s building. However, the building is no longer standing. Today, the oldest standing building on the property is the Van Cleave’s cabin, built in 1921, which is still in use. Next month’s Iti Fabvssa article will discuss the history of the Talihina Indian Hospital and the development of the Choctaw Nation Healthcare System.

Links

• Department of the Interior’s Office of Indian Affairs 1917 tuberculosis pamphlet printed in Choctaw and English

Bibliography

• Choctaw Herald [Hugo, Oklahoma]. 1915. “Choctaw Sanitorium will be Built.” April 1: 2.
• Commissioner of Indian Affairs. 1912 (Annual Report). “Health.” In Report of the Commissioner of Indian Affairs to the Secretary of the Interior, for the fiscal year ended June 30, 1912, pp. 19-21, Washington.
• Daily Ardmoreite [Ardmore, Okla.]. 1915. “Frame Hospital Building.” April 20: 3.
• Department of the Interior Office of Indian Affairs. 1917. Hichushi-ililli (Tuberculosis) vt Hatak-vpi-humma Okla Aiitintakla Ya Aiasha. Washington, D.C.
• Des Moines Register [Des Moines, Iowa]. 1915. “Receives Important Government Contract.” May 29: 7.
• Frith, John. 2014. History of Tuberculosis. Part 1 – Phthisis, consumption and the White Plague. Journal of Military and Veterans’ Health 22(2): 29-35.
• Godfrey, Anthony. (2017). Historic American Buildings Survey, Talihina Indian Hospital. U.S. West Research, Inc. Salt Lake City, Utah.
• Murphy, Joseph (1910). Manual on Tuberculosis: Its Cause, Prevention, and Treatment. Office of Indian Affairs, Government Printing Office, Washington.
• Muskogee County Democrat [Muskogee, Oklahoma]. 1916. “Parker to see Dream Realized: Only Sanatorium for Indians in the World is Formally Opened at Talihina.” November 16: 3.
• Muskogee Times Democrat [Muskogee, Oklahoma]. 1916. “Hospital for Choctaws and Chickasaws in Talihina, Okla.” March 14: 3.
• Talihina American [Talihina, Oklahoma]. 1918. “A Brief Visit to the Indian Hospital.” May 17: 1.
• Talihina American [Talihina, Oklahoma]. 1920. “Sanatorium – Delphian Club.” July 2: 8.
• Talihina Democrat [Talihina, Oklahoma]. 1910. “Sleeping in the Open Air.” July 29: 3.
• Talihina Tribune [Talihina, Oklahoma]. 1916. “Choctaw Hospital Open for Patients.” November 10: 1.
• Talihina Tribune [Talihina, Oklahoma]. 1916. “Choctaw Sanitarium Formally Opened.” November 24: 1.
• Swanton, John R. 2001 [1931]. Source Material for the Social and Ceremonial Life of the Choctaw Indians. The University of Alabama Press, Tuscaloosa.