Wednesday, March 13, 2013

Interview with Author KATHY OTTEN

Boston City Hospital-

Have you ever wondered what a hospital was like in the olden days? Most people, especially the rich and middle class, were treated at home. They preferred surgery in the bed room or on the kitchen table rather than go to a hospital. Only those too sick to take care of themselves went to the hospital, a place know for filth and pestilence.

In my newest Victorian, holiday novella, Another Waltz, my hero ends up in a hospital in Boston.  While doing the research I became engrossed in a fascinating book, A History OF The Boston City Hospital From Its Foundation Until 1904, by David Williams Cheever, George Washington Gay, Amos Lawrence Mason, Johns Bapst Blake, Boston City Hospital

Built to provide comfort and care to the poor patients of the city, construction of Boston City Hospital was begun in 1861, on Harrison Avenue in the South End of Boston, north east of Roxbury.

In the 1830’s a project was begun in which fill was brought in by trains to fill in a large portion of Boston’s Back Bay and it was on the former Tidal Marsh that the hospital was built.

The four buildings of the original group were designed in the French Renaissance style.  The administration building was an imposing structure of brick, with tall wooden columns, balustrades and porches with a large dome at the very top, 148 ft. above the street. The first floor was used for general administrative purposes, with a reception room for visitors and offices and apartments for the superintendent and trustees. The second floor contained private rooms for patients and the third floor, flooded with light from the great dome, was used for operating rooms. Two stairways and a hand elevator were used to move patients. The basement rooms were 13 ft. high with another sub basement. These lower stories contained a kitchen, storerooms, a dispensary, a laboratory, and a dining room for the employees, with rooms for clerks and stewards.

To the left and right of the administration building were Pavilion’s I and II.  One hundred feet away, they were connected by a cover colonnade. Each building was 180 ft. X 48 ft. and had three stories with a basement 3 ½ ft. below the grade of the ground. Pavilion I, the surgical side, contained Wards, A, B, C, & D, and Pavilion II, the medical side held Wards, E, F, G, & H.

Because of the surgical and antiseptic methods of the day, hospital gangrene and general sepsis were common. In 1866, Pavilion III, known as the “Foul Ward,” was built where the old Roxbury canal had channeled its sewage into the old marsh. The main ward was for men and the second story for women.

The original boiler room was located on Albany Street, parallel with the Administration building. Steam was generated from three tubular boilers at thirty pounds of pressure. Steam was carried to a large battery of steam coils, and fresh air, drawn through a latticed window was forced by a large propulsion fan 15 ft. in diameter, through a large sub basement conduit. From here the heated air was distributed by smaller ducts, to the various wards.  A secondary system of ducts admitted cold air and by mixing the valves the correct portion of hot/cold air could be maintained.

The problem was that the conduits, which in some places were 10 ft. wide and 12 ft. high, had too many leaks to properly achieve this.  Then rats, which soon burrowed between the sewers and the imperfectly constructed conduits, caused sewer gas to be mixed with the heated air and pushed into to the wards. All patients in beds near the air inlets invariably ended up with septic complications, many of whom died.

Then because the hospital was built on such a low grade, the flow of tides caused seepage of ooze into some areas of the buildings.

In these early days sewage was removed by barrel sewers, but the sluggish flow caused solids to settle and form deposits that gradually became obstructive.

The original medical and surgical staff consisted of eighteen members. One third was consulting physicians and surgeons. The rest were house officers, (interns) who roomed in various parts of the hospital and were equally divided between the buildings.

Patients slept on beds with horse hair mattresses with blue and white striped ticking.  They were covered with a coarse linen sheet and beige wool blankets. In the wards of the hospital, there were seven windows on each side of the ward with two beds to each window.  It had also been voted that except for emergency cases, no one could be admitted to the hospital without a satisfactory character reference.



After a magical waltz in a winter wonderland with the only man who has ever made her believe she is beautiful, Madeline Winthrop doesn't think life could be anymore perfect--until the night of the Christmas ball when she learns everything James Sullivan has told her is a lie.
Revenge against Madeline's brother forces James to do what ever is necessary to get back what was stolen from him, even if he has to use Madeline to do it. But the one thing he doesn't count on is the way she makes him feel.


Above her loomed a wide porch with four Corinthian columns and balustrades. She blew her runny nose and pushed her spectacles tight to the bridge of her nose. After stuffing her handkerchief into her coat pocket, she grasped the fabric of her skirt and carefully limped up each snowy step one at time, eighteen times.

Inside, the ceiling soared above her head even higher than twelve foot ceilings in Payton’s house. On either side two large staircases stretched toward the second floor. A door snapped shut somewhere; the sound echoed through the building. Across the width
of the room she spotted a sign over a door of a room marked Visitors. Her heels clicked loudly against the tile, their cadence out of time. After all these years, she could still hear the sing-song chants of the girls from boarding school ringing in her head. “Gimpygirl!
Gimpy-girl!” Even her brother had mimicked their taunts.

“Excuse me?”

The woman seated behind the desk raised her head. Her shrewd gaze silently appraised Madeline from the bonnet which protected her head to the kid gloves which covered her hands.

Madeline continued. “I’m looking for a man—”

The woman interrupted with a quick bark of laughter, flashing rows of crooked, yellowed teeth. “Dearie, ain’t likely anyone of your quality would be here.”

Madeline shuddered at the limp strands of salt and pepper hair, which had fallen from the woman’s bun to frame her face and sagging throat. The fingernails of her hands, as they dealt a game of solitaire, were rimmed with black.

Adjusting her spectacles Madeline repeated her question. “Do you have a patient here by the name of Sean MacAuley?”

“An Irishman, eh? Well, we got lots a them here, but none by that name.”

Madeline glanced beyond the desk, to the file cabinets, tables, and shelves, stacked with ledgers and piles of papers. How could this person remember the name of every patient?
“Could you please check your records? He would have been admitted the night before last.”

The matron heaved a sigh, which strained the bosom of her too-tight blouse, as she half-heartedly sifted through the piles of papers littering her desk. After a couple of minutes, she looked up and shook her head.

Madeline’s shoulder’s drooped. Where else could he be? This had to be the right hospital. Unless he’d gone back to where he’d been staying. With all the hotels in the city, it would be like hunting for a needle in a haystack. Maybe she should just forget the whole idea and let him go.

“There was a man—” the woman added, startling Madeline from her musing. “—the police brought him in. Don’t know his name.” The wooden chair creaked under her cumbersome weight as she flipped open the book beside her. “He was listed as an accident patient. That would put him in North Pavilion,” she pointed toward a side door on the right.

Madeline murmured her thanks and once outside walked beneath the covered colonnade, which spanned the curved distance between the administration building and the entrance to the Pavilion.

Once inside, the nurse in Ward A informed her that the beds were filled to capacity, but some of the male patients were being tended to in the basement, and Sean might be with them.

Stale sweat, urine, and vomit blended together with an assortment of noxious odors, forcing
Madeline to swallow an urge to gag.

Though less than half of the wall was actually below ground level, she still wondered how these poor souls could survive in such damp conditions. The nurse on duty indicated the bed at the end of the row as the one, which held the nameless patient.

As she started down the wide aisle separating about twenty beds, for the first time she prayed that Sean wouldn’t be here. She pictured him on a train, heading back to Texas, his wide grin in place as he seemingly laughed at the world like it was all some secret joke.

She passed through a pocket of cold air, into a wave of heat blowing from a large ventilation duct, then shivered as she moved back into the cold. A few more steps and she was forced to detour around a pile of soiled linens and dirty bandages which littered the aisle like flotsam in a stream, all while maintaining her focus on that last bed. She glanced around, certain every eye was on her as she limped through the ward, relieved to find most of the men were either asleep or watching her with vacant eyes.

As she came to a stop at the end of the iron bed, a gasp that was part relief and part horror escaped her lips. For although she was relieved to have finally found the man, who, until Thursday night had been known to her as James Sullivan, she barely recognized the battered visage of the man sleeping restlessly before her.


  1. Oh I can't even begin to image how filthy and disgusting hospitals were back then. YUCK! I think I'd prefer my bedroom or kitchen table too LOL

    Your books sounds great - loved the blurb! Wishing you the best, Kathy!

    *waving* Hey Sarah!!! Thanks for sharing another new-to-me author.

    1. Hi Rene,
      Thanks for stopping by. They had no idea about germs and bacteria back then and at this point in time, didn't worry too much about the sewer gases being pumped through the ventilation system. Can you imagine that in a hospital today?

  2. No wonder no one who avoid it wanted to go to the hospital. Wonderful excerpt. I tweeted.

    1. Hi Ella,
      Thanks for tweeting! :) You're right. No one wanted to go to the hospital back then. They thought of it as a death sentence, though the doctors really did try their best. They just didn't have the knowledge.

  3. My grandmother always said that a hospital was a place to die. I'm sure that she'd heard those stories of filth and death from her parents as a child. This post was excellent. The excerpt made the experience of the hospital real. thanks you for the interview and information. Best success to you, Kathy, on Another Waltz.

    1. Hi Sandy,
      I remember my mother telling me how she had her tonsils out on the kitchen table, and that would have been back in the thirties. I guess even then hospitals were scary.
      Thanks for your good wishes! :)

  4. Fascinating. As a medical professional (Rad.Technologist/mammographer) I love reading about old hospitals.The changes in medicine since the 1800's is amazing enough, but you wouldn't believe the changes that have been made in just the last 32 years. Wow! Love your excerpt and blurb. Yet another TWRP book to add to my TBR list.

    1. Hi Lilly,
      Thanks for stopping by. I'm working on a new book that takes place in a hospital during the Civil War and the medical stuff is both fascinating and terrifying. And seeing what your job is reminds me I'm due for a mammogram. LOL

  5. This was a fascinating read, Kathy! Being raised amongst doctors, dating back hundreds of years, it's very interesting to think about what some of them worked in. Some only went to patients' houses, which now I understand why. Thank you for the post, and your book sounds great!

    1. Hi Lani,
      Thanks for stopping by. The book I used for research (mentioned in the blog) had lots of cool pictures too. They did mean well when they built the hospital, there was just so much they didn't understand. Even the medical training was sadly lacking.

  6. Replies
    1. Hi Gerri,
      Thanks for stopping and taking the time to leave a comment. I appreciate your kind words.

  7. Great post, Kathy! I love American Victorian romances! Not enough of them out there, though.

    And I'd heard that people of that era avoided hospitals at all cost, because they were so dirty and infested with disease.

    1. Hi Susan,
      You are so right. Even now people avoid hospitals and doctor's offices because they don't want to catch anything. Thanks for stopping by.

  8. Jennifer Page(JC)March 13, 2013 at 1:44 PM

    How interesting Kathy! Reminds me of the Mental Hospitals and how the Geel(Belgium) made changes for the better. All the best with this Romance...Love the characters already! Great interview Sarah:

    1. Hi Jennifer,
      I looked at mental hospitals a long time ago, when I was playing around with an idea for a book I just finished. Now those were scary places. And a husband could just commit a wife for something as simple as PMS depression and leave her there and there was nothing she could do.
      Thanks for the kind words. :)

  9. Very interesting, Kathy. I can't imagine having to recover in conditions like that. Guess that is why many did not.


    1. Well hey there Allison! How are you? Many people were pretty sick or injured when they arrived and unable to care for themselves, otherwise they never would have consented to go. I suppose that in and of itself lowered the odds for recovery.

  10. Hi Kathy,
    Wonderful article. A lot of the time patients got sicker in hosptial than they would have at home. And I guess the surgical instruments would have been very basic.



  11. Thank you everyone for stopping by and showing your support. I am just now able to get on here and say something. Internet was being goofy!