by Karol K. Weaver
If you drive through Fountain Springs in Schuylkill County, Pennsylvania, you can see what remains of Ashland State General Hospital. Founded to provide care for railroad workers and miners, the hospital operated for nearly a century and was eventually closed under the name of St. Catherine’s.
Like other miners’ hospitals in Pennsylvania, Ashland had been founded through the combined efforts of state and business officials. A state representative from Orwigsburg, John T. Shoener recommended the establishment of a medical institution to treat injured miners. The state provided money for both the purchase of the land and the construction of the hospital. State leaders continued to fund the hospital after its opening. Coal and railroad bosses, likewise, contributed monies to the hospital—in part, to discourage train travel by injured miners to Philadelphia. They figured that the sight of mangled miners was bad for the transportation business.
During its years of operation, hospital staff took care of many patients including working men, women laboring to deliver their newborns, ailing youth, and old men struggling to breath due to the ravages of black lung. Moreover, the hospital trained hundreds of nurses, both women and men, many of whom went on to have life-long careers at hospitals located in the anthracite coal region and elsewhere.
My connection to Ashland Hospital is both personal and professional. Along with my elder siblings, I was born there. Like most dads of the time, my father waited, perhaps not as excitedly for his eighth child, in the waiting room and, then, as he had done for his other children, thoughtfully chose my name, Karol, likely thinking of the four-year-old son, Karl, whom he had buried years earlier.
As a young girl, my sisters and I also waited for what seemed like hours for my mother to finish visiting her father. At that time, children were prohibited from visiting patients. Instead, we sat quietly in the lobby, went to the canteen to buy drinks and packages of cheese and crackers, or rolled down the hill at the front of the hospital. My mother eventually returned and herded her three dizzy and tired daughters into the station wagon for the ride home to Strong, the small coal village where we lived.
In the same hospital, I was a teenage high-schooler completing chemistry homework as my nonno lay sleeping when I was directed by a nurse to phone my mom and dad to tell them that my grandfather was passing away and they needed to come quickly to say their goodbyes. In time, with my toddler son in tow, I visited my mother there as well, recuperating in the long-term care ward.
Ashland Hospital was not only the setting for happy and sad memories, but the subject of my professional work. As a historian of medicine, the anthracite coal region became the place I studied—focusing on the practice of medicine, the types of labor that men, women, and children did, and the leisure and play in which they participated.
My family and work connections to Ashland Hospital have taught me the important functions that small, rural hospitals played and should continue to play in the health care of Americans. Unfortunately, the massive health care systems that dominate the medical marketplace don’t see these hospitals as profitable and, therefore, necessary.
The latest example of this was the closure of UPMC Susquehanna Sunbury Hospital (originally known as Sunbury Community Hospital) in Northumberland County. The hospital was shuttered, hundreds of employees lost their jobs, and residents lost access to close, convenient, and local health services. In addition to the hospital’s closing, Sunbury Community Health and Rehabilitation, which occupied a floor of the hospital, also ended its services resulting in the loss of over 20 jobs and the relocation of its elderly residents to other facilities. The closing of the hospital raised fears of the most visible marker of economic decline: blight. Like cancer, one empty building metastasizes into many, destroying whole neighborhoods. Like the coal communities that surrounded Ashland, Sunbury still struggles under the deindustrialization that devastated Pennsylvania towns.
But the lack of access to local health care services is not just a Pennsylvania problem. Across the nation, small, rural hospitals, most in the US South and with Texas leading the way, sit closed, while residents are forced to travel miles to large suburban and urban health systems. In emergency situations, the distance is too long and patients die before they ever make it to the hospital. The lack of hospital services mirrors the absence of women’s health clinics as a result of restrictive legislation and regulations designed to permanently end these services. Moreover, the high co-pays and out-of-pocket expenses for the insured parallel the medical deserts brought about by the closure of small hospitals. If you can’t afford to be sick, you don’t seek health care whether it can be found or not.
And, now here we are in the middle of a pandemic. News reports tell nervous Americans about the limited number of hospital beds and the high number of COVID-19-infected persons in urban areas and urban hospitals. Politicians shamelessly talk about profits being more important than people and proclaim their willingness to sacrifice the elderly. Grocery store workers, health care workers, warehouse workers, and truckers, like the miners and factory workers of years ago, put their lives and the lives of their loved ones in harm’s way. Community members, like the men, women and children in coal country many years ago, band together forming mutual aid groups, checking on their neighbors, and re-purposing materials they can’t afford or find.
Sitting here, I can’t help thinking about Ashland.
Karol K. Weaver received her Ph.D. from the Pennsylvania State University. She has written two books, Medical Revolutionaries: The Enslaved Healers of Eighteenth-Century Saint Domingue (University of Illinois Press) and Medical Caregiving and Identity in Pennsylvania’s Anthracite Region, 1880-2000 (Penn State Press). She is a proud coal cracker.
Also by Karol K. Weaver
Small Town Pharmacist