Lakeville State Sanatorium Design

When the Lakeville State Sanatorium opened in January, 1910, it was considered a model of tubercular hospital design. Identical ward buildings flanking a central administration building were constructed for male and female patients.

The design of these ward buildings by architect John A. Fox and the layout of the Lakeville complex reflected current thinking on modern sanatorium design at the time. Concurrent with the construction of the Lakeville hospital was the publication by the National Association for the Study and Prevention of Tuberculosis of a guide to sanatoria design. Entitled Tuberculosis Hospital and Sanatorium Construction, the volume discussed the importance of proper design, and it featured a photograph and floor plan of the Lakeville men's ward to illustrate the tenets it outlined.

The book's remarks about sanatoria in general were applicable to Lakeville as constructed:

These buildings are intended, as their name indicates, to house and care for patients who are unable, because of the advanced condition of their disease, to live in lean-tos or open cottages....

An advanced case hospital does not mean a home for incurables, for there can be no hard and fast line of demarcation drawn between curable and incurable cases. It has been found that many patients sent to institutions where they can be isolated until their death, improve under good hygienic surroundings and recover for all practical purposes. It is the opinion of many authorities that the advanced case does better on a porch in the open air than in an enclosed room and can stand with benefit a comparatively large amount of cold and exposure. It is therefore necessary that buildings for this purpose, besides being heated and supplied with the comforts and conveniences of a general hospital, also have large verandas connected with the wards and rooms by windows cut down to the floor, and doors through which beds can be rolled, in order to provide the same facilities for the open air treatment necessary for incipient cases. Such porches should be used in pleasant weather by patients, even when far advanced in the disease, as there is hope for all when they are not in a dying condition....

An essential point to be considered in planning buildings for advanced cases, is that tuberculous patients in the last stages of the disease are very annoying to each other, and should therefore be housed in separate rooms instead of wards. They are easily affected by disturbances, and any excitement, such as grief, anger, or worry, is usually followed by a fit of coughing and depression. Coughing is not only bad for the individual, but when patients are housed in wards it may disturb ten or fifteen others, and is also a strong suggestion which often causes an epidemic of coughing among them. The mistake and cruelty of placing in one room a number of persons suffering from a serious chronic disease is beginning to be appreciated; and there is no doubt that many patients who fail to make satisfactory progress against disease when housed in wards, rapidly improve when removed to the quiet and privacy of a separate room.... The psychological tendency of a private room is to make patients more contented, and also to increase their self-respect.

Advanced case hospitals are built not only in order to care for the patient, but also to prevent the spread of pulmonary tuberculosis, which is due in a great measure to the cases of consumption which remain and die in their homes, infecting other members of their families. If all advanced cases could be cared for in hospitals, it is believed that the disease would more rapidly disappear. Public opinion at present will not allow the passage of laws compelling persons in the advanced stages of this disease to enter institutions for their segregation; therefore, hospitals should be made comfortable and home-like in order to attract the patients and hold them.


Specific to Lakeville, the book noted of the men's ward:

This is one of a group of four buildings erected as a hospital for treating patients in all stages of pulmonary tuberculosis, and is one of two pavilions constructed from similar plans. It is two hundred and forty-eight feet long, built of wood, and rests on a concrete foundation and brick piers. For description it can be divided into a central block 36 feet wide by 65 feet deep; two wings 64 feet wide by 20 feet deep; and two extensions from the wings built in the form of right angles, each having about nine hundred square feet of floor area.

The central block is two stories high with a cellar under it which contains three large locker rooms and a storage area for trunks. On the first floor is a sun parlor; a large room equipped with lavatories, baths, and toilets; a diet kitchen; a treatment room; and three small wards. The second story is 36 feet wide by 50 feet deep and is divided into nine bedrooms, a bath, and a linen closet.

All the space in each wing is devoted to a large ward for advanced cases housing twenty patients. The extensions from the wings are open air pavilions and house twelve incipient cases. The building faces south with porches in front of the wards nine feet wide and in front of both arms of the pavilions five feet wide. The building has a capacity of seventy patients and cost $17,600.

Illustration:
"State Sanatorium, Lakeville, Mass.", postcard, c. 1910.
This postcard view of one of the two ward buildings at Lakeville was produced shortly after the hospital's opening in 1910, and construction materials appear to be strewn about. Patients may be seen at on the "platform" or porch in front of the right-hand ward. Access to the porch was through full-height windows which reached to the floor permitting beds to be rolled outside.

Lakeville State Sanatorium, Pavilion for Men, First Floor Plan, from Thomas Spees Carrington, Tuberculosis Hospital and Sanatorium Construction (New York: The National Association for the Study and Prevention of Tuberculosis, 3rd ed., 1914), p. 101.

Source:
Thomas Spees Carrington, Tuberculosis Hospital and Sanatorium Constuction. New York: The National Association for the Study and Prevention of Tuberculosis, 3rd ed., 1914.

Postcards from the San

Though employees of the Lakeville State Sanatorium and many local residents may have held fond recollections of the state tubercular hospital, an equal number of patients treated there probably recalled their days in Lakeville less favorably, and for many the duration of their stay was frequently plagued by bouts of loneliness. Most were far from family and friends whom they saw only infrequently. Coupled with the rigors of their treatment (patients were out of doors in all but the wettest of weather) and the uncertainty of their fate (in a landmark 1940 study of 63 Lakeville Sanatorium children with tuberculosis of the spine, only 60% survived), the loneliness many felt was but another aspect of their stay.

While many picture postcards survive from the era to document the physical appearance of the institution, what is often overlooked is the reverse of these cards with their handwritten messages which frequently record the emotional state of the patients who wrote them. It is these brief messages written long ago by now forgotten patients which help give a poignant glimpse into the world inside the San. In late 1915, one such patient known to history only as Ray wrote to Miss Ethel Small of Somerville informing her that he was “feeling fine but near froze to death.” It is likely that he had been wheeled in one of the iron beds onto the veranda or the semi-enclosed pavilion for therapy, despite the frigid November weather. Olof experienced the sanatorium at a much pleasanter time of year. Writing to his nephew Ted Nelson at Atlantic in March, 1913, "Uncle Olof" was apparently overwhelmed at the natural setting in which he found himself, one which had initially attracted the state's attention when searching for a suitable site on which to erect the sanatorium. “Nice place here Ted: Bull Frogs is singing all night & the Robins in the morning won’t leave us sleep.” The postcard which Maud Lapham sent her friend, Mrs. Mary A. Howard of Randolph, however, was more revealing and spoke in September, 1911, of the difficulty of being alone in unfamiliar surroundings. “Dear Friend – Thank you very much for [your] card and wishes. I had as pleasant a time as I could among strangers. In the evening the nurses all came in and Mrs. Kelly (the matron) as guest of honor. She is a lovely woman.” In a similar vein, Rose who had recovered sufficiently to “be up” confided to Lucy Webster of Taunton, in April, 1915: “Am getting more used to my surroundings but there is no place like home to me” and she urged Miss Webster “Come over when you can”.

Without question, the most telling account of the Lakeville State Sanatorium from a patient’s perspective is The Baby’s Cross by C. Gale Perkins (2003) which chronicles the 12 years the author spent as a child in the institution between 1936 and 1948. Her story is one of great fortitude and perserverance in the face of adversity, and it undoubtedly captures many of the emotions and experiences of the patients who once sought treatment at Lakeville. Visit her webiste at http://ervharmon.com/thebabyscrossbycgaleperkins for more information, links to photographs and videos of her talks and the sanatorium, or to purchase her book.

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Top: "Lakeville State Sanatarium [sic], Middleboro, Mass.", H. A. Dickerman & Son, Taunton, MA, c. 1910, postcard.

The view depicts the side of one of the two adult ward buildings which were identical. It was on this card which the patient known only as Rose wrote Lucy Webster in April, 1915. "Come over when you can," it urged.

Middle: Reverse of the same postcard showing the complete message in pencil written by Rose. Hundreds of these cards were undoubtedly sent monthly to loved ones, relatives and friends, recording not only the physical but the emotional state of sanatorium patients.

Lakeville State Sanatorium

One of the most fondly recalled local institutions, the Lakeville State Hospital originated as a tubercular sanatorium in 1908 and 1909. Originally opposed by some local residents who feared the presence of a tubercular hospital in their midst, the state sanatorium came in time to be a welcome addition to the community, long afterwards referred to with some affection as the “San”.

Recognizing the need for hospitals where tubercular patients could be isolated and treated, as well as the inadequacy of the existing state sanatorium at Rutland and other state institutions to cope with the sheer number of tuberculosis patients, the 1907 Massachusetts legislature authorized the establishment of three new state sanatoria, including one for southern Massachusetts in yet undetermined location.

Sites for the three new sanatoria were quietly scouted under the direction of Dr. Sumner Coolidge of Watertown. A one-time public school music teacher, Coolidge had acquired his medical degree from Harvard in 1900 before embarking upon a career as a physician and medical officer with the Isthmian Canal Commission in Panama.

For the southern Massachusetts sanatorium of which he was to be appointed superintendent, Coolidge investigated a number of sites including one site in East Middleborough, Dr. Edward S. Hathaway's "Fairview" property (which at the time was open land between the Nemasket River and Fairview Street), and the Stetson Farm in Lakeville. Wary that Middleborough might eventually be chosen to play host to the institution, the Middleboro Business Men's Club, concerned about the infectious nature of tuberculosis and the presumed public health threat a sanatorium might pose, made it publicly known that it considered it "inadvisable" that a sanatorium be located in town.

Ultimately, however, it was in Lakeville that the sanatorium would be located when Coolidge settled upon a portion of the Doggett Farm on Main Street as the eventual site, its elevation, southern exposure, and dry soil recommending it for this use.

In order to stem any groundswell of opposition to the acquisition of the Doggett Farm, and to preclude any seller from taking advantage of the state by inflating their asking price, the Commonwealth did not purchase the property directly, but, rather through Coolidge as its agent. Sixty four acres of the farm, including the Doggett farmhouse, were purchased from Lakeville Selectman Fred A. Shockley who owned the property in conjunction with A. Davis Ashley of New Bedford. To Shockley, Coolidge represented "that he was buying a place on which to erect a massive country residence for himself, and outlined a series of improvements which would be carried out on the estate. He said the grounds would be handsomely laid out, and that there would be expansive lawns, shrubbery and the rest, and that water was needed on the property to keep them in shape." Reputedly, there was little haggling over the price, Coolidge (and the state) agreeing to Shockley's asking price. "He paid practically the first price asked, and was well satisfied apparently with his bargain." The purchase was made on the first of September, 1908, at which time an additional ten acres on Rhode Island Road which adjoined the rear of the Doggett Farm and which included the small Lily Pond were bought from Frances King of Middleborough.

Cooolidge dutifully conveyed the property to the Commonwealth that same day, and it was shortly following this that the state's proposed use for the property became common knowledge, creating in the words of the Middleboro Gazette, "considerable indignation among Lakeville residents." Undoubtedly, some of this ire was ascribable to Lakeville’s sense of having been "duped" by the Commonwealth. Accordingly, there was talk of initiating a petition opposing the location of the sanatorium in Lakeville, but this threat appears to have come to nothing. Part of the success for this must lie with Dr. Cooolidge, who surely relied upon public relations skills developed in Panama. Additionally, part of Coolidge's prescribed duties as superintendent of the sanatorium was public lecturing on the cause and treatment of tuberculosis. It was in his public capacity that he spoke at the opening of the Fall Brook Farm "automobile inn", on July 1, 1909, jokingly comparing the two institutions. Further the fact that Coolidge and his family were to make their home at the sanatorium (and, in fact, did so until the late 1920s), may have allayed the concerns of opponents.

Eventually, when the 150 patient sanatorium opened in January, 1910, the Gazette was able to report that "the misgivings which existed shortly after it was announced the structures would be located nearby have since passed, and there is a general good feeling, and no one seriously objects to the location of the institution." Over time, the sanatorium's role would evolve, and the positive work accomplished there would endear the institution to workers, patients and local residents, alike. Ironically, an institution which acquired its site in 1908 under veil of secrecy for fear of local opposition, half a century later had become so familiar and popular a landmark, that in 1964 when the Commonwealth formally reinvented the sanatorium as Lakeville Hospital, "many local people who worked there or had been associated in some other way, found it difficult to think of it other than as the Lakeville Sanatorium, or, 'the San.' "

Top:Detail, "General View of State Sanatarium [sic], Lakeville, Mass. Unidentified postcard, c. 1910, paper.
The view depicts the cupola-topped Administration Building at center with the smaller Dining Hall just to the left of it. Flanking the Administration Building are the Men's and Women's Ward Buildings. In the distance is Main Street.
Middle Top: "The Next to Go", American Red Cross, poster, 1919.
Middle Bottom: "Lakeville State Sanatarium, Men's Ward, Middleboro, Mass.", H. A. Dickerman & Son, Taunton, MA, postcard, c. 1910, paper.
The Men's and Women's Wards were identical wood-shingled buildings outfitted with expansive windows and skylights as both fresh air and sunlight were considered to aid in the cure of the disease. Patients would be wheeled in their beds directly onto the open porches. The Ward Buildings were constructed in 1909 and razed in the 1960s along with the other original sanatorium buildings. Note that the caption misidentifies the location as Middleborough.
Bottom: "Prevent Disease", Rensselaer County Tuberculosis Association, Troy, NY, poster, c. 1925.