Dec. 17, 2009

125 years of student health care at Iowa State

by Annette Hacker, News Service

Delve into the early days of health care at Iowa State, and you'll find the stories as captivating as those in any novel. The university's health history is a real page turner -- from the altruistic and forward-thinking motives in establishing a college "health service," to the quaint turn of phrase here and there, to some gritty details about late 1800s sanitation described (by Iowa State's first physician) as "a most frightful state of affairs."

But more about that soon enough.

ISU has had a student health center, in one form or another, for 125 years this fall. Iowa State was among the first colleges in the country to open a student hospital (1884) and to have its own physician or health officer (1877). In the late 1800s, only about a dozen U.S. colleges and universities employed full-time physicians, and most of them practiced at places such as Harvard, Yale, Johns Hopkins, Vassar and Wellesley.

The college health movement grew out of departments of "physical education," "hygiene," or "sanitation," with a healthy dose of intercollegiate athletics thrown in. In short, early college medical facilities were born out of need, and the physicians who ran them juggled any number of jobs -- including town doctor, professor and football coach.

The beginnings of Iowa State's student health center were no different.

A history of health service at then-Iowa State College, penned by Dr. J. F. Edwards, professor of hygiene and head of College Health Service (1921-36), noted, "Iowa State from the very beginning has always been solicitous for the health and welfare of her students. With the establishment of the college, the village of Ames grew apace and soon outstripped the formerly more pretentious villages of Ontario and Nevada."

Ames attracted fine doctors, although there was no local hospital (Mary Greeley didn't open its doors until 1916). Among the physicians practicing in Ames was Dr. David Fairchild, who founded the county medical society before being elected the first college health officer in 1877 ("without salary of course"), records indicate.

At that time, there had been considerable sickness at Iowa State in the nine years since classes had begun. The situation culminated in 1877 with 25 cases of typhoid fever (four victims died) and 19 cases of malaria. (Student enrollment at the time was 260.) Fairchild and a committee began to study the causes of student disease.

It didn't take them long to discover why people were getting sick.

Old Main was a sick building

Old Main, which housed the entire college for its first few years, was jinxed. Built in 1868, Old Main stood for only 34 years. There were classrooms, a library, chapel, dining halls and residences for faculty and staff. The building was troubled from the start, and eventually became a living monument to financial woes, architect changes and substandard construction.

President Adonijah Welch knew he had a problem on his hands as early as 1870, when he reported the building "was destitute of all those conveniences which would put it in fit condition for the reception of students. With a singular lack of foresight, the architect had completed the structure without making any provision for lighting, heating, supplying with water, or for adequate drainage."

Expensive modifications were made, but they weren't satisfactory. By 1877, Fairchild and his colleagues discovered badly leaking sewer and water pipes in Old Main, inadequate ventilation and foul-tasting and smelling drinking water. The college sealed off the old sewage system and constructed a new one that emptied into Squaw Creek.

Old Main was damaged by an 1882 tornado and ultimately destroyed by fires in 1900 and 1902. College leaders didn't waste any time to begin construction on a new, improved central building in 1903. You know it as Beardshear Hall.

First Iowa State hospital

In 1882, Iowa State leaders pressed on, outlining the need for a college hospital. President Welch (in the 10th biennial report) wrote, "A College Hospital which could be built at a limited expense would thus enable us, in nearly all cases, to save the suffering, if not the lives, of the young people committed to our charge."

Iowa State's first student health center was built in 1884, where the Memorial Union now stands. It was called the Sanitary Department -- an effort to allay parents who might be alarmed by the need for a hospital at the college. It was a modest, two-story frame building, constructed around the same time as a more expensive, brick veterinary hospital. The Veterinary Department also claimed the first floor of the Sanitary Building for offices and a museum, leaving only the second floor for sick students.

President William Beardshear already was advocating a remodel of the hospital by 1893, and that occurred during the 1894-95 term at a cost of $700.

After the death of President Beardshear, President A.B. Storms again called for better facilities, for the hospital was crowded and it hadn't been built for winter use. "It is commented on by visitors that the college has made better provisions for its cattle and sheep than for its sick students," he wrote in his 1905-06 biennial report.

By 1907, Iowa State's hospital had moved to the West Boarding Cottage, where it would remain until 1918. The "little red hospital" routinely accommodated up to a dozen patients, and could care for as many as 20 to 30 during an epidemic. The building continued to be used as an isolation annex to the "new" hospital (Student Services Building) until 1933.

Health promotion and disease prevention

The early physicians who ran Student Health from its beginning through the mid-1930s -- Drs. Fairchild, Harriman, Tilden, Paine and Edwards -- were concerned not only with taking care of ill students, but also with their overall health and wellness. In the early 1900s, physical education was required for Iowa State freshmen and sophomores, who were treated to lectures in student habits, college spirit, hygiene and disease carriers, among other topics. Home economics majors received an even bigger dose of phys ed coursework, and they were the only ones to receive credit for it. Despite efforts to make physical education credit courses for all, "the deans of the other divisions claimed that their curricula were already crowded to the full."

Iowa State doctors monitored sanitary conditions at the college and in the community. They were activists, pushing for ordinances to improve milk and restaurant inspection and waste disposal. They worked to ensure a safe water supply.

When a proposed restaurant ordinance failed, Edwards took matters into his own hands and inspected off-campus cafes and ice cream parlors frequented by students. Violators cleaned up their restaurants only after Edwards threatened to publish a list of approved establishments -- decades before TV reporters would think to produce "Dirty Dining" exposés during sweeps week.

Other duties as assigned

Harriman, an Iowa State alumnus who served as college physician from 1894 to 1907, also taught 18 lectures and two lab classes each week in the veterinary department. History remembers him fondly as "a man of exceptional ability and devotion to his profession." After battling a typhoid epidemic on campus, he asked to be relieved of his duties as veterinary professor so that he could focus entirely on his medical practice.

W.C. Paine, who served as head of the health service and director of physical education after Dean Samuel Beyer merged the two departments around 1919, also coached the football team.

Thielen Student Health Center today

The university hospital is long gone, but Thielen Student Health Center (TSHC) continues to care for Iowa State students. The health center includes a full-service pharmacy, laboratory and X-ray facilities, and a wellness center focused on vital topics for students: fitness, nutrition, stress management, smoking cessation, alcohol and drug education and sexual health. There is a peer education program, as well as leadership opportunities for students through the Student Health Advisory Committee.

In addition to routine office visits, TSHC also provides travel immunizations, immigration physicals, allergy shots, sports medicine and more. During much of the center's 125th anniversary year, physicians have been busy treating students with flu-like illnesses. TSHC has played a major role in the public health campaign to help prevent the spread of H1N1 influenza on campus, and to encourage those eligible to get vaccinated.

Thielen Student Health Center has a staff of 77, including 10 physicians and two advanced registered nurse practitioners who see more than 33,000 patients each year. Dr. Fairchild, who cared for Iowa Staters in the cramped, drafty upstairs of the first campus hospital, surely would be pleased with such progress.

Published by University Relations, inside@iastate.edu, (515) 294-7958, Ames, Iowa 50011.

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