– by Meggie Crnic, Senior Lecturer at the University of Pennsylvania
As I carried the hefty, bound volumes to my research station, I wondered what stories they might reveal. Unwrapping the protective covers, I maneuvered a book to examine its spine. It was a Children’s Seashore House (CSH) patient log book from the 1920s.
From my previous research I knew that the CSH was a pediatric hospital in Atlantic City, NJ. It opened in 1872 to care for Philadelphia’s children who could not otherwise afford time at the seashore. The CSH was a beachfront institution where physicians used “marine medication,” to care for children with a range of pediatric disorders. At the hospital children experienced sea-air, sea-water, and sun bathing as their therapies. Elite medical research supported marine medication and prominent physicians on both sides of the Atlantic prescribed patients time at the shore. The belief in the curative and restorative powers of marine environments transcended national, cultural, religious, and class boundaries. It also gave rise to a vast network of pediatric seashore hospitals in the late 19th and early 20th centuries.
Opening the logbooks revealed one of the most surprising practices of American seashore hospitals: mothers could stay with their children. Historians of medicine had established that 19th century working-class patients avoided hospitals at all costs, and that urban pediatric hospitals separated children from their parents with restrictive visiting hours. Yet the CSH built small individual cottages where mothers stayed from one to two weeks with their children. These cottages were often filled to capacity.
I wanted to know more about the women who came. What motivated mothers to bring their children to a hospital? Moreover, what was their experience like once they were there? I hoped the log books would reveal some answers. They did.
On my first day at the Historical Medical Library, I took stock of the holdings which included admissions records, letters, annual reports, and photographs. I scanned the log books quickly. Nurses had recorded each patient’s name, address, age, date admitted, length of stay, medical diagnosis, and condition at discharge. Patients arrived with a wide range of conditions. Some sounded odd to modern medical ears, like debility and marasmus. Other children came with more recognizable diagnoses like infantile paralysis (polio), rickets, and tuberculosis. Most patients left the hospital “well,” “improved,” or “cured.”
At first the records seemed standard. But as I continued to read I was delighted to discover notes scratched into the margins. Here nurses recorded mothers who were “undesirable,” “untidy,” or “very dirty.” I wasn’t surprised – scholars have characterized this time period as one of conflict between medical officials and working-class patients. I wrote a note to myself to return later when I could closely scour the records for more notes.
When I went back to the archives, I expected to find more evidence of discord between nurses and mothers. I found some, but not as much as I expected. Mothers who didn’t keep their cottages clean annoyed the nurses as did patients who did not appear to require the hospital’s services. During the summer of 1924 nurses wrote that one mother was “prosperous looking,” another was “able to go elsewhere,” and a third was admitted “free – but doubtless able to pay.” Yet, these notes were the exception. The vast majority of mothers escaped mention.
I was initially disappointed not to find more marginalia. But as I spent more time with the log books, even more interesting patterns and practices emerged. I discovered that mothers traveled with friends, family members, and neighbors. They actively sought admission to the hospital and recommended the institution to other women. They brought older girls to help with child care. Many families came for multiple summers, some with only “well” children.
What informed this set of practices? While there is scant evidence directly from mothers, it became clear from the log books that they used the Children’s Seashore House as a vacation destination.
One common practice was traveling with friends and family. I recognized this pattern when I saw multiple mothers arriving from Tree St. in Philadelphia over several years. Looking back through the log books, I found that the Stockman family who came to the CSH in September 1917 returned in July of 1919. They skipped 1918, likely because their youngest son, James, was born. They must have enjoyed their first year. Not only did Elizabeth Stockman bring her four healthy children Ellen, Harry, Samuel, and James to the hospital in 1919, she apparently recommended the CSH to their neighbors, the Steers. Florence Steer brought her children to the hospital later that summer.
I recognized that I needed more evidence to confidently conclude that Elizabeth recommended the CSH to Florence. I found it in the admissions records for 1920. On July 26, 1920, both the Steer and Stockman families arrived at the CSH, where they stayed for just over one week. In addition to bringing her three boys, John, Bernard, and George (age from 2 to 7), Florence Steer also brought six-year-old Edith Halbach. While the records do not tell us who Edith was, it is possible she was a niece or neighbor’s child. Regardless, the practice suggests that women helped one another with child care.
The Steer and Stockman families were not unique. The log books are filled with similar stories of women traveling together and bringing healthy children to stay in the hospital on the beach. These practices, recorded in the CSH’s logbooks, reveal new insights into urban families’ views and uses of hospitals at the turn of the 20th century. They tell us that urban, working-class mothers were savvy consumers of the medical marketplace. Far from avoiding hospitalization, mothers sought admission to seashore hospitals as a way to access a week or two at the beach for themselves and their children. Traveling with friends and family with healthy kids in tow had more in common with health-seeking tourism than with urban hospitalization. Mothers’ practices reveal that they viewed their time at seashore hospitals as beneficial, and even, perhaps, enjoyable.