Martin Shargel led a protest by hospital staff at D.C. General, drawing media attention, but he says nothing really changed.
D.C. General wasn't intended to be a homeless shelter, as it is today. Until 2001, it was the city’s public hospital, the place where hundreds of thousands of Washingtonians were born, and where low-income residents turned when they couldn't get help elsewhere.
The hospital’s history dates back to the very founding of the nation’s capital, and for 200 years, it was a place where good intentions collided against the harsh reality of underfunding and mismanagement.
Resources Stretched Thin
In the 1960s, D.C. General Hospital was, like many big-city public hospitals, overcrowded and understaffed.
“We had to turn away people all the time. It was a constant triage of who was the sickest and who needed the most and how could we manage that," says Martin Shargel, who started working at D.C. General in 1968.
He was a young doctor, finishing up his residency. The hospital was a mess.
“We had inadequate laboratory and X-ray services; we couldn't even find X-rays very often," Shargel says. "It took sometimes days before people could locate files.”
Shargel started organizing fellow residents and interns — he became president of the association representing them. They put together a report showing that compared to other local hospitals, D.C. General had half the staff doing twice the work.
“We decided to have what we called a heal-in," he says.
Martin Shargel worked at D.C. General from 1968 to 1971. (Jacob Fenston/WAMU)
Shargel led a peaceful rebellion of doctors and nurses. They would admit every patient who came in the door needing care, even though there wasn't room.
“The stretchers were lined up and down the hall; they had no room assignments.”
This tactic caught the attention of reporters and politicians.
“Everybody agreed that care was inadequate. Everybody agreed that there was overcrowding, everybody agreed that there wasn't enough money.”
But, he says, things didn't change. “It was mostly puffery. Nothing happened; nothing substantial and material happened as a consequence. Promises, promises.”
A History of Inadequacy
Tim Krepp, a local tour guide and historian, says things weren't all that much different at the hospital 100 years earlier. “If you are of any means whatsoever, in say, 1860, you would not come here. This is the worst place you could possibly come."
In 1872, a health board report called the hospital a “very primitive” collection of “wooden shanties,” declaring, “Charity under this guise becomes a curse.”
“It’s important to make that distinction between charity, which was to help folks — this was to get them off the streets, this was because, 'We don't want to look at poor people, we'll ship them off to a workhouse to get them out of the way.'”
The hospital was founded in 1806, originally near Judiciary Square. In 1846, it was moved to its current location, on what was then the edge of the city.
Back then, Krepp explains, hospitals were for poor people — people who couldn't afford to have a doctor come to their home. So the hospital was built on the city’s outskirts, next to the jail and the workhouse.
“The workhouse, the jail, and the hospital today we think of those as three different functions. In the 19th century, this would have been one function. You would have had a hard time telling who was down here because they were a criminal, who was down here because they were poor, and who was down here because they were sick and had no better options.”
By the end of the century, there were calls to close the dilapidated hospital, and rebuild a modern facility, away from the malaria-ridden banks of the river. It would be built on high land, at 14th and Upshur Streets, amidst the new upper-middle class neighborhoods popping up in Northwest D.C.
“The citizens of Piney Branch, of Petworth, of Park View, all rose up against it. And again, in things that echo to today, ‘It doesn’t suit the neighborhood, it’s going to destroy property values.'"
A nurse and doctor monitor a patient in a fever machine used to kill germs at Gallinger Municipal Hospital in 1935. (Library of Congress)
So the hospital stayed put, but in 1922 it reopened in a new brick structure, replacing the old hodgepodge. The sturdy new building was rechristened Gallinger Municipal Hospital.
But just 20 years later, it was “a filthy place swarming with flies,” according to witnesses at a U.S. Senate hearing.
One senator read from a letter complaining that “mice thrive on every floor.” And, “roaches, some of enormous size, infest every part of the hospital.”
In another rebranding effort, the name was again changed, in 1953, to D.C. General.
Things got so bad, that by 1975, the hospital lost its accreditation until 1978.
D.C. General Becomes a Different, Modern Problem
By the late 1990s, the much-maligned public hospital was draining city coffers, as the District struggled to get its finances under control. Mayor Anthony Williams closed the hospital in 2001, replacing it with an insurance scheme, the D.C. Healthcare Alliance. The mayor said it would provide better primary care than the old hospital, and save money.
“People say, ‘If we move to this new health care system, people are going to die.’ And my answer is, ladies and gentlemen, people are already dying. We have a horrible life expectancy for African American men, horrible statistics for diabetes, horrible statistics for HIV/AIDS,” said the mayor, speaking on WAMU in 2001.
“What happens now, I can go to D.C. General 10 times but no one’s really keeping track of me as a patient in a health care system," he said.
In the 2002 mayoral race, Williams came under attack for closing the hospital.
D.C. Council member Carol Schwartz criticized the move during a 2002 mayoral debate on WAMU, and said that as mayor, she would reopen D.C. General.
“That hospital, D.C. General, was closed against the unanimous, the unanimous support of this Council. You know the Council very rarely has unanimous votes.”
“Closing a hospital in a poor community is like shutting the schools, or closing a church. It is one of the great anchoring edifices of a community,” says Sara Rosenbaum, a public health professor at George Washington University.
But she says the D.C. Healthcare Alliance has been a success. “We have transformed insurance coverage for people in Washington, D.C. Our numbers rival the best numbers in the country," she says.
But Rosebaum says that doesn't mean people can easily get care. the empty hospital left a big void in D.C.’s low-income neighborhoods.
“The fact of the matter is that the supply of health care professionals in the United States is distributed very unevenly. They tend to cluster where the money is," she says.
D.C. General dismissed its last patient on June 25, 2001. Just one year later, the doors were open again, a temporary solution for the city’s growing homeless population. There were just 12 beds that first year.
By 2010, the city had crammed some 200 families into the old hospital, in a makeshift shelter designed for 135. Once again, overcrowding at D.C. General was making headlines.
Music: "Song #8" by Star FK Radium from Solitude Rotation