Wednesday, August 9, 2017

Montefiore Hospital Pittsburgh - A Unique Design

Architecture is not my area of expertise ( at my age about the only expertise left is shooting off my mouth) but I know a really special hospital building when I see it.  Pittsburgh's Montefiore Hospital was built into a hillside, ala, Pennsylvania bank barn style. The main entrance was located at the top of the hill which meant that a substantial portion of the hospital was below you as you entered. A subterranean wonderland of caring catacombs.
Montefiore Hospital, Pittsburgh, like a tree, it's supporting
roots were underground

The apex of the hill entrance floor was aptly named MAIN. There were three floors below main identified by letters."C" level on the very bottom  contained the operating rooms and recovery rooms, "B" level housed critical care units and "A" level contained the morgue and  cafeteria which served the best homemade bagels I have ever tasted. This was the only hospital I worked at that had the morgue so close to the cafeteria. This hospital made exclusive use of those double decker gurneys to transport bodies and morgue supplies were delivered in a cart that looked exactly like patient tray carriers so the general public was unaware of any morgue related activity near the dining area. Pretty clever.

Locating the OR on the very bottom of the hospital was a real switheroo for an older hospital as the most common locus was the very top floor. Explosive anesthetics were never used at Montefiore because a basement explosive mishap would have been catastrophic. There was little foot traffic on "C" level and this was a very quiet OR.

Montefiore's ER was underground on "B" level and accessed by ambulances entering a tunnel like opening from a side street. When recovering trauma patients related stories about near death experiences involving journeys through a tunnel, nurses set them straight by explaining that their near death experience was not all that ethereal. They were just entering the ER.

Having worked at Catholic, Protestant, and Jewish Montefiore, my nursing journey (I hate that journey business) has been an ecumenical experience. Of the three permutations, Montefiore was special. Some hospitals are focused on research, education, or making money but Montefiore was patient care oriented to the highest degree. Patient needs were the highest priority here.

There was never any of that "We will have to see if you are covered" or "That  treatment is unavailable because it's against church teaching."  Patients migrated to Montefiore like salmon swimming upstream knowing that once in the hospital, kindness and concern reigned even if their journey was one way. Dying patients never received a hospital bill.

The director of nursing even made rounds to the nursing units and never harangued or harassed a soul. She frequently inquired if we needed anything. If it was for a patient, we got it pronto.
Montefiore had its own 3 year nursing diploma school that was open from 1902-1974 and floors were staffed almost exclusively with RNs

In 1990 Montefiore was bought out by a giant healthcare corporate entity, UPMC. The first thing to go were the homemade bagels - they fired the baker. Next on the corporate agenda was renaming all the hospital floors; "C" became "1" and so forth. They even installed kitschy computer screens in subterranean rooms and connected them to an outside camera.

Maybe the renamed floor numbers made sense, but you cannot replace caring with virtual window  kitsch. Today a patient is lucky to find a pleasant nurse that is not umbilicated  to one of those computer on wheels monstrosities. It breaks my heart to return to Montefiore today. What is gone will never be replicated

Thanks for taking the time to peruse my foolishness. I have no idea how that stray line crept in at the conclusion, but I cannot seem to get rid of it!

could be wheeled from an ambulance to the ER without even having to open a door. si sized o


  1. I stay because your world of nursing was almost gone when I started. I caught glimpses of what it was from time to time but it steadily changed. I eventually moved on to NP because it's there that I get to so much more of the traditional teaching and focus on the patient. Thank you for the memories of what I missed.

  2. There are so many more opportunities for whippersnapperns today. Everyone in my diploma class went to work in the hospital after graduation and stayed there - It's what we were trained for. Educating nurses is a much better concept.

    If the truth be told, there were very few cures back in my time. If we could somehow combine yesteryears culture of care with today's technology, we would really have something.

    Thanks so much for taking the time to leave a comment. It makes my day!

  3. Dear Old Fool- I’ve been following your blog for a couple of months now, and your posts never fail to please.

    I found this image repository for Pittsburgh and there are pages of interesting pics related to Montefiore Hospital—;type=boolean;med=1;view=thumbnail;cc=hpichswp;c=hpichswp;start=61;q1=MSP%20286;back=back1502483140;size=20

    The “Ladies' Hospital Aid Society” sure put together some festive looking coffee shops over the years, and the House Staff Residence quarters would be the envy of interns today.

    Keep up the great work!

  4. Thanks for the kind words and indulging in my foolishness. There are a number of photo collections that contain images of the oxygen therapy ward of the 1940s. No hyperbarics just 100% oxygen contained in several rooms by elaborate air locks. I was fascinated by the air tight doors that remained in place until the 1970s.

    Montefiore was a very memorable place that really cared about nurses and house staff.