The Establishment of Fort Stanton Hospital, 1897-1929

The culmination of U.S. continental expansion and settlement happened at the same time as the emergence of industrialization, urbanization, and the spread of disease, the confluence of which ultimately led to Fort Stanton's repurposing. Between 1850 and 1910, the average manufacturing plant multiplied its capital 39 times, boosted the value of its output more than 19 times, and increased its number of employees sevenfold. Industrialization fueled urbanization, as most of the factories were located in cities. In the same 60-year window that saw the unprecedented growth of manufacturing, the number of cities surged from 939 to 2,262 and the number of urban centers with populations over 100,000 more than doubled from nineteen to fifty. By 1920, the majority of Americans lived in towns and cities for the first time in the nation's history.

The country's rapid urbanization led to a massive shortage of affordable housing and unsanitary living conditions. According to some estimates, over half the population of New York City lived in slums in the late nineteenth century. These inhabitants endured substandard housing, poor nutrition, and inadequate sanitation. Consequently, cities emerged as epicenters of disease in the United States. Typhoid, cholera, polio, influenza, and most of all tuberculosis flourished in urban environments. At the turn of the twentieth century, tuberculosis was the third leading cause of death in the United States and accounted for nearly half of the deaths of people between the ages of fifteen and thirty-five. The prevalence of diseases in cities led to notable divergences in the life expectancy between rural dwellers and urbanites. In 1900, rural white males lived on average ten years longer than their urban counterparts.

The proliferation of tuberculosis occurred as the field of modern medicine was taking shape, and the disease became a major focus of medical research. In 1882, German physician Robert Koch first identified the bacteria that caused tuberculosis, tubercle bacillus. In 1895, researchers developed the first x-rays, which became a vital tool to diagnose the disease. To treat tuberculosis, medical practitioners established medical facilities called sanatoria that sought to provide ideal conditions to arrest the disease in patients. Such facilities emphasized rest to permit healing, exercise to provide strength, and rich food such as eggs and dairy products to restore wasted tissues. In the United States, the modern sanitorium movement began in 1885 with the establishment of the Adirondack Cottage Sanitarium in upstate New York. By the turn of the century, there were 96 sanatoria in the United States, mostly concentrated on the East Coast.

Convalescing in a salubrious environment emerged as an important treatment for tuberculosis. Dr. Walter Wyman, who became the third U.S. Surgeon General in 1891, was among the leading researchers on the benefits of climate to treat the disease. He ran the U.S. Marine Hospital Service, the forerunner to the U.S. Public Health Service, which was responsible for providing medical care for the sailors serving in the U.S. Merchant Marine and U.S. Revenue Cutter Service, later known as the Coast Guard. The cold, damp, and cramped living conditions aboard ships resembled the living conditions in cities, and tuberculosis was a major problem within these services. In 1895, Dr. Wyman published the first study arguing that the arid and mild climate of the Southwest was an ideal location to treat tuberculosis patients.

Dr. Wyman utilized his research to successfully lobby to establish a federal sanitorium in the Southwest. In 1898, he dispatched Dr. J.O. Cobb to investigate abandoned forts in Arizona and New Mexico as possible sites for a medical facility. After visiting Fort Stanton, Cobb described it as "an ideal site" as a result of "its undoubted advantage of climate, a generous water supply, a large reservation, and substantial stone buildings." Fort Stanton and the landscape of zúuníidu thus offered a uniquely salubrious environment that stood in stark contrast to the unhealthy conditions found in most of the country’s cities.

In 1899, President William McKinley transferred control of Fort Stanton to the U.S. Marine Hospital Service. The site was rechristened the Marine Hospital Service Sanitorium, but became known colloquially as Fort Stanton Hospital. As the first federal sanitorium in the United States, Fort Stanton Hospital was designed not only to provide care for Merchant Marine and Revenue Cutter Service sailors afflicted with tuberculosis, but also to conduct research on the benefits of climate to treat the disease. Techniques developed at the site thus promised to influence the treatment of tuberculosis patients nationwide.

Dr. Cobb became the first medical director of Fort Stanton Hospital and oversaw the transformation of the former military fort into a modern sanitorium. The site at the time of his arrival was in disrepair. One of his colleagues later wrote, "The buildings were in such a dilapidated condition as to be absolutely uninhabitable when the station was established [in 1899]." Cobb spent six months updating Fort Stanton Hospital to prepare it for patients. He launched a series of remodels, which included painting the undressed sandstone buildings white. He renovated the officer's quarters in order to house the early medical staff, including an east addition and a second floor. He converted two barracks into wards capable of each holding 60 patients. He transformed the remaining barrack into a dining hall, which included adding a kitchen. The gambrel roofs and Palladian windows today date from Cobb’s renovations. Cobb also equipped the old hospital (extinct) on the southwest corner of the parade ground with advanced equipment to treat tuberculosis, including a bacteriological laboratory, x-ray equipment, and surgical instruments. Finally, he contracted for a modern steam laundry, a one-ton ice plant, and a power plant. Fort Stanton Hospital emerged from the overhaul as a state-of-the-art medical facility.

The first patient arrived at Fort Stanton Hospital at the end of 1899. The facility thereafter maintained a population around 200 patients. The patients reflected the heterogeneous composition of sailors, comprising an assortment of nationalities and ethnicities. They received treatment designed to halt the disease and restore them to working capacity. It consisted of lots of food, rest or graduated exercise, and as much exposure to open air as possible. The medical staff added to the sanitorium's population. It consisted of six surgeons, five nurses, and 25 additional attendants. Most of the staff were themselves afflicted with tuberculosis. Cobb and a number of other physicians had arrested cases of the disease. The architect J. Ross Thomas, who oversaw much of the fort’s early renovations, was a third-stage consumptive. The patients and the staff were thus engaged in a shared enterprise to improve their conditions within the healthful atmosphere of zúuníidu.

Tents became one of the key early innovations at Fort Stanton Hospital. Initially, patients slept in the wards with their windows and doors open to get as much fresh air as possible. One enterprising patient, however, bought a tent and began to sleep outdoors. This practice intrigued Cobb and his staff and they provided several tents to patients as an experiment. The results were so impressive that Dr. Paul M. Carrington, who succeeded Cobb as medical director in 1901, rapidly expanded the tent program. He worked with Thomas, the architect, to design tents specifically tailored to the needs of tuberculosis patients. They began to construct the tents out of a mixture of wood and canvas to emphasize ventilation. Carrington subsequently described the tents as "a nearly perfect consumptive building." By 1912, two-thirds of the patients lived in 87 tent houses. The majority of these structures were located on the hill south of the parade ground. There was also a smaller, segregated tent area for Black patients to the southwest near the current nurses' quarters.

During his tenure as Fort Stanton Hospital's medical director, Carrington oversaw other changes to the site. Between 1901 and 1912, he converted the parade ground into an exercise lawn where patients played tennis and croquet. South of the tent terrace, he built a golf course. He also renovated the adjutant's office, converting part into a library and adding a second floor. After the old army hospital burned down in 1905, Carrington requested a new hospital and later a new residence for female nurses. While funding for these projects never materialized, Carrington's entreaties provided the basis for the later construction of a power plant in 1935 and hospital in 1936.

During the early years of the twentieth century, the Mescalero continued to evolve and adapt. In 1902, the federal government declared the tribe self-sufficient and ended the ration program, even though the Mescalero lived in intense poverty. The continually resilient Mescalero, in response, pivoted into forestry and the cattle industries. They were successful enough in the venture that they even accumulated enough resources to offer refuge to other Apache that they had developed bonds with during the Apache Wars. In 1905, they welcomed 37 Lipan, which were all that remained of the once powerful band. In 1913, the Mescalero received 187 Chiricahua, who had been living as prisoners of war at Fort Sill in Oklahoma. In the meantime, the Bureau of Indian Affairs contracted with the physicians at Fort Stanton Hospital to provide the Mescalero with medical care. Members of the tribe continued to visit and interact with the fort until the establishment of the Mescalero Indian Hospital in 1916. Fort Stanton thus became a place of care rather than oppression for the Mescalero, perhaps finally embodying what Josecito had first envisioned for the site in 1853.

The treatment and research conducted at Fort Stanton Hospital had national significance. The physicians at the facility published articles and presented papers highlighting the therapeutic benefits of the high desert in treating tuberculosis. Carrington published an influential study in 1908 on the results of treating 1,337 patients at Fort Stanton. The majority of the patients (57 percent) had advanced cases of tuberculosis, which were generally perceived as uncurable. Over a third of the patients died and were buried at Fort Stanton’s Merchant Marine Cemetery. But Carrington revealed that among the advanced cases at Fort Stanton, 12 percent were cured and another 27 percent had significantly improved. The results were viewed as nothing short of a medical miracle at the time. Carrington’s study, along with subsequent research and patient testimonials, was published in newspapers across the country and bolstered both Fort Stanton Hospital’s national reputation and served as a strong endorsement of its treatment methods.

The medical successes at Fort Stanton contributed to the development of New Mexico more broadly, as well. Fort Stanton Hospital called attention to the the unique health benefits of the high desert and helped launch New Mexico’s sanitorium industry. At the time of the hospital's establishment in 1899, there were only two other sanitoriums in New Mexico: St. Vincent Sanitorium in Santa Fe (1883) and St. Anthony’s Sanitorium in Las Vegas (1897). A decade later, the number of sanitoriums in New Mexico jumped to twenty-nine. By 1929, the number more than doubled and there were sixtyeight sanitoriums scattered across the state. The development of the sanitorium industry reshaped the demographics of New Mexico.

Tens of thousands of health seekers migrated to New Mexico. By 1920, these migrants accounted for ten percent of the state population and the majority of New Mexican households had at least one family member afflicted with tuberculosis. The industry also attracted large numbers of physicians to the state. Between the late nineteenth century and 1914, the number of doctors in New Mexico increased over sevenfold, from less than one hundred to 737. Thus, the sanitorium industry, which Fort Stanton Hospital pioneered, lay the foundations for New Mexico’s modern healthcare system. It also led to a concentration of brainpower that contributed to the later establishment of Cold War research institutions within the state.

Go Back to History