The 13th Stationary/83rd (Dublin) General Hospital, Boulogne, 1914-1919.

Casualties from the Western Front during the First World War were often evacuated to base hospitals on the northern coast of France for more advanced and specialist care. These temporary base hospitals frequently had more than 1,000 beds and were typically staffed by older, more senior doctors than were present nearer the front line. The 13th Stationary Hospital opened in October 1914 on the Boulogne docks and became the main specialist unit for the treatment of eye, face and jaw injuries. In May 1917 it was renamed the 83rd (Dublin) Hospital when the staff was augmented by volunteer staff from Irish hospitals. The hospital subsequently housed an innovative 'physical medicine' or rehabilitation unit. The hospital remained open for the duration of the War, moving to Langenfeld in the Ruhr following the Armistice.

An old friend you've never met.

For 36 years, Simon Lillie has stood watch at Methodist Hospitals in Gary, Ind. The affable 64-year-old is never reluctant to extend a welcoming hand or lend an ear.

Initial management of hospital evacuations caused by Hurricane Rita: a systematic investigation.

INTRODUCTION: Hurricanes remain a major threat to hospitals throughout the world. The authors attempted to identify the planning areas that impact hospital management of evacuations and the challenges faced when sheltering-in-place. METHODS: This observational, retrospective cohort study examined acute care institutions from one hospital system impacted by Hurricane Rita in 2005. Investigators used a standardized survey instrument and interview process, previously used in the hospital evacuation context, to examine hospitals' initial internal situational awareness and subsequent decision making that resulted in evacuation due to Hurricane Rita. Participants from each hospital included representatives from senior leadership and clinical and nonclinical staff that comprised the Incident Management Team (IMT). The main measured outcomes were responses to 95 questions contained in the survey. RESULTS: Seven of ten eligible hospitals participated in the study. All facilities evacuated the sickest patients first. The most significant factors prompting evacuation were the issuing of mandatory evacuation orders, storm dynamics (category, projected path, storm surge), and loss of regional communications. Hospitals that sheltered-in-place experienced staff shortages, interruptions to electrical power, and loss of water supplies. Three fully-evacuated institutions experienced understaffing of 40%-60%, and four hospitals sustained depressed staffing levels for over four weeks. Five hospitals lost electricity for a mean of 4.8 days (range .5-11 days). All facilities continued to receive patients to their Emergency Departments (EDs) while conducting their own evacuation. CONCLUSION: Hospital EDs should plan for continuous patient arrival during evacuation. Emergency Operation Plans (EOPs) that anticipate challenges associated with evacuation will help to maximize initial decision making and management during a crisis situation. Hospitals that shelter-in-place face critical shortages and must provide independent patient care for prolonged periods.

[The establishment of the hospital-system in the Byzantine Empire]. / A kórházi rendszer kialakulása a Bizánci Birodalomban.

Byzantine hospitals developed out of Christian institutions for the poor and homeless. Philanthropy provided the initial impulse to create hospices (xenons) and to expand these institutions into specialized medical centers (iatreons or nosokomeions). However the Byzantine nosocomeions resemble more closely modern hospitals than they do any of the institutions of Greek-Roman antiquity or any of the houses of charity in the Latin West during the Middle Ages. Since the 4th century the Byzantine hospitals have stressed the central position of the nosocomeion in Byzantine society at the intersection of state, ecclesiastical and professional interest. In the great cities and in the capital, more than hundred hospitals worked in the East-Roman Empire. The Byzantine hospital rules guaranted patients private beds, required physicians to wash their hands after each examination and arranged the physical plant to keep all the sick warm. The Byzantine hospitals had separate sections (in modern terms: surgery-trauma surgery, internal medicine, ophthalmology, etc.) and at the beginning of the sixth century a separate institution for women. From the sixth century at least, bathing facilities normally adjoined Byzantine nosocomeia. By the twelfth century Byzantine hospitals also set aside a room or perhaps a separate building to treat outpatients. In addition to the main dormitories the surgery, baths and outpatient clinic, the large parts of hospitals also had separate rooms (or adjoining buildings) for library, for lecture hall, for administrative functions and record keeping for storage and for other services.

Working in the asylum: attendants to the insane.

Contemporary representations of nineteenth-century attendants were often negative, finding fault with both their character and conduct. Historians were inclined initially to agree, concluding that attendants were 'recruited from the dregs of society' and that asylum work was 'an occupation of last resort.' Other scholars argue that such conclusions rely too much on contemporary depictions. Taking Victoria as a case study, this article explores who attendants were and why they chose to do asylum work. Many of the attendants employed in Victoria's asylums were ordinary working people, recruited for their skills and experience, and for whom attending held considerable attractions. For some, indeed, attending became their life's work and an occupation whose reputation they felt was worth defending.

Education, expertise, experience and the making of hospital workers in Canada, 1920-1960.

Beginning in the 1920s, many Canadian hospitals underwent an extensive period of modernization. A wide variety of workers, generally termed "allied health professionals," began to work alongside physicians and nurses. This paper examines the history of two such groups, x-ray and laboratory technicians, paying particular attention to the ways in which technical education was transformed and, through this transformation, new occupational identities forged. Initially, those who staffed the laboratory and x-ray departments were given quick, practical instruction. In many cases, these workers continued to work in various settings across the hospital. The informal instruction of the 1920s and 1930s was displaced by formal, accredited training programs, replete with national examinations linked to a practice registry in the 1940s. Hospital administrators, the Canadian Medical Association and technicians themselves were all engaged in this transformation. At the same time, national organizations such as the Canadian Society of Laboratory Technologists or the Canadian Society of Radiological Technicians, founded in the late 1930s and early 1940s respectively, attempted to create a common professional identity with a clear scope of practice. Despite this, technical workers' professional identity remained malleable and highly dependent upon context long after the creation of supposedly national accreditation standards.

[The place of consultation in medicine "carries" the hospital Saint-Anthony (Paris) in the fight against the production of German war by the sabotage of the service of obligatory work (S.T.O.), 1943-1944]. / La place de la consultation de médecine "porte" de l'hôpital Saint-Antoine (Paris) dans la lutte contre la production de guerre allemande par le sabotage du service du travail obligatoire (S.T.O.), 1943-1944.

During the World War II Germany had to improve its production of war through recruiting workers particularly in foreign countries like France. The medical centre of the Hospital Saint-Antoine Paris succeeded to let escape about 1 500 workers through false diagnoses or fake medical records.

Old patterns, new meaning: the 1845 hospital of Bezm-i Alem in Istanbul.

This paper discusses the history of an 1845 Ottoman hospital founded by Bezm-i Alem, mother of the reigning sultan Abdülmecit I (reigned 1839-1856), embedded in the medical and political contexts of the Middle East in the nineteenth century. The main focus of this paper is the Ottoman discourse of modernization, which identified progress with modernization and westernization and induced a belief in the positive character of progress, with a high degree of optimism regarding the success of the process. The Bezm-i Alem hospital illustrates the medical reality of the 19th century, reconstructed through Ottoman eyes rather than from the perspective of foreigners with their own agenda and biases. In many respects it continued previous medical traditions; other aspects reveal brand new developments in Ottoman medicine and hospital management. Ottoman medical reality was one of coexistence and rivalry: traditional conceptions of medicine and health were believed and practiced side-by-side with new western-like concepts and techniques.

The rise and fall of the asylum worker's association: the history of a 'company union'.

In the nineteenth century, the only method open to asylum nurses and attendants to air a grievance, apart from resigning from their employment, was to present a petition to their employing authorities. In fact they were still making use of the petition as late as 1899, when a petition was presented in London, by attendants in favour of shorter hours. (This was turned down for reasons of expense.)