The Hospital by Jan de Hartog: Exposing Houston's Healthcare Crisis

Written by Dutch-born playwright and author Jan de Hartog and published in 1964, The Hospital exposed the horrible conditions at Houston’s Jefferson Davis Hospital. In 1962 de Hartog and his wife Marjorie settled in Houston where he served as a dramatist-in-residence at the University of Houston and taught an advanced course in playwriting. Shortly after their arrival, the de Hartogs learned from acquaintances that help was needed to feed the newborns at Jefferson Davis Hospital in the city’s Fourth Ward. Because of a staffing shortage, hours would sometimes go by before the babies were fed.

The de Hartogs, who were Quakers, offered their assistance as volunteers at the hospital. Jan de Hartog worked as an orderly in the emergency room. What he saw at the hospital stunned him. Eight months into their work, de Hartog exposed what he called a “monument of misery” at the hospital in a letter published on April 21, 1963, in the Houston Chronicle. De Hartog described a facility where “the floors are slippery with blood and vomit” and malfunctioning beds were “propped up with chairs under the mattresses and held together with surgical tape.”

De Hartog said he was compelled to write the letter about the hospital’s conditions after Houston city councilman Frank Mann suggested a cut in the hospital’s budget. At the time, funding for Jefferson Davis Hospital was provided by the city and county. A thirteen-member board of managers, appointed by the Houston city council and Harris County Commissioners Court, oversaw its operations. Medical services were provided by Baylor College of Medicine. Weeks after de Hartog’s April letter, a new city/county hospital—Ben Taub General Hospital—opened in the Texas Medical Center. De Hartog was concerned the problems at Jefferson Davis would continue at Ben Taub.

Houstonians both commended and criticized de Hartog for making his findings at the hospital public. Those siding with him contrasted elected leaders’ treatment of the hospital system with their support for the Astrodome. Former Chronicle editor M. E. Walter challenged de Hartog’s assessment of conditions at Jefferson Davis and noted its “splendid record over the country for curing the sick….” Walter noted that community leaders tried to solve the problem by setting up a new taxing agency through a hospital district, but that it had been shot down by voters in previous years.

De Hartog followed up on his letter by challenging Harris County residents to contribute funding to augment nursing services at the city/county-run hospital, and he pledged $10,000 of his own money. Though the move fell short of its $60,000 goal, residents, aided by the de Hartogs and their fellow Quaker friends, mobilized to provide volunteer services at Ben Taub as trained orderlies and nurses’ aides.

De Hartog’s experiences at both hospitals garnered national attention after he published The Hospital in October 1964. In the book, de Hartog described in greater detail the conditions at Jefferson Davis, including a patient who died of suffocation because a tracheotomy tube was not cleaned in a timely manner, the result of staffing shortages. De Hartog also wrote of a nurse removing a cockroach from a child’s tracheotomy tube. One nursing supervisor backed up de Hartog’s claims in The Hospital and noted a severe shortage of registered nurses at Ben Taub.

In a review of the book, the Wall Street Journal criticized de Hartog’s portrayal of his efforts to bring attention to the plight of Houston’s charity hospitals and said, “There is a conceit that shines through such mercy and it is most apparent when the author must interrupt his narrative to refute his own ‘taint of saintliness.’” However, the review also praised de Hartog’s success in stirring residents to take action and stated that he “succeeds in arousing the compassion of the reader….”

Proceeds from the book went to the nurses’ aid training program. The book helped renew calls for the Harris County Commissioners to order an election to create a hospital district. In early 1965 voters had their say on the matter, but despite endorsements from de Hartog and county leaders, the measure was defeated. Disappointed, de Hartog again asked residents to volunteer their time at the hospitals. He left the city a short time later.

On November 20, 1965, county residents finally approved the creation of a hospital district to oversee operations of Jefferson Davis and Ben Taub hospitals, the fifth time the measure had gone to voters.