The Heritage Building in 1913: The ‘College Wing’

The opening of the Toronto General Hospital at College and University in 1913 was really its second re-location from its original site in 1819, when it occupied a small building at King and John in what is now Toronto's Theatre District. From there, it moved northeast to Gerrard Street East and Parliament in 1855. While the TGH had enjoyed a respectable international reputation as a ”model hospital,” with this relocation the board envisioned the hospital becoming a world leader. After 31 months of construction under the direction of Toronto architects Darling & Pearson, the new Toronto General Hospital was officially opened on June 18, 1913. With 11 buildings over nine acres and 670 beds, it became the largest private hospital in North America and, as proclaimed by the Toronto Star, "the most modern and complete hospital in the world." The total cost of the project was $3,500,000 (equivalent to about $65,000,000 today) of which an astonishing $1,400,000 was paid by private donations in denominations as low as $1.

THE COLLEGE AND UNIVERSITY COMPLEX

The College Street building was the centrepiece of the new hospital complex, housing the main entrance, administration and medical and surgical wards in its west and east wings, respectively. Further south down University Avenue lay the Out-Patient building and Emergency Department, the latter outfitted for the first time in Toronto’s history with motorized Cadillac ambulances. Along the southern edge of the property were the Nurses’ Residence and the Private Patients’ Pavilion. (In the days before Medicare, private patients willing to pay for an extra measure of comfort were an important source of the hospital’s income.) Facing Elizabeth Street were the Servants’ Quarters, the Lying-In Department, power plant and the laundry. The perimeter created by the entire complex produced a large quadrangle in the centre of the property, filled with landscaped gardens and lawn space.

THE ARCHITECTURE AND BUILDING DESIGN

While the interior of the main building at 101 College has undergone several renovations and expansions since 1913, its exterior has changed little. The free Renaissance treatment of the façade remains intact, as do the terra cotta trimmings, interesting spacing of windows and the iron fence along the front. The outside bricks were larger than usual and specially made to obtain the desired colour; it was felt that red was too ‘factory-like’ and white too cold, therefore beige bricks were created by a special procedure of mixing and firing a variety of different clays. Oddly enough, this apparently daring choice of brick become a matter of some controversy, such that C.K. Clarke, superintendent of the hospital from 1911 to 1913 saw fit to defend it, writing:

A good deal of criticism has been made of the brick by the man on the street… [but] the Trustees showed themselves men of good sense when they selected this particular brick, as it is beautiful from an aesthetic standpoint, and lends character and dignity to a group of buildings that will receive a great deal of study from the rising generations.

The new hospital was equipped with the most modern new technologies and aimed to set new standards in hygiene. All interior surfaces were smooth and washable to prevent germs from accumulating; the design even sought to avoid or round out corners where possible. The walls were covered in a specially designed impervious paint, furniture was made from steel and bathroom surfaces were done in grey Tennessee marble. Most of the floors inside had a cement finish topped with red Scotch battleship linoleum to give a smooth, noiseless surface. This feature, according to an extensive article on the new TGH in Construction magazine in 1913, was "an ineffable boon to the nurses who will have to traverse it almost unceasingly for hours both day and night." The ventilation system completely exchanged each room’s air every ten minutes and every six minutes in toilets, operating rooms and kitchens. Further to maximize patients’ comfort, there was an electric nurse-paging system and a draft-proof ventilation system. Even the driveways were taken into consideration: they were paved with wood to minimize the noise made by passing cars.

THE COLLEGE WING LAYOUT

The Heritage Building was the main entrance to the hospital, but was not designed for admitting patients; the Emergency and Out Patient Buildings served that purpose. When visitors entered off College Street, they would first see the main rotunda and waiting room, with its marble floor and stained glass windows. To the left was the general office, while the information bureau and telephone exchange were on the right. Nearby were the offices of the medical and nursing superintendents, the secretary and steward, along with the boardroom.

On the south side of the rotunda were wards for semi-public patients. Directly above them were the Ear, Eye, Throat and Nose Department on the second floor and the Gynaecology Department on the third, both of them public wards. On the fourth floor, quarters were provided for 27 doctors. The medical and surgical wings lay on the west and east sides of the building, respectively. Both were three stories high, each floor with a full operating suite and a veranda overlooking the gardens at their south ends, "a priceless factor in the welfare and recovery of patients" according to Construction magazine.

In the basement, there was a lecture hall for university students, the Radiology Department and the innocuously titled but rather sinister ”Hydrotherapy Department.“ Here patients were immersed in baths for up to several days at a time to treat various afflictions, including the colourfully titled ”alcoholic delirium.“ For sufferers of nervous disease this unfortunately entailed ”electric baths,“ which ran a current through the bathwater.

The Toronto General Hospital became the frontrunner of clinical care in Canada and North America. Importantly, however, it was equipped in anticipation of a teaching and research collaboration with the University of Toronto. In fact, it was this affiliation that provided much of the impetus to build the Hospital in the first place. From 1913 onwards, the Toronto General Hospital became a party to world-class research and a leader in clinical development.

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