Jean Richardson, A History of the Sisters of Charity Hospital, Buffalo, New York, 1848-1900 (Lewiston, Queenston, Lampeter: The Edwin Mellen Press, 2005) $109.95. ISBN 0-7734-6035-7 (hardcover), pp. x + 213.

Reviewed by Dr Joos van Vugt, Radboud University, Nijmegen, the Netherlands

Jean Richardson, assistant professor in the Department of History and Social Studies Education at Buffalo State College, has written a thorough study on the development of ‘Sisters Hospital’ in Buffalo (N.Y.). This hospital was founded in 1848 by three Sisters of Charity. The need for a local hospital was evident: Buffalo was a fast-growing industrial town, which attracted thousands of immigrants mainly from Ireland and Germany. The town’s infrastructure was by no means able to cope with the increase of its population. Housing conditions were poor, epidemics and industrial accidents were rife. Well-to-do citizens with health problems could resort to private doctors but there was hardly any health care available for the many destitute immigrants. No wonder the sisters and their hospital were more than welcome in Buffalo, even among the Protestant citizens who proved willing to set aside their anti-Catholic biases.

In many respects, Richardson’s story follows well-trodden paths of hospital history: the development from charity to health care, from care to cure, from religious dedication to professional commitment. Nevertheless, her study reveals some striking aspects. For instance, I was surprised to learn that from the very beginning the Sisters Hospital received, as a matter of course, a substantial annual State appropriation.  Being an outsider, I would have expected a mid-nineteenth century American State to leave private hospitals to their own financial devices. Not so, apparently.

By founding their hospital the Buffalo sisters took the lead in institutional health care in Buffalo. Protestant and public institutions came later and were hard-pressed to catch up. Thanks to the dedication of the sisters and their low cost of living, their hospital never lost its qualitative edge. The sisters even weathered the modernization drive of the late nineteenth century by establishing a nursing school, expanding the hospital buildings and upgrading the quality of their care. Again, I was struck by the level of autonomy the sisters acquired and maintained vis-à-vis priests, bishops, lay employees and, eventually, doctors. In view of the fact that Richardson repeatedly stresses the tenacity and boldness of the sisters in this respect, one might assume that such autonomy was not self-evident in the U.S. Other studies on American sister communities, however, reveal the same characteristic. It seems that somehow the circumstances in the U.S. fostered a more independent attitude among American sisters than was usual among their European colleagues, who were often (not always) more subservient to their male masters. The American pioneering spirit, perhaps?

An interesting aspect of the hospital’s history is its involvement in the vicious rivalry between different factions of doctors in Buffalo. One of those factions represented an older, old-fashioned and arrivé generation of doctors, the other a younger, more progressive generation of medical upstarts. Both factions founded medical colleges and tried to gain a foothold within the Sisters Hospital for the sake of training facilities, clinical experience, and a profitable private practice. I do not know if this rivalry was more or less a local phenomenon or the symptom of nationwide shifts in the medical profession, but it is interesting anyhow.

Jean Richardson has written a competent book on the Sisters of Charity Hospital but it is more about the hospital itself than about the sisters. Her study pays adequate attention to the social and political context of the Sisters Hospital but her approach is highly institutional. Apart from a few prominent sisters, the nursing sisters themselves are largely missing from her narrative. Of course, she mentions in general terms the high quality of their work, their dedication, and their religious fervour. But a lot of questions remain: how many sisters were there? Where did they come from? How old were they? At which age did they retire? How did they maintain such continuity in their deployment in Buffalo? What is known about their training? What working conditions did young sisters encounter when they entered the hospital? How did the sisters cope with the pressure of work which, given the usual practice in Catholic hospitals, must have been tremendous? Did any sisters leave the community and if so, do we know why? Were the nursing sisters shifted around the many hospitals of their congregation and did they stay in one place for years on end? Did nursing sisters always remain in the hospital or were they also put to work in any of the other charitable institutions of their congregation? Agreed: questions like these are not easily answered given the rather formal character of nineteenth century archives but they should at least be formulated lest all those sisters who toiled for the sick and the poor of Buffalo remain hidden behind the façade of their hospital.