Central State Hospital in Indianapolis served the Indiana community for 146 years.
Photo (source): The “Old Main” building of the hospital served as the Men’s Department.
Prior to the establishment of mental health facilities in the United States most individuals suffering from mental disorders were relegated to living as beggars in almshouses, being secluded in damp basements, or confined for the rest of their days in prison. Patients in asylums fared only slightly better, as they were often subject to questionable treatment at the hands of their physicians.
At the time conventional medical practitioners did not have the benefit of advanced imaging techniques, testing procedures, and psychiatric treatment breakthroughs we take for granted. Physicians in the 1800’s believed that forms of “insanity” were thought to all derive from either direct physical or indirect moral sources. Brain specimens from patients post mortem often revealed direct physical sources for insanity such as physical trauma, lesions, tumors, syphilis, or other organic causes. Indirect moral sources as a cause for insanity ranged a wide gamut from the entirely plausible to highly improbable. These factors could include fatigue, seduction, jealousy, religious excitement, drunkeness, tobacco use, drug addiction, masturbation, lack of education, and financial difficulty.
The government of Indiana’s official concern for individuals with psychological issues dates back to 1827. That year the state legislature allocated a small parcel of land known as “square 22” with a small log cabin in Indianapolis to be used as a “lunatic asylum.” In 1844 political activist Dorothea Dix persuaded the Indiana General Assembly to appropriate funds for an official state-run asylum. Governor Whitcomb appointed his associate Dr. John Evans as commissioner in charge of developing the hospital. In fall of 1845 the state purchased a 160-acre plot of farmland three miles from the center of Indianapolis from Nathaniel Bolton for the sum of $5,300.
Photo: A well worn workbench in the former power station.
To prepare for construction Dr. Evans travelled east to study mental institutions at his own expense. His subsequent building recommendation for the hospital followed the Kirkbride Plan. One defining element of Kirkbride Plan architecture is a central core with staggered wings. Each area had prescribed uses to maximize hospital efficacy. The core contained offices, reception room, visitor’s suite, kitchen, chapel, and other essential rooms. The wings were partitioned into wards accommodating patients according to their classification and gender. In addition to patient rooms, the Kirkbride Plan also allocated space for recreation, hygiene, food service and other hospital logistics. The grounds surrounding these types of buildings were quite expansive and ornate, thus guaranteeing a level of seclusion from an intruding and curious public.
In addition to architectural style requirements, the Kirkbride Plan is heavily ingrained with Moral Treatment philosophy. In combination with medical care patients were expected to participate in recuperative therapy, religious exercise, education courses, work therapy, social engagements, and a host of other activities perceived to have curative effects. Hospital staff were discouraged from using restraints whenever possible, refrain from using physical violence, show compassion to their wards and have a thorough understanding of their condition.
On May 5, 1846 construction of the Indiana State Hospital for the Insane broke ground. As time progressed a myriad of support structures sprawled across the expansive plot of land. These included expansions to the “Old Main” Men’s Department, the “Seven Steeples” Women’s Department, Central Boiler House and Plant, Carpenter’s Shop, Pathological Department, Kitchen, Dining Rooms, Greenhouse, Cold Storage, Upholstry Department, Amusement Hall, Chapel, Fire Department, staff homes, and Administration Building among others. The elegant architecture of the “Seven Steeples” Women’s Department was admired for its elegance, but in reality it possessed eight steeples.
The new facility opened its doors and welcomed five patients on November 21, 1848. Treating mental illness at that time involved a great deal of speculation with little hope for recovery for many patients. The hastening pace of industrialization, the ravages of the Civil War, and friction between Victorian era and American societal norms further compounded matters. As such the patient population at the hospital would greatly increase to the point where it suffered from chronic overcrowding.
Photo: Aged chairs succumbing to the elements in one of the many derelict hospital structures.
Ideally the ultimate goal of any hospital is to provide the best care it can for patients. In pursuit of this goal, however, the hospital was not able to avoid becoming a pawn for those with political or ideological agendas. In fact the hospital experienced regular intervals of discord both internally and publicly. Cyclical underfunding brought about by fiscal conservatism ensured that the hospital was consistently unable to perform some of its duties. Outrage directed towards the hospital in times of crisis were then typically followed by a period of progressive reform.
On the surface the hospital appeared to be quite progressive in its efforts to properly treat its wards. Behind the scenes, however, was a hidden reality for the most indigent and dangerous patients. In 1870 the Indiana Governor received the following report on some of the deplorable conditions at the hospital.
“…basement dungeons (are) dark, humid and foul, unfit for life of any kind, filled with maniacs who raved and howled like tortured beasts, for want of light, and air, and food, and ordinanry human associations and habiliments…”
Dr. Everts – Superintendent
Central State Hospital for the Insane
Declining conditions at the hospital also included lack of proper staff training, heat, proper lighting, ventilation, structural maintenance, proper bedding, and kitchens infested with cockroaches due to inadequate funding. Dr. Everts efforts to highlight the plight endured by the hospital fell on deaf ears, which led to his resignation in 1872.
It took the printed word of actual hospital patients who endured the conditions at the hospital to arouse public indignation. Civil war veteran and former patient Albert Thayer disseminated his accounts along with others via a broadside called “Indiana Crazy House” to churches, politicians, and Indiana citizens. Thayer’s efforts were somewhat successful in improving physical conditions at the hospital. Despite these improvements, primary caregivers at the hospital continued to be poorly trained medical attendants rather than actual physicians. Patient abuse at the hands of their overwhelmed caretakers continued unabated. The misuse of sedatives and physical restraints to ease the staff workload was common practice.
In late 1883 the hospital hired the first officially recognized female medical doctor in Indiana. At the time of her arrival Sarah Stockton was just one of only 22 female physicians in the United States. Dr. Stockton was tasked primarily with the care of female patients. Her focus centered on reproductive ailments, which were at that time generally thought to exacerbate mental illness.
Dr. Stockton’s hiring was just one of the calculated efforts by Superintendent Richard Fletcher to bring about reform. To protest the poor conditions at the hospital Fletcher caused a spectacle when he publicly burned the hospital’s physical restraints in a bonfire in 1885. Several other practical reforms were instituted under his tenure. Medicinal use of whiskey was reduced from three gallons per day down to just one pint. Patients enjoyed the benefit of free dental care. He also brought dignity to those patients who had passed on by abandoning the practice of anonymous burials.
Photo (source): 1931 aerial photo from the south looking north. Notice the two large staggered Kirkbride Plan buildings.
With the construction of other mental health facilities the official hospital name changed around 1889 to Central Indiana State Hospital for the Insane to reflect its geographic location in relation to the others. This period is marked by positive change brought about by Superintendent George Edenharter. One of the first pathology laboratories in the nation opened under his leadership in 1896. This state of the art teaching and research facility included a lecture amphitheater, autopsy room, photography room, library, anatomical museum, and research laboratories.
Criminology also made significant strides at the hospital under the direction of Dr. Max Bahr. Bahr’s research focused on the link between crime and mental illness. You can hop over to here to get in contact with the best legal firm. He developed some of the first forensic psychiatry courses for American lawyers. During his tenure the name of the hospital changed to Central State Hospital (CSH) in 1926.
The pathology department would gain international renown in 1931 when Dr. Walter Bruetsch made significant discoveries in the treatment of syphilis. He discovered that malaria triggered the production of white blood cells that consumed both syphilis and malaria. Prior to his discovery, syphilis had been the largest cause of mental illness. This major breakthrough made significant headway in treating syphilis until the advent of penicillin.
During the 1950s advances in psychopharmacology shifted public perception of mental health facilities nationwide. Up until that point the patient population had swelled to approximately 2,500. Throughout the 1960s and 1970s a trend towards deinstitutionalization became a matter of public health policy. As a result patients with conditions that could be controlled with medication and cases of mental retardation were moved into smaller facilities, half-way houses, or trained to live autonomously. The total number of patients would continue to decline until its eventual closing.
Photo (Jonathon Much): A chair waits in the Administration Building.
With an ever declining in-patient population and movement toward deinstitutionalization much of the hospital languished. In the mid-1960 Superintendent Clifford Williams reported that there was only one bathtub and three toilets serving all 24 wards. Patients were also kept in perpetual darkness as rooms did not have lighting.
Public attention during the 1970s also focused on the repeal of one of Indiana’s most dubious public health laws. In 1907 the state passed the first eugenics law, which empowered the state to forcibly sterilize the poor, drunkards, sexual deviants, the mentally deficient and those with communicable or hereditary disease. The law was overturned in 1921 on constitutional grounds, but a 1927 revision resumed the use of forcible sterilization. Up until 1974 the state carried out approximately 2,500 forcible sterilizations, some of which occurred at CSH. Bowing to public pressure the law was finally repealed in 1974.
In the same decade some of the remaining Victorian-era buildings, including the ornate Seven Steeples, were demolished to make room for practical facilities with modern amenities. Beneath the surface, however, still exists a service tunnel network that spans five miles that connected all of the buildings.
Reports of patient abuse and deaths once again cast a dark shadow in the early 1990s. By then the total patient numbers had dwindled to under 400. Between 1988 and 1992 as many as 24 patients may have died under questionable circumstances. One patient died of exposure from a broken window. Another patient was found dead after drowning in a bathtub. Yet another had died from a medication overdose. After a grand jury investigation into at least ten of the suspicious deaths then Governor Evan Bayh decided to shut down the aging hospital. Although the writing was on the wall the state allocated $2.2 million for renovations, excluding labor costs, in 1993 to bring the hospital up to code. In June, 1994 the last 18 patients were transferred to other facilities. With its beds empty the hospital closed its doors after 146 years in public service.
Today there are 19 structures in various states that are scattered on the grounds. Of these the Administration Building, Dining Hall, Laundry, and Pathology Building are registered as historically significant buildings. In 2003 Indianapolis purchased the property from the state for $400,000 and has marketed it as a great opportunity for mixed development. Construction crews have already begun working on the east side of the property, which means the end is in sight for many of the forgotten hospital structures.
Exploring the hospital grounds proved to be a greater challenge than originally anticipated. Although many of the buildings are exposed to the elements, extreme cold during the exploration hampered the effort. Both the bottles of water and soda I carried with me froze to the point where they became undrinkable. My fingers could not stand being exposed for a few seconds at a time even with hand warmers inside of retractable gloves. Condensation from my respirator dripped constantly throughout the day rendering a drip ice pattern on the front of my jacket. The lenses I tried to use became unresponsive or were fogged up. At one point the mode and power switch on my camera froze together, which rendered the entire camera inoperable. Staying warm took priority over concentrating on finding subjects to photograph. Being a Wisconsin native bore no weight in this cold and the overall quality of photos taken suffered.
Photo: Amphitheater in the Pathology Building used for medical instruction.
After spending most of the day feeling like Han Solo frozen in carbonite I decided to head over to the Indiana Medical History Museum housed in the former Pathology Building. The guided tour is somewhat brief, but densely packed with fascinating medical history. The guide escorts visitors through the various rooms dedicated to specific tasks involved with treating patients. Throughout the tour they tread a fine line between satisfying the morbidly curious while simultaneously respecting medical history. Visitors are confronted with the authentic medical instruments, techniques, and ephemera from the periods they represent. Although some of installation pieces may induce nausea, this is usually replaced by an instant appreciation for modern medical practices. I can confidently prescribe this museum to anyone within the vicinity. Side effects may include curiosity, amazement, and learning.
There are a dearth of available sources that tout the hospital’s attraction as a haunted location. These pieces like to highlight the darker areas of its history to accentuate its mystique. Some go so far as to present what they believe to be bona fide evidence of paranormal activity. It is important to remember that these people in the majority of cases are by no means actual scientists using proven methods. They run around in the dark and claim to hear or see things for what they are not. In some ways they share traits with those who were legitimate patients suffering from paranoia, hallucinations, and delusions. By muddying the history these people do its doctors and patients a disservice.
Advances in medical testing, forensics, diagnosis procedure, pharmacology, and psychiatry have greatly reduced the need for patient institutionalization. For as long as the human body is plagued by illness, there will always be the need for institutions to house patients who need care. If there is anything that the history of Central State Hospital can teach us it is that medical care is not a pawn for political, ideological, or budgetary gain. It is in the public interest to adequately fund healthcare for all. It is the kind, compassionate, and morally right thing to do as disease cares not for anyone’s convictions.
Video (nichdane04): Century old brain specimens from CSH are being used to study mental illness.
Ancestry.com – Page with photos of Central State Hospital
Asylum Projects – Entry for Central Indiana State Hospital
Ball State University (PDF) – Central Greens, LLC 2011 Creative Project Summary for CSH reuse
City of Indianapolis (PDF) – 2005 Private Contractor bidding form for CSH property
City of Indianapolis (PDF) – Keramida assessment of CSH brownfield cleanup alternatives
City of Indianapolis (PDF) – Central Greens, LLC land reuse proposal
Flickr – My Central State Hospital set
Flickr – agnisflugen2’s CSH set
Flickr – gdnght1’s CSH set
Flickr – rachel42’s CSH set
Google Books – The Encyclopedia of Indianapolis entry on CSH
Google Books – Indianapolis Monthly has a great photo of the IMHM lab
Google Books – Psychiatry in Indiana
Google Books – Shook Over Hell mentions CSH
Google Books – Weird Indiana entry on CSH
ICMHSR – Group tracking former CSH patient welfare
IMHM – Homepage for the Indiana Medical History Museum
IMHM (PDF) – Ellen Dwyer’s account of the hospital history
IN.gov – State government page on Dr. Sarah Stockton
IN.gov – General CSH resources
Indiana Public Media – Article on Central State Hospital
Indiana University – Indiana Consortium for Mental Health Services tracking of CSH patients
Indiana University (PDF) – Paper has short Sarah Stockton bio
Inside Indiana Business – 2003 article on the city of Indianapolis’ plan to buy CSH land
Kirkbride Buildings – Describes the architectural style of the Kirkbride Plan
Leagle – Gooley v. Moss case where a CSH patient was forcibly sterilized in 1969
Library of Congress (PDF) – Written Historical and Descriptive Data
Opacity – Forum has CSH Men’s and Women’s Department maps
SpringerLink – Seven Steeples actually had eight of them
Whitepaper Bluesky LLC (PDF) – Central State of Mind reuse plan
Wikimedia – Photo of the Indiana Medical History Museum building
Wikipedia – Entry for Central State Hospital
Wikipedia – Entry for Deinstitutionalisation
Wikipedia – Entry for the Kirkbride Plan
Wikipedia – Entry for Moral Treatment
WTHR NBC13 – Mentions new construction on the site
WTHR NBC13 – Mentions apartment construction planned for the site
YouTube – nichdane04’s video on how CSH brain specimens are helping contemporary researchers
Photo (source): Ravenswood Hospital as it appeared in 1945.
The American healthcare system is for profit. American citizens’ health, safety, and well-being are managed by large companies looking to stay in the black. The other democracies and various forms of government in industrialized nations have recognized the danger that this poses to general public. While private medical care still thrives in these countries, there is at least a public healthcare plan to insure that all citizens have a safety net. The United States is the only country where citizens decide between health and crushing debt, even if they have insurance. These medical bills often go unpaid as patients hover around bankruptcy or simply do not have the means to pay them. Despite the inability of patients to pay, healthcare providers are required by federal law to treat patients. To stay financially competitive healthcare providers seek to mitigate their risk and cut costs wherever possible.
For one Chicago youth those risk-averse penny-pinching measures hastened his untimely death.
Photo: The Adler Pavilion portion of Ravenswood Hospital.
While playing basketball on North Wolcott Avenue, Christopher Sercye, age 15, was shot twice in the abdomen by gang members on Saturday May 16, 1998 around 6pm. His panic-stricken friends dragged Christopher about 100 yards to the ramp outside the emergency room of the nearby privately-owned Ravenswood Hospital before collapsing. Some reports say the injured teen was within 30 feet of the door, while others say he was 50 feet. In any case the teen was well within view of hospital staff. The first of five separate phone calls to emergency services came in at 6:15pm.
One friend ran inside the hospital and got two police officers to rush to Christopher’s aid. The officers and witnesses begged hospital staff to assist, but they demurred citing hospital policy that forbid them to exit the building. The officers on scene were also bound by protocol to not move injured people and wait for paramedics. At 6:23pm a request for an ambulance went out over police radio. Ignoring protocol one of the officers finally commandeered a wheelchair and rushed Christopher into the emergency room with a barely detectable pulse.
Photo: EKG readings from a patient file left in the hospital.
An ambulance finally arrived on scene at 6:29pm, but left after seeing Christopher being wheeled into the hospital. Emergency Room staff began administering treatment immediately. Two minutes later Christopher suffered cardiac arrest. Doctors discovered that the bullets punctured Christopher’s aorta, mesenteric vein, and colon. Christopher was pronounced dead at 7:33pm.
Prime suspect Aureliano Fajardo was arrested the next day. Two other accomplices, Salvador Aguilar and Lionel Duran, were also arrested in connection with the murder. Fajardo and Aguilar were kept on $1 million bond, while Duran was kept on $500,000 while charged with first-degree murder.
Two days after the shooting Ravenswood president and CEO John E. Blair rescinded the policy preventing hospital staff from exiting the building. In response to Christopher’s death Blair stated, “Above all, I want to make sure that if a tragedy like this ever occurs again, we have a different result. Media reports of the tragedy of Christopher’s death garnered national outrage. President Clinton threatened to revoke the $59 million annual Medicare funding for the hospital, but was later overruled by the Health Care Financing Administration.
Those who remember 8th grader Christopher Sercye described him as a leader with sense of humor. His family filed a lawsuit against Ravenswood Hospital later that year. In 2003 the courts ruled in favor of the family and awarded them $12.5 million for the wrongful death. That same year the “250 Yard Rule” was amended to the EMTALA law. The rule states that healthcare providers are required to respond to any “presentation” warranting medical assistance within 250 yards of the main hospital campus building.
Photo: A hospital bed takes up a majority of floorspace in this cramped patient room.
Ravenswood Hospital had long been a pillar of the north side Chicago community before being embroiled in controversy. The original hospital was built in 1907, but by the 1990s had expanded to meet community demands. The hospital had just under one thousand beds at its apex. It also included ambulatory care, a psychiatric unit, rehabilitation, oncology, coronary care, trauma ward, nursing school and student residence on site the 7.5 acre site.
The hospital fell on hard times during the 1990’s as HMOs, insurance companies, Medicare and Medicaid began cutting costs wherever they could. Advocate Health Care purchased the flailing hospital in 1998 much to the chagrin of community members and hospital staff. Blair, the hospital president and CEO who had weathered the Christopher Sercye debacle, said “In the weeks to come we hope everyone will agree that this move has great potential for employees and will enhance our ability to serve the community.” Almost immediately Advocate began consolidating medical services with other are hospitals it owned. Despite the drastic cuts the hospital managed to operate at a $35 million loss in 2001 alone. Ravenswood’s closing could not have come at a worse time as a number of historic Chicago area hospitals, such as Edgewater, were closing their doors. When Advocate finally sold the hospital they salted the earth by including a non-compete clause forbidding new owners to operate a medical facilty.
Photo: An X-Ray machine on the top floor scorched by fire.
A majority of the hospital was closed off while other parts were rented to various tenants. Ravenswood may limp along until its ultimate demise, but its death makes way for new life. Private school Lycée Français de Chicago plans on demolishing the entire complex in 2013 to make way for a new building. If the school is able to raise the necessary funds they will occupy their new home by 2015.
There are currently 50 million Americans who do not have health insurance coverage. Even those who are insured risk being dropped by insurance companies should they incur medical bills. As Americans we pay not only a financial cost, but also a social cost (PDF) when profit is placed over health and well-being.
Ain’t No Way To Go – Article on Christopher Sercye’s tragic death.
Answers – Discusses the hospital closure in 2002.
Center Square Journal – Lycee Francais de Chicago will demolish the site in 2013.
Chicago Reader – Controversy over the Ravenswood Hospital closing.
Chicago Reader – Controversy over Advocate Health Care’s takeover of the hospital
Chicago Talks – Financial stress ultimately leads to the hospital closing.
Chicago Tribune – 1998 article on Medicare funding for the hospital.
Chicago Tribune – 1998 report of the crime and subsequent arrests.
Chicago Tribune – 1998 article mentions Christopher Sercye’s funeral.
Chicago Tribune – 2001 article about Fajardo committing murder behind bars.
Curbed Chicago – Architect mockup of what the Lycee Francais de Chicago building would look like.
emtala.org – Explains the EMTALA 250 Yard Rule.
Flickr – Nitram242’s Chicago Hospital Closure set.
Google Books – Jet article states that Christopher Sercye was shot in the heart.
Hospital Data – Statistics for the facility.
New York Times – Mentions Christopher Sercye being dragged “within 30 feet” of the hospital.
Power Rogers & Smith – Lists the 2003 $12.5 million settlement for Christopher Sercye’s wrongful death.
Scribd – Lycee Francais site survey from 2007.
Slate – Opinion piece about the policies that led to Christopher Sercye’s death.
Sun-Sentinel – 1998 article on Christopher Sercye’s death.
USA Today – Settlement announcement for Christopher Sercye’s death.
Wikipedia – Emergency Medical Treatment and Active Labor Act
YouTube – Video shot in the hallways.
YouTube – Hospital closing reaction video.
This week the American Urbex Podcast delves into one of the biggest cases of Medicare fraud in US history.
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Edgewater Medical Center article on American Urbex
Edgewater Medical Center on Flickr
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Photo: Edgewater Medical Center looms over the bustling neighborhood.
When an animal in the wild suffers from some genetic or incidental malady the results are often fatal. Years of natural selection from generation to generation insure that only those who are best suited to survive in their environments will continue to survive. One of the things that sets humans apart from animals is that we make every effort to insure that our species will continue to thrive in spite of what ails our bodies. Medical staff are ethically obligated to provide the best possible quality of care for patients, no matter the affliction. For some executives and doctors at Chicago’s Edgewater Medical Center personal profits came before those ethical standards, while they used the best hospital beds for this purpose. The unnecessary suffering and premature deaths they caused resulted in the shuttering of a historic Chicago neighborhood hospital. The tragedy makes one wonder if the culprits are even human at all.
Photo (Chicago History in Postcards): Edgewater Medical Center as it appeared in the 50-60s. The original building is to the left and Mazel House 1953 expansion to the right.
Dr. Maurice Mazel founded the Edgewater Hospital at the outset of the Great Depression in 1929. He personally oversaw hospital operations until his death in 1980. During his tenure notable births included current US Secretary of State Hillary Rodham Clinton and serial killer John Wayne Gacy. His wife, Circus Hall of Fame performer Harriet Mazel-Szanto, functioned as chairman and CEO from 1980 to 1984. She later shed the CEO title, but remained on as chairman until 1988. After her passing the hospital built under the benevolent Mazel family name sought new ownership.
Photo (Wikimedia Commons): The benevolent Dr. Maurice Mazel reclining for his photograph.
Businessman Peter Rogan acquired Edgewater Medical Center in 1989 for $1 million cash and assumed its $10 million in liabilities through the Edgewater Operating Company (EOC) he created. In 1994 Rogan sold EOC and the real estate to the Edgewater Property Company (EPC), which he also controlled. In the deal Edgewater Medical Center paid an exhorbitant $79,500/mo. rent to EPC. At the helm of both entities Rogan funneled profits directly into his own pockets.
Corruption rooted itself deep into Edgewater’s staff. Rogan orchestrated a complex system of kickbacks for doctors and staff complicit with committing fraud against Medicare, Medicaid and private insurance companies. Vice president Roger Ehmen and medical director Dr. Ravi Barnabas were able to turn the nearly bankrupt hospital into a lucrative profit center. The pair tapped Dr. Sheshiqiri Rao Vavilikolanu and Dr. Kumar Kaliana to recruit potential patients. For years the doctors sent hospital employees into the Chicago community to find potential patients. It did not matter if they did not have heart conditions, were drug addicts, were unable to speak English or even had no health insurance coverage. Recruiters instructed the potential patients how to feign symptoms in order to mandate services rendered by Edgewater Medical Center. In return the patients were offered money, food, cigarettes and other amenities for their cooperation.
Another complicit Edgewater physician participated in the massive fraud scheme. Dr. Andrew Cubbria tapped into the recruited patient pool for unnecessary angiogram and angioplasty operations. Albert Okaro, 42, underwent an invasive and unnecessary cardiac surgery that ultimately killed him. The patient’s death was regarded as collateral damage for Dr. Cubria. Tax-payer funded healthcare programs and private insurers reimbursed the hospital for more than 750 invasive, and expensive, cardiac surgeries performed by Dr. Cubria alone.
One Edgewater physician, Dr. Krishnaswami Sriram, billed the government for seemingly impossible human feats. According to Dr. Sriram’s billing records on November 12, 1997 he saw 187 patients… all of whom coincidently had congestive heart failure. In January 1999 a severe snowstorm brought Chicago to a standstill. Despite the hazardous weather conditions Dr. Sriram was apparently able to visit 31 elderly patients at their homes and 18 more in medical facilities. Thirty-two of Dr. Sriram’s patients also managed to incur new medical costs long after their deaths. On paper it appeared as though Dr. Sriram was indefatigable. His records indicate that he met with patients every single day in 1997 and 1998, while missing only two days of work in 1999.
Photo: Collected tissue sample slides filed away.
Dr. Sriram’s apparent superhuman ability to visit patients did not go by unnoticed. Some of the elderly patients he targeted began to grow suspicious after noticing over-inflated billings on Explanation of Benefit forms. At least 15 patients contacted the Wisconsin Physicians Service, which handles claims in the Illinois area. Wisconsin Physicians Service alerted the FBI and they immediately began an investigation.
Things began to unravel in 1999 when the hospital payed out over $1 million to stave off an impending federal lawsuit over Medicare billing irregularities. The ambitious Dr. Sriram was taken into custody in 2000. Feds exposed the rest of the fraud operation in 2001.
The upheaval brought on by the charges cut the hospital’s day-to-day operations off at the knees. In November 2001 the US government, which accounted for 90% of Edgewater Medical Center income, ceased Medicare payments indefinitely. Unable to find a suitable financier the hospital shut down in December 2001. The remaining 450 staff were suddenly out of a job or had to transfer to other area healthcare facilities. In addition to the displaced staff, 52 patients were transferred to other facilities for ongoing care.
Photo: Patient records stacked on the floor almost reach the ceiling.
In 2006 courts ruled that former owner and executive Peter Rogan was on the hook for $64.2 million in damages and penalties. The US Justice Department charged Rogan in 2008 with obstruction of justice and perjury for his attempts to hide his assets. One of the trusts was set up in the Bahamas and was entitled the Peter Rogan Irrevocable Trust. Rogan insisted that he maintained no control whatsoever over the assets and could not access it. In addition to the federal charges, French bank Dexia is working with the Justice Department to recover assets scattered throughout various bank accounts and front companies in the Caribbean. The cases are still in litigation.
Senior vice president Roger Ehmen and Dr. Ravi Barnabas were convicted for their roles in the fraud operation. Ehmen received 6 1/2 years of prison time and was ordered to pay $5 million in restitution. Ehmen was quoted at sentencing stating,”Words alone cannot describe the deep sorrow and regret I have. I will have to live with this guilt for the rest of my life.” Medical director Dr. Barnabas was sentenced to 4 years and 4 months prison time and ordered to pay $1.1 million in restitution. Dr. Barnabas’ physician license is still listed as active in Illinois.
Photo: A photo of the human heart with arteries highlighted.
Dr. Sheshiqiri Rao Vavilikolanu confessed that he unnecessarily admitted over 900 patients. He was sentenced to 3 years and 11 months prison time and ordered to repay $6 million to Medicare and Medicaid. Dr. Vavilikolanu’s license is listed as suspended. Dr. Kumar Kaliana admitted to mail and healthcare fraud. He received a 1 year and 4 months sentence and forced to return $156,000, along with $1.1 million in restitution. Dr. Kaliana’s physician license is still listed as active.
The courts came down most heavily upon Dr. Andrew Cubria. In addition to Albert Okaro’s untimely death in 2000, the feds discovered that at least one more unnecessary cardiac operation resulted in the death of another patient in 1999. Dr. Cubria was sentenced to 12 1/2 years prison time for his wrongdoing. He was also ordered to return $2 million of his profits and pay $14.4 million in restitution. His physician license was suspended thereafter.
The man whose superhuman feats caught the eyes of the FBI was also brought to justice. A teary-eyed Dr. Sriram wept as he plead guilty to mail fraud, healthcare and tax fraud. He faces up to 18 years in prison, but he has been appealing that ruling. As part of his plea the doctor has agreed not to practice medicine and his physician license is listed as on probation in Illinois.
Photo: A massive x-ray machine still residing within the hospital.
After a decade of abandonment Edgewater residents are aiming to rid themselves of the abandoned hospital. According to The New York Times the property is in the hands of the Edgewater Medical Center Bankruptcy Estate, which is comprised of 250 creditors who are still owed in excess of $110 million. Of the creditors French bank Dexia is owed in excess of $55 million. Unable to recoup their costs creditors would like to see the hospital razed in favor of a business development. Edgewater community members would rather have the real estate transformed into park land. According to an official city-authorized assessment the hospital is valued at $5.9 million. The cost to demolish the hospital is estimated to be $6.5 million alone.
What will happen to that hollowed-out shell that was once Edgewater Medical Center? With the American economy on track for an extended downturn it is unlikely that private developers will invest in the property. With federal, state and city budgets already slim it is unlikely that a public works project will be in the pipeline anytime soon.
Photo: One of the intensive care units in the abandoned hospital.
A healthy portion of large abandoned buildings that urban explorers seek out are left behind after major changes in economic markets, competition and innovation leave stagnant companies behind. That is not the case with Edgewater Medical Center. What sets this building apart from other urbex locations is that it was created by criminal acts over an extended period of time. Even though the hospital was dated, they were still operating in a capacity that for the most part benefitted patients. By the time the FBI discovered the corruption it had already metastasized and killed Edgewater Medical Center.
Like most hospitals with chronologically staggered additions it is a winding labyrinth. Some of the floors look practically identical and it is easy to lose ones bearings. Yet each section of the hospital is still unique in its own way. Biohazard containers, alcohol swabs, diabetic supplies and other pharmaceutical supplies are littered throughout some of the rooms. Medical records, tissue samples, autopsy records and medical images can still be found in one of the labs. Heavy equipment such as a hyperbaric chamber and x-ray machine are tucked away behind closed doors. Above the Kadin Memorial Nurses’ Residence is an filthy empty pool under a skylight. Vintage furniture from the 1970’s occupies some of the rooms even though eviction notices from 2002 are matted into the floor. The administration building is, perhaps poetically, completely devoid of and vibrant momentos of life. It is quite unsettling to see a once intentionally sterile hospital environment ravaged by the uninhibited destructive elements of nature.
Photo: Vintage furniture still occupies some of the nurses’ apartments.
The story of Edgewater Medical Center foreshadowed many of the problems that plague the American healthcare industry today. Profit-focused healthcare endangered the lives of those who could not or were unable protect themselves. Patients at Edgewater Medical Center were exploited by the greed of administrators and doctors to the tune of millions. The system failed and took vital healthcare services away from one Chicago neighborhood.
The United States is and remains the only industrialized nation to not offer all citizens access to public healthcare options. There are now over 50 million Americans without health insurance of any kind. Even those fortunate enough to be insured are at the mercy of a healthcare system driven entirely by profit motives. Health decisions are prioritized every day to keep businesses in the black, rather than keep patients living long and healthy lives.
Photo: One of the laboratories with numerous patient records and equipment.
Flickr – My photoset of the abandoned hospital.
BNet – Mentions Edgewater Hospital founder Dr. Mazel.
Chicago History in Postcards – Old postcard of Edgewater Medical Center.
Chicago News Cooperative – 2010 article on the abandoned hospital.
Chicago Tribune – 1989 article marking Harriet Mazel-Szanto’s death at Edgewater Medical Center.
Chicago Tribune – 1999 article on Edgewater staff paying out to avoid Medicare fraud litigation.
Chicago Tribune – 1999 article discussing AARP research on for-profit hospitals.
Chicago Tribune – 2000 article on Edgewater Dr. Sriram’s billing of dead patients.
Chicago Tribune – 2001 article about Edgewater closing its doors.
Chicago Tribune – 2001 article on Roger Ehmen’s and Dr. Ravi Barnabas’ sentencing.
Chicago Tribune – 2001 article on sentencing for Dr. Sheshiqiri Rao Vavilikolanu and Dr. Kumar Kaliana.
Chicago Tribune – 2001 article on convictions related to the Edgewater fraud case.
Chicago Tribune – 2002 article on Dr. Cubria’s sentencing.
Chicago Tribune – 2002 article on Dr. Sriram’s sentencing.
Chicago Tribune – 2004 article outlining settlement from Albert Okaro’s death.
Chicago Tribune – 2008 article on the case against former chief executive Peter Rogan.
Chicago Tribune – 2009 article detailing the recovery of Peter Rogan’s assets.
Chicago Tribune – 2010 article on the hospital’s future. Land Value: $5.3m. Demo: $6.5m estimated.
Christopher T. Hurley & Associates Newsletter – Dr. Andrew Cubria specifically selected poor and Spanish speaking patients to commit fraud.
Coalition Against Insurance Fraud – 2002 blog on Dr. Andrew Cubria, who performed 750 unnecessary invasive procedures.
Curbed Chicago – Plans for redevelopment into a park with pictures.
Edgewater Historical Society – Small entry on Edgewater Medical Center.
Facebook – Group for people born at Edgewater Medical Center.
Flickr – Comptesse DeSpair’s great set of Edgewater Medical Center photos.
Flickr – Search for “Edgewater Hospital” ranked by interestingness.
Google – Search for Edgewater Medical Center 1970-2011.
Hospital Data – Statistics for Edgewater Medical Center.
The New York Times – Examines economic difficulties for redevelopment.
NWI – 2008 article on the international battle over recovering Peter Rogan’s assets.
US Bankruptcy Court – 2007 bankruptcy court ruling against Braddock Management and Bainbridge Management.
US Department of Justice – 2003 press release for criminal fraud charges and $2.9 million civil judgement against the management firms that ran Edgewater.
US Department of Justice – 2008 press release detailing charges against owner Peter Rogan.
QuoteUs – Insurance blog article on the most outrageous insurance frauds. Mentions Edgewater doctor Andrew Cubria.
Yahoo – Recent efforts by Edgewater residents to turn the complex into a park.
Wikipedia – US Secretary of State Hillary Rodham Clinton was born at Edgewater Medical Center.
Wikipedia – Convicted serial killer John Wayne Gacy was born at Edgewater Medical Center.
An excerpt from Savage Inequalities by Johnathan Kozol on the medical facilities available to East St. Louis residents in 1990.
East St. Louis-which the local press refers to as “an inner city without an outer city”-has some of the sickest children in America. Of 66 cities in Illinois, East St. Louis ranks first in fetal death, first in premature birth, and third in infant death. Among the negative factors listed by the city’s health director are the sewage running in the streets, air that has been fouled by the local plants, the high lead levels noted in the soil, poverty, lack of education, crime, dilapidated housing, insufficient health care, unemployment. Hospital care is deficient too. There is no place to have a baby in East St. Louis. The maternity ward at the city’s Catholic hospital, a l00-year-old structure, was shut down some years ago. The only other hospital in town was forced by lack of funds to close in 1990. The closest obstetrics service open to the women here is seven miles away. The infant death rate is still rising.
As in New York City’s poorest neighborhoods, dental problems also plague the children here. Although dental problems don’t command the instant fears associated with low birth weight, fetal death or cholera, they do have the consequence of wearing down the stamina of children and defeating their ambitions. Bleeding gums, impacted teeth and rotting teeth are routine matters for the children I have interviewed in the South Bronx. Children get used to feeling constant pain. They go to sleep with it. They go to school with it. Sometimes their teachers are alarmed and try to get them to a clinic. But it’s all so slow and heavily encumbered with red tape and waiting lists and missing, lost or canceled welfare cards, that dental care is often long delayed. Children live for months with pain that grown-ups would find unendurable. The gradual attrition of accepted pain erodes their energy and aspiration. I have seen children in New York with teeth that look like brownish, broken sticks. I have also seen teen-agers who were missing half their teeth. But, to me, most shocking is to see a child with an abscess that has been inflamed for weeks and that he has simply lived with and accepts as part of the routine of life. Many teachers in the urban schools have seen this. It is almost commonplace.
There is some hope for current East St. Louis residents as the area is now served by the Kenneth Hall Regional Hospital. In a city where the median income is ~$26,000/household I doubt most residents have the luxury of having health insurance. A national health care option would have greatly improved the quality of life in the area, but the healthcare reforms passed this year fall short of offering such an option.
In December 2009 my grandmother passed away and the funeral was in St. Louis. I had some time before the service to drive through East St. Louis. Passing by the Gateway Community I noticed how easily it would have been to gain access through the ground level windows. By the time I returned in March 2010 a fence around the perimeter of the hospital had been erected. Plastic now lined the windows on the eastern wing and it appears that asbestos abatement is underway. In the parking lot was a pickup truck with a security guard keeping a close eye on us as we encircled the hospital on foot. It was a bit of a let down, as I had scheduled my day around exploring the hospital. News reports indicate that this former hospital building is indeed coming down. I was glad to get a few shots of it before it is completely gone.