A Hospital is Born

She didn't wait for permission
Presbyterian Hospital on Ridge Avenue, 1900. (Courtesy UPMC Presbyterian)
From the Spring 2003 issue. See all of our past issues here.
Amazing what you can do with $5. Visit UPMC Presbyterian and see the evidence. In 1893, Louise Wotring Lyle came to Pittsburgh as a newly minted MD when female physicians were about as common as female shot-putters. Appalled by the health problems of the city’s burgeoning immigrant population, she decided that a new, charitable hospital was needed, and that she was the one to organize it. 
The fact that she was a widow with only a year’s professional experience, and a mere $5 in her purse, didn’t stop her. She persuaded a North Side landlord to lease her an old three-story house and forego a security deposit, then bought furnishings on an installment plan. She spent one of her precious dollars getting the place cleaned; soon after, she pronounced the six-bed hospital ready for patients. 
She called it the Louise J. Lyle Hospital, but that name was only a placeholder. Lyle had grown up in a strong Presbyterian family, married a minister and from childhood had been filled with missionary zeal. She was flabbergasted that Pittsburgh, then the stronghold of Presbyterianism, did not have a sectarian hospital when Presbyterian hospitals were being founded in Chicago, New York, Philadelphia and elsewhere. She went to the local Presbyterian ministers and asked for support. But, she was to recall decades later, “I was told, ‘No money in sight.’” She asked the presbytery, the local church governing body, for permission to name the place “Presbyterian Hospital.” They waffled. Lyle acted, referring to her hospital as Presbyterian Hospital before they could reach a verdict. 
Within a year, the hospital was in the black. The unstoppable Lyle had successfully proselytized local congregations and persuaded Pittsburgh’s most prominent Presbyterian women to constitute the first Ladies Board of Managers, which would be responsible for the hospital’s daily operations. In 1895, the hospital’s trustees, at Lyle’s strenuous urging, officially adopted the name Presbyterian Hospital. 
Lyle’s hospital moved three times on the North Side (then Allegheny City) before it came to Oakland. The founder herself never saw the 12-story structure that is now the jewel of UPMC. But, at 90 and in a wheelchair, she visited the site and gave it her blessing. According to the Presbyterian Hospital Bulletin, she turned to her companions and smiled, declaring that “her heart was filled to overflowing with gratitude and thanksgiving because of the result of her work in helping to found the hospital so many years ago.” In 1938, six years after her death, Presbyterian began welcoming patients as a University of Pittsburgh teaching hospital.
Left: Louise Wotring Lyle. Graduating class of hospital nurses in 1915. Right: Surgery in Progress, c. 1914. (Photos courtesy UPMC Presbyterian)
Founding what grew into one of the nation’s leading teaching hospitals was only one achievement of this remarkable woman. She was the youngest of 11 children of a prominent Washington County family. Her father, Abraham Wotring, was a judge so bent on education for his children that he set up a neighborhood academy in his home, where Louise was educated before attending the Washington Female Seminary. At 20, she went off with a clergyman brother-in-law to nurse Civil War wounded, roll bandages and make hospital supplies. In her travels, she met a young ministerial student, Joseph Lyle, and after the war she married him.
The Rev. and Mrs. Lyle did missionary work in Indiana and Illinois, then served congregations in Homestead and Wheeling. (Lyle plunged into the role of the minister’s wife with such energy that she rates her own mention in the history of the presbytery.) Then in 1884 Joseph Lyle died—some reports say he never recovered from war wounds. Louise Lyle was widowed at 41. 
Their Wheeling church had been heavily damaged by a devastating flood. After the reverend’s death, Louise stayed on and raised the money to rebuild it. Then she took up temperance work and prison reform. Next she moved to Cincinnati, where she established a free dispensary for women and children and helped found what eventually became the Presbyterian Hospital and Women’s Medical College of Cincinnati. Along the way, she founded a hospital in Newark, Ohio, as well as the Cincinnati Visiting Nurse Association. That was not enough; the restless Lyle decided to become a physician. But after studies in Chicago and Cleveland medical colleges, she was called back to Cincinnati to raise funds for the medical college she’d helped to establish. (Reports conflict about why she left Cleveland; one claims grades were an issue.) While fundraising, she enrolled as a student and earned her MD in April 1892. She returned home to Washington County, passed her state board examinations and hung out her shingle. Within a year she was in Pittsburgh, setting up her shoestring hospital. 
According to the late Ruth Maszkiewicz in her history, The Presbyterian Hospital of Pittsburgh 1893–1927, Lyle’s favorite leisure pastime was hunting. “She was an expert with a rifle,” Maszkiewicz wrote. You might think this sharpshooter would exude a steely determination and toughness. A photo of Lyle shows a woman in a dark, buttoned-to-the-throat Victorian dress. She wears her hair closely cropped, no jewelry and a no-nonsense expression. Still, you can discern a faint smile and twinkle in the eye. Martha Swearingen, who was in Presby’s first nursing class in 1897, saw her as anything but stiff. When she returned for a class reunion decades later, Swearingen described Lyle: “She had a quick tongue, a ready wit and a great many friends.” 
She was also a persuasive talker. Every hospital room required a gas stove, Swearingen remembered, but in the early hand-to-mouth days, money wasn’t always available. “Dr. Lyle would go out and beg, and usually she came back with the stove, many times with the donor having supplied a boy to carry it to the hospital.” She asked for donations of food, too, and used them to build a culinary reputation. She planned all the menus, supervised the cooking and even arranged the patients’ trays. 
She certainly needed all those skills and attributes in the early days. Her first patient—referred by Jane Vincent, Pittsburgh’s first woman physician—signed in at $15 a week, but not many followed. It looked like Lyle’s dream might die in infancy. Then—godsend!—three nurses from another hospital (seeking “more congenial quarters,” Lyle said in 1922) asked to be accepted as temporary lodgers. Their payments kept the hospital afloat until patients came. 
And come they did; 385 were treated in the first year. “From that time,” Lyle said in 1922, “the hospital was full, and many were turned away.” Women came from West Virginia, Virginia, Ohio, Maryland and elsewhere, surviving arduous horse-and-buggy journeys, to be treated for kidney sarcomas, pleurisy, typhoid, abdominal tuberculosis. By 1895, Lyle said in the 1922 interviews, all debts were paid and the hospital had a nest egg in the bank. 
Soon Presbyterian expanded to the building next door, becoming a 24-bed hospital. But the new hospital was less than convenient: There was no connection between the two structures. To transfer patients between the surgical suite and wards, staff had to wheel patients outdoors to get to the adjacent building. (This led to the wisecrack that “patients never knew whether they were coming or going.”) In 1899 the hospital moved again, to the 90-bed former “Doctor Sutton’s Hospital” on Ridge Avenue. Those quarters eventually also proved too small. In 1911, Presbyterian built a new home: a six-story hospital (now part of Mercy Providence Hospital) on Arch Street. 
By then Lyle was back in private practice in Washington County. From the first, she had been the hospital superintendent; after the incorporation, she was also named to the board of managers. Then a bizarre incident in 1899 ended her appointment. 
One night, a critically ill woman was brought to the hospital door. Lyle admitted her. There was no available space in the women’s ward, so she placed the dying woman in the men’s. According to a story Lyle later told the trustees, she went to the home of a comanager, Anna Shields, and asked for consent in this emergency to lodge the woman with the male patients. Shields, however, maintained that Lyle had not asked her consent, but merely informed her that the woman had been put to bed in the men’s ward for the night. The board agreed that since it was a life-or-death situation, Lyle was right to admit her. However, they noted, she should have moved the male patients elsewhere to maintain segregation of the sexes. The board accepted Shields’ explanation, and Lyle offered to resign. Ten of 13 trustees voted to accept the resignation and sent her off with two months of salary and what the board minutes describe as a “kindly” letter in light of the scandal. 
But she did not cut her ties to Presbyterian. As a private practitioner, she continued to send patients there, and, in 1911, at 69, took an active role in planning the new hospital. She helped it through a financial crisis in the early 1920s, when the state cut off funds to religiously affiliated hospitals, and according to a later superintendent, Mary Miller, maintained a continuing interest in the hospital throughout her last days. 
Lyle died October 16, 1932, in Buffalo, Washington County, in the home where she was born. The record says she was “active” (probably meaning that she did not retire) until a few weeks before her death. 
There is no memorial plaque to its founder on the current UPMC Presbyterian, but clearly the indomitable woman with $5 and a vision was the hospital’s cornerstone.
Megan E. Sofilka contributed to this story. 
Left: Rounds in the men’s ward, a private, room, the nursery (all c. 1915). (Photos courtesy UPMC Presbyterian)


Not much was easy about establishing Presbyterian Hospital, but Louise Lyle would have found it even less so without her groundbreaking foremothers. Elizabeth Blackwell was the first woman known to graduate from a medical college. In 1847, the faculty of Geneva Medical College, in Geneva, N.Y., not wanting to deny a qualified candidate, asked the students to decide on Blackwell’s admission—whoops! The students thought it was a joke and unanimously approved it. But Blackwell wasn’t the first woman doc. Five-foot, pale, high cheek-boned James Barry with small hands and feet passed for a man in the British Army until her death in 1865. Though it had been suggested to her, Blackwell passed on the idea of cross-dressing in order to pursue medicine. Barry, however, did so for more than 40 years, treating royalty and performing the first cesarean section in Africa. By the 1880s, when Lyle was widowed, these women had paved the way for about 470 female certified physicians in the United States. —SZ