For many Black people born and raised in St. Louis, Missouri, Homer G. Philips Hospital is not quite a myth, but the institution is certainly a legend. The hospital symbolically represents something that once was but no longer is. You may hear about the hospital talking to your parents, (great) grandparents, (great) aunts and uncles, cousins, and friends, who once roved the halls of the 753-bed, five-building campus off Whittier Street as they searched for health care; but you cannot always get a complete story. In Climbing the Ladder, Chasing the Dream, freelance journalist Candace O’Connor excavates the story of Homer G. Phillips Hospital (HGPH) and offers the first full monograph about the institution’s history—finally offering answers to the city’s legend.
Through archival work, interviews with nurses, student alumni, doctors, and politicians, as well as historical and current newspaper articles, O’Connor tells the story of the “World’s Finest Negro Hospital,” according to the St. Louis Star Tribune. (71) Woven through thirteen core chapters and an introduction, O’Connor utilizes historical narrative and investigative journalism to share the highs and lows of creating and operating one of the largest and most acclaimed Black hospitals and clinical training centers from 1937 to 1979. Her narrative begins in Smithson, Missouri, not too far from Sedalia, before the hospital was even constructed. There, O’Connor begins with the story of the hospital’s namesake, Homer G. Phillips (born Wesley Phillips), chronicling his early years of delinquency and later years of activism through the law practice that he eventually relocated to St. Louis. Phillips had a fervent desire to see another segregated hospital created for Black St. Louis and he passionately supported the hospital’s creation until his untimely and still unsolved murder. (Chapter 1) Yet a chain of events including the continued decline of the Black City Hospital #2 and the continued activism of local citizens through their aldermen led to the city’s commitment to building the hospital towards the end of the Great Depression. (Chapter 2)
O’Connor outlines the source of pride the hospital was for the Ville—the neighborhood where it was located—and highlights its role in the advancement of medical training for Black doctors and nurses who traveled to North St. Louis during the Great Migration. (Chapters 3-5) Chapter 6, “A First-Class Place,” is a fascinatingly rich chapter that chronicles HGPH’s relationships with Washington University and St. Louis University and the conditional partnerships that arose with the White-only institutions through the 1950s. O’Connor is careful not to overstate the salience of the hospital for Black medical care without highlighting the profound systemic issues that burdened care in “Cheating the Grim Reaper” (Chapter 7) and “Killer Phillips” (Chapter 8). “Three quarters of the African-American babies in St. Louis were born at Homer G. Phillips,” writes O’Connor (174), yet the Civil Rights Movement brought about new challenges for the staff at the hospital to continue to provide “first rate” care to adults and children. (Chapter 9 and 10) A blend of social and political factors including the civil rights movement’s fight for more integrated spaces (like hospitals and schools) and shifts to Medicare and Medicaid funding suddenly diversified Black people’s options of where to seek medical care. Historians of medical and nursing education will find in Chapter 11, “Future Nurses Club,” an illustrious account of how nurses, especially Black nurses, are the backbone of our medical system. Yet, despite the best intentions for training and care, HGPH, precariously positioned in a racially polarized city, was forced to close in 1979, although the emergency room and clinic remained open until 1985 (Chapter 12 and 13). The rich account ends on a semi-optimistic note, heralding the opening of the Homer G. Phillips Senior Living Center in 2002. But while the physical building remains intact, is the spirit and purpose of Homer G. to ameliorate the perpetual disparities in Black health outcomes still present through the building’s repurposing? Which leads me to ponder, who is the intended audience for Climbing the Ladder, Chasing the Dream?
Phillips had a fervent desire to see another segregated hospital created for Black St. Louis and he passionately supported the hospital’s creation until his untimely and still unsolved murder.
As a journalistic exercise, the text shares salient and compelling stories of the tremendous labor that Black medical doctors and nurses accomplished for sick St. Louisans (Black and some White after desegregation) despite systemic discrimination, political upheaval, restricted budgets, and inadequate facilities compared to all-White hospitals. In many ways, the author’s writing honors and exalts the exceptionalism of the nurses that made their way to St. Louis during the Great Migration. She simultaneously deifies the doctors, mainly men, who graduated from Howard University’s School of Medicine and Meharry Medical College, arrived in St. Louis, and finally were given a place to practice their skills and professionalize themselves as doctors. These feats were nothing but heroic and are important to the narrative O’Connor wrote. Yet, the stories shared throughout the book focus less on first-person accounts from those who received care from HGPH and instead center on the challenges of Black medical professionals. By focusing principally on doctors and their accomplished nurses (often the Black elite of St. Louis), O’Connor negatively juxtaposes the people they served as “derelicts” and “indigents” (as described by O’Connor) of the Ville and not Black St. Louisans struggling under similar if not worse experiences due to systemic racism and poverty. These descriptions underscore a “them versus us” narrative between hospital staff and Black patients, rather than Black HGPH’s affiliates versus the White antagonists who perpetually undermined the hospital’s long-term success.
An emphasis on how the roots of White supremacy and anti-Blackness shaped the hospital’s inception and closing are paramount, not subordinate to the Homer G. Phillips Hospital story. Yet, O’Connor uses the word racism a mere four times throughout her nearly 300-page narrative—once minimizing the trauma of the hospital’s closing for Black St. Louisans by describing the event as simply “tinged by racism.”As a native and anthropologist of St. Louis, I believe that to reckon genuinely with the realities of a place that Harvard historian Walter Johnson calls “the broken heart of America,” journalists, scholars, and citizens alike must begin to see the triumphs and failures of Homer G. Phillips for what they truly are: Black Americans’ continued fight for equal treatment in a country and city where actors of White supremacy dictated not only the extent of their human rights but of their actual lives. Climbing the Ladder, Chasing the Dream should concern readers who will find within its pages no condemnation of the living political actors (Mayors Jim Conway and Vincent C. Schoemehl Jr.) who each ran for office “promising to save the hospital.” Both of whose decisions, whether politically, financially, or racially driven, or some combination of these motives, continue to have negative reverberations and impact the lives of Black residents in the Ville and Greater St. Louis to this very day.
As a native and anthropologist of St. Louis, I believe that to reckon genuinely with the realities of a place that Harvard historian Walter Johnson calls “the broken heart of America,” journalists, scholars, and citizens alike must begin to see the triumphs and failures of Homer G. Phillips for what they truly are: Black Americans’ continued fight for equal treatment in a country and city where actors of White supremacy dictated not only the extent of their human rights but of their actual lives.
At best, O’Connor’s book is a thoughtful journalistic endeavor chronicling the experiences of Homer G. Phillips’s doctors, trainees, and students. Climbing the Ladder, Chasing the Dream persuasively shows that without Homer G. Phillips the lawyer, there would likely have been no hospital, and without Homer G. Phillips the hospital, we would not have a significant majority of the Black medical doctors and nurses we have today. As the first full monograph on the history of the hospital, it should be commended. The story reminds readers of the rich and important history of Black activism that has shaped Black St. Louis’s fight for equal and just treatment in health care. Yet, more contextualization of the capacious realities of anti-Black racism, a deeper consideration of state and federal policies, a foray into newspapers and archives outside of St. Louis and Missouri, and conversations with other Black medical historians such as Carnegie Mellon Professor Ezelle Sanford, could have made the book something more than a journalistic paean to the doctors and nurses that roamed HGPH. Candace O’Connor’s work should be used as a springboard for journalists and scholars who wish to extend her contributions about HGPH and reveal how racial and economic inequities in St. Louis, Missouri, actually shaped the health of an entire nation.