You read Climbing the Ladder, Chasing the Dream and wonder, dazed, why no one put all this rich material together before. At once intimate and sweeping, the book is the first full history of St. Louis’s most extraordinary, embattled, and glorious hospital.
Homer G. Phillips commands quite a few superlatives: it trained more Black nurses and doctors than any other hospital in the world; it was recognized as one of the finest institutions of its kind in the world; and it was one of the most important Black institutions in twentieth-century America. The book grounds those superlatives and brings them home—because Homer G. Phillips was easily the most important Black institution in St. Louis. It gave excellent, dedicated care to people who, until then, had been relegated to a hospital basement or a back room. And along the way, it changed the social fabric.
The nurses of Homer G., now retired but still loyal, went looking for someone who could tell the story. Not to romanticize the glory days—because that would mean forgetting the cruel reasons the hospital had to exist in the first place—but to record them, so the world could know what happened there.
The Missouri History Museum recommended Candace O’Connor. She had written many other local histories and several hospital histories, and she was known for taking care with the past and for being honest about the problems of racial discrimination. She took on the project eagerly.
I ask her if anyone minded that she is White and hear a relieved exhale.
“I’ve been expecting that question, and no one has asked it yet,” she says. “It’s a reasonable question.” What eased her mind about writing the book was the fact that “the nurses came to me. I wasn’t intruding; they were requesting.” Now, when O’Connor speaks about her research, she brings Black nurses and doctors with her, because they were the ones who educated her.
It took a while for trust to build. She understood and waited it out, interviewing everyone she could find, going to the nurses’ meetings and driving with retired nurse Georgia Anderson through the Ville. “It just hurts my heart,” Anderson murmured as they drove through the neighborhood, once so tidy and self-sufficient, that surrounded the hospital.
The nurses all knew about the project—it was their idea. When O’Connor contacted Black doctors who had studied or worked at Homer G., they said wow, good, finally!—yes, and let me tell you about it. They spoke for hours. So did the White doctors who had done rotations there. One remembered showing up to shadow an OB doctor one evening. The doctor was in a car crash and never made it in. “You’re in charge,” the nurse announced. “And you’re going to be delivering a baby.’” His pallor increased: “I—haven’t had the course yet!” To which she replied, “Young doctor, you are having the course right now,” and talked him through it.
It took only a few interviews to show O’Connor that this would not be a typical hospital history. This place was more than a hospital. “It was an engine for social change”—starting with Homer G. Phillips himself. One of ten kids, he lost his mother when he was a boy and learned to push on alone. As a young lawyer, he represented victims of the 1917 East St. Louis race riots pro bono. Strong-minded, enthusiastic, and outspoken, he fought hard for a new hospital that would give adequate care to St. Louis’s fast-growing Black population. Then, after Mayor Henry Kiel agreed to designate $1 million of an $87 million bond issue, the project was stalled by his successor, a mayor St. Louisans are inclined to forget.
Victor Miller was caught up in a scandal, rumored to be involved with the Klan, and eventually forced to step away from his mayoral duties for a “rest.” By then, he had already managed to delay Homer G. Phillips for a decade, hating the idea of spending that $1 million on a Black hospital and of locating it in the Ville, a Black neighborhood where doctors and lawyers lived alongside factory workers and housekeepers, and kids could see all sorts of ways to grow up and live a good life.
Because of Miller’s obstruction, Phillips never saw the hospital built. He was accosted and shot in 1931, eight years before his dream opened. His murder remains unsolved, a fact that haunted many of the people O’Connor interviewed. Gathering documents and media coverage from the time (out-state Missouri papers disclosed far more freely than the St. Louis outlets), she pieced together a theory. When she asked an older woman what had been rumored in the Black community at the time, the answer echoed O’Connor’s guess. Police reports and the timeline lent support, too, but she still wishes she could have seen the court file. “Oh, that’s been missing for decades,” she was told.
Climbing the Ladder shows the injustices of segregation, the extraordinary accomplishments made in spite of its constraints, and what was lost, the sharpest irony of all, when segregation ceased. Once those with money could move anywhere in St. Louis, the Ville emptied out. Now smart Black doctors could train anywhere they liked, so Homer G. Phillips had to scramble for staff. So much energy and care had gone into making the best of a raw deal, and much had been made, but when more was possible, those solutions slipped away.
St. Louis was busy trying, and often failing, to prise itself away from segregation, corruption, and hate. The fate of the Ville, a neighborhood made green and tidy by the wealth of people who were barred from many other neighborhoods, was low priority. The future of a hospital founded for Blacks before they could go anywhere they chose? Soon, that hospital would have no future at all.
Yet for more than three decades, Homer G. Phillips had been a victory.
Dr. James Whittico told O’Connor about the first time he saw the hospital: “I was coming down Easton Avenue, and I turned onto Whittier”—and there it was. Stepping inside the marble entryway, he blurted, “Oh, my God.” Then repeated it.
The beauty of that building mattered. Black St. Louisans were thrilled to receive care in a place they trusted, a place that for once was not a ramshackle or second-rate facility. All that most of them let themselves feel at the time was gratitude, maybe even a little borrowed pride. Outrage over the larger context—the craziness that there would even be a need to designate a special hospital—would come much later. For now, the excellence of this one was a sign, hard-won, of respect.
Nurses sent postcards of Homer G. Phillips Hospital back to friends and family in the South. “Young people would see this gorgeous hospital and decide that was their ticket out,” O’Connor says, having talked to several women whose lives played out just that way. “They would not have to be a White lady’s servant or get trapped into marrying a farmer.” Instead, they could scrape together $300, show up, and work as hard as they had to, failure not an option. “When they finish three years later, they walk across that stage, and they are members of the middle class,” O’Connor says, slipping into present tense because she can see it. “The trajectory of their lives changed completely.”
Many of the graduates stayed on, happy to work in a hospital so amazing that one St. Louis woman brought her granddaughter every week to sit in the emergency room and watch. A man named Barnard swallowed razor blades wrapped in bread in order to be admitted, because he knew he would be taken care of there.
This confidence was new to Black St. Louisans. Before Homer G. Phillips existed, they often had to climb on a bus, feverish or in pain, and ride halfway across town, not knowing what attitude a White doctor might take toward them. Many had recovered from surgery in Ward 0400, a segregated surgical ward for Blacks in the basement of Barnes Hospital. “Lights hanging down and no windows,” a woman who worked there as a private-duty nurse told O’Connor, her voice grim.
There were many stories, illustrative and horrible. A light-skinned Black man, badly injured in an auto accident, was taken to Homer G. Phillips. They took one look and decided he was White, so they shipped him to City Hospital, where someone decided he was Black and sent him back to Homer G. Phillips. He died en route.
By the 1950s, both hospitals were integrated, which was how a white guy with a “Kill All Negroes” tattoo wound up getting his life saved by the doctors and nurses at Homer G. Phillips. “You want to change that?” a Black doctor asked wryly, nodding toward the tattoo. The man said, “I’m sorry! I’m sorry!”—and conceded that he had received excellent care.
The racial divide was crossed daily at Homer G. Phillips, expertise traveling in both directions. Tight bonds were forged, some of them unexpected, like the deep friendship between H. Phillip Venable—who was Black, chaired the ophthalmology department, and enjoyed earning his reputation as a firecracker—and Bernard Becker, the mild-mannered, softspoken White doctor who held the same position at Washington University.
All of this—the backdrop of hatred and tension, the millions of instances of cooperation, the intense care, the larger inequity—felt relevant. As she began to pull a narrative from reams of notes, O’Connor felt only two urgent mandates. First, the nurses wanted their story told. “These were women who, in another day and time, might have been doctors,” and they had kept the place going. Second, several people wanted acknowledgment that the closing of Homer G. Phillips could have been, at least in part, racially motivated. “They felt that in 1979, you could have chosen to close City Hospital No. 1 and kept Homer G. Phillips,” O’Connor explains. “They had just put millions of dollars into the ER, and it seemed stupid to waste those improvements.” Instead, the hospital was abruptly and forcibly closed—with police, dogs, and helicopters.
O’Connor talked to James Conway, who had been mayor at the time. “He said the other hospital was somewhat better equipped,” she says, “and he said, which was sort of funny, that it was more centrally located. I mentioned that to a Black person, and he said, ‘Well, if you lived where we lived, it wasn’t centrally located at all!’”
It is easy to posit racism on the part of the city’s power brokers, but you also have to factor in the decline of the city (which was linked to racism, via White flight and an eroding tax base) and the emerging financial and staffing problems, now that an increase in opportunities had drained Homer G. Phillips’ talent pool. “A lot of things piled up,” O’Connor says. What is clearest is how painful the hospital’s closing was, and how symbolic it felt.
A small, soft bit of solace came in 2004, with the $32 million restoration of Homer G. Phillips as a senior living and health center. Closed for almost a quarter-century, the building shone again. The nurses hung a big, gleaming plaque in the front hall, listing the names of all the nursing graduates, and rooms were named for Homer G. Phillips doctors. “So the identity was not lost,” O’Connor says.
Now, the role this extraordinary hospital played in St. Louis history will be preserved as well.
Read more by Jeannette Cooperman here.