It's 1862 and New Westminster is booming with all the trappings of modern life - the population has surpassed 1,000, there's a Masonic Lodge, three churches and a newspaper (the only one in the province, in fact) publishing twice a week.
There are several hundred buildings, but the roads, by and large, are dirt or mud; beyond the edges of the budding city, the forests and streams are as wild and untamed as they have ever been.
The Royal Engineers arrived three years past, making camp above the town. There's a temperance society - always valuable in the newly settled west - and a city directory from 1863 lists a butcher, baker, hair dresser, tailor, harbour master, judge and government offices of all kinds.
This same directory makes note, briefly, of a turning point in the city's history that year: "There is also a hospital, supported by voluntary contributions."
There's no additional description or commentary; indeed, the listing of the specific denominations of the three churches garners more flowery words than the hospital does.
And yet, this seed - this small building, slimly staffed and running on "voluntary contributions" - would grow to something that could not have been imagined in the 1800s.
MODERN MEDICINE
Today's Royal Columbian Hospital towers above the Sapperton area of New Westminster, the din of traffic around it occasionally interrupted by the siren of an arriving ambulance or the roar of a passing SkyTrain.
Between Sherbrooke and Keary streets, the hospital is actually a collection of buildings, with administration in one, maintenance in another, and the health centre, patient tower and ER in adjacent structures.
Like any modern hospital, it faces its share of challenges: funding, overcrowding, the growing demands of an aging population. But despite that, medical miracles happen here each and every day.
The facility is a level 1 trauma centre for the entire province and a referral centre for the Fraser Health Region.
It has one of the province's best and busiest neonatal intensive care units, where babies born so premature they are on the cusp of viability have survived, and a maternity ward where the most high-risk mothers have been saved.
About a third of all angioplasties and more than 20 per cent of the heart surgeries performed in B.C. are done here, and some 10,000 trauma patients arrive here annually - some of them via the hospital's helipad, where victims of car accidents, shootings, and worse arrive clinging to life.
A SIMPLE START
For the then-princely sum of $3,396, Royal Columbian Hospital opened its doors 150 years ago at Agnes and Clement with 30 beds, open only to men and cared for by male nurses and male doctors.
(It's not that women wouldn't have received care if they needed it, says Dale Miller, a local historian who, with partner Archie Miller writes a regular history column for this paper and provided historical information about RCH to The Record earlier this year. Women would have been cared for at home, she said, due to issues of modesty and decorum, with the doctor visiting from the hospital - standard procedure in health care in the mid-1800s.)
That first year, the hospital cared for 19 patients - seven from the local city, one from the New Westminster jail, six from Yale, two from the Cariboo, two from Victoria and one from Pitt River.
From the day it opened in 1862 until 1870, a total of 355 patients received care at Royal Columbian, according to early hospital records.
Medical notes taken from that period give a glimpse into the dangers of life in the settling West: typhoid fever, syphilis, pneumonia, measles, albumenuria, and injuries to knees, legs, arms and hands.
Three patient profiles from the 1870s are typical:
A patient identified only as Bradbury was admitted Nov. 1 with paralysis on the left side. Treatment included extra milk or beef tea once a day, a strychnine-laced ointment on his arm and leg, and later, port wine four times a day. He was discharged on April 4 and, the file notes, he was "relieved" to be recovered.
Yale resident John Vesey was admitted in early July 1876 at the age 21 from an injury rarely seen these days: cannon shot to both hands had left his "fourth and fifth phalanges left hand shattered; hands much torn; fifth phalanx (right) hand broken."
Carbolic acid ointment, extra milk, beef tea, linseed meal poultices and a tincture with camphor were part of his treatment plan. An eye injury presumably occurred at the same time as notes indicate he received an eye wash of "zinc sulph.vin opii, aquae," applied with a feather, to his eyeball the day after he arrived.
The outcome was not so good for Peter Guichon, a 32-year-old admitted on Aug.
16, 1878 with a temperature of 101 and a diagnosis of meningitis.
Despite a cold vinegar and water bath applied to his head "constantly," an ammonia prescription in milk, brandy with water every two hours and, presumably, constant monitoring, his temperature rose to 104 and, by 4: 30 p.m. the following day he had passed away.
Poultices, ointments and hot beef tea may not sound like much compared to the medical technology available today, but for early pioneers in the area the expertise at the new Royal Columbian Hospital saved many lives that might otherwise have been lost.
CUTTING EDGE
In the last year, The Record has profiled a number of cases at RCH that highlight the unique medical expertise of the facility and its staff.
In December came the story of Natasha Pinch and little baby Rebecca.
At just 28 weeks pregnant, Natasha collapsed on the floor of her Powell River home; her husband, concerned that he couldn't get a hold of her by phone, rushed home and found her unconscious.
Within hours, mom and baby were at RCH, flown down by helicopter when it became clear the situation was more dire than could be handled locally - they both survived and Rebecca spent the next three months in RCH's neonatal intensive care unit.
When visited by The Record, baby Rebecca weighed just three pounds at four weeks of age, a full pound up from her birth weight of only two pounds.
Then in early 2012, The Record shared the story of B.C. Lions player Stanley Franks, who blew out a knee while on the field. Rushed to RCH by ambulance, he was told there was a good chance he'd wake up after surgery without a leg.
But the first surgery was a success, saving the limb, and four weeks later, Dr. Darius Viskontas performed an intricate procedure to repair the knee itself.
It's unlikely that Natasha, Rebecca or Stanley would have survived comparable complications or injuries had they happened 150 years ago.
Medicine - and the hospital itself - has come a long way.
THROUGH THE YEARS
In 1889, the hospital was relocated to the site that it still sits on today. In 1901, the nursing school was established and, a year later, the auxiliary (which continues to this day). In 1912, Victoria - by then the capital of B.C. - gave $130,000 towards construction of a new building, which was added to $13,000 from the City of New Westminster.
Challenges in the coming decades included the Spanish Flu epidemic in 1918, the Great Depression in the 30s and, later, the need for a venereal disease clinic as a result of the spread of certain illnesses. A new wing in the 1950s added much-needed space; the health-care centre was opened in the 1970s and a new emergency room in the late '80s.
And change continues: in June of this year, Health Minister Mike de Jong announced the government was committing to a redevelopment of the RCH campus to keep pace with growing regional needs.
From 30 beds in 1862 to an overhauled facility in the coming years, from patients with cannonball wounds to those injured in a car accident, it's all but impossible to recognize today's RCH as the same one that opened its doors 150 years ago.
Indeed, the only thing unchanged here - aside from the Fraser River that continues to flow by - is its very purpose: simply, to help those who need it most.
This Sunday, the hospital is officially marking its 150th anniversary. For more, see the hospital foundation's website at http: //rchfoundation.com.
