CMMC Emergency Department History

Need for emergency services sparked movement to create Central Maine General Hospital

Growing industrial city had no "accident room" for injured workers

"Strangers from distant places are always visiting our streets and are liable to accident, sudden illness and death. It is a reproach to our humanity that for the accommodation of such cases the Police Station, vacant apartments, and stables have to be used." - Objective number four in a published plea for subscriptions to support a hospital, 1888.

In 1865, Lewiston Mayor William P. Frye secured a building he hoped would be used as an "accident room" where doctors could tend the growing numbers of mishaps occurring in area mills. Mayor Frye hoped that physicians using the building would buy it and establish a private hospital.

This structure, which might be regarded as Lewiston's first hospital, eventually was moved to a place "near the river road a mile or two out of the city" where it was "converted into a pesthouse" - a refuge for the poor who suffered with contagious diseases, especially smallpox. But the need for a treatment facility to care for the acutely ill and seriously injured continued to grow.

In the late 1800's the populations of Lewiston and Auburn soared as immigrants flocked to the area seeking work in the industries that had grown up along the banks on the Androscoggin River. By 1880, Lewiston was a thriving industrial city of more than 19,000 people.

"A bad condition of affairs"

According to the Lewiston Journal, the relocation of the Maine State Fair to Lewiston in 1881 thrust before the public the realization that "a bad condition of affairs existed" in that there was no place in Lewiston or Auburn that "sudden emergency cases could be properly treated." The Journal reported at least two unfortunate incidents that occurred in relation to the fair: a woman "was delivered of a child in a horse stall on the fair grounds"; and a man "suddenly died on a table in the Lewiston Common Council room," though he "might have been saved had there been a suitable place to take him."

The need for a hospital, for an accident room, was again being discussed and Dr. Edward H. Hill, who had long advocated the establishment of a hospital, took up the cause. He wrote countless letters to legislators, businessmen and fellow physicians, stressing that as the mills and factories expanded and the area's population grew, so did the need for a hospital and emergency care services.

Central Maine General Hospital is formed

Eventually, Dr. Hill's efforts paid off. A hospital committee, headed by J.L.H. Cobb, a prominent businessman who had risen from millhand to management at Lewiston's Bates Mill, was formed in the mid-1880s. With the legal help of Judge Albert R. Savage of Auburn (who would be appointed chief justice of the state Supreme Court in 1913), a set of bylaws and a constitution were written. Nelson Dingley - a congressman, former governor, and owner and publisher of the Lewiston Journal - offered his advice at these meetings as well. Also contributing to the effort was William P. Frye, who had tried to establish a hospital some 23 years earlier. The day after Christmas in 1888, Central Maine General Hospital was incorporated.

The hospital directors developed a list of reasons why the public should support the establishment of Central Maine General Hospital. Included on this list were the following:

• ". . . a large proportion of our population have no suitable conveniences for cases of sudden and dangerous illness. . . . It's the opinion of our physicians that many deaths are constantly occurring in our midst from this very lack of suitable accommodations."

• "In towns devoted to manufacturing and mechanical pursuits, a much larger proportion of accidents are to be expected than in some other communities."

• "Strangers from distant places are always visiting our streets and are liable to accident, sudden illness and death. It is a reproach to our humanity that for the accommodation of such cases the Police Station, vacant apartments, and stables have to be used.

When efforts to secure a location for the new hospital bogged down, Dr. Hill realized that public sentiment supporting the project could wane. He purchased a two-story wooden structure located at the corner of Hammond and Main streets in Lewiston from local ice dealer Oliver Newman for $6,000. He then approached his fellow physicians, asking them to cosign a promissory note and purchase the property from him for the purpose of creating a hospital. They obliged and Central Maine General Hospital opened on July 1, 1891.

CMMC created Maine's first modern emergency department

Advent of the automobile presaged development of emergency medicine specialty

An advertisement appearing in the Maine Medical Journal in 1917 promised an issue devoted to the purchase and care of motor vehicles, because "every physician owns one or more automobiles." As the article suggested, the motor vehicle was becoming the standard mode of transportation in Maine.

In a letter to a colleague, Central Maine General Hospital administrator Rachel Metcalfe remarked that the hitching post in front of the hospital was being used less and less as travelers made the switch from horse and buggy to the automobile. At the same time she watched as more and more emergency surgery was performed due to automobile accidents. This upward trend in "accidents from careless driving" combined with an increase in industrial accidents at area mills, kept physicians and nurses at Central Maine General Hospital increasingly busy.

1931: West Wing houses specially-designed emergency room

When the hospital's new West Wing opened in July 1931, it was hailed as the "most modern" of its type in all of New England. In the midst of the Great Depression, the four-story brick addition - which still comprises the portion of Central Maine Medical Center occupying the corner of Main and Hammond streets - marked the community's resolve to have a first-rate hospital facility. Highlighting the new building was a street-level Emergency Room.

The original West Wing floor plan shows a ground floor emergency room that could be accessed through a separate Hammond Street entrance. This entrance featured a drive up ramp where ambulances could unload patients. Emergency care was provided at this location until the late 1960s.

The importance of the telephone as a tool for summoning emergency medical assistance was recognized by CMGH in the mid-1930s when an "all-night telephone service" was established.

1950s and 60s: Emergency room visits rise dramatically

In the mid-1950s Central Maine General Hospital released the results of study showing that emergency room visits were up by 268 percent, and most of this increase was attributed to automobile accidents. Since emergency care often calls for diagnostic services, other hospital department's had shown corresponding growth in the volume of services they provided. The Radiology Department's service volume had increased by more than 100 percent and the number of blood transfusions had grown by 162 percent.

By the early 1960s utilization of the CMGH emergency room had doubled again. Physician coverage of the emergency room was provided by medical residents and medical staff members on a voluntary on-call basis, but the limitations of this system were becoming increasingly evident.

When the four-story Memorial Wing opened in February 1968, the emergency room was relocated to the first-floor of the new addition. The new ER was accessed from Main Street through specially-designed ambulance bays. It would still be two years, however, until a full-time emergency physician would staff the CMMC emergency room.

1970: First 24-hour, physician staffed emergency department

Though emergency medical services are available at most hospitals today, the development of emergency medicine as a specialty is a relatively recent phenomenon. In the summer of 1970, CMMC was the first hospital in Maine to create a full-time, around-the-clock emergency service.

Providing the medical leadership for CMMC's new Emergency Department was William Spear, M.D., a general practitioner who became associated with Central Maine General Hospital as an intern in 1941. A Boston native, Dr. Spear graduated from Lewiston's Bates College and earned his medical degree from the Boston University School of Medicine.

Dr. Spear played a central role in the development of emergency medical services throughout Maine. He was elected the first president of the Maine Chapter of the American College of Emergency Physicians, and served as chairman of the Governor's Advisory Board for Licensure of Ambulance Services, Vehicles and Personnel. He retired in 1976 and passed away in 1979.

From the 1980s forward: A regional referral center

By the 1980s, CMMC had become the resource hospital for emergency medical services in the Androscoggin, Oxford and Franklin counties region. In 1988 CMMC broke ground for the Norman E. Ross Centennial Wing and when the building opened in 1990 the Emergency Department began operations from its current location on the ground floor.

In 1994 CMMC welcomed trauma surgeon Larry O. Hopperstead, M.D., back to the Medical Center as director of the hospital's new Trauma Program. Dr. Hopperstead practiced emergency medicine in the Lewiston-Auburn area from 1978 to 1982, serving as medical director of the CMMC Emergency Department. He was instrumental in the formation of Tri-County Emergency Medical Services (TCEMS) and served as the organization's medical director.

In 1997 the Emergency Department opened the FirstCare Center in direct response to patient requests for faster care for minor injuries and less-serious illnesses. Access to the center is gained through the Emergency Department where a single point of entry for orderly patient processing supports both the CMMC Emergency Department and the FirstCare Center.

CMMC joined forces with Eastern Maine Healthcare in Bangor in 1998 to create LifeFlight of Maine, a medical helicopter service. From bases in Lewiston and Bangor, LifeFlight provides air medical services to the entire state, including the islands off Maine's coast. Since beginning operations, LifeFlight has been credited with saving the lives of many individuals due to its ability to react quickly to medical emergencies in far-flung regions of the state.

Who led CMMC's effort to create a full-time emergency department?

Providing the medical leadership for Central Maine General Hospital's Emergency Department after it was relocated into new space in 1968 was William Spear, M.D., a general practitioner who became associated with Central Maine General Hospital as an intern in 1941. A Boston native, Dr. Spear graduated from Lewiston's Bates College and earned his medical degree from the Boston University School of Medicine.

Dr. Spear played a central role in the development of emergency medical services throughout Maine. He was elected the first president of the Maine Chapter of the American College of Emergency Physicians, and served as chairman of the Governor's Advisory Board for Licensure of Ambulance Services, Vehicles and Personnel. He retired in 1976 and passed away in 1979.