Three decades ago, Howard County's first hospital opened its doors with a staff that was young and idealistic and a dress code that was relaxed.
"Nurses here wore clogs, never wore nursing caps. Half of them weren't even wearing bras," said Gretchen Craig, 59, who helped start what was known then as the Columbia Medical Center. "It was crazy times."
The hospital evolved as the county flourished. Now the fourth-largest employer in the county, Howard County General Hospital serves more than 100,000 patients each year on its Columbia campus.
Despite yesterday's rain, Howard County General celebrated its 30th anniversary with a community health fair under a large tent featuring blood pressure and other health screenings, as well as birthday cake cut by Gov. Robert L. Ehrlich Jr.
Participants scooped up pocket-sized first aid kits and lanyards from health care services and enjoyed clowns and other entertainment. Sue Ellen Weisberg, a Columbia resident, had her blood pressure checked. Weisberg recalls going door-to-door in her Longfellow neighborhood to raise money to construct the original hospital building.
"There was a big drive to build a community hospital, and that's what it is," she said. "The hospital continues to be a very vital part of our community."
As the hospital celebrates its past, its officials consider its future - the challenge of meeting the demands of a rapidly aging county.
It all began with the needs of James Rouse's planned community of Columbia. He expected his villages to dramatically increase the population of rural Howard County to more than 100,000 by the 1980s. All of those people would need medical services nearby.
At Rouse's prompting, Johns Hopkins Hospital and the Connecticut General Life Insurance Co. teamed up in 1968 to create Columbia Medical Plan, one of the first health maintenance organizations. The plan, now Patuxent Medical Group, provided care to members who paid a monthly subscription.
The plan founded the 59-bed Columbia Medical Center in 1973, incorporated as the Columbia Hospital and Clinics Foundation, on the second floor of the plan's eight-sided building.
That facility had a small nursery, emergency and operating rooms, but no dietary department. Nurses - called "health associates" - microwaved airline-style meals for patients.
"I always remember them saying you have to be flexible," said 62-year-old Connie Scanlon, one of the first health associates.
Now Scanlon trains new nurses hired by the hospital. She sometimes sees one of her first patients walking around Columbia - a young man who had come in with a broken leg.
"The doctors were all very young, all well-trained," said Dr. Phillip Webster, a pediatrician who started at the new hospital when it opened when he was 27. "We all felt like pioneers."
Within a year of opening, the board of trustees changed the name to Howard County General Hospital, and it became independent of Johns Hopkins. Patients with all types of insurance could be admitted.
Howard County General has always been the only hospital in the county. Before it opened, people would drive up to 15 miles from Columbia to hospitals in Montgomery or Baltimore counties. Lutheran and Bon Secours hospitals wanted to build their own 200-bed facilities in the 1970s, but could not get state approval.
It took a little time for the hospital to overcome skepticism about Columbia from county residents who had lived there for generations, however.
Scanlon now leads orientation sessions for new nurses. She recalled how the wife of a comatose patient in the three-bed critical care unit took his nurses aside for special instructions.
"I remember her saying to us, `Whatever you do, don't tell him where he is, [because] he said he'd never come to this hospital,'" Scanlon said.
"A lot of people felt that way in the county. We had to build up our reputation," she said.
That changed as the hospital became more established. Later, county residents purchased bonds to build additions throughout the years - some constructed only to later be razed to make way for newer buildings.
Last year, an expanded emergency room opened, three times the size of the previous facility. And the hospital ranks fifth in the state in deliveries at its new labor and delivery unit, complementing the upgraded neonatal intensive care unit.
Financial constraints affected growth decisions, a pattern that will continue, said Victor A. Broccolino, hospital president and CEO since 1990.
Mounting debt prompted Howard County General to seek a partner in the late 1990s. Johns Hopkins Medicine took on $57 million owed by the hospital when it finalized its agreement in 1998.
The merger worried residents, who feared that an outside group would reduce access to care. But the opposite has occurred, said Webster, the pediatrician. Now more specialists have offices in the county, which is convenient for his patients.
