New Siteman Cancer Center, Update on my Cancer

This post is about two indirectly related topics: the new Siteman Cancer Center building under construction on the Washington University School of Medicine/BJC campus and an update on my stage 4 kidney cancer.

Let’s deal with the latter first. You may have noticed I’ve not posted in three months, this is not due to a lack of topics, interest, photographs, etc. In April my routine CT/Bone scans showed that my cancer was progressing — tumors (yes, plural) were growing again. At that time I’d been on my 2nd line of treatment for 21 months, my 1st line of treatment lasted 18 months.

After a 2 week delay to select the next treatment, get insurance approval, and secure more grants for the huge monthly co-payments I began my 3rd line of treatment. Instead of the previous infusion of drug a every 4 weeks plus a daily pill I now take 3 pills daily (2 medications). For 12 weeks since my previous scans I had no idea if these two new medications were working, or not. Twelve weeks is a very long time to wait when you don’t know if medication is working. But I recently got the good news – my recent scans showed my tumors as “stable.” During that 3 month uncertain period I was in a bit of a funk. I’m in a better mindset now, ready to get back at it.

For 45 months now I’ve been a patient at Siteman Cancer Center, 7th floor of the Center for Advanced Medicine on the southwest corner of Forest Park and S. Euclid –one block west of the new building under construction. It’s clearly more crowded than intended — one treatment pod for 6 patients was originally the employee breakroom!

So when WashU/BJC announced in July 2021 plans for a new building it was very exciting. I just wasn’t certain I’d live to see it.

By including parking in the building it’ll make visits easier for patients and their family — the current journey from parking in the Euclid Garage to the Center for Advanced Medicine (CAM) is long. In addition to Siteman on 7 patients routinely visit radiology on 2 & 3. It’ll be nice having everything in a more compact footprint.

The new Siteman building will be connected to the rest of the Washington University Medical School/BJC campus via the interior elevated walkway system — aka The Link. The green arrow in the photo above shows where the walkway will go along the top level of the Euclid Garage, along the north side.

The new building is supposed to open next summer, so I’m fairly optimistic at this point I’ll still be around for lab work, radiology, and doctor visits.

— Steve
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St. Louis urban planning, policy, and politics @ UrbanReviewSTL since October 31, 2004. For additional content please consider following on Facebook, Instagram, Mastodon, Threads, Bluesky, and/or X (Twitter).

Jewish Hospital Merged With Barnes Hospital in 1996, But An Older Jewish Hospital Building Remains Integral To Current Treatment

The Washington University Medical School campus (aka Barnes, BJC) in St. Louis’ Central West End neighborhood has changed considerably in the last 100+ years. It’s also quite a bit different from when I moved to St. Louis in 1990. It will continue to evolve. This post isn’t a detailed look at the huge number of incremental changes, it’s a look at a little bit of history about the Jewish in Barnes-Jewish Hospital.

It’s not clear to me which medical facility first located within the area bounded today by Kingshighway on the west, Forest Park Ave. on the north, Sarah on the east, and I-64 (US-40) on the south. I do know the automobile either hadn’t been invented, or was just a toy for the wealthy.  Hopefully someone will do a book on the history of medical facilities in the region.

St. Louis’ first hospital for Jewish residents perhaps began with a meeting 143 years ago today, on October 27, 1878. This was just after the city/county divorce so the city’s current limits were already set. Forest Park was still wild, much of the city’s new limits were rural.

Leaders of the city’s Jewish community met at Harmonic Hall to form the Jewish Infirmary and Hospital Association of St. Louis. As early as 1853 Isidor Bush, businessman and philanthropist, had joined with other Jewish leaders to establish a Jewish hospital. After several false starts, Bernard Singer president of the United Hebrew Relief Association of St. Louis, subscribed $1,620 toward the establishment of a home for old and infirm Jews. The meeting that he called was well attended and an additional $870 was pledged.

More money was slow in coming , however, and finally the association revised its plans to allow for the building of a home for the aged and infirm, with a hospital as an appendage. In 1882 the United Hebrew Association dedicated the Home for the Aged and Infirm Israelites at 3652 S. Jefferson Avenue. Today Jewish Hospital, as part of the Washington University Medical Center, is one of the city’s finest medical institutions. (Source: St. Louis Day by Day by Frances Hurd Stadler, 1990, pp204-05)

The author doesn’t connect the dots between the 1882 dedication and the 1990 second printing of her book. I suspect the hospital appendage never happened, but one finally opened:

In 1902, The Jewish Hospital of St. Louis opened at 5415 Delmar Boulevard. Prior attempts to create such a hospital had cited the need to care for the poor Jewish refugees of St. Louis; however, when the Jewish Hospital become a reality, it did so under the directive to afford care to the sick and disabled of, “any creed or nationality.” By 1905, additions to the original hospital building were already required to accommodate more patients, marking the first in a long line of expansions the Jewish Hospital would undergo over the years.

By 1915, the hospital was treating close to 2,000 patients annually. The following years made it clear that further expansion was needed, and in 1920 the hospital purchased land on Kingshighway Boulevard for the purpose of erecting a larger hospital building. The Delmar location was sold, and, following years of construction and funding campaigns, the hospital at 216 South Kingshighway Boulevard was dedicated in May 1926. By the end of 1927, the new building’s first full year in operation, the hospital had treated 5,146 patients. In 1951, a plan was finalized which provided for the integration of three St. Louis Jewish health agencies into what would become the Jewish Hospital Medical Center. The Jewish Hospital of St. Louis merged its operations with those of the Jewish Sanatorium, the Miriam Rosa Bry Convalescent-Rehabilitation Hospital of St. Louis, and the Jewish Medical Social Service Bureau. To accommodate the operations and patients of these health agencies, the Jewish Hospital was required to expand at its Kingshighway location. A building expansion program which included the addition of two new buildings and a six-story wing created room for the patients of the three other agencies to be moved to the newly named Jewish Hospital Medical Center in 1956.

Over its years of growth, Jewish Hospital and its staff have achieved several medical firsts, including performing the first successful in vitro fertilization in Missouri in 1985 and creating the first major in-patient child psychiatric service in the St. Louis area in 1958. When Washington University Medical School and Associated Hospitals (WUMSAH) was formed in 1962, Jewish Hospital was one of the original participating institutions, and in 1963 Jewish Hospital became a major teaching affiliate of Washington University Medical School.

In November 1992, Barnes and Jewish Hospitals signed an affiliation agreement, agreeing to pool resources wherever possible. This affiliation agreement was completed in March 1993 to create Barnes-Jewish, Incorporated (BJI). In April of 1993, BJI and Christian Health Services announced that they would affiliate to create BJC Health System, an affiliation which was finalized in June 1993. In January of 1996, a merger of Barnes and Jewish Hospital, built on the sharing of resources which began with the completion of the affiliation agreement in 1993, was legally completed, and the two became the present day Barnes-Jewish Hospital. Barnes-Jewish Hospital is consistently ranked among the best hospitals in America by U.S. News and World Report. (Wash U/Becker Archives Database)

Only one Jewish Hospital building remains: the 1970s (60s?) Schoenberg Pavilion.

Schoenberg Pavilion was a building at Jewish Hospital, before the 1996 merger with Barnes Hospital — creating Barnes-Jewish Hospital. Today it looks very different than it did then. You cannot directly enter the building from the outdoors — only through the Center for Advanced Medicine (CAM) on the east or the newish Parkview Tower, on the west.  The north side faces Forest Park Ave. and the south side is green space over an underground parking garage.

Inside the Schoenberg name is preset at the bank of elevators inside the 70s building.

Inside the entry at the new Parkview Tower is a big sign with mottos from Barnes Hospital and Jewish Hospital.

Jewish Hospital began a dozen years before Barnes Hospital, likely serving Jewish and n0n-Jewish patients. Though probably not black patients for many years.

And finally, in the main floor hallway connection the Center for Advanced Medicine to the Parkview Tower people from the history of Barnes & Jewish are highlighted in a beautiful display.

As I receive treatment at Washington University Medical School/BJC I’m thankful for the generosity of those who helped start and continue such a fine institution.

— Steve Patterson

Mid-Century Modern vs. 21st Century Density

A developer has proposed a new apartment building that was require the demolition of a mid-century modern (MCM) building. I’ve been watching the debate of preservation of MCM verses increased density on Twitter & Facebook. I want to weight in, but first some background.

The non-profit service group Optimist International was founded elsewhere more than a century ago. In 1924 St. Louis was selected as the location for its worldwide headquarters. Decades later their 2-story building at 4494 Lindell (@ Taylor) was designed by local architects Schwartz & Van Hoefen.

Schwartz & Van Hoefen is also known for:

• Marchetti Towers I & II, SLU campus.
• Mansion House, 4th Street downtown.
• Council Plaza, which included a “flying saucer” gas station (later various places like Naugles & Del Taco, now a Starbucks & Chipotle)
• Northland Cinema (demolished)
• Busch Stadium II (local architect, demolished)

There have been numerous proposals for the property, including one for renovated and updated office space. The most recent, announced last week, calls for demolition of the original 2-story building and late 70s 4-story addition. In their place a new 7-story apartment building.

This recent proposal is what got people fiercely debating, falling roughly into 3 camps: we need to preserve our few remaining mid-century modern buildings, more density is good, and preservation focus should be on saving 19th century buildings. This is a generalization of their points so let’s get into some specifics.

Many see an artist’s rendering of a proposed project from a bird’s eye and get all excited. From this vantage point artists can make anything look good — they could make the workhouse look like a lush resort.  Humans, however, don’t experience the built environment from a bird’s viewpoint.

Those on the side of preservation of Optimist International are correct that increasingly we’re seeing MCM buildings being razed, especially in the Central West End. Last century these MCM buildings were seen as important symbols of reinvestment as the wealthy began to flee the city, as Gaslight Square began to fade.

One disputed point is “architectural merit”, I’m not qualified to argue for or against on this particular building. However, from the Mansion House nomination to the National Register of Historic Places I can learn about the firm responsible:

The firm of Schwarz & Van Hoefen was a midcentury incarnation of one of the longest-running continuously operating firms in St. Louis. It began in 1900 as Mauran, Russell & Garden when three architects broke away from the St. Louis office of Shepley, Rutan & Coolidge (which was set up locally as Shepley, Rutan, Coolidge, and Mauran). John Lawrence Mauran brought along two younger colleagues, Ernest Russell and Edward Garden, and the firm almost immediately received several important commissions. Ned Garden left the firm in 1909, to be replaced by William Crowell in 1911. After Mauran’s death in 1933, Russell & Crowell added W.Oscar Mullgardt.

By the mid-20 century, more than half a century into its existence, the partnership remained one of the leading architectural firms in St. Louis. Esley Hamilton wrote that in the 1950s and 60s, the firm “was unusual in maintaining its design flare while working on large commercial projects. The firm completed many architecturally significant works during this period. In addition to the Mansion House, four of their other projects were recommended for National Register listing in the City of St. Louis’ Modern Movements survey of 2013.

This means that 1/5 of the 25 properties on the list were by the various iterations of this single partnership, more than any on other firm on the list.

The four other buildings on the list are as follows. The Wohl Recreation Center (1959) at 1515 N. Kingshighway Boulevard is a glass-skinned neighborhood recreation center commissioned by the City of St. Louis. The Engineers Club of St. Louis (1959) at 4359 Lindell Boulevard is a low-rise addition to the emerging Modernist corridor; its use of traditional masonry and playful forms is very striking. The original two-story section of the Optimist Building (1961, 4490-94 Lindell Boulevard), a block to the west of the Engineers Club, has an exposed concrete frame.[Emphasis added] Finally, the Steinberg Art Gallery Building at Washington University was a collaboration between the partnership and architect Fumihiko Maki, who is credited with the design (1960, 6201-53 Forsyth Blvd.)

In addition to the buildings recommended for listing in the City’s Modernism survey, the partnership of Schwarz & Van Hoefen designed many other important buildings in St. Louis. Among the most visible is Council Plaza, which consists of two towers and two smaller buildings located at 212 – 310 S. Grand Boulevard (NRHP 3/02/2007).

So the architectural firm is an important part of our history. The city’s modern architecture page includes the survey mentioned above, which lists the Optimist International property as significant and worthy of individual listing. The list only contains 25 properties. So one of the two buildings is architecturally significant. Saying otherwise ignores the established record.

I love density, but it’s also correct that the Central West End isn’t where we need to be building more density. That said, I do like that the proposed apartment building includes small studio apartments. If only new CWE residential projects included some affordable and low-income units — they are not the same thing. An alternative is paying into a fund the help building units elsewhere in the city. Elsewhere means cheaper, less desirable neighborhoods…like where I’ve lived for before and for the last 2+ years.

One pro-preservation argument I saw said the Optimist International building was urban, in line with adjacent properties. Well, yes and no. It’s not set back behind a surface parking lot and the entrance clearly fronts onto the primary street.   The Lindell facade respects the established building line, the Taylor side is a set further back than the slightly older Grant Medical Clinic at 114 N. Taylor, designed by Harris Armstrong. In addition to being set back further than other buildings a low stone wall & raised lawn separates the building from the Taylor facade.  As a result of the design, the Taylor side has zero activity/openings/entrances. This is not urban form.

The proposed 7-story apartment building would be built out to the building line, not set back. It would have have a few retail storefront spaces right off the Taylor sidewalk. Balconies would also face Taylor, the common pool area also faces Taylor. I believe Taylor Ave would be more active and interesting with the proposed building, compared with the existing.

I do think we need to save our architectural history from all centuries. Both 19th & 20th century buildings are threatened, often for different reasons. While I love clean 20th century modernism it often is a negative to the urban experience. Claiming MCM buildings are urban is just as disingenuous as those who say the Optimist International building has no architectural merit.

In the event the current proposal falls through, I could see a reuse project where the 1979 4-story addition is replaced by a taller tower with west-facing balconies. A few storefronts or entrances are carefully cut into the Taylor facade. with a section of lawn & wall removed to create an entrance to each. Cafe tables with umbrellas would look great. Maybe the main building has storefronts, residential lobby on the ground floor and structured parking on the upper floor? New residential units would all be in the new tower to the east. The roof of the old building could be a green roof with outdoor seating, activities.

— Steve Patterson

The St. Louis Region Needs a Moratorium Stopping Construction of New Gas Stations

Earlier this month a city in Northern California has done what other municipalities should do: ban the construction of new gas stations.

The city of Petaluma has become the first in the nation to ban the construction of new gas stations in the city, as part of its aggressive goal to reach carbon neutrality by 2030.

On Monday night, the city council unanimously approved the measure with a second reading of the ordinance, effectively adopting the ban immediately.

The ordinance was widely embraced, as the city council said it faced no opposition.

In a city of some 60,000 residents, covering 14.5 square miles, Petaluma currently has 16 gas stations with another previously approved filling station on the way.  (Source)

It’s foolish to keep devoting more and more land & money into a business model that’s in decline. As vehicles have gotten more efficient gasoline sales have been in decline, as electric vehicles begin to  flood the market gasoline sales will continue falling off. One estimate is 60%-80% of existing gas stations could close by 2035.

Petaluma California is similar in land area & population to the St. Louis suburb of Florissant. By my count Florissant also has 17 gas stations.

Our region has food deserts, but not gas station deserts. Gas stations, mostly large convenience stores that also sell fuel, are everywhere. Former gas stations, vacant & repurposed, are also everywhere.

These will not be repurposed later into EV charging stations as EVs are recharged overnight, at home. Yes, eventually EV batteries will be able to be charged significantly faster, but by then cars will either be owned by ride share companies or it can go off on it’s own and park on a charging pad while you work.

Gas stations are a blight, a big hole in the urban fabric. They’re anti-pedestrian. These should no longer be built in the city, county, or region. A big part of why Petaluma banned new gas stations is a grassroots organization called Coalition Opposing New Gas Stations — we need a similar effort here.

— Steve Patterson

Auto-Centric Pandemic, Vaccine Site Adjacent To Light Rail Station Didn’t Mention Using Transit

The previous 12 months have highlighted how auto-centric the United States is. So far during this pandemic we’ve seen drive through food banks, and COVID-19 testing. Each with cars backed up for miles. To keep the cars on the road there were also lines at licensing offices.

From May 28, 2020:

On Friday, May 29 CVS Health will open 22 new COVID-19 drive-thru test sites across Missouri, including locations in St. Louis.

CVS Health expects to have up to 1,000 locations across the country offering this service by the end of May.

The testing will be by appointment only. You won’t go into the store, but sit in your car and administer the test. (Fox2)

From June 11, 2020:

Many St. Louis-area residents endured long lines and waiting times at licensing offices Thursday, which recently re-opened due to COVID-19 worries.

Thursday, a News 4 crew found some people who waited several hours at two licensing offices in west St. Louis County, where only a few people are allowed inside at one time to due to COVID-19 restrictions. (KMOV)

From November 25, 2020:

From California to New York, pictures have emerged of thousands of people waiting to receive groceries from their local food banks ahead of the Thanksgiving holiday.

It’s one side effect that has cropped up as a result of the coronavirus pandemic that continues to sweep the nation. Experts say the problem is rooted in high unemployment and low cash flow. (CNBC)

So it was no surprise when it came time for vaccinations that many sites weren’t accessible by foot or public transit. As with food & testing, people in their cars were backed up for miles to get a shot.

Last Thursday:

Traffic was backed up for more than a mile in both directions entering the county’s drive-thru mass vaccination site. The event, put on by the St. Charles County Health Department with support from the Missouri National Guard, was expected to vaccinate 4,000 people by the time it wrapped up Thursday evening. (KMOV)

Monday I got my first shot. I’d been on a waiting list at BJC only, as I knew I’d be able to take transit. Many people signed up for multiple lists with the expectation they’ll drive wherever they need to.

I was given a choice of vaccination sites, but I picked the 4353 Clayton location because I knew it was adjacent to the Cortex MetroLink station. The instructions from BJC, however, didn’t mention transit at all.

• Due to social distancing restrictions, do not arrive before your scheduled time.
  • If you arrive earlier, please remain in your vehicle until it’s time to enter the building.
• Please park in the lot at the front of the building, labeled “30 minute visitor,” or the lot west of the building, labeled “2 hour visitor.”
  • Free valet parking is also available at the front of the building.
  • Click here for a parking map.

Despite my criticism of their lack of mentioning transit, the entire process was very well orchestrated. Outside they had signs & people to direct drivers. At the building they had people stationed at every step to keep the flow going. I was in and out in under a half hour!

– Steve Patterson