Often called the Ellis Island of Chicago, the publicly owned Cook County Hospital—constructed between 1912-1914—served as a medical facility where no one would be turned away. Dramatized by the long-running medical drama ER, Cook County’s persistent presence on the horizon (easily seen from the Eisenhower Expressway coming into the city) made the hospital a visual landmark for residents and visitors alike. For over twenty years, a coalition of partners and elected officials worked to protect this significant building from threatened demolition.
While known for its classic Beaux Arts architecture, designed by architect Paul Gerhardt, the structure has a long history related to public health. Not only was Cook County Hospital the location of the first blood bank in 1937, It was also the nation’s first trauma unit in 1966, and one of the first hospitals early on to treat AIDS patients. Lisa DiChiera, director of advocacy for Landmarks Illinois (LI) said, “even before talking about the architecture, which in itself is spellbinding, [Cook County Hospital] houses incredible social history for Chicago, and is a place more than almost anywhere else, where anyone who has family history in Chicago could find a connection.”
In the late 1990s, Cook County announced plans to construct a new, more modern institution, and in 2001 slated Cook County Hospital for demolition. For the next twenty years, Landmarks Illinois advocated for saving the old hospital. In 2020, a 132 million-dollar renovation of the 1914 structure was completed resulting in a mixed-use preservation success story that serves the medical community and its surrounding neighborhood.
I talked to DiChiera about the journey and lessons learned in the fight to protect Cook County Hospital.
Tell us about the advocacy efforts? What tools were effective in changing hearts and minds into supporting the project?
[The] first time Landmarks Illinois produced an actual reuse study for the building was in 2003, when we recruited an architecture firm, Antunovich Associates. We felt this firm had the experience and the wherewithal to put together a thorough preservation document that proved through design and numbers that this building was reusable. It was like we had to put our money where our mouths were—figuratively because we managed to get that work done for us pro bono. But Landmarks Illinois was an early user of this strategy from an advocacy perspective, to basically bring in the right experts to demonstrate to the county they would save money and achieve their planning goals by doing this.
It was like we were doing the county’s job. And as frustrating as that is, that comes with the territory in historic preservation advocacy: especially when it comes to threatened historic buildings that are publicly owned. It is so common to have to do their homework for them and take that on and say, "Look, we'll do it. We'll do the condition assessment. We'll do the study. We'll show you that this could be to your benefit." This is a strategy we have continued to use with Prentice Hospital (which unfortunately we lost), with Lathrop Homes, where we had to demonstrate to the Chicago Housing Authority that this very important early public housing project absolutely should not be cleared and could be reused for today's standards in mixed-income and public housing, and now with the state-owned Thompson Center.
Partners are also an important part of the process. It is so important for historic preservation organizations or advocates engaging in a historic preservation campaign to build a coalition, and to find not only design experts and construction firms who can work with you to prove out the viability of an older building, but you also have to make friends with developers too. Developers are usually who we need to take these buildings on.
Early on, we pushed the county to recognize that in an RFP they could seek a developer to do the renovation and a long-term lease back to accommodate the county’s needs. Or that a long-term lease of the property to a developer would put the building newly on the property tax rolls and bring new income to the county that they never had before. We also educated them about the financial incentives a developer could use, including the federal historic tax credits. It's all part of a playbook that seems obvious to those of us working in preservation, but that county officials, planning officials never, never, never would've thought of in the first place, and never even thought of as a possible scenario, let alone a viable scenario.
Which is essentially the broader point. It's up to us to continue to educate our public officials and to build coalitions of advocates and those with the expertise we need to help our efforts.
How did the listing on the National Trust’s 11 Most Endangered Historic Places listing in 2004 impact the advocacy efforts to protect Cook County Hospital?
By 2003, Landmarks Illinois had already had the building on our statewide most endangered list, and the newly formed Preservation Chicago had put it on their citywide endangered list.
What was helpful with the National Trust 11 Most list in 2004 is that it elevated the building’s importance, from the perspective that was important both locally and nationally. It had an important story to tell, and also as a big, historic hospital, I think for the National Trust it was a building type that commonly is threatened in many places, could demonstrate that former hospitals are important assets in many cities, and are able to be reused.
From a sustainability perspective, throwing buildings like this into a landfill makes no sense. If there is a reuse opportunity, buildings like these have multiple opportunities to be put back into productive use, put back onto tax rolls, for creating jobs, for creating economic development. The National Trust really helped elevate that argument for us in addition to highlighting its architectural pedigree and its importance from a social and historic significance perspective.
What were some of the challenges with this project?
I mentioned education earlier. With a fight of this length of time, there are a lot of advocates who were with this from the very beginning to the very end. There are a lot of people who came in halfway through. And, if you can imagine the challenge: elections happen and you lose certain public officials who you convinced, and then they lose their public office, or change their jobs and now you must re-educate a whole new group of people elected to public office. [Consequently], there is a revolving door of education and persuasion that is constant, constant, constant.
With that in mind, burnout is always a risk on a major campaign. Whether it is county board members saying, "Ugh, we've gone over this over and over and over. Do we need to hear it again?" Or even certain city officials who'll just be like, "Yeah, it's not our problem. It's a county problem." You're always at risk of the mental burnout and certain people saying, "Come on, you've been at it for 15 years. If you can't solve it by now..."
So that's why we really give kudos to Cook County President Toni Preckwinkle. When she was elected to office, she was a former city alderman on the city's South Side, and someone who was generally a good proponent of historic preservation. She came in sort of with a new set of eyes, and while she wanted to make sure her staff and team was doing its due diligence, ultimately the decision was: "This building is too important to just throw away, it’s an asset, and we’re going to find its value."
The team she brought in finally took us seriously from the perspective of: "These people are professionals. They know what they're talking about. We need to listen to them, and we need to get their perspective." And then she brought in a consulting firm, Chicago Consultants Studio, that recommended a design charrette, that engaged a broad swath of people in the process. There had never been public engagement on the part of the county. So reaching out to key civic organizations to look at this from various perspectives. The charrette, consisting of five, invite-only teams included Landmarks Illinois, Metropolitan Planning Council, the Chicago Central Area Committee, and two teams from Lambda Alpha/Ely Chapter. The charrette was called “Unlocking the Value of the Old Cook County Hospital,” and the public was invited to attend all the presentation meetings that were held on the hospital campus.
Landmarks Illinois’ team’s mission was to develop a realistic, financeable project that could generate, again, value for the county, and by looking at multiple scenarios for reuse—office, residential, and mixed use. The third option, mixed-use, is ultimately what happened. Even though Landmarks Illinois had since 2003 done more than one reuse study as part of its advocacy efforts, this charrette was the first time you had true buy-in from the county because they were sponsoring the vision and moving the process forward.
In its original use the hospital served the poor and immigrant communities of Chicago. Why is this project so important, especially as we are in the midst of a pandemic?
While Old Cook County Hospital is no longer a hospital, it will house a museum dedicated to its history of serving thousands of Chicagoans for over 75 years, including during the 1918 pandemic. What's interesting is that because this is a medical district, it's not like you have houses next door to the old hospital. This is a large institutional campus. But again Cook County Hospital was always a place for all citizens and immigrants no matter their race or class and no matter where they lived in the city.
There's no doubt that the way this building has been repurposed will be beneficial to people who live, work and visit the immediate area: that they can walk there and grab a lunch , or a family member of a patient hospitalized nearby can stay at the Hyatt Place & Hyatt House now in the building.
Interestingly, though, rehabbing and reusing the historic hospital is phase one, with larger ongoing investment in the medical district by this development team led by Murphy Development Group, whose future projects will include new facilities in the surrounding area, providing needed resources to all citizens of Chicago and this region. Its economic impact will be greater than its immediate neighborhood.
You’ve been advocating for this project for a long time—how do you feel about finally seeing it reopen?
I am modest from that perspective. This was not me alone. I was just with it for a long time. Not only is it hugely gratifying to see over 20 years of advocacy finally come to success—because you certainly have your low moments along the way where you just feel like you're hitting your head against a brick wall, or a terra cotta wall in this case. I always had to try to kind of keep my motivation level up from the standpoint of saying: "I still know that we're right in this fight. I know that we're still saying and doing the right thing, that we're still fighting for the right thing."
Of course, this cannot be stated more times, partnership is key. It took a coalition. I never would claim Landmarks Illinois was alone in this fight. Preservation Chicago and the National Trust for Historic Preservation worked on this with us, not to mention key Cook County commissioners, who believed in this building from the very beginning. People like, Cook County Commissioner Larry Suffredin, and former Commissioner Mike Quigley, who's now Congressman Quigley.
Congressman Quigley's office helped us with getting the National Register nomination done because they had a staff person who was a history major. Oral historian Studs Terkel participated in one of our coalition press conferences. I also want to acknowledge architect Joe Antunovich, who's firm Antunovich Associates gave us thousands of pro bono hours over 15 years during this fight. He also went with former LI president David Bahlman and former LI Director of Preservation Planning Jim Peters—to meet personally with every Cook County commissioner to explain the reuse study he did on our behalf back in 2003.
The most gratifying thing about this save is sometimes you'll actually hear someone say, "Oh my god, I was born there," or "My mother–her life was saved there," or, "My family came to this country from Eastern Europe and we were so poor, and no one would help us, and we went to Cook County." And so that's satisfying because people have a love for it as a place. We were right about its reuse having economic benefits, and the importance of saving Chicago’s best example of Beaux-Arts architecture, but those stories really tug at your heartstrings. It makes you feel good that you’ve helped save a place that is so important in people’s family history.
Priya Chhaya is the associate director of content for the National Trust for Historic Preservation.