Á horni Þingholtsstrætis og Spítalastígs stendur hús sem á sér viðburðaríka sögu. Það var byggt árið 1884 sem fyrsta sjúkrahús Reykvíkinga. Síðar var það gert að farsóttaspítala og geðsjúkrahúsi og seinast að gistiskýli fyrir heimilislausa.
Farsótt. Hundrað ár í Þingholtsstræti 25 er saga um heilbrigði og sjúkdóma, sem sumir þóttu ógnvænlegri eða skammarlegri en aðrir. Þetta er saga af lækningum og tilraunum til að vernda samfélagið gegn smiti og sóttum. Þetta er saga borgar og saga velferðarkerfis en ekki síst saga af fólki: Sjúklingum og hjúkrunarkonum, læknum og ljósmæðrum, hómópötum, þurfamönnum, vinnukonum, verkamönnum, útigangsmönnum, sjómönnum, lögreglumönnum, miðlum og skáldum. Aðalpersóna bókarinnar er þó gamla timburhúsið sem enn gengur undir sínu dulúðuga nafni: Farsótt.
Kristín Svava Tómasdóttir er sagnfræðingur og ljóðskáld. Hún er höfundur bókarinnar Stund klámsins, sem hlaut Viðurkenningu Hagþenkis árið 2018, og einn af höfundum Konur sem kjósa, sem hlaut Fjöruverðlaunin í flokki fræðirita árið 2020. Kristín Svava hefur sent frá sér fjórar ljóðabækur, síðast Hetjusögur sem hlaut Fjöruverðlaunin í flokki fagurbókmennta árið 2020.
Inngangur: Ung kona er lögð inn á Farsóttahús
I. HLUTI 1884–1903 Sjúkrahús Reykjavíkur
Einkennilegasti spítali í heimi
Húsráð og hómópatar
Dauðinn slekkur ljósin, lífið tendrar þau
Mjög lítilfjörlegt hús úr timbri
Spítalaráðskonan og samstarfsfólk hennar
Kennslustundir í Þingholtsstræti
Ástir og örlög
Blóð og slæm lykt
Í sjúkraskránum
Einstaklega greindur drengur
Sullaveikiskólinn
Sjúkrahús Reykjavíkur lagt niður
II. HLUTI 1903–1920 Gamli spítalinn
Sóttvarnir við upphaf nýrrar aldar
Aldrei að víkja
Sóttkveikjur og eldkveikjur
Heimilisfólk í gamla spítalanum
Hvíti dauðinn
Þarna voru lík krufin, þarna voru soðin mannabein
Örbirgð nær út fyrir dauðann
Spænska veikin
III. HLUTI 1920–1968 Farsóttahús Reykjavíkur
Farsóttahús, berklaspítali og geðsjúkrahús
Stórdrottningin og smákóngurinn María Maack
Olnbogabörn bæjarfélagsins
Smitberar
Á ferð um Farsóttahúsið
Kvennaríkið
Einangruð börn
Hver mannsævi er alger í sjálfri sér
Guð elskar þá sem hjálpa sér sjálfir
Sjúkrahúsmál um miðja öldina
Sjokklækningar í Þingholtsstræti
IV. HLUTI 1969–1984 Gistiskýli Reykjavíkur
Gamalt hús verður gistiskýli
Áfengisvandamálið og gistihús hins opinbera
Heimsókn í gistiskýlið
Lífsins lausamenn
Með amfetamínpillur eins og piparmyntur í dósum
Þín lágu hús, þitt gull og brennivín
Sjúkdómur eða sjálfskaparvíti
Líkþrá nútímans
Ástand viðunandi, listgildi hlutlaust
Lokaorð: Farsótt í hundrað ár
Þakkir
Summary: The Reykjavík Quarantine Hospital
Myndir
Heimildir
Nöfn og efnisorð
The Reykjavík Quarantine Hospital
100 Years at Þingholtsstræti 25
On the corner of Þingholtsstræti and Spítalastígur in downtown Reykjavík stands an old, two-story timber house. Þingholtsstræti 25 has been put to various uses in its nearly 140-year lifespan: it’s been a hospital, a school, a boarding house, and a shelter. This book explores the history of Þingholtsstræti 25 from the year it was first built, 1884, until its centenary in 1984, and is structured around each distinct phase of the building’s life.
Part One covers the years 1884 to 1903, during which time the nation’s first hospital, Sjúkrahús Reykjavíkur (Reykjavík Hospital), was housed there. The hospital was independently founded by The Reykjavík Hospital Association and was also where Icelandic medical and midwifery students were educated.
Reykjavík Hospital has gone down in history with a spotty reputation. It was never heavily patronized—in fact, it was sometimes said that the poor couldn’t afford to be admitted there and the monied didn’t care to be, as they could convalesce at home under better conditions. Case in point: at the time Reykjavík Hospital was operational, the town had neither sewage nor running water systems and all of the hospital’s waste was collected in a foul-smelling compost heap on the premises. Even so, this was a time of significant progress in the field of healthcare. Clinical microbiology had taken hold among a new generation of Icelandic physicians who were educated abroad during the 1890s, resulting in surgical procedures that were increasingly safe and successful. Widespread echinococcosis in the country provided this new generation of Icelandic physicians with ample opportunity to gain surgical experience.
In 1902, Reykjavík’s medical landscape was altered considerably by the opening of two new hospitals, both of which were established by private entities: Landakotsspítali, which was founded by Catholic nuns from France, and Franski spítalinn (the French Hospital) on Lindargata, which was also founded by the French, on account of the thousands of Frenchmen fishing in Icelandic waters at the time. In the end, it was decided that the Reykjavík Hospital would close. Its last patients were
discharged in 1903.
Part Two of the book covers the years 1903 to 1920. During this period, Þingholtsstræti 25 was used as both a school and a boarding house. The Reykjavík Hospital Association rented the house to municipal authorities to continue using as classroom space for medical and midwifery students. Boarders, including many of the aforementioned students, also lived there. When the Reykjavík Hospital Association was dismantled in 1910, ownership of the house was turned over to the town of Reykjavík. Midwifery students were taught there until 1920, while in 1911, academic instruction for medical students was moved to the
newly founded University of Iceland. However, the former hospital’s morgue continued to be used for autopsies—both postmortems and dissections conducted as part of anatomy students’ education. Medical program instructors frequently had trouble sourcing corpses, and it was often paupers on public assistance who ended up on the autopsy table. Their bodies were “traded in against their debt,” as one doctor put it.
The early 20th century was a time of increasing activity in the field of public health, not least in the prevention of disease and infection. Infectious diseases such as echinococcosis, leprosy, and tuberculosis (TB) were systematically targeted for eradication and new laws were enacted to prevent epidemics on par with measles and scarlet fever. Previously, public health efforts had focused on preventing such epidemics from being brought into the country via arriving ships, but during the first two decades of the 20th century, extensive protections were enacted domestically. These included patient isolation and even the quarantining of whole regions when circumstances demanded. More extensive infection prevention measures called for more hospital space, as it wasn’t possible to isolate all infectious patients at home. Shortly after the Spanish flu ran rampant across Iceland in 1918, with widespread infection and fatalities, municipal authorities in Reykjavík decided to transform the old hospital on Þingholtsstræti into an isolation facility for patients with infectious diseases. And so in 1920, Farsóttahús Reykjavíkur (the Reykjavík Quarantine Hospital) opened its doors.
Part Three of the book covers the years in which the Reykjavík Quarantine Hospital was operational: 1920 – 1968. The most common epidemics of the interwar period were scarlet fever, diphtheria, and typhoid fever. Over time, however, the danger posed by these diseases diminished. There were several reasons for this, including improved hygiene, systematic vaccination, and the antibiotics that were introduced just before the mid-20th century. Although the Reykjavík Quarantine Hospital was established as a short-term isolation facility, due to the ongoing space shortage in hospitals, a mixture of patients—many of
whom had TB—were admitted there almost immediately. During the interwar period, Þingholtsstræti 25 was, for all intents and purposes, simultaneously a short-term isolation facility and a sanatorium, much to doctors’ dismay.
Around the middle of the 20th century, two additional infectious diseases— polio and the mysterious Akureyrarveiki, or ‘Akureyri Disease’— impacted the operations of the Quarantine Hospital. When Akureyri Disease first manifested during the fall of 1948, doctors thought it was polio, but it was later revealed to be another disease entirely. Its name, morbus Akureyriensis, is derived from the fact that the vast majority of those infected in the first epidemic lived in Akureyri. During the winter of 1949–1950, an extension was built onto the southern side of the Reykjavík Quarantine Hospital. A small bathing pool was installed on the upper floor of this annex for patients with polio and Akureyri disease, whose treatment regimens included baths and exercise in warm water. Organized polio vaccination began in 1956 and Akureyri Disease seems to have been eliminated along the way because it hasn’t cropped up since. It’s thought to have been caused by a virus related to the polio.
When the need for hospital space for TB and other infectious disease patients began to decline in the mid-20th century, a few independent psychiatrists were given permission to treat their patients at the Quarantine Hospital. These psychiatrists belonged to a group of Icelandic doctors who wanted to use new psychiatric treatment methods, not least electroshock therapy. However, the supervising physician at Kleppur, the state-run psychiatric hospital, was opposed to such treatments
and would not employ them there. Around the mid-1960s, the Heilsuverndarstöð Reykjavíkur (Reykjavík Health Clinic) opened on Barónstígur and took over the supervision of infectious disease patients in the capital. The Reykjavík Quarantine Hospital was then completely converted into a psychiatric hospital and operated as such until 1968,
when the facility closed.
Part Four begins in 1969, by which point, there was considerable discussion about the plight of unhoused people struggling with alcohol dependency in the capital. Under pressure from NGOs that took an interest in the concerns of this demographic, the Reykjavík social welfare committee agreed to establish a shelter for unhoused problem drinkers on the first floor of Þingholtsstræti 25. The shelter opened in the fall of 1969 and could accommodate sixteen individuals. It was open overnight; patrons would arrive in the evening and leave again in the morning after being served breakfast. Most of them only stayed in the shelter for a few nights, but a small, core group slept there much more frequently and a very few of these individuals actually registered the shelter as their legal domicile. Most shelter patrons were middle-aged men, some of whom had been problem drinkers since they were teenagers. Others had abandoned wives and children. Now and then, they would go to rehab facilities or the hospital, where they could get hot meals and a physical and mental reprieve from their alcohol abuse and
constant exposure to the elements—in some cases, they could even earn a little money. On occasion, they found work and housing after leaving these facilities, but in the end, they often started drinking again and their money didn’t last long.
Opinion was divided about the shelter and the best way to provide assistance to those who struggled with alcohol dependency. The prevailing idea at the time was that problem drinkers’ tendency to overconsume alcohol stemmed, first and foremost, from sloth and a lack of self-control, but the arrival of Alcoholics Anonymous (AA) in Iceland and the influence of American rehabilitation ideology helped the concept of alcoholism as a chronic disease gain broader traction. The shelter was not a rehab facility, but rather a place for individuals struggling with alcohol dependence to have their basic needs for food and shelter met. It operated at Þingholtsstræti 25 until 2014. The book, however, ends its study in 1984, the house’s 100th anniversary.
For most of its existence, Þingholtsstræti 25 housed public institutions and as such, its history is also a social history in the broadest sense. The history of Reykjavík and the history of the Icelandic welfare state, in both legislation and implementation, provide a backdrop to its story—and not only as concerns the public sector, but also as relates to the numerous NGOs that were involved in shaping the conversation around health and welfare issues. Þingholtsstræti 25 has been used in different capacities over the years, but certain thematic constants are threaded throughout this book. This is a book about health and illness, about the ways in which a person’s position in society impacts their overall health and vice versa, about public perceptions of certain diseases as somehow more shameful or dangerous than others. Diseases do not, after all, manifest solely as physical and mental symptoms that individuals experience and doctors diagnose and treat. They have social
and cultural significance that in turn, influences the way that society and even the patients themselves view their disease. And so, this narrative also interweaves a number of larger questions about personal and societal responsibility, about seeking help and being forced to seek help.
This approach is in line with an international evolution in the way we write about medical history, namely, to foreground the complex social and cultural context of health and disease. Scholars have responded to calls to document “medical history from below,” to spotlight not only the work of doctors and the triumphs of Western health science, but also the diverse experiences and voices of patients. We must keep in mind the ways in which gender, class, and other factors impact a person’s ability to cope with unexpected illness. These considerations are underpinned by questions of who is considered a fully-fledged member of society, with all the concrete rights and intangible opportunities that affords, and who, for any number of reasons, is kept on the margins of society—or even outside it all together.
