Jane Dryden Louis retains more memories of the Brackenridge Hospital emergency room than she does of the house in Wilshire Woods where she grew up.

That is because for decades her father, Dr. Bud Dryden, was the one of the public hospital’s most loyal physicians.

"We never went anywhere without stopping at the emergency room at some point," Louis, 65, says. "I grew up on a stool next to the pneumatic tube section in the nurse’s station."

Since 1884, when the taxpayer-funded City-County Hospital opened on the same site, dedicated doctors like Dryden — as well as nurses, aides, volunteers and other workers — have labored day and night caring mostly for patients who couldn’t pay or didn’t have access to health care otherwise.

On May 21, all patients will be moved by ambulance from what many Austinites call Brack — the current, blocky structure was built in phases between 1969 and 1984 — across East 15th Street to the Dell Seton Medical Center at the University of Texas.

The sleek new teaching hospital, which carries on the educational mission started at Brack by Dryden and his colleagues, looks not at all like the older hospital.

But then again, almost everything about public health has changed drastically since the 1880s, when Austinites first debated whether it was a good idea to build a hospital that would help anyone who came through its doors.

And since the early 1900s, when Dr. Robert John Brackenridge campaigned for the City Hospital’s first modern facilities— Travis County had dropped out of the partnership by this time — buildings remembered by locals for their distinctive dark brick.

Or for that matter, since the late 20th century, when for financial reasons the city turned over responsibility for Brack to an outfit run by the Daughters of Charity of St. Vincent de Paul, which evolved into the Seton Healthcare Family.

That nonprofit group, now part of St. Louis-based Ascension Health, will own and operate the new teaching hospital in tandem with the Dell Medical School, located handily across Red River Street.

While almost everyone is impressed by the latest medical enterprise, Louis, who is among the thousands of native Austinites born at Brack, can’t help feeling some nostalgia.

"The name and the identity is really gone," she says. "What was special about Brack was its care for indigents. What Brack meant for so long to the city is gone. It ends May 21."

Predecessor to Brack, the City-County Hospital, built in 1884, stood on the same block as the later public hospital. The land was set aside by the Republic of Texas in 1839. Contributed by Austin History Center C00053

American-Statesman Staff

Becoming Brack

When surveyors working for Edwin Waller, agent of Texas President Mirabeau B. Lamar, laid out a graceful, durable plan for Austin in 1839, they set aside a block in the far northeast corner of the 1-square-mile grid — at North and East Avenues, now East 15th Street and Interstate 35 — for a hospital.

Like other area land reserved by the Republic of Texas for public use, it passed through a number of hands before it ended up as the City-County Hospital in 1884.

But not without a fight. Americans in general did not trust hospitals. They were seen not as places of healing but rather as "pest camps with walls."

Austin did not name its first city physician for public health until the 1870s, after several Southern cities suffered a yellow fever epidemic.

Furthermore, the city and county governments, always strapped for cash, could not decide who should pay for what at the new hospital.

"The city said, ‘We are not paying for uniforms and the like,’" says Carl McQueary, historian and archivist for Ascension Texas. "The county said, ‘We’re not paying for nurses or overtime, etc.’ Good old boys and good old boys firing off barbs. It was tense from the beginning."

At least seven Austin hospitals of various sizes and functions preceded City-County, including the Texas State Lunatic Asylum — built in 1861 and still standing as part of the Austin State Hospital complex on Guadalupe Street — as well as two military wards used during Reconstruction and four physician-run infirmaries located mostly north and west of the Capitol.

"In this climate was born Brackenridge Hospital, the first hospital in Texas dedicated to care of everyone, regardless of credit status or bank account or lack thereof," Lisa Farenthold and Sara Rider wrote in their 1984 book, "Admissions: The Extraordinary History of Brackenridge Hospital." "Its appearance was not hailed with universal joy, for Texas has always been an independent-minded state which regarded Austin as a center of radicalism."

The new limestone Queen Anne-style building at 1405 Sabine St. rose three stories and included gables and two steeples.

"It’s the oldest public hospital in the state and one of the oldest in the country," McQueary says of Brack’s lineage. "That was the subject of a certain amount of civic pride. Houston was trying to do the same thing, and we wanted to be first. Houston, all those years later, was still chafing about not being the capital."

The place instantly started leaking. And nobody could agree who should fix it. That sort of squabbling remained the case until the county withdrew from the project in the early 1900s, after which it was known as the City Hospital.

EXPLORE: A map of 21 Central Austin hospitals, past and present

At the time, 20 or so doctors practiced in Austin, a city of 14,000. By 1892, the resident physician and the head matron of the public hospital were each given $600 a year, making them among the highest-paid city employees.

Yet their efforts were never enough.

"At that point, the medical profession had grown and improved and standardized," McQueary says. "It soon became apparent that the hospital wasn’t meeting our needs. It was where you went if you were shot or you were going to die."

Meanwhile, two private hospitals with charity links joined the scene. In 1895, the handsome, wide-porched Austin Sanitarium opened just north of the Capitol on East 14th Street. It evolved into St. David’s Hospital after a devastating fire and a move to the Judges Hill neighborhood.

In 1902 the Daughters of Charity — even more apropos to the history of Brack, since they would later take over the public hospital — who were based in Maryland, built the imposing Seton Infirmary in what was Tobin Park on West 26th Street, just northwest of the UT campus and close to the streetcar suburb of Hyde Park.

"The mother superior met with local doctors," McQueary says. "They raised $5,300 to pay for it by holding things like bake sales and staging an operetta. Compared to back East, Austin was the wilderness. The Daughters were taking a risk. But they also knew the need was great. They’d seen the City Hospital."

The Brackenridge campus in 2016. JAY JANNER/AMERICAN-STATESMAN

Jay Janner/American-Statesman Staff

The good doctor

Back at the public hospital in the early 1900s: Dr. Brackenridge, brother of UT backer George W. Brackenridge, pushed for an up-to-date replacement for the Victorian-era City Hospital.

Part of a civically engaged family — he and his brothers founded First National Bank of Austin, and James M. Brackenridge served as county judge — the doctor never practiced medicine in Austin. Yet he left a lasting impression on the city, not unlike Dr. Neal Kocurek, who held a similarly revered position as city leader 100 years later.

A supporter of women’s suffrage, education and social welfare, Brackenridge campaigned feverishly for changes in state laws and for a $50,000 city bond election to benefit "the small taxpayer and breadwinner" as well as the indigent. New schools, streets and sewers were approved along with the hospital, influenced in part by the national City Beautiful movement, which sought to make urban areas safe, sanitary and appealing.

In 1915, the first of a series of buildings, all five or more stories and clad in red-brown masonry, rose on the hospital site to replace the original public health pioneer. At first, the medical structures were oriented to East Avenue, but another formal entrance was added on what became East 15th Street. A nursing school was soon included; it closed in 1983.

In 1918, Brackenridge died of a massive heart attack and was buried in Oakwood Cemetery. City leaders later renamed the public hospital after him.

Brackenridge’s pride persevered and grew, taking care of several generations of Austinites until 1984, when the last of the brick buildings was demolished and today’s soon-to-be-closed concrete structure was completed. Many of the old bricks were buried in an East Austin ravine, according to Louis, who proudly preserves one of the survivors.

"My father had them dumped there," Louis says. "He felt like it was his hospital."

The Seton Infirmary, built in 1902 on West 26th Street, was run by the Daughters of Charity of St. Vincent de Paul, which later took over operation of Brack. Contributed by Austin History Center C07895

American-Statesman Staff

From one crisis to the next

As countless television shows attest, hospitals are almost unavoidable settings for human drama. Months after the new public hospital opened in 1915, leaders responded to a smallpox epidemic.

"This is when the Travis County officials asked the Daughters of Charity to help care for these patients at a camp about 7 miles north of the city limits," McQueary says. "This camp was known as the ‘Pest Camp’ and ‘Fort Prairie,’ but the Daughters of Charity called it ‘Saint Joseph’s Camp.’"

In 1918, a deadly strain of flu began infecting hundreds of millions of people worldwide; it eventually killed upward of 50 million. Hundreds of Austinites died.

"The city officials came to me and said, ‘Put your white dress on and take charge,’" Edna Shultz, matron of the City Hospital, told a reporter. "It’s wasn’t long after that that influenza struck, taking more lives than did the war in Europe. I was warned that something awful was happening in Fort Worth and Dallas, that a terrible disease was making people ill. The city officials told me to get everybody out of the hospital who wasn’t seriously ill and prepare for the worst. Then they brought in Army cots and I was ready."

The UT ROTC unit was hit particularly hard, but under Shultz’s care, only one student died. Meanwhile, a similar scene could be witnessed at Seton on West 26th Street.

"The sisters responded immediately, and the Army set up large tents on the grounds of Seton Infirmary and also converted a three-story fraternity house that was across the street from Seton into a temporary shelter for patients," McQueary says. "The Army provided all of the iron cots, straw mattresses and blankets, and the sisters provided bedding, dishes and other items not specified."

The Daughters received a gold medal for their efforts from the government, but little or no money.

In the 1930s, tuberculosis was the local scourge. In 1940, the County Tuberculosis Sanatorium opened on Tannehill Road, probably in the same location as the former smallpox camp. It saw its last patient in 1970, and its low-lying modernist building now serves as a Salvation Army shelter.

Segregation complicated matters. While Brack and Seton served paupers and patients of all races, the Missionary Sisters of the Immaculate Heart, along with Father F.R. Weber of Holy Cross Church, in 1940 opened a charity hospital on Concho Street specifically to serve the African-American community. Eleven years later, Holy Cross Hospital, where many children were born, moved to what would become Martin Luther King Jr. Boulevard.

In 1984, the Daughters of Charity bought Holy Cross Hospital, which closed five years later.

Brack opened the region’s first intensive care unit in 1960. On Aug. 1, 1966, sniper Charles Whitman climbed the UT Tower to spread mayhem.

"Dad spent that whole day operating on people," Jane Louis recalls about her father, Dryden. "It was just unbelievable. People coming in droves. No EMS system. The ambulances were run by funeral homes. Every operating room was going full-blast."

Many of the city’s patients avoided Brack altogether. An Austin Citizen newspaper article dated Oct. 28, 1971, describes the scene: "Some nights down there are busy with bar-room knifings, paycheck fights, ruptured appendices and battered drivers."

Around the same time, Dr. Sam Swearington told a reporter that he was disturbed over a community feeling that treatment at Brack was so subpar that folks didn’t want to use the city-owned facility.

"I don’t know how true this is," Swearington said. "I don’t feel this way about Brack, but this is the feeling of many doctors."

Along with the crises, history also reminds us of the steady goodwill shown by providers at Brack and Seton before they merged activities in 1995.

Sister Philomena Feltz, for instance, started work at Seton Infirmary’s kitchen on Feb. 4, 1932, as Austin was dealing with the Great Depression.

"She knew immediately that many people had no money to buy food for themselves or their families, and that was when she started her famous soup line, which stretched behind the kitchen," McQueary says. "Eight to 30 families were fed soup and bread daily."

In fact, Feltz served Austin’s ill and hungry for 60 years. A street is named for her in the Mueller development near the Dell Children’s Medical Center of Central Texas.

The waiting rooms at Brackenridge Hospital’s clinics were fuller than ever during the Great Depression. Contributed

American-Statesman Staff

Keeping up with the times

Without improvements — large and small — hospitals seem to go out of date pretty quickly. Brack expanded steadily during the 1930s and ’40s. New procedures and technology were introduced each year. Televisions arrived in 1958, computers in the 1970s.

By the 1960s, however, city leaders were talking about a new facility. Once again, politicians clashed about how to pay for it. A 1964 bond election approved $3.5 million for the construction of what became the current Brack. Ground was broken in 1969. It wasn’t completed until 1984, which contributed to its confusing, patched-together layout.

Meanwhile, Brack became a regional pioneer in open-heart surgery, organ transplants and cancer care. It opened the Children’s Hospital next door in 1988; the spot will remain as a training facility while the Brack block is developed as an Innovation Zone. In 2007, children’s care move to the Dell Children’s Medical Center in the Mueller development.

Brack reached another major milestone in 2009 when it became the city’s first Level 1 trauma center.

A seismic shift occurred, however, in 2011 when state Sen. Kirk Watson laid out his "10 Goals in 10 Years" plan to reinvent the region’s community health care. Among the plans were a medical school for UT, a state-of-the-science teaching and safety-net hospital and clinics and education measures to keep people from landing in the emergency room in the first place. The school and teaching hospital were made possible in large part because of grants from the Michael and Susan Dell Foundation, but also because of local fundraising led by lawyer and civic leader Pete Winstead.

RELATED: 5 things to know about Dell Seton Medical Center

A crucial lure: The medical complex centered on the land designated in 1839 for a hospital would also become a place for experimental labs and a biomedical district. In 2012, Travis County voters approved Central Health’s Proposition 1, which directed property taxes to support Watson’s vision.

Overseeing the transition to the new teaching hospital was a fresh force in town, Chicago-born Christann Vasquez, who helped grow hospitals in Houston and San Antonio. She was attracted to Austin’s radical shift in delivering health care.

"We are going to be accountable to the population and build a healthier community," Vasquez said in 2015. "Keeping them healthy, not just helping them when they are sick."

Brackenridge Hospital at 1400 East Ave. photographed by Neal Douglass in 1948. Contributed by Austin History Center ND-48-389-01

American-Statesman Staff

A Brack baby remembers

Jane Dryden Louis’ family never strayed far from the old Brack. Her mother, Evelyn Woodley Dryden, gave birth to her three children there and often spent long hours visiting with nurse friends.

Her elder son, Kenny Dryden, now a commercial developer, and the younger one, Buddy Dryden, a retired homebuilder, worked there summers.

"And both brothers worked on construction on the new hospital," Louis says. "I had a summer job there when it was still in the red-brick building. I served as a nurse’s aide on the pediatric floor."

Her father, Dr. Dryden, was elected Brack’s chief of staff a number of times.

"My dad ruled that ER," Louis says with a gentle smile. "For example, when he came through the 15h Street door, the telephone operator, who worked right by the door, called the nursing stations on every floor to say that Dr. Dryden was on his way. As a kind of a warning."

Dryden kept his Brack office 50 yards from the ER. His patients were primarily African-American and Hispanic.

"He always saw his own patients and anyone who didn’t have a doctor," Louis says. "He had five files, three for nonpaying, two for paying. That’s just who he was. He grew up poor. And there were very few doctors who would treat black people."

Dryden also initiated a medical education program at Brack, which anticipated by decades the paired mission of Dell Medical School and Dell Seton Medical Center.

Her father retired six months before he died in 2002 at age 88.

Louis: "So he never really retired."

While many Austinites will retain memories of Brack after May 21, few will recall it as Louis does.

"My dad always used to stop on the road at car wrecks to help the injured," she remembers. "On at least one occasion, he left us on the side of the road to take the patient to the hospital. Some people would call that traumatic. For us, it was normal."

In the 1970s, Dryden served two terms as an Austin City Council member and successfully advocated for the area’s first EMS system.

Louis: "After that, we didn’t stop anymore."