Discussion 4

Week 4 – Expansion Across North America & Canada

As week dive into Week 4 of our studies, you’ll start to see how the message of health and healing becomes more and more a part of a wider expansion into health, from a variety of sources. As the Adventist church expands, the message of health is a natural point of contact beyond just holding tent meetings and evangelistic crusades. The over-arching goal was to obviously provide healthcare with a goal of providing healing in service of the gospel mission, but it also enabled communities of Adventists to work and learn and grow within stable environments that proceeded to provide education and employment beyond that of pastors or evangelists. For this week’s readings, you’ll have a chance to continue the story of Adventist health care through the Chapters in Robinson, who is clearly an advocate of the divine calling of the health message but also allows for a sense of growth and human evolution in the process. For a wider background on the specific institutions that are growing up through there, the second set of readings will let you explore three specific sanitariums that rose up across North America as a result of successful endeavors in Battle Creek by the Whites and Kellogg. And finally, your last reading will contain the founding document/statement of one of the sanitariums, which allows you to get a sense of how they themselves saw the mission of the health within the local context. Hopefully, this will allow you to sense not just the historical growth, but also the level of intentionality applied to this institution building that grew out of the White’s prophetic visions in the earlier part of the 19th century.

Be sure to form your answers around the questions beneath each reading!

Readings in Robinson – The Story of Our Health Message – Ch. 20-21 – Robinson – Ch 20-21.pdf

Download Robinson – Ch 20-21.pdf

1. In Chapter 20, Robinson details the founding of the “School of Hygiene” in 1878. Unlike modern nursing programs that often prioritize acute care in hospital settings, this early curriculum emphasized that “sickness is everywhere” and trained students to “educate the people” on preventing disease through hygiene and temperance. Based on the reading, how did this “sanitary” approach redefine the scope of nursing practice in the late 19th century? Do you believe the current nursing curriculum effectively balances this historical emphasis on prevention with the modern demand for cure?

2. The readings suggest a strategic tension between providing medical relief and advancing religious goals. The text states, “In no other way can we gain the confidence and gratitude of an individual so readily as by affording him relief in his distress”. Discuss the ethical and professional implications of using healthcare as a method to “remove prejudice” against a specific religious group. How did the early Adventist leadership reconcile the need for genuine, altruistic care with the explicit goal of “waking up minds” to the “third angel’s message”?

3. In Chapter 20, Dr. Kellogg argues that while established medical colleges in large cities were excellent for studying anatomy and clinical material, they suffered from a “universal lack of attention to hygiene”. Consequently, the Sanitarium established the “School of Hygiene” not to replace medical school, but to provide the preventative foundation that regular medicine ignored. As nursing students today, do you observe a similar gap in modern healthcare education? Does the current curriculum sufficiently bridge the gap between treating acute illness (anatomy/pathology) and preventing disease (hygiene/lifestyle), or is this historical critique still valid?

4. In Chapter 21, Ellen White provides a graphic description of the professional toll taken on physicians, describing them as often deprived of sleep, subject to “unmerited reproaches,” and “left to stand alone” against temptation and criticism. She argues that because of these pressures, the physician needs “divine wisdom” even more than the minister. Discuss the issue of provider burnout presented in this text. How do the “arduous duties” described in the 1880s mirror the challenges of nurse burnout and fatigue in the modern healthcare system, and what support systems (spiritual or otherwise) are necessary to sustain a career in caregiving?

Readings on ESDA – Sanitariums across North America –

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1. The readings detail the founding of the Oakwood Sanitarium, with Ellen White arguing that “the colored race should have the benefits of such an institution as verily as should the white people” and that the facility should not be “shoddy” or “contracted”. However, the article notes that the institution eventually closed in 1922 due to “many handicaps,” including a lack of funds and sufficiently trained personnel. Compare the challenges faced by Oakwood with the resources available to the Nebraska Sanitarium, which benefited from a large bequest and proximity to a major college. How does this historical example of resource disparity in segregated healthcare inform current discussions regarding funding and staffing in underserved communities?

2. Compare the founding economic models of the Iowa and Nebraska Sanitariums. The Iowa Sanitarium was established through grassroots efforts where members donated “cash and canned fruit” to fund the work, whereas the Nebraska Sanitarium benefited from a symbiotic relationship with Union College (sharing dormitories and labor) and a massive bequest from the K.G. Smith estate. Based on the eventual fate of these institutionswith Nebraska being reabsorbed by the college for housing and Iowa struggling to modernize before its destructiondiscuss the pros and cons of “grassroots” independence versus “institutional” integration.

3. The history of the Iowa Sanitarium ends tragically with a 1943 fire that destroyed the facility and resulted in the death of a baby. The article notes that the institution was underinsured (insured for $50,000 against $100,000 in damages) and, crucially, had “failed to modernize and become a hospital” prior to the disaster. Analyze the importance of institutional adaptability and risk management. How did the refusal or inability to transition from a “sanitarium” (focused on water cures and rest) to a modern “hospital” contribute to the obsolescence and ultimate closure of facilities like Iowa and Alberta?

4. The articles highlight a critical turning point in Adventist healthcare expansion: the transition from “sanitarium” to “hospital.” The text explicitly notes that the Iowa Sanitariums decline was partly due to the fact that it “failed to modernize and become a hospital,” clinging instead to the older model of “rational treatments” (hydrotherapy, diet, and rest). Evaluate the tension between maintaining a specific therapeutic method (the “Sanitarium” distinctives) and the pressure to expand into a modern acute-care facility. For a nursing administrator, at what point does adherence to a specific “method” of care become a liability? Could the Oakwood or Iowa institutions have survived if they had abandoned the “homelike,” educational sanitarium model earlier in favor of standard medical hospitalization?

Photo slideshow from the early Sanitarium Days –

1. Based on this short slideshow, and the things you’ve been reading so far, give a short impression of the why the growth of healthcare in this Seventh-day Adventist Church has survived so long, despite the shifting emphases over the decades? Why has it maintained it’s ability to balance both the spiritual as well as physical health of its patients over time? Does it still emphasize the spiritual aspects as much, or has that changed in the modern institutions in some significant ways?