18,000 deceased patients
sleep in unmarked graves
because Koch Hospital’s
cemetery records were
destroyed in a fire.

The last exit leaving
St. Louis on the J. B. Bridge—
Koch Road. But what
remains in my mother’s
mind, is the people.

(An interview with Barb Troup)

In 1854, Koch Hospital served
as a quarantine hospital
overlooking the Mississippi.

During the 1980s,
like many cities, St. Louis
closed, merged, and privatized
public health care,
23 facilities disappeared.
Lives were displaced
until there was
to go.
people were

92 acres of sloping grassy fields,
terra cotta roof, copper trim, red brick.

The National Registration of Historical Places Inventory Nomination Form—Koch Hospital demonstrated the struggles of St. Louis to provide free medical care for non-affluent citizens. In the 1950s, Koch Hospital addressed a housing shortage for indigent, homeless, mental health patients, and elderly patients.

Questions for Barbara Troup. Director of Nurses at Koch Hospital

How long did you work at Koch?
–From 1951 to 1986, thirty-five years.
My Uncle Buck died from tuberculous there,
but I wasn’t afraid.

Where did your patients go when Koch closed?
–Dozens of nursing homes
were assigned
a few patients each.
Veterans went to the VA. Others went to
Homer Philips, Truman Center, City Hospital,
the last 6 Tuberculous patients went to Springfield (State Hospital).
There was a boarding home in the Carondelet area that took some of the men.

Did you ever see any of them again?
–I ran into a few at City (Hospital).
And for a time, I would try to visit patients.
But once I found my little ol’ man
in a hospital. His entire
backside was covered with
open bedsores.
His back,
even his
The pustular sores
were toxic—
he was dying
from bed sores,
I knew.

He was such a
little man,
such poor care.
I dressed his
wounds and
said good-bye.

Are there really thousands of unmarked graves?
–Yes. I do know the unmarked graves
were behind the main building. That’s true.
Although, I never saw proof that the Typhoid
bodies were buried under the main circle drive.

Was the quarry always blocking the view?
–The quarry was there long before me.
I toured the tunnels once. They meandered
under Koch’s property. I remember
boats stopping at the quarry dock and forcing
infected (or suspected) crew members
off boats. If they thought someone had
an infectious disease, the boat stopped,
and we took the sick guy into our care.

Describe Koch Hospital.
It was a place where people felt part of a
community. Very few patients were healthy
enough to be released–you know, go home.

Koch was our own town. We had a
US Post Office, my son worked
there one summer. Doctors lived on
campus above the main building. We had
apartments for our assisted living patients.

There were 19 buildings, 426 intermediate beds,
39 hospital beds, 166 resident beds,
a chaplain
3-5 social workers
And a full-time teacher
for the kids.

Sometimes, family members were quarantined together.
There was a mother with her daughter,
so sweet.
So sad too—
one would watch
the other

We had a jail. If someone was
spreading infectious diseases,
a judge would send a court order
for the arrest. Police delivered suspects
to Koch, jailed them in our Lock Ward.
One person climbed down bed sheets
from the third floor trying
to escape. (Barbara Laughs)

Did you have a favorite patient?
— I got a call from the Blue Goose Bar
saying one of my patients needed
a ride back to the hospital.
The Blue Goose
was almost 5 miles off campus.
I took an entire handle of whiskey
from this TB patient.
I put it in my desk drawer,
and told him
I would give it to him
when he was released.
Every single day during
my rounds, he asked if his whiskey
was safe. It was in my drawer for years.

Did he ever get his whiskey?
–He never was released, no.

Andrea Reynolds is a writer and a teacher from Missouri. Her work has appeared in The Ucity Review, Litmag, and Littoral Magazine. She holds an MFA from the University of Missouri – St. Louis.