An historic map dating back to the late nineteenth shows St. Franciscus Hospital comfortably nestled between St. Mary’s Cemetery and the emerging neighborhood of Lawrenceville. The scale of the structure becomes more apparent when we zoom in on the adjacent residential parcels, so newly created that they don’t yet have houses on them.  I haven’t a clue as to what kind of dialogue existed between institutions and the public a century ago, but I like to imagine what a nineteenth-century block watch meeting would have been like.  Prospective home builders and a smattering of residents crowd around a table in St. Mary’s Lyceum analyzing that turn-of-the-century map.  A portly bearded man in a snug three-piece suit jabs his meaty finger at large square labeled The Insane Department and bellows, “Pardon me, Sirs, are you suggesting that we build houses a stone’s throw from the nuthouse? If so, perhaps they have a padded room for you!”  The meeting then deteriorates into a hysterical free-for-all about a lack of parking for horses and buggies.

That disbeliever was proved wrong; by the early 1900s, countless row houses were constructed one hundred feet from the sanitarium (and in full disclosure, this author and his family have lived in one of them since 2004 (the houses…not a sanitarium)). Parcel by parcel and block by block, the densely packed residential neighborhood blossomed adjacent to the hospital whose name was later shortened to St. Francis, then lengthened to St. Francis Asylum for the Insane, then shortened back to St. Francis.  Or so say the maps.

Source: Historic Pittsburgh

In the century that followed, St. Francis held a place in the hearts of the community as an employer of so many of its residents, but its impact was felt much further.  Beyond providing comprehensive medical care, as a treatment center for those with mental illness or addiction, the hospital provided effective and compassionate care for families throughout Western Pennsylvania.

One hundred thirty-seven years after its inception, St. Francis announced in 2002 that it would close its doors permanently,  with the silver lining being that the St. Francis complex would be the new site for the UPMC Children’s Hospital of Pittsburgh (CHP).  CHP was internationally renowned as a place that could perform extraordinary feats, and locally trusted as the go-to place for families throughout the region.  Most everyone who grows up in Western Pennsylvania is treated at Children’s sooner or later, for broken bones, ear infections or more complicated illnesses of all kinds.  In this way, Children’s was St. Francis’s next of kin and its rightful successor.

One doesn’t need an degree in urban design to know that the best reuse of a vacated hospital is another hospital, so CHP’s relocation was a once-in-a-lifetime opportunity that provided the community with much relief and hope following the St. Francis announcement.  There were concerns, of course, about how an aged-but-familiar hospital replaced with a new modern one would impact the community.

There was one salient and notable difference: whereas a new community grew around an existing hospital, its replacement would have to be designed and built to fit within an established community.  In other words, the initial development of the primarily residential neighborhood responded to the scale and use of St. Francis and, in doing so, achieved a long-lasting harmony.  Now, the burden of maintaining that balance had shifted to the forthcoming hospital.

CHP’s tradition of providing the very best care for children can’t be overstated, and it’s not the place of this author to discuss that issue.  What I am qualified to explore is the role of this institution as a neighbor, and how it has been woven into the fabric of Lawrenceville – one of Pittsburgh’s most sought-after neighborhoods.  After all, CHP relocated from the institution-driven neighborhood of Oakland to a primarily residential one, and like any valued institution – schools, places of worship, government buildings, etc. – it’s not only fair but necessary to evaluate how they alter, for better or worse, the community that predated it.

Lawrenceville’s relationship with CHP is now more than five years old, and with that milestone I set out to collect stories, observations and bits of data – a palette from which I’d try my hand at painting a picture of how this development, unprecedented in its scale, has affected the trajectory of one of Pittsburgh’s most dynamic neighborhoods.

The business owners, residents, CHP employees and other professionals who contributed to this story (most of whose names are changed or omitted) centered my attention on the following questions:  What impact has CHP had on real estate values of nearby residential properties?  Or on the business development in the Penn Main commercial district in which it resides? And has the quality of life changed for nearby residents since CHP’s arrival?

My conclusions, which were observational and not analytical, surprised me.

Awaiting the New Neighbor

As the opening of new CHP campus drew near in 2009, attempts to foretell its economic impacts began to show.  A sudden spike in home values revealed that houses were being priced and bought at a speculative future worth, and not at their present-day value.  Simultaneously, a few new businesses opened along Penn Avenue, indicating that a more robust business district was imminent.  This phenomenon, in hindsight, raised some obvious questions, including: How do urban hospitals impact their host communities – economically, socially and physically?

Though the community had opportunities to see the virtual hospital in 3D computer renderings before the design was approved, many were shocked by the imposing steel skeleton that now towered over everything as far the eye could see.  A collective sigh of relief, with hints of anxiousness, followed the completed construction of this more than $600 million LEED certified project which, beleaguered by delays had fallen two years behind schedule.  During this time, some local businesses closed and vacancies remained as such, and there was an overall sensation of time standing still.

Eventually the day arrived in May 2009 when patients were transferred by helicopter from the soon-to-be former Children’s Hospital in Oakland.  It was surreal and exciting, like M*A*S*H.  Throughout the day, dozens of thundering choppers floated down onto the helipads, before levitating and darting away like dragonflies.  The transformation was finally complete.

The Avenue

CHP sits within the small business district known as Penn Main, which began to stagnate before St. Francis announced its closure; and in the minds of many, Children’s would be the cure for its malaise.  On some level, most were aware that revitalizing a tired business district is not the job of a hospital.  But whether it was blind faith or common sense, it wasn’t unreasonable to expect that changes were forthcoming along Penn Avenue and nearby Main Street.  After all, with hundreds of employees (including, yes, wealthy doctors) and thousands of visitors, how could all those vacant storefronts not fill up?  In fact, full occupancy (or close to it) was discussed as a given, and the primary question was with what?  The mindset was that the community needed to be vigilant to ensure that these modest storefronts would attract neighborhood-serving businesses and not hospital-serving ones such as medical offices and suppliers that sold gauze pads.

“But until these long-vacant properties are leased, there is no room for the district to grow.”

There were 32 existing businesses in the Penn Main district before CHP broke ground, including gas stations, restaurants, professional offices and a strange company that sold brushes of every imaginable sort.  Since then, several have closed, several have opened, and several have opened and closed.

One business that exemplified the vacillation within Penn Main was the Lunchbox, a small deli opened by Brian Peltz while hospital construction was underway.  Directly across from the hospital, the Lunchbox thrived on 44th Street early on, relying heavily upon the dozens of construction workers on site each day.  Once the hospital opened, the Lunchbox’s business dropped off dramatically, and Peltz scaled back his menu, and to make up for lost revenue he began selling snacks, lottery tickets, and cigarettes.  “Lawrenceville Eateries on Life Support” paints a vivid picture of how the Lunchbox and other establishments along Penn Avenue were impacted.  Soon after, the Lunchbox had closed, but within another year the Green Bamboo Chinese restaurant took its place and remains open today.

Penn Main business district

Penn Main business district

There are currently 31 businesses in the district, one less than when construction of CHP began. Not the juggernaut many hoped for; nor the Medical Row others feared. To their credit, at the community’s behest CHP agreed not to include street-level retail in their design that would compete with existing and future storefront businesses along Penn Avenue.

On the spectrum between the sky is falling and the sky is the limit, it didn’t seem to occur to most everyone that a world-renowned hospital would have no measurable impact whatsoever on its adjoining business district as a whole.  In short, a non-factor.  With thousands of people there every day, how can this be?

The reasons aren’t all that mystifying.  According to a local data analyst, hospitals have regional economic impacts related to employment, vendors and other services, but generally are not economic engines at the neighborhood retail level.  A decade ago, a student project at Carnegie Mellon University conducted in partnership with the Lawrenceville Corporation concluded that the local business community should not expect hospital employees and guests to leave the hospital all that much.  Beyond that, there was little empirical evidence to go on, besides a Montreal-based case study which was difficult to read because it was written in French, and may have had gravy on it.

Within CHP is a cafeteria-style restaurant that not only offers extensive, high-quality food options such as sushi, but sells it at almost absurdly low prices.  A 24-hours kiosk (which is actually only open 23 hours a day; I found that out the hard way at 4:05 a.m.) sells Starbucks coffee, soft drinks and snacks, and nearby is a gift shop and a Rita’s Italian Ice cart.  Human nature may necessitate variety or the need to just get out from under the same roof from time to time.  But where there are people who are overwhelmingly busy, or under stress, or in a constant hurry (read: most everyone in a hospital), it becomes readily apparent why patronizing outside businesses is the exception and not the rule for most.

Though the district as a whole has remained status quo, it would be misleading to say that CHP has not had any impact on individual businesses; after all, people associated with it do patronize local businesses, just not all that much.

Several business owners shared their thoughts about the hospital as it pertained to their establishments, and as for the bottom line – how much revenue is a direct result of the hospital – responses varied from ‘negligible’ to ‘very important.’  One owner attributed sixty percent of receipts to the hospital.  “I wouldn’t be here without their business,” he said.  When I asked about what changes might facilitate additional business and occupancy, nearly all said –  before I could get the whole question out of my mouth – parking.

Others pointed to a more specific problem: long-vacant storefronts.  Within one critically important block of Penn Avenue adjacent to the hospital, there are eight storefronts that have been continuously vacant.  Seven of them are owned by the same family. (I was unable to obtain comments from the family who controls these properties.)

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Long-vacant storefronts

Permanently dark windows deter prospective investors, which is a drag on existing businesses that covet more businesses and the additional foot traffic that would come along with it.  The result has been business development gridlock.  Yet, new businesses do continue to invest in the district, but they rotate in and out of the same storefronts.  This represents change, but not growth.

One native resident suggested that Children’s “take Penn Main under its wing and revitalize it,” noting that the district was much healthier during the St. Francis days; but another lifelong resident’s perspective was different: Penn Main was always “a bit sad”.  In either case, St. Francis didn’t actively tend to the commercial district’s needs then, just as CHP doesn’t now, and most agree that that isn’t the hospital’s responsibility to do so.  In nearby Bloomfield, West Penn Hospital employees receive discounts at local businesses through the West Penn 10% Club, a program run by the Bloomfield Development Corporation.  Christina Howell, the organization’s Executive Director, told me that the new program has been successful, and new businesses continue to join.  Such a program seems adaptable to Penn Main, but should be noted that it requires a community organization to coordinate it, not a hospital.

As with business owners, many residents stressed that CHP does not provide adequate parking for its users, which negatively impacts the business district (an issue discussed later in this story).  If CHP collaborated with local organizations and the City to support a long-term parking solution, the district could grow, they believe.

“Lawrenceville is emerging as a growth center…that sends economic ripples into adjoining neighborhoods.”

Though Bloomfield and Lawrenceville have little in common with the neighborhood of East Liberty, there is something that the former could learn from the latter regarding Penn Main.  After years of fruitless struggles to rebuild the core commercial district of East Liberty along Penn Avenue, the community adopted a strategy to redevelop from the outside in by starting anew and building upon the edges it shared with stronger markets, namely Shadyside.  As part of the first phase of the Eastside development, it was no coincidence that Whole Foods opened its first regional store in East Liberty along the Shadyside border.  What mystified a great many people made complete sense – Whole Foods was now located at the geographical center of the greatest concentration of wealth in Western Pennsylvania.

Penn Main is not at all suitable for large-footprint retailers, yet the strategy is germane: it shares an edge with the rapidly increasing wealth in Lawrenceville.  In East Liberty, this strategy forced major infrastructure investments, such as converting one-way streets into two-ways, and thus lends support to the argument for public investment in, say, a much-needed parking structure.

Let’s stroll away from the avenue and have a look the residential fabric that surrounds it.