COLUMBIA — It's a challenge to fit high-tech medical functions into buildings from the 1930s through 1950s.
But the University of South Carolina’s School of Medicine has done it since moving onto the grounds of the Dorn Veterans Affairs Medical Center in the early '80s.
Before it was ever listed on the National Register of Historic Places in 2009, the school embraced preservation of the medical district’s Colonial Revival structures, complete with large-columned porticoes and decorative bricking. And it does so even now that it's planning ahead for a possible new $200 million health sciences campus at Columbia's BullStreet District in 2030, when the lease agreement on the VA buildings ends.
“We have a beautiful campus; it definitely has character," said Larry Knott, who has spent nearly 40 years as director of facilities planning for the school, overseeing maintenance of a number of the Depression-era structures.
Buildings in the Dorn VA Historic District date back as far as 1932. The facility was one of 50 similarly designed hospitals across the country, according to a 1984 journal article describing how the school combined historic buildings with modern function. Competition for the large, federally funded hospital campuses was fierce between both states and cities and was a major prize for the Capital City.
The historic set of hospitals was influenced by the agency's first director, Charles Forbes, who felt strongly they be built in a pavilion style, separating out treatment functions into different buildings. The large, ornate gallery porches look nothing like modern hospitals, but in the pre-air-conditioning era they're beauty also had function, increasing patient comfort by allowing for cross ventilation in the South Carolina heat.
Knott has been part of the team through the painstaking removal of lead paint from those grand columns fronting each of the buildings. Same for those in the former main hospital building’s foyer, where he thinks the decision to add contrast to the crown molding topping the columns really makes their design pop.
When the old clay tile roofs had to be replaced, the school and VA kept the same look using architectural shingles. And when a number of the former operating rooms were made into research labs, Knott and others ensured preservation of the marble on the walls and the terrazzo floors.
“Even the glass we installed on the porches of Basic Science Building 1 had to be approved, but the effort was certainly worth it,” then Associate Dean for Administration O.M. Higgins said in the 1984 journal article.
Because they were enclosed, those porches can now function as lab space.
One of Knott’s biggest challenges, working with the State Historic Preservation Office, came in the total renovation of the former psychiatric building in 2008. Old metal grills used for ventilation under windows on the building were replaced with fiberglass panels that maintained the look. Some of the building’s porches had been previously bricked in. The school returned those to their original appearance with arch windows installed to make the space usable.
A practical man, having gotten his start in maintenance work, Knott said the complexity of historic preservation at times tested his patience, like when it took six months to pick a shade of paint.
“It had to grow on me to really appreciate the need to maintain this,” Knott said. “But if you lose that it’s gone forever.”
Some of Knott's favorite parts of the historic structures are never seen by the public. He loves walking through the attics and admiring how well the hand-hewn peg and notching in the rafters fits together. Crawling under the buildings, he admires the craftsmanship of trenches cut by hand using pick axes.
“You can see the marks in the old red clay,” he said.
But staying true the buildings’ forms has been a sometimes cost-prohibitive and limiting factor on what researchers at the school are able to do. What's necessary for research space have changed tremendously, Knott said, and air and ventilation are mechanically a challenge in the old structures.
In addition to research capabilities, student body growth is another factor in consideration of a new facility.
In the spring, the school had 390 students enrolled in the M.D. program and 315 enrolled in graduate programs for a total of 705 students, spokeswoman Alyssa Yancey said. When the school first moved to the VA, enrollment was about 150.
In addition, Dorn VA has seen its own expansion, with a 3 percent annual growth rate in patient volume, said Director David Omura. Across its main campus and seven satellite clinics, Dorn VA’s health system serves 85,100 veterans. Before coronavirus struck the state, the main hospital usually saw 3,500 to 3,800 outpatients daily. There’s also a 90-bed nursing home on site and 200 inpatient beds.
To accommodate that growth, the hospital has roughly $160 million in capital projects its completing over the next 2 to 3 years, Omura said. These include a new mental health building, rehabilitation center, primary care offices, a prosthetics center and ophthalmological care space.
Among this is renovation of the historic building that once served as nurses quarters, said Chief of Engineering Chris Zell. The original windows are being maintained after having the lead paint stripped from their frames and mortar on the brick facade is being repaired.
“It really is a showstopper,” Omura said of the building, which when complete will house offices for primary care physicians and free up space in the main hospital tower.
Omura said he and USC President Bob Caslen speak often about how the school might maintain some presence on the VA campus should it move when its lease expires. But final decisions have yet to be made.