Train Doctors


There are headlines aplenty these days around the topic of health care, but would it surprise you to learn that one of the early adopters of employer-based health care was the railroads?   

While the vast majority of nineteenth century workers had to find and pay for their own medical care, the railroads were developing a unique and valuable employee medical benefit. 


Because the nature of railway work and travel conditions led to a heightened likelihood of injuries to employees as well as passengers and bystanders some form of available medical services became almost a necessity.  The problem became exacerbated with the opening of the transcontinental railroad.  As an ever increasing number of people were transported across unsettled territory, territory that never seen trained physicians or even the most rudimentary of medical facilities, the railroads had no choice but to hire their own physicians and set up medical facilities along their routes.

Thus was born the era of train doctors.  Most of the men and women who answered this call were actually general practitioners who could also perform surgery.   And because of the unique dangers railroad workers faced, the so-called train doctors found themselves faced with types of injuries which few had dealt with before.  They were pioneers in the development of trauma care under primitive conditions, developing techniques and treatments that eventually found their way into routine medical practice.

From the outset, most of these practitioners expressed concern over the conditions and equipment they had to work with, as well as the ability to see their patients in a timely manner when minutes could literally mean the difference between life and death.

first-aid-kitOne tool that resulted from the drive to get stop-gap care to workers who sustained injuries in remote areas, were special packs devised by railway surgeons to be carried on all trains.  These packs were stocked with basic emergency supplies such as medicines, sterile dressings and basic implements.  These were, in fact, the precursors of the modern day first aid kit.  Train doctors also promoted the training of key railroad workers in the use of such materials so that the injured party could be given appropriate first line aide until a proper physician could be reached.

As for facilities, at first, railroad doctors tried using hotel rooms, spare rooms in residences or even back porches for emergency medical care, but such rooms not only lacked the necessary equipment, their use also resulted in a large expense for the railroads who not only paid for the use of the room but also faced cleaning and replacement costs for bloodstained linens and furniture.  As an alternative, the train doctors pushed for the development and use of hospital cars to serve as both properly equipped surgical facilities and transportation for seriously ill or injured patients.  




The adoption of such cars greatly improved the survival rate of the seriously injured railroad worker and eventually evolved into highly sophisticated facilities.  They contained room to bed and care for three to four patients as well as a fully equipped operating room.  They were scrupulously maintained in order to provide a clean environment in which the surgeon could effectively perform his duties, stabilizing his patients before sending him or her on to a regular hospital.

Speaking of hospitals, the railroads were also very influential in hospital2establishing such facilities along their routes.  In mid-century it was remarked that a person traveling from St. Louis to El Paso would traverse 1300 miles without passing a single hospital.    And this was only one of numerous such stretches in the country.  The first railroad to respond to this glaring need was the Central Pacific Railroad which opened its own hospital in Sacramento in 1869.  Other railroads quickly followed suit, establishing their own hospitals along well traveled routes.

Dr. C.W.P. Brock, President of the National Association of Railway Surgeons, was quoted as saying: Mr. Greeley’s advice to the young man to “go west” may be followed with great benefit by railway surgeons from the older sections of our country; and when they have seen the superb hospitals and the practical workings of the system they will say, as the Queen of Sheba said after seeing the splendors of King Solomon, “that the half had not been told.”


narsOn a more practical front, another surgeon was heard to estimate that “the daily cost per patient at a railway hospital runs from 40 to 60 cents, compared to $1.00 to $1.50 at a city or contract hospital.”

Train doctors were overall a progressive lot.  They endorsed the emphasis on sterilization and overall cleanliness in patient care well before such thinking was met with universal acceptance.  They were also progressive in their attitude toward embracing women into their profession.  In 1894. Dr. Carrie Lieberg of Hope, Idaho was appointed division surgeon on the Northern Pacific.

In addition to surgery on railroad-related injuries and general trauma care, railway surgeons also took on the role of overall health care provider.  They treated a wide range of illnesses, performed routine checkups, delivered babies and advised on safety, health and sanitation issues.

Alas, the train doctors are no more.  There are a number of factors that contributed to the eventual demise of the once highly effective and indispensible system.  Key among them was the change in government regulations and the explosion of medical advances in the 1950s.  The last of the railroad hospitals were sold or closed in the 1970s and the remaining train doctors retired, joined other practices or set up private practices of their own.

But these dedicated men and women left an enduring legacy.   badge

Their trade journal, The Railway Surgeon, though it reinvented itself a number of times, remains in print today under the name Occupational Health and Safety

The modern day specialty of occupational medicine can trace its roots to these surgeons.  They also helped to shape modern medical practice, especially in the area of trauma study and care.  They were pioneers in front line field care, in the stabilization and transport of the seriously injured, in overall trauma care and in the development and use of the modern day first aid kit.

All but forgotten by the vagaries of our national memory, train doctors nevertheless played a major, but largely unsung, role in making the settlement of the western frontier a safer proposition for all who travelled through or eventually settled in the surrounding areas.


Website | + posts

Winnie Griggs is the author of Historical (and occasionally Contemporary) romances that focus on Small Towns, Big Hearts, Amazing Grace. She is also a list maker, a lover of dragonflies and holds an advanced degree in the art of procrastination.
Three of Winnie’s books have been nominated for the Romantic Times Reviewers Choice Award, and one of those nominations resulted in a win.
Winnie loves to hear from readers. You can connect with her on facebook at or email her at

22 thoughts on “Train Doctors”

  1. Gosh, don’t you just love history. Thanks Winnie for sharing this is an awesome blog. I never knew any of this.

    Have a great day, I’m off to work.

  2. I have never heard of this before.
    I’m always amazed at the pieces of history that are out there and more or less lost.

    I read such an interesting article about sterilization and the war that went on over it.
    Some doctors talked of germs and sterilization but because germs were of course unseen, many doctors thought of ‘germs’ as oh, I can’t say it right, like these doctors were evil, ungodly, saying germs existed. So rather than treat it as science it got mixed up with superstition and religion. So boiling a scalpel was sinful.

    I’m not saying it right but it was something like that.

  3. 1970? Really? I had no idea the railroad hospital cars were still in use that recently. This is great stuff, Winnie. All kind of ideas are rolling around in my mind. 🙂

  4. Winnie, this is astounding. I’ve never heard of train doctors. Your blog is so interesting and it has my brain running in forty different directions. I guess the people in the old West used the train for a great many things. One of our Filly sisters (it may have been you) wrote a blog a little while back featuring train preachers who oftentimes held church in the train cars and they traveled all across the country preaching the gospel.

    I’m really amazed at the things I learn from these blogs. Lots of little details a writer can put in a story.

    Great post!

  5. Sherry – yes and that’s what makes research so fun. I stumbled on this little tidbit quite by accident.

    Mary – isn’t it amazing that some of the things we take for granted today were once so hotly debated? Hard to believe how long it took folks to equate cleanliness as part of proper medical care

  6. Tracy – actually it was the last of the railroad hospitals that closed in 1970 – not hospital train cars. Still, the cars themselves were still in use as late as 1945 and perhaps even longer. I couldn’t find a definitive date of when the last one was retired.

    Linda – yes it was me who posted about the train preachers. And I agree, such tidbits spawn all sorts of interesting story ideas 🙂

  7. Winnie,

    This is such a wonderul find. I never really thought much about this until I read your blog.

    People take things for granted and life is short. Its really a shame the way things are this day.

    I wish I would have lived in the 1800s but of course with the Native Americans

    Walk in peace and harmony,


  8. Melinda – thanks for the kind words about my post and for stopping by to drop a note

    Elizabeth – yep, those physicians took their primitive work conditions and pioneered a whole new medical field

    Colleen – You’re welcome! I just love digging into these little footnotes of history and playing ‘what if’ games with them

  9. Hi Winnie,
    This is fascinating. I too, never knew about train doctors. The 1st, first aid kits and the fact that they trained workers how to use them in case of an emergency, was really neat to learn. Many companies today, do the same. And it blew my mind that we had these hospital cars up until 1970.

    Great blog!!

  10. Thanks so much, Winnie! After reading your blog, I went searching for information on the Southern
    Pacific Hospital which I remembered seeing from
    one of the major roadways here in Houston over the years. It is still there, BTW, as a part of the Harris County Med. District serving as the Thomas Street Health Clinic. In addition, I found a piece on historic district preservation of part of the area where I grew up and went to high school. Now I have something to bring to the discussion when I attend my high school reunion
    in September. BTW, it will be the 55th reunion
    of the “antiques” from the Jefferson Davis Class of 1954

    Pat Cochran

  11. Charlene – Glad you enjoyed the blog and yes, one of my favorite tidbits from the research was learning how this tied to the development and use of first aid kits and training.

    Pat – Glad I helped you learn more about a piece of your area’s history. And congrats on your 55th reunion – WOW!! Hope you have a great time.

  12. Thanks for a wonderfully informative chat. They were responsible for many innovations in medical care that most people never consider the origins of. Would never have thought that Occupational Health an Safety was the offspring of The Railway Surgeon.
    Thanks again for my lesson of the day.

  13. Winnie. . . I’m late but just had to tell you this was a great blog. I love blogs that tell me something I didn’t know. Thanks.

  14. Pat – always good to hear from you, and I’m so pleased I could share a tidbit of history with you that you didn’t already know.

Comments are closed.