An Unusual School Celebrates Its First Century

K-12 hospital school gives kids a chance for normalcy and connections to other kids during long recoveries

At most schools, the two students would never have met.

One boy was a teenager in high school, the other a child in early elementary school. Because they were attending the school at Lucile Packard Children’s Hospital Stanford, in one big classroom for grades K-12, they became buddies.

They shared similar, life-threatening cancer diagnoses and were enduring many of the same treatments. But they also wanted to have fun and feel like regular kids. They bonded over the challenges of hospitalization and cooked up goofy hijinks. In an old photo, they’re grinning wildly as they show off matching chemotherapy ports.

Although it’s been more than 20 years since she worked with the two in the photo, Kathy Ho, who has taught high school at the Packard Children’s hospital school for 27 years, remembers their friendship fondly. Watching the growth of such unusual, deep bonds has cemented her commitment to her job.

“I could easily go and work in a regular school, but there are things about being in a hospital school that you just don’t get elsewhere,” Ho said. “One of them is the camaraderie and mentorship that you’re not going to find anywhere else.”

Ho shared the story during a celebration for a big milestone: The hospital school at Packard Children’s is now 100 years old. The school, part of the Palo Alto Unified School District, educates students inside the hospital walls as they receive medical care.

Many children’s hospitals have such a school to help patients keep up with their studies. Hospital schools typically offer in-person instruction — in a classroom, at the bedside or both — to inpatients in kindergarten through grade 12. At some hospitals, including Packard Children’s, they are part of the Child Life and Creative Arts team, which works in many different ways to help kids feel like kids while they’re hospitalized.

Hospital School teachers and staff: Helen Madrigal, Robert Siu, Kathleen (Kathy) Ho, Elena Melendez, David Berry, and Gina Ng

The school now at Packard Children’s was founded in January 1924 in the Stanford Convalescent Home, the earliest precursor to today’s children’s hospital. The Con Home, as it was called, was a facility open from 1919 to 1969, where kids could recover from such conditions as malnutrition, tuberculosis and polio.

Although the capabilities of medical science have changed almost unimaginably in the past 100 years, the core mission of the school has remained: While children are sick, the hospital school gives them a place to connect to ordinary life, where they can make friends, engage with their studies and get a break from medical procedures.

“We treat every kid as though they’re about to go back to regular school,” Ho said. “We want them to have as normal a childhood experience as possible.”

David Berry sorting books at the
Hospital School library

Kathy Ho helping Ruben Roldan solve math homework at the Hospital School

Sunbaths, sleep — and school

In the 1920s, the Stanford Convalescent Home was the only medical institution located at the university’s campus, as Stanford’s medical school and hospital were then 40 miles away in San Francisco. However, sunny, then-semi-rural Palo Alto, California, was considered an ideal place for children to recover from serious illness.

The Stanford Convalescent Home, circa 1923.

Soon after its founding, the Con Home moved into the one-time residence of Leland and Jane Stanford on Sand Hill Road. Jane Stanford died in 1905, and the building sustained severe damage in the 1906 earthquake. The original structure was converted into a 15-bed facility for children recovering from serious illnesses. In late 1923, a second building — called the McLaughlin Unit — was constructed next door, bringing capacity to 40 beds and leaving space for a classroom. The unit housed bed-bound children, while the original building, thereafter called the Stanford Unit, housed “runabout” patients.

Children received the best available treatments for the era: fresh air, sun baths, plenty of sleep and nutritious food. With the expansion, the Con Home’s leaders began collaborating with the Palo Alto school district to equip and staff a classroom. As the home’s 1923-24 annual report described:

“The former dining room of the Stanford Unit has been converted into a delightful school room … The school is especially adapted to its convalescent pupils and does not interfere with the rest periods or sun treatments. The sessions are shorter than usual, with frequent recess; and especial attention paid to recreation,” wrote Jessie Treat, chairman of the home.

The opportunity to attend school was important to children’s recoveries, Treat wrote: “Mental development is secondary to physical welfare, but to some degree they may be worked out simultaneously even among convalescents.”

The school’s first students dealt with a variety of medical conditions. Medical director Harold K. Faber reported that for the period from Oct. 31, 1923, when the McLaughlin Unit opened, to Jan. 1, 1925, 240 children were admitted to the Con Home for, on average, 46 days each.

The most common diagnoses reflect the challenges of pediatric medicine in the pre-antibiotic era: severe respiratory infections, including bronchitis and pneumonia; malnutrition; tuberculosis; cardiac disease, chiefly endocarditis; and chorea minor, a movement disorder. The mix of patients also reflected what was then the cutting edge of medical science: One child was being treated for diabetes, which was often fatal before mass production of insulin began in late 1923.

Convalescent home exterior 1923

Dr. Gardner visiting children 1933

All of these children had the opportunity to benefit from the school. Teachers visited bed-bound patients in the McLaughlin Unit, while Stanford Unit patients came to the classroom.

“I have been much impressed with the importance both physically and mentally of the school work which is done in the Stanford Unit and on a smaller scale in the McLaughlin Unit,” Faber wrote in the annual report. “The older children, without this work, would worry a good deal at the loss of time and probably of promotion in school. It is important, too, for their minds to be profitably occupied and for their physical activities to be somewhat limited during the convalescent period.”

Classroom camaraderie

Patients came and went from the Con Home and its school as the decades progressed and medical science improved. There were children like 8-year-old Mary Ann Lee, now Mary Ann Sing, who came to the Con Home for about a year in 1947 to recover from severe asthma.

“My father was a dentist, and my mother was a nurse by education,” said Sing, now 84. Sing’s asthma had caused her to lose a lot of weight. Her worried parents consulted their family doctor, who suggested that a temporary move from the cold, damp climate of San Francisco, where they lived, would improve Sing’s health. (Asthma medications like albuterol, a bronchodilator that can be delivered by inhaler, were still decades away.)

Some of what Sing recalls about the classroom — such as the students sitting at individual desks in straight rows — differ from the school’s current setup, where children work at large tables. But much is similar. A third-grader at the time, Sing enjoyed making friends with other pupils of all ages.

“It was good that they did not separate people by age or grade,” she said. “We had one teacher and there was camaraderie.”

She paused for a moment and chuckled.

“Especially when — you know how kids are — when you have a substitute, we treat that person differently. We did the same thing then, and I had a good time, I participated in that. I wasn’t a goody two shoes.”

The kids’ shenanigans were silly, “nothing really bad,” Sing said, adding that she later experienced similar treatment at the hands of mildly naughty students when she became a teacher.

Sing’s parents came to see her every Sunday for the Con Home’s weekly visiting day. Patients and families were separated by a rope and not supposed to touch each other.

“At first, I recall that my mother tried to run over and hug me, and I told her, ‘You can’t do that!’” Sing said, adding that she doesn’t recall being particularly homesick.

Sing has good memories of Stanford student volunteers helping her with everyday tasks (washing her hair, for example); of a woman who read bedtime stories to the patients — “she was excellent”; of her favorite food from the Con Home menu (turkey a la king with rice); and of the home’s Christmas celebrations, which included a party, gifts and a visit from carolers.

After about a year, having regained weight and with her asthma in remission, Sing returned home. Thanks to instruction at the Con Home school, she had kept up with her classmates back home, she found. She graduated from Lowell High School in 1957, then from the San Francisco College for Women (later incorporated into the University of San Francisco) with a major in history and political science. Eventually she married, had three children, obtained a teaching credential, and became a high school social studies and English teacher.

Connecting with students

In 1969, the Con Home was replaced by the $5 million, 60-bed Children’s Hospital at Stanford. This was where young patients received care until the present-day hospital’s current West building opened as Lucile Salter Packard Children’s Hospital at Stanford in 1991.

A teacher and students work on lessons, circa 1960.

Kevin Danie began working as at the hospital in 1988 and ended up teaching every grade level in the school for a total of about 20 years, interspersed with intervals of teaching in other schools in Palo Alto.

He enjoyed the connections he developed with children whose chronic medical conditions required repeated hospitalizations. Getting to know the students helped him make lessons fun. For one student, he would always say “Correct” in an exaggerated, silly voice when she got an answer right.

“She just loved that and called me ‘Mr. Correct,’” Danie said. “I did that with her for about six or seven years. Then she got to high school and when I tried it, she said, ‘You’re a little extra, aren’t you?’” He laughed and remembered thinking, “My audience has changed.”

“Being silly and individual for them, I loved,” he said. “It was the ability to provide that normalcy and just give kids an opportunity to not think about their reason for being in the hospital.”

But the structure of the classroom — with its environment of teachers, classmates and lessons — held an even stronger message about normalcy for hospital school students, regardless of whether they were expected to make a full recovery or had lifelong conditions.

“Normal for them is to go to school. If there was no school, it’s sort of saying, well, we don’t value your normal life,” Danie said. “And being in school was a chance to let them know they’re not alone, and share the experience of hospitalization with other kids.”

Continuity and growth

Today, Lucile Packard Children’s Hospital Stanford includes the 1991 building (now called the West building) and the adjacent Main building, which opened in 2017. The facility has 361 beds and is at the center of a large pediatric medical network, Stanford Medicine Children’s Health, with more than 85 locations. The network has close ties to the Stanford School of Medicine, and its physicians offer groundbreaking treatments for complex heart conditions, cancer, premature birth, rare genetic diseases and much more — all reflecting a longstanding commitment to advancing evidence-based medical care for kids.

Packard Paws’ Pet Therapy dog Donatella

Creative Arts Music Therapists:
Rachel Komroff, Alexandra Ferrer
and Emily Offenkrantz

Through every expansion, the school has helped young hospital patients keep up with their studies. The school is now located in a classroom inside Packard Children’s, where Kathy Ho and two other teachers instruct around 450 students per year. The Ronald McDonald House at Stanford, which provides accommodations near the hospital to patients and their families, houses a second classroom, founded in 2017, which serves another 50 students per year.

The COVID-19 pandemic’s effects on schools across the country had ripple effects on the hospital school, Ho said. Most schools now offer online portals for students to access their lessons when they are ill, for example. As a result, hospital teachers now frequently guide children through lessons from their home classrooms.

But hospital teachers still have plenty of work to ensure that their students can gain as wide an educational experience as possible. They figure out how to offer art lessons, science experiments, ways to learn about the natural world — all from the confines of the hospital. For many years, they hosted an annual prom each spring; it’s been on hold since the pandemic, but the team is hoping to bring it back this year.

“I’m pleased when I read about things that happened in our school 100 years ago. I’m proud to be part of the tradition,” Ho said. “Creating a positive, joyful community for hospitalized children — the sort of place where you might make friends with a much younger kid who shares your diagnosis or join pals in mischievously teasing the substitute teacher — is just as important as it was a century ago.”

(Historical photos and archival material courtesy of the Stanford Medical History Center.)