In the Mountains: The legacy of care and service built into the walls of Tate Hall

Tate Hall dormitory was formerly Grace Hospital, a community medical hub that served the High Country

Today Tate Residence Hall sits proudly at the front of the Lee-McRae College campus. The building’s beautiful stone façade represents the image of Lees-McRae in many people’s heads, but the history of the building, and the story behind its name are even more representative of the values of community, education, and growth that have been tenets of Lees-McRae since its founding.

The building that is now Tate Hall was once a bustling hospital. The hospital, always overflowing, serviced patients from nine surrounding mountain counties in North Carolina and Tennessee, acting as the primary medical center for more than 60,000 Appalachians and providing them with life-saving medical care.

Recognizing a Community Need

In the same way Lees-McRae founder Rev. Edgar Tufts identified a need for greater educational opportunities in the mountains, he also noticed that the people of the High Country were in desperate need of more accessible medical care. After completing a difficult journey over 30 miles of rough and muddy roads to reach a doctor in Roan Mountain, Tennessee when his wife needed medical care, Tufts made the decision to start the long journey of bringing that care to his small mountain town of Banner Elk, North Carolina.

The project started slowly, as he recruited doctors to move to Banner Elk. Dr. Charles Reed became the first doctor to live in the office-home Tufts constructed on the institute’s campus that would later come to be known as the predecessor to Grace Hospital. At the time, many people were ignorant of the necessity of hospitalization and modern medicine, so having even one doctor in the town was a great improvement.

This story really begins, however, with Dr. Reed’s successor, Dr. William Cummings Tate, a young doctor who had just completed his education at the University of Tennessee Medical School and moved to Banner Elk to take Dr. Reed’s place.

The office-home Tufts constructed was small, and Tate had two of the rooms outfitted into “hospital rooms,” but he spent the beginning of his medical tenure in Banner Elk caring for patients in their own homes with only a saddlebag of equipment.

Tufts’ daughter, Margaret Tufts Neal, writes about the early days of medical care in Banner Elk in her book chronicling the history of Lees-McRae, “And Set Aglow a Sacred Flame.” Of Tate she said, “he soon became one of the most beloved and trusted saddlebag doctors in western North Carolina. He answered the call of need in any hour, in all kinds of weather, by any road or trail, within any distance that could be reached by his horse.”

Quickly it became apparent that the two rooms in his home were not enough to service the continuously expanding group of patients under Tate’s care. Two more rooms were prepared, and other beds were added, but more space, equipment, and an operating room were desperately needed. In the spirit of Lees-McRae, the community and friends of Tufts came together, and funds were raised to fulfill those needs. One of these donors was Mrs. Helen Hartley Jenkins, a woman who had a personal interest in medical advancement and had learned of the work in Banner Elk through the Southern Mountain Workers Association.

According to Neal, “a report from the hospital in 1919 stated that patients in the hospital that year numbered 1,256; outpatients—those treated but not kept in the hospital—numbered 10,000; 125 major operations were performed and 101 minor surgical cases.”

As the hospital grew and developed, Tate continued the same standard of extremely dedicated care that he had previously deployed by traveling far and wide to provide care for the people of the High Country as a saddlebag doctor.

Breaking New Ground

By this time the hospital’s reputation as a dedicated medical center that didn’t turn away anyone in need began to establish itself, and demand for care continued to grow. Not only did the number of in-home visits increase, but patients began to travel to Banner Elk to seek care. Some patients traveled 50 miles or more along difficult mountain roads.

It was clear that more space, equipment, and medical professionals were needed to keep up with the demand of the growing patient population, but partially due to the hospital’s policy to accept all patients regardless of income, money for a new construction was slim.

“There were no hospital ‘rates,’ no payments from medical insurance, no Medicare,” Neal recounts in her book. “Patients paid what they could, and often that was in farm produce or services.”

The development of the hospital could have stopped here had it not been for another generous gift of $22,000 from Jenkins. Thanks to her donation, construction of a larger, more up-to-date hospital building began in 1920. This new hospital building was to serve as a memorial to Jenkins’ sister Grace Hartley Stokes and would officially be called Grace Hospital.

Once it was completed, the new “fireproof” brick building housed 25 hospital beds. It was officially dedicated to Stokes in June 1924. Now with more space came the question of additional medical professionals with whom to fill it. Dr. R. H. Hardin of Boone and Shulls Mill, and Dr. S. G. Miller of Covington, Virginia, eventually joined Tate in providing medical services at the new Grace Hospital.

The surplus of resources created by the renovation did not last long, however, and hospital staff reported bed shortages within just a couple months of the new hospital’s opening. At this time patients overflowed from the rooms, receiving medical care on cots and even tables in sunrooms and hallways when all the beds were full.

“Better roads, the beginning of hospital insurance, and education regarding the necessity of hospitalization, all contributed to the increased number of patients,” Neal wrote. “But the factor that brought most of the patients was the confidence the mountain country had in the skill of Dr. Tate and Dr. Hardin.”

All the while the spirit of service that came to be associated with Lees-McRae continued. The pay-what-you-can system that was established during the time of in-home care remained the standard at the hospital. Neal noted that “fifty-four percent of the patients did not pay either the hospital or the physician. Seventy-five percent did not pay the physician. Yet the hospital did not receive any financial aid from the church’s budget or any foundations. It was maintained by the moderate fees of the few who could pay and by gifts from concerned and interested individuals.”

Grace Hospital II, 1924: Although it was the first building which bore the official name “Grace Hospital,” in her book "And Set Aglow a Sacred Flame," Neal refers to this new brick hospital as Grace Hospital II, establishing it as the follow-up to the first hospital which was established in the doctor’s office-home.

Moving Into a Modern Era

The generosity of these donors was needed once again, when the number of patients at Grace Hospital reached a record annual high of 929 bed patients and 6,150 office calls. Once again, the hospital had outgrown itself, and another renovation was in order, and once again a generous gift from Jenkins helped make the construction of Grace Hospital III possible.

A four-story building constructed of native stone was built to house 60 patients and was fully outfitted with up-to-date operating rooms and laboratories. The newest version of Grace Hospital opened for patients on April 29, 1932.

An edition of the Lees-McRae news publication “The Pinnacles” from May 1932 announced the dedication of the building they dubbed, “the new Grace Hospital,” noting that “the new sixty bed hospital is the largest institution of its kind in a town of its size in the United States.” The new Grace Hospital continued to serve the people of the High Country for almost 30 more years, until once again the medical facilities there outgrew themselves.

This was a time of transition not only for the building itself, but also for the Lees-McRae campus surrounding it. The school was growing, and more and more students were seeking an education in the mountains. To solve both the need for more hospital space and more residential space for Lees-McRae students, a new hospital was constructed off-site, and the “new Grace Hospital” became the “old Grace Hospital” as plans were made to turn the building into a residence hall.

By 1961 the renovation to convert the hospital was completed, and the building was officially renamed for the man who had dedicated his life serving his community within those four walls, Dr. Tate. An announcement of the building’s renovation was made in the June issue of “The Pinnacles” from that year, explaining that the completed building would be equipped to house approximately 120 students, allowing Lees-McRae to increase its student population to nearly 400 on campus.

While Dr. Tate passed away before the building’s dedication to him and his lifelong medical work, “The Pinnacles” honored him in their announcement, specifically noting his years of dedicated and loyal service.

Now, more than 100 years after the first iteration of Grace Hospital began to serve the people of Banner Elk and its surrounding counties, and sixty years after the building was converted into a dormitory, Tate Hall still stands in the center of the Lees-McRae campus as a reminder of how far this institution has come.

The building continues to proudly house Lees-McRae students within its walls, helping the college carry out founder Rev. Edgar Tufts’ vision of a vibrant college of opportunity, where students travel from far and wide to the little mountain town of Banner Elk to receive an education and be part of a community. Tate Hall is a physical representation Lees-McRae history.

Dr. Tate’s son, Dr. Lawson Tate, left, is shown with his mother and his wife in front of the newly renovated dormitory for girls on the Lees-McRae College campus.
By Maya JarrellSeptember 23, 2022
Campus Life