Illustration · An imagined hospital admitting desk at night, with a newcomer’s bag and his sponsor’s hat set down on it. Not drawn from a photograph of any of the hospitals.
Hospitals that didn’t want drunks would take one with a sponsor, who saw to the bill, the visitors and the ride home.
“More and more, AA groups are adopting the idea of ‘sponsorship.’”
The way in
Hospitals didn’t want drunks. “We had been noisy nuisances who ducked paying bills and seldom got well,”Bill W. wrote. Yet most early members believed a newcomer had his best chance if he started out in a hospital, where he could get sober, think clearly, and be found when members came to visit.
The hospitals that took AA’s drunks wanted someone to answer for each one, and that someone was the sponsor. In Cleveland, Deaconess Hospital gave AA beds and visiting privileges from the end of May 1939. In Akron, from August 1939, Dr. Bob and Sister Ignatia took them in at St. Thomas, as The flower room tells. Charity Hospital in Cleveland followed in 1940, and Knickerbocker Hospital in New York in 1945, with Dr. Silkworth. At Knickerbocker no one came onto the AA ward without a member of AA, who brought him in and took him home five days later.
Bill described the job in AA’s magazine, the Grapevine, in May 1947. The sponsor “helps make hospital arrangements, takes his man there, visits him frequently, and sees that he is visited by other AAs.” For those few days the newcomer was, in Bill’s word, the sponsor’s “ward.”
The bills were the trouble. In Cleveland, members put newcomers into Deaconess “without any forethought as to how the bills would be paid,” Al G. remembered. By 1940 they owed $1,200 to $1,400, and paying it off took two or three years. In the big cities, Bill wrote, “Anybody sponsored anybody, and those hospital bills still didn’t get paid.”
Some hospitals told the groups to name members they could deal with, “or else.” So the groups opened small offices, with paid secretaries to line up hospital beds and sponsors. By 1951, Bill wrote, one large office had “sponsored and hospitalized 7,000 alcoholics.”
ListenVisiting hoursAbout 1 minute
It’s the 1940s, at Knickerbocker Hospital in New York. A nurse on the AA ward sees a little man waiting outside with a bag, and she knows the rule: nobody comes onto this ward alone. A member of AA brings you in, and a member of AA takes you home. So she asks him, where’s your sponsor?
The rule had grown up because hospitals didn’t want drunks. They made noise, they slipped away without paying, and they seldom got well. A hospital would take one if somebody it trusted vouched for him, saw to the bill, and kept the visitors coming. That somebody was the sponsor.
In Akron the visitors came from noon until ten at night. In Cleveland the unpaid bills piled up. And the little man at Knickerbocker? He wasn’t a patient. He was the doctor.
Three hospitals, one rule
Three wards
What a newcomer met at three hospitals that took AA’s drunks, from getting in to going home.
From members’ memories in Dr. Bob and the Good Oldtimers (1980), Bill W.’s articles and books, and an account of Knickerbocker’s ward from about 1948 reprinted in Dale Mitchel’s biography of Dr. Silkworth. Where the sources say nothing, the card says so.
Members’ memories
Deaconess, Cleveland, from May 1939
Getting in
A member’s wife, Edna McD., a county visiting nurse, found an administrator willing to try. The first patient, at the end of May 1939, was a bartender.
The visitors
The beds came with visiting privileges for AA members. After the newspaper series that fall, one hospital couldn’t hold all the newcomers, and they went into hospitals all over town.
The bill
Nobody planned for it. By 1940 the members owed $1,200 to $1,400, and raised the money over two or three years.
Going home
The books don’t say.
Members’ memories
St. Thomas, Akron, from August 1939
Getting in
Through Dr. Bob, who “sponsored the new cases into the hospital,” as Bill W. put it. No one was admitted twice.
The visitors
AA members only, from noon until ten at night: at least 15 a day, 60 to 100 in five days. A corridor served as a lounge “where sponsors could visit patients.”
The bill
The hospital’s fees were moderate. Dr. Bob never sent a bill, and Sister Ignatia often took patients on a “pay later” basis.
Going home
With a parting gift from Sister Ignatia, which The flower room describes.
An account of the ward
Knickerbocker, New York, from 1945
Getting in
“The patient is brought to the hospital by his sponsor, an A.A. member.” No one came onto the ward without one.
The visitors
In the ward’s lounge, nicknamed Duffy’s Tavern, patients talked with “their A.A. sponsors, their only visitors.”
The bill
$75 for five days, about 1948. By 1950, Bill reported, the ward’s charges had been “invariably paid, money on the line.”
Going home
“The patient leaves on the fifth day with his A.A. sponsor.”
Somebody to answer
The hospitals didn’t need AA to run their wards; Bill himself said doctoring was “the affair of doctors.” What they needed was somebody to answer for each patient, coming in and going out.
For a closer look
Go deeper
A nurse’s first day at Knickerbocker; how many patients went through St. Thomas; and how the hospitals made the groups organize.
Where’s your sponsor?
“Relax, young lady, I’m Doctor Silkworth.”
His answer, as the nurse remembered it.
On her first day on Knickerbocker’s AA ward, a nurse named Teddy saw “a wistful-looking little man with a red face and blue eyes” waiting outside.
She knew that no one was admitted to the ward without a member of AA. So she told him not to worry, they would take care of him, and asked, “Where’s your sponsor?” She took his bag and was asking for his hat when he answered.
He was Dr. William D. Silkworth, the ward’s doctor, then in his seventies. Teddy wrote the story down herself; Dale Mitchel’s biography of Silkworth prints it.
4,800 or 5,000?
How many alcoholics went through St. Thomas while Dr. Bob lived? Dr. Bob and the Good Oldtimers says 4,800 were admitted under his care. Bill W., writing in 1954, said “more than 5,000” passed through the ward. Neither says where the count came from.
Knickerbocker’s two counts agree with each other. The account of about 1948 gives about 1,200 patients a year. At AA’s first international convention, in Cleveland in 1950, Silkworth’s associate, Dr. Meyer Texon, reported 5,000 in four years, by Bill’s summary.
Every one of those patients had a sponsor. Bill marveled at the ward’s record with the bills: “Who had ever heard of 5,000 drunks who really paid their bills?”
“Or else”
Before the hospitals, Bill wrote in 1951, groups tried tapering newcomers off at home, and the newcomers “tapered on.” Some groups tried AA hospitals of their own, with doctors on call. “All these early attempts were busts.”
When hospitals did open their doors, the city groups made a mess of it. Anybody sponsored anybody, the bills went unpaid, and members told doctors how to run their wards. Some hospitals told the groups that responsible members would have to be named, “or else.”
That pushed the groups into opening offices with paid secretaries, over loud objections. Members feared fees, politics and professionals. In 1957 Bill named the reason they gave in: “Sponsorship into these places and out of them became imperative.”
Sources
Dr. Bob and the Good Oldtimers. AA World Services, 1980. Chapter XIV (St. Thomas Hospital) and chapter XV (Deaconess Hospital and the Cleveland bills).
The Language of the Heart. AA Grapevine, 1988. Bill W., “Adequate Hospitalization: One Great Need” (May 1947), “We Came of Age” (September 1950), “Services Make AA Tick” (November 1951), “Another Fragment of History: Sister Ignatia and Dr. Bob” (February 1954) and “For Sister Ignatia” (August 1966), all first printed in the AA Grapevine.
Alcoholics Anonymous Comes of Age. Alcoholics Anonymous Publishing, 1957. “When A.A. Came of Age” (Cleveland’s hospitals) and “Service: The Third Legacy” (sponsorship into the hospitals, the first offices).
Dale Mitchel, Silkworth: The Little Doctor Who Loved Drunks. Hazelden, 2002. Page 103 (Teddy’s first day) and Appendix C, “Duffy’s Tavern,” pages 174–176: an account of the Knickerbocker ward from about 1948, which Mitchel prints as written by Silkworth and never published.