In Laurie Halse Anderson’s novel *Fever 1793*, Bush Hill is a mansion on the outskirts of Philadelphia that has been converted into a hospital for yellow fever victims. It’s a real place, and Anderson draws heavily on historical accounts to portray it. In the story, the main character Mattie Cook ends up at Bush Hill during her illness, and her time there becomes a turning point in the plot. Understanding what Bush Hill actually was, and why people were so terrified of it, adds a lot of depth to what happens in the novel.
The Real Bush Hill Estate
Bush Hill was originally the country estate of Andrew Hamilton, a prominent Philadelphian. The grand house sat about a mile north of City Hall, on land that today falls near Buttonwood Street between 17th and 18th Streets in the Spring Garden neighborhood. The property covered roughly 153 acres, stretching from 12th to 19th Streets. When yellow fever swept through Philadelphia in the summer of 1793, city officials needed somewhere to isolate the sick, and Bush Hill’s size and distance from the city center made it the obvious choice. It was quickly turned into a makeshift hospital.
Why People Feared Being Sent There
In both the novel and real history, Bush Hill had a terrifying reputation. In the early weeks of the epidemic, the hospital was barely functional. Almost no one was willing to work there because fear of infection was so overwhelming that neighbors wouldn’t even visit each other, let alone care for strangers who were actively dying. The few attendants who did show up were, by most accounts, unqualified and neglectful. Publisher Mathew Carey, a contemporary observer, described Bush Hill as “a great human slaughter house.” The dying and dead were mixed together in the same rooms. Basic sanitation was nonexistent, with human waste left in the open. Staff reportedly helped themselves to food and supplies meant for patients.
The terror surrounding Bush Hill extended beyond what happened inside. People were so afraid of the fever that orphaned children who had been near the sick were turned away from homes. Being sent to Bush Hill felt like a death sentence, and in the novel, this dread is something Mattie and other characters experience firsthand.
It’s worth noting that some historians believe Bush Hill’s early reputation was partly fueled by gossip. Carey, Benjamin Rush, and other prominent figures who wrote about its horrors didn’t actually spend time inside the hospital during its worst period. Their accounts, while not necessarily wrong, were secondhand and possibly exaggerated.
How Bush Hill Was Transformed
The hospital’s turning point came when two volunteers stepped in to manage it. Stephen Girard, a French-born merchant, and Peter Helm, a German-born barrel maker, took charge of daily operations. Girard’s most important move was hiring Jean Devèze, a French refugee doctor who had treated yellow fever patients in the Caribbean colony of San Domingue (modern-day Haiti). Devèze brought real experience with the disease, something almost no American doctor had at the time.
Devèze’s approach focused on supporting patients’ bodies rather than weakening them. He used cold baths to manage fevers, along with quinine, tonics, and stimulants. He organized a proper staff of nurses and apothecaries. By October, Bush Hill had become an efficient, functioning hospital that successfully treated large numbers of sick Philadelphians. The transformation was dramatic: a place that had been synonymous with death became one of the few places in the city where patients actually had a chance of recovering.
The Medical Debate in the Novel
Anderson weaves a real historical conflict into *Fever 1793* through Bush Hill. The French doctors at the hospital practiced a very different kind of medicine than Philadelphia’s most famous physician, Benjamin Rush. Rush believed in aggressive bloodletting and purging, draining patients of blood and giving them powerful laxatives to force out the disease. These treatments were brutal and often left patients weaker than the fever itself did. Rush trained Black volunteers to administer his methods when he couldn’t keep up with the number of sick.
In the novel, when Mattie arrives at Bush Hill, she encounters the French doctors and their gentler methods. This contrast between the two medical approaches is something Anderson highlights deliberately. Mattie’s experience at the mansion exposes her to the idea that the widely accepted treatments might not be the best ones, a realization that mirrors what actually happened historically as Devèze’s patients fared better than many of Rush’s.
Bush Hill’s Role in Mattie’s Story
For Mattie, Bush Hill is both a place of crisis and recovery. She arrives there sick with yellow fever, facing exactly the kind of fate that terrified every Philadelphian in 1793. But because the novel takes place after Girard and the French doctors have improved conditions, her experience is not the nightmare that the hospital’s early reputation would suggest. Anderson uses the setting to show how the epidemic brought out both the worst and the best in people: the neglect and chaos of the early hospital alongside the courage of those who volunteered to fix it.
Bush Hill also serves as a dividing line in the novel’s plot. The Mattie who leaves the hospital is harder and more independent than the girl who entered it. She has survived the fever, which means she is now immune, and she returns to a city that has been completely reshaped by the epidemic. The mansion functions as the story’s pivot, separating Mattie’s relatively sheltered life before the fever from the harsh reality she faces afterward.