"Many of the sisters were excited and all us of had just recently finished our training in Chicago," said Sister Monica. "We were waiting for the sandbags to come so we could immobilize his leg. Instead, the sisters got some bricks, wrapped them in protective cloth and used them to cover his leg. We improvised."
For that first operation, the surgeon didn't have a scrub suit so he borrowed a pair of pajamas from the hospital's chaplain.
"We got 12 patients that next morning," said Sister Monica. "It seemed like we were never tired because we could see the progress."
Nazareth's story actually began in 1936, when the late Reverend Mother Mary Ignatius, Superior Provincial of the Holy Family of Nazareth, saw a need for a hospital in one of Philadelphia's neighborhoods.
Most of Northeast Philadelphia was farmland and many of the roughly 60,000 residents were an hour's drive from the nearest emergency room.
The cost of this new hospital was about $800,000, a far cry from Nazareth's newest $40 million wing but a sizable sum in those days, said Sister Mary Salvatore, a hospital administrator for 33 years. The funds came from the donations and fund-raising of parishioners and community groups.
An eight-floor, 116-bed brick building was built on the former site of an abandoned farmhouse on a pastoral Holme Avenue, just off Roosevelt Boulevard, which was then one lane north and one lane south.
"We were the only hospital between Frankford and Fairless Hills," said Sister Salvatore, president of the Nazareth Hospital Health Care Foundation. ''Pennypack Park was all around us."
Fifty years later, Nazareth hospital is still operating at a time when many other hospitals have failed. Although it did not escape funding pitfalls, Nazareth managed to rise from a fiscal crisis and join other hospitals in offering advanced technology. It also offers many free health-care services to the community.
Angelo DiBella, the physician who heads Nazareth's Family Practice Department, remembers the hospital's earliest days. He was a boy growing up in Holmesburg when it was built.
"From my bedroom, I could see Nazareth being constructed," said DiBella. ''I was about 12 then and people would say, 'What are those nuns putting a hospital in the country for?' "
Less than 10 years later, the "country" was turning into suburbia, with mushrooming residential and commercial growth. By 1950, the Northeast population was at 148,736, and Ward 35 - roughly Frankford and Cottman Avenues to the county line - had become the city's largest, according to a 1951 almanac.
Nazareth also grew. In the early 1950s, it was forced to put patients in the corridors. The resident sisters had to give up the sixth floor to make room for more patients. A convent was built next door in 1952.
The hospital expanded its pediatrics, maternity and nursery units, and added a pharmacy, a laboratory and a special nursery for the premature babies who once had to be sent downtown to the University of Pennsylvania Hospital. The bed count rose to 200.
Other hospitals, such as Holy Redeemer and Lower Bucks, were also cropping up in the area.
"Holy Redeemer was a sister hospital in a way," said Sister Salvatore. ''When they started, we were consulted."
The emergence of these other hospitals had little impact on Nazareth ''because we didn't really have the capacity," said Sister Salvatore.
"We worked according to need and population growth," she said. "The new hospitals were to everyone's advantages. They gave us the capacity to expand."
Despite the influx of other hospitals, unprecedented residential and commercial growth continued to tax Nazareth's capacity. In 1959, the hospital was declared a special-need area by the U.S. Public Health Service and was granted federal funds for a new building.
The St. Joseph's Building, opened Sept. 1, 1963, brought Nazareth to 407 beds, its record capacity. The $11 million project consisted of a new emergency room, a modern laboratory, 11 operating rooms and a revamped recovery room, and new radiology, admissions and records departments.
At that time, the old building was renamed the Marian, after Mary of the Holy Family. Twenty-five years later, Nazareth completed its trinity of buildings by adding the final one, Holy Family Pavilion, "to represent Jesus," said Sister Monica.
Today, the hospital has 347 beds and the latest in technology.
Like most hospitals, Nazareth has also had financial troubles. Because of federal cutbacks, declining admissions and rising debts, the $33 million Holy Family Pavilion almost didn't make it.
Three years ago, the hospital found itself in debt. By 1989, the debt had spiraled to $4.4 million. Nazareth borrowed $5.5 million, trimmed and restructured its staff and, at the bidding of the Philadelphia Hospital Authority, hired an outside consultant to redraw its financial picture.
According to Liz Womack, a hospital spokeswoman, Nazareth also suspended some of its free community services. This and other steps have helped the hospital break even since July.
It was able to finance the Holy Family Pavilion, which opened in spring 1988. The hospital opened a Department of Medical Imaging, armed with the latest technologies in X-ray, ultrasound, nuclear medicine and radiation therapy. The department also included computerized axial tomography (CAT scan) and magnetic resonance imaging (MRI), which helps physicians diagnose and study diseases.
"Our intent is to provide the best diagnoses. That is what our society wants - efficiency, fewer costs. It costs more to come back than it does to sit around and wait for that extra test," said Douglas Cole, a radiologist in the medical imaging department.
Nazareth isn't alone in taking advantage of the new MRI technology, which was developed in the early 1970s, but officials say the hospital has invested heavily in getting the most advanced machinery.
"We're top flight," said Cole. "There isn't anything we . . . have that isn't state of the art. We have not cut any corners."
At one time, the hospital had one room and one machine for medical imaging. Now, in Holy Family Pavilion, there are separate machines - and rooms.
In one room, 10 to 12 mammograms are done a day. Another room is designed specifically for arteriograms - X-rays of arteries obtained after an injection of special dyes. Yet another room is for CAT scans.
"We don't have to take up time and space doing different things," said Christine McCarthy, senior special-procedures technician. "We can handle outpatients, emergency patients, in-patients and take cases on weekends."
Over the years, Sister Salvatore said, Nazareth had expanded its role in the community, offering free screenings for diabetes, breast cancer, glaucoma, cervical cancer, skin cancer and high blood pressures.
That role has been particularly important to women. At one breast-cancer screening, Nazareth included breast examinations, a lecture on self- examination and a discount on mammograms. Among the support groups that meet at the hospital is one that focuses on women's issues and stress- management.
Back in 1940, many of Nazareth's nurses were nuns.
In the words of Sister Clemens, a retired Nazareth nurse, the young nuns ''were a competent nucleus of pioneers."
"Sister Miriam was our first certified X-ray technician. . . . Sister M. Lucian, now retired, . . . started our School of Anesthesia."
Although many of the pioneers of the present are not sisters, they are family.
"I'm not Catholic," said Norma Bock, clinical director of Maternal/Child Health. "In fact, they call me Sister Norma Protestant."
But Bock is right at home at Nazareth. She came to the hospital in 1951 to work for one year. That one stretched into 39.
"During the baby-boom years, we had about 3,500 (births) a year," she said. "I've been through two renovations and the whole gamut of OB-GYN care."
The toughest time was "when the (number of births) dropped so low. It was demoralizing. People were sent to different departments because we didn't have any work for them. We just weren't busy."
During the 1950s, she said, families were bigger - an average of three or more babies a mother - and mothers wanted to be sedated during delivery.
"Now," said Bock, "Mom's awake and Dad's there. We have some cameras. But we do try to get them to be tasteful about it."
While changes have come to Nazareth, one thing has remained constant, officials say. The feel of the place is the same.
"Families work here," Bock said of the husbands who work alongside their wives, and the mothers and daughters, the cousins, the siblings. "And there's a family feeling here. It's the Christian background. Socially, we do a lot of things together, dinner, get-togethers."
In the lobby of the Marian Pavilion, a golden tree hangs on the wall. At its feet, carved in bronze is the Holy Family. Engraved on the fruit of the tree are names of people who have donated money to the hospital, figures averaging in the hundreds of dollars.
This tree of life is symbolic of the order's ministry of health care and education, said Sister Salvatore.
"During the Depression, people gave a dollar, 50 cents," she said. "Our Mother foundress always said Nazareth would grow nickel on top of nickel."