It was July 7, 1946, and Howard Hughes, internationally famous engineer, film director and business magnate, had just crashed an XF-11 aircraft into three California homes near the local country club. Hughes had walked away from other plane accidents, but nothing like this one. He came out with a crushed collarbone, multiple cracked ribs, a collapsed lung and third-degree burns from trying to maneuver his way up from the wreckage.
Though Hughes didn’t know it, the plane crash would change his life, sending him into a spell of drug addiction and paranoia. It would also, some say, change the American hospital bed industry.
At a nearby hospital, Hughes had a lung drained and multiple blood transfusions. But Hughes, a rich man accustomed to bending the world to his will, didn’t like the bed he was in. So he called in some of his own engineers from Hughes Aircraft to redesign it, reportedly equipping the bed with hot and cold running water, six moveable sections and push-button adjustments operated by electric motors. “I think he left in an ambulance,” an unnamed nurse told the Associated Press at the time, “but I’d believe it if someone told me he flew home in that bed.”
His kitted-out hospital bed drew widespread publicity. Some believe it kickstarted research into improved hospital bed design and spurred a swell of interest in patient comfort. Others doubt that Hughes played much of a role in the creation of the bed, or that the bed really had all the innovative features the newspapers described. After all, separating fact from fiction could be tough when it came to this playboy-turned-billionaire recluse. Even the actual date of Hughes’ birth was disputed.
Whether or not Hughes’ hospital bed was as groundbreaking as reported, he wasn’t solely responsible for the hospital bed revolution of the mid-20th century. A confluence of factors, including newfound postwar healthcare needs, transformed the hospital bed from a place for convalescence into an FDA-approved hub for patient care, simultaneously a site for therapy, connectivity to providers and recovery-hastening comfort.
The first hospital beds
The first modified hospital bed, with adjustable rails that moved up and down, was introduced between 1815 and 1825, according to a Journal of Physics study. Before this innovation, the hospital bed was essentially seen as a piece of furniture, looking much like a scaled-down bed for sleeping. By 1874, the first patent for an adjustable mattress frame was registered. In 1909, Dr. Willis D. Gatch, former chair of the surgery department at the Indiana University School of Medicine, created the gatch bed, with three separate, adjustable segments that allowed both the head and feet to be elevated.
Over the next few decades, the medical community paid little attention to hospital beds, until the post-World War II era, when healthcare priorities shifted from preventing mass death to providing comfort to the living. With growing numbers of wounded people and veterans in chronic pain, hospitals needed better beds — ones that could adjust position and accommodate multiple kinds of patients, from invalids to the elderly.
In addition to its dimensions and its focus on comfort, Howard Hughes’ bed helped popularize using levers to position the patient, says Guillermo Fajardo-Ortiz, a surgeon at the National Autonomous University of Mexico who authored a study on the history of the hospital bed. But “the conventional hospital bed had already begun to be modified after two world wars, to attend to the wounded and fractured,” he says; at the same time, other experts in Europe and America were also playing around with the hospital bed, independently coming up with designs very similar to Hughes’.
One notable innovator was Dr. Marvel Beem. In 1945, he was already selling hospitals a new kind of bed, complete with a built-in toilet and washbasin. That same year, Beem showed off his prototype push-button bed in a LIFE magazine profile. “Invention of Los Angeles doctor eliminates the bedpan,” the article trumpeted.
So why does Hughes get so much attention? “There is some conjecture that Howard Hughes saw that LIFE article and it gave him an idea,” says Hughes biographer Pat Broeske, who co-authored Howard Hughes: The Untold Story. “But I really do think he popularized the notion of the redesign of the hospital bed, and what it could do, that it can be automated.”
Hughes’ notoriety made him uniquely situated to become a hospital-bed influencer; the media was transfixed with him at the time. “The hospital room looked like a who’s who of hot women in Hollywood,” says Broeske. “It was ridiculous, all the women showing up crying and wanting to see Howard.”
Broeske believes that Hughes, a lifelong tinkerer, was personally involved in redesigning the bed. “I think Hughes worked on something that was already being invented,” she says. “There’s a theory sometimes that a time comes for certain inventions, which is why you see multiple inventors working on things. A need arises. Howard was a patient in pain, and he really saw the need for this hospital bed.”
“Howard Hughes’ bed had, from the legends I’ve seen on the internet, lots of different motorized parts and heating and cooling and things that you’d see in beds today,” says Neal Wiggermann, research scientist at Hill-Rom, a company that’s been making hospital beds and other medical products for decades. “It’s a question of whether he invented those things out of thin air, or whether a lot of those ideas maybe existed but he had the means to put them together into a bed.”
Still, Wiggermann says he doesn’t think today’s hospital bed owes much to Hughes. “Maybe some of that technology had an influence somewhere, but I wouldn’t say there’s any tangible evidence of that from my perspective.”
After all, the user-centered design process Wiggermann uses, which involves hours of patent comfort-testing on every bed prototype, is a way to design a bed that can be functional for as many people as possible. “Howard Hughes could just design for one,” he says. “We have to design for all these users, with different body shapes and different patient conditions.”
The modern bed
Hughes may not have invented the modern hospital bed, but he did help drag the notion of patient comfort into the mainstream. But how much does today’s hospital owe to Hughes’ prototype?
After the news coverage died down, Hughes left behind the world of hospital bed redesign forever. A footnote in Richard Hack’s 2001 biography claims that the mattress was eventually discovered in 1976, unused, in a storage locker at Hughes Aircraft.
But while Hughes retreated from the world, the world of hospital bed redesigning had just gotten started. By 1949, controls allowing for upward and downward movement began to appear, and by 1952, Hill-Rom designed the first bed with an electric engine. By 1956, the company built its first bed with full electrical functioning. By 1978, hospital beds had side rails with built-in control pads. The 1980s focused on hospital bed mattresses, equipping them with motion detectors and devices to summon nurses. By 1983, an electric bed for use at home was invented, and by 1993, industry standards for hospital beds were put in place to prevent accidents.
The latest FDA-approved hospital beds can measure a patient’s heart and respiratory rates without any connecting wires or leads. The bed can detect if the patient is starting to exit and alert nurses. Some beds can detect incontinence and help turn patients to prevent bed sores.
According to Wiggermann, the hospital bed will keep getting smarter, until it can predict patient behavior and outcomes, down to how long a patient might be convalescing. The bed of the future is one that prioritizes patient comfort, just like Hughes might have wanted.
“Other technology might come and go,” Wiggermann says. “[Other] things that you see in an ICU room right now might be obsolete in decades, but there’s always going to be a bed.”