Little is known about the person Anna Seiler. She is the daughter of the councillor Peter ab Berg and childless widow of Heinrich Seiler, hospital master of the Lower Hospital at the lower end of the town, who died in 1338. She probably experienced first-hand the substandard care received by poor patients in hospitals and the devastating plague in 1349. As she has no direct descendants, it is perhaps these experiences that led her to found the Inselspital. The many open questions provide scope for the imagination: In her novel, Therese Bichsel has imagined how Anna Seiler's life might have been.

A few years before the Inselspital was founded, the plague swept through Bern for the first time in 1349 – a third of the inhabitants died of the disease. Until the 17th century, devastating epidemics occurred time and again. The Bernese doctors were powerless and suspected the causes to be pathogenic air, a "plague poison", or the punishment of God. The Church benefited from the crises: Like Anna Seiler, many affected families donated money and property to secure salvation.

In the 15th century, the so-called "Siechenhaus" (infirmary) was built on the north-eastern outskirts of Bern on the Breitfeld for the incurable and chronically physically ill. In the middle of the 18th century, a "madhouse" was also built on the Breitfeld. In the 19th century, there was a reassessment of mental illness: This was now perceived as a social, political and medical problem. As a result, cantonal "insane asylums" were established. This is also the case with the Waldau, which opened in 1955 and also serves as a university hospital [Link Waldau].

Around 1700, the "Schultheiss" (Cantonal Mayor) and the council repeatedly try to improve the conditions for the patients. For example, they prohibited the pharmacist from loud "mortar play" and took action against the "annoying fumes" from the neighbouring dye works. They also prevented the hanging up of laundry in the courtyard of the hospital by outsiders. When numerous "journeymen, craftsmen, servants and young women" attended the sermon, a ban was imposed: The sermon was intended exclusively for the "sick and weak".

Wilhelm Fabry is the best-known Bernese city doctor of the early modern period. Fabry, who was born in Hilden, Germany, did not study at a university, but completed a professional apprenticeship as a wound doctor. After his period of travels, he worked in Cologne, Lausanne and Payerne and was finally appointed "Medico and Chirurgo" of the city of Bern in 1614. His numerous textbooks, which have been published several times, have earned him recognition far beyond Bern – for example on gangrene, field surgery or bladder stone incisions.

In the 17th century, the hospital was run by the so-called "Inselmeister". A scribe, a servant, a house servant and gatekeeper, a baker, a cook and three maids would assist him. In total, the hospital team comprised 17 employees. A stately number of staff when compared to the almost 40 patients and the four nurses. However, this was necessary because the barter economy still prevailed.

Even Bernese people often don't know this: Where the "Inselspital" stood for centuries, today lies the "Bundeshaus Ost". The name "Inselgasse" still remains from the hospital. After the sale of the land to the Confederation and the demolition of the hospital building in 1887, the Bundeshaus Ost was built by 1892. During the most recent renovation from 2012 to 2015, archaeologists uncovered the spacious cellar complex where the hospital foundation trust stored donations in kind such as grain and wine.

Albrecht von Haller (1708-1777) was a physician, anatomist, experimentalist, botanist, poet, critic, magistrate and probably the most important Bernese scholar to this day. Haller and Bern – not always an easy relationship. His expertise in salt extraction, orphanage planning or impending epidemics were greatly appreciated, but the rigid power system did not allow him to rise to the highest offices. Later, he was placed on a pedestal and positioned in front of the university's main building as a leading figure of modern research. Today, people are more reserved with role models: He now stands a little further removed and receives less attention.

For centuries, the hospital was an independent foundation that ensured free nursing care. After the foundation of the canton and the university, however, complicated questions arose regarding financing and administration. With the so-called "Dotationsvergleich" (endowment settlement) of 1841, the canton and the civil community went on to clarify different responsibilities. The Inselspital went on to become an "independent institution with the right of incorporation", with the right of supervision resting with the cantonal government. From 1877 onwards, the state contributed an annual sum of 25,000 Swiss francs to the training of future doctors. However, discussions about state participation continued. The annual flat rate increased again and again until, in 1959, the state took over the operating costs of the clinics completely.

In the mid-18th century, the main estate belonging to the Inselspital also included vineyards, forests, mills and alps in addition to the large building. The Alps, in particular, guaranteed regular interest income. The Blapbach Alp has been owned by the hospital since its foundation. Anna Seiler donated the alp in the upper Emmental. For a long time, access was awkward. In 1839/40, therefore, farmers – with financial support from the Insel – blasted a tunnel through the Girsgrat with "Bern powder", which is considered one of the oldest road tunnels in Switzerland.

The reasons for the new building: Lack of space and poor hygienic conditions. Time and again, the hospital had to turn patients away. When the façade recesses were removed to gain more space, the light and air supply deteriorates. The neighbourhood was also considered problematic: On market days, horse manure on the north side and smoke from the gasworks on the south side made for "bad air". The unhygienic conditions were held responsible for the high mortality rate during operations. The Medical-Surgical Society of the Canton of Bern, therefore, proposed a new building as early as 1867, to no avail, and in 1878 Theodor Kocher, as Rector of the University, also pleaded for a contemporary hospital.

The new Inselspital no longer consisted of one large building, but of several smaller pavilions arranged symmetrically. The administration and financial management buildings were now on a central axis, and those of the surgical and medical departments to the side. On Freiburgstrasse, there were now the double pavilions for the non-clinical departments (without teaching), while behind them were the double pavilions for the clinical departments (with teaching), in which a lecture theatre was also integrated. This loose arrangement of buildings corresponded to the style of the time. It was intended to prevent infections and contribute to recovery with a park-like atmosphere.

Helicopters taking off, rattling rotors: Air rescue is clearly visible and audible on the hospital grounds today. In 1984, the Inselspital concluded an agreement with REGA for the first time. But it was not until 1993 that a contract satisfactorily regulated the deployment of emergency doctors for both sides. Since 2000, the helicopters have landed on a platform above the Inselspital emergency centre.

As early as the early 19th century, the hospital’s management body began to think about efficient patient transport. In 1829, it commissioned a model of a carriage for the then proud sum of 382 francs. The dimensions were enormous: There would have been room for 42 patients to be transported to Schinznach-Bad for a spa treatment. It all came down to the model – the Grand Council decided against the giant carriage and in favour of several, smaller carriages.

Theodor Kocher, professor of surgery in Bern from 1872, shaped not only Swiss but also international surgery for decades. Despite numerous professional opportunities abroad, he remained loyal to Bern and made a lasting commitment to the university and the Inselspital. With aseptic measures, methods of haemostasis or his "surgical operation theory", he strived to achieve safe surgery.

In 1935, Kocher's successor Fritz de Quervain produced a film that offers real insight into everyday hospital life. Surgeons in white clothes, microscopic examinations in the laboratory or X-rays. Even though the film's soundtrack has not been preserved, the message is clear: Around 1930, medicine was no longer a craft, but a science.

In 1918, medical scientists knew the concept of infectious diseases, but disagreed on what exactly was responsible for infection. Bernese researchers provided a number of different explanations. The bacteriologist Georg Sobernheim detected the so-called Pfeiffer's bacterium in many of the patients. Hermann Sahli also argued in favour of a bacteria-based analysis and attributed the disease to a mixture of bacteria and the toxins they secrete. Sahli used the term "virus" (Latin for "poison"), but did not mean pathogens that are even smaller than bacteria. It was not until 1933 that the influenza virus was discovered and postulated as a plausible cause of influenza illness.

The government banned public gatherings, closed schools and isolated patients to contain the epidemic. Doctors disagreed about the benefits of the mask. Dr. Hegg, an ear, nose and throat specialist at the Inselspital, recommended folding moist cloth material and inhaling Vioform powder. Hermann Sahli wanted to get to the bottom of the matter. He had all available masks tested and came to the conclusion that they were completely permeable and, therefore, useless. Therefore – according to Sahli – the "grotesque image of a muzzle-wearing public without hygienic remorse" was able to be dispensed with.

As late as 1918, Hermann Sahli began to develop a vaccine serum with Georg Sobernheim. Bern was ideally equipped for life science work involving animals. However, because animals were considered barely susceptible to vaccination, Sahli conducted the trials directly on every second patient at his clinic. The results of these trials were inconclusive. Soon, therefore, he had to conclude: "The decision, I believe, must be postponed until a subsequent epidemic. Because we are simply too late with our attempts. The epidemic is beginning to wane, a large proportion of humanity has already been naturally exposed to it and become immune." The situation was similar for numerous researchers who were carrying out similar experiments all over the world.

The process of increasing specialisation did not go unchallenged: A prominent critic of "specialism" is Hermann Sahli, who was director of the medical clinic of the Inselspital from 1888. He was an advocate of holistic internal medicine and was committed to strengthening the role of general practicioners. To this end, he wrote a comprehensive, near 3000-page textbook on diagnostic methods and developed simple but reliable instruments, such as the haemometer for measuring haemoglobin content.

The construction of the Lory-Spital was made possible by the Bernese merchant Carl Ludwig Lory. In 1909, he bequeathed three million Swiss francs to the Inselspital for future expansion. However, he set a number of conditions: The operation of the structural extension must be secured. Due to a lack of materials and a tight financial situation, however, construction activity came to a standstill during the First World War. It was not until the "Inselhilfsgesetz" of 1923 and the new state treaty that a comprehensive building programme became possible.

During the building programme of 1925, the Bernese state undertook to modernise the surgical clinic. This was because, as was the case under Theodor Kocher, the spatial conditions of the surgery were considered insufficient. After Kocher's successor Fritz de Quervain advocated structural measures, at first a study and then a new building were commissioned. The new, four-storey building from 1931 was simple and functional. The operating theatres were located in a greenhouse-like porch and there is a sunbathing terrace for patients on the flat roof. By the early 1960s, the clinic had to make way for the new Operating Theatre West.

For a long time, most of the women worked in nursing, housekeeping and the kitchen. In 1927, Rösli Tschudi, a nurse at the hospotal, was employed for the first time, followed by Maja Thut, a physiotherapist, in 1933. Both welfare and physiotherapy were typical fields of work for women in the early 20th century. In the second half of the 20th century, the first women were appointed to leading positions – for example, as laboratory assistants, dieticians or head nurses. Women doctors, on the other hand, remained outnumbered for a long time. As late as 1954, there was exactly one female doctor at the Inselspital.

Bern was one of the first universities to admit women to medical school. However, female doctors at Inselspital remained the exception. Elsbeth Köng was one of the first female senior doctors. In 1955, she set up a counselling centre for children with cerebral movement disorders – especially after polio – in the basement of the Inselspital. At the beginning of the 1960s, the post was officially integrated into the Inselspital with Elsbeth Köng as head physician. The men, however, remained the large majority for a long time. As late as 1970, there were 107 senior male doctors compared to only five senior female doctors.

In 1961, the nurses' and staff house were opened. This was to improve the conditions of employment. The hospital specifically recruited migrant women – especially from Spain and Greece – for housekeeping and kitchen duties.

The patients of Inselspital also always reflected underlying social developments. With increasing immigration, the proportion of migrant women patients also began to increase. As early as 2005, every fifth patient in the Inselspital was not born in Switzerland. The Confederation, therefore, began pursuing a strategy of creating a health system that meets the needs of a society that is changing as a result of migration. The Inselspital, for example, began using translations to try to make health services accessible without language barriers.

In the 1960s, passenger traffic increased strongly, and not only in Bern. More and more people now owned their own car. For decades, the hospital management has had to deal with the "parking problem". Finally, in 1995, the multi-storey car park on Murtenstrasse was opened, alleviating the lack of parking spaces. At the same time, the use of public transport was being promoted. As early as the 1940s, the Inselspital was connected to the trolley bus network found in the city of Bern.

The ophthalmologist Hans Goldmann (1899-1991) developed diagnostic equipment for ophthalmology in collaboration with the Bernese company Haag-Streit in the 1940s and 1950s. These include the perimeter for measuring a person’s visual field, the slit lamp for detailed illumination of the back of the eye and the tonometer for measuring eye pressure. They contributed not only to the renowned status of Bern ophthalmology, but also to the economic success of local medical technology. All three devices are still manufactured today on the basis of Goldmann's principles and are in use worldwide.

This high-rise tower for hospital beds is an expression of the intensive construction activity at the hospital Bernese voters approved loans for a complete renovation. In several stages, operating theatres, the polyclinic, research and service buildings as well as staff quarters would go on to be built. In this way, hospital management was trying to align the hospital with the requirements of the times.

New buildings need space – and older ones have to make way. The administration building with the patient admission, the laundry and the central kitchen with its striking boiler tower are demolished in 1964 to make room for the planned high-rise hospital bed block.

A stay in a university hospital offered one great advantage: Patients would receive the best medical care available. However, there was also a downside: They would become objects of examination and study for medical students. In the past, patients were often presented in the lecture hall in front of a large audience as a scientific case. Today, greater emphasis is placed on respectful interaction and learning in small groups.

In the second half of the 20th century, the hospital greatly expanded its training offer – mainly in response to the shortage of personnel. The older midwifery school or the vocational school for medical gymnastics were supplemented by a school for nurses, a school for dieticians, a school for nutritionists or a school for medical-technical radiology. For a long time, the schools were housed in temporary facilities. It was not until 1996 that the training centre was able to be opened on Murtenstrasse.

Only part of the infrastructure and technology was visible to the patients. The various hospital buildings were connected underground by a tunnel system. In it, employees were able to cross almost the entire area on foot, on bicycles or by electric vehicle and other means of transport. It has been in operation since 1970 and remains indispensable today: The pneumatic tube delivers medicines or laboratory samples quickly and reliably.

Will lab samples come by airmail in the future? This is quite possible, but remains a pipe dream. In 2018, Inselspital began conducting a pilot test with drone transport operations between Insel and Tiefenau Hospital together with Switzerland’s postal service. However, the hospital will refrain from regular operations until further notice – not least for safety and security reasons.

The new children's clinic is a real showpiece. For the "Year of the Child", Swiss President Hans Hürlimann and his wife Marie Theres were given a tour around the premises. In June 1979, there was even a royal visit: Ettore Rossi guided the Spanish Queen Sophia through the children's clinic, which was inaugurated a year earlier, to great publicity and media attention.

There is evidence of a library for the hospital patients since the 1930s. In 1948, the hospital librarian already had 2210 books at her disposal, which she would bring to the various wards with the book trolley. The novels, stories, guidebooks or language textbooks were not only intended to entertain, but to help make good use of the time spent in hospital.

The kitchen from 1884 was originally designed to cater for just 400 meals. In the following decades, as the number of patients increased, so did the number of food portions. Around 1960, the kitchen is overloaded, with almost 900 meals being prepared, meaning a new building had now become unavoidable. In 1964, the new restaurant building and the new kitchen were finally ready for use. Thanks to additional kitchens, for example, in the paediatric clinic, further innovations such as the first tray conveyor belt in Switzerland in 1965 or an electronic ordering system, the further increase in demand was able to be met.

In the 1960s, the laundry service in the utility building was no longer able to cope with the increasing demand. Professional laundry needs, in particular, had increased significantly. The Inselspital, therefore, founded a central laundry function together with the city and the canton in 1969. Scandinavian countries that successfully set up large laundries for homes and hospitals served as a model.

At the end of the 1980s, the Bernese Grand Council allocated more than six million Swiss francs for the purchase of an MRI scanner. A special building has to be erected in the car park of the Inselheim, where the device would later be put into operation in 1989. The device renders tissues and organs visible and would thus complement the traditional X-ray technique.

Until the 1980s, surgeons had to resort to the knife for the removal of kidney and bladder stones. In 1985, Inselspital put the first kidney stone crusher into operation. The huge device treats kidney stones without any need for surgical intervention: A crane would lift the patient into a large tub filled with water. The staff uses X-ray equipment to locate the stone before firing shock waves that shatter it.

In the early summer of 1987, a notorious prisoner paid a visit to the Inselspital: The "breakout king" Walter Stürm was transferred to Bern by helicopter due to his hunger strike. Since 1971, there has been a prison ward underground, in the premises of the emergency hospital. Stürm complained about the missing windows, but was otherwise considered a model patient. In July 1987, after more than three months, he broke off his hunger strike. His protest, however, did not remain fruitless, at least for the Inselspital: A walking yard was later added to the prison ward.

Even as far back as the early 20th century, Bernese doctors were highly respected: Nadezhda Konstantinovna Krupskaya, married to Vladimir Ilyich Lenin since 1898, suffered from Graves' disease of the thyroid gland. While in exile in Switzerland, she had her goitre successfully removed in July 1913 at the Inselspital or Theodor Kocher's private clinic. As she continued to suffer from the illness, she also turned to Hermann Sahli, who examined her shortly before her return to Russia in 1917 and prescribed sedatives and sleeping pills.

The Inselspital, built in 1884, was expanded over the course of 100 years with ever more new institutes and clinics. Since the 1990s, the approach to planning took a different course. The idea now was to create large, flexible buildings that you can "fill" differently depending on your needs. Medicine is today characterised by an increasing number of specialties, but this does not mean more and more new special clinics. The disciplines are increasingly being brought together in centres. This approach promotes interdisciplinary cooperation.

It is not only the Inselspital premises that are changing – the organisation is also undergoing adjustments. In 2009, the cantonal government decided to merge Inselspital with Spital Netz Bern AG with the aim of strengthening Bern as a medical centre and optimising rising costs. In 2016, the Inselspital and the hospitals of Spital Netz Bern AG finally merged to form Inselgruppe AG.