Dr. Wade St. Clair did not venture far from home when he opened his practice in the growing town of Bluefield in 1902. A native of neighboring Tazewell County, Virginia, he attended the University of Virginia's Medical College and completed postgraduate training at New York's renowned Polytechnic Clinic. He also pursued additional training in the hospitals of Vienna, Austria, enjoying the benefits of an outstanding education that qualified him to set up practice in any community in the United States. By selecting the Bluefield area, he maintained family connections and positioned himself to take advantage of the financial benefits offered by the expansion of the coal economy.
To pursue his ambitions, St. Clair joined with an outsider, Francke Fox, to set up the Bluefield Sanitarium. Fox, who hailed from North Carolina, was the son of a physician. A graduate of the University of Virginia who completed his medical degree at New York University, Fox established his first practice in Waynesboro, Virginia, in the Shenandoah Valley. This enterprise failed to prosper, however, and in 1892, he accepted a contract with the Norfolk and Western Railroad to care for its employees in the Pocahontas Coalfield.
Fox and St. Clair combined to establish Bluefield's first hospital in 1902, an institution that eventually developed into one of the most modern and progressive in the region. When they expanded the facility in 1914, the doctors took advantage of the financial success achieved by St. Clair's father, a native industrialist who had profited from the region's development. Alexander St. Clair, who continued to reside on the family farm in Tazewell County, became a partner in the corporation established to fund the new facility.
Through their partnership, St. Clair and Fox achieved the prosperity available to those physicians, whether local or newly arrived, who exhibited a willingness to treat medicine as a commercial enterprise and to pursue financial success aggressively. The Bluefield Sanitarium grew into a thriving business that offered miners and their families unique opportunities for medical and hospital care and illustrated the creativity and vigor of educated physicians' new medical ideas.
During the 1920s, the most impressive high rise in Bluefield history was built, the twelve story opulent West Virginian Hotel, now the West Virginia Manor and Retirement Home. In 1924, nearby Graham, Virginia decided to rename itself Bluefield, Virginia to try and unite the two towns, who had been feuding since the civil war. Nobel-prize-winning economist and mathematician John Forbes Nash was born in Bluefield in 1928.
The Great Depression however, broke the city's back. With the government nearly bankrupt, and series of devastating structural fires that swept through the downtown area and nearly took down every high rise the city had so feverishly built, the city was nearly destroyed.