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This paper approaches the question of engineering from a different angle, namely the construction and design of the infrastructure of care at the turn of the 20th century in the United States. While the design and construction of healthcare facilities for the laborers might seem unlikely topics of importance for mine developers in remote Western territories, modern hospitals were an essential part of the engineered environment in mining camps, a reflection of the dangers inherent in the work but also of a need to develop control over an unstable landscape. Many have dismissed the importance of these hospitals in the West, seeing them as at best a ploy to reduce costs from and reports of accidents and at worst a token façade of philanthropy. While these might be aspects of their significance, the hospitals also served a critical role in claims to American dominance over the landscape in that their creation symbolized the march of Western civilization and progress in the formerly Mexican territories. The hospitals created in Colorado and Arizona rivaled those of more established eastern cities, featuring modern machinery, ventilated wards to combat the heat, and clean, efficient designs, with multiple facilities for varied types of inpatient care, laundry, cooking, and other necessary functions. The importance of these institutions is underscored by their ubiquitous presence in the stockholder reports and advertising, which prominently featured photographs and detailed plans of the highly modern, efficient hospitals and professional staff trained in medical schools, symbolizing both modernity and compassion. The veneer of modernity that these facilities provided belied both the condition of the miners and that of the mines themselves, and also belied the racial and social tensions that shaped the experience of patients and staff within the hospitals.