The 1920s are romanticized as a simpler time, but changes were beginning then that lasted through the 40s. 1923, America was still recovering from its participation in the First World War. Extreme luxury and extreme poverty existed side-by-side, champagne fountains and soup lines. After the stock market crash of 1929, even former executives were on the street selling apples. Space was tight at Clark Memorial. Despite improvements, the hospital only had 35 beds.
One of the most difficult times for the hospital was the Great Flood of 1937, which forced it to close for more than two months. Spring Street languished in 20 feet of water. At its worst, the flood swelled to 80 feet deep. Buildings were lifted off their foundations and floated downstream. The Ohio River claimed 135 lives and one million people were left homeless.