Note: I've relied heavily on P. Preston Reynolds' excellent history of Watts Hospital - "Watts Hospital: 1895-1976. Keeping the Doors Open." in writing this entry. It's the best place-based book about a structure/set of structures in Durham - I highly recommend it for further reading if you are particularly interested in the hospital/hospital campus.The original Watts Hospital - Durham's first hospital - had been established by
George Watts on February 21, 1895 to provide hospital care to white men and women of Durham. The original hospital was a frame 'cottage' hospital located at the corner of Guess Road and West Main St.
Within 10 years, patient demand had outstripped the capacity of the old hospital. Watts made plans to expand the hospital on site, and engaged the firm which had designed the original hospital - Rand and Taylor of Boston, MA. Taylor, however, came to Watts with a proposal for an entirely new hospital - ambitious in scale and far from the "smoke, noise, and trains" in town. Taylor evidently placed multiple petri dishes around Durham, and chose the site that grew the fewest bugs - a 56 (or 43, or 60, depending on the source) acre tract at the northwest edge of town - outside of city limits, actually, in West Durham. The site was a "splendid grove of oak and hickory."
Ground was broken in May 1908, and the hospital was dedicated on December 2, 1909. Watts spent $217,000 on the site and construction.

Under construction, looking northwest from Broad St., 1909.
(Courtesy Duke Rare Book and Manuscript Collection - Chamber of Commerce Collection)
The initial complex consisted of 5 buildings: an administration building, operating building, power house, laundry, and one patient pavilion.
Per Reynolds:
".. all the buildings were constructed of fire-proof materials. The front lobby walls were paneled in quarter-sawn oak.... The new features in the administration building included a small isolation ward of two beds and a pathological and bacteriological laboratory, which the architects thought was the first of its kind 'outside of the large cities of the South'. Near the main kitchen was a separate diet kitchen for the nursing students and another eating area for the [B]lack employees. The second floor accommodated private patients and maternity patients who were separated from one another by stairs, a nurse's station, and an elevator. The third floor provided living quarters for the nurses. Not counting infants, this building could hold 45 patients."
"The patient pavilion was two stories high and housed 14 patients on each floor. A dining room for the convalescents, a ward kitchen, elevator, work rooms, solarium, and balcony completed the picture."
"The operating building had an ambulance entrance, rooms for major and minor surgery, and a separate area for the care of accident victims. Builders installed a skylight in the major operating room to provide adequate light. The x-ray room opened to the surgical suites. The walls and floor were of marble, tile, and terrazzo."

Watts Hospital from Broad Street
(Courtesy Duke Rare Book and Manuscript Collection)
The Watts-Hill families completed at least three other structures in a similar style to Watts Hospital:
the Hill House,
the Temple Building, and
the Beverly Apartments. The last of these structures was given to the Board of Trustees of Watts Hospital in 1911 as an additional source of income.
As at the original Watts Hospital, a nurse training program was an essential part of the facility. A nurses' home, named Wyche House after the 6th hospital administrator and nurse supervisor, Mary Wyche, started construction soon after completion of the original facility, and was completed in 1910 for $45,000. A separate patient pavilion for women was completed in 1911, also at a cost of $45,000.

Watts Hospital, 1915. From right to left: Wyche House, the administration building, the men's pavilion, and the women's pavilion.
(Courtesy Duke Rare Book and Manuscript Collection)
George Watts provided additional funds to expand the laboratory and the x-ray department in 1919, as part of his ongoing quest to create facilities at Watts Hospital that were the equal of the northeastern hospitals that the wealthy of Durham had previously traveled to for treatment (particularly Johns Hopkins)

Watts Hospital, Main entry from Broad Street, ~1920.
(From "Watts Hospital: Keeping the Doors Open" by P. Preston Reynolds)

Looking northwest, 1920s.
(Courtesy State Archives of North Carolina)
He began to pull back from active involvement in the hospital as his own health began to fail that same year;
John Sprunt Hill, his son-in-law, stepped in to many of Watts' responsibilities that same year. Watts' last living efforts for the hospital were attempts to work with President William Preston Few to establish a medical school for Trinity College, a school which would utilize Watts Hospital as its teaching facility. Watts' death in 1921 stymied this effort.
Watts provided shares in the British-American Tobacco Co. and $200,000 to the hospital in his will. He stipulated that the hospital should construct a new patient wing to honor his first wife, Laura Valinda Beall Watts.
John Sprunt Hill took the mantle of President of the Board of Trustees after Watts' death, and began to champion the cause of a medical school affiliated with Watts Hospital. He devised the "Durham Plan" to establish the North Carolina Medical School in Durham. The state legislature would issue $4 million in bonds, $4 million would be collected from private sources, and Watts Hospital would provide $1.5 million. However, Hill suddenly dropped the campaign - at about the same time that James B. Duke asked Hill to help him craft the charter to establish the Duke Endowment.
A third generation of Watts-Hill joined the stewardship of Watts Hospital in 1925 when George Watts Hill became chairman of the building committee. Soon after, the hospital board began the work to expand the hospital with the new patient pavillion; they hired Taylor (by then Taylor and Kendall) to design the patient pavilion provided for by George Watts' will. The Valinda Beall Watts Pavilion was completed in 1927; it served urology and pediatrics, and had 50 private rooms, along with a kitchen serving the private patients. A radiology suite was constructed in 1934.
Per the Durham Centennial Edition in 1953 "two additions" to Watts Hospital were built by contractor George W. Kane, but I'm not sure which two.

Aerial view of Watts Hospital looking northwest, including the newly completed Valinda Beall Watts pavilion, late 1920s.
(Courtesy The Herald-Sun)

Valinda Beall Watts pavilion, 1930s
(Courtesy Durham County Library - North Carolina Collection)

West entrance to Watts Hospital, late 1920s.
(Courtesy Durham County Library - North Carolina Collection)
New competition was afoot for Watts Hospital; James B. Duke's endowment of Trinity College to become Duke University provided for the establishment of a medical school and hospital with the new university campus. Watts Hospital had no explicit role in the new medical school when Duke Hospital opened in July 1930. But the attraction of new medical professionals to Durham, particularly specialists, proved somewhat of a boon initially for Watts as the new staff often practiced at Watts as well. Soon, however, competition was acute, as Duke and Watts both opened outpatient clinics in 1931. Duke clearly did not mean to steer clear of the role of community hospital.
Interestingly, Durham had always provided minimal support for the hospital, which George Watts had stipulated should provide care to the community regardless of a patient's ability to pay. City and County donations to the hospital to offset charity care covered ~ 1/3 of the costs in the early 1930s. As the cost of medical care continued to grow, ironically, with the successful treatment of acute disease and rise in preventive care, hospitals nationwide, including Watts, would grapple with how to procure sufficient funding.
Watts Hospital was in somewhat of a unique position because of its First Family, the Watts-Hills, and their explicit involvement in the formation modern health insurance. I've written a bit about this on
my post about the George Watts house (Harwood Hall), which would become the site of the Hospital Care Association building by the 1960s. This organization would later become Blue Cross-Blue Shield of North Carolina.
Watts would also play a role in training nurses during World War II - a significant mobilization of Federal funds into health care and medical training. In 1945, the Hill House - a dormitory and classroom building for the nursing school - was built to the west of the earlier Wyche House, funded primarily by Federal funds. The passage of the Hill-Burton Act in 1942 would provide for Federal funding to support construction of hospital facilities nationwide.

1938 view of West Club Blvd, with the hospital grounds to the left.
(Courtesy Duke Forest Collection)

1945 aerial, looking west-northwest, showing the new Hill House to the north of the original hospital wings.
(From "Watts Hospital: Keeping the Doors Open" by P. Preston Reynolds)

Old Administration Building, 1950s
(Courtesy The Herald-Sun)
In 1953, a George Watts Carr designed addition, which included a new emergency room entrance, main entrance, modern delivery/operating rooms, new xray, lab, and kitchen facilities, as well as 100 new beds was constructed west of the Valinda Beall Watts Pavilion. The addition cost $2,577,000 to build, and opened on December 20, 1953.

(Courtesy John Schelp)

(Courtesy The Herald-Sun)

Construction of new emergency entrance, 08.29.56
(Courtesy The Herald-Sun)
The increasing reliance on Federal and state funding to support capital and operating costs at Watts would also, eventually, lead to the ultimate demise of Watts hospital, as Federal legislation - including the Civil Rights Act of 1964 and the enactment of Medicare in 1965 - would demand that hospitals be racially integrated.
Like most institutions in Durham, the hospital system was racially segregated - Watts had, until the 1960s, always served only white patients. One of the more unique things about Durham has always been the strength of the African-American community during the segregation era; when Watts had originally proposed adding a wing to Watts Hospital to treat African-American patients in 1900, he was persuaded by the African-American community that this was not in their best interest. The better solution would be to construct a hospital where African-Americans could both be seen as patients
and be medical providers. The result was the construction of the
original Lincoln Hospital in 1901. Lincoln grew and prospered as an institution and moved to
new, larger quarters on Fayetteville St. in 1925.
This led to interesting motivations in the move towards desegregation in the 1960s. By that time, despite large additions to both Lincoln and Watts Hospitals in the 1950, the two were providing hospital facilities to Durham that would be difficult to retrofit for evolving patient needs/desires.
As the larger of the two institutions, with greater room to expand, Watts was seen by the white community as the natural location for an expanded, consolidated hospital for Durham. A Hospital Study Committee also found that the patient census at Lincoln was low. Duke Hospital had always treated both whites and African-Americans, although it was internally segregated. But Duke had fully integrated its patient services in the 1950s.
Like many of the segregated institutions of the African-American community, Lincoln was no longer exclusively, or even widely patronized by the 1960s. The migration of the African-American consumer to new choices meant the demise of many retail establishments, as well as institutions such as Lincoln. Like much of Hayti, though, community leaders attached an understandably fierce pride to Lincoln, and the symbolism attached to its proposed closing was powerful. Fear regarding the adherence of Watts to a true integration of patient services, with equal care provided to African-Americans and whites was quite real.
In October 1964, the Watts Hospital Board of Trustees voted 7-4 to integrate Watts Hospital.
A $15 million bond was proposed to enact a plan proposed by the Health Planning Council, a group comprised of leaders from both Watts and Lincoln Hospitals as well as others. The plan would involve the expansion of a now-integrated Watts Hospital to become the primary hospital for the community. Lincoln would have reduced services, but continue to exist with some upgraded facilities. From the start, the bond issue struggled. Durham has had multiple instances, to this day, where the African-American community and the conservative white community find their interests aligned. This was one of those instances - the conservative white community (represented by the "White Citizens Council") objected to a single primary hospital for both the white and African-American community, as they favored segregation. The African-American community (represented by the then-"Durham Committee on Negro Affairs") also objected - because of the reduced role for Lincoln.
The bond issue was soundly defeated in November 1966.
A multi-racial Hospital Study Committee was set up, which recommended the construction of a new hospital, and the conversion of Lincoln and Watts into extended-care facilities. This initially also met with opposition, but eventually all parties agreed to the need for a new facility, after assurances that it would provide equal integrated facilities for African-American patients and medical staff. The $20 million bond measure passed by a 2-1 margin on November 4, 1968. This would lead to the construction of
Durham County General Hospital on the former County Home site on N. Roxboro Road. Seemingly, the only way to move past the old divide between Watts and Lincoln was to start anew. This facility would be renamed Durham Regional Hospital in the 1990s.
(Reynolds does a wonderful job breaking down the political motivations and perverse incentives at play during the push to both grow Durham's hospital facilities and integrate them at the same time. )

Main entrance, 07.17.70
(Courtesy The Herald-Sun)
The new hospital was completed and ready for patients in 1976. On October 10th of that year, all patients were transferred from Watts to Durham County General. (Patients at Lincoln had previously been transferred to Watts in September of that year.)
Watts was never transformed into a health facility - administration offices and the nursing school remained on site until the early 1980s. It presented an ideal venue for another institution, however.
The idea of a 'magnet-school-for-North-Carolina' originated with Governor Terry Sanford, and was continued by Jim Hunt. In 1977, the goal of establishing a public, residential high school that would attract talented students from throughout the state was brought before the General Assembly. In June 1978, the GA approved $150,000 in funds to begin a search process for a suitable site and establish the school. In November 1978, Durham was named the host city for the school, which would be known as the North Carolina School of Science and Math.
In September 1980, the school opened its doors with 150 high school students -the first state residential high school of its kind. It currently serves 650 high school Juniors and Seniors from throughout North Carolina with a specialized curriculum in math and science.

Former Watts Hospital Administration Building, 09.12.09

Former Men's Patient Pavilion, 09.12.09

Former Women's Patient Pavilion (left) and X-ray pavilion (right), 09.12.09

Former Wyche House/Nursing Students' Home, 09.12.09

Former Valinda Beall Watts Pavilion, 09.12.09

1953 "Brick Addition" to Watts Hospital, 09.12.09
Below, a drawing that NCSSM handed out during the Watts-Hillandale tour showing the buildings on the campus, dates, and historical uses. The drawing is also in Preston Reynolds' book.
Find this spot on a Google Map.
36.018264,-78.920964