Profanity Hill, the earliest settlers called this steep ridge east of downtown, for the swearing required to climb it, and yet First Hill became Seattle's first elite residential neighborhood in the 1880s and 1890s. The Denny party members and successful businessmen built their Victorian mansions here, above the mud and commerce of the waterfront. The neighborhood earned its current nickname of Pill Hill in the early twentieth century as the mansions were replaced by hospitals: Swedish Medical Center, founded in 1910 by Swedish immigrant physicians; Harborview Medical Center, the county's public hospital and regional trauma center; and Virginia Mason, founded in 1920.
Today First Hill has more hospital beds per square mile than almost any neighborhood in the country. The first streetcar in Seattle ran up First Hill in 1884; a modern First Hill Streetcar line, opened in 2016, connects the neighborhood to Capitol Hill and the International District. The Frye Art Museum, founded in 1952 from the collection of meatpacker Charles Frye, offers free admission and focuses on nineteenth-century realist painting — a reminder that the fortunes built in Seattle's early industries were sometimes converted into cultural institutions of enduring value.