Bellevue
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“Initially, I thought I had died”: “Last Man Out,” Sixty Minutes II, November 4, 2004.
“So many lives were lost that day”: Stuart Marcus, “Remembering 9/11: Reflections from Bellevue Hospital and New York University Medical Center,” Surgery (2002), 502–5.
“Has anyone seen Richard”: New York Times, September 29, 2001. Also, Victor Seidler, Remembering 9/11: Terror, Trauma and Social Theory (2013), 39.
“I would look down during nights on call”: Russell Saunders, “Never Forget,” The Daily Beast, September 10, 2015.
“Often, the capacity of emergency generators”: J. David Roccaforte, “The World Trade Center Attack: Observations from New York’s Bellevue Hospital,” Critical Care (2001), 307–9.
“disasters outside their walls”: Insurance Journal, November 6, 2012.
“We were told it would take ten seconds”: Interview with Dr. Doug Bails.
“There was no electricity”: Insurance Journal, November 6, 2012.
“The patients started arriving at around 1:00 a.m.”: Phyllis Maguire, “New York Hospitals and the Hurricane,” Today’s Hospitalist (December 2012).
“Do you think they’d have kept me in there”: David Remnick, “Leaving Langone: One Story,” The New Yorker (October 30, 2012).
“In the event of total power loss”: Interview with Dr. Laura Evans; Laura Evans et al., “In Search of the Silver Lining: The Impact of Superstorm Sandy on Bellevue Hospital,” Annals of the American Thoracic Society (April 2013), 135–42.
“There was no division of labor”: “The Night of the Hurricane,” Bellevue Literary Review (Spring 2013).
“This being Manhattan”: Danielle Ofri, “Bellevue and the Hurricane,” New England Journal of Medicine (December 13, 2012), 2265–67.
“19 S East Stairwell”: The whiteboard still hangs in 17 West as a reminder of Sandy.
“I am caught behind a team”: Kelsey Frohman, “Bellevue Hospital: Sandy Recap,” Ravenscroftschool.com, October 30, 2012.
“I have to pee”: Ibid.
“All hospitals are required to do disaster planning”: New York Times, November 2, 2012.
“It’s Bellevue, we’re used to crisis”: Erin Haggerty, “When Bellevue Had to Evacuate Its Criminally Insane,” Bedford + Bowery, October 29, 2013.
“I can recall the patient monitor going black”: “Alumni Share Stories from Hurricane Sandy,” University of Wisconsin–Madison School of Medicine, March 12, 2013.
“The amount of heroism that arises”: Sheri Fink, “Beyond Hurricane Heroics—What Sandy Should Teach Us About Preparedness,” Stanford Magazine (Summer 2013).
Chapter 20: Rebirth
“Most of our knockout mice”: Interview with Dr. Bruce Cronstein.
“I felt an awful sense of despair”: Gordon Fishell, “After the Deluge,” Nature (April 25, 2013), 421.
“We made a dash to retrieve”: Interview with Dr. Martin Blaser. Also, Martin Blaser, Missing Microbes (2014), 258.
“It was like Sophie’s Choice”: Apoorva Mandavilli, “One Year After Sandy, Uneven Recovery at New York University’s Labs,” Scientific American (October 29, 2013).
“We began packing up”: “ACTG Still Struggles in Sandy’s Aftermath,” ACTG AIDS Clinical Trials Group (December 2012).
“We knew that a hurricane was coming”: Fishell, “After the Deluge,” 421.
“If you were one of the mice”: “Sandy and the Laboratory Mice,” Earth in Transition (October 2012).
“We will never place animals”: Daniel Engber, “Sandy’s Toll on Medical Research,” Slate (November 1, 2012).
“People don’t pick hospitals”: Reuters, November 4, 2012.
“[Our] centers are the site of massive rodent slaughter”: Engber, “Sandy’s Toll on Medical Research.”
“I talk about disasters”: Ibid.
“Hand-scrawled messages were taped to our cubicle”: New York Times, November 26, 2012.
“using vast sums of money”: Chris Glorioso, “I-Team: Two Years After Sandy, FEMA Aid to Hospitals Questioned,” NBC News, New York.
“When NYU has an army of wealthy donors”: Louis Flores, “Criticisms over Obscene NYU Sandy Grant,” www.progressivequeens, November 7, 2014.
“came from Africa”: Dallas Morning News, September 25, 2014.
“We were looking at the pictures”: New York Times, October 25, 2014.
“In all fairness”: Dallas Morning News, October 12, 2014.
“It’s a cool gadget”: New York Times, February 10, 2015.
“Blood draws should be kept to an absolute minimum”: Bellevue Hospital Center, Ebola Virus Disease Response Guide, 2014.
“Our philosophy for Ebola”: Nicholas St. Fleur, “What Makes a Hospital ‘Ebola Ready’?,” Scientific American (October 23, 2014).
“EBOLA HITS NYC”: New York Post, October 23, 2014.
“She is our flagship”: Transcript: Mayor de Blasio at Bellevue Hospital on the Discharge of Dr. Craig Spencer, November 11, 2014.
“Reasons to Love New York”: New York, December 14, 2014.
“We like to think of ourselves”: Interview with Dr. Doug Bails.
Epilogue
“very combative”: “Active ALC cases for January 13, 2016” (copy in author’s possession).
“Think of fifty valuable beds”: Interview with Dr. Doug Bails.
“our triple threat”: Interview with Dr. James Lebret.
“not yet accepting the status quo”: Marc Gourevitch et al., “The Public Hospital in American Education,” Journal of Urban Health (September 2008), 779–86.
“It is not for sale”: New York Times, April 25, 2016.
Illustration Credits
Insert A
1 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
2 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
3 Old Paper Studios / Alamy
4 Library of Congress Prints and Photographs Division;
5 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
6 The Granger Collection, New York
7 U.S. National Library of Medicine;
8 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU
9 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
10 Courtesy of Bellevue Hospital Center Archive
11 The Granger Collection, New York;
12 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU
13 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU
14 U.S. National Library of Medicine;
15 Courtesy of Bellevue Hospital Center Archive
16 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
17 Class album—Manuscripts & Archives, Yale University
18 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
19 Philadelphia Museum of Art, gift of the Alumni Association to Jefferson Medical College in 1878 and purchased by the Pennsylvania Academy of the Fine Arts and the Philadelphia Museum of Art in 2007 with the generous support of more than 3,600 donors. Object number: 2007-1-1
Insert B
20 Library of Congress Prints and Photographs Division;
21 Courtesy NYC Municipal Archives
22 Courtesy of Bellevue Hospital Center Archive;
23 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
24 Courtesy NYC Municipal Archives
25 © Carl Mikoy;
26 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
27 Courtesy of Bellevue Hospital Center Archive
28 Courtesy of the Lillian and Clarence de la Chapelle Medical Archives at NYU;
29 Jim Henderson;
30 Courtesy of Dr. Fred T. Valentine
31 NYU School of Medicine;
32 Jose Jimenez / Primera Hora / Getty Images
33 Anatoly Kashlevskiy;
34 Courtesy of Dr. Douglas Bails
35 Courtesy of Dr. Douglas Bails
36 Karsten Moran / The New York Times;
37 Courtesy of Dr. Douglas Bails;
38 REUTERS / Adrees Latif
39 © Troi Santos;
40 © Bruce R. Jaffe
ABOUT THE AUTHOR
David Oshinsky, Ph.D., is a professor in the NYU Department of History and director of the Division of Medical Humanities at the NYU Langone Medical Center. In 2006, he won the Pulitzer Prize in History for Polio: An American Story. His other books include the D. B. Hardeman Prize–winning A Conspiracy So Immense: The World of Joe McCarthy, and the Robert Kennedy Prize–winning Worse Than Slavery: Parchman Farm and the Ordeal of Jim Crow Justice. His articles and reviews appear regularly in The New York Times and The Wall Street Journal.
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Costing £80 for building materials and fifty gallons of rum for the workmen who laid the beams and raised the roof, the New York City almshouse opened in 1736 with a single-room infirmary—“the seed from which grew the mighty oak of Bellevue.”
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As New York’s population exploded in the early nineteenth century, the need for a larger almshouse complex could no longer be ignored. Opened in 1816 on the old Bellevue estate bordering the East River, the so-called Bellevue Establishment was the largest and most expensive building project in the city’s history to date, containing an almshouse, an orphanage, a lunatic asylum, a prison, and an infirmary. An infectious disease hospital would be added in 1826.
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David Hosack, the leading physician for New York City’s elite in the early 1800s, listed Alexander Hamilton, Aaron Burr, and steamboat inventor Robert Fulton among his patients. He also treated the sick at the almshouse and envisioned a true public hospital for the indigent.
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Considered the most talented American surgeon of the first half of the nineteenth century, Valentine Mott took the lead in creating NYU Medical College in 1841. His Saturday clinics at Bellevue Hospital attracted students and physicians from across the region. One prominent surgeon wrote that Mott “performed more of the great operations than any man living.”
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Following a series of deadly typhus epidemics that took the lives of hundreds of patients and numerous doctors at Bellevue, reforms were instituted that became a model for future hospital care. Among these was a competitive examination for beginning physicians, known as interns, who lived in the hospital and served the everyday needs of the patients. Here is the first class of Bellevue interns, circa 1856.
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A rendering from Harper’s Weekly showing rats crawling over Bellevue patients in 1860. The hospital received a storm of criticism after an infant apparently was gnawed to death. Though an autopsy showed that the baby had died before the rats consumed the body, sanitary problems would plague the hospital.
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The first physician to reach the mortally wounded President Abraham Lincoln at Ford’s Theatre, Charles Leale, twenty-three, a recent graduate of Bellevue Hospital Medical College, performed admirably under impossibly difficult conditions, though his role remains controversial to this day.
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Stephen Smith (standing to the patient’s right) was a founder of Bellevue Hospital Medical College and a general surgeon at the hospital for more than sixty years. His classic 1865 study, Sanitary Conditions of the City, warned of the disastrous consequences of ignoring the living conditions and medical needs of the poor.
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Applying the lessons he learned as a medical administrator in the Civil War, Edward Dalton organized the nation’s first civilian ambulance corps at Bellevue in 1869. Here, a Bellevue ambulance surgeon provides assistance to an injured New Yorker.
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America’s first professional nursing school opened at Bellevue in 1873. Preferring single, literate, religious women from cultivated families, it rejected most applicants on account of “bad breeding.”
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By the 1870s, Bellevue had one of the largest, most modern morgues in the world. Streams of water showered down on the faces of the corpses to keep them fresh for identification by relatives and friends. The unclaimed corpses were shipped to Potter’s Field for burial.
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In 1876, O. G. Mason, Bellevue’s official photographer, took the first photograph of a blood transfusion in progress. Carefully staged, it showed the kind of medical progress being made at the hospital.
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Bellevue’s Lewis A. Sayre, the nation’s first professor of orthopedic surgery, invented the “tripod suspension derrick” to correct spinal deformities. His demonstration, photographed by O. G. Mason, contained overtones of eroticism at odds with Victorian norms.
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Mason’s best-known photograph was of a nineteen-year-old woman with elephantiasis. With only her face shielded, and her hands clasped as if in prayer, the subject’s lower body shows the full force of her disease. Some accused Mason of pandering to the P. T. Barnum “sideshow” aspects of popular culture; others viewed the photograph as an accurate rendering of a medical condition.
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Mason photographed thousands of patients at Bellevue. His aim, he said, was to depict Bellevue as a hospital devoted to top clinical care and daring medical innovation. In this instance he followed the progress of a patient who had lost his entire nose to a dangerous infection and whose middle finger would be used to fashion a new one.
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William Welch, a former Bellevue intern, introduced the nation’s first modern pathology course at Bellevue Hospital Medical College. Despite intense efforts to keep him on the faculty, including a $75,000 gift from industrialist Andrew Carnegie for a new pathology building, Welch accepted a position as one of the founding members of the Johns Hopkins Medical School.
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As an intern and later a surgeon at Bellevue, William Halsted worked tirelessly to bring antiseptic methods to the hospital. A brilliant innovator, his work at Bellevue was cut short by his experiments with cocaine as an anesthetic, which led to an addiction to various drugs. His close friend William Welch brought him to Johns Hopkins, where Halsted resurrected his surgical career.
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Bellevue’s Frank Hamilton, one of America’s finest military surgeons, was brought down to Washington to help treat President James A. Garfield following the assassination attempt in 1881 that eventually took Garfield’s life. Many accused Hamilton, who did not believe in Lister’s antiseptic methods, of medical malpractice in treating the president’s wounds.
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The Gross Clinic, an enormous canvas painted by Thomas Eakins for the 1876 Centennial Exhibition in Philadelphia, is one of the most important and controversial renderings of a medical subject in American history. Some see it as an unabashed tribute to Dr. Gross, who was among the greatest surgeons of his era; others see it as a subtle slap at Gross for his failure to embrace the antiseptic methods of Joseph Lister then coming into fashion.
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Posing as a mentally disturbed young woman, Elizabeth Jane Cochran, using the pen name Nellie Bly, wrote a scathing exposé of conditions in two of the city’s leading psychiatric facilities—Bellevue and the Octagon on Blackwell’s Island. Published first in Joseph Pulitzer’s New York World and then in a book titled Ten Days in a Mad-House, Bly’s writings cemented the connection between Bellevue and insanity that endures in the public imagination.
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In 1904, with immigration from Europe at its height and concerns about public health (especially the spread of tuberculosis) growing rapidly, the city hired one of the nation’s leading architectural firms, McKim, Mead & White, to provide plans for an expanded Bellevue on the current hospital grounds.
The plans would be scaled back, and the final structures completed almost four decades later, but some of the buildings remain in use today.
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In times of medical crisis, Bellevue’s wards teemed to overflowing. During the 1918–19 influenza pandemic, which killed upward of fifty million people worldwide, patients at Bellevue slept in corridors, in closets, and on beds of straw on the floors. No one was turned away.
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Menas S. Gregory ran the psychiatric division at Bellevue for the first third of the twentieth century. A devoted reformer, he minimized the use of narcotics and restraints, and had the bars removed from the wards inhabited by all but the most violently insane. In 1933, Gregory’s grand vision, a massive psychiatric building, opened on the Bellevue grounds. Gregory would be fired shortly thereafter amid charges that he mistreated his staff.
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In 1918, New York City created the post of medical examiner to replace the inept and scandal-ridden coroner system then in place. The first medical examiner, Charles Norris (right), a professor of pathology at NYU, demanded that his office be run out of Bellevue, where his laboratory was situated. With the aid of Alexander Gettler, a brilliant chemist, Norris turned the infant field of forensic medicine into a vital professional discipline.