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Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital
David Oshinsky chronicles the history of America's oldest hospital and in so doing also charts the rise of New York to the nation's preeminent city, the path of American medicine from butchery and quackery to a professional and scientific endeavor, and the growth of a civic institution. From its origins in 1738 as an almshouse and pesthouse, Bellevue today is a revered public hospital bringing first-class care to anyone in need. With its diverse, ailing, and unprotesting patient population, the hospital was a natural laboratory for the nation's first clinical research. It treated tens of thousands of Civil War soldiers, launched the first civilian ambulance corps and the first nursing school for women, pioneered medical photography and psychiatric treatment, and spurred New York City to establish the country's first official Board of Health.
As medical technology advanced, "voluntary" hospitals began to seek out patients willing to pay for their care. For charity cases, it was left to Bellevue to fill the void. The latter decades of the twentieth century brought rampant crime, drug addiction, and homelessness to the nation's struggling cities problems that called a public hospital's very survival into question. It took the AIDS crisis to cement Bellevue's enduring place as New York's ultimate safety net, the iconic hospital of last resort.
As medical technology advanced, "voluntary" hospitals began to seek out patients willing to pay for their care. For charity cases, it was left to Bellevue to fill the void. The latter decades of the twentieth century brought rampant crime, drug addiction, and homelessness to the nation's struggling cities problems that called a public hospital's very survival into question. It took the AIDS crisis to cement Bellevue's enduring place as New York's ultimate safety net, the iconic hospital of last resort.
400 pages, Hardcover
First published November 15, 2016
About the author
David M. Oshinsky
17 books121 followersDavid M. Oshinsky is the director of the Division of Medical Humanities at NYU School of Medicine and a professor in the Department of History at New York University.
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November 15, 2016
Bellevue is featured in many historical mysteries, as well as many fictional books on madness and insanity so I was very curious to read the real story behind this storied hospital. I also loved the way this book was laid out, in a linear fashion, after a preface that explores what will be found within, the famous people who have been patients and some who died there.
We learn about the changing faces of this hospital, a hospital that in one form or another has been active since the 18th century. The epidemics treated here, the doctors, but also the changing faces of medicine as a whole. We are also treated to a history of New York, the changing neighborhoods, the immigrants, and how all played out in this amazing hospital. Bellevue was the first to have an ambulance, the first nursing school, and so much more. How it was affected by Hurricane Sandy and the Ebola scare not too long past. One thing that has never changed is its standard to treat those who cannot afford to pay, and not to release a patient that has no one to care for them on the outside.
So my outlook on this hospital has changed from a formidable fear to one of deep admiration. Love how books can do that.
We learn about the changing faces of this hospital, a hospital that in one form or another has been active since the 18th century. The epidemics treated here, the doctors, but also the changing faces of medicine as a whole. We are also treated to a history of New York, the changing neighborhoods, the immigrants, and how all played out in this amazing hospital. Bellevue was the first to have an ambulance, the first nursing school, and so much more. How it was affected by Hurricane Sandy and the Ebola scare not too long past. One thing that has never changed is its standard to treat those who cannot afford to pay, and not to release a patient that has no one to care for them on the outside.
So my outlook on this hospital has changed from a formidable fear to one of deep admiration. Love how books can do that.
October 1, 2017
This book was 100% written by a historian, not a biographist, so temper expectations accordingly. Bellevue is a famous--some might say infamous--hospital in New York City, and when I saw my friend Melora's review, I was intrigued by the combination of NYC, medicine and general nuttiness. However, Oshinsky believes one should start at the very beginning; to wit, from the very origins of ownership on the piece of land Bellevue occupies to its more modern role in the city. Along the way he digresses into the development of medical practice, immigration, the Civil War, politics in NYC, public health, the politics of poverty and health, electroshock therapy, AIDS, and Sandy. The topics are often interesting, but result in an uneven whole.
Bellevue, the name of a river estate, was leased in 1795 by to become a hospital for people suffering from 'yellow fever" since it was so far from the city. As Oshinsky continues, he traces the origins of disease management in the burgeoning seaport of NYC and Bellevue's role in both caring for poor immigrants and unusual diseases.
He recounts how the 'practice' of medicine grew, developing from its infancy along the lines of surgeons (the 'bone-setter'), doctors and apothecaries. Doctors were usually wealthy people who may have gone to school, or may have only apprenticed, and Bellevue's never-ending supply of patients meant a never-ending opportunities for students to learn on people who couldn't afford to go elsewhere. Oshinsky is especially fascinated by the practice of blood-letting and tells us far too much about it. However, it was apparently part of the cause of death of one of our Presidents.
A section on the Civil War brought advances in medicine--eventually--and about the same time, anesthesia was developed that allowed people to better tolerate surgery. Progress was made on successful amputations that doctors during the war brought back to Bellevue. Bellevue doctors were also connected with treating Presidents Lincoln and Garfield.
Meanwhile, as NYC grew, so did the need for more medical facilities, which often seemed to pan out among class lines, with New York Hospital taking fee-paying patients. As NYC struggled with immigrant issues and prejudice, hospitals started to 'specialize,' with Jews' Hospital opening in 1855 (now the famous Mount Sinai) and the 'German Hospital' in 1868 (anti-German sentiment in WWI led to it being renamed Lenox Hill in 1918). There were also hospitals focusing on Presbyterians, Episcopalians, German Catholics (St. Francis) and poor Italians (Columbus). [Ed.: now that America is less religious, we just have hospitals for the Catholics. And a lot of hospitals unofficially stratified by economic status]
Public health departments took off because of a Bellevue doctor who realized many of his typhus patients lived in a particular East Side tenement. Collaborating with a journalist, they shamed a landlord into repairs. He testified before Congress and helped write the Metropolitan Health Act, revolutionizing public health and improving a child mortality of 25% [Ed.: another good thing government does, people, is look after your health and safety]. Another doctor who had helped start an 'ambulance corps' during the Civil War ended up at Bellevue, where he became instrumental in getting ambulance stagecoaches (stocked with whiskey, bandages and a straightjacket, all the essentials of a modern E.R. --I'm joking!)
A section on Hurricane Sandy in 2012 was intriguing. Despite the lessons from Hurricane Katrina, and Hurricane Irene the year earlier, staff at Bellevue decided to shelter in place and stay open. Though generators were on the thirteenth floor, the fuel pumps for Bellevue (located along the river, remember) were in the basement. As the local Con Edison blew, the generators ran dry and a gasoline bucket brigade was formed. When the extent of Sandy's damage became clear, Bellevue finally closed, resulting in a patient diaspora.
I also found the section on AIDS fascinating. NYC was pretty close to ground zero with the epidemic, and Bellevue, with its tradition of providing health care to the uninsured, indigent people of the city, was one of the first places to notice the unusual clusters of Kaposi's sarcoma and pneumocistis carcinii (since renamed jiroveci) that characterized late stages of the syndrome. It dovetailed briefly with a discussion on hospice/end-of-life care and nursing, which was both interesting and sad.
Overall, sections were extremely interesting, but there was a lot of digressive and filler material that detracted from the focus on Bellevue specifically. For instance, the section on Hurricane Sandy was contrasted with another nearby semi-private hospital, Tisch Hospital, as well as hospitals in New Orleans. Independently of a book about Bellevue, that would have been an interesting book in and of itself. I certainly found descriptions of dealing with hospitalized patients during disaster fascinating. The section on AIDs is likewise contrasted with response to the crisis in San Francisco--interesting, definitely, and again worth of a book--but less important to Bellevue itself. It felt like many historical books focused to the mass market, digressing into semi-titillating side-stories that aren't as germane.
Overall, lots of fascinating topics covered, contextualized by one of America's first hospitals to serve the poor. There's a nice set of colorplates in the edition I read, which is interesting, and particularly helpful in discussion of a somewhat controversial painting of surgeon pre-sterile surgery. Many thanks to Melora for bringing it to my attention!
Bellevue, the name of a river estate, was leased in 1795 by to become a hospital for people suffering from 'yellow fever" since it was so far from the city. As Oshinsky continues, he traces the origins of disease management in the burgeoning seaport of NYC and Bellevue's role in both caring for poor immigrants and unusual diseases.
He recounts how the 'practice' of medicine grew, developing from its infancy along the lines of surgeons (the 'bone-setter'), doctors and apothecaries. Doctors were usually wealthy people who may have gone to school, or may have only apprenticed, and Bellevue's never-ending supply of patients meant a never-ending opportunities for students to learn on people who couldn't afford to go elsewhere. Oshinsky is especially fascinated by the practice of blood-letting and tells us far too much about it. However, it was apparently part of the cause of death of one of our Presidents.
A section on the Civil War brought advances in medicine--eventually--and about the same time, anesthesia was developed that allowed people to better tolerate surgery. Progress was made on successful amputations that doctors during the war brought back to Bellevue. Bellevue doctors were also connected with treating Presidents Lincoln and Garfield.
Meanwhile, as NYC grew, so did the need for more medical facilities, which often seemed to pan out among class lines, with New York Hospital taking fee-paying patients. As NYC struggled with immigrant issues and prejudice, hospitals started to 'specialize,' with Jews' Hospital opening in 1855 (now the famous Mount Sinai) and the 'German Hospital' in 1868 (anti-German sentiment in WWI led to it being renamed Lenox Hill in 1918). There were also hospitals focusing on Presbyterians, Episcopalians, German Catholics (St. Francis) and poor Italians (Columbus). [Ed.: now that America is less religious, we just have hospitals for the Catholics. And a lot of hospitals unofficially stratified by economic status]
Public health departments took off because of a Bellevue doctor who realized many of his typhus patients lived in a particular East Side tenement. Collaborating with a journalist, they shamed a landlord into repairs. He testified before Congress and helped write the Metropolitan Health Act, revolutionizing public health and improving a child mortality of 25% [Ed.: another good thing government does, people, is look after your health and safety]. Another doctor who had helped start an 'ambulance corps' during the Civil War ended up at Bellevue, where he became instrumental in getting ambulance stagecoaches (stocked with whiskey, bandages and a straightjacket, all the essentials of a modern E.R. --I'm joking!)
A section on Hurricane Sandy in 2012 was intriguing. Despite the lessons from Hurricane Katrina, and Hurricane Irene the year earlier, staff at Bellevue decided to shelter in place and stay open. Though generators were on the thirteenth floor, the fuel pumps for Bellevue (located along the river, remember) were in the basement. As the local Con Edison blew, the generators ran dry and a gasoline bucket brigade was formed. When the extent of Sandy's damage became clear, Bellevue finally closed, resulting in a patient diaspora.
I also found the section on AIDS fascinating. NYC was pretty close to ground zero with the epidemic, and Bellevue, with its tradition of providing health care to the uninsured, indigent people of the city, was one of the first places to notice the unusual clusters of Kaposi's sarcoma and pneumocistis carcinii (since renamed jiroveci) that characterized late stages of the syndrome. It dovetailed briefly with a discussion on hospice/end-of-life care and nursing, which was both interesting and sad.
Overall, sections were extremely interesting, but there was a lot of digressive and filler material that detracted from the focus on Bellevue specifically. For instance, the section on Hurricane Sandy was contrasted with another nearby semi-private hospital, Tisch Hospital, as well as hospitals in New Orleans. Independently of a book about Bellevue, that would have been an interesting book in and of itself. I certainly found descriptions of dealing with hospitalized patients during disaster fascinating. The section on AIDs is likewise contrasted with response to the crisis in San Francisco--interesting, definitely, and again worth of a book--but less important to Bellevue itself. It felt like many historical books focused to the mass market, digressing into semi-titillating side-stories that aren't as germane.
Overall, lots of fascinating topics covered, contextualized by one of America's first hospitals to serve the poor. There's a nice set of colorplates in the edition I read, which is interesting, and particularly helpful in discussion of a somewhat controversial painting of surgeon pre-sterile surgery. Many thanks to Melora for bringing it to my attention!
October 13, 2018
One does not have to live in NYC to know the name Bellevue, the famous (or infamous) public hospital which began as an almshouse in 1796 and over the years, slowly morphed into a collection of buildings serving and housing the indigent and "criminally insane". Much of the bad reputation that unfortunately still sometimes clings to Bellevue was resultant from those early days when the conditions were similar to the horrors of Bedlam, London's most notorious asylum. But the Bellevue of today is the safety net of health care in NYC, open to all regardless of ability to pay, and serving as a teaching hospital for several prestigious medical schools.
Pulitzer Prize winning author, David Oshinsky, takes the reader on a fascinating trip through the history of this medical institution and of the dedicated men and women who fought against public apathy and lack of funds to improve health care for the poor and forgotten. Bellvue created the first ambulance service, nursing school for women based on the model created by Florence Nightingale, outpatient clinics and departments of psychiatry and pediatrics. But the buildings were falling into horrible disrepair and the lack of patient revenue was creating a huge financial deficit. There was talk of closing Bellevue but President Lyndon Johnson's creation of Medicare and Medicaid saved the day, providing medical insurance coverage to those who previously were treated free of charge and Bellevue prevailed.
This is the biography of a hospital which rose from a cesspit to one of America's most esteemed public medical facilities. It is enlightening and inspiring and highly recommended.
Pulitzer Prize winning author, David Oshinsky, takes the reader on a fascinating trip through the history of this medical institution and of the dedicated men and women who fought against public apathy and lack of funds to improve health care for the poor and forgotten. Bellvue created the first ambulance service, nursing school for women based on the model created by Florence Nightingale, outpatient clinics and departments of psychiatry and pediatrics. But the buildings were falling into horrible disrepair and the lack of patient revenue was creating a huge financial deficit. There was talk of closing Bellevue but President Lyndon Johnson's creation of Medicare and Medicaid saved the day, providing medical insurance coverage to those who previously were treated free of charge and Bellevue prevailed.
This is the biography of a hospital which rose from a cesspit to one of America's most esteemed public medical facilities. It is enlightening and inspiring and highly recommended.
January 1, 2017
The book gathers momentum; the topics covered near the end - the AIDS crisis of the 80s and 90s, the rape and murder of the pregnant 33-year-old pathologist Dr. Kathryn Hinnant within the walls of the hospital in 1989, Hurricane Sandy in 2012 and finally the care of Dr. Craig Spencer who contracted and survived the deadly Ebola virus in 2014 - close the book with a bang. They are exciting and engagingly told and they all relate directly to the management and underlying spirit of this renowned public hospital. I believe such an ending will influence how readers rate the book. I am rating the entire book, the book as a whole. It is interesting throughout, but much of it lacks the powerfully engaging feel of the ending.
In focusing on the history of one hospital, Bellevue, the author has as well covered the development of medical science in the US from the 1700s up to 2015. Diseases, epidemics, treatments, social conditions and changing attitudes. Bellevue began as an almshouse, pest house and death house. The guiding rule being that no one would ever be turned away, a place open to all - the diseased, the destitute, the criminal and the insane. A "place of last resort", that is Bellevue.
The telling moves forward chronologically. We follow The Yellow Fever Epidemic of 1795, the Cholera Epidemic of 1816, the 1847-1848 Typhus Epidemic, the long string of resident doctors, early attitudes toward dissection in the US and abroad, teaching, education and the development of associate medical schools, discrimination by religion, race and gender, medical innovations and theories, anesthesia, germ theory, antisepsis and urban sanitation. The maimed of the Civil War, victims of the Great Influenza and always the poor and down-and-out of the largest growing urban metropolis in the US, New York City. Prohibution 1920 - 1933, the stock market crash in 1929 followed by the Depression, the opening in 1933 of the separate Bellevue Psychiatric Hospital, seven years in the making with the support of scandal and gossip riddled Tammany Hall politician Mayor Jimmy Walker, Dr. Lauretta Bender’s work with insulin shock therapy and electric shock therapy as head of the children’s ward of the asylum. What were the effects Lyndon Johnson’s Medicare and Medicaid Bill of 1965 and of the deinstitutionalization of the 80s on the homeless and poor and the hospital’s clientele? We are delivered an overview of how historic world, national and events tied directly to New York City played out within the halls of Bellevue. Of course, this cannot be a complete compendium on the progress of medical science.
There are numerous quotes, but rather than clarifying they often made that being said less rather than more clear. The quotes were too often ambiguous, open-ended or with implied innuendos. The same is true of the wording in other lines. Varying interpretations could be drawn. I remarked on several occasions, “What is that supposed to mean?”
Details were at times excessive. I don’t necessarily need to know the names of the individuals who died. Providing adequate data and yet not overloading is a tricky balance. At times my attention wandered and I wished for better editing.
On completing the book, I asked myself why it had not reach up to the quality of David McCullough’s nonfiction books. Where did the difference lie? In McCullough’s books the details serve a purpose; on the basis of them you can draw meaningful conclusions. Excessive details are removed. Secondly, his characters are introduced with pertinent observations about their respective personalities. The reader quickly understands and has a feeling for who each individual is. I never felt the slightest sympathy, empathy, distaste or appreciation for any person mentioned in Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital. They are named; they are not known. McCullough, on the other hand, recreates live human beings. He does this superbly in his biographies, but even in books about inanimate objects, such as The Great Bridge: The Epic Story of the Building of the Brooklyn Bridge, McCullough draws the readers toward the individuals. In The Greater Journey: Americans in Paris, McCullough brought to life the numerous doctors. Both of these books overlap with Bellevue’s content.
The audiobook is very well narrated by Fred Sanders. Read clearly and at a good speed. One has time to absorb details. Not over dramatized; Sanders lets the author's words speak for themselves.
Definitely a good book which I can recommend to others, but not as engaging as a book by McCullough.
In focusing on the history of one hospital, Bellevue, the author has as well covered the development of medical science in the US from the 1700s up to 2015. Diseases, epidemics, treatments, social conditions and changing attitudes. Bellevue began as an almshouse, pest house and death house. The guiding rule being that no one would ever be turned away, a place open to all - the diseased, the destitute, the criminal and the insane. A "place of last resort", that is Bellevue.
The telling moves forward chronologically. We follow The Yellow Fever Epidemic of 1795, the Cholera Epidemic of 1816, the 1847-1848 Typhus Epidemic, the long string of resident doctors, early attitudes toward dissection in the US and abroad, teaching, education and the development of associate medical schools, discrimination by religion, race and gender, medical innovations and theories, anesthesia, germ theory, antisepsis and urban sanitation. The maimed of the Civil War, victims of the Great Influenza and always the poor and down-and-out of the largest growing urban metropolis in the US, New York City. Prohibution 1920 - 1933, the stock market crash in 1929 followed by the Depression, the opening in 1933 of the separate Bellevue Psychiatric Hospital, seven years in the making with the support of scandal and gossip riddled Tammany Hall politician Mayor Jimmy Walker, Dr. Lauretta Bender’s work with insulin shock therapy and electric shock therapy as head of the children’s ward of the asylum. What were the effects Lyndon Johnson’s Medicare and Medicaid Bill of 1965 and of the deinstitutionalization of the 80s on the homeless and poor and the hospital’s clientele? We are delivered an overview of how historic world, national and events tied directly to New York City played out within the halls of Bellevue. Of course, this cannot be a complete compendium on the progress of medical science.
There are numerous quotes, but rather than clarifying they often made that being said less rather than more clear. The quotes were too often ambiguous, open-ended or with implied innuendos. The same is true of the wording in other lines. Varying interpretations could be drawn. I remarked on several occasions, “What is that supposed to mean?”
Details were at times excessive. I don’t necessarily need to know the names of the individuals who died. Providing adequate data and yet not overloading is a tricky balance. At times my attention wandered and I wished for better editing.
On completing the book, I asked myself why it had not reach up to the quality of David McCullough’s nonfiction books. Where did the difference lie? In McCullough’s books the details serve a purpose; on the basis of them you can draw meaningful conclusions. Excessive details are removed. Secondly, his characters are introduced with pertinent observations about their respective personalities. The reader quickly understands and has a feeling for who each individual is. I never felt the slightest sympathy, empathy, distaste or appreciation for any person mentioned in Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital. They are named; they are not known. McCullough, on the other hand, recreates live human beings. He does this superbly in his biographies, but even in books about inanimate objects, such as The Great Bridge: The Epic Story of the Building of the Brooklyn Bridge, McCullough draws the readers toward the individuals. In The Greater Journey: Americans in Paris, McCullough brought to life the numerous doctors. Both of these books overlap with Bellevue’s content.
The audiobook is very well narrated by Fred Sanders. Read clearly and at a good speed. One has time to absorb details. Not over dramatized; Sanders lets the author's words speak for themselves.
Definitely a good book which I can recommend to others, but not as engaging as a book by McCullough.
December 31, 2016
Many Americans, even those who have never lived in New York City, have heard of Bellevue Hospital, certainly of some patients, and probably some of its doctors. Its storied history captures our imagination: it has fearlessly and insistently treated epidemics for centuries, as well as the widest range of disease in our nation’s largest city. For most of its history, Bellevue was a teaching hospital associated with two IV League medical schools, Columbia and Cornell, along with that of New York University. In 1966, Columbia and Cornell turned over their commitment to NYU, who produced distinguished physicians trained on some of the world's most difficult and unusual cases.
Land situated on the banks of the East River, about 3 miles from downtown Manhattan, called Bel-Vue, was leased in 1795 to serve as a hospital for those afflicted with yellow fever. It could be reached by boat, on horseback, or by carriage. The location meant one could enjoy cooling breezes and yet be far enough away from the city to avoid spreading infection. Ever since that time, Bellevue has served as a public hospital open to handle the contagious cases for which there is no cure.
The story of Bellevue is in many ways the story of medicine in the United States, plagued by lack of understanding of the role of sanitation in perpetuating disease, and discovering how lack of family or opportunities might lead to poverty, madness, and despair. Almost from the start, Bellevue had patients unable to pay for their care or explain their malady, and yet they could not be turned away. It has always been a refuge for those who had no where else to go: the homeless, the indigent, the immigrant. Today Whites rank last in ‘patient race.’
Bellevue not only handles disease, but has always handled catastrophic injuries from the city and environs. Oshinsky describes the aftermath of the 1863 Conscription Act riots, riots which began because the poor were drafted to serve in the Union army: the city erupted in mob violence, poor on rich, white on black, native on immigrant, Catholic on Protestant. More than one hundred died, and injuries were grievous.
Oshinsky is careful not to whitewash Bellevue’s history. His descriptions can be shocking in what they tell us of conditions there throughout the years. Never particularly well-funded, this public hospital was at the mercy of state budgets and political jockeying, and yet it attracted outsized medical talent by dint of its size, location, and affiliation. The worst bits--doctors operating before antibiotics or anesthetics, or psychotic homeless camping in unused closets—cannot keep the reader from finishing this read in absolute awe of the place.
Bellevue has been rebuilt several times, the latest ribbon-cutting in 1973 after two decades of construction to the tune of $200 million. Twenty-five floors for patients, each an acre or more in size, with stunning views of the river or the Manhattan skyline. Twenty elevators service the space. An I.M. Pei (Pei Cobb & Fried) -designed atrium connecting the old buildings with the new was completed in 2005.
Bellevue has had famous patients (including exposé-writing journalist Nellie Bly), and famous doctors (Dr. Andre Frederic Cournand and Dr. Dickinson Richards won the 1956 Nobel Prize for their work on cardiac catheterization). The ambidextrous surgeon Dr. Valentine Mott "performed more of the great operations" at Bellevue "than any man living," in the words of Sir Ashley Cooper, England's leading surgeon at the end of the eighteenth century.
Any day at Bellevue is positively epic in scope, novelistic, operatic even. When Oshinsky talks about NYC's Office of Medical Examiner being headquartered at Bellevue in the early part of the twentieth century and managed by Bellevue's chief pathologist, the powerful combination of politics, criminality, medicine, and forensics feels explosive. This is Life writ large, in all its manifestations, and Death, likewise. It is a gigantic, voracious story.
For those interested in the history of medicine, this is a must-read. The heroic pieces of the story are difficult to resist. David Oshinsky won the 2006 Pulitzer Prize for History for Polio: An American Story and knows how to tell a big story. There can't be that many who could do what he has done with this magnificent effort. Published in 2016 by Doubleday. Photographs on my blog, and in the finished copy of this book.
Land situated on the banks of the East River, about 3 miles from downtown Manhattan, called Bel-Vue, was leased in 1795 to serve as a hospital for those afflicted with yellow fever. It could be reached by boat, on horseback, or by carriage. The location meant one could enjoy cooling breezes and yet be far enough away from the city to avoid spreading infection. Ever since that time, Bellevue has served as a public hospital open to handle the contagious cases for which there is no cure.
"I don’t think there is a disease in Osler’s Textbook of Medicine that I didn’t see," said Bellevue medical intern Dr. Connie Guion in 1916.Bellevue was the center of the AIDS epidemic in New York beginning in the 1980 and in 1990 Bellevue’s Infectious Disease Specialist Dr. Fred Valentine was instrumental in finding a cocktail of drugs that would keep the infection from progressing. Most recently in 2014, Dr. Craig Spencer, a volunteer with Doctors without Borders, arrived in Bellevue to be treated for Ebola, New York’s only Ebola patient. Aggressive treatment and early diagnosis helped to assure his survival, and he was released three weeks later.
The story of Bellevue is in many ways the story of medicine in the United States, plagued by lack of understanding of the role of sanitation in perpetuating disease, and discovering how lack of family or opportunities might lead to poverty, madness, and despair. Almost from the start, Bellevue had patients unable to pay for their care or explain their malady, and yet they could not be turned away. It has always been a refuge for those who had no where else to go: the homeless, the indigent, the immigrant. Today Whites rank last in ‘patient race.’
Bellevue not only handles disease, but has always handled catastrophic injuries from the city and environs. Oshinsky describes the aftermath of the 1863 Conscription Act riots, riots which began because the poor were drafted to serve in the Union army: the city erupted in mob violence, poor on rich, white on black, native on immigrant, Catholic on Protestant. More than one hundred died, and injuries were grievous.
"This is war zone medicine," a Bellevue emergency room doctor observed in 1990. "You'll never go anywhere in the world and see something we haven't seen here."In 2001 Bellevue ramped up to take victims of the World Trade Center attack, only to discover an unusual sense of helplessness when few treatable injuries resulted from the incident.
Oshinsky is careful not to whitewash Bellevue’s history. His descriptions can be shocking in what they tell us of conditions there throughout the years. Never particularly well-funded, this public hospital was at the mercy of state budgets and political jockeying, and yet it attracted outsized medical talent by dint of its size, location, and affiliation. The worst bits--doctors operating before antibiotics or anesthetics, or psychotic homeless camping in unused closets—cannot keep the reader from finishing this read in absolute awe of the place.
Bellevue has been rebuilt several times, the latest ribbon-cutting in 1973 after two decades of construction to the tune of $200 million. Twenty-five floors for patients, each an acre or more in size, with stunning views of the river or the Manhattan skyline. Twenty elevators service the space. An I.M. Pei (Pei Cobb & Fried) -designed atrium connecting the old buildings with the new was completed in 2005.
Bellevue has had famous patients (including exposé-writing journalist Nellie Bly), and famous doctors (Dr. Andre Frederic Cournand and Dr. Dickinson Richards won the 1956 Nobel Prize for their work on cardiac catheterization). The ambidextrous surgeon Dr. Valentine Mott "performed more of the great operations" at Bellevue "than any man living," in the words of Sir Ashley Cooper, England's leading surgeon at the end of the eighteenth century.
Any day at Bellevue is positively epic in scope, novelistic, operatic even. When Oshinsky talks about NYC's Office of Medical Examiner being headquartered at Bellevue in the early part of the twentieth century and managed by Bellevue's chief pathologist, the powerful combination of politics, criminality, medicine, and forensics feels explosive. This is Life writ large, in all its manifestations, and Death, likewise. It is a gigantic, voracious story.
For those interested in the history of medicine, this is a must-read. The heroic pieces of the story are difficult to resist. David Oshinsky won the 2006 Pulitzer Prize for History for Polio: An American Story and knows how to tell a big story. There can't be that many who could do what he has done with this magnificent effort. Published in 2016 by Doubleday. Photographs on my blog, and in the finished copy of this book.
November 9, 2020
The venerable Bellevue Hospital in New York City is considered to be the flagship of public hospitals. The staff there will treat and provide exceptional care to anyone, regardless of their ability to pay.
Bellevue can trace its roots to the 1660’s when the Dutch West India Company established an infirmary to serve its soldiers. When the British took control of Manhattan Island, they built a permanent almshouse there in 1736. However, as the needs of the citizens grew, a larger building was constructed further north along the East River.
Author David Oshinsky’s meticulously researched and well written book traces the history of Bellevue as it grew along with the city of New York, from its early days to the present. It is a fascinating account of the growth, not only of Bellevue and New York City, but also about the growth, practice, and advancement of medicine itself. Anyone interested in medicine would learn much from reading this enlightening book!
Bellevue can trace its roots to the 1660’s when the Dutch West India Company established an infirmary to serve its soldiers. When the British took control of Manhattan Island, they built a permanent almshouse there in 1736. However, as the needs of the citizens grew, a larger building was constructed further north along the East River.
Author David Oshinsky’s meticulously researched and well written book traces the history of Bellevue as it grew along with the city of New York, from its early days to the present. It is a fascinating account of the growth, not only of Bellevue and New York City, but also about the growth, practice, and advancement of medicine itself. Anyone interested in medicine would learn much from reading this enlightening book!
February 15, 2018
2018 Reading Challenge: microhistory
Bellevue has always been synonymous with mental health similar to Bedlam in London, but its history is actually much more complex. From treating the tens of thousands of victims of the Spanish flu to the less than a handful of cases of Ebola, Bellevue is a top medical and research facility of America. "More than a hundred languages" are spoken in the halls of the campus the most common including Spanish as well as Haitian Creole. Bellevue saw the first outbreaks of AIDS, it had a wing solely for tuberculosis, it is where NYC's homeless are sent.
But being a public center of city healthcare brings crime including drug use, rape, and murder. Mark David Chapman was diagnosed while Lennon's body "lay wrapped in a sheet..a few buildings away" in the compound. This is just one instance when the staff was placed in a precarious position, when personal feeling had to be put aside for professional oath.
There have been various famous patients to grace the beds of Bellevue, the most obscure story belonging to folk songwriter, Stephen Foster. There are also several history writing physicians. And Bellevue also opened the first male nurse training school. It was a trailblazer from the day it opened.
All of this has been realized on a budget next to nil. As mentioned Bellevue is a public hospital; they take all charity cases. ANY cases the private hospital doctors wished not to treat for whatever reason and in turn were referred to Bellevue must be accepted. When the police round up displaced persons who need care, this is where they are taken.
Recently Bellevue has gone through some transitions. Research is not as prevalent due to losses sustained from Hurricane Sandy. The architecture has been updated and expanded; but what has not changed is its lack of funding. The mayor does what he can working money into the budget. There is also a relationship with NYU. Alas Obamacare has done nothing to assist in the travails of a poor unwell patient.
Bellevue has always been synonymous with mental health similar to Bedlam in London, but its history is actually much more complex. From treating the tens of thousands of victims of the Spanish flu to the less than a handful of cases of Ebola, Bellevue is a top medical and research facility of America. "More than a hundred languages" are spoken in the halls of the campus the most common including Spanish as well as Haitian Creole. Bellevue saw the first outbreaks of AIDS, it had a wing solely for tuberculosis, it is where NYC's homeless are sent.
But being a public center of city healthcare brings crime including drug use, rape, and murder. Mark David Chapman was diagnosed while Lennon's body "lay wrapped in a sheet..a few buildings away" in the compound. This is just one instance when the staff was placed in a precarious position, when personal feeling had to be put aside for professional oath.
There have been various famous patients to grace the beds of Bellevue, the most obscure story belonging to folk songwriter, Stephen Foster. There are also several history writing physicians. And Bellevue also opened the first male nurse training school. It was a trailblazer from the day it opened.
All of this has been realized on a budget next to nil. As mentioned Bellevue is a public hospital; they take all charity cases. ANY cases the private hospital doctors wished not to treat for whatever reason and in turn were referred to Bellevue must be accepted. When the police round up displaced persons who need care, this is where they are taken.
Recently Bellevue has gone through some transitions. Research is not as prevalent due to losses sustained from Hurricane Sandy. The architecture has been updated and expanded; but what has not changed is its lack of funding. The mayor does what he can working money into the budget. There is also a relationship with NYU. Alas Obamacare has done nothing to assist in the travails of a poor unwell patient.
December 14, 2016
I found this book “Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital” absolutely fascinating. Oshinsky not only tells the sweeping detailed history of Bellevue but also the history of American medicine, nursing, public health, environmental health, medical research/ education, and public hospitals.
The author states it was one of the first hospitals starting in the 1660s. It is famous not only as a mental hospital but as one of the finest emergency and trauma centers in the country. It has a long history as the leading infectious disease facility treating yellow fever, tuberculosis, AIDS to Ebola. Steven Forster died at Bellevue and Francis Ford Coppola filmed scenes of the Godfather in its morgue.
Oshinsky tells about the hospital’s role during the Civil War caring for the most Union soldiers of any hospital. The author tells of advances in medicine, nursing and ambulance service during the Civil War. Bellevue was the first hospital to have ambulance services starting after the Civil War. They also designed the first horse drawn ambulance used in the City. Through affiliations with medical schools, it became the largest teaching hospital in the country and a leading research facility. Bellevue is the leading research facility on AIDS. Bellevue treats more than 600,000 patients annually.
The book is well written and meticulously researched. Oshinsky writes in a clear, concise way that is easily readable. Oshinsky is a Pulitzer Prize winning journalist. This is the first book I have read by Oshinsky. I am looking forward to reading more of his books. Oshinsky builds a strong case for the need of public hospitals. I highly recommend this book.
Fred Sanders does an excellent job narrating the book. Sanders is a stage actor and audiobook narrator.
The author states it was one of the first hospitals starting in the 1660s. It is famous not only as a mental hospital but as one of the finest emergency and trauma centers in the country. It has a long history as the leading infectious disease facility treating yellow fever, tuberculosis, AIDS to Ebola. Steven Forster died at Bellevue and Francis Ford Coppola filmed scenes of the Godfather in its morgue.
Oshinsky tells about the hospital’s role during the Civil War caring for the most Union soldiers of any hospital. The author tells of advances in medicine, nursing and ambulance service during the Civil War. Bellevue was the first hospital to have ambulance services starting after the Civil War. They also designed the first horse drawn ambulance used in the City. Through affiliations with medical schools, it became the largest teaching hospital in the country and a leading research facility. Bellevue is the leading research facility on AIDS. Bellevue treats more than 600,000 patients annually.
The book is well written and meticulously researched. Oshinsky writes in a clear, concise way that is easily readable. Oshinsky is a Pulitzer Prize winning journalist. This is the first book I have read by Oshinsky. I am looking forward to reading more of his books. Oshinsky builds a strong case for the need of public hospitals. I highly recommend this book.
Fred Sanders does an excellent job narrating the book. Sanders is a stage actor and audiobook narrator.
January 30, 2019
This long and occasionally dry "microhistory" profiles Manhattan's Bellevue Hospital from its origins in the late 18th Century as an almshouse in a semi-rural location overlooking the East River, to today's battled and beleaguered complex that Mayor Bill di Blasio has assured us has a place in Manhattan's future as well as its past. Bellevue's tale unfolds best as a series of tragedies and challenges, one after the other, including smallpox, plague, typhoid, cholera, influenza, tuberculosis and AIDS. It even had a hand in treating Ebola; and the hospital staff's response to Superstorm Sandy (2012), when the generators were flooded out, is nothing short of heroic.
I for one, though, would like to have seen more of a sense of historical continuity over the years. For example, World War II rates just a few brief mentions when surely the amount and origin of inpatients during the war years must have changed significantly. Read this book if you like -- I know of no substitute -- but expect slow going at times.
Author David Oshinsky also wrote the award-winning Polio: An American Story.
I for one, though, would like to have seen more of a sense of historical continuity over the years. For example, World War II rates just a few brief mentions when surely the amount and origin of inpatients during the war years must have changed significantly. Read this book if you like -- I know of no substitute -- but expect slow going at times.
Author David Oshinsky also wrote the award-winning Polio: An American Story.
November 16, 2018
A well written and sometimes interesting history on Bellevue Hospital in NY. If I assessed the twenty chapters individually or read as a serial spanning twenty weeks, Bellevue would definitely be four star material.
However there is little flow to the book overall and the chapters do not relate to one another so I couldn't take any big themes away. My second gripe with the book is that there was little description of the hospital overall so it is hard to really place the building in my mind or anchor much to it. My last gripe is that the chapter focal points were sometimes on people, sometimes on the illnesses, sometimes on ethnic groups, sometimes on business and so on.
Here is a brief review of the chapters, in chronological order.
1. Beginnings. going back to the 1660's and up through the late 1700s all kinds of diseases that killed people. A lot of research for this chapter covering 100 years. 5 stars.
2. Hosack's vision. Covered Hosack's vision to treat the poor and disadvantaged. 4 stars.
3. The Great Epidemic. Covered the Typhus outbreak of 1847. Interesting but at only nineteen pages it was too short. 3 stars.
4. Teaching medicine. Bellevue incorporates a medical college in 1850s. Turning point for the advancement of medicine. 3 stars.
5. A Hospital in War. Covers the civil war. Very interesting, too short. 4 stars.
6. Hives of Sickness and Vice. On sanitation and connecting the dots to the source of cholera, typhoid. 5 stars.
7. The Bellevue Ambulance. Very interesting micro-history on the first ambulances in the 1870's. 4 stars.
8. Bellevue Venus. Confusing chapter, famous picture of the woman with elephantitis. 2 stars.
9. Nightingales. Advancement of nurses. 4 stars.
10. Germ Theory. A takeaway message of the book but too short at ten pages. 4 stars.
11. Tale of Two Presidents. Bellevue treated two presidents, one of whom died, James Garfield and the other, Grover Cleveland, survived a serious surgery because of antiseptics. 4 stars.
12. The Mad-House. Insane asylum. Relevant but a little out of place. 3 stars.
13. The New Metropolis. Covered the early 20th century. Probably the only disappointing chapter. A lot of random facts about pay and population but only two pages on the influenza epidemic. 1 star.
14. Cause of Death. Chapter on Denatured alcohol. Very good but too short. 3 stars.
15. Shocking Truth. Introduction of shock therapy on mental patients. Good but too short. 3 stars.
16. Survival. Discussed the lean years of mid 20th century when finances were crushing the hospital. Out of place. 2 stars.
17. AIDS. Very informative chapter, probably the best one. 5 stars.
18. Rock Bottom. Similar to chapter 16. 2 stars.
19. Hurricane Sandy. Interesting chapter, close call to losing power and patients. 4 stars.
20. Rebirth. Mildly interesting chapter. 3 stars.
3.5 stars for Bellevue
FWIW. If you are looking for a great non-fiction book written about a hospital then the best that I have read, hands down, is 'Five Days at Memorial' by reporter Sheri Fink. This 2014 book covered the five days of devastation that Hurricane Katrina threw at Memorial Hospital in New Orleans, primarily flooding, that led the doctors to make some very difficult and with hindsight terrible decisions. Warning there are some terrifying scenes, the euthanasia scenes described in the book still give me nightmares. The book won many awards.
However there is little flow to the book overall and the chapters do not relate to one another so I couldn't take any big themes away. My second gripe with the book is that there was little description of the hospital overall so it is hard to really place the building in my mind or anchor much to it. My last gripe is that the chapter focal points were sometimes on people, sometimes on the illnesses, sometimes on ethnic groups, sometimes on business and so on.
Here is a brief review of the chapters, in chronological order.
1. Beginnings. going back to the 1660's and up through the late 1700s all kinds of diseases that killed people. A lot of research for this chapter covering 100 years. 5 stars.
2. Hosack's vision. Covered Hosack's vision to treat the poor and disadvantaged. 4 stars.
3. The Great Epidemic. Covered the Typhus outbreak of 1847. Interesting but at only nineteen pages it was too short. 3 stars.
4. Teaching medicine. Bellevue incorporates a medical college in 1850s. Turning point for the advancement of medicine. 3 stars.
5. A Hospital in War. Covers the civil war. Very interesting, too short. 4 stars.
6. Hives of Sickness and Vice. On sanitation and connecting the dots to the source of cholera, typhoid. 5 stars.
7. The Bellevue Ambulance. Very interesting micro-history on the first ambulances in the 1870's. 4 stars.
8. Bellevue Venus. Confusing chapter, famous picture of the woman with elephantitis. 2 stars.
9. Nightingales. Advancement of nurses. 4 stars.
10. Germ Theory. A takeaway message of the book but too short at ten pages. 4 stars.
11. Tale of Two Presidents. Bellevue treated two presidents, one of whom died, James Garfield and the other, Grover Cleveland, survived a serious surgery because of antiseptics. 4 stars.
12. The Mad-House. Insane asylum. Relevant but a little out of place. 3 stars.
13. The New Metropolis. Covered the early 20th century. Probably the only disappointing chapter. A lot of random facts about pay and population but only two pages on the influenza epidemic. 1 star.
14. Cause of Death. Chapter on Denatured alcohol. Very good but too short. 3 stars.
15. Shocking Truth. Introduction of shock therapy on mental patients. Good but too short. 3 stars.
16. Survival. Discussed the lean years of mid 20th century when finances were crushing the hospital. Out of place. 2 stars.
17. AIDS. Very informative chapter, probably the best one. 5 stars.
18. Rock Bottom. Similar to chapter 16. 2 stars.
19. Hurricane Sandy. Interesting chapter, close call to losing power and patients. 4 stars.
20. Rebirth. Mildly interesting chapter. 3 stars.
3.5 stars for Bellevue
FWIW. If you are looking for a great non-fiction book written about a hospital then the best that I have read, hands down, is 'Five Days at Memorial' by reporter Sheri Fink. This 2014 book covered the five days of devastation that Hurricane Katrina threw at Memorial Hospital in New Orleans, primarily flooding, that led the doctors to make some very difficult and with hindsight terrible decisions. Warning there are some terrifying scenes, the euthanasia scenes described in the book still give me nightmares. The book won many awards.
December 13, 2016
David Oshinsky’s wonderful book Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital is more than a history lesson of an iconic New York City institution. It’s a chronicle of the city of New York itself. And that might not be going far enough, it’s the tale of the United States as well, all told through the events happening at the oldest public hospital in America. We have disease, war, politics and corruption, a little racism, and ultimately a group of people dedicated to giving care to a class of people unable to find anywhere else to go.
Bellevue is much more than a mental hospital. It was first started in 1736 as a public hospital to help those that could not afford traditional medical care (a very progressive idea in a time where local doctor generally made house calls—something along the lines of: oh no, Beth is sick and not getting better. Jo, stop your writing and go get the doctor!)
New York at this time was no bed of roses. First came the yellow fever epidemic, then a little ray of sunshine called Typhus (or as the politically correct at the time called it: Irish Fever) to be followed by cholera, influenza, and then AIDS. The common theme is of course these plagues hit the poor, the immigrants, the folks shoved three deep into tiny housing and filthy rundown areas. So of course there was a level of rhetoric and crude racism blaming the Irish, the Italians, the Jews, etc. for these epidemics that would make even a Trump supporter uncomfortable.
Oshinsky book is an exciting read full of witty, gross, and uplifting stories as Bellevue struggles to find its direction through changing eras and evolving times. You may want to scream in frustration as the doctors blame the cause of diseases on bad clouds and smells as they stick their dirty hands in open wounds and use unwashed medical scalpels and forceps. Or cringe as a sobbing father struggles to hold his son still as he undergoes an amputation without anesthesia.
Looking back at these guys with 21st Century eyes it’s easy to gap in amazement (and may times laugh out loud-- startling the dear sleeping wife)as the Bellevue medical professionals feel bleeding someone, or giving children electroshock therapy, or sewing a finger to the face of a man who had lost his nose, or injecting warm tobacco, were true medical innovations. But these were also doctors and administrators who created ambulances, who implemented nursing schools, and above all, who cared for the folks who could not care for themselves.
This book is great. A sure sign of a good book is how hard it is for me to shut up about what I read, and I have to tell you I was yapping about this guy to just about everyone. As my wife and co-workers can attest, it was almost physically impossible for me to button it or shut my pie-hole about this great read. I annoyed them so much I think they wanted to send me to Bellevue. Anyway, this is a really really good one. Read it!!!
Bellevue is much more than a mental hospital. It was first started in 1736 as a public hospital to help those that could not afford traditional medical care (a very progressive idea in a time where local doctor generally made house calls—something along the lines of: oh no, Beth is sick and not getting better. Jo, stop your writing and go get the doctor!)
New York at this time was no bed of roses. First came the yellow fever epidemic, then a little ray of sunshine called Typhus (or as the politically correct at the time called it: Irish Fever) to be followed by cholera, influenza, and then AIDS. The common theme is of course these plagues hit the poor, the immigrants, the folks shoved three deep into tiny housing and filthy rundown areas. So of course there was a level of rhetoric and crude racism blaming the Irish, the Italians, the Jews, etc. for these epidemics that would make even a Trump supporter uncomfortable.
Oshinsky book is an exciting read full of witty, gross, and uplifting stories as Bellevue struggles to find its direction through changing eras and evolving times. You may want to scream in frustration as the doctors blame the cause of diseases on bad clouds and smells as they stick their dirty hands in open wounds and use unwashed medical scalpels and forceps. Or cringe as a sobbing father struggles to hold his son still as he undergoes an amputation without anesthesia.
Looking back at these guys with 21st Century eyes it’s easy to gap in amazement (and may times laugh out loud-- startling the dear sleeping wife)as the Bellevue medical professionals feel bleeding someone, or giving children electroshock therapy, or sewing a finger to the face of a man who had lost his nose, or injecting warm tobacco, were true medical innovations. But these were also doctors and administrators who created ambulances, who implemented nursing schools, and above all, who cared for the folks who could not care for themselves.
This book is great. A sure sign of a good book is how hard it is for me to shut up about what I read, and I have to tell you I was yapping about this guy to just about everyone. As my wife and co-workers can attest, it was almost physically impossible for me to button it or shut my pie-hole about this great read. I annoyed them so much I think they wanted to send me to Bellevue. Anyway, this is a really really good one. Read it!!!
March 28, 2018
An excellent, well-researched, and entertainingly-written history of two centuries of medicine and public health in America, seen through the prism of one of our greatest hospitals. In the later chapters, I was reminded of those events to which I was a witness and which the scientists at the Public Health Research Institute were important players: the AIDS & TB epidemics and hospital-acquired infections. And I will always be haunted by the endless posters which lined First Ave in front of Bellevue Hospital after 9-11.
June 20, 2019
I found this a really satisfying look at Bellevue. It's a public hospital that is very much the indicator of our society. What its people do is laudable, incredible, & plain fantastic, although this shows plenty of warts, too. There were a lot of interesting insights into people, politics, & the state of medicine with much slipping back & forth through time. Not what I expected, but more in many ways. The only minor nitpick I had was that it took 3 or 4 mentions of Lewis Thomas before the author explained who he was very briefly in the epilogue.
This is pretty much the way the book went for me:
Finishing the 4th chapter, the history of Bellevue is clear as mud. Lots of skipping around, but the gist is it went from an alms house in the 18th century to finally turn into a respected hospital just before the US Civil War started. As a history of the institution, it is pretty bad. As a history of the medicine, science, society, disease, immigration, & other issue of the times, it's great.
The hardest issue the author is facing is trying to educate me on the times & how Bellevue responded. Things were so different back in the late 18th & first half of the 19th centuries. Manhattan still had pigs in the streets & individual, contaminated wells. Immigrants suddenly came in floods & lived huddled together in terribly squalid conditions. Without an understanding of disease causes & vectors, Bellevue was basically a place for people without means to die.
The medicine of the time was horrific! Recovery was often better served by avoiding the doctors with their blood-letting, purgatives, & mercury-laced poisons. Anesthesia wasn't available until the mid 1840s & many a prospective surgeon (including Darwin) quit rather than chop away at a screaming patient.
The book continued in the vein. There are some really scary practices revealed. What passed for medical ethics is horrifying even 50 years ago. Still, they argued against the Feds poisoning people during Prohibition. The numbers they had to deal with during various epidemics & catastrophes were staggering in one way or another. This is a fairly recent book, so it goes all the way up to its reopening after hurricane Sandy closed it for the first time in 150 years or more.
Very well narrated. Highly recommended to everyone!
This is pretty much the way the book went for me:
Finishing the 4th chapter, the history of Bellevue is clear as mud. Lots of skipping around, but the gist is it went from an alms house in the 18th century to finally turn into a respected hospital just before the US Civil War started. As a history of the institution, it is pretty bad. As a history of the medicine, science, society, disease, immigration, & other issue of the times, it's great.
The hardest issue the author is facing is trying to educate me on the times & how Bellevue responded. Things were so different back in the late 18th & first half of the 19th centuries. Manhattan still had pigs in the streets & individual, contaminated wells. Immigrants suddenly came in floods & lived huddled together in terribly squalid conditions. Without an understanding of disease causes & vectors, Bellevue was basically a place for people without means to die.
The medicine of the time was horrific! Recovery was often better served by avoiding the doctors with their blood-letting, purgatives, & mercury-laced poisons. Anesthesia wasn't available until the mid 1840s & many a prospective surgeon (including Darwin) quit rather than chop away at a screaming patient.
The book continued in the vein. There are some really scary practices revealed. What passed for medical ethics is horrifying even 50 years ago. Still, they argued against the Feds poisoning people during Prohibition. The numbers they had to deal with during various epidemics & catastrophes were staggering in one way or another. This is a fairly recent book, so it goes all the way up to its reopening after hurricane Sandy closed it for the first time in 150 years or more.
Very well narrated. Highly recommended to everyone!
December 28, 2016
A fascinating well told history of Bellevue and medicine. Maybe not an totally easy read, but definitely absorbing-- not the least bit dry. I would recommend this to anyone who loves history, has an interest in medicine, and especially those, who when they hear "Bellevue" it strikes a chord.
October 11, 2016
When I read non-fiction, I usually end up reading something weird (Agent Zigzag or Grunt) or something awful (Nazi Hunters or Five Days at Memorial). It’s rare that I read a book that highlights the better angels of our nature, but that’s what I found (for the most part) in David Oshinsky’s Bellevue: A History of America’s Oldest Hospital. There are varying dates for the founding of Bellevue Hospital stretching back to the 1730s. Bellevue has been open ever since the eighteenth century and only closed briefly once, during Superstorm Sandy. The hospital’s mission has always been to take care of patients who couldn’t pay for their care. Even today, they take care of people no one else will...
Read the rest of my review at A Bookish Type. I received a free copy of this book from Edelweiss for review consideration.
Read the rest of my review at A Bookish Type. I received a free copy of this book from Edelweiss for review consideration.
November 14, 2017
To tell the story of Bellevue, America's first hospital, is to tell the story of the United States. From it's humble beginnings as a almshouse that served soldiers in the 1600's it has morphed into a world class hospital that treats the complex cases of ebola today. This book covers every major advancement of medicine from an influenza outbreak, the idea that germs could cause sickness, the formation of a nurses, pain medication, mental health advancements, the Aids epidemic, and Super Storm Sandy, and chronicles them through the microscopic lens of Bellevue Hospital. This book is a fascinating journey through medical history. While reading this you can't help but feel grateful for those medical pioneers of the past. After reading about some of the medical treatments of the past I feel fortunate to live in 2017 where we have anesthesia, medical imagining devices, and modern drugs.
August 20, 2017
Oshinsky traces Bellevue hospital's history, from its beginnings as a “hospital for the accommodation and relief of such persons afflicted with contagious distempers” in 1795 through to its operations today, and along with the history of this specific hospital he conveys much of the story of public hospital care in America. As well as the story of Bellevue, Oshinsky tells the story of how Americans – doctors and nurses, researchers, social reformers, and others – have addressed the problems posed to a rapidly growing urban population by disease, sanitation challenges, poverty, and prejudice. Beginning with yellow fever and the eventual recognition of the conditions that nurtured it, Oshinsky's narrative goes on to include surgery during the Civil War, the professionalization of nursing, germ theory, the surgeries of Presidents Garfield and Cleveland, mental illness, and AIDS. A few things, such as the shock therapy used on young children in the 1940's and the antisemitism in medical schools in the 1920s through the 1950s, stood out as particularly startling for me, but, really, the whole book is interesting. The stories of significant individuals and their roles are engagingly presented, and the sense of the “big picture” is well maintained. A big story, coherently told.
4 1/2 stars, rounded up. I enjoyed this as an audio recording, well narrated by Fred Sanders.
4 1/2 stars, rounded up. I enjoyed this as an audio recording, well narrated by Fred Sanders.
April 27, 2017
Oshinsky is a great writer. One of my favorite books in the world is Worse Than Slavery. I always expect another marvel like that from him. Nothing can ever live up to it though. Still, this book had no shortage of really interesting stories (most I have already read elsewhere) about the extremely interesting history of how Bellevue has morphed over the years. Oshinsky does a great job of incorporating the various medical advances and politics maneuvers seen throughout the history of America's (arguably) oldest hospital.
For more information on the AIDS epidemic, briefly mentioned in this book, I recommend And the Band Played on by Randy Shilts. Bellevue also touches, very briefly, on the ebola epidemic. I highly recommend reading David Quammen's Spillover because it was one of the most spectacular books I have had the pleasure to read. It tells a scary, thrilling, and compelling tale of the search to define and cure the virus.
For more information on the AIDS epidemic, briefly mentioned in this book, I recommend And the Band Played on by Randy Shilts. Bellevue also touches, very briefly, on the ebola epidemic. I highly recommend reading David Quammen's Spillover because it was one of the most spectacular books I have had the pleasure to read. It tells a scary, thrilling, and compelling tale of the search to define and cure the virus.
September 26, 2018
Super interesting concept--to tell the story of a single hospital--you inevitably end up telling a lot of different stories. Most of it dragged on for me. The ending was really interesting--AIDS and Ebola, murders in the hospital, and the changing nature of NY, but some of the earlier material was a bit monotonous.
August 30, 2017
This is the best non-fiction book I have read this year. As other reviewers have noted, it's more of a history lesson set within the walls of Bellevue. Topics covered include the Civil War, Florence Nightingale, Nellie Bly, the assassination of President Lincoln, various plagues, AIDS, Superstorm Sandy, and much much more. Highly recommend this for anyone interested in history, medicine, or even just good non-fiction writing.
March 29, 2017
This book is more than just the history of Bellevue. The hospital has been around so long that it serves as a backdrop for the history of medicine in the US. The sections covering the epidemics, prohibition, AIDS, and Hurricane Sandy were fascinating. The history of the hospital itself was interesting except the few times that the author ventured into detailed reports of administration - those sections took a bit of skimming.
Highly recommend to anyone interested in New York, history, or medicine.
Highly recommend to anyone interested in New York, history, or medicine.
August 27, 2021
This is a wonderfully organized (even though is presented chronologically) and colorful history of one of our flagship Hospitals in American history. Bellevue's history is told within the context of immigration, healthcare science, and the politics of New York. It is extremely well researched but is easily read with most explanations included in the text rather than as footnotes (there are notes added, but the text is clear enough to allow one to actually read the book rather than always flipping back to the notes pages). The book begins with New York as a "wilderness" and moves forward to include Bellevue's response to 9/11 and Hurricane Sandy.
Anyone who enjoys reading non-fiction will appreciate this book.
Anyone who enjoys reading non-fiction will appreciate this book.
October 28, 2017
David Oshinsky, currently a professor of history at NYU, delves into the history of the storied Bellevue Hospital in New York City -- from its origins in an almshouse established in 1736 to its response to Hurricane Sandy. He argues that the cultural narratives surrounding Bellevue, i.e. narratives of bedlam, disrepair, and even murder, have eclipsed its contribution to the medical history of this country: "The relentless focus on its eccentricities has obscured its role as our quintessential public hospital." To correct this misapprehension of the hospital, Oshinsky focuses primarily on its role in handling medical crises in the city and on the contributions its doctors and nurses have made to the advancement of medicine. That said, for those who like the more sordid tales of its past, he weaves those into his narrative as well, including the 1987 murder of Dr. Hinnant in her office by a homeless man who had been squatting for over two months inside the hospital without anyone knowing.
By way of its contributions to US medical history, he details a number of firsts. For example, it was the first hospital in the United States to perform a caesarian section; it created the first ambulance service in response to Civil War casualties; it also played a leading role in the 19th century in pioneering medical photography and in the early 20th century in advancing forensic medicine.
But beyond these firsts, through the lens of Bellevue, the reader also has front row seats in the various medical socio-cultural, and economic debates that have torn this country over the years. In the medical arena, we see for example the debates over the origins of disease: miasma v. germ theory. It is a debate that reaches its climax in the wake of James Garfield's death following an assassination attempt. He did not die from the bullet, but rather from the infection that wracked his body after his doctors probed his wounds without having washed his hand. His death accomplished what Joseph Lister's lecture had failed to do, i.e. get the American medical community to wash their hands!
In the socio-cultural and economic arenas, we see how views on race in the country are intimately linked to socioeconomic status. As a public hospital that treated those who could not pay, Bellevue's population changed over the years, mirroring the waves of immigration from abroad and from within. With each wave of immigration, the racial scourge on America changed from the Irish to the German to the Eastern European. The arrival of the Civil War exposed racial and economic divides within the city. NYC was deeply divided by the Civil War; investors were unhappy because they had large sums invested in the South; the immigrant poor and working class feared that emancipation would endanger their fragile economic status, as they would now have to compete with a new group of workers, freed slaves. When in 1863, the Union imposed a draft; riots broke out in NYC. Although all men of a certain age were required to register for the draft, rich men could buy waivers. And the resulting riots pitted Irish workers against an Irish police force.
In more recent times, through the lens of Bellevue, we see prejudice rear its ugly head during the AIDS epidemic beginning in the early 1980s. How private hospitals turned away AIDS patients and how because it was viewed as a "Gay Disease", the development of treatments was slow.
Through the lens of Bellevue, we also see the transformation of the public health system. The advent of Medicare and Medicaid meant that more people opted not to use Bellevue and chose private hospitals; and so Bellevue's percentage of paying customers dropped even further. Not to mention some private hospitals milked the newly insured and then once their insurance ran out pushed them out the doors and back to Bellevue. As a result, Bellevue fell into disrepair and hundreds of public hospitals across the country were forced to close their doors.
But there are questions that go unanswered. For example, how did the idea of patient consent develop at Bellevue and at other hospitals? Most likely this question goes unanswered because the author provides only minimal coverage of the history of psychiatric care at Bellevue. We do learn of the use of shock treatment on poor patients (including children) without consent. But we never learn how or why that changed. It also does not address the impact of the Opioid epidemic on its resources and its practices.
It also leaves unaddressed the services that Bellevue has provided for victims fleeing torture in other parts of the world. Given the book's emphasis on Bellevue's shining moments in medical history, this omission is surprising.
But because Bellevue has always been the hospital of last resort for the uninsured, for the penniless immigrant, and for those down on their luck, the most important question it raises: How will Bellevue face the newest challenge -- the demise of Obamacare and what will its population look like then? It is a question that has implications for public (and private) hospitals across the country.
By way of its contributions to US medical history, he details a number of firsts. For example, it was the first hospital in the United States to perform a caesarian section; it created the first ambulance service in response to Civil War casualties; it also played a leading role in the 19th century in pioneering medical photography and in the early 20th century in advancing forensic medicine.
But beyond these firsts, through the lens of Bellevue, the reader also has front row seats in the various medical socio-cultural, and economic debates that have torn this country over the years. In the medical arena, we see for example the debates over the origins of disease: miasma v. germ theory. It is a debate that reaches its climax in the wake of James Garfield's death following an assassination attempt. He did not die from the bullet, but rather from the infection that wracked his body after his doctors probed his wounds without having washed his hand. His death accomplished what Joseph Lister's lecture had failed to do, i.e. get the American medical community to wash their hands!
In the socio-cultural and economic arenas, we see how views on race in the country are intimately linked to socioeconomic status. As a public hospital that treated those who could not pay, Bellevue's population changed over the years, mirroring the waves of immigration from abroad and from within. With each wave of immigration, the racial scourge on America changed from the Irish to the German to the Eastern European. The arrival of the Civil War exposed racial and economic divides within the city. NYC was deeply divided by the Civil War; investors were unhappy because they had large sums invested in the South; the immigrant poor and working class feared that emancipation would endanger their fragile economic status, as they would now have to compete with a new group of workers, freed slaves. When in 1863, the Union imposed a draft; riots broke out in NYC. Although all men of a certain age were required to register for the draft, rich men could buy waivers. And the resulting riots pitted Irish workers against an Irish police force.
In more recent times, through the lens of Bellevue, we see prejudice rear its ugly head during the AIDS epidemic beginning in the early 1980s. How private hospitals turned away AIDS patients and how because it was viewed as a "Gay Disease", the development of treatments was slow.
Through the lens of Bellevue, we also see the transformation of the public health system. The advent of Medicare and Medicaid meant that more people opted not to use Bellevue and chose private hospitals; and so Bellevue's percentage of paying customers dropped even further. Not to mention some private hospitals milked the newly insured and then once their insurance ran out pushed them out the doors and back to Bellevue. As a result, Bellevue fell into disrepair and hundreds of public hospitals across the country were forced to close their doors.
But there are questions that go unanswered. For example, how did the idea of patient consent develop at Bellevue and at other hospitals? Most likely this question goes unanswered because the author provides only minimal coverage of the history of psychiatric care at Bellevue. We do learn of the use of shock treatment on poor patients (including children) without consent. But we never learn how or why that changed. It also does not address the impact of the Opioid epidemic on its resources and its practices.
It also leaves unaddressed the services that Bellevue has provided for victims fleeing torture in other parts of the world. Given the book's emphasis on Bellevue's shining moments in medical history, this omission is surprising.
But because Bellevue has always been the hospital of last resort for the uninsured, for the penniless immigrant, and for those down on their luck, the most important question it raises: How will Bellevue face the newest challenge -- the demise of Obamacare and what will its population look like then? It is a question that has implications for public (and private) hospitals across the country.
May 11, 2019
One of the best nonfiction books I've read recently! I thoroughly enjoyed this book on the hisotry of Bellevue hospital. The author did an excellent job of incorporating the wider social, cultural, technological, and economic history of the area. Each chapter discussed a specific topic and the ones on public health, forensic medicine, nursing, AIDS, and Hurricane Sandy were my favorite. This book is very informative and well-researched without being one bit dry.
Highly recommended!
Highly recommended!
October 28, 2016
Pulitzer-prize winning journalist David Oshinsky writes a comprehensive, readable history of New York City’s legendary public hospital, which along the way becomes a slice of social history of the city itself and an outline of the development of American medical practices as well. The name alone is enough to evoke imagery, associations, some realistic and some fantasy (the name being synonymous, like Bedlam, with the last stop for the very mentally ill) but the truth itself is enough to solidify the legend. They deserve it, for what they’ve accomplished there.
I lived for a couple of years a few blocks away from Bellevue, in a university housing building that I believe was one of theirs at one point. There were rumors of underground tunnel networks connecting the buildings, and that came up in the book as well – the tunnels are there, so who knows! I had care there a few times through the city’s public hospital program. I remember it ran like a remarkably well-oiled if very hectic machine. This biography of the institution outlines exactly why that is and all the trials, missteps, and ultimately successful streamlining that went into making it work that way. We get the whole horrifying history of how surgeons first began chopping into people without anesthesia or much idea of what they were doing, some of the eyebrow-raising treatment methods for psychiatric patients, all the way up to how Bellevue’s actions and experiences shaped post-Sandy research and storage facilities and how they saved New York’s only Ebola patient in 2014. I was continually surprised at the history behind this place, it afforded a completely new respect for the hospital and the employees.
The hospital has been the epicenter of some of the most infamous medical crises and social issues of the past nearly three centuries, including epidemics of yellow fever, influenza, the diseases associated with urban overcrowding, several presidential assassinations, and most recently New York’s only ebola patient. Since it’s founding as an almshouse in the 1700s, it’s been the go-to for cutting edge advancements in care and technique, even while serving some of the most desperate members of society – those who are sick, uninsured, and unable to seek other alternatives for care. No one is turned away. Oshinsky also covers the city politics that come into play, regarding funding issues and university association.
Bellevue’s history is inextricably linked to American medical and social development, and while reading, I learned so much that I had no idea was at all connected to Bellevue. Like why circumcision of non-Jewish males became the norm in America; the difficulties associated with finding corpses for dissection and education and how much controversy and horror was involved; and my favorite bit, the story of an Austrian child of poor immigrants who developed so many elements of modern forensic science and medicine that Oshinsky points out that he was the field. My mouth was practically hanging opening reading paragraph after paragraph of his now-commonplace accomplishments. There’s such an incredible education in this book, and it’s written so well and smoothly, in a personable, storytelling style with no textbook feeling.
There was a point after a very strong beginning to the book where I felt it lagged a bit, around the Civil War sections. But the rest of the book is so excellent and such an accessible account of the hospital and its social context that a few slow chapters don’t seem so bad. I can imagine this would appeal immensely to medical students and those studying biology and the social sciences, but I’d recommend it to anyone, really. It’s just all-around fascinating.
I received an advance copy courtesy of the publisher for review.
I lived for a couple of years a few blocks away from Bellevue, in a university housing building that I believe was one of theirs at one point. There were rumors of underground tunnel networks connecting the buildings, and that came up in the book as well – the tunnels are there, so who knows! I had care there a few times through the city’s public hospital program. I remember it ran like a remarkably well-oiled if very hectic machine. This biography of the institution outlines exactly why that is and all the trials, missteps, and ultimately successful streamlining that went into making it work that way. We get the whole horrifying history of how surgeons first began chopping into people without anesthesia or much idea of what they were doing, some of the eyebrow-raising treatment methods for psychiatric patients, all the way up to how Bellevue’s actions and experiences shaped post-Sandy research and storage facilities and how they saved New York’s only Ebola patient in 2014. I was continually surprised at the history behind this place, it afforded a completely new respect for the hospital and the employees.
The hospital has been the epicenter of some of the most infamous medical crises and social issues of the past nearly three centuries, including epidemics of yellow fever, influenza, the diseases associated with urban overcrowding, several presidential assassinations, and most recently New York’s only ebola patient. Since it’s founding as an almshouse in the 1700s, it’s been the go-to for cutting edge advancements in care and technique, even while serving some of the most desperate members of society – those who are sick, uninsured, and unable to seek other alternatives for care. No one is turned away. Oshinsky also covers the city politics that come into play, regarding funding issues and university association.
Bellevue’s history is inextricably linked to American medical and social development, and while reading, I learned so much that I had no idea was at all connected to Bellevue. Like why circumcision of non-Jewish males became the norm in America; the difficulties associated with finding corpses for dissection and education and how much controversy and horror was involved; and my favorite bit, the story of an Austrian child of poor immigrants who developed so many elements of modern forensic science and medicine that Oshinsky points out that he was the field. My mouth was practically hanging opening reading paragraph after paragraph of his now-commonplace accomplishments. There’s such an incredible education in this book, and it’s written so well and smoothly, in a personable, storytelling style with no textbook feeling.
There was a point after a very strong beginning to the book where I felt it lagged a bit, around the Civil War sections. But the rest of the book is so excellent and such an accessible account of the hospital and its social context that a few slow chapters don’t seem so bad. I can imagine this would appeal immensely to medical students and those studying biology and the social sciences, but I’d recommend it to anyone, really. It’s just all-around fascinating.
I received an advance copy courtesy of the publisher for review.
April 2, 2022
Dobra książka, pełna informacji o rozwoju szpitalu Bellevue od XVIII w, a tym samym medycyny. Przeplatana cytatami z różnych materiałów archiwalnych oraz historiami, dzięki czemu przyjemnie i szybko się czyta.
Read
May 24, 2019Great overview of a great hospital. This is the type of public hospital to be proud of, one staffed by researchers, medical innovators, number of specialities, large numbers of patients to learn from and to treat in new experimental and then quickly standardized ways.
Long Live Bellevue so that untold numbers of people may live to fulfill their destinities.
Long Live Bellevue so that untold numbers of people may live to fulfill their destinities.
March 2, 2018
This was a fascinating look at the history of Bellevue Hospital in Manhattan, from its earliest beginnings to recent years. It covers a lot of ground, examining both the changes in the science and art of caring for the sick, as well as the social issues involved in running a public hospital with a policy of taking all comers. This one is worth a read for anyone who's interested in health care issues.
June 22, 2017
The history of Bellevue mirrors the history of health care in America. From bloodletting to insulin shock to organ transplant, this iconic hospital has welcomed patients and doctors as New York and the country grew and changed the world. Very well done.
August 31, 2017
Over the years, I’ve heard Bellevue mentioned in television and movies. Last year, I discovered an excellent review about the history of this institution and it has been on my “To Read” list for over a year, until I found adequate time to dedicate to this work.
First and foremost, as the years have progressed, hospitals in New York City have developed into well-defined examples of private vs public and make no mistake, for all of the good it has done, Bellevue is [very much considered] a public hospital.
Some things that I learned:
Although it really was not the first hospital, some people do consider Bellevue to be the first hospital in this country, as Bellevue’s or as it was known back in the day, Bel-Vue’s, history can be traced back to the 1660’s.
Over the years, just as in war, and sometimes because of it, the medical staff at Bellevue developed new techniques and cures for tackling even the most difficult diseased and health crises.
Throughout this book, I learned about various people that made a difference during their affiliation with Bellevue, also known as almshouse, pest house, or death house, as they dealt with diseases and other health issues, such as Yellow Fever, Typhus aka Irish Fever, Ship Fever, or Jail Fever, TB, AIDS, 9/11, and Ebola.
The history about the American physician as compared to their counterparts in the late 18th century was riveting. I especially found the three categories of British medicine: physicians, surgeons, and apothecaries, as well as the descriptions of each, to be most interesting.
By contrast, the world of the American physician and the way people were treated (medically) was most primitive.
The comparison between New York Hospital (private) and Bellevue (public) was another intriguing aspect of this book. Their often shared history is sprinkled throughout and although they share a l-o-n-g history, what occurred after Hurricane Sandy just a few short years ago was fascinating (p. 312), but you have to know and understand said history to realize the impact these decisions had.
To understand Bellevue and its storied history, you have to know the history of New York City (and sometimes the “world” events surrounding the city). Oshinsky does an excellent job in illustrating specific events that occurred during specific periods, i.e. describing New York, its population, etc. during various points, the development of medicine during the Civil War, etc.
During the 1840’s, Bellevue was admitting thousands of patients, mostly immigrants, and mostly people who were unable to pay for care.
Over the years, Bellevue has had to reinvent itself in order to stay relevant. This began with physical improvements, including the addition of a morgue ($60,000) in the 1850’s.
The chapter discussing how hospitals “acquired” bodies (just short of grave robbing) and the description of the “Bone Bill” was engrossing. I would say there are no words, but in reality, there were quite a few. Today, if we treated the deceased as some were treated in the 1850’s, people would be doing more than protesting.
During the first decade of the 19th century, fewer than 400 men had medical degrees in the U.S. Between 1850 and 1859 that number jumped to 17,000+. The preferred “loftier” careers during this period were law and clergy.
As interest in medicine (as a career) progressed, Bellevue reinvented itself, again. In April 1861, Bellevue Hospital Medical College opened its doors. To put this in perspective, this was the day before Confederates attacked Fort Sumter to start the Civil War.
As the war was ending, we learned that the ambulance was widely recognized as a lifesaving tool. In 1869, an idea known as “Rapid Response” that used police wagons to carry the sick and injured was introduced by Edward Dalton. From here, the civilian ambulance seemed to be the obvious next step.
In 1869, Bellevue’s two ambulances had responded to 74 emergencies. A decade later, its fleet of seven would answer close to 2,000 calls, the number peaking at close to 4,400 in the early 1890’s.
Side Note: The brief history provided on Edward Dalton was heartbreaking.
Even its reputation for accepting the “dregs of society,” by 1870, “Bellevue was the uncontested giant of American hospitals. With over 1,200 beds, its sheer size attracted elite physicians for whom the lure of “interesting” patients outweighed the fear of deadly “miasmas” and physical blight.”
Thus, the chapter on Germ Theory and the information tied to the International Medical Conference during our country’s Centennial celebration, as well as English physician, Joseph Lister was riveting. It is during this chapter (and later) that they (doctors of this period) start talking “Antiseptic Surgery.” A WOW (and not in a good way) moment for me was when I read about surgeons holding instruments in their teeth, and more! Ugh! Talk about unsanitary …
From here, we moved on to a discussion about germs and James Garfield. If you read Candace Millard’s book, Destiny of the Republic, you know that the bullet fired from Charles Guiteau’s gun did not kill Garfield. Oshinsky reinforces this point. He also goes back and looks at the “care and treatment” of a few other presidents, but you’ll have to read the book to learn more. However, I will say this, Thank, goodness, for the advances made in medical science over the years!
Between 1879 and 1920, hospital admissions rose from just over 6,500 to more than 45,000! It wasn’t because of immigrants or disease. Rather, it was because public opinion changed in regards to hospitals. They, especially Bellevue, were no longer considered dumping grounds for the lower classes, it had begun to attract “respectable” fold long accustomed to being treated at home. According to Oshinsky, the era of the “private” patient had arrived.
As I mentioned earlier, Bellevue was constantly reinventing itself to stay at the forefront of “modern” medicine. This was never more apparent than with the development of what is now known as Forensic Science by Bellevue physician, Dr. Charles Norris and NYU Chemist, Alexander Gettler. At one time, Oshinsky states, “they didn’t revolutionize this field, they were the field!”
Today, we often hear Bellevue mentioned with regards to its Psych Ward. However, Bellevue had been around for a long time, and developed some amazing ideas, before the Psychiatric building was constructed and opened in 1933, thanks to the legacy of former Mayor, Jimmy Walker.
Side Note: Jimmy Walker was quite a character. His illegal antics make the likes of what has occurred in Chicago, in regards to political corruption, over the years, look like child’s play.
In 1956, a Nobel Prize came to Bellevue. The recipients were Andre Frederic Cournand and Dickinson Richards. They were honored for their groundbreaking work in Cardiac Catheterization. The history of this period, while interesting, was also a little disturbing because a) a share of this prize was given, somewhat controversially, to the little known German researcher who had invented the procedure before joining the Nazi Third Reich as a physician and propagandist: Werner Forssmann, and b) how Forssmann first tested Catheterization (for this last bit, I had to do a little outside [the book] research).
The topic of survival in relation to finances and insurance was fascinating and one that transcended time and is still relevant, today. One thing that I found intriguing was I assumed Medicare and Medicaid was hatched in one of FDR’s New Deals. Wrong! On July 30, 1965, President Lyndon Baines Johnson signed legislation that created Medicare and Medicaid, with former President Harry S. Truman, an early crusader for national health insurance, standing proudly at his side. The difference between these two forms of “socialized medicine,” while not at all surprising, was enlightening.
In the chapter about AIDS, I was stuck by the paragraph where Oshinsky says “ … some medical professionals seemed grateful for the chance to work with AIDS patients. AIDS was humbling. It taught humility and perspective . . . It deepens your humanity.” (p. 272)
The legal and ethical discussion was another interesting one. Doctors and if / how they treat you is not always cut and dried. It’s when all of these other factors weigh in that things get complicated.
The story surrounding the death of Kathryn Hinnant was heartbreaking, but it also makes me wonder how security at the hospital has changed in the last [almost] 30 years.
Today, almost 16 years after the fact, Bellevue’s role in 9/11 is ongoing. Its pathologists played a major part in identifying the victims, a painstaking process with 1.200 people still unaccounted for.
Even with 9/11, the term “Emergency Preparedness” wound not truly be developed until Hurricane Katrina in 2005. Today, Emergency Preparedness falls into two categories: Before Katrina and After Katrina. I believe this may develop further with the recent events tied to Hurricane Harvey.
Over the years, Bellevue has stayed true to its original purpose. Today, as before, its patients are overwhelmingly immigrants and their young children – no longer from Europe, but Mexico, Central America, the Caribbean, West Africa, South Asia, and China. Few carry private or group insurance. Indeed the hospital receives more money from the Department of Corrections for treating prisoners than it does from Blue Cross / Blue Shield. Most patients rely on some form of Medicaid; the rest are called “Self-Pay” aka “No-Pay,” meaning the uninsured.
First and foremost, as the years have progressed, hospitals in New York City have developed into well-defined examples of private vs public and make no mistake, for all of the good it has done, Bellevue is [very much considered] a public hospital.
Some things that I learned:
Although it really was not the first hospital, some people do consider Bellevue to be the first hospital in this country, as Bellevue’s or as it was known back in the day, Bel-Vue’s, history can be traced back to the 1660’s.
Over the years, just as in war, and sometimes because of it, the medical staff at Bellevue developed new techniques and cures for tackling even the most difficult diseased and health crises.
Throughout this book, I learned about various people that made a difference during their affiliation with Bellevue, also known as almshouse, pest house, or death house, as they dealt with diseases and other health issues, such as Yellow Fever, Typhus aka Irish Fever, Ship Fever, or Jail Fever, TB, AIDS, 9/11, and Ebola.
The history about the American physician as compared to their counterparts in the late 18th century was riveting. I especially found the three categories of British medicine: physicians, surgeons, and apothecaries, as well as the descriptions of each, to be most interesting.
By contrast, the world of the American physician and the way people were treated (medically) was most primitive.
The comparison between New York Hospital (private) and Bellevue (public) was another intriguing aspect of this book. Their often shared history is sprinkled throughout and although they share a l-o-n-g history, what occurred after Hurricane Sandy just a few short years ago was fascinating (p. 312), but you have to know and understand said history to realize the impact these decisions had.
To understand Bellevue and its storied history, you have to know the history of New York City (and sometimes the “world” events surrounding the city). Oshinsky does an excellent job in illustrating specific events that occurred during specific periods, i.e. describing New York, its population, etc. during various points, the development of medicine during the Civil War, etc.
During the 1840’s, Bellevue was admitting thousands of patients, mostly immigrants, and mostly people who were unable to pay for care.
Over the years, Bellevue has had to reinvent itself in order to stay relevant. This began with physical improvements, including the addition of a morgue ($60,000) in the 1850’s.
The chapter discussing how hospitals “acquired” bodies (just short of grave robbing) and the description of the “Bone Bill” was engrossing. I would say there are no words, but in reality, there were quite a few. Today, if we treated the deceased as some were treated in the 1850’s, people would be doing more than protesting.
During the first decade of the 19th century, fewer than 400 men had medical degrees in the U.S. Between 1850 and 1859 that number jumped to 17,000+. The preferred “loftier” careers during this period were law and clergy.
As interest in medicine (as a career) progressed, Bellevue reinvented itself, again. In April 1861, Bellevue Hospital Medical College opened its doors. To put this in perspective, this was the day before Confederates attacked Fort Sumter to start the Civil War.
As the war was ending, we learned that the ambulance was widely recognized as a lifesaving tool. In 1869, an idea known as “Rapid Response” that used police wagons to carry the sick and injured was introduced by Edward Dalton. From here, the civilian ambulance seemed to be the obvious next step.
In 1869, Bellevue’s two ambulances had responded to 74 emergencies. A decade later, its fleet of seven would answer close to 2,000 calls, the number peaking at close to 4,400 in the early 1890’s.
Side Note: The brief history provided on Edward Dalton was heartbreaking.
Even its reputation for accepting the “dregs of society,” by 1870, “Bellevue was the uncontested giant of American hospitals. With over 1,200 beds, its sheer size attracted elite physicians for whom the lure of “interesting” patients outweighed the fear of deadly “miasmas” and physical blight.”
Thus, the chapter on Germ Theory and the information tied to the International Medical Conference during our country’s Centennial celebration, as well as English physician, Joseph Lister was riveting. It is during this chapter (and later) that they (doctors of this period) start talking “Antiseptic Surgery.” A WOW (and not in a good way) moment for me was when I read about surgeons holding instruments in their teeth, and more! Ugh! Talk about unsanitary …
From here, we moved on to a discussion about germs and James Garfield. If you read Candace Millard’s book, Destiny of the Republic, you know that the bullet fired from Charles Guiteau’s gun did not kill Garfield. Oshinsky reinforces this point. He also goes back and looks at the “care and treatment” of a few other presidents, but you’ll have to read the book to learn more. However, I will say this, Thank, goodness, for the advances made in medical science over the years!
Between 1879 and 1920, hospital admissions rose from just over 6,500 to more than 45,000! It wasn’t because of immigrants or disease. Rather, it was because public opinion changed in regards to hospitals. They, especially Bellevue, were no longer considered dumping grounds for the lower classes, it had begun to attract “respectable” fold long accustomed to being treated at home. According to Oshinsky, the era of the “private” patient had arrived.
As I mentioned earlier, Bellevue was constantly reinventing itself to stay at the forefront of “modern” medicine. This was never more apparent than with the development of what is now known as Forensic Science by Bellevue physician, Dr. Charles Norris and NYU Chemist, Alexander Gettler. At one time, Oshinsky states, “they didn’t revolutionize this field, they were the field!”
Today, we often hear Bellevue mentioned with regards to its Psych Ward. However, Bellevue had been around for a long time, and developed some amazing ideas, before the Psychiatric building was constructed and opened in 1933, thanks to the legacy of former Mayor, Jimmy Walker.
Side Note: Jimmy Walker was quite a character. His illegal antics make the likes of what has occurred in Chicago, in regards to political corruption, over the years, look like child’s play.
In 1956, a Nobel Prize came to Bellevue. The recipients were Andre Frederic Cournand and Dickinson Richards. They were honored for their groundbreaking work in Cardiac Catheterization. The history of this period, while interesting, was also a little disturbing because a) a share of this prize was given, somewhat controversially, to the little known German researcher who had invented the procedure before joining the Nazi Third Reich as a physician and propagandist: Werner Forssmann, and b) how Forssmann first tested Catheterization (for this last bit, I had to do a little outside [the book] research).
The topic of survival in relation to finances and insurance was fascinating and one that transcended time and is still relevant, today. One thing that I found intriguing was I assumed Medicare and Medicaid was hatched in one of FDR’s New Deals. Wrong! On July 30, 1965, President Lyndon Baines Johnson signed legislation that created Medicare and Medicaid, with former President Harry S. Truman, an early crusader for national health insurance, standing proudly at his side. The difference between these two forms of “socialized medicine,” while not at all surprising, was enlightening.
In the chapter about AIDS, I was stuck by the paragraph where Oshinsky says “ … some medical professionals seemed grateful for the chance to work with AIDS patients. AIDS was humbling. It taught humility and perspective . . . It deepens your humanity.” (p. 272)
The legal and ethical discussion was another interesting one. Doctors and if / how they treat you is not always cut and dried. It’s when all of these other factors weigh in that things get complicated.
The story surrounding the death of Kathryn Hinnant was heartbreaking, but it also makes me wonder how security at the hospital has changed in the last [almost] 30 years.
Today, almost 16 years after the fact, Bellevue’s role in 9/11 is ongoing. Its pathologists played a major part in identifying the victims, a painstaking process with 1.200 people still unaccounted for.
Even with 9/11, the term “Emergency Preparedness” wound not truly be developed until Hurricane Katrina in 2005. Today, Emergency Preparedness falls into two categories: Before Katrina and After Katrina. I believe this may develop further with the recent events tied to Hurricane Harvey.
Over the years, Bellevue has stayed true to its original purpose. Today, as before, its patients are overwhelmingly immigrants and their young children – no longer from Europe, but Mexico, Central America, the Caribbean, West Africa, South Asia, and China. Few carry private or group insurance. Indeed the hospital receives more money from the Department of Corrections for treating prisoners than it does from Blue Cross / Blue Shield. Most patients rely on some form of Medicaid; the rest are called “Self-Pay” aka “No-Pay,” meaning the uninsured.
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