While browsing through the electronic non-fiction section of my local library using the Libby app on my iPad (also available for Android), I ran into this one by David M. Oshinsky: Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital.
I’m 17% into it and so far, so good. I expect, like the otherwise good The Ghost Map, I won’t be able to stay with this one. The Ghost Map got bogged down in detail and mind-numbing minutia. But it’s another book for which I would say “Read the first half.” It’s a very good real-life detective story and covers an interesting (if gruesome) bit of history.
I suspect it will be the same for Bellevue. Ironically, here on the upper Left Coast, that name is most associated with one of the richer communities east of Seattle. For most, however, it’s always the place in movies where they take the crazy people, including Santa Claus in Miracle on 34th Street.
So, what have I learned? What keeps it interesting despite the story being an inherently grim one? Well, it contains some interesting history of New York. And although the waves of immigration to America becomes but a well-learned statistic, this book brings it to life. It was a veritable plague upon the City of New York.
But one must imagine that for people to suffer what they did, things must have been worse at home. Sometimes the worse thing for them was hospital care. People who avoided hospitals in this period (prior to the early 20th century) were better off. They were places to catch things worse than what one went in with. And medical “care” was still an unscientific mess. Anyone who believes in “global warming” and a number of other pseudo-sciences should read this book. It’s a prime example of how awesomely stupid the “scientific community” can be. They are as prone to anyone to groupthink — even more so.
Without even a scrap of evidence, they were still bleeding people as a curative. “Miasma” was still the reigning theory of sickness. If you can believe this (and if you are here, you can), one enterprising doctor of a ward in an early incarnation of Bellevue said basically, “If bad air is the cause, then why the hell not open the windows and clean the rooms?” He did, even going so far as taking the doors off their hinges. Patients were cleaned and alcohol (really) was used instead of bleeding. This doctor intuited that bleeding only make patients weaker.
And apparently he had a great success rate. It is said (who knows if it is true) that he was able to cure all typhoid cases and never caught it himself. But he was a rarity. His common sense is notable by its widespread absence.
Bellevue itself was a conglomeration of things. First it was just a small clinic. Then it became bigger and was the de facto dumping ground for the incurable and the insane….none of whom could pay. Later, when a large facility was built on Blackwell’s Island (Roosevelt Island), Bellevue found some relief. But any relief periods would be busted by either another wave of immigration or another wave of pestilence — the one going hand-in-hand with the other, of course.
There were one or two other private hospitals that did develop. And they were important. Bellevue was supported by government funds. What certainly helped to make these hospitals (public or private) viable in this period was that doctors (aside from some on-site permanent staff) worked for free (at least they did at Bellevue). It was their opportunity to practice medicine (aka “experiment on the patients” — things were a bit more lax back then) as well as get actual fees from the students they could bring along with them to tudor.
It was a win-win situation, except for the fact that the doctors knew next to nothing about how to cure people of anything but a broken arm. Many, perhaps most, of the private hospitals that began to pop up (Jews’ Hospital — now Mt. Sinai — St. Luke’s or St. Vincent) specialized in their own people but also filtered in regards to the deserving poor as opposed to the undeserving poor (prostitutes, alcoholics, those who refused to work, etc.) Bellevue was the alternative for the undeserving poor. It was commonly a place where many went to die.
These other early hospitals did not intend to function as hospices and did not accept patients who had not chance to recover. With most, you had to be referred to them by a credible source. When plagues hit, they relaxed their standards. But that generally was their orientation.
Where am at in the book at the moment is that a law was just passed in New York City that allowed bodies unclaimed after 24 hours to be used in medical schools for teaching. This was hoped to put an end to the common practice (even by the most respectable of doctors) of grave robbing. It did so. One of the argument so the time in favor of the law is that those who sponged off of society ought to, at least in their death, give something back.
Death was so common, it’s hard to imagine living in that time. Many did not. When an outbreak of yellow fever or typhus occurred, it was a veritable Exodus by the well-off as they exited the city en masse to wait it out in the countryside. I’ll give the book some more time and see where it goes.