The View from the Vue

THE VIEW

FROM THE VUE

Larry Karp

FOR MYRA

        
Preface

        Introduction: An Overview of The Vue

1.     Don’t Go Away Mad

2.     It’s Hard to Get Good Help Nowadays

3.     Of Bums and Camel Drivers

4.     The Chicken-Soup-for-Lunch Bunch

5.     Gays, Too, Came to The Vue

6.     Marriages Are Made in Heaven

7.     Things Ain’t Always What They Seem

8.     The Healing of John the Baptist

9.     I’d Rather Be Lucky Than Good

10.   The Dumping Syndrome

11.   A Receptacle for All Purposes

12.   You Rape ’Em, We Scrape ’Em

13.   Come Quick, Doc, He’s Dead

14.   All the Monkeys Weren’t in the Zoo

15.   Visitations at The Vue

16.   A Blood Brotherhood

17.   They Shall Beat the Interns into Pruning Hooks

18.   And Gladly Did They Learn

19.   Internship Is Fun and Good for You

20.   Everything’s Up-to-Date at the Vue

        Epilogue

One day in the autumn of 1958, I went for an interview to New York University School of Medicine. N.Y.U.’s major affiliated teaching facility was (and still is) Bellevue Hospital. During the course of my interview, the Dean asked me why I wanted to go to medical school. I told him:

The Dean cleared his throat, and I jumped out of my chair. But then I saw the corners of his mouth flickering upward, and I heard him say:

I thanked the Dean and went home. My letter of acceptance arrived three days later.

So, I went to Bellevue. During the next six years, as medical student, intern, and resident physician, I watched in gratified amazement as great giant hordes of peculiar individuals acted out their scenes before me. I had been right: there seemed to be something in those dingy wards and hallways that brought out the exceptional in the inhabitants, whether they were patients, relatives, or hospital employees.

When the new Bellevue Hospital, twelve years in the building, finally opened a few years ago, alumni throughout America sighed in relief and offered the opinion that life at The Vue would henceforth be very different. But I knew better. It didn’t matter that the physical structure was new, because the hospital would continue to be inhabited by the very same cast of characters who had always caused Bellevue to be a singularity, and who always will.

This is a book about the singular people of Bellevue Hospital.

L
AURENCE
E. K
ARP

We called it THE VUE, and without a doubt that was the most complimentary nickname Bellevue Hospital ever had. More than once I heard someone call the place Bedlam Hospital, after the infamous London madhouse. Other sobriquets were even more derogatory. In the process of interviewing an internship candidate, one of the residents referred to his place of employment as Satan’s Little Acre. And one day, as I got up to debark from a bus pulling to a stop in front of Bellevue, the driver sang out, “Foist Av’noo’n Twenty-six Street. Noo Yawk City Slaughterhouse.”

There existed many reasons for the plethora of nasty names. Throughout its very long history Bellevue has traditionally dispensed free medical care to the needy, and people generally feel that anything free is worth no more than the price. Bellevue has long been associated with medical schools; hence it became known as the place where innocent patients were butchered by students while learning their trade. Then too, The Vue possessed a well-earned reputation as an outstanding research center which, unfortunately, gave rise to the belief that if you were lucky enough to escape the blunders of its medical students, some nut in a long white coat would turn you into a guinea pig. Nor did certain of Bellevue’s component parts help its image; for any huge general hospital which also happens to contain within its walls both a major psychiatric institution and the city morgue is more likely to inspire trepidation than adulation in the minds of the local populace.

Perhaps as much as anything, Bellevue’s very appearance was responsible for its lack of charisma. Many of today’s medical centers, especially those seen on television, are soaring glass-and-concrete architectural triumphs, designed to lead people to imagine that the gods of healing truly do reside there. In contrast, Bellevue appeared to have been constructed by a man whose mother had been frightened by a Picasso drawing of a toad.

Set down on a rectangular plot bordered by the East River Drive, First Avenue, Twenty-sixth Street, and Thirtieth Street, The Vue was a dreadful mélange of squat buildings of dark red and dirty yellow brick. The various edifices were put up between 1904 and 1940, each part a seeming afterthought, connected to the others by endless mazes of hallways and subterranean tunnels. The entire complex was surrounded by a black iron fence. An uninformed visitor to New York City, on seeing the hospital, would most likely have assumed it to be a prison built especially for the detention of the most despicable and miserable sorts of criminals.

If such a visitor were sufficiently courageous to set appearances aside and walk into the hospital, he would have been even more dismayed. Entering through the main door, he’d have found himself in a large lobby, consisting of a wide walkway running past a line of information cages, whose bars reinforced the general prison-like appearance of the institution. On the other side of the walkway, and occupying most of the lobby area, he’d have seen rows of brown wooden benches. Most of the seats would have been occupied by as colorful a representation of the lower socioeconomic classes as one could possibly find anywhere on earth.

Bowery bums would have been scattered here and there, mostly sitting hunched forward, staring at the floor. Perhaps one, his head wrapped in bandages and gauze, would have been lying on his side, his knees drawn up to his chest and his mouth hanging slackly open. Nearby, but at a discreet distance, an old woman with a shawl over her stringy gray hair might have been sitting with a shopping bag between her feet, her eyes darting back and forth as though on guard against an imminent assault. Three benches away, there could have been a junkie, nodding off to sleep. Around them all, large numbers of ragged little children of all sizes and colors would have been charging back and forth, playing tag and chasing each other between the benches. Occasionally, the old woman would have become irritated and shooed some of them off. They’d have laughed at her and continued their games. The visitor would have wrinkled his nose against the stench of unwashed bodies and exhaled alcohol.

Proceeding past the lobby and through the labyrinthine halls, the visitor to New York would have come upon one or another of the patient areas. Private rooms were a rarity at The Vue, the few that existed usually being reserved for sick doctors or nurses who chose to be treated on their home grounds. Open wards were the rule; they contained anywhere from twenty to forty beds in two or three long rows stretching the length of the room. Curtains could be pulled around the beds at the sides of the ward, but privacy was impossible to the inhabitants of the center row.

Everything in the place was in disrepair. Cobwebs and dirt hung in the corners between the high walls and the ceilings. No wall was without its region of peeling paint or plaster. The hands on the flyspecked clocks stood motionless, except for the occasional pair that zoomed through hours in seconds, giving off a buzzing noise as they did. Lighting was dim throughout, and dark shadows that moved slowly across the walk, floors, and ceilings produced an atmosphere of depression which continually affected the mood and behavior of the inhabitants.

Right from its beginning, Bellevue was Bellevue. The institution dates its origins, spiritually, if not physically, to 1736 when a six-bed infirmary was set up in the New York Publick Workhouse and House of Correction, located in the region of the present-day entrance to the Brooklyn Bridge. There, the medical and surgical needs of the inmate prisoners and indigents were attended to.

As early as 1811, New York was beginning to show signs of growing pains, so the city purchased a large farm on what was then uptown land, near the East River. A part of this region was known as Belle Vue (which it may well have been at the time), and the public hospital facility constructed on the site took its name from the location. Like the city it served, it grew like Topsy.

By 1877, one hundred years ago, The Vue had twelve hundred beds, an emergency room, ambulance services, and outpatient facilities. (These latter three attributes were all Bellevue innovations.) It even had its own medical school: after a decade during which lectures and surgical demonstrations were presented on a loosely organized basis, the Bellevue Hospital Medical College was founded in 1861. This marked the formal beginning of The Vue as a teaching institution, a
modus operandi
which has persisted to the present day. But not via the same vehicle. Little more than thirty years after it had begun operations, the physical plant of the Bellevue Medical School was destroyed by fire. The faculty then accepted the offer of the nearby New York University Medical College to share its facilities and, in 1898, the Bellevue people decided to merge with their benefactors rather than rebuild. Thus began the association between N.Y.U. and The Vue, which has continued without interruption for the past seventy-nine years.

During this interval, Bellevue has been the focal point of many historic medical crises and catastrophes. During the early years of the twentieth century, there were several spectacular fires in lower Manhattan. When the steamer
General Slocum
burned in the East River in 1904, more than a thousand of its passengers were killed and several hundred were injured. The majority of these survivors were brought to The Vue by horse-drawn ambulances. The same equine-powered conveyances also brought in the victims of the 1911 Triangle Shirtwaist Company fire and the 1912 Equitable Life Assurance Building conflagration.

The year 1918 marked the great influenza epidemic, and the lion’s share of the seriously ill New Yorkers received their inpatient care at The Vue. Since there was no effective treatment for the condition, mortality rates were astronomical: on one particular day that fall, sixty-two Bellevue inmates lost their battle with the flu bug. Included among the grim statistics were several members of the hospital’s nursing and physician staffs.

In the spring of 1947, New York City had a serious smallpox scare. The disease was brought in by a traveler from Mexico who, on his way to Maine, got as far as Gotham before collapsing. Guess where he went for help at that point. Before the problem was declared solved, two months had passed, twelve people had come down with smallpox (two of whom died), six million citizens had been vaccinated, and the city had spent more than $800,000 to prevent the generalized epidemic which otherwise would certainly have occurred.

Around the turn of the century, it became apparent that the physical facilities were grossly inadequate for the medical load, and what was left of the grass and trees from old Belle Vue began to disappear under tons of brick and mortar. New buildings were erected in 1904, 1908, 1911, 1916, and 1917. In 1926, Mayor Jimmy Walker referred to the psychiatric facilities as “a state of affairs in which I wouldn’t ask my dog to be kept.” Four years later, Beau James presided at the ground-breaking ceremonies for the new psychiatry pavilion, which was opened in 1935. Lastly, the administration building, at the front and near the middle of the complex, was completed in 1940. With that, almost every inch of space was occupied, with the exception of a parking lot in the back.

But Manhattan continued to outgrow The Vue, and by the early 1960’s, New York City’s Municipal and Hospital administrations reached the decision that the conglomeration of now old buildings could no longer be tolerated, and that an entire new Bellevue must be built. That was the end of the parking lot. Having the unmistakable evidence of wisdom of brick-and-mortar neighbors on all sides that proved the folly of wasting air space in twentieth-century New York City, the administrators and the architects resolved that Nova Bellevue would scrape the sky like all modern structures, and thereby require a minimum of ground space. A deep hole was sunk into the turf where Pontiacs and Volkswagens had once pranced, and there it remained for several years, periodically filling up with water, awaiting the resolution of multiplex municipal squabbles that delayed construction progress. But finally, in 1966, construction was resumed, and after seven more years had passed the new building was dedicated. All things take time. Especially at Bellevue.