Nursing Book Club

Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital by David Oshinsky

A colorful (and gruesome) history of big city medicine

To understand the beginnings of charity hospitals is to understand the relationship of society to its poor and sick. In his 2016 book Bellevue, David Oshinsky, Ph.D., director of the Division of Medical Humanities at NYU School of Medicine, describes the origins of one of the oldest and most historically important public hospitals in the U.S.

Almshouses had always existed to care for the indigent, those with no where else to go or no one else to care for them. New York City’s first almshouse was built in 1736 and originally served only 19 people at a time, with a small six-bed infirmary.

By 1795, the city’s population had mushroomed, contagious diseases abounded in the crowded urban conditions and that growing almshouse housed now almost 800 people.

Beautiful View

In 1811, the city purchased land near the East River for a larger facility, known as Belle Vue (“beautiful view“) for its garden-like surroundings. The new facility, now called spelled “Bellevue,” opened in 1816. Although Bellevue was not the first American hospital — that honor belongs to Pennsylvania Hospital in Philadelphia, which began to see patients in 1752 — it is certainly one of the best-known.

Bellevue is famous for the patients it has treated — including Norman Mailer, Sylvia Plath, Charlie Parker, Charlie Mingus, William Burroughs and Mark Chapman — and as a location for books and films. Bellevue was the setting for the 1945 Academy Award winner The Lost Weekend and a brief sequence in 1947’s Miracle on 34th Street. The Bellevue morgue (New York’s first city morgue) also played a role in Francis Ford Coppola’s The Godfather in 1972.

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On the Cutting Edge

However, the Bellevue story has many less-glamorous chapters.

The history of the hospital is also a history of how immigrant populations have been served, how the treatment of mental illness has evolved and the sometimes gruesome development of modern medicine. Bellevue has been on the front lines of the battles against everything from yellow fever to AIDS and Ebola.

The hospital has focused on medical education since before the Civil War and was the training ground for three medical schools in New York City (Columbia, Cornell and New York University). Bellevue has also given us other important advances, including the nation’s first civilian hospital ambulance service, started in 1869.

With over 200 years of history, the important medical and historical events that have taken place there could fill several more books. Not all are in the distant past either. Some more recent shocks have included the 1989 murder of a physician by a homeless man who had been living undetected, within the hospital and the evacuation of the facility during Superstorm Sandy in 2012, the first time that the entire hospital had ever needed to be closed.

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Bellevue has come a long way from its roots. The sheer size of the modern hospital is impressive: more than 2,000 beds with a 600-bed building for psychiatric patients (later turned into a homeless shelter) and the ability to deliver care in more than 100 languages.

Behind the Curtain

Oshinsky is a fabulous storyteller. Once begun, I found the book difficult to put down. While I never worked at Bellevue, I did bedside nursing in other major New York City hospitals and feel proud to share an understanding of the very difficult work that goes on there. It is also fascinating to understand the political and financial machinations that lay behind the hospital’s efforts to serve enormous populations, with varying degrees of success.

Today’s healthcare decision-makers can only benefit from reviewing the ways we have cared for the poor and mentally ill in the past. Medical miracles proliferate around us at an ever-climbing cost, but who will bear that financial and social burden? Oshinsky gives us a look at how these issues have played out in prior generations.

Bellevue: Three Centuries of Medicine and Mayhem at Americas Most Storied Hospital by David Oshinsky (Anchor, 2017).

Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.

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