Like Broadway, Harvard, and Alcatraz, it holds such a prominent place in American culture we know it by a single name: Bellevue.
Founded as an almshouse in lower Manhattan in the early 18th century, Bellevue has treated the famous and infamous, been memorialized by poets and novelists, and made more appearances in the news and in movies than any other American hospital. From the late 19th century, when an expose of the inadequacies of its treatment of the mentally ill appeared in Joseph Pulitzer’s muckraking New York World, through media coverage of its prominent role in the AIDS epidemic, Hurricane Sandy, and the Ebola crisis, Bellevue has rarely been out of sight — or out of the public imagination.
In his brilliant and deliciously readable new book, “Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital,” David Oshinsky, a professor of history and director of the division of medical humanities at NYU, entertains the reader with lurid tales of murder, madness, grave robbing, and even cannibalism that have been part of Bellevue’s legendary past. But, as in “Polio: An American Story,’’ for which he won the Pulitzer Prize in history in 2006, Oshinsky uses his subject as a lens through which to explore broader themes. The story of Bellevue, Oshinsky convincingly demonstrates, is the story of modern medicine, of New York City, and of America itself.
As a public hospital since its inception, Bellevue has always held a unique and precarious position as a “vital safety net,’’ according to Oshinsky. From the 1700s, when it housed victims of a yellow fever epidemic (thousands of whom now lie buried beneath Washington Square Park), to the 1800s, when Irish immigrants fleeing the potato famine sought care there, to today when refugees from around the world flock to its open doors, Bellevue has served the poor, the suffering, and the shunned. Now, as in the past, Oshinsky writes, “ . . . those with viable options almost always wind up somewhere else.” The diversity of its patients has made Bellevue a humanitarian bastion and also a leader in medical education and research.
But, Oshinsky argues, being a haven for the poor and the outcast has made Bellevue vulnerable. “In that role, Bellevue has borne witness to every imaginable disease and public health scare, every economic swing and population surge, every medical breakthrough and controversy going back more than two centuries . . . Its survival has never been assured.”
Nowhere has this vulnerability been more evident than on Bellevue’s psychiatric wards. The mentally ill, who, like immigrants, criminals, and the poor were among the hospital’s earliest patients, were once kept chained in its basement. In the 19th century, conditions became only somewhat less abysmal when an asylum connected with Bellevue was established on what is now Roosevelt Island. Journalist Nellie Bly was admitted there after feigning hallucinations. Her article, “Ten Days in a Mad-House,” did not improve Bellevue’s already dubious reputation.
During the Depression, despite quipping glibly that the mentally ill needed “more pasta and less psychiatry,” Mayor Fiorello Laguardia poured federal dollars from the New Deal into Bellevue’s psychiatric department. By the 1940s, Bellevue had become a pioneer in the field and introduced shock therapy to the United States. But the glory of this advance would be tarnished by revelations that Bellevue psychiatrists had misused the new treatment in children.
Eugene O’Neill, Norman Mailer, Sylvia Plath, and John Lennon’s killer, Mark David Chapman, have been among Bellevue’s many well-known psychiatric patients, as were the alcoholics in Billy Wilder’s 1945 Academy Award-winning film, “The Lost Weekend,’’ and Kris Kringle, in the Christmas classic, “Miracle on 34th Street.’’ Today, more than a century after Charles Dickens, no stranger to gritty scenes, reported feeling “deep disgust and measureless contempt” during a tour of Bellevue’s asylum, “being taken to Bellevue” is still often (unfairly) considered a nightmarish prospect.
Also unfair is the fact that the more sordid aspects of Bellevue’s past are better known than the hospital’s many achievements. Bellevue is home to the nation’s first maternity ward and ambulance service and New York City’s first morgue; the first mitral valve replacement and cadaver kidney transplant were performed there; Bellevue physicians made groundbreaking discoveries in the treatment and prevention of tuberculosis, hepatitis, HIV, and Ebola; and a Bellevue physician won the Nobel prize for his contributions to the development of cardiac catheterization.
Oshinsky’s admiration and affection for Bellevue is clear, as in his moving description of the bucket brigade of staff who passed hundreds of five-gallon gasoline containers up 13 flights of stairs when Hurricane Sandy knocked out the hospital’s power in 2012. But warm feelings don’t keep Oshinsky from offering the darker side of such heroic episodes. He also recounts how thousands of lab animals, caged in the basement of a nearby NYU research building, drowned during the storm.
Underfunded, overcrowded, and faced with epidemics, scandals, and assorted catastrophes, Bellevue has seemed on the brink of extinction for three centuries. In this masterful history, Oshinsky reminds us that, like the city it serves, Bellevue always bounces back.
Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital
By David Oshinsky
Doubleday, 387 pp., illustrated, $30
Suzanne Koven is a primary care physician and writer in residence in the division of general internal medicine at MGH. She can be reached at email@example.com