Biography of a Hospital

Book review: Bellevue, by David Oshinsky

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.

Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital
by David Oshinsky
published November 15, 2016 by Doubleday 

I received an advance ebook copy courtesy of the publisher via Netgalley for review.

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