New York City likes to wear its makeup thick. In places like Fresh Kills, Rikers, and Bellevue—a landfill, a jail, and a public hospital, respectively—you’ll find glimpses of the things that the city would rather not show you about itself: its dirt, its inhumanity, its sickness. But each of those institutions sits far from most people’s everyday paths through the city. Stay long enough in New York, however, look and listen closely enough, and you will catch the occasional glimpse: the late-night trash trains moving slowly through the subway system; the view of a sprawling jail complex as you fly into LaGuardia Airport; the fables surrounding Bellevue’s psych ward, which has become a synecdoche for the hospital. (After his own stint there, the bassist Charles Mingus composed “Lock ’Em Up,” whose subtitle promises a “Hellview of Bellevue.”)
David Oshinsky, author of the Pulitzer Prize–winning Polio: An American Story, delves into the history of the medical facility in his latest book, Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital. A historian at the University of Texas, Oshinsky argues that the cultural narratives surrounding Bellevue have eclipsed much of its medical and historical significance to New York City, and indeed to America: “The relentless focus on its eccentricities has obscured its role as our quintessential public hospital.” Oshinsky attempts to remedy this (mis)understanding by concentrating on Bellevue’s robust and distinguished medical legacy.
He colors his study with a multitude of stories, all of which stress Bellevue’s many important medical and scientific “firsts.” We learn, among other things, that Bellevue was the first hospital to perform a birth by Caesarean section in the United States; that it innovated the use of ambulance services during the Civil War; and that it helped pioneer medical photography in the mid-19th-century.
Bellevue is America’s oldest public hospital, beginning its existence in 1736 as a meager six-bedroom almshouse on the site of today’s City Hall. In the 1700s, New York was hit by waves of epidemics—smallpox, diphtheria, scarlet fever, and influenza—that new immigrants brought with them. The spread and longevity of these diseases were heightened by the close proximity of residents and the poor sanitary conditions across the city. In 1795, the New York Common Council leased a parcel of land along the East River—known as “Bel-Vue”—as a place to quarantine victims of yellow fever some miles away from the city itself. After leasing Bel-Vue for several years, the city finally purchased the site in 1798, with the goal of providing “a single complex for the diseased, desperate, criminal, and insane.” By 1816, Bellevue had become the antidote for all of the rapidly growing city’s ills, as officials expanded the facility—now known as the “Bellevue Establishment”—to include an orphanage, a morgue, a pest house, a prison, and an asylum. Centralizing these public services in one place underscored the prevailing public-health approach at the time: containment and isolation.
Oshinsky contrasts Bellevue with New York Hospital, the city’s other key medical facility during this period, to demonstrate its burgeoning—and stigmatized—image with the public. New York Hospital “had been built as a refuge for the sick, [Bellevue] as a warehouse for the destitute,” he notes. “One had a welcoming facade; the other resembled a walled-in fortress.” So common was this attitude toward Bellevue that New York Hospital actually began “dumping its sickest patients” there.