By George Capsis
It was two o’clock in the morning when Maggie discovered, that with blood thinners to avoid a blockage in a newly-implanted heart stent, her nose would not stop bleeding—it flowed but it really gushed, and for the first time in our 55 years of marriage, I saw fear in her eyes. We got dressed and walked to the St. Vincent’s Emergency Room, and a very calm, very mature nurse stopped and asked us to stay a while, “just to be sure.”
So there we were, sitting with a dozen or more recovering emergency room patients, and I tried to guess what they were in for. The serious ones were silent with closed eyes and some with bandages, but there was a very young girl, who at a party took drugs for the first time. And then there was the guy too drunk to drive home to Brooklyn, just sleeping it off.
Even before St. Vincent’s closed its doors, Beth Israel on 16th Street and 1st Avenue knew its emergency room was too small, so they doubled the size. And now Dr. Davis, who heads the parent hospital Mt. Sinai, announces that to end the projected $400+ million loss, they will close the 126-year-old hospital overlooking historic Stuyvesant Park and sell the very valuable real estate to a luxury condo developer. But have no fear, with the $500 million, they will get their will to build urgent care centers all around the community they now serve.
For maybe ten years now, the concept of urgent care centers has been (as they say) gaining ground, and you get different reasons as to why depending on whom you ask. But no question, an urgent care center is much cheaper to build and operate.
Now, when in 2010 we had lost St. Vincent’s, the CFO of North Shore Long Island Jewish Hospital (now Northwell), Michael J. Dowling, got up on the stage of P.S. 41 to a bristling, angry, and packed auditorium, to explain in his Limerick accent that the 161-year-old hospital would be replaced with an urgent care center, “that could take care of 85% of all medical emergencies.” All I could think of was, “What happens to the 15%?”
I have no doubt that hospitals today are crazy expensive to operate. And I wonder how the four or five remaining large economically viable ones in New York do it, when drugs like the life-saving but patented EpiPen can rise from $100 to $600 in just months (when do sharp business practices become greed?).
A lot of studies have been done recently on who goes to the emergency room. But it starts with people who have little or no insurance and know by word of mouth that the law says they have to be treated; they just take it as a matter of course, and they don’t have to make an appointment and certainly do not have a primary care physician. If you have a serious pain, you go to the hospital emergency room. If, right now, you go to the Beth Israel Emergency Room off 1st Avenue on 16th Street, you will find a lot of people sitting and waiting and waiting, sometimes for hours.
But when Caroline and I went to what is now called Lenox Health Greenwich Village, there was nobody waiting. Indeed, the entry desk clerk asked me how I was before I could ask for Alex Hellinger, the Director. I recalled that last year I had come as a patient, and they offered me a drink while I waited just minutes for the nurse, then for the doctor—oh wow, sheer luxury.
At St. Vincent’s, as Associate Director Dr. Kaufman offered, the “emergency room had 22 operating rooms and treated heart attacks, strokes, infections, overdoses, psychotic episodes, and suicide attempts.” And as I write this, I can see Director Hellinger’s smiling offer that they “treat” all of these as well; but if they have to operate, they “stabilize you,” and send you by standby ambulance to Lenox Hill or a hospital of your or your doctor’s choice.
So what is new with this gleaming white 13th Street and 7th Avenue facility? It has installed a complete set of gleaming state-of-the art-imaging equipment. They seem to have all of it—MRI, ultrasound, digital x-ray and, I would guess, the full selection of medical imaging equipment currently being used. An MRI operator proudly offered that their new software app made it one of the most advanced machines in the city.
And pride and competence emanated from the staff—they have one of, if not the most advanced medical imaging facilities in the city. I recalled an x-ray I had taken for my knee operation a year ago in a medical office on 14th Street, where the operator asked me to pull up my feet so he could get around the operating table that almost touched the wall.
But they do not have an operating room, nor does the management plan to ever have one.
They will have outpatient surgery, which is sort of new. Let me give you an example: 40 years ago, when we bought 69 Charles, I was moving heavy slates in the garden when my intestines popped through my flabby stomach muscles (a hernia), and I spent two days in Mt. Sinai. Then a few years ago, I had another and went to the Phillips Ambulatory Center, and after my non-invasive operation I was invited to go home.
Next year, Lenox Health will invite West Village physicians to rent offices on one of its six floors all-glistening with recent refurbishing. And they even plan a community conference room—wow, we could use that.
OK, if we measure the quality of this imaging center, it is one of the best. But when I spoke to the head physician, Dr. Scott Cruzen, as to where they take a heart attack victim, he offered quickly “Beth Israel,” which has a 24-7 operating room. But that hospital is slated to close, which means that a heart attack patient now may experience massive muscle loss, permanent heart failure or death traveling to NYU or Bellevue. No, we still need a for-real operating room in the West Village. But I can still hear Michael Dowling saying in his Irish brogue, “a new hospital will cost you a billion dollars.”
Ah, but we have Dr. Davis of Mt. Sinai offering a hospital with 24-7 emergency rooms to be built on a small plot they own next to the shabby Eye Ear hospital on 2nd Avenue and 14th Street, and a superb start of a hospital in the Cancer Center built by St. Vincent’s before they went under, on 15th Street between 8th and 9th Avenues. Dr. Kaufman has suggested leasing floors above it from the new landlord, Google, and making it into a full hospital (it already has two operating rooms), and Lenox Health could be the diagnostic center for that hospital.
This city has lost 20 hospitals in 16 years but with this loss is the loss of real emergency rooms with 24-7 operating rooms. So, the distance a heart attack victim has to travel is growing and as Dr. Kaufman complains, “ they calculate the loss in operating dollars but nobody is counting the loss in lives.”