St. Vincent's Hospital: what can be done?

 The grassroots movement to replace St. Vincent’s Hospital with a similar facility received a boost on October 17 at a rally in front of the hospital site at 7th Avenue and 12th Street. Speakers ranging from an 11-year-old P.S. 41 student whose brother’s life was saved by St. Vincent doctors to Lt. Dan Choi (who stood up to the Army’s “don’t ask, don’t tell” policy) were on hand to lend their support to the cause.

Among them was Dr. David Kaufman, who served as an attending physician at St. Vs for over 30 years and as director of HIV clinical research. He reminded the assembled crowd that 340 inpatient beds, 22 operating rooms in full-time use, 23 clinics, 18 mental health sites and dozens homeless shelters and outreach programs can’t be shut down in under a month without any fallout. And that’s not even counting the over 60,000 emergency visits that the hospital’s ER logged annually. Dr. Kaufman’s rhetorical question to the powers that be was, “Where have all the patients gone?”

Dr. Kaufmans’s speech brought some much-needed hard numbers to the debate over St. Vincent’s, so WestView will be reprinting it in its November issue. When I spoke to Dr. Kaufman over the telephone, he told me that although he initially thought the cause of The Coalition for a New Village Hospital was a lost one (as apparently do all of our local and state politicians), or at least far-fetched, he’s been encouraged in recent days by the turnout at the rally (an estimated 500 to 1,000 people, depending on whose counting) and by “murmurings” he’s been hearing.

I didn’t feel encouraged after reading an excellent cover story in this week’s New York magazine, St. Vincent’s is the Lehman Brothers of Hospitals, in which writer Mark Levine placed St. Vincent’s closure amid a larger picture of New York hospitals as an outmoded economic model. The high cost of doing business in New York City, shrinking Medicaid and Medicare dollars, powerful private insurers who bully smaller hospitals into low reimbursement rates, and on and on...suffice it to say the story paints a depressing picture.

The even bigger problem for the West Village at the moment, however, is state health commissioner Richard Daines, who did not support a take-over bid by Mt. Sinai, and seems to be content to watch a Darwinian state healthcare scenario unfold to the detriment of the poor, the weak and the uninsured. As Dr. Kaufman put it, our best hope may lie in the power of the vote. “November second,” he told me. “The only way it’s going to change is if we get rid of Daines. Presumably a new governor will put someone different [in the health commissioner’s position.]”

Dr. Kaufman’s parting words were on the 17th were, “This is not a done deal. Maybe, just maybe, it is a new beginning. But it will take the relentless pressure and voice of our community. We need you to speak up, speak out, write, email, demonstrate and never give up.”

For a list of things you can do and politicians you can contact, go to the Coalition's Web Site, and scroll down to "Can't make it today? Here's what you can do."

Remembering St. Vincent's Emergency Room

I’ve spent time in many hospital emergency rooms, but my late-night visit to St. Vincent’s in January 2007 stands out. There were more crazy people, more cops and more drunk and deranged people than average, for one thing. Since I was in Greenwich Village very late on a Friday night, this shouldn’t have been surprising. Getting something as simple as a blanket took an eternity, and the nurses had a gruff, seen-it-all attitude. The place felt more like a scene from M*A*S*H than the sleepy scenarios I’ve witnessed at emergency rooms in Jasper, Alberta, or Toronto. The only one that comes close for sheer colorfulness was Los Angeles County-USC Medical Center’s ER, which featured a higher number of gunshot victims and patients chained to gurneys and guarded by police officers.



This St. Vincent’s memory came to mind because I’ve been speaking to people to get their “St. Vincent’s ER Saved My Life” stories for WestView. Many of them are elderly, and are understandably frightened that since St. Vincent’s April closure, the closest Level 1 trauma center on Manhattan’s West Side is St. Luke’s Roosevelt at 114th Street and Amsterdam Avenue. Their worry: What will happen if another life-threatening asthma attack occurs, or heart attack, stroke or terrorist bombing? The extra 15 minutes or longer, depending on traffic, it takes to get to Bellevue or St. Luke’s could mean the difference between life and death.



The level of complacency among residents here in the West Village is puzzling. As one senior activist in my building put it, “No one cares, because none of them go to St. Vincent’s.” That’s probably true. Affluent, newer residents have specialists and family doctors elsewhere, who did not have admitting privileges at the atrociously mismanaged St. Vincent’s. Perhaps they imagine themselves being expedited to New York Presbyterian’s ER via helicopter when disaster strikes.

 

Older residents—especially those who saw the pivotal and compassionate role St. Vincent’s played in the community during the 1980s AIDS crisis—recall nuns and nurses who were like angels, compassionate doctors and a sense of community at the medical center. By the time I got there, however, it was clearly a hospital and staff that had seen better days, and was just trying to hang on. The important thing, though, was that it was there, it was open, and it offered the community trauma, emergency and crisis centers, as well as the full range of medical specialists on the premises 24/7.

Walk-in urgent care centers are simply no substitute.