Bellevue Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital: Book Review


By David Oshinsky

In 2016, a Johns Hopkins safety review panel reported that every year, 250,000 deaths in the United States are attributable to medical error. That’s a whopping 9.5% of all deaths in the country. As eye-opening as this statistic may be, it pales in comparison to deaths attributable to medical misadventure in previous centuries. According to David Oshinsky, author of Bellevue, eighteenth and nineteenth century medical treatment was as likely to be the cause of death as it was to save life. The evolution of medical care from that dark age occurred in fits and starts. Dr. Oshinsky offers a gripping description of the journey from darkness to the relative enlightenment of today.

This author skillfully blends medical and social history. He demonstrates the knack of a skilled teacher as he weaves anecdotes into a narrative of hard facts. Dr. Oshinsky has so much information at hand, that he doesn’t need to resort to conjecture to enliven his story. Truth, he proves, is indeed stronger than fiction.

Examples of Dr. Oshinsky’s dynamic writing are on display throughout the book, most memorably in his descriptions of surgery without anesthesia and treatment without antiseptics. In the first case, a boy’s leg is amputated. The father is present and aids in restraining his son. The sound of a saw fills the surgical theater as the child, without benefit of anesthesia, loses his leg. Shrieks fill the room. The father faints. We, the readers, are left with an indelible impression.

In another instance, President James Garfield suffers the consequences of medical obstinacy. The President is shot. An assassin’s bullet must be removed. The esteemed Dr. Frank Hamilton of Bellevue is called in. He, confident in his skills, declines to follow new guidelines in medicine that prescribe sterilization before contact with a patient. Garfield dies, month later, of massive infection. It is the medical consensus that this death was due not to an assassin’s bullet but to medical misadventure.

Dr. Oshinsky comes to the task of writing his book with excellent credentials. He is a professor of history at New York University and the director of Medical Humanities at NYU Langone Medical Center. In addition, he has won a Pulitzer Prize for an earlier book, Polio: An American Story.

The current book, Bellevue, is about the history of a public institution, and it is more. It traces the history of health care in New York City. It introduces readers to some giants of modern medicine, including Robert Koch, Joseph Lister and Florence Nightingale. The author’s broad perspective offers insight into the immigrant experience and its intersection with New York City politics. Dr. Oshinsky’s wide lens creates a richly textured tableau in which Bellevue Hospital is the focal point.

Bellevue is an easy read. I recommend it to anyone interested in history, and to those readers who would like to gain insight into the culture of the medical profession.

By A. G. Moore 2/10/17

The picture of Bellevue Hospital (above) is used under a Creative Commons
 4.0 International License

The Tightrope of the Absurd: A rational Spirituality for the 21st Century and On being Human

sisyphus-tiziano_-_sisifo
Sisyphus, by Titian, 1548-1549. Copyright Expired

By Sybe Starkenburg

The Tightrope of the Absurd is not light reading. I actually began to write about the book before I had finished reading because I wanted to lodge a disagreement with the author. That’s a good thing. A great book is not one that I agree with. It’s one that makes me think, that expands my universe of observation and consideration. The Tightrope of the Absurd does that.

An example of my philosophical falling out with the author follows: Mr. Starkenburg states that “Good is everything that benefits mankind…” and that “the main value of life is life itself”. I took exception to this proposition because I found the two parts of this statement to be in conflict. It struck me, as I read, that the human race is essentially parasitic on earth, that humans are inimical to earth’s existence. It can be argued that, as humans evolve, we consume and destroy the planet that sustains us. Our predatory relationship with the host planet is so extreme that many scientists believe space travel is an imperative. We look forward to leaving this dying orb and colonizing others, so we can feed off them, and move on again. Just a thought I had. Mr. Starkenburg’s book does that to me–makes me think.

Mr. Starkenburg is a well-read man. He brings together ideas from some of the most profound thinkers through the ages. A few to whom Mr. Starkenburg gives deference, I consider to be lightweights, or even disreputable. One of these is Ayn Rand. Mr. Starkenburg and I can disagree about that. What matters is that I care to disagree, that I’m moved enough by his suggestions to take exception to them.

The essence of Mr. Starkenburg’s argument, as I understand it, is this: The only path to humanness, to being truly human, is through rational, conscious and deliberate thought. Religion, in his view, is not rational but is based on belief and custom. Religion, he suggests, is an obstacle to achieving humanness.

Mr. Starkenburg evaluates the need that religion seems to fill in people’s lives. One need, or hunger, that it satisfies is the search for meaning. Can life have meaning without religion? In response to this question, Mr. Starkenburg cites the philosophies of, among others, Jean-Paul Sartre and Viktor Frankl. Sartre asserts that life has no essential meaning, but is merely improvised. According to him, none of us has a script. We merely respond to circumstances as they arise. Frankl, who survived a Nazi concentration camp, suggests that meaning can be found in life but only if it is lived in a way that is true to each person’s intrinsic nature: Be True to Thyself

Weighing the philosophies of Jean-Paul Sartre and Viktor Frankl is an interesting exercise, no matter the outcome. That’s the value I found in The Tightrope of the Absurd. It wasn’t in the strength of Mr. Starkenburg’s arguments, although he solidly supports every position he holds. The value was in the way he built those arguments, the wide array of material he brought into the discussion, and the place he left for me to agree or disagree.

It would be impossible in the space of a short review to do justice to Mr. Starkenburg’s book. To sum up, anemically: Sybe Starkenburg offers a moral and philosophical thesis about how to have a full, thoughtful and positive life. He suggests that empathy is a critical component to this life, empathy not only toward people, but toward other species.

Not everyone will enjoy this book, but readers who are open to new perspectives probably will. And if they are, like most of us, beset at times by a vague uneasiness about existence and religion, this book may suit them. It will not answer every question, but it will address the urge to find answers. It will offer ideas about how to think and where to search for answers to questions that are pushed to the back of the mind. Mr. Starkenburg would surely recommend that these questions be welcomed, because they won’t go away. They’ll lurk in the background and influence every other area of life until they are confronted rationally, consciously, and deliberately.

North Korea’s Hydrogen Adventure and The Atomic Age: A Look Back at History

By A. G. Moore

nagasaki blast scaled for site
Atomic Cloud Rising Over Nagasaki, August 9, 1945 Photo credit: Hiromichi Matsuda (松田 弘道) August 9, 1945

It was June, 1942.  The world was at war.  In Europe, the war had begun in 1939; in the US active engagement had not begun until 1941.  Fighting was fierce and the outcome uncertain. After much prodding by scientists, including Albert Einstein, US President Franklin Roosevelt agreed to approve development of an atomic bomb. Thus commenced The Manhattan Project.

A debate about the location of the project ensued.  It was eventually decided that physical construction of the bomb would take place in a remote location–Los Alamos, New Mexico. This was to be a top-secret effort, joined by scientists from several nations.

Work proceeded feverishly.  The race was on, participants believed, to beat the enemy in the development of a catastrophic weapon.  They were convinced that whoever got the weapon first would likely win the war. When researchers thought they finally had a workable bomb, many wondered if they should test it. Would the world blow up? This was a question actually asked by one of the researchers, Edward Teller.

On July 16, 1945 the first atomic bomb was detonated in Los Alamos. Though a few scientists thought the device might not work at all, Enrico Fermi, a lead scientist, took bets on whether or not the explosion would ignite the atmosphere. He speculated that if this happened it was possible that not only New Mexico would be incinerated, but also that the world would be destroyed. While some colleagues thought Fermi was jesting, it was seriously considered that the bomb could turn the whole planet into a bomb.

Nonetheless, scientists proceeded with the detonation.  As it turned out, they did have a workable bomb. The results of their labor–the first atomic bomb in history–was given to politicians. At this point, WWII in Europe was over.  Germany had surrendered in May of ’42.  Germany’s defeat allowed the US and its allies to focus energies on the remaining opponent, Japan.
Throughout the war there had been two fronts, one in Europe, against Germany and the other in the Pacific, against Japan. Japan was a tenacious and fierce opponent. As German forces withdrew, Japan fought on and showed no intention of bowing before an invading army.

Faced with a grueling and bloody ground assault, the US decided to choose a more efficient road to victory over Japan.  On August 6, 1945 the atomic bomb was dropped on the city of Hiroshima, Japan.  Two days later, a second bomb was dropped on Nagasaki, Japan. Some observers estimate the number of deaths from the Hiroshima blast to have been about 135,000 and from the Nagasaki blast to have been about 75,000.  Neither of these figures include long-term exposures to the blast.

The Japanese quickly surrendered.  Faced with what appeared to be the obliteration of their nation, they agreed to almost every demand made of them.   WWII came to an abrupt end and the world entered a new era: the Atomic Age.

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Much of the above essay was adapted from the book, What is Radioactivity? The Basics, which is a Rhythm Prism publication.