From its founding 1736, Bellevue Hospital has been a dumping ground into which a city poured its poor, elderly, and dying. What makes the oldest hospital in the United States unique is that Bellevue is a place from which no one in need is turned away. Bellevue Diary is a collection of short stories borne out of Dr. Monif 's year of internship that collectively pays tribute to this great hospital. "Bellevue Diary is mosaic of short snippets of stories. Mosaics have to be near perfect to work. Ironically, this one comes close. What is surprising that it works on multiple levels: a historical characterization of a place and time and the impact of the Bellevue Hospital on a young physician's professional and spiritual growth into which is woven a thesis of death's ultimate meaning. The pieces all come together to make this mosaic good reading" -Peter Firchow, PhD Former Professor of English - University of Minnesota

Bellevue Diary

Lights within the ShadowsBy Gilles Monif

iUniverse, Inc.

Copyright © 2011 Gilles Monif
All right reserved.
ISBN: 978-1-4620-0845-2

Contents

Fred....................................................xBellevue Hospital.......................................2The Room................................................4Doubts..................................................5The Chest Service.......................................8FUO.....................................................8Double Jeopardy.........................................13The Gift................................................14Good Offense, Bad Defense...............................17Tobacco's Addictive Grip................................18The Social Order........................................19Left Breast Coat Pocket.................................19The Dining Room.........................................20A Journey Not Kept......................................21Peking Duck.............................................22Doubts..................................................26A-3.....................................................27Night Sounds............................................28The Touch...............................................29Emergency Room Baptism..................................30No Problem, Big Problem.................................31Checks and Balances.....................................33Mine or Theirs..........................................34VIP Rounds..............................................35Schwarzewolke...........................................36Not My Job..............................................37Fecal Impaction.........................................38Goya versus El Greco....................................40Everybody Knows.........................................41Biggest Show in Town....................................42Coming Home.............................................43Oy, Oy, My Heart........................................45Bells Unrung............................................46A Circus Team...........................................47Hubris..................................................49Sugar-Coated Bagel......................................52My Lady.................................................54Female Medical Clinic...................................56A Grand Event...........................................57When Breath Permits.....................................57Night Becomes Morning...................................58Matthew Greene..........................................62Unanswered Question.....................................63The Front Porch.........................................65Wrong Direction.........................................66Here, Kitty, Kitty......................................67Proximity's Price.......................................68Mother by Necessity.....................................69Second Thoughts.........................................70Chutzpah................................................71Crashing the Gate.......................................72Little Words............................................74Sooner..................................................78New Year's Eve..........................................80A Different Bed.........................................81Miss PanAm..............................................82The Cup.................................................84Snow....................................................85A Drop of Truth.........................................87Reflections of the Father...............................88Not Bricks..............................................90Ashes to Ashes..........................................91A Matter of Pennies.....................................91Score: Country One......................................94Barton & Sons...........................................95Mayhem..................................................96Bellevue Nurses.........................................99Moses...................................................100The Rock................................................104That's It...............................................106The Ugliest Man in the World............................109Sunday Morning..........................................113The Poem................................................115

Chapter One

Bellevue Hospital

In 1736, Bellevue Hospital, the oldest public hospital in the United States, was founded. At the time, George Washington may have been four or five years old.

Following a fire that occurred sometime around the turn of the century, between 1906 and 1939 Bellevue was rebuilt in bits and pieces. She now shows her age: a conglomerate of brick buildings stretching along First Avenue from Twenty-Fifth Street to Thirtieth Street. The one architectural element that gives her an illusion of grandeur is the Administrative Building, which faces First Avenue. Its strong, vertical, inlaid concrete columns take one's gaze upward to a pseudo-Athenian temple facade that towers two stories above the adjacent roofs.

What makes Bellevue great is that she is the hospital from which "no one is turned away." She is an open-ended funnel into which New York dumps its poor, elderly, and dying. If an individual presents at another hospital for admission and it is apparent that he or she will demand a disproportionate amount of care, the admitting physician has only to write "No beds" and the patient is Bellevue-bound.

Competition for internships at Bellevue Hospital is intense. Its 2,500 patient beds are the medical equivalent of what was once the great library at Alexandria. Within each bed, a potential lesson waits—a lesson in which knowledge is exchanged for a dose of healing. Educationally, big-city hospitals are the Harvards of the medical world, and, as at Harvard, learning can come at a steep price.

The Medical and Chest Services are divided between three medical schools: Columbia University (since 1888), Cornell University (since 1888) and New York University (since 1898). Each institution has imparted to its house staff a unique profile. The Cornell interns and residents are dubbed the "All-American boys." By and large, they tend to be clean-cut and have the distinction of having been elected by their respective school faculties to the national honorary society, Alpha Omega Alpha (AOA). The New York University interns and residents emphasize academic brilliance over decorum and appearance. The Columbia interns and residents are called "the aristocrats of Bellevue." The latter image is largely fashioned by the predominance of Columbia graduates among its house staff. They are New York's response to the proper Bostonians.

My reasons for wanting to be part of the Columbia Medical Service had to do with something else. The Columbia Medical Service at Bellevue had produced more academicians than even the Thorndike Service at Boston City Hospital. In the 1950s, a Nobel Prize in Medicine had been awarded to its director and his collaborators for pioneering research in the area of pulmonary physiology. What I did not know when making my selections for the National Internship Matching Program was that his retirement was imminent.

The Chief of Service's replacement seemed a strange choice: an uptown physician whose patients had, more likely than not, frequented Harkness Pavilion at Presbyterian Hospital. At Bellevue, the patients, more often than not, called the Bowery home.

Despite having graduated in the top ten of my class and having very strong...