As urgent care centers in other parts of Manhattan struggle to cope with the influx of patients resulting from the April closure of St. Vincent’s Hospital, many West Villagers are fearful of what might happen when the next family emergency, freak accident, or major disaster hits.
Jane (she requested her full name be withheld) is one West Villager who has good reason for concern. Thirteen years ago, she was in the best health of her life, as she puts it, “in phenomenal shape.” She took regular flamenco and yoga classes and lived a typical active New York City life.
On the Saturday of Memorial Day weekend, Jane attended two flamenco classes, went shopping and then to dinner and a movie with a friend. At around midnight, she started to feel unwell, and returned to her apartment on Greenwich Street between Charles and Perry Streets. A raging headache set in, accompanied by incessant vomiting and terrible knee pain. She wondered if she had overdone it at dance class, and was reluctant to bother her doctor on a holiday weekend with what might be a 24-hour bug.
“I’m the daughter of an internist and my mom was a medical nurse, so I’m good about describing symptoms over the phone,” Jane explains. It was about eleven a.m. when she finally spoke with her doctor and described her symptoms. He did not offer a diagnosis and did not think her condition was serious enough to warrant a trip to the emergency room. He advised her to take some Aleve to relieve the joint pain she was experiencing.
As the day wore on, however, Jane became increasingly sick and weak. By 3 p.m, she recalls, a weird rash covered her body. Again she called her doctor, whose specialty was hematology. Despite her textbook description of a hemorrhagic rash, he again told her to take Aleve. Jane had felt too ill all day to leave her apartment to purchase some Aleve. A kindly neighbor had been looking in on her, and Jane asked the neighbor to buy the Aleve.
Alarmed by the rash, however, her neighbor urged Jane to call her father, who, along with her mother, lived in Chicago. “By then I was too weak to move at all,” Jane recalls. She managed to reach her father and describe her symptoms. His response: “Jane, get to the hospital immediately.” He believed she had contracted either meningococcal meningitis, the bacterial form of a potentially fatal disease, or acute leukemia, and that she was going into septic shock. It turns out that two of his guesses were correct; the sudden onslaught of meningitis had overwhelmed Jane’s immune system, releasing toxins that caused a destructive cycle of clotting and hemorrhaging. Her blood pressure plummeted, sending her into septic shock.
Within minutes, her neighbor had called an ambulance and her father was on the phone first with the paramedics and then with the St. Vincent’s emergency room. By then it was after five p.m., over 17 hours after Jane had first began to feel symptoms. Although Jane’s doctor was affiliated with New York Hospital, paramedics told her she had to get to the nearest hospital immediately. When she arrived at St. Vincent’s, she had no blood pressure and her organs were failing. A team of doctors went to work on her immediately, one of them Dr. William Mandell, who went on to become head of infectious diseases at St. Vincent’s.
At about 10:30 p.m., Jane went into a coma, remaining in that condition for eight days on full life support, and receiving last rites from a hospital priest. Several of her flamenco friends visited during this time, one of them a flamenco guitarist. He played the first notes of a piece the class had been rehearsing, where the first movement of the dance was a curling movement of the hands. During the opening bars of the song, at the designated moment, Jane’s hands moved slightly. It was the only movement she made all week.
“Doctor’s didn’t expect me to live,” Jane recalls. “Both my parents flew in from Chicago, and the doctors allowed my father take part in determining treatment. They absolutely saved my life.” The doctor who successfully attempted to get her blood pressure back told Jane, “If you had arrived here fifteen minutes later, there would have been nothing we could have done for you.” Later, Jane’s father told her that had she taken Aleve as her doctor ordered, she probably would have gone into immediate kidney failure.
With St. Vincent’s gone, the nearest Level One Trauma Center – the highest designation for trauma care a hospital can receive – on the West Side is at St. Luke’s Roosevelt Hospital at Amsterdam Avenue and 114th Street. On the East Side, the closest Level One Trauma Center is located at Bellevue Hospital (First Ave. and 26th Street). Beth Israel Medical Center (First Avenue and 16th Street). New York Downtown Hospital (William and Beekman Streets), and St. Luke’s Roosevelt (Amsterdam Avenue and 59th Street) are both Level Two Trauma Centers.
Level 1 Trauma Centers are staffed at all times with in-house specialists rather than on-call specialists, and have immediate access to the latest technology and operating rooms. They communicate via radio with the transporting ambulance and meet patients at the door. They are also required to care for more patients a year than Level 2 center; research has shown a correlation between improved survival rates and higher numbers of patients cared for per year.
Eileen Dunn, formerly president of the nurse’s union at St. Vincent’s, says, “On the West Side of Manhattan now, people don’t realize that they’re living under a cloud of ‘what if.’ As a healthcare professional, you never want to have to ask, ‘What if I’d been quicker?’ ‘What if I’d been in the room?’ I strive to never have to say that. But what if a plane went down on the West Side, and you had to get victims to the East Side to a Level One Trauma Center, or if a bomb goes off in a meatpacking district club filled with young kids, or at [the site of the former] World Trade Center? No one thinks about being a patient in a hospital, but we are all one minute away from being one.” Dunn adds, “It’s a really serious situation that we haven’t been able to get the public to understand.”
“When I was in the St. Vincent’s trauma room, there were at least seven or eight doctors in that room working on me,” Jane recalls. “At a certain point I lost count of all the lines they had put in me.” Even with the excellent care she received, Jane lost several of her toes from the trauma, as well as a finger. She could not move, let alone walk when she emerged from the coma, and spent a month in rehabilitation to learn to walk again. Although she says people who know her don’t sense any change in her cognitive abilities, she notices minor deficits now. Still, she is grateful that she came out relatively unscathed compared to what the meningitis could have done to her: “I could be deaf or blind, lost arms or legs, or died,” she says.
“It is such a loss,” says Jane of the shut-down of St. Vincent’s. “I had never been to an emergency room before this happened to me. I knew it was there, but I certainly didn’t know how important it would be to me. People just don’t understand how important it is to have a hospital in close proximity, especially living in a city like New York, where we face many more physical challenges."
Of the urgent care center North Shore Long Island Jewish Health System hoped to open on the site of St. Vincent’s on 12th Street, and now slated to open on 20th Street in Chelsea, and others like it, Jane says, “Those are nothing. That’s not health care. They presuppose that you know how to diagnose yourself, that you know when you’re in an emergency.” Her own case, she says, is proof that because of the extreme duress and chaos of a true medical emergency, no one can make such assumptions.