Residents created a petition, addressed to NYU Langone Medical Center leadership, outlining the increased risk they face as the demand placed on the hospital system "skyrockets." Although senior psychiatrist Dr. Marvin Stern was available for medical students and house staff, there was not nearly the psychosocial support available as there is today . © 2021 NYU Langone Hospital—Long Island Site Designed & Developed by Multimedia Solutions Multimedia Solutions At the time, Bellevue only possessed one hemodialysis machine – on the Urology service – and it was unavailable. Let us now see how the Bellevue house staff experience has progressively evolved decade by decade from the romanticism of the ‘60s. During attending rounds, the focus was on a meticulous physical exam and rigorous clinical thinking; indeed, as CTs and MRIs were not yet available and X-rays were often of poor quality, the physical exam was crucial. Families of house staff were allowed to join the feast on weekends . Lastly, interns ran the complete blood counts, urinanalyses, and ascitic and cerebrospinal fluid analyses themselves [1,2,3,4]. Image courtesy of Wikimedia Commons. These homecare patients suffered from various maladies, such as chronic heart disease, strokes or other neurological problems, and severe rheumatoid arthritis contractures . Senior residents rotated through electives, including the Chest Service, Neurology/Neurosurgery, and various consult services . Patients with acute myocardial infarction required three weeks of hospital bed rest; those with endocarditis needed four weeks of IV antibiotics;those with hepatitis stayed up to two months until their liver function tests improved . Due to limitations in space, wards were capped at 36 patients, in which case new admissions would be sent to another team . Hometown: Plano, TX Undergraduate: Pepperdine University (Malibu, CA) Medical school: AUC (St Maarten) Internship: Internal Medicine, Nassau University Medical Center (East Meadow, NY) The most prevalent diseases seen by house staff included cardiovascular (drug-related endocarditis complicated by valvular disease and heart failure, rheumatic fever), infectious (residual polio, pneumonia complicated by meningitis, miliary tuberculosis, diffuse gonococcal infection, schistosomiasis in Puerto Rican patients) and malignant diseases [1,2,3]. By the 1960s, Bellevue’s residency program was already well known for its hands-on clinical experience with acute, severe illnesses in medically complex patients, as well as for the resultant high quality of its house staff. First, central venous pressure (CVP) was measured with a water manometer, then repeated while pressing on the abdomen. Overall, approximately one member of the house staff per year developed the type of tuberculosis observed in highly immune individuals: pleural effusion without evidence of a pulmonary lesion . April 23, 2020. I will be compensated and protected under a similar contract to what current NYU residents sign. Duodenal ulcers and associated gastrointestinal bleeding were also commonplace, as H2 blockers did not yet exist . The romantic hospital of the ‘60s – with sprawling wards where interns jumped from roof to roof to transport patient labs – has been replaced by our dear H building, where interns can record their rather heavy “honest weights” outside the attending rooms while admiring the flamboyantly-colored artwork adorning the walls (my favorite piece hangs over the sink in the 16SW observation room). Dr. Grieco’s office, meanwhile, is neatly organized, mirroring his thorough physical exam and structured clinical reasoning during teaching rounds, traits that one can imagine trace all the way back to attending rounds circa 1963 . In 1960, the Medicine service at Bellevue Hospital consisted of four divisions, though this configuration would change dramatically over the next decade. For example, Pochapin asked if his residents had signed the petition so he could meet with them to address the issue, and did not intend for it to be threatening, Greiner said. New York University residents are seeking compensation for the increased risk they face as they are called to the front lines of the COVID-19 pandemic, but leadership has declined their request for hazard pay and now stands accused on social media of gaslighting residents. He presents to me the original, meticulous description of the “methanol” epidemic of 1963, the typewritten paper now foxed, the dark glass presentation slides with light writing still preserved. "We're being asked to go to the front lines and put ourselves in harm's way, yet there are minimal conversations happening about how to protect us physically and economically. Both outpatient and inpatient services were completely free of charge regardless of the patient’s legal status or income; medical costs were completely covered by taxes . All rights reserved. Suddenly, NYU teams had twice as many patients for whom to care, prompting the creation of the Intermediate Medical Care Unit (IMCU), a non-teaching, non-house-staff ward with retired physicians taking care of less active patients with the help of nurse practitioners . © 2021 NYU Langone Hospital—Long Island Site Designed & Developed by Multimedia Solutions Multimedia Solutions They could usually siphon a few hours from their long shifts for sleep [1,2,3,4]. Doctors instead commissioned their patients’ English-speaking children, other patients, or staff to help with translation, inevitably leading to misunderstandings [2,4]. When other hospitals closed their doors to new admissions because they were full, Bellevue accepted them [1,3]. The house staff of the ‘60s performed virtually every task themselves, including blood draws and lab analyses [1,2], and nurses were far more limited in their responsibilities . However, the core culture of Bellevue has not changed. Complicating matters further, the hospital was only equipped with a handful of ECG machines, and interns typically had to page overhead to locate one . The most critically ill patients were admitted to the Emergency Ward (EW) until 1962, when the Intensive Care Unit (ICU) opened . Saint Vincent Hospital Internal Medicine Residency Program current medical residents. When house staff managed to sneak a break, they could only be contacted by overhead speakers (pagers were still a thing of the future); these calls could not be heard from the bathrooms . At the end of June 1968, it was announced that a new Bellevue Hospital building would be constructed with a capacity of less than 1,000 beds, replacing the old 2,000-bed building . The Internal Medicine Residency program in NYU Langone’s Department of Medicine offers different tracks that allow residents to personalize their training according to their interests. Interns and residents would set these respirators at a peak inspiratory pressure of 15, though what that number actually represented sometimes remained unclear . Measles patients, meanwhile, were admitted to the isolation ward, composed of twelve private rooms shared by the Medicine and Pediatrics departments . With a rich 280-year history of continuous active service to New York City, Bellevue Hospital is a special place. In 1978, The Humanistic Aspects of Medical Education program was introduced to allow students and house staff to share their experiences of becoming a physician. To aid in the care of the “methanol” patients, Dr. Saul Farber gave the keys to his laboratory to Dr. Lowenstein so that he could access his blood gas analysis machine, pH meter, flame photometer, and osmometer. Please take the time to meet these outstanding residents. Interns and residents rotated in two-month blocks . I would like to thank Dr. Jerry Lowenstein, Dr. Martin Kahn, Dr. Anthony Grieco, and Dr. Lois Katz for their precious time, insight, and teaching. "No one is trained to confront this amount of death in such a short period of time.". New York Gov. The ICU housed between twelve to sixteen patients . The Manhattan VA hospital, conversely, had its own house staff, and thus Bellevue residents did not rotate there . The workup of edema posed an even greater adventure, in part because the echocardiogram had not yet been invented . ", In an email sent to urology residents, department chair Herbert Lepor, MD, acknowledged that some of his residents had been assigned to COVID-19 wards, but said demanding hazard pay now was "not becoming of a compassionate and caring physician.". We are notifying patients individually when they can schedule. Interns and medical students drew blood, pushed the chart rack, and carried a scale to record daily weights . American University of Antigua College of Medicine. I am amazed from the photograph at how little Dr. Kahn and Dr. Grieco have changed . The content of this site is intended for health care professionals. Dr. Lois Katz graduated in the NYU class of ’66. Consequently, interns sometimes found themselves pronouncing people dead in the middle of active, dangerous street fights . Many patients also presented with complications related to alcohol and drug use [1,2,3]. Their responsibilities did not end there. Pulmonary edema was managed with supplemental oxygen, intramuscular injections of a mercurial diuretic, IV morphine, and sequential application of a tourniquet to each extremity to decrease venous return . All locations are open for appointments and procedures. There was only one nurse per ward at night, including in the ICU . They also served at the University Hospital, initially located on 28th street and Second Avenue until 1964, when it moved to what is now Tisch hospital [1,3]. 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