Summary:

“Few hospitals are more deeply embedded in our popular culture” than Bellevue, David Oshinsky writes in the introduction to his new book Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital.  What follows, however, is not just an account of the (in)famous hospital, but a history of New York City, of disease and medicine and of America itself. Thus, the pages of Bellevue take us from Revolutionary War to Civil War, from Miasma Theory to Germ Theory, from the Spanish flu epidemic to the AIDS epidemic and from the disaster of 9/11 to the devastation of Hurricane Sandy. Along the way, the reader is introduced to giants of the medical and political world, many of whom were connected intimately to the hospital.  In Oshinsky’s telling, Bellevue is a hospital of firsts. The hospital with the first ambulance corps, first in-hospital medical school, first pathology lab. It is—at the same time—a hospital rooted in tradition. It is startling in reading Bellevue, for example, to realize that halfway through the book, the doctors who are being celebrated as central to the hospital’s longevity still subscribed to Miasma theory and could do little more for their patients than bleed them and give them alcohol.  Bellevue is also—and in Oshinsky’s eyes this seems most important—a hospital of immigrants. It was and is, a hospital where those for whom no one else would care could come, where no one would be turned away. Over the years, this has meant that Bellevue has opened its doors to Irish immigrants who were thought to be causing the Typhus epidemic, to Jews who were thought to be causing tuberculosis outbreaks and to homosexuals who were thought to be causing the AIDS epidemic. The demographic of patients who come to Bellevue has changed drastically throughout its history, but the underlying ethos of the hospital has been unwavering. 

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Summary:

 In his introduction, the author summarizes the history of polio’s first appearance as an epidemic in the United States, the ensuing research, subsequent applications of new information, attempts at abatement and ultimate success in the development of preventative measures.

Embedded in the successes and failures of the research applications are the details of human interactions.  Their impact on the goal of achieving near extinction of polio in America constitutes a dramatic subplot, which the historian adroitly weaves into the work.

For the reader who has only a sketchy knowledge of this important period in medical research, this history provides details of human exchanges, conflicts and resolutions necessary to bring the scientific developments to fruition.  Central among the multiple struggles rests the basic disagreement between Jonas Salk and Albert Sabin, two of the most prominent scientists working against the clock to develop the most effective and safest form of immunization.  Each new surge of the disease added to the urgency of the problem as well as to the question of the best solution.  Salk felt strongly that the immune system should be stimulated by a killed virus preparation, while Sabin was equally convinced that only the living virus could provide this need.  Each view had its own cadre of supporters and of opponents.

Funding issues also troubled those fighting the polio epidemics.  The March of Dimes is credited with raising a record $55 million in the fight against polio in early 1954, becoming the first major infectious disease battle to benefit from a concerted public awareness campaign and demonstrating the power of such volunteer driven efforts to supplement public and other private funding efforts.

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