Bellevue

Chapter 13

Tuesday, July 2, 9:37 p.m.

As Mitt passed beneath the marble archway of the old façade into the relatively new Bellevue Hospital lobby-atrium, he glanced at his watch and did a little arithmetic in his head. With a sense of disbelief, he calculated that he’d been in the hospital for just about forty hours with maybe four or so hours of interrupted sleep. It was no wonder he was having “walking” nightmares, especially when he added the anxieties of starting his residency and the emotional shock of having to deal with the deaths of three of his assigned patients.

When he finally reached the street and exited out onto First Avenue, he was surprised by the sultriness of the early-July night. He’d become so acclimated to the low humidity and fully air-conditioned hospital environment that he’d completely forgotten that it was summer. As he walked, there was something comforting about the press of cars, taxis, and buses heading north and the familiar sounds of horns and the low roar of hundreds of automotive engines. He even appreciated gazing at the pedestrians he passed heading in the opposite direction although none would return his stare. For him it was like rejoining the normal world after being in a totally artificial environment.

Quickly he came abreast of the old Bellevue Psychiatric Hospital, and just as he had early Monday morning and despite his exhaustion, he couldn’t help but stop and gaze between the pickets of the rusting wrought iron fence at the nearly hundred-year-old edifice’s First Avenue entrance. In sharp contrast to all the other buildings in the immediate area, which were ablaze with lights, its hundreds of windows were dark and forbidding. As he stood there with a fresh appreciation of the power of his imagination, he was suddenly fearful that he might start to hear cries of anguish from its thousands of previous inpatients. As if to underline that fear, he began to feel paresthesia, which made him abruptly leave. The last thing he wanted to do at the moment was to encourage any more hallucinations of any variety.

At the nearby corner, he had to wait for the traffic light to turn in his favor to cross busy First Avenue. He then quickly headed west along 30th Street. At his apartment building, he keyed its outer door with a huge sense of relief. Feeling much too tired to check his mailbox, which he normally did, he instead went directly to the tiny, claustrophobic elevator. Under normal circumstances, Mitt much preferred to use the pleasant, nautilus-like, original, open stairway with its decorative railing that wound up the center of the building, as he appreciated the exercise as well as the view. With his exhaustion, none of that mattered on this particular evening.

With even more relief, he keyed open the double locks on his apartment’s front door. Once inside, he pulled off his white doctor’s coat and draped it over the arm of the couch. As he headed into his bedroom, he undid his tie and pulled off his shirt. Stepping out of his pants, he eyed his bed with relish but knew he had to take a shower, as much to wash away the negatives of the day as to get clean.

Somewhat unexpectedly, when he got out of the shower, he felt almost human, and although 5:30 a.m. would be arriving much sooner than he’d like, he belatedly remembered he’d promised to call his parents. With that thought in mind, he rescued his mobile phone from his pants pocket and dialed his father’s phone, knowing his dad would certainly be awake while awaiting the first financial news from Europe. With his towel wrapped around his waist, Mitt went out to sit on his brand-new couch, putting his feet up on the coffee table.

“I was so hoping to hear from you,” Benjamin answered without any hello. “Hold on, let me put you on speaker.”

Mitt raised his eyes heavenward, as he knew that if his mother joined the conversation, it would take longer. But he didn’t complain.

Mitt explained that he was calling as late as he was because he’d just gotten home. He openly emphasized he was justifiably exhausted in hopes of keeping the conversation short.

“I want to hear about your first days as a resident,” Benjamin said, completely avoiding the exhaustion issue. He was obviously impatient to hear the details.

Mitt made a sudden decision to gloss over the “bad” and emphasize the “good.” It immediately occurred to him that explaining the bad would take significantly more time and effort, neither of which he felt capable of. Accordingly, he went on to say that in just two days and one night he could appreciate what an unbelievably eye-opening experience the residency was going to be and that he’d already learned much more than he could ever have expected.

“I’m not surprised in the slightest,” Benjamin said smugly. “I told you so, didn’t I?”

“I believe you did,” Mitt fibbed. He couldn’t remember his father saying anything of the kind, but he wasn’t up to an argument.

After a little more back-and-forth, Mitt was about to say good night when his tired mind somehow recalled Dr. Harington’s surprising revelations about the Fuller Bellevue doctors. Despite his exhaustion, Mitt described what he’d been told about their relatives’ disappointing stances on a number of contemporary issues and even that Homer had been a renowned grave robber for dissection corpses. When Mitt finished, he asked his father if he’d ever heard anything at all in those veins.

“No,” Benjamin said definitively, almost angrily. “Absolutely not. That sounds totally out of character from everything I’ve ever heard. I’m shocked to hear someone would even imply such a thing. I had always heard that, if anything, all four of our physician ancestors were ahead of their times. Who is this Dr. Harington, anyway?”

“She’s an attending surgeon and a specialist at that,” Mitt said. “She’s associate chief of cardiothoracic surgery. As I understand it, she’s highly thought of professionally and personally. She’s also an ardent aficionado of Bellevue Hospital history, which is how she happened to know about our ancestors.”

“Well, I will certainly ask my brother if he’s ever heard anything along the lines of our relatives being out of step with medical advances. It’s a bit shocking, and it seems rather odd to me that someone like this Dr. Harington would try to tarnish their reputations.”

“She wasn’t calling into question their reputations,” Mitt was quick to correct. “Just the opposite. She was extremely complimentary about all our Bellevue relatives, particularly about the surgeons and their technical skills. She knew that your namesake had been only the second person in the world to fracture, or open up, a damaged mitral valve. And she was specifically aware that Homer had been able to do a mid-thigh amputation in nine seconds.”

“Well, there was a reason they called it the ‘era of heroic surgery,’ ” Benjamin said, audibly calming. “It is incredible what they were able to do without anesthesia. To tell you the truth, I cannot even conceive of doing surgery without anesthesia — from both the doctor’s and the patient’s point of view.”

“How much sleep did you end up getting?” Clara asked, interrupting the conversation. Mitt would always be her little boy, and he loved her for it.

“Not much,” Mitt said vaguely.

“Then we should let you go, so you can get some rest,” Clara said.

“Good idea,” Mitt admitted. “I’m beyond tired, and I’ll be collapsing into bed the moment we hang up.”

After goodbyes and Mitt promising to call again probably sometime Thursday evening, the conversation ended, and he tossed his phone onto the coffee table. He sat there for a moment intending to get right up, head into the bedroom, and climb into bed as he’d said, but he didn’t. Instead, he went back over the call with his parents, particularly revisiting his father’s surprise and umbrage. That thought led to his remembering Dr. Harington’s promise to email the reference she’d described. Mitt leaned forward and opened up his laptop, which happened to be sitting on the coffee table right in front of him. After a few keystrokes to get into his email inbox, he let his eyes run down the list of thirty to forty that had not been opened. Almost immediately he focused on one from HaringtonMD and clicked it open. After a brief explanatory note from the doctor in the body of the email, there was an attachment, which he opened in turn.

Quickly he scrolled through the attachment, recognizing it to be an unpublished article that had been submitted to a journal called The History of Medicine Review but returned to the author, Robert Pendleton of NYU medical school. It had been rejected by the journal’s editorial board with a letter dated October 10, 1975, containing criticisms and suggestions. Mitt had never heard of this particular journal, but it didn’t surprise him. As a medical student, he’d learned there were upward of thirty thousand medical journals, most of which were totally off his radar. The only publications he was familiar with were the main clinical journals, like The New England Journal of Medicine, JAMA, and The Lancet.

The article was titled “Eight Renowned Bellevue Hospital Physicians: Those on the Right Side of History and Those on the Wrong Side.” Glancing at the letter sent by the journal’s editorial board, he noticed that they first took issue with the title, saying it was much too long. He then read that it was the board’s unanimous opinion that the article itself was also too wordy and that if the author wanted it to be published, it should be significantly tightened up. The main criticism, however, was directed at the author’s failure to mention Dr. William Halsted’s disastrous addiction to cocaine despite his being on the right side of germ theory. They felt that such an omission should be rectified.

But as Mitt read on, he saw that the editorial board’s response wasn’t all negative. They had a very positive response to the author’s newly discovered sources as revealed in the article’s appendix. The board went on to suggest that he consider publishing them in their entirety as an additional piece. They added that it was the board’s strong opinion that such material would be of enormous use for future medical historians.

Despite his numbing weariness, Mitt was intrigued, wondering what could have constituted newly discovered sources that apparently involved his ancestors. As he put off climbing into his beckoning bed, Mitt’s intention was to leaf quickly through the article with the idea of finding the appendix and at least get some inkling of these newly discovered sources. As for the article itself, he vowed to find the time to read it the following day. But as he tried to scan the article, a name on the very first page caught his eye: Dr. Homer Paul Fuller. As Mitt skimmed through the section, he was immediately intrigued. He read that his ancestor had studied under Dr. David Hosack, actively aided him in procuring bodies for anatomical dissection, and then teamed up with him to help move Bellevue, which had been a relatively small almshouse in lower Manhattan, up to a newly constructed, very large establishment in its current location on the East River.

On the next page he read that Homer had eventually worked closely with Dr. Valentine Mott, who was considered the best surgeon in the world at the time, and Homer’s technical skills had been favorably compared to Mott’s. But then he read how he and Mott had nearly come to blows over the issue of anesthesia. With mounting disbelief, Mitt read that Dr. Homer Fuller believed that the pain people experienced served a specific purpose as a punishment from God and that anesthesia was the work of the devil in denying it.

“Good God!” Mitt voiced out loud. For a moment he stared up at the ceiling in disbelief. He was shocked and even embarrassed that he was related to someone who could think something so anti-scientific.

After a shake of his head, he went back to skimming the article. The very next page confirmed what Dr. Harington had said about Dr. Otto Fuller. Robert Pendleton wrote that Otto, who had worked with Dr. William Halsted and was considered his equal in surgical skill, had specifically and openly mocked germ theory during one of his Bellevue Hospital amphitheater operations in front of hundreds of student doctors and nurses. He was quoted as saying that the concept of germ theory was based on the craziest idea he’d ever heard, namely that hundreds of invisible particles mysteriously swarmed around in the air. Ridiculous, he was quoted as saying.

“Ridiculous is right!” Mitt said out loud. Although Mitt knew that people shouldn’t be judged in hindsight, at the same time he was embarrassed to be directly related to such a scientific philistine and to have held him up as a medical inspiration for his entire life.

Almost afraid to have the worst confirmed about Benjamin and Clarence, Mitt went back to skimming Pendleton’s unpublished article. On the very next page, he read that Dr. Benjamin Fuller — as Dr. Harington had said — was indeed vehemently against the informed consent movement, firm in his unswerving belief that charity patients had an obligation to offer up their bodies for the benefit of medical research. Benjamin had even gone to the extent of advocating absolutely no constraints on physicians in terms of their research projects and even whims, and he specifically was against any kind of research review boards, believing such restrictions were anti-science and a drag to the advancement of medical knowledge.

Before he went on to the section about Clarence Fuller, Mitt took the time to again glance up at the ceiling with unseeing eyes. Did he want to share the article with his father or not? As much as what he was learning was upsetting to him, he sensed it would be more distressing to his father, who constantly made positive references to their forebearers’ legacy. With a shrug and without a conclusion, Mitt went on to the final pages.

As he feared, learning about Clarence’s early advocacy of lobotomies was perhaps the most distressing aspect of the entire article, particularly as it was suggested that Clarence’s motivations for doing so revolved around his own personal career aspirations. Mitt read that Clarence wanted to be chief of Bellevue’s Psychiatric Division, which he felt he deserved as recognition for all the work he’d expended helping the then-psychiatry chief, Dr. Menas S. Gregory, get the new Bellevue Psychopathic Hospital funded and constructed.

Mitt was aghast to read that Clarence performed over two hundred lobotomies before stopping them and then trying to hide his initial advocacy. Even more disturbing, Mitt learned he’d done over forty on children, some as young as four. Apparently Clarence believed he was in direct competition for the departmental chiefdom with Dr. Lauretta Bender. Bender was head of Pediatric Psychiatry and was gathering worldwide renown from doing electroconvulsive therapy on children with moderate success.

Mitt clicked to the last page of the article, the appendix, where he hoped to find an explanation of what constituted the newly discovered sources that provided so much information about his relatives. Unfortunately, it wasn’t much. All Robert Pendleton wrote was that he had uncovered a vast trove of heretofore unknown Bellevue Hospital patient records going back to the end of the eighteenth century and extending well into the twentieth that had been collected by Dr. Clarence Fuller.

“That’s it?” Mitt questioned aloud with disappointment. The terse statement begged the important questions of where these records had been found and where were they now. With a bit of disgust, he snapped closed his laptop. He’d had quite enough of the article and quite enough of the day. With some effort, he got to his feet and padded into his bedroom, ready to turn out the lights literally and figuratively. He was desperate for rest.

While he was brushing his teeth, he paused. In the background he thought he heard something — he could just make out the indistinct sound of a crowd of people crying out in pain and distress, possibly undergoing surgery without anesthesia. He shook his head in amazement, dismissing yet another demonstration of the suggestive power of his imagination.