Author: David Oshinsky

Data: Vintage/Penguin Random House, 416 pages, $17 paperback

By Mims Cushing

For the Times-Union

It began as a poorhouse, a “pesthouse,” for those with contagious diseases. The behemoth that was to become Bellevue started in 1736 as a one-room infirmary in New York City with only 19 paupers, erected on today’s City Hall Park. In time Bellevue moved and built many elaborate edifices. It was dizzying.

The “Mayhem” in the title is evident in the first chapter and many others. Bellevue was swamped with thousands of patients with Yellow Fever in the 1800s. (Mosquitoes were not suspected as the cause of Yellow Fever for many years. How could a minuscule insect be the cause of so much misery and deaths?)

The “Medicine” was calamitous. The blood-letting was considered successful if the patient was rendered unconscious. The book is as much about the hospital as it is about the medicine of Bellevue’s infancy. Did you have breast lumps? Try “Indian Vegetable Salve” for 50 cents. ”Ladies Silver Pills” costing $1 were for men and their indelicate problem. We associate these cures with spaghetti westerns, but these were sold in Manhattan. If people could buy them, why should they need hospitals? People felt the sick could be better served at home and more safely. If a child has swallowed something, turn him upside-down. No need for a doctor or a hospital, they felt.

Bellevue decades ago was shunned by upper class New Yorkers. Perhaps it was the swarms of rats, snaking up through the sewers and taking up residence in Bellevue’s bathtubs — 40 found in one tub. Perhaps it was the hellacious epidemic of typhus caused by lice that frightened people away, And surely it was the death rate of more than 20 percent that scared them off. One after the next, Bellevue survived chilling plagues and problems. Today Bellevue serves the top echelon of society, admitting powerful captains of industry as well as charity cases.

We often associate Bellevue with mental illness perhaps because of the many movie plots dealing with electric shock therapy, which Bellevue did use. The stigma from Hollywood plots such as “The Snake Pit,” did not die easily. In fact Bellevue was a forerunner in psychiatric treatment. When the AIDS scourge came along, the hospital did not want to be associated with it. They considered not allowing entry to patients with that disease, but they eventually did. The chapter about AIDS describes the compassion. Indeed, it was AIDS that secured Bellevue as an iconic place of last resort.

The endnotes go on for 41 pages. It is impressive that in a relatively short book the author covers so much information on various topics connected with Bellevue: the beginnings of clinical research, the inauguration of a civilian ambulance service and the story of the Nightingales, or nurses and dreadful nursing school conditions early on. He also describes the settlers’ skills brought from overseas. The book coheres well despite all these diverse topics.

To have gone from a setting in the 1700s that housed paupers with plagues to a place offering first-class care to anyone is remarkable. The impressive and fascinating “Bellevue,” winner of the 2016-2017 New York City Book Award, must be read.

Mims Cushing lives in Ponte Vedra Beach.