When a ferry crashed in lower Manhattan earlier this month, ambulances took dozens of people to hospitals around the island.
Bellevue Hospital took in 31 passengers, but they all had minor injuries. The most seriously hurt patients from the crash went elsewhere. Dr. Suzi Vassallo said that's because Bellevue still can't handle serious traumatic injuries.
Superstorm Sandy closed Bellevue in October.
The hospital got back in business in December, but only partially. "We don't have an operating room yet," Vassallo said. "And you always have to have that kind of backup for any critical trauma."
Recently, Dr. William Goldberg arrived at his ER shift and found that a stabbing victim had been transferred to another hospital.
"He was probably fine, but because we don't have the resources we normally have, they basically packed him up and shipped him over to Cornell," Goldberg said, referring to New York-Presbyterian's Weill Cornell Medical Center, the area's only other trauma center.
It's a point of pride among staffers that Bellevue usually takes all comers — whether they have a bad stomach ache or a gunshot wound. Goldberg says not being at full capacity, even temporarily, stings a little.
Ambulances don't bring the most serious cases here, and when people walk in the door who might be suffering a heart attack or a stroke, doctors and nurses stabilize them and send them to a full-service facility. For the moment, Bellevue doesn't have an "upstairs" where it can send patients for surgery or keep them overnight for observation.
To operate on patients, house them overnight, monitor them in the intensive care unit, or deliver their babies, hospitals need rock-solid electrical and fuel systems. They need heating and cooling. They need pumps to move water and fuel—and elevators to move people—up and down the 22-story complex.
All of these were lost for Bellevue in Superstorm Sandy.
Hundreds of people are working to restore the systems. Belllevue's chief engineer Patrick O'Brien, gave a tour of the basement, where the problems started.
Flooding wrecked the water pump motors, leaving the hospital no way to replenish four 55,000-gallon rooftop towers that supply water to the complex. Only one of the pumps has been restored, just enough to get things going, pending a longer-term solution. Eventually, a new system will place two pumps on the second floor, presumably out of harm's way from flooding.
The room with the fuel pump had a heavy steel and rubber "submarine door," so that even in the event of a flood, the fuel pumps could still send oil up to the backup generators on the 13th floor and keep the hospital running. But when Sandy came, these pump motors also got soaked and failed.
Reconstruction is costing hundreds of millions of dollars, and has proved to be a series of compromises between what can be done now and what will have to wait. While some large systems are being moved out of the basement to higher ground, others, such as the air handlers that cool and heat the buildings, will stay put — and could be damaged in the next storm.
"At some point, you have to just make priorities, you just can't move every single thing, it's just not feasible," O'Brien says.
Bellevue's reopening will be welcomed by nearby hospitals, which have seen their emergency rooms slammed by seasonal flu. New York-Presbyterian's CEO Dr. Steven Corwin says Cornell is seeing twice the usual number of trauma patients in its ER, putting a strain on the hospital during emergencies.
Take, for instance, a serious car accident. "You could be talking about 10 or 15 doctors, allied health personnel, in a trauma room, to stabilize somebody to have multiple operations," Corwin says. "So that's a big burden on an emergency system, especially if you're getting routine visits and influenza visits as well."
State health inspectors visit Bellevue next week to test newly repaired systems. They'll declare whether Bellevue is ready to take in patients and keep them overnight. If not, then O'Brien and others will need to keep working around the clock, and the ER staff will keep dispatching patients to other hospitals.
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MELISSA BLOCK, HOST:
When Hurricane Sandy struck last October, the storm knocked out four hospitals in Manhattan, including Bellevue, the nation's oldest public hospital. Last month, Bellevue reopened limited emergency services. But if patients need advanced care or an overnight stay, they have to go elsewhere. Well, that may be about to change.
As Fred Mogul of member station WNYC reports, inspectors are set to visit Bellevue next week to decide when it can fully reopen.
FRED MOGUL, BYLINE: Earlier this month, a ferry crash in Lower Manhattan sent dozens of people to nearby hospitals. News reporters descended on the scene.
(SOUNDBITE OF NEWS CLIP)
UNIDENTIFIED MAN: Reports of the - of people being taken from the ferry by the FDNY and EMT crews. Some of them...
MOGUL: Four miles north, the Bellevue Hospital emergency room, one of the biggest in the city and usually one of the busiest, went into high gear. Thirty-one injured passengers were brought in for treatment. But despite all their bruises and bandages, Dr. Suzi Vassallo says if Bellevue hadn't still been recovering from Sandy, the scene would've been quite different.
DR. SUZI VASSALLO: We would've had the most critical patients. In this case, we had the lesser injured patients.
MOGUL: Currently, Bellevue can't handle serious traumatic injuries.
VASSALLO: We don't have an operating room yet. And you always have to have that kind of backup for any critical trauma.
MOGUL: Vassallo is standing in the ER on a quiet weekday morning as patients file in with flu symptoms. Since reopening in December, the Bellevue ER has been doing only partial duty. For the moment, it doesn't have an upstairs to send patients for surgery or to keep them overnight for observation.
DR. WILLIAM GOLDBERG: I'm concerned about her 'cause I think she's infirm, but...
MOGUL: Recently, Dr. William Goldberg arrived on his ER shift to find a stabbing victim had come in and been transferred to another hospital.
GOLDBERG: He was probably fine, but because we don't have the all resources we normally have, they basically just packaged him up and shipped him over to Cornell.
MOGUL: It's a point of pride among staffers that Bellevue usually takes all comers, whether they have a bad stomachache or a gunshot wound. Goldberg says not being at full capacity, even temporarily, stings a little.
GOLDBERG: It's frustrating for us 'cause we want to do everything that we're trained to do. And when you can't do it, you feel a little disabled.
MOGUL: To operate on patients, to house them overnight and monitor them in the ICU, or deliver their babies, you need rock-solid electrical and fuel systems. You need heating and cooling. You need pumps to move water and fuel, and elevators to move people around a 22-story complex. All of these were lost in Sandy.
Chief engineer Patrick O'Brien is one of the people in charge of bringing them back.
PATRICK O'BRIEN: All right, they just need okay to go ahead and do that.
MOGUL: O'Brien takes me around the basement. He starts with the pump room and points out the flood line marked by FEMA with bright orange spray paint about six feet high on the wall.
O'BRIEN: As you can see, the water line is above the motor, so that was our problem. So we lost these pumps.
MOGUL: Flooding wrecked the pump motors, leaving no way to replenish the huge rooftop towers that supply water to the hospital. Only one out of four pumps has been restored, enough to get things going for now.
O'BRIEN: A new pumping system is being designed, you know, to place two house pumps on the second floor for our flood, so we will not lose water again.
MOGUL: Reconstruction is costing hundreds of millions of dollars, and is a series of compromises between what can be done now and what will have to wait. While some systems are being moved to higher ground, others will stay put and could be damaged again.
O'BRIEN: At some point, you have to just make priorities, you just can't move every single thing, it's just not feasible.
MOGUL: Bellevue's reopening will be welcomed by other nearby hospitals, many of whose ERs are also being slammed by seasonal flu. At New York-Presbyterian's Cornell campus, CEO Dr. Steven Corwin says twice the usual number of trauma patients are coming into the ER, putting a strain on the area's only other full-fledged trauma center.
DR. STEVEN CORWIN: You could be talking about 10 or 15 doctors, allied health personnel, in a trauma room, to stabilize somebody to have multiple operations. So that's a big burden on an emergency system, especially if you're getting routine visits and influenza visits as well.
MOGUL: Back at Bellevue, state health inspectors come next week to test newly repaired systems. And they'll declare whether Bellevue is restored enough to take in patients and keep them overnight or whether O'Brien and others will need to keep working around the clock, and the ER staff will need to keep dispatching patients to other hospitals. For NPR News in New York, I'm Fred Mogul.
BLOCK: This story is part of a collaboration between NPR, WNYC and Kaiser Health News. Transcript provided by NPR, Copyright NPR.