Midnight Mutterings | A book

Eric Manheimer, MD, was medical director at Bellevue Hospital for more than thirteen years, beginning in 1997. His book was published in 2012 and was the basis for an overwrought (in my opinion), five season television series called New Amsterdam. Manheimer was one of the producers. Near the end of Manheimer’s real tenure as medical director, he was diagnosed and treated for squamous cell throat carcinoma, which was much more serious in real life than in the TV series. In real life he was away from work for months with surgeries, radiation and chemotherapy and other treatments including a through abdomen feeding tube.

Although the title of the book includes the words ‘Twelve Patients,’ the medical stories include much of the history of the hospital, Manheimer’s own life and circumstances, as well as historical, geographical, social, economic and political climate of the moment as well as the patients own particular circumstances. Of course, Manheimer disguises all patients actual identities.

Bellevue is (if I have this correct) the oldest public hospital (which means they are required to accept and treat all patients regardless of insurance status or ability to pay) It is also one of the largest hospitals in the nation with thousands of patient beds, many inpatient and outpatient units and clinics, and serves not only the five boroughs of New York City but also Riker’s Island, a large prison facility which has housed some of the most infamous criminals in history. Many ‘firsts’ in medicine occurred at Bellevue, including the first pediatric psych unit with a public school, the first maternity unit, and several now-common surgical procedures among other innovations.

If I were to reread Twelve Patients, I might start at Chapter 10, about a famous prisoner who has TB, HIV and a long history of addiction. trauma surgeries, mental illness as well as homelessness and all the problems resulting from and complicated by, poverty. Manheimer uses the patients’ cases to relate to the social, economic, and other problems of our imperfect social networks. His experiences and views are interesting to me, particularly as they relate to immigration. I have forgotten which chapter contains the idea that Mexico is the ‘cemetery for thousands of people trying to get to safety’ in the United States.

Though Manheimer was no longer Medical Director during Donald Trump’s first term in office, his book is full of stories of immigrants, legal and illegal. I wish I knew his views on what happened in 2016 when immigrants trying to get across the border, or had crossed earlier, were detained, after which children were separated from parents, and families never reunited because of faulty or absent records. Manheimer is fluent in what he calls Mexican Spanish and immersed in history, geography and culture of Mexico, where his family has a second home. I shudder when I hear President-elect Trump’s plans for mass deportations as soon as he takes office. I heard yesterday that some land has become available in Texas for detention camps. How can that possibly happen in the numbers he promises with the resources available? I can only recall his earlier promised threat of a wall that Mexico will pay for…

Here’s a bit of what Manheimer had to say about immigration post 9/11 when the US “militarized the border and increased the border patrol from four thousand to over twenty thousand….the most insidious was the criminalization of immigration. Crimigration….privatized detention centers…placed over four hundred thousand immigrants in its centers. Undocumented immigrants are summarily convicted of a misdemeanor and deported or spend a few months in detention. The next conviction is a felony with up to twenty years in prison.” (Page 272)

Are we there again, magnified? Have we learned nothing?

This is a book about everything in our culture. Bellevue Hospital was like a small nation which had a benevolent leader for thirteen years. I wish we could support such a leader in our larger culture. Whatever happened to the idea that administrators’ main job is to help other people in the organization do their jobs better?