SIEGEL: And first you have to explain that as Bellevue evolved, the very definition of what a hospital is was evolving with it. Describe what Bellevue was when it began in the 18th century and what it became.--Marshal Zeringue
OSHINSKY: Bellevue in the 18th century was really both a poorhouse and a pesthouse. It was a place you came to die. It really began with the great yellow fever epidemics of the 1790s. And at that time, the great Bellevue estate, which became the hospital, was on the East River about two miles away from where most of New York was located. And you would send people who really had no chance of recovering.
SIEGEL: A defining relationship that you return to often in your book about Bellevue is between the hospital and the poor. Historically, well-to-do New Yorkers wouldn't have wanted to be in the same building as most of Bellevue's patients. What drove that sense of mission not just to get them out of the way, but what drove the sense of mission to treat the poor of New York?
OSHINSKY: There had always been a kind of group of physicians who believed it was their Christian duty to treat the poor. They also believed that if they wanted to do surgery or other kinds of medicine, it would be very easy to do it on uncomplaining bodies.
SIEGEL: There is that dark side - that the poor are often considered useful subjects for experiment.
OSHINSKY: That is true, and that is part of our medical history. On the other hand, it did push the needle forward. Medical reform and great medical discoveries also came with what you would consider today to be sort of outlandish assaults upon...[read on]