美国国家公共电台 NPR Bellevue Hospital Pioneered Care For Presidents And Paupers

Bellevue Hospital Pioneered Care For Presidents And Paupers¹

play pause stop mute unmute max volume 00:0007:53repeat repeat off Update Required To play the media you will need to either update your browser² to a recent version or update your Flash plugin. ROBERT SIEGEL, HOST: 

Having grown up less than a mile from Bellevue Hospital, I knew from an early age that it was a New York City institution. But until reading David Oshinsky's book about Bellevue, I didn't realize that it's been a monumental institution for all of American medicine.

There are things we expect to see at a hospital - ambulances, a maternity³ ward⁴, nurses, medical students, forensic⁵ pathologists, medical photography, all things that were pioneered at Bellevue, whose roots go back to 1738. David Oshinsky, welcome to the program.

DAVID OSHINSKY: Thank you, glad to be here.

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.

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 epidemics⁶ 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 Christian⁷ 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 the bodies of the poor.

SIEGEL: To read your book about a hospital that started out in the 18th century is to be reminded that for the first virtual half of Bellevue's life, doctors really didn't know much about disease or help much for that matter. I mean is it only when germ theory comes over from Europe in the mid-, late-19th century that Bellevue becomes a scientific institution that's guided by people who know what they're doing?

OSHINSKY: That is correct. Most physicians at Bellevue and elsewhere believed in the miasma⁸ theory that virtually clouds of bad air caused all kinds of disease. They had no concept that an invisible organism could cause so much damage. And that was what germ theory was about.

And Bellevue physicians really were on the forefront, particularly the younger generation, in sort of pushing germ theory forward. You also had a hospital where there was no anesthesia until the 1840s, so if you...

SIEGEL: It didn't stop them from doing surgery, though.

OSHINSKY: It certainly did not, but you had to do it within nine, 10 seconds when you cut off a limb or that person would die of shock and pain and blood loss. And even once anesthesia comes, post-operative infections are extraordinarily⁹ high.

It's only when you have professional nursing and germ care and the coming of X-ray machines and the kind of pathology where you can actually do lab work inside a hospital that makes a hospital better in terms of saving a person's life.

SIEGEL: You relate the stories of two presidents in the 19th century whose medical and surgical¹⁰ care illustrated¹¹ how much medicine changed during a very short period of time - in 1881, the death of President James Garfield not directly from an assassin's bullet but from the infection that set in during treatment versus¹² Grover Cleveland's cancer surgery in 1893. Both involve physicians who are connected to Bellevue.

OSHINSKY: They did. Garfield was hit by two bullets, neither of which was fatal. But the lead surgeon was Frank Hamilton from Bellevue. And Hamilton came down to Washington, and he put his finger into Garfield's wound and put dirty probes into Garfield's wound.

About 15 or 20 years later, Grover Cleveland had a mass in his mouth which turned out to be cancerous. It was during the Great Depression of 1893. The country was panicked. Cleveland did not want to alert his critics.

So what happened is they hired a yacht with a number of Bellevue surgeons and physicians. They sailed up the East River to a very, very calm piece of water. And they removed this mass from Cleveland's mouth in a one-and-a-half-hour operation using every imaginable kind of antiseptic technique of that era. And Cleveland survived the operation and died of a heart attack many, many years later. So there really is a continuity...

SIEGEL: Yep.

OSHINSKY: ...Not only with germ theory but with the Bellevue physicians.

SIEGEL: There's a dynamic that recurs¹³ in your book about Bellevue that is - yes, germ theory is brought over from Europe, and it revolutionizes medicine at Bellevue and elsewhere. But there's also great resistance to it and people - senior physicians mocking the idea that little microscopic¹⁴ beings are creating disease.

Yes, they innovated¹⁵ with women nurses, but there also was tremendous resistance against them. In the end, when these innovations arrived and there was resistance, somehow the progressive side prevailed. The story of female doctors like Edith Lincoln are stories in Bellevue's history where it was just a more open place.

OSHINSKY: You know, there is resistance in medicine to new discoveries, new aspects of research at all time. At Bellevue, it would often take the perspective of younger physicians pushing newer reforms. But that's what Bellevue was all about. You're absolutely right. It was a continuum.

Because it was the place that turned no one away, it dealt with anything that came through New York City - cholera¹⁶ with the Irish in the 1830s, tuberculosis¹⁷ with Jews and the Italians around the turn of the century, the great influenza¹⁸ epidemics. Bellevue treated more AIDS patients than any hospital in the country, and more AIDS patients died at Bellevue than any hospital in the country. And Bellevue was really in crisis mode at that time but courageously¹⁹ prevailed.

SIEGEL: It was an emotive ethical²⁰ crisis during that time as well, a professional crisis. What do you do if you're treating a disease whose transmission you don't really understand? And if the physician is at risk, is it ethical to say, I'm out of here?

OSHINSKY: That was one of the big issues at Bellevue and hospitals across the country. Doctors were wary²¹, and there were studies done where even a percentage of young interns²² at Bellevue felt that maybe they had the right to determine whether to treat these patients or not.

In the end - and this is the important point - Bellevue prevailed. The Bellevue message prevailed, the ethos that we treat everybody regardless of disease, regardless of their social standing²³. And they did, and I think people look back upon that era with great pride.

SIEGEL: David Oshinsky, thanks a lot for talking with us.

OSHINSKY: My pleasure. Thank you.

SIEGEL: David Oshinsky's new book is called "Bellevue: Three Centuries Of Medicine And Mayhem At America's Most Storied Hospital."

1 paupers   

n.穷人( pauper的名词复数 )；贫民；贫穷

参考例句：

• The garment is expensive, paupers like you could never afford it! 这件衣服很贵，你这穷鬼根本买不起！ 来自互联网
• Child-friendliest among the paupers were Burkina Faso and Malawi. 布基纳法索，马拉维，这俩贫穷国家儿童友善工作做得不错。 来自互联网

2 browser   

n.浏览者

参考例句：

• View edits in a web browser.在浏览器中看编辑的效果。
• I think my browser has a list of shareware links.我想在浏览器中会有一系列的共享软件链接。

3 maternity   

n.母性，母道，妇产科病房；adj.孕妇的，母性的

参考例句：

• Women workers are entitled to maternity leave with full pay.女工产假期间工资照发。
• Trainee nurses have to work for some weeks in maternity.受训的护士必须在产科病房工作数周。

4 ward   

n.守卫，监护，病房，行政区，由监护人或法院保护的人（尤指儿童）；vt.守护，躲开

参考例句：

• The hospital has a medical ward and a surgical ward.这家医院有内科病房和外科病房。
• During the evening picnic,I'll carry a torch to ward off the bugs.傍晚野餐时，我要点根火把，抵挡蚊虫。

5 forensic   

adj.法庭的，雄辩的

参考例句：

• The report included his interpretation of the forensic evidence.该报告包括他对法庭证据的诠释。
• The judge concluded the proceeding on 10:30 Am after one hour of forensic debate.经过近一个小时的法庭辩论后，法官于10时30分宣布休庭。

6 epidemics   

n．流行病

参考例句：

• Reliance upon natural epidemics may be both time-consuming and misleading. 依靠天然的流行既浪费时间，又会引入歧途。
• The antibiotic epidemics usually start stop when the summer rainy season begins. 传染病通常会在夏天的雨季停止传播。

7 Christian   

adj.基督教徒的；n.基督教徒

参考例句：

• They always addressed each other by their Christian name.他们总是以教名互相称呼。
• His mother is a sincere Christian.他母亲是个虔诚的基督教徒。

8 miasma   

n.毒气；不良气氛

参考例句：

• A miasma rose from the marsh.沼泽地里冒出了瘴气。
• The novel spun a miasma of death and decay.小说笼罩着死亡和腐朽的气氛。

9 extraordinarily   

adv.格外地；极端地

参考例句：

• She is an extraordinarily beautiful girl.她是个美丽非凡的姑娘。
• The sea was extraordinarily calm that morning.那天清晨，大海出奇地宁静。

10 surgical   

adj.外科的，外科医生的，手术上的

参考例句：

• He performs the surgical operations at the Red Cross Hospital.他在红十字会医院做外科手术。
• All surgical instruments must be sterilised before use.所有的外科手术器械在使用之前，必须消毒。

11 illustrated   

adj. 有插图的，列举的 动词illustrate的过去式和过去分词

参考例句：

• His lecture was illustrated with slides taken during the expedition. 他在讲演中使用了探险时拍摄到的幻灯片。
• The manufacturing Methods: Will be illustrated in the next chapter. 制作方法将在下一章说明。

12 versus   

prep.以…为对手，对；与…相比之下

参考例句：

• The big match tonight is England versus Spain.今晚的大赛是英格兰对西班牙。
• The most exciting game was Harvard versus Yale.最富紧张刺激的球赛是哈佛队对耶鲁队。

13 recurs   

再发生，复发( recur的第三人称单数 )

参考例句：

• This theme recurs several times throughout the book. 这一主题在整部书里出现了好几次。
• Leap year recurs every four years. 每四年闰年一次。

14 microscopic   

adj.微小的，细微的，极小的，显微的

参考例句：

• It's impossible to read his microscopic handwriting.不可能看清他那极小的书写字迹。
• A plant's lungs are the microscopic pores in its leaves.植物的肺就是其叶片上微细的气孔。

15 innovated   

v.改革，创新( innovate的过去式和过去分词 )；引入（新事物、思想或方法），

参考例句：

• He innovated a plan for increased efficiency. 他引进提高效率的（新）方案。 来自辞典例句
• We are using innovated metal detector which is imported from the U.K. 本工厂有先进的生产设备，拥有从英国进口的金属探测机。 来自互联网

16 cholera   

n.霍乱

参考例句：

• The cholera outbreak has been contained.霍乱的发生已被控制住了。
• Cholera spread like wildfire through the camps.霍乱在营地里迅速传播。

17 tuberculosis   

n.结核病，肺结核

参考例句：

• People used to go to special health spring to recover from tuberculosis.人们常去温泉疗养胜地治疗肺结核。
• Tuberculosis is a curable disease.肺结核是一种可治愈的病。

18 influenza   

n.流行性感冒，流感

参考例句：

• They took steps to prevent the spread of influenza.他们采取措施
• Influenza is an infectious disease.流感是一种传染病。

19 courageously   

ad.勇敢地，无畏地

参考例句：

• Under the correct leadership of the Party Central Committee and the State Council, the army and civilians in flooded areas fought the floods courageously, reducing the losses to the minimum. 在中共中央、国务院的正确领导下，灾区广大军民奋勇抗洪，把灾害的损失减少到了最低限度。
• He fought death courageously though his life was draining away. 他虽然生命垂危，但仍然勇敢地与死亡作斗争。

20 ethical   

adj.伦理的，道德的，合乎道德的

参考例句：

• It is necessary to get the youth to have a high ethical concept.必须使青年具有高度的道德观念。
• It was a debate which aroused fervent ethical arguments.那是一场引发强烈的伦理道德争论的辩论。

21 wary   

adj.谨慎的，机警的，小心的

参考例句：

• He is wary of telling secrets to others.他谨防向他人泄露秘密。
• Paula frowned,suddenly wary.宝拉皱了皱眉头，突然警惕起来。

22 interns   

n.住院实习医生( intern的名词复数 )v.拘留，关押( intern的第三人称单数 )

参考例句：

• Our interns also greet our guests when they arrive in our studios. 我们的实习生也会在嘉宾抵达演播室的时候向他们致以问候。 来自超越目标英语 第4册
• The interns work alongside experienced civil engineers and receive training in the different work sectors. 实习生陪同有经验的国内工程师工作，接受不同工作部门的相关培训。 来自超越目标英语 第4册

23 standing   

n.持续，地位；adj.永久的，不动的，直立的，不流动的

参考例句：

• After the earthquake only a few houses were left standing.地震过后只有几幢房屋还立着。
• They're standing out against any change in the law.他们坚决反对对法律做任何修改。