St. Vincent's Closing Will affect you. Wether you know it or Not!

  

Dustin Fitzharris

For over 160 years, St. Vincent’s Hospital has never strayed from its core mission to provide care with respect, compassion and dignity for the poor and displaced members of society. The strength of the hospital’s character was never more apparent than in 1981, when a mysterious disease began affecting gay men in Southern California and New York City. “The best evidence against contagion is that no cases have been reported outside the homosexual community or in women,” said the CDC’s Dr. James Curran that summer about the disease that the some began calling Gay-related Immune Deficiency (GRID), or “the gay plague”.

Many hospitals turned patients away, but not St. Vincent’s Hospital Manhattan, near the border of the Greenwich Village on West 12th Street. In fact, the hospital treated and diagnosed some of the first known cases of what would eventually become known as AIDS.

Dr. Dennis Greenbaum, Chairman of Medicine at St. Vincent’s, has been with the hospital for 42 years. He saw the horror that HIV/AIDS wrought in the early days. “We didn’t know how to protect ourselves. The ICU would be filled with crying families,” Greenbaum says. “There were funerals every week. I used to live on 13th Street. I had four next-door neighbors who lived in a huge loft and all of them died. I used to go to a lot of [patients’] funerals. Then we lost our own doctors. We lost the chiefs of our HIV program.”

Now the hospital that has seen so much loss and done so much to support the gay community is suffering against its own insurmountable odds. Wracked with $700 million in debt, St. Vincent’s announced on April 6 that it would close its doors and end all inpatient services. The change will put members of the gay community at risk. Even though the outpatient HIV/AIDS programs will continue to operate at this time, in the future they, too, could be eliminated or changed significantly.

Dr. Antonio Urbina, medical director of St. Vincent’s HIV/AIDS Education and Training Program, says the transgender community is especially vulnerable. “There was always a mission that we give competent, culturally sensitive care to the LGBT community,” Dr. Urbina says. “Oftentimes transgender [people] are harshly treated at institutions. Without having a culture of compassion and understanding, that group can be further victimized. Because of that, they may stop accessing routine healthcare.”

Just blocks away from the hospital is the LGBT Center, which has long relied on St. Vincent’s emergency room—the only one in Manhattan below 59th Street with a Level-1 trauma center—to provide aid for individuals who have been gay-based or who are threatening suicide. In future times of crisis, where will the Center be able to turn for help quickly? The emergency room department, in coordination with the New York State Department of Health and the FDNY, has already been instructed to divert ambulances to other facilities. At this time they will continue to take walk-ins.

Speaker Christine Quinn has called this is “a dark moment for our city,” and that, “The absence of these health services will prove to be quite literally a matter of life and death for many who work and live on Manhattan’s West Side and Lower Manhattan.”

Nicole Bruno knows that all too well. On February 26, her father, who lives in Chelsea, suffered congestive heart failure and was on the verge of dying. Knowing that St. Vincent’s saved his life and realizing that minutes could mean the difference between life and death, she can’t fathom not having a hospital nearby. And to make matters worse, St. Vincent’s doesn’t know when or where they are going to move her father, who is still in the ICU. Bruno says they just keep telling her, “Before we transfer him, we’ll let you know.”

“He’s very, very sick, and I’m worried about the transfer,” she confesses with emotion. “I’m worried he’s not going to get the care he was getting at St. Vincent’s because I really don’t know anything about these other hospitals. Now I have to go and do leg work in addition to working a full-time job. I don’t want them to move him.”

St. Vincent’s hospital was also crucial to those affected by the terrorist attacks on September 11 because of its lower Manhattan location. Now there are concerns that people in need will not receive appropriate and timely treatment for what could be lifesaving procedures.

One option is to turn the ER into an urgent care center that could remain open all night, but patients would not be able to stay for more than 24 hours. If they required more care, they would be transferred to another hospital. Earlier this month Quinn and elected leaders representing the St. Vincent’s community sent a letter to Governor Paterson informing him of their dissatisfaction with this option, saying anything less than a full 24-hour emergency room is “unacceptable.”

St. Vincent’s says elective surgeries were scheduled to end on April 14, at which point the hospital plans to start diverting surgical, rehab and psychiatric inpatient services elsewhere—along with their staff.

Jo Hamilton, Chair of Community Board No. 2 of Manhattan, is concerned. “It was only two years ago that both the state and city testified before the Landmarks Preservation Commission that it was essential for St. Vincent’s to remain in their current location and be given the opportunity to modernize their facilities,” Hamilton said. “So it is curious and, frankly, disappointing that the state and city are not on the front lines—time is of the essence because the health and safety of downtown New Yorkers is at stake.”

However, Governor Paterson has worked to deliver emergency funds to keep the hospital running. In February, he gave $9 million from the state to keep the hospital fully functioning and open. Private creditors matched these funds with an additional $5 million. At the time Paterson said he would continue to work aggressively with the hospital, its board leaders, unions and elected officials in the effort to save the hospital from closing, but it appears the end is near despite these efforts.

A variety of factors have brought the hospital to this point—everything from the recession to cuts in Medicare and Medicaid to the hospital being founded on Catholic principles of charity, meaning many patients who are unable to pay for care still receive treatment. St. Vincent’s is also one of the only freestanding hospitals in the city, meaning it is not partnered with another institution. The hospital has looked to change that in order to stay afloat, but has not been successful in its search. Recently Mount Sinai Medical Center decided against a partnership.

Representing a different point of view, Robert Woodworth, Director of Meeting and Conference Services at the LGBT Center and a former city planner, says he doesn’t think the community should bemoan this change. He notes that there is nothing that says a hospital must be on 12th Street and Seventh Avenue South, or even in that vicinity; just because it’s been that way for over a hundred years doesn’t make it permanent. What is crucial, he says, is how to manage change.

“If they close the hospital, [that] does not take in account how they close the hospital,” Woodworth says. “Until the marshal comes and padlocks the doors, something will happen. People will have to do things to provide healthcare to keep an emergency room open and some surgical programs open.”

That may sound rational, but it doesn’t ease the minds of Nicole Bruno and others who are waiting to find out where their loved ones will end up for care, or tell us how to fill the void that will soon exist where St. Vincent’s once stood