PROGRESS REPORT: I survived, but will Lower Manhattan healthcare?

Arthur Schwartz recovering at Beth Israel Hospital this past January after undergoing cardiac surgery. Photo by Maggie Berkvist
Arthur Schwartz recovering at Beth Israel Hospital this past January after undergoing cardiac surgery. Photo by Maggie Berkvist

BY ARTHUR Z. SCHWARTZ | I woke up on the last Saturday in January feeling awful. My heart, said “code red.” The first decision was where to go. I live a block from Northwell’s Lenox Health Greenwich Village emergency department, so I figured that would be the fastest way to get an EKG.

I went there and told the guy at the front desk, “I think I am having a heart attack.” He told me to have a seat, and I responded, “Did you hear what I said? I said ‘heart attack!’ ”

He got up, grabbed a nurse, and they took me right into a room. They hooked up an EKG machine, and immediately a tech said, “Yes, yes.”

I said, “Yes what?”

“You are going in an ambulance to the Beth Israel cath lab,” I was told.

Fearing that doctors were leaving Beth Israel, I replied, “Can’t I go to N.Y.U.?

“No, we don’t have an arrangement with N.Y.U.,” they said.

I then got wheeled on a gurney and entered the ambulance. The E.M.T. medic asked me my name, and I said: “Am I having a heart attack?”

“You are in the middle of one,” he responded.

My brain rotated among three related thoughts. First, that I could die any second. The second was how my chances of living were reduced because I must be driven all the way to First Ave. to receive treatment. The third was how much worse my chances would be two or three years from now if Beth Israel were to close. At least the second and third thoughts keep me from focusing on the first.

I arrived at Beth Israel and the E.M.T.’s wheeled me up to the cardiac cath lab — which was closed. They then took me down to the emergency room, where I saw my son Jacob and yelled, “Get me out of here!”

Of course he couldn’t. Soon, I was immersed in wires and IV’s and, within minutes, I was transferred to the now-open cath lab, where they ran a wire up to my heart and then sedated me big time. Someone stuck some consent papers near me, I signed, and they added two stents to my heart. Most importantly, I was alive! And my heart, which suffered some damage, is functioning well.

One can speak intellectually about hospital closings and how additional minutes in an ambulance can cost lives. I now speak from “the heart.” If Beth Israel had not been here, I might not be alive. Or, the damage to my heart might have been more extensive. Of course, it would have been even better if Northwell’s Lenox Health Greenwich Village were a full-service hospital.

The doctors at Beth Israel were outstanding. The cath lab folks and the emergency room technicians saved my life by doing their jobs with precision. The cath unit  is a proud group. They are the first line in saving the lives of people with heart attacks, or people at risk of heart attacks. The surgeons and equipment are top of the line. The nurses have 20 to 30 years of experience.

Last May 26, Mt. Sinai’s president, Kenneth Davis, said that Beth Israel Hospital was “transforming, not closing,” and that “nobody was closing the doors, taking away the keys and telling everyone who is employed here that they are [no longer] employed, [or] telling patients to find another place.” He repeated that “this is not a closure,” but the nurses told me otherwise. So I began to dig deeper.

Other than stent surgery, heart surgery no longer takes place at Beth Israel. So, if someone arrives in an ambulance and the E.R. determines that a bypass is needed, the patient returns to the ambulance and gets sent to Mt. Sinai up on E. 99th St. The nurses told me that whole floors at Beth Israel are closed down, and that nothing at the hospital is being “transformed.” Staff members are leaving in droves since, they say.

The staff I met emphasized that there is a constant need for 250 to 300 beds and that Mt. Sinai’s plan for a 70-bed hospital at E. 14th St. and Second Ave. is a joke. Also, Beth Israel takes everyone —insurance and no insurance. They all believe that if the current Beth Israel, at E. 16th St. and First Ave., closes, Lenox Health Greenwich Village, at W. 12th St. and Seventh Ave., will send people to Bellevue, at E. 27th St. and First Ave., which is an overcrowded city hospital, or Lenox Hill Hospital on E. 77th St. A nurse said the extra time traveling to the Upper East Side could have cost me my life.

After I got out, I learned that the state Department of Health commissioner — who reports to Governor Cuomo — had approved nine applications by Mt. Sinai Beth Israel either to alter its Union Square East Phillips Ambulatory Care Center (PACC) and New York Eye and Ear Infirmary facilities or, more importantly, eliminate critical (and profit-making) parts of Beth Israel. These applications are what state D.O.H. has approved since that “closing in four years” announcement was made:

The elimination of 26 inpatient physical-medicine and rehabilitation beds. According to Beth Israel, “In the first six months of 2016, there were 290 discharges, with 3,396 patient days — a 71.6 percent utilization rate.” The 26 beds brought in a $17 million profit in 2015.

• The dismantling of 73 inpatient beds in the maternity unit — 42 for mothers and 31 neonatal-care beds — effective May 22, 2017. Also, the closure of 45 bassinet well-baby nurseries ended its status as a Level III perinatal center. According to Beth Israel, the maternity beds had a 56.7 percent occupancy rate in 2016. As recently as 2013, Beth Israel had 10.5 deliveries per day and a neonatal occupancy rate of 44.6 percent. (In its application, Beth Israel notes that those rates have declined notably in 2017. Could it be because word is out that the hospital is closing down?) This unit brought in a $39 million profit to the hospital in 2015.

The elimination of 20 inpatient pediatric beds (closed on Jan. 24, 2017). During the first six months of 2016, Beth Israel had 761 patients in these beds, for a total of 1,709 patient days — a 21.2 percent utilization rate. These beds brought in a $9 million in profit to the hospital in 2015.

The elimination of the cardiac-surgery operating room. Between 2012 and 2015, Beth Israel performed between 287 and 325 cardiac surgery procedures per year. These surgeries brought in a $17 million profit in 2015.

• The elimination of all five pediatric intensive-care unit beds. During the first nine months of 2016, they served 112 patients, who were in the beds a total of 402 patient days. As recently as 2012, the occupancy rate was 41.7 percent. These five beds brought in a profit in excess of $1 million in 2015.

• A $10 million demolition of a building at 321 E. 13th St., next to the New York Eye and Ear Infirmary.

• A $4 million renovation at 10 Union Square East to create an urgent-care walk-in center.

• The addition of a second MRI to the Union Square East PAAC at a cost of $5.5 million.

That such moves could be made — secretly — without public hearings or even public notice from the state Health commissioner, much less Mt. Sinai, and without studies about the impact is a breach of the public’s trust.

When Beth Israel closes, there will be no Level I trauma hospital south of 114th St. on the West Side (since Roosevelt Hospital on W. 59th St. is also being “modified”). And below Bellevue, at E. 27th St., there will be no Level I trauma-center hospital, either. There will only be four hospitals between the tip of Manhattan and 70th St. where someone can deliver a baby or have cardiac surgery. The new 70-bed hospital Mt. Sinai plans to open at E. 14th St. and Second Ave. will not serve these needs, or many others.

Come to the “Crisis in Lower Manhattan Healthcare Town Hall Meeting,” on Thurs., May 4, at 6 p.m., at Local 32 BJ, at 25 W. 18th St.

Schwartz is male Democratic district leader for Greenwich Village and political director of New York Progressive Action Network