Another Chapter in Bellevue Hospital's History

At the peak of Hurricane Sandy, with Con Ed power already cut off and Bellevue running on generators, Bellevue’s Emergency Command Center fell eerily silent. The order had gone out for the evacuation of all staff from the basement. That meant water was rising and electrical and mechanical systems were at risk, including a critical fuel pump that propelled diesel from the hospital’s underground storage tanks to the main generators on the 13th floor.

Hope remained that the pump would hold out against the fury of the East River. But more bad news followed within minutes – the pump had failed, despite being housed in an airtight, sealed room with a submarine-style waterproof door. Now reliant on a back-up fuel tank located near the generators, priorities quickly altered. Bellevue needed fuel, needed it fast, and needed a way to get it up 13 floors to its generators.

Within an hour, NYPD and OEM supplied a 2,600 gallon fuel truck and Bellevue staff formed a ‘bucket brigade’ over 50 people strong. Staff passed containers of fuel from the truck hand-by-blue-gloved-hand up 13 flights of stairs to the reserve fuel tank. It was a daunting task, but it worked: Bellevue never lost power.

Over the next four days, hundreds of National Guardsmen kept the bucket brigade going. They were from the local armory and had pledged their full support to Bellevue. They manned each of the hospital’s 21 floors alongside hospital staff members.

The cavernous, 180,000 square foot basement quickly became impenetrable with an estimated17 million gallons of flood waters, but the hospital managed to maintain relative normalcy for another two days.

“Upstairs, medical care was proceeding surprisingly smoothly. Medications were administered. Laboratory testing continued. The pharmacy kept the floors supplied with medications,” said Dr. Danielle Ofri in a first-person account published in the New England Journal of Medicine. “And this being Manhattan, deliveries of pizza and Chinese take-out food never flagged — though it was the doctors, nurses, and medical assistants who had to carry it up 17 flights of stairs.”

Then the order for full evacuation requiring the transfer of more than 500 patients finally came on Wednesday.

“What transpired next can only be described as breathtaking,” added Dr. Ofri. “There was certainly tension in the air, but the evacuation was smooth, calm, and orderly. Intense clinical preparation preceded each patient's exit. The sickest patients were brought down first. Then the hospital was evacuated ward by ward into the early hours of Wednesday morning. Patients who couldn't walk were carried down on sleds by the National Guard troops, accompanied by medical chaperones.”

The Guardsmen mobilized into rotating six-man teams and carried patients on special safety sleds down the hospital’s stairwells to a mobile transfer triage area in the hospital lobby. Once there, patients were prepped and tenderly transferred to a waiting cadre of ambulances lining up around the perimeter of Bellevue’s campus, their red and white lights flashing.

A small army of non-direct care staff were posted to each unit on each floor, serving as messengers and runners, relaying communiqués, distributing supplies, distributing flashlights, facilitating requests, and assisting clerks.

Two days later, one elevator was brought back into service enabling the removal of the last remaining patient, a young man in his late thirties with a serious heart condition. Before the storm, Bellevue cardio-thoracic surgeons had performed an open heart procedure to insert temporary pumps to strengthen the weakened heart. One device was no longer needed and had to be removed in order to reduce the risk of complications during transfer.

“The rest of that story is one for the history books, involving the heroic efforts of a large team of doctors, nurses and Operating Room staff, “ said Lynda Curtis, Sr. Vice President of the HHC South Manhattan Network and Executive Director of the hospital. “The team set to work creating a pristine operating theater for surgeons Abe Deanda and Leora Balsam. The operation was not only a success, but the expert post-operative care facilitated a seamless transfer of the patient. We even managed to have the patient’s family on-site throughout the entire operation and transfer.”

Suddenly empty of patients for the first time in its 276 year history, staff members reported feeling a sense of loss and grief. The patients they had cared for so tirelessly were in other facilities, other unknown environments. How would they manage? An emergency room doctor ached with concern about a homeless patient who often showed up at the ED and had no other supports. All were reminded about the sublime mission of public hospitals.

Bellevue is now focused on recovery and getting back to full strength for the community – a community of individuals who rely on public hospitals for their health care needs. Walk-in outpatient services opened Nov. 19th, emergency room care will be brought back by mid-December and the hospital is expected to start admitting patients in February 2013.

November 2012