Bellevue Hospital in New York, New York

For the inhabitants of New York City in the gaslight era, there was one name that was guaranteed to chill the heart: Bellevue.

Whilst places like Five Points, Murderer’s Row, and the Mulberry Bend were terrifying in their own right, Bellevue Hospital held a dark sway over the city’s collective consciousness. A forbidding presence on 1st Avenue and 26th Street, the hospital became a byword for degradation, foulness, and death; it was the one place a New Yorker didn’t want to go, because the chances were you wouldn’t come back. 

Founded in 1736, Bellevue is America’s oldest public hospital. Starting as an alms house with six beds for the city’s poor, the dangers to the public from outbreaks of diphtheria, cholera, and yellow fever saw the need for a place of quarantine. At a time when Manhattan didn’t yet extend beyond Wall Street, the empty mansion of the Quaker-merchant Murray Family a few miles to the north was selected for New York’s first hospital. The mansion atop what is now Murray Hill commanded spectacular vistas over the East River and the farms of Brooklyn and was so named Bellevue. 

Whilst a New York City hospital built on Broadway in 1771 catered to high society,  Bellevue soon became a refuge for the undesirables of the time, mostly the immigrants living in the torrid slums of lower Manhattan. For the 300,000 souls per square mile crammed into the tenements, Bellevue was often their last port of call. In 1879 Harpers New Monthly Magazine ran an article on New York’s hospitals. Bellevue was described as being "for the poorest of the poor, the dregs of society, the semi-criminal, starving unwelcome class who suffer and die unrecognized."  It was overrun with foundlings (New York’s abandoned infants), the insane, alcoholics, victims of epidemics, the homeless, and patients ranging from the suicidal to the homicidal. Overcrowded, sleeping three to a bed, or more often on the floor, conditions were abysmal. In 1876 it was reported that 48% of all amputations proved fatal due to the poison in the walls. Harper’s summed the miserable institution up thusly, "The wards are filled with wasted souls drifting through the agonies of disease toward unpitied and unremembered deaths."

The alcoholic cells were often merely way stations for a trip to the asylums of Blackwell’s (now Roosevelt) Island, lying in sight from Bellevue up the East River. If patients were lucky enough to be cured, as reporter and champion of tenement reform Jacob Riis wrote in his photoessay, How the Other Half Lives, "the maelstrom has no bowels of mercy; and the would-be fugitives are flung back again and again into the devouring whirlpool of crime and poverty, until the end is reached on the dissecting-table, or in the Potter’s Field."

But for all it’s infamy, Bellevue was also a pioneering hospital. It housed the cities first morgue, and it was the first hospital in America to run a maternity ward. A veteran of the Civil War, surgeon Colonel Edward Barry Dalton saw the need to get the wounded to medical aid as quickly as possible; he created a horse drawn wagon with removable slatted beds in the back, and in so doing invented the first ambulance. It was also the first hospital to use hypodermic syringes, have a pediatric ward, and also the first to contain a specialized unit for outpatients. 

In 1912, New York’s premier architectural firm McKim, Mead and White designed a new campus for the hospital, which mirrored the increasingly better standard of medical care. Today, Bellevue runs a state of the art, first rate medical service. In a gleaming new building that retains some of the original McKim, Mead & White renovations, it has built a reputation as one of America’s most progressive and renowned hospitals. In the mid 1980s, it was one of the first hospitals to create an AIDS clinic. True to its origins as a refuge for the unwanted, Bellevue was in the news in recent months for taking in Craig Spencer, a recovered New York ebola patient.

But just as the old Bellevue had struck fear into the hearts of 19th century New Yorkers, a building constructed on the hospital grounds in 1931 would do the same for the 20th: the infamous Bellevue psychiatric hospital. Resembling a forbidding Georgian house, the red brick building was located a few blocks to the north of the hospital on 1st Avenue. This haunting-looking structure, still surrounded by a rusting iron spiked fence and covered in ivy as it was in the 1930s, it has inspired horror films, nightmares, and comic books. A dark building long associated with neglect, dubious, and disturbing psychiatric practices (the first uses of insulin shock therapy happened here), Bellevue was New York’s bedlam, where its homeless alcoholics and insane were left to be forgotten. The New York Times reported in 1983 that, "the Bellevue psychiatrists must try to serve all the disturbed people in New York – the ‘jumpers’ who threaten to leap from the Empire State Building or the Brooklyn Bridge; the ‘slashers’ who cut their wrists or chests; people who overdose on narcotic drugs or alcohol, and people who run around without clothes or harass passers-by at Grand Central Station."

This was once home to Mark Chapman, the night he shot John Lennon. Edie Sedgwick, Allen Ginsberg, Eugene O’Neill, and William Burroughs all stayed here at one point, as did Norman Mailer the night he stabbed his wife. In popular culture and the minds of New Yorkers, Bellevue was the end of the road. Billy Wilder’s Oscar winning 1945 picture The Lost Weekend, about the devastating effects of alcoholism, was even set there.

Decades of malpractice soon caught up with the squalor of Bellevue. Geraldo Rivera’s 1972 ground breaking expose of the gruesome Willowbrook on Staten Island shone a desperately needed light on the city’s asylums. The psychiatric unit moved into the newer buildings to the south and is now regarded as one of the countries best facilities.

The old Bellevue psychiatric hospital closed in 1984. Today it’s partially used as a shelter for the homeless, but the imposing building lies mostly empty and abandoned. At night a few lights can be seen behind ragged curtains, where the tireless staff still care for the cities poorest of the poor, just as they did nearly 300 years ago.