by Greg Santa Maria
Anyone will tell you that St. Vincent's Hospital has always been there. Saint Vincent's rose up from the ground in Greenwich Village at the beginning of time and maintained its mission throughout the ages. Through tragedy after tragedy, historical holocaust and epidemic, Saint Vincent's persevered and led New York City through many dark times. Now it appears that no one is there to save her.
Some cultures say it's not appropriate to speak of the dead, but I will take that chance. As my EMS alma mater and the facility where I spent half my paramedic career lay dying at the hands of insurmountable debt, it was hard to imagine that's what would kill her. But I digress. For those of us who were fortunate enough to be a part of the Saint Vincent's family, there is a compelling need to share her story, her contributions, leadership and victories, particularly in the field of EMS.
It would take a thousand pages to describe what an invaluable asset Saint Vincent's has been to the people of New York City for the last 160 years. Saint Vincent's also shared its expertise with hospitals around the world. This was particularly evident in its post-9/11 activities when staff members traveled as far as Australia to share the hospital's experiences and lessons learned from the World Trade Center attacks. As one of those people, I can speak with firsthand knowledge about the difference we made to other hospitals and EMS providers on our journeys.
Following is a rather condensed version of accomplishments and responses that shaped Saint Vincent's, and particularly its emergency services, into an icon.
Saint Vincent's Hospital opened its doors in 1849, and soon became one of the first hospitals in New York City to operate an ambulance service. In 1870, the first Saint Vincent's horse-drawn ambulance hit the cobblestones. In what would remain a tradition until the very end, the Saint Vincent's Ambulance Department was born.
Even in the early years, Saint Vincent's led the way, using the first motorized ambulance in New York City in 1900. In 1911, Saint Vincent's Ambulance, manned by hospital interns, responded to the Triangle Shirtwaist Factory fire in Manhattan, where they watched helplessly as those trapped in the fire jumped to their deaths onto the street below.
It was a tragic premonition of what their successors would witness 90 years later on September 11, 2001. Saint Vincent's Hospital received and treated numerous survivors of that now historic event.
In 1912, Saint Vincent's received and treated victims after the sinking of the Titanic, including Sarah Roth,1 who married her suitor, Daniel M. Iles, while recovering at the hospital. Although this was exciting for the other hospitalized disaster survivors, Saint Vincent's was mourning the loss of an attending physician, Dr. Francis Norman O'Loughlin, who perished aboard the ship. A plaque honoring his memory still stands in the hospital's main entrance as a proud reminder of the dedication and sacrifice that our "family" has demonstrated and endured over the years.
As EMS evolved into the current system, Saint Vincent's continued to lead the way with progressive medical innovations in the realm of prehospital care. In 1968, Dr. William Grace, following the lead from a project in Ireland, introduced the first mobile cardiac care unit in New York City. This unit was staffed with a hospital team and designed to bring advanced cardiac care to the people of New York City. This shaped the future of EMS and advanced life support in the area.
In 1975, when FALN terrorists bombed Fraunces Tavern in the Wall Street area, Saint Vincent's paramedics and responders from multiple other EMS agencies transported patients to Saint Vincent's Hospital for trauma care.
Serving the Greenwich Village community during the 1980s HIV/AIDS epidemic, Saint Vincent's became the center of the HIV battle in New York City. Throughout the early years of the emergence of the disease, when people with HIV and AIDS were being treated as modern lepers, Saint Vincent's treated those patients with dignity and respect, never losing sight of its mission.
In 1981, Saint Vincent's opened the Institute of Emergency Care, where a flagship paramedic program was developed that would become one of the most respected and unequivocally the longest running paramedic program in the region. Spanning 29 consecutive years and graduating hundreds of paramedics and thousands of EMTs over that time, Saint Vincent's contribution to the New York City EMS system was immense.
Under the exemplary medical direction of Dr. Richard Westfal, who led the Ambulance Department and Institute of Emergency Care through the end of the 20th and into the 21st century, Saint Vincent's continued to provide leadership to the EMS system. Dr. Westfal became one of the early chairs of the New York City REMAC ALS Committee, working to develop comprehensive patient care protocols and consistent patient care models. He epitomized what Saint Vincent's Emergency Services was all about: quality patient care performed by top professionals trained within her walls. Some say that Dr. Westfal was a catalyst for all that was EMS at Saint Vincent's.
In addition to conducting EMS training, Saint Vincent's provided ambulance service in and around Greenwich Village. It was not unusual to see the “Vinnie's Bus” sitting in front of the hospital, waiting for another call, always on guard and protecting the community.
In 1991, paramedics responding to the Union Square subway crash delivered numerous patients from the event to St. Vincent's.
At the time of the first World Trade Center bombing in 1993, Saint Vincent's held a contract to provide a first aid station in one of the underground levels at the Trade Center complex. On the day of the bombing, two Saint Vincent's paramedics who were in the station became victims themselves. Even though they were stunned by the event, they managed to evacuate multiple patients and use the lights on their ambulance to lead dozens of others safely outdoors.
1996, Saint Vincent's staff became some of the first New York City first responders trained in NBC response by the Department of Defense under Nunn-Lugar grants. This staff went on to serve on internal and external multidisciplinary planning committees, a concept shared in New York City long before the time of NIMS.
On September 11, 2001, Saint Vincent's paramedics witnessed American Airlines Flight 11 make contact with Tower 1 of the World Trade Center. Three crews responded immediately and began treating victims; a fourth crew arrived shortly after the first three. Throughout the morning, paramedics from Saint Vincent's, along with their counterparts from numerous EMS agencies from across the city, responded in and out of the complex, assisting in what would become the largest rescue effort in history. Like so many others, Saint Vincent's staff risked everything and sacrificed a bit of their sanity that day.
In the days that followed, staff supported the rescue and recovery effort while continuing to respond to 911 calls throughout the village. Saint Vincent's Hospital received hundreds of patients from the event and became a memorial to the lost, with flowers, candles and constant prayer vigils. Pictures of the missing collected in such large numbers that the hospital dedicated an entire outside wall to protecting them. For years after the event, the Wall of Hope and Remembrance remained a place of solace and peace.
Not long after the September 11th attacks, Saint Vincent's became part of the response to an anthrax threat unfolding across the United States. With hundreds of patients showing up at the emergency department for testing, Saint Vincent's was again called upon to serve its community while still recovering from its own emotional wounds of September 11th.
In 2003, during the Northeast blackout, Saint Vincent's increased its EMS presence to assist NYC with an impaired response system. Crews endured multiple-flight patient carry-downs, fuel shortages, lack of hot coffee (necessary paramedic fuel) and very little in the way of relief over the two-day event.
The post-9/11 era proved to be a time of major transition for Saint Vincent's Hospital. The Institute of Emergency Care and Ambulance Department worked to upgrade protective measures for its crews, and to protect the emergency department and secure the facility in the event of another terrorist event. Massive efforts in decontamination training were undertaken, emergency plans were upgraded and preparedness training programs were developed for EMS providers.
An outreach program was spearheaded by Doctor Westfal to assist major employers in preparing for terrorist events. In addition, Saint Vincent's introduced a standard to the REMAC ALS subcommittee outlining personal protective equipment to be utilized on ambulances operating in the 911 system. Saint Vincent's outfitted and trained all of its paramedics with protective suits and PAPRs in an effort to reduce potential casualties from additional attacks. Paramedics followed a regular regimen of "suiting up" during call review sessions to maintain their capabilities. The Institute of Emergency Care and Emergency Department received numerous requests to provide training to hospitals in and out of the state. Saint Vincent's name became synonymous with emergency preparedness and remained a leader in the field for years.
In maintaining its dedication to EMS education, paramedic class XXI, which was to begin on September 10, 2001, was only delayed a few weeks and never cancelled. This tradition has continued nonstop since 1981 up to class number XXIX, which will end the run this summer.
So here is a picture of historical significance--a fixture of New York City's illustrious Greenwich Village that was left to slowly bleed to death over the past few years. It's incredible that with all the lives that were saved in this institution, nobody could figure out how to save her. There is much speculation about how the original wound was missed. I don't think I want to know right now. I would rather look at her as someone who took a wrong turn along the way and ran out of gas trying to find her way home. What is more important is to hypothesize what will happen after her impending death. As of this writing, the ED is closed and the once robust ambulances are scheduled for their last tours before the end of the month.
For the people of New York City, this means that from 59th Street down to The Battery on the West Side, there is no hospital and no trauma center. Residents who have an accident, heart attack or allergic reaction could literally be 30 minutes or more from a hospital. Their care will be determined by traffic patterns and additional wait times in emergency rooms. Ambulances may not arrive as quickly now, and more than 60,000 ER visits will have to be absorbed by other already overcrowded emergency rooms. They are already feeling the impact, and it has only been a few days. How will they maintain the additional patient loads from a hospital that provided charity care?
Other facilities and the city will replace the ambulances with capable EMS providers, but it will not be the same. The chemistry between Saint Vincent's and the people of Greenwich Village was special and will never be replaced.
When I spoke to some of my old friends at Saint Vincent's today, an obviously melancholy mood emanated over the telephone. We have been through so much together, but we have always been able to lean on each other and make the bad go away. It won't go away this time. Not surprisingly, someone said, "People keep coming to work. They haven't given up. They are still out there, for now, doing what they do best."
If you were ever part of the Saint Vincent's family, you realize why these EMS providers are still hanging in. It's because it has always been an honor to work at the best ambulance garage in the city. It's hard to let go.
I salute all my friends and family at Saint Vincent's for what they have endured--for what they have given to the people of New York City. They are old souls, linked to the spirits of even older souls who started an amazing legacy 160 years ago. We will always remember that we were part of something so big it's hard to find words to describe it.
My Saint Vincent's EMS family is a beacon in the fog, and nothing will ever extinguish their spirit.
1. Cupid Wins Out. The Daily Banner 1912 http://www.encyclopedia-titanica.org/cupid-wins-out.html.
Greg Santa Maria is the manager of Prehospital Care and Emergency Preparedness for Sanford Health in Sioux Falls, SD. He is the former paramedic program director and smbulance department manager at Saint Vincent's Hospital in Lower Manhattan where he also served as a key leader of the Saint Vincent's Hospital Disaster Preparedness initiative. He received a distinguished service award for his participation in the response to the terrorist attacks on the World Trade Center, September 11, 2001. For the past 12 years, he has been working as a subject matter expert in the realm of hospital emergency management and disaster preparedness. He has developed a health system-based incident management team within the Sanford Health System. This team has conducted numerous exercises with response partners in South Dakota, Minnesota and Iowa. He has recently worked on and led several projects related to the H1N1 outbreak. He has published several EMS related review books, written articles on emergency preparedness and EMS response to mass casualty incidents, participated in numerous television, print and radio broadcasts, and has spoken nationally on issues of preparedness and disaster response. He is currently a member of the Interstate Chemical Threat Workgroup advisory board. Contact him at SANTAMAG@sanfordhealth.org.
Reprinted courtesy of - EMS Responder.com -the online home of EMS World Magazine
Original posting April 15,2010
Keywords: St. Vincents Hospital, New York City, Mobile Coronary Care Unit
External Resource Link: http://emsresponder.com/features/article.jsp?id=12872&siteSection=19
Last Revision Date: 4/16/10 - 4:23 PM