The nations oldest public hospitaland the premier emergency institution in New York Cityis the go-to place in the aftermath of a plane or train wreck, an all-out gunfight or a commercial airliner slicing through a skyscraper. Its staff has spent enormous time in preparation for the numerous scenarioschemical, biological, nuclearfor which New York is the expected target.

Now it too has become a casualty of Sandy as the last 200 or so of the hospitals 725 patients were being evacuated Wednesday night after fuel pumps for backup generators failed, a similar fate to what befell nearby NYU Langone Medical Center.

My colleague Larry Greenemeier pointed to the need for a fundamental reassessment of the city's urban infrastructure after the post-posttropical storm cleanup finishes. Planning for the next timeGood Night Irenewill by necessity require taking into account public-health preparedness.

Bellevue, the first responder for so many health-care firsts, will be at those meetings because of its karmic history. Bellevue developed New York's first sanitary code, a worldwide precedent. It established the first hospital catastrophe unit. The first ICU in a municipal hospital went there. The list is actually quite a bit longer.

Bellevue has always been a bulwark of tough-guy New York, ready for the unexpected. Now it needs to set a new example in preparing for the unpredictable health requirements of a densely packed populace that faces a rising tide of warming salt water that threatens to make the Big Apple a physically smaller place.


Image Source: Jim Henderson