Volume 79, Number 35 | February 3 - 9, 2010
West and East Village, Chelsea, Soho, Noho, Little Italy, Chinatown and Lower East Side, Since 1933
In healthcare, time is muscle
By Yves Duroseau, MD and Christopher McCarthy, MD
Of all the worthy reasons that the Green-
wich Village community and New Yorkers at large have cited in pushing to save St. Vincent’s Hospital, a three-word phrase that doctors in the E.R. routinely employ could very well serve as the most compelling motive for keeping our doors open.
“Time is muscle.”
When a person has a heart attack, he or she immediately starts losing muscle in the heart and, as more time passes, the strength of the heart, and the ability for it to continue beating, diminishes.
Today, when New York City paramedics respond to a potential heart attack, they will quickly perform an EKG in the field. If there is a heart attack, they will immediately be routed to the nearest hospital with a capability to perform a catheterization 24/7.
When that patient is located in Greenwich Village, Chelsea, Hudson Yards, Tribeca or an assortment of other neighborhoods, he or she is more often than not routed to St. Vincent’s Hospital.
If there were no St. Vincent’s, that same heart attack sufferer would be sent to a hospital on either First Ave. or at W. 58th St.
Imagine that trip at 4:30 on a Friday afternoon during the summer.
Time is muscle.
While this bit of medical jargon is limited to heart attacks, the same principles apply with nearly all emergency medical conditions.
And considering the facts that 63,000 patients visited the St. Vincent’s emergency department last year; approximately 25 ambulances — and at times 50 — pull up to our doors every day; and that no fewer than a dozen patients who suffered cardiac arrest were brought back to life in the field and taken here to be stabilized last year alone — every second really does count.
When someone suffers a stroke, physicians can administer TPA — a clot-reducing drug — which can lessen the severity of the stroke. However, if that drug is administered more than three hours after the onset of a stroke, not only is it less effective, it can actually harm the patient.
The same “time is muscle” rule applies with any serious trauma. Car crashes, construction accidents, pedestrians being hit by trucks or automobiles; we see all of these major traumas most every day at St. Vincent’s, and all of these traumas can be better treated if they are dealt with rapidly.
And St. Vincent’s is the only regional trauma center on the West Side south of 114th St.
But if the clock stops ticking on St. Vincent’s, it won’t be just critical patients who suffer, either... .
Yes, other hospitals’ emergency departments — many of which are already overcapacity — would further swell; but those 63,000 diverted emergency room visits only tell half the story. St. Vincent’s also admitted 13,000 patients from the E.R. to its in-patient beds.
Shut down our E.R. and our in-patient services, and other hospitals’ facilities will bend to the point of breaking. We know this because we’ve experienced firsthand the consequences of other hospitals going on diversion.
The results are increased time to see an emergency physician, increased time for treatment and pain medication, long waits on uncomfortable stretchers for admission, loss of privacy and all the other problems that come with emergency department overcrowding.
And time is muscle.
Duroseau is medical director, Emergency Medicine, St. Vincent’s Hospital Manhattan; McCarthy is director, Pre-Hospital Care and Emergency Preparedness, St. Vincent’s Hospital Manhattan.