Twelve Patients: Life and Death at Bellevue Hospital (The Inspiration for the NBC

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In the book, Manheimer said, "I wanted to tell the story of the social and political things festering in this country, but I wanted to tell the patients' stories that could narrate it ... So I went through the notebooks and chose 12 patients that illustrated 12 important themes." Dr. Manheimer describes the plights of twelve very different patients–from dignitaries at the nearby UN, to supermax prisoners at Riker’s Island, to illegal immigrants, and zing.Wall Street tycoons.

Manheimer and his wife, Professor Diana Taylor, are fluent Spanish speakers with a deep knowledge and interest in South American politics and culture. The couple has traveled extensively through South America and own a Mexican vacation home.This gives Manheimer ample opportunity to interact with Mexican, South American, and Dominican patients moving through Bellevue’s system. Many are undocumented, impoverished, and forced to endure abysmal working conditions.

Author Contributions

Sako, W.; Goto, S.; Shimazu, H.; Murase, N.; Matsuzaki, K.; Tamura, T.; Mure, H.; Tomogane, Y.; Arita, N.; Yoshikawa, H.; et al. Bilateral deep brain stimulation of the globus pallidus internus in tardive dystonia. Mov. Disord. 2008, 23, 1929–1931. [ Google Scholar] [ CrossRef] [ PubMed] There are many moments within this book that are sad. Not every patient will make it out of the hospital, not every ending is happy. That is of course part of the point isn’t it? Not every ending in real life is happy either. There are going to be trials and up’s and downs and moments that cannot be overcome. It is how we choose to let those hard times, those somewhat impossible times define us that really makes things what they are, right? The Author for example, could have let his own illness overtake him, to give in to how hard his situation was and not fight. However, he chose to fight instead of give up and that can sometimes be more scary then just giving up. Believe me, I know. Kiriakakis, V.; Bhatia, K.P.; Quinn, N.P.; Marsden, C.D. The natural history of tardive dystonia. A long-term follow-up study of 107 cases. Brain 1998, 121, 2053–2066. [ Google Scholar] [ CrossRef][ Green Version]

Manheimer intends more than 12 sharp little medical biographies. He uses each case as a springboard from an ailing individual to greater social ills. While these digressions are intended to edify, Manheimer’s impassioned asides lose urgency with unnecessary repetition.Kupsch, A.; Klaffke, S.; Meissner, W.; Arnold, G.; Schneider, G.H.; Maier-Hauff, K.; Trottenberg, T. The effects of frequency in pallidal deep brain stimulation for primary dystonia. J. Neurol. 2003, 250, 1201–1205. [ Google Scholar] [ CrossRef] Andrews, C.; Aviles-Olmos, I.; Hariz, M.; Foltynie, T. Which patients with dystonia benefit from deep brain stimulation? A metaregression of individual patient outcomes. J. Neurol. Neurosurg. Psychiatry 2010, 81, 1383–1389. [ Google Scholar] [ CrossRef][ Green Version] Lerner, P.P.; Miodownik, C.; Lerner, V. Tardive dyskinesia (syndrome): Current concept and modern approaches to its management. Psychiatry Clin. Neurosci. 2015, 69, 321–334. [ Google Scholar] [ CrossRef][ Green Version]

Further, Manheimer is preaching to a left-wing choir, assuming readers share his liberal political leanings on everything from the need for socialized medical care to a call for more lenient immigration policies. While many readers may wholeheartedly agree with Manheimer, others may be so distracted by his overt liberal agenda that they abandon the book. It's also very depressing. Most of these cases are not cured and most of these patients were victimized before they became ill. I decided to read this book after finding out that the new TV series New Amsterdam is based on it. I can see some of the information in the chapters woven into some of the episodes my husband and I have watched. There are some hard truths in this book. I found it fascinating when Dr Manheimer was talking with Marta in the chapter Four Generations; about immigrants from Central America and the apparent propensity for diabetes and obesity. This spanned the four generations that the doctor knew about. There is a passage in the chapter that reads "The key strategy of the food industry has been taken from the legal, legislative, marketing, and risk-adjusted playbook of the tobacco wars." It talks about how junk food/sodas are marketed to the public and the rise in sedentary lifestyles and obesity. The opening chapters of Twelve Patients are compelling enough to overcome the book’s flaws. We meet Juan Guerra, a 59-year-old career criminal dying of cancer. Manheimer’s description is of a basically decent person who had little chance in life. Despite multiple incarcerations, drug problems, and terminal illness, Guerra has managed to keep his family together, including his devoted wife of 35 years. The hospital staff secures his freedom so he can go home to die. The author's youthfulness helps to assure the inevitable comparison with the Anne Frank diary although over and above the sphere of suffering shared, and in this case extended to the death march itself, there is no spiritual or emotional legacy here to offset any reader reluctance.

The title of this book, 'Twelve Patients', is a bit inaccurate. There are twelve stories in the book about patients and their care, however the author also has his own medical story to tell. The author, Eric Manheimer, is the Medical Director of Bellevue Hospital in New York City. He has throat cancer. So nestled among the 12 stories chosen, is his regiment and life altering condition, as he oversees Bellevue.

Can’t do it. The author desperately needs an editor; his writing is full of snags, like a nail that needs filing. Time shifts are all over the place without adequate transitions, and the tangents! So. Many. Needless. Tangents. I’m not trying to write unkindly of Dr. Manheimer’s effort. Certainly he is skilled, generous, and devoted. But we aren’t all writers. This isn’t to say Dr. Manheimer doesn’t have a great deal to import, but Twelve Patients: Life and Death at Bellevue Hospital would have benefited greatly from professional assistance—better editing, even a professional ghostwriter. Burke, R.E.; Fahn, S.; Jankovic, J.; Marsden, C.D.; Lang, A.E.; Gollomp, S.; Ilson, J. Tardive dystonia: Late-onset and persistent dystonia caused by antipsychotic drugs. Neurology 1982, 32, 1335. [ Google Scholar] [ CrossRef] [ PubMed] In providing medical care for these people who have already suffered so much, Manheimer also battles with the constraints of the US health care system. He shows how treatment regimes can sometimes confuse diagnoses and disguise underlying problems - he clearly favours a more hands-off and holistic approach to patient care - but his critique of the overall system is more subtle than one might expect.

urn:lcp:twelvepatientsli0000manh:lcpdf:f345ac1a-0eeb-47ed-8e9f-792beeeab5e5 Foldoutcount 0 Identifier twelvepatientsli0000manh Identifier-ark ark:/13960/s215pn5wtcv Invoice 1652 Isbn 9781455503889 Kefalopoulou, Z.; Paschali, A.; Markaki, E.; Vassilakos, P.; Ellul, J.; Constantoyannis, C. A double-blind study on a patient with tardive dyskinesia treated with pallidal deep brain stimulation. Acta Neurol. Scand. 2009, 119, 269–273. [ Google Scholar] [ CrossRef] Magariños-Ascone, C.; Regidor, I.; Gómez-Galán, M.; Cabañes-Martínez, L.; Figueiras-Méndez, R. Deep brain stimulation in the globus pallidus to treat dystonia: Electrophysiological characteristics and 2 years’ follow-up in 10 patients. Neuroscience 2008, 152, 558–571. [ Google Scholar] [ CrossRef] A story about Arnie, a Wall Street high-flyer who loses everything to drug and alcohol addiction, is less cohesive yet still saddening. While it’s easy to hate a man who grew wealthy off the losses of others, Arnie pays dearly. Even when he manages to clean up, he’s left unemployed, with the fallout of angry ex-wives and deeply troubled adult children. et his story ends on a fragile note; we learn nothing about what happens to him. Closing this vignette, Manheimer writes: “I… pondered the nature of forgiveness.” Don’t we all.