BELLEVUE: A Documentary of a Large Metropolitan Hospital

Five days in the life of Manhattan's biggest hospital, painstakingly charted through the daily routines of fourteen staff members, ranging from the executive director to the head Emergency Ward nurse. These portraits present few personality frills -- and are all the better for it. The bon vivant chief of surgical pathology, the sympathetic second-year resident in psychiatry, the male nurse in Adult Emergency Services, the fifth-year resident in surgery (a nun headed for a missionary hospital in Ghana) all blur into one doggedly purposeful human being trying to stave off chaos for at least the next half hour. The reader's most vivid impression! is of constant performance at the outer limits of stoned exhaustion. The huge hospital itself emerges with startling authenticity: its appalling physical plant, its ridiculous hierarchical complexities, its heterogeneous collection of the inner-city sick, lost, and dying. The care they receive is by turns thorough and superficial, loving or brusquely impersonal. In the eyes of the over-worked staff members, they are chiefly problems to be dealt with as efficiently as possible; continuity is at a minimum. Yet the staff not only functions but struggles toward something approaching a professional conscience. ""You can't treat patients like your relatives,"" argues a resident eager to do an elaborate and painful test on a neurology case, and his chief shoots back, ""And you shouldn't treat patients as academic problems either."" Gold hasn't left out Bellevue's blights, but his account also conveys the surprise of finding a shaky, clumsy, overloaded, and conflict-ridden organization miraculously sustaining a spirit of common endeavor that seems to have vanished from more gracefully functioning institutions.