If you are ever sick, the island at the heart of the city is the place to be. Out my window, as I write, I can see the sign of a hospital, all of three blocks away, behind the church steeple and across the park. You could get there faster on foot than it would take to hail a cab. Rolling up the river, there is another hospital every mile or so. They have their counterparts on the island’s opposite coast, as if it had been folded lengthwise to make a medical inkblot. The most characteristic city-street sound, over the all-hours rumble and hum, is the stab of ambulances, pulsing through blocked intersections and around double-parked trucks. Where do people in the other boroughs take their ills and injuries? Who knows? They can always come here.
I know where the sick in the country go: far away. A friend’s health took a hit recently. In the country, when you look out your window what you see is trees, and maybe a neighbor. There is an urgent-care facility — a stopgap, the civilian equivalent of medics in old WWII-themed TV shows — in his town, and two small hospitals in a small city to the north, and a third in another small city across the river to the east. What hit my friend was beyond the capacities of these places; he had to go to the state capital.
My friend’s town has a Thruway exit. The Thruway is our piece of the interstate system — two lanes each way, with a pastoral median strip between the directions. It is named after a dead governor who never quite got to be president, and runs 500 miles from the city to the Great Lakes. The posted speed limit is 65 mph. Clots of traffic appear when a state trooper sits in the median strip, enforcing compliance by his presence. Seventy mph is polite, although there are always weaving printer-heads who push it. Down the long slopes come the semis, looming in the rearview mirror like Trump supporters, wellhewon wellhewon wellhewon. Up the corresponding rise they labor and falter, like deficit hawks, trill-ion trill-ion trill-ion.
We do live in an attractive state, broad enough for expanse — the first western, The Last of the Mohicans, was set here — and mild enough to be inviting. Rock faces and streams throw a little wildness, grading and bridges smooth it out. The leaves are half turned, maples going or gone, oaks still green, pines awaiting their time. Cover crops in fields still glow. The occasional cell-phone tower, if that’s what it is, looks friendly rather than menacing: AT&T come home. I know the state harbors as much ugliness as any other — junkyards, storage facilities, mall parking lots — but regulation keeps it far from drivers’ eyes.
For gas, food, and drink there are rest stops. Nathan’s hot dogs. Machines that flatten your pennies. Folders on nearby waterfalls, battlegrounds. In season, farmers’ markets. And always, necessarily, coffee coffee — the fuel of humans. Drivers bound for hospitals, whether patients or visitors, pass them by without resting.
One of the sick friend’s relatives said the hospital was “right off the Thruway.” Out of inertia dignified as resistance, I do not have GPS on my windshield, but I printed out a Google map before I left. The route it prescribed to get you “right off the Thruway” took you through the weft of a city laid out long before the telegraph. The streets bore names of heroes of the Revolution (which happened 150 years into the city’s life). Grids melded at acute angles with other grids. Square signs printed with a bold H showed the way, until they stopped appearing (make a note on the sign supervisor’s performance review). The housing was quite charming, if one had time or inclination to be charmed — Civil War–era row houses (250 years into the city’s life), restored or begging to be. Looming always just in eyeshot were the skyscrapers of the Mall, the folly of another governor who never quite got to be president, looking like what the stage props in Spinal Tap would have looked like if they had been done to proper size. When intuition, the last resource of confusion, gives out, you stop, do a U-turn, realize you’re on a one-way street, do a bigger U-turn around the block — and finally you have come to the hospital.
Now, the last question, the question that confronts everyone admitted to or passing through any great hospital: Where am I? The hospital in the state capital clearly grew over time. Great buildings, side by side or facing each other across a street, bear the names not of heroes of the Revolution, but of letters of the alphabet. The specialty into which my friend’s affliction falls is treated in Building — , just a skywalk away from the building with the parking garage. The elevator releases you to a waiting room with a cafeteria — coffee coffee — and a player grand piano, playing simple cocktail music (I could follow the chord progression through the octaves pressed by the ghostly left hand). Another hallway took us to another waiting room, filled with family, who directed us finally to my friend.
It’s a big country. Big enough to stretch out in, big enough to get lost in. I’m not complaining — I think. The ultimate satire of the can’t-we-all-stay-home mentality was written by James Fenimore Cooper’s contemporary Washington Irving when he penned “Rip Van Winkle.” Rip lives his whole life in the village where he grew up — and even so, his world changes unimaginably. (And just think what Rip’s medical care was like, at the hands no doubt of the village barber.) You better be ready to move, because everything is moving all around you.
Still, it seems hard having to take an impromptu long-distance vacation for a medical emergency — hard on the family, hard on the patient.
But maybe it’s always a long trip to illness.