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VA NY Harbor Health Care System


Same care, different look

Dr. David Gelman, Emergency Department

Dr. David Gelman, Emergency Department

Thursday, December 27, 2012
Enter the glass lobby doors at VA’s Manhattan Campus these days and you’ll find that the hospital is still temporarily closed, due to the damage it sustained during the hurricane. Recovery efforts are well underway and until the doors reopen to usual, robust services, you’ll find a panel of specialists seated in a line just inside the entry advising Veterans who, for a variety of reasons, have come to the VA’s 23rd Street Medical Center – unaware of the temporary closure and availability of only very limited services at the site. Veterans are currently being seen at other locations.

On one recent morning, Pharmacy Services was represented by Herbert Brychta, Pharm.D. Commenting on life after the storm, Brychta acknowledged that things may look different, but the mission to serve Veterans is still the same. He noted that it's important for Veterans to know that when prescriptions are renewed by a provider in the lobby, they either have to be mailed to the Veteran or filled for pick-up through the Brooklyn VA. Brychta, an Army Veteran, said most patients get multiple prescriptions and many prefer not to reorder them online. When they come in to renew their prescriptions, they’ve also been asking questions, such as whether it’s OK to take a medicine with food and whether it matters if a medicine is taken in the morning or at night. Some need guidance on replacing medications that were lost or forgotten during the disruption of the storm.

That day, like every day, Emergency Department Psychiatrist Arnaldo Gonzalez-Aviles and Emergency Attending Physician Dr. David Gelman were speaking with patients in the hospital lobby. Dr. Gonzalez-Aviles has been directing mental health patients to VA’s Chapel Street Clinic nearby, where a wide range of services previously offered in Manhattan are now available. Dr. Gonzalez-Aviles said that just as was the case before the storm, the patients he is seeing now have a range of mental health problems including schizophrenia and depression. Many have mental health problems related to drugs and alcohol. Often, the problems are worsened by joblessness.

Dr. Gelman and his colleagues assess patients who report for care and determine whether their needs could be served by a brief exam in the mobile vans, more extensive evaluation or another VA hospital, or if they are so ill they warrant an ambulance transfer to the nearest hospital.

Finding ways to deal with the turmoil and displacement caused by the hurricane has been a challenge for both patients are clinicians “It’s not just that patients and clinicians have to travel further for care. It’s also been disruptive to usual patterns of care, the relationships between providers and patients, patients and each other. It’s more difficult for everyone than I had first imagined.” Dr. Gelman added, “the patient’s accommodations have been amazing, exceeded only by the strength and resilience of our Veterans.”

Two mobile clinics are set up outside the building, staffed by clinicians who provide some basic services in this limited space to patients. Army Veteran Shirley Nealy, who came to the hospital with concerns about her blood pressure, had her blood pressure taken, had blood drawn for lipid assessment, and received a flu shot on a recent visit. She’ll get a follow up shortly.

“Although the superstorm wreaked havoc on the buildings, the people who use this hospital and the people who work here are highly resilient and creative. There are about 50 to 100 committed individuals everyday restoring the building and coming up with creative solutions to meet the needs of Veterans who rely on the 23 street campus. That’s who we are after all, a group of men and women trying to mitigate the health consequences of war. This is just another unwanted tragedy to work through, and these capable professionals are just the kind of people who can overcome anything,” said Dr. Curt Dill, Chief Emergency Services (Manhattan campus).


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