Lenox Hill: Portrait of New York City hospital obscures more than it shows
11 July 2020
Netflix is currently streaming the mini-series documentary Lenox Hill, which focuses on four doctors at the hospital of the same name in New York’s Manhattan.
The nine-part series has received overwhelmingly positive reviews and attracted a fair amount of public interest, no doubt driven by its concentration on health care workers who have been fighting on the frontline of the COVID-19 pandemic for almost half a year now.
At the center of the series are two neurosurgeons, Dr. David Langer and Dr. John Boockvar, who primarily treat patients with brain tumors; an emergency room (ER) physician, Dr. Mirtha Macri; and Amanda Little-Richardson, a physician completing the final year of her obstetrics and gynecology residency. The series shows the doctors’ interaction with patients—many of them critically ill with cancer—and their personal lives.
Directors Adi Barash and Ruthie Shatz filmed the series at Lenox Hill, founded in 1857, over a period of 18 months, concluding in 2019, shortly before the coronavirus pandemic broke out. Netflix recently added a bonus episode of 30 minutes, which follows three of the doctors through their battle against COVID-19.
The series gets off to an intriguing start: in the first episode, viewers get an inside look at some of the discussions about brain tumor treatment, as well as insight into the dilemmas facing doctors who have to balance their medical work with administrative duties and the pressure facing Lenox Hill to “compete” with other hospitals—especially NewYork-Presbyterian and Mount Sinai.
In one scene, Dr. Langer has to beg the hospital’s administrator for more rooms for his staff and for operations, arguing they have delivered higher caseloads and a rapidly growing department.
Langer complains that competitiveness and doctors’ “big egos” harm collaboration in the medical field and stresses that his team wants to act differently. Some rivalries and “egos” may well be damaging, but what are the conditions in the health care system and society as a whole that generate these pressures and attitudes among medical professionals? The series does not ask itself the question.
This general issue, the drive to compete on the “health care market” and its consequences, is effectively dropped for most of the remaining episodes of Lenox Hill. Indeed, the phrase “private profit” is never mentioned, as if it had absolutely nothing to do with the US health care system.
Instead, the focus in six out of the eight initial episodes is squarely on the interactions between doctors and patients. Some of this is quite interesting. The work of Langer and Boockvar in particular speaks to the enormous advances in medicine and especially oncology over the past decade. Brain tumors that would have once led to the death of patients within just 18 months or less can now be treated, prolonging the lives of patients for years.
The sequences in Lenox Hill featuring the ER doctor, Mirtha Macri, who treats homeless people struggling with drug addiction and mental health issues, and other impoverished layers, provide a glimpse of the social reality facing millions of workers in New York and other parts of the US—but no more than a glimpse. Macri is also the only one who raises, in the last episode, the devastating impact that lack of insurance often has on many of her patients. She speaks well and with great empathy about the needs of her patients. Yet at no point does the series go beyond individual encounters or statements on these issues.
While we see close-up after close-up of brain surgery, the overwhelming social reality of health care for profit is left out. As a result, much of Lenox Hill descends into a somewhat more polished version of reality television.
To the extent that political issues are raised at all, they are treated in a thoroughly conventional manner and never transgress limits deemed acceptable by the Democratic Party wing of the establishment. There is discussion of racial disparities in health outcomes, especially the high rate of African-American women dying in childbirth, yet the terms capitalism and medical debt are not mentioned once. It may be an accident that two out of the handful of patients treated for brain tumors in the series are cops, and there is praise for the New York Police Department by the ER doctor at one point. But in their combined impact, all of these sequences, carefully selected and edited together, send a clear message: do not question the status quo.
Reality makes a mockery of this message. The world has witnessed with shock and horror how the COVID-19 pandemic overwhelmed New York City hospitals, which count among the best in the world. In the richest capitalist country on the planet, at least 697 health care workers have died because they were not given adequate personal protective equipment.
The bonus episode of Lenox Hill, devoted to the pandemic, again provides nothing but a glimpse of this reality. We see our ER doctor, Macri, who works on the frontlines of the pandemic even though she is pregnant, struggling with the mental impact of the crisis on herself and her staff. The neurosurgeons also become involved in the fight against the virus. While Lenox Hill was far less severely affected than public hospitals like Bellevue or Elmhurst, as happened in other New York hospitals, several workers died of COVID. But the series does not provide any figures. Nor does it even hint at the shortage of critical medical equipment. It ends by showing Lenox Hill staff and anti-police violence protesters applauding each other.
All this raises the question as to what motivated the making of Lenox Hill. To be sure, it gives some inkling of the work and heroism of health care workers. But it does so by completely divorcing their work from the broader social reality in which it takes place. The result is a series that at times becomes so artificial that it borders on advertisement—not so much for the workers, but for the hospital.
One therefore needs to ask: was Northwell Health, which owns Lenox Hill and spends millions on its “brand,” involved in financing and producing this series?
Lenox Hill, a major hospital that ran into financial difficulties, was taken over by Northwell Health in 2010. The ER that Dr. Mirtha Macri works in used to be part of St. Vincent’s Hospital, one of 16 hospitals that have shut down in New York state over the past two decades.
With 70,000 employees, Northwell Health is a multibillion-dollar company and New York’s biggest private employer. It runs 23 hospitals and 700 outpatient facilities. Northwell has its own research center, the Feinstein Institute for Medical Research, medical school and a whole network of hospices, urgent care, dialysis and rehabilitation centers.
The company enjoys enormous political influence and has donated to New York Governor Andrew Cuomo’s campaigns. CEO Michael Dowling is a multimillionaire and was on the board of Cuomo’s COVID-19 task force, whose criminal delays directly contributed to the rapid spread of the virus in New York and its high death toll.
Dowling is also a member of Cuomo’s “billionaire panel,” which includes figures such as Bill Gates and Eric Schmidt, tasked with “reimagining” New York. Northwell Health, which owns at least two nursing homes where many COVID-19 deaths occurred, was also part of the hospital association that successfully lobbied Cuomo to shield nursing home executives from prosecution.
Meanwhile, an investigation by Gothamist found that Northwell Health was suing more patients for unpaid medical bills than any other hospital chain in New York. Out of 31,000 patients sued by New York hospitals between 2014 and 2019, Northwell Health accounted for between a third and a half. At Lenox Hill, a man from Queens was sued to pay a bill for $1,000 in $50 installments. He had been at the hospital after his partner had been raped and was told to get an HIV test even though he had no insurance. He told the Gothamist: “I could have gone to my doctor and had it done for $200 to $300. I should not be responsible for this. I cannot afford this.”
A truthful depiction of the state of hospitals in New York City and the US as a whole is impossible without an honest reckoning with the thorough domination of the health care system by private profit with now-deadly consequences amid the pandemic—both for the staff and for the patients. The makers of Lenox Hill were, unfortunately, unwilling to take this on.