Empty Mansions

in to a room on the eleventh floor with a lovely view down to a city park and Gracie Mansion, the Federal-style home that is the official residence of the mayor of New York.
    After living mostly alone at home for so many years, now Huguette was in a hospital with its constant noises and staff coming and going. At first she was a difficult patient, swathed in sheets and refusing to let anyone see her. A nurse wrote in the chart that she was “like a homeless person—no clothes, not in touch with the world, had not seen a doctor for 20 years, and threw everyone out of the room.”
    A week into her stay, Huguette was evaluated by a social worker, who filled out the standard initial assessment. The patient, just short of ageeighty-five, was scheduled for surgery to remove basal cell tumors and to reconstruct her lip, right cheek, and right eyelid. She had been “managing poorly at home—reclusive—not eating recently” and was dehydrated. Her only support system was her friend Suzanne Pierre, “helping with her affairs,” and a maid—no family. Her mental status was always awake and alert, but she was skittish: “Patient refused to speak with social worker. Patient has not been to doctor in many years—had refused medications in past. Patient anxious and uncooperative at times.”
    Her plans after treatment? “Spoke with friend, Mrs. Pierre—feels patient will need convalescent care in facility but does not want to go to nursing home which she feels would be depressing.… Patient may need to go to a hotel with a nurse to recuperate.”
    As for financial problems, “none noted.”
    Huguette did not move on to a hotel. Within just over two months, she was an indefinite patient, a tenant, with Doctors Hospital charging her $829 a day. Eventually the rent rose to $1,200, or more than $400,000 a year.
    Huguette had a series of surgeries in 1991 and 1992, with Dr. Jack Rudick removing malignant tumors and making initial repairs to her face. She was healthy, though she still needed a bit of plastic surgery, especially on her right eyelid. “It is not necessary,” she told her doctors. “I am not having any surgery. I don’t like needles.” She was not badly disfigured by the cancer. And there might have been another reason, Dr. Singman speculated. “This she has steadfastly put off,” he wrote in her chart in 1996, “I presume to avoid the final treatment and then possible discharge home.”
    A board-certified specialist in internal medicine, cardiology, and geriatrics, Dr. Singman assured her that she could have round-the-clock nurses at home, and he would visit daily. “I had strongly urged that she go home,” he said. She was, however, “perfectly happy, content, to remain in the situation she was in.” When one of the first night nurses kept urging her to move back home,Huguette fired her. In the end, Dr. Singman accepted her decision, writing in her chart in 1996, “I fervently believe that this woman would not have survived if she had been discharged from the hospital.”
    Dr. Singman’s backup, internist Dr. John Wolff, said he agreed. Huguette“was so content and so secure in the environment. There’s no question in my mind that’s really where she chose to be.” He brought her flowers on her birthday and liked to stop in. “She was a lovely woman, and we would talk. Her mind was clear. There was no confusion about her. Very warm, gracious, sweet, gentle, interested in other people, independent, guarded.”
    Huguette was hardly ever sick. She refused to take a flu shot—she didn’t believe in medicine, she told her nurses, and felt that “nature should take its course.” Her only persistent medical issues were mild: osteopenia, a decrease of calcium in the bones not advanced enough to be called osteoporosis; a slightly elevated systolic blood pressure (150/80); and two nutrition issues, a mild electrolyte disorder and a mild salt depletion. Her illnesses passed quickly, usually with her refusing antibiotics. She had a bout of pneumonia, the seasonal flu, and a surgery to check out a suspicious lump that was benign.
    In other words, from age eighty-five to well past one hundred, a stage when most people need elaborate pillboxes marked with the days of the week, Huguette was remarkably healthy, requiring no daily medications other than vitamins. Yet she was living in a hospital.
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    Dr. Singman said Huguette at first was “extremely frightened” of new people. She