Since Hurricane Sandy hit, "One On 1" has focused on prominent New Yorkers involved in recovery efforts. This week's segment profiles the man in charge of the city's vast municipal health care system, Health and Hospitals President and CEO Alan Aviles. NY1's Budd Mishkin filed the following One On 1 profile.
On the first night of Hurricane Sandy, Alan Aviles witnessed something in the lobby of Coney Island Hospital in Brooklyn that was never covered in any of his classes in law school.
"Water sloshes in and there are three emergency rescue officers and they have a raft, and in the raft there are three adults and two dogs and they floated into the first floor of the hospital before they disembarked," he remembers.
Aviles is the president of the Health and Hospitals Corporation, the largest municipal health organization in the country. He saw the short-term effects of Sandy -- patients relocated, facilities damaged.
But he also sees the storm, and in fact his job, through the lens of his first career as a public interest lawyer.
"I view this position as one involving advocacy around one of the major civil rights issues still to be addressed, whether we treat access to affordable health care as a civil right in this country as it is in most industrial countries in the world," he says.
How did a lawyer become the head of a $6.7 billion operation that serves 1.3 million New Yorkers, overseeing almost 100 hospitals, nursing homes, diagnostic and treatment centers and community-based clinics? Aviles initially served as HHC's general counsel.
"The then-president, when I was briefing him on something, said, 'We had a lawyer once who became president of HHC, and so you never know.' And I literally laughed out loud," Aviles says. "I thought that was most preposterous thing I ever heard."
It turned out to not be preposterous. Aviles has been HHC's president since 2005, the longest tenure for an HHC president in decades.
Aviles gave NY1 a tour of the damage at Coney Island Hospital on the same day that he gave a similar tour to Senator Charles Schumer. He led the crew through a basement that was filled to the top with water following Sandy.
In 2011, the hospital was evacuated for Hurricane Irene, but there was no flooding. Aviles says that may have affected the feeling in the hospital before Sandy.
"There was some sense going into this that while we had to be prepared, while we'll go through drills, perhaps this was not going to be a big deal," he says.
They quickly realized it was a very big deal.
"It was amazing how quickly after landfall was announced on the radio that water began to hit the hospital area," Aviles says. "There was enough water and super humidity over a period of time that most of this equipment needs to be replaced at this point. "
The Coney Island Hospital emergency room is closed, but a small temporary ER is up and running, which is absolutely crucial to the people in the neighborhood.
"It's allowed us to provide some level of emergency services to a community where the next emergency room of any significance is Maimonides Hospital, which is seven miles away," he says.
The morning after the storm, Aviles moved from Coney Island Hospital to Bellevue, hoping there might be even one elevator working to help evacuate patients. There wasn't.
"The amount of water entering that cavernous basement, it was 186,000-square-feet down there, an enormous complex, filled with several feet of water," Aviles says. "All of the 32 elevator shafts, completely flooded. At that point we decided we have to get everybody out of here."
Aviles grew up in the Bronx and attended the Bronx High School of Science. He says his parents taught him the values of fairness and equity.
He worked his way through college as a bartender alongside his dad at the old Schrafft's restaurant in Lower Manhattan, an experience not shared by many of his uptown peers at Columbia University.
"So many people who went to Columbia back then were quite privileged in terms of their background. I think that disparity hit me full force during that time," Aviles says. "Also it was a time of social upheaval, Vietnam War and everything else. So I guess it was at that point that I started thinking about those inequities and what kind of work might address some of that."
Aviles became a civil rights attorney. At the beginning of the AIDS epidemic, he represented a West Village doctor threatened with eviction by his co-op board opposed to treating AIDS patients in the building.
"They were concerned about passing them in the lobby, being in the elevator with them," Aviles remembers. "There was no rational basis for that fear but it was very real and characterized the incredible stigma that those with AIDS were facing at that time."
His interest in science and the social sciences coalesced when he began working for HHC, despite some initial skepticism.
"Lawyers are not exactly on the hit parade of a lot of doctors, given our malpractice situation in the United States. But that quickly passes, because at the end of the day, HHC is a very mission-driven organization," says Aviles.
He became emotional when discussing the efforts of 37,000 HHC employees during Sandy, especially the safe evacuation of nearly 1,000 patients, including some in critical condition, some on ventilators and some from the neo-natal unit.
"We have this critical mass of people who are really the greatest asset of the organization," Aviles says. "They are constantly wanting to make it better and they want to demonstrate, even though we are a public hospital system, we can render care every bit as good as any you can get in the city. "
His short-term concern is getting enough government funding to rebuild. But the dilemma for the future is about more than just money and repairs. He wonders how New York and the HHC will deal with the next Sandy and the one after that.
"We still have a vulnerable emergency department, no matter what we do in this space," Aviles says. "If we get anything like Sandy or something worse we will wind up with water here again and tearing down walls and being out of commission for extended periods of time."
That is one of the main reasons why Aviles is paying close attention to the Hurricane Sandy relief package Congress is now considering. He says the money is important not only for recovery but also to prepare the system to withstand future storms.