Get off the No. 7 train at the Seventy fourth Street-Broadway stop, in Queens, walk past La Abundancia Bakery, the Bollywood Beauty Salon, the New Hae Woon Dae Korean restaurant, the offices of Vishwanath Puttaswamygowda, M.D., and then past the New York Seventh-Day Adventist Chinese church (advertising free conversational-English classes), and you will find yourself at Elmhurst Hospital Center, in Elmhurst, the most diverse neighborhood in New York City and maybe in the world. The hospital serves 1.7 million patients a year, and offers translation services in a hundred and fifty-three languages. The Colombians, Bangladeshis, Koreans, Belarussians, Burmese, Chinese, Vietnamese, Croatians, Mexicans, and other immigrants who live nearby use Elmhurst for their care, and their communities back home often know about the hospital as well. It is not unusual for the exotically sick to fly to LaGuardia or J.F.K. from overseas to check in to Elmhurst. Diseases rare enough to merit special-case-study attention in The New England Journal of Medicine are, at Elmhurst, relatively common. If a young Southeast Asian is brought to the emergency room one morning because he is suddenly unable to move, even a junior physician knows to list familial periodic paralysis—an obscure disease that is considerably more common in the Philippines—as a possible diagnosis. An ambitious pedagogue of medicine couldn’t dream up a more diverse patient population for physicians-in-training.

The hospital was started on Roosevelt Island (then known as Blackwell’s Island), in the early nineteenth century, as a public institution that cared for prisoners and the poor; it went on to tend to soldiers in the Civil War and both World Wars. In 1950, the hospital, preparing for a postwar population boom in Queens, moved to Broadway between Seventy-seventh and Eightieth Streets, where it inhabits the kind of unremarkable complex of brick buildings in which filings for building-code exceptions might be processed. In the early nineteen-sixties, when the city could no longer afford to staff its public hospitals (of which Elmhurst is the second largest, after Bellevue), Elmhurst entered into an arrangement with Mount Sinai Hospital and School of Medicine, a private institution on the Upper East Side of Manhattan. Today, most physicians practicing at Elmhurst are interns, residents, and faculty professors at Mount Sinai. Elmhurst gets inexpensive staff; Sinai gets a unique training center. “It is pretty much universally residents’ favorite place to rotate,” Dr. David Muller, the dean for medical education at Mount Sinai, told me. If you want to learn not to be misled by the glittering chest X-ray of a Korean patient—in Korean acupuncture, the tips of the needles break off and remain lodged under the skin—go to Elmhurst.

Doctors also like to train at Elmhurst because of Dr. Joseph Lieber, a diagnostician and clinical educator who has been at Elmhurst, working from 4 A.M. until late at night, almost every day for the past twenty-five years. Practicing medicine at Elmhurst entails a daunting workload—at times, the hospital runs at a-hundred-and-forty-per-cent capacity—and the pay is not competitive with that of a private hospital or office. Yet an unusual number of doctors who train at Elmhurst choose to return to work there full time; they invariably cite Lieber as one of their main reasons for returning. His office is cluttered with tchotchkes from all over the world—a peaceful alpaca, a monkey in a toboggan, a miniature Taj Mahal—but, when I asked him about his travels, he said, “Maybe twice a month, I travel over to Sinai for teaching. Also, on Sundays, it’s true, I tend to go home earlier.”

Lieber, who grew up in East New York, Brooklyn, has never left North America; the souvenirs are gifts from residents and patients. Ellena Linden, an Elmhurst physician who also did her training there, said, “Dr. Lieber basically is Elmhurst. He’s first in and last out. We all have his pager memorized, because we call him with every kind of question.” Lieber is a kidney specialist (cardiologists are considered cowboys; renal doctors are considered nerds), but he covers general medical wards. As I shadowed him one day, he received two consult calls (one on dermatology, one on gynecology) while visiting a post-kidney-transplant patient—a Dominican man who was trying to get his medications covered by Medicare. “We cite Lieber as a final authority, regardless of medical specialty,” Linden said. “And, besides medicine, he also happens to know everything about military history, though that doesn’t come up as often.”

I first met Lieber more than ten years ago, when I was a misguided and miserable medical student training at Elmhurst. Though a crowded public hospital with patients from all over the world is potentially a great place to learn, that is not a given. Initially, I focussed on the fact that Elmhurst had three varieties of security (corrections officers, hospital police, and N.Y.P.D. officers), an unrelenting paint scheme of beige and sickly green, and, in the basement, instead of a hospital cafeteria, an all-night McDonald’s. (The McDonald’s has since been replaced by an Au Bon Pain.) During overnight shifts, young doctors napped in geriatric restraint chairs or on stretchers borrowed from the emergency room. The patients were interesting, of course, but there were just so many of them, and they weren’t all complex medical mysteries like the ones on “House.”

I remember following around a patient in the E.R. who had acute alcohol intoxication, and who kept disrobing and trying to leave the hospital, naked and attached to his I.V. drip. During the anthrax scare, a woman came in complaining of shortness of breath and holding a Ziploc bag containing a powdered-sugar doughnut missing one bite. She was worried that the powder was anthrax. The attending physician carefully opened the Ziploc bag with his gloved hand, removed the doughnut, took a bite out of it, and said that it seemed fine to him. Another time, a Japanese woman who spoke no English came in with small flat red spots all over her body, the classic presentation of a highly lethal cancer of the platelets, which is what it proved to be.

Amid the extraordinary bodily ruin and beeping hospital machinery, I felt as if I were moving through the world of Terry Gilliam’s “Brazil.” I knew that I was learning something about life, but I did wonder, at times, if I was learning much about medicine. (Add to this the problem of my being in medical school for a very bad reason—simple chronic failure to disappoint parental hopes.)

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Then I came under Dr. Lieber’s tutelage, and cheerlessly fluorescent Elmhurst seemed suddenly transformed into the Athenaeum. Which is odd, because, in appearance, voice, and choice of digressions, Lieber resembles a nineteen-fifties Catskills comedian. Asked how he manages to work so many hours, he likes to quip that his wife doesn’t want him at home. He is fifty-six years old, short, freckled, and plagued by allergies that leave his eyes red and irritated, and he wears what I know how to describe only as a little Hitler mustache. His mother was a schoolteacher, and his father ran a Kosher butcher shop. (“But eventually meat went out of style,” he says.) He calls his co-workers “boss” in the singular and “troops” in the plural, and there is something benignly martial about him. His office shelves display dozens of model tanks, many of them made by an enthusiast who works in the hospital’s boiler room.