Though Ed Koch served terms as mayor and has been celebrated as the “quintessential New Yorker” ever since, his decision to close down a Harlem hospital is still a source of regret.

Question: What is your biggest regret as mayor?

Ed Koch: Well, I would say every Mayor before me, and myself included was told by all the experts that a hospital located in Harlem which did not provide very good medical care should be closed, that it was not possible to remedy it for a number of reasons, one of which was that the doctors there did not want to rotate through a teaching hospital because they wanted to keep their jurisdictions. That Hospital, called Sydenham had been opened during a period when black doctors were not welcome at many white-dominated hospitals and so they opened their own hospital, but not providing very good care for a whole host of reasons.

Every Mayor before me had backed off because of threats of rioting and citizen anger. I said, no, I'm going to do what is right for the people of Harlem and every other district in this city and provide good medical care where I can. We're going to close it and put in clinics; and we closed it.

I think we saved $9 million. It was the highest cost hospital with the worst outcomes according to the Budget Director at the time. And the people were very angry. And on reflection, even though I was praised for being courageous about it and doing the right thing. It was the wrong thing. We saved $9 million. So what. In those days, even $9 million was relatively small sum in terms of government expenditures. I didn't recognize the psychological impact of closing Sydenham, the pain. And so, I've told people when they've asked me questions similar to yours, that I regret having closed that. But it's done.

Question: Was it a mistake to run for a fourth term?

Ed Koch: Well, yes and no. Yes in the sense that I now believe three terms is adequate and should be the max. I think after that your energy is drained.

No, in that I would have done a very good job even with that caveat and as I said, after I lost to David Dinkins won and then people came through in regret of having thrown me out I said, part jokily and part seriously. When people said, "Oh, Mayor, you must run again." I said, "No, people threw me out and now the people must be punished." So, those are my feelings.