OK, let's go over this.
Huge, powerful hospital in quaint, quiet, historic neighborhood sez they need to be really, really big in order to survive. Only a huge tower—right over THERE!, among those tiny buildings—will save them. Over there, though, is the O'Toole Building. And the O'Toole is landmarked. We know that, sez Big Hospital, but we're poor. We're so poor. To walk over to the next block would cost us too much. We're a hardship case! Can we have an exemption, so we can tear the beautiful, but really inconvenient thing down?
"Landmark Schmandmark," sez Landmarks Commission. That's not a problem! But that tower you wanna build is too high! 329 feet is too tall! It's making celebrities like Susan Sarandon mad! And everyone else, too. And gets us bad press. We hate it soooooo much. What? Now it 299 feet tall? Still too huge! What? Now, it's 286 feet high? Oh, JUST RIGHT! That's what we were looking for in a neighborhood where most buildings are 15 stories smaller. You're swell St. Vincent! And good and kind, too. And you love Greenwich Village. Love it so much you're willing to destroy it in order to give its residents good health care!
Don't you think so, human rubber stamp, bad actor and professional puppet, Landmarks Commission chairman Robert B. Tierney? "A superb effort," you say? I thought you'd say that, Bob. What Lehman Brothers is to Wall Street, you are to historic preservation! Have an exploding cigar on me, motherfucker.