“it is a preeminent medical center for the entire mid-atlantic region” = “Capital of Appalachia”
Upstate is actually a series of hospitals specializing in different areas. One specializes in peds. One is a level 1 trauma center and has a burn unit, which is what we use it for. There is a cancer hospital and other things. I just know my trauma and burn patients get flown there. Binghamton is just a level 2 trauma center. PA has different designations, that’s just what they call them here in NY.