Category: New York City

More NYC Hospitals Lost To Economic Crisis

from the NY Daily News: graffiti on the walls boarding up St. Johns Queens Hospital
from the NY Daily News: graffiti on the walls boarding up St. John's Hospital

New York City’s hospitals, already strained and overcrowded, are experiencing a spree of closings, felled by the economic crisis. St. John’s Queens Hospital and Mary Immaculate Hospital have gone bankrupt and boarded up the entrances.  This leaves Queens-dwellers with few options, and those few options in an awful overcrowding situation.

“It’s a real failure of government to set priorities and manage them properly,” Gioia said. “They throw up their hands when the money runs out and say, ‘What can we do?’ That’s not good enough.”

Mayor Bloomberg called the closures “sad” and said the city has to do more with less in these tough economic times.

“Having said that, there is no reason for us to … walk away from our basic functions of government,” he said, adding that the Fire Department will dispatch more ambulances in Queens and for other hospitals to fill the void.

Carlos Quiles, a nurse who lost his job at St. John’s, said the next best option for care in Queens is Elmhurst Hospital Center, which is already filled to capacity.

“I can’t understand the wisdom behind closing the hospitals,” he said. “The politicians clearly have no understanding of the ramifications.”

Source: NY Daily News: Councilman Eric Gioia rips hospital closings in Queens

That nurse is right, the politicians don’t get it. They’re not envisioning the overcrowding and wait times this will cause. I’ve never heard of a hospital here that isn’t packed, we’re already seeing ER wait times in excess of 8 hours in some of the city-run hospitals, and you suddenly remove nearly a thousand beds from the equation?? That’s really not gonna be pretty.

In Manhattan, Cabrini Medical Center had to close. There’s been lots of talk about that here in the hospital I live in, because we’ve taken in some of Cabrini’s refugee respiratory therapists. The gossip now is about which hospital is next in line at the guillotine (some say Maimonides Hospital in Brooklyn won’t make it) and whether any of the doctors and nurses in my home hospital will be safe. “I don’t know if we’re safe,” my doctor said, sighing.


Changing The Name Of The New World Trade Center…

…to “World Trade Center.” Yep, they are reclaiming the old name.

Since I’ll soon be living near the WTC site, I felt obligated to blog about this.  Personally, I don’t really care what they name it (“a rose by any other name…”) but I am interested in the outcry the change has precipitated, and am curious about the whole thing.

View of the new WTC from across the Hudson river
View of the new WTC from across the Hudson river

Rendering of what the new WTC will look like, 2005 redesign

Why did they dump the name “Freedom Tower?”

Here’s my theory: the World Trade Center authorities just announced their first lease (to a group other than the U.S. government). They are selling two floors to the Chinese, to create a Chinese business center.  Problem: no Chinese businessmen could find “Freedom Tower,” because “freedom” is one of the blocked terms on Chinese search engines (if you blog that word in China, it’ll be erased, or “harmonized” by state censors).  In order for it to sell space to Chinese tenants, the building had to have a new name.  That’s what I think happened.


Observing The Economic Crisis First Hand

From everything I see in the media, it looks grim, like we’re deep into a Great Recession. There are bread lines of sorts forming at food banks, and charities send 18-wheelers to small towns whose sole employers have closed shop.  At the same time, states like Georgia have all but ended assistance to the poor (Georgia TANF recipients fell nearly 90 percent between January 2002 and November 2007, even as unemployment climbed 30 percent). The private health care system seems to be about over, as hospital closures force more Americans into the few public hospitals and federally-backed community health centers around, and the uninsured balloon to 86.7 million.  Meanwhile, the government is pushing a bank bailout plan that probably won’t work.

But what have you observed first hand? Is it bad where you are? How do you think the economic crisis will effect you? How do you think it will effect people with disabilities?  Will we be the first thrown under the bus, as was proposed in California?

Here’s what I’ve observed first-hand. In New York, one of the pillars of our economy is the financial sector, and it has collapsed.  The crisis has forced the state to cut services. A lot of people are upset about the state and city budget cuts; a protest at city hall 25,000-people-strong definitely made my girlfriend’s travel more interesting. At the hospital I currently live in, they are clamping down on expenses to ride out the cuts.  For fiscal year 08-09 there is a hiring freeze (which means when my favorite person on staff moved to Canada, they can’t replace her), they made it harder to get overtime, supply orders have been scaled back, the employee uniform stipend was cut to nearly nothing, and their customary free Thanksgiving turkeys were canceled (the latter two don’t bother me, as they never would’ve existed in Alabama anyway).  My doctor thinks that the South Campus ultimately won’t survive.  And the doctors and nurses are buzzing about the startling hospital closures in Queens and wondering who’s next.

Granted, I’ve not seen outside the hospital walls (and I’m eager to check out the city and report back) but so far, what I’ve seen first hand hasn’t been that bad.   Not compared to the effect of the devastating cuts that I saw first-hand in Alabama in the late ’90s and early ’00s, that actually caused deaths (when the economy was booming and services should have been increasing).   Is it bad where you are?

As odd as this sounds, I think there are possible upsides to global economic collapse.

The Upsides

With Wall Street cratering, many in the finance and related industries have left the city for higher ground, leading to an unprecedented situation: for once in Manhattan, apartment vacancies are up and rents are down.

Shopping habits have definitely shifted, the era of wanton excess being cool (that should’ve never happened) is finally behind us, and more businesses, desperate for customers, have stopped treating us like crap.  Nothing is devoid of upsides.

What have you witnessed first hand?


Lucky Unit 13 (Long Essay on Institutional Living)

Because Medicaid makes getting on home care waivers ridiculously complex and difficult, whereas institutionalization is easily funded, I ended up here, at a city rehab hospital while I wait for home care to be set up for me in Manhattan.  This is my waiting period.

Institutionalization, the most costly, elaborate and inconvenient option, is the easiest to get (in Medicaid law) because the 1965 Medicaid statute hasn’t been updated since technology advanced to allow severely disabled people to live at home.  The best, newer services (home care) are a long road to get to, whereas they’ll happily give you an express ticket to the most difficult, costliest, dinosaur services (institutionalization).  THE SYSTEM IS BACKWARDS, in an almost Lewis Carroll kind of way.  I’m wondering why “fiscal conservatives” would rather keep me in a gillion dollars/day hospital instead of home care for half that.

So for now, I’m living on an island designed for the reform of 19th century plug uglies, in what I’ll call the “Alcatraz Institute for the Permanently Crippled,” in unit A13, until I get home care.

Ah, lucky unit 13, an alternate world within this alternate island universe.

Me in my room on unit A13.

By accident, I ended up at the North campus.  The South campus, which has a long history, was at the forefront of the advent of mechanical ventilation during the polio epidemic (picture wards filled with iron lungs) and then the invention of the ventilator.  Dr. Alba Dumbledore saw it all happen.  She’s been at the South campus, which probably has 200 vent patients now, for over 50 years.  She was on first name basis with the guys who invented the LP vents and PLVs, some of the first home ventilators, and she’s very supportive of people on vents living independently at home.  And I have never met a doctor so knowledgeable about the ins-and-outs of daily ventilator use, or as flexible to make the patient comfortable, as her.  “Sure, I had one guy with a tidal volume of 2000 so he could fill his leak and talk easily,” she said.  Unfortunately, I’ve only met her once, my first week here.

The South campus had no vacancies, and, at the last minute, they discovered the alarm system in their “overflow rehab unit” was broken.  So I was admitted to the North campus, two miles from Dr. Dumbledore.

The North campus is more of a general medical-surgical hospital, with over half of the units allotted for their nursing home, but there is also one ventilator unit (with roughly 28 vent patients, only two of which are non-comatose and talking) and adjacent to that, the rehab unit (A13) where I live in the closest room to the nurses’ station.  When lying on my side, I can look out my door and see the staff of both A13 and A14 at the nurses’ station.

I was put in a rehab unit, not because of my medical condition, which is typically considered by them to be beyond repair, but because of my goals (get as much rehabilitation as possible, and then transition to the community). All the other ventilator patients in the North campus are cared for by the Department of Medicine, not the Department of Rehabilitation.
Here on the rehab side A13 it’s 30 patients or so at absolute maximum, and we get people (mostly men) here for respiratory and/or trach-related rehab, like people who are trached temporarily following an accident or mega-illness and are here to be un-trached AKA “decannulated,” and also more traditional rehab like guys who’re post-heart attack and quadruple-bypass surgery, guys recovering from a broken leg or getting shot, every description of person and injury.

Lots of black guys who were shot and subsequently became paraplegic, quadriplegic and the like were rehabbed here and then, largely due to lack of housing and home care and NOT medical necessity, spend the rest of their lives in the nursing home section. They congregate in the halls, the brotherhood of shot Brooklyn dudes in powerchairs creating a mobile “front stoop” community that feels just like the front stoop-congregating in inner city Mobile, AL. These prominently visible guys give the North Campus its predominant culture and “feel,” though there are many less visible people caught here for more unexpected and random reasons, like the older Jewish guy who was here for cardio-rehab 20 years ago or something and ended up staying here because he lost his apartment, despite having no medical needs excepting taking his heart meds. He needs help with affordable housing, not a nursing home-level of care™.
There are lots of immigrants here too, this being one of the few rehab hospitals that will take an injured or disabled person who is uninsured and/or undocumented from Bellevue or other city hospitals.
There’s an older Afro-Cuban dude here in an old metal clunker hospital wheelchair who claims to be a “brujo” (male witch) able to put hexes on people and often gets into confrontations with the nurses…

Coming in, I was quietly hoping they’d be able to improve my condition (at least slightly) with all the state-of-the-art ventilators, lasers and nano-tech they obviously must have in the wealthiest city in America, but … not so much.  I’ve not seen any nano-tech or lasers, but I have become acquainted with the next generation of ventilators.  The respiratory therapists don’t have to hunker down over clipboards and write down all the vent settings anymore, they just wave their Palm Pilot-looking handheld computers near the vent’s on-board infrared sensor, and the vent sends all the settings information to them.  In-line PEEP valves are now obsolete, as the vent’s computer now does that automatically.  But in the case of the portable vent (the LTV) that they have on my wheelchair, newer is not always better.  The turbine motor on the damn thing screams like a banshee trying to deliver the high volume (900+) I need, and the nurses actually mistake that high-pitched squeal for an alarm.

Why are they not aggressive with the rehab of Nick?  Because A13’s attending physician is naturally tentative and cautious.  “I wouldn’t want to hurt Nick.”  When problems have come up she’s learned a lot from the advice of other doctors (and me) and now has built up some Nick-expertise.  Also, she’s sort of adopted me, and her over-protective nature has probably saved me from being reflexively herded into the nursing home section, so I wouldn’t want to ship out to another hospital, and very possibly land with a doctor who genuinely doesn’t care.

In truth, this is probably the best of the city-run hospitals.  The worst are like this.   Here, a patient would almost never get abused or neglected; the charge nurses or a doctor would eat the culprits for breakfast.  And, interestingly, the three shifts’ mild antagonism and urge to discredit each other for self-aggrandizement (“we’re the only ones that do anything!”) sort of acts like America’s three branches of government should, checks and balances against each other.   They can’t screw up too badly, or the other shifts will make hay of it.  “I have to bathe you now, or Tour Two will talk again.”

“It’s Not You, It’s Me”

Admittedly, I like most of the staff and have become a staff favorite.  Once, they brought me up to a nurse’s free luncheon and fed me goodies, despite a quizzical nursing director (“remember to take him back to the unit.”)  I am one of the more polite patients here and that goes a long way (a surprising amount of patients are bitter, and take out their frustrations over their newfound disabilities on the staff).  Also, I have to respect how hard most of the staff here work; on their feet for the entire shift (minus a one-hour break) juggling around 18 high-need patients.

The problem is that the institutional structure of the environment, the arbitrary and very strict policies they’re forced to follow, don’t jive with my free-spirited personality (to put it mildly).  It’s not you, it’s me.

What I hate the most is when they force Alejandra out of the hospital if she lingers after Professor Umbridge announces sweetly, “VISITING HOURS ARE NOW OOOOVER!!” over the Soviet loudspeaker that no one can ever turn off (it reminds me too much of this link I added to the Spring Hill College Wikipedia page).  And they use their security guards to enforce visiting hours if necessary.  More than once she’s either been escorted out by security, or just dodged the guards.  Why is a small girl in a powerchair such a threat?  It seems so unnecessary and inhumane to force us apart when we need to be around each other.

Forced separation from my other half is the part I hate most about this place, along with their strict safety policies.
Like whenever they have to re-insert my g-tube, they force me to undergo a painful stomach x-ray (or they won’t clear the nurses to continue tube feedings) just to protect against a one in a million chance freak tube accident that there’s no medical evidence to suggest will occur.  I’ve lost count of the unnecessary stuff I’ve undergone because “we can’t override policy.”  There are myriad examples of “practicing defensive medicine” (CYA) in every hospital nowadays, this one is not unique.

Home care, with one-on-one staff, is simply better than institutional care, where staff may not be available to even help you sip a drink at night, and you have to wait for them to finish with other patients, whose needs may be more critical than yours.  “YOUR ASS WILL BE WASHED IN THE ORDER IT WAS RECEIVED.”

More importantly, it’s ME.  I’m just not suited to institutional living; I want to cross uncrossed boundaries and experience new things.  On one of my birthdays (my 20th?) we went to a Mobile Mysticks hockey game.  After the game concluded, I drove my chair out onto the ice (where other spectators were) without permission, speeding away from Mom, nurses, who all yelled for me to stop.  The chair had never been on ice before (though the knobby tires I had were well suited for it) and I just wanted to experience something different, be different, not be like anyone else    Once my family saw it was safe out there, my brother drove out too.

A nice cage is still a cage.
People will often yell “STOP!” before you demonstrate the ice is safe.  In my life, I hope to show many people.


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Living In A City of Immigrants: Dismantling Anti-Immigrant Ideas

I don’t live in Alabama anymore. I live in New York City in a rehab hospital now. This song, “City of Immigrants” really captures the heart of this city (and I love folk music).

Hat tip to Mark for pointing out this video!

This is a great city, and probably the most diverse on Earth. As an avid observer of humans sent from another planet, I find this place fascinating. The song’s line “all of us are immigrants” couldn’t be more blatantly true as it is here in this hospital.
NY residents from earlier waves of immigration are evident; I see Irish people and Italians. and a lot of black Americans who left the South seeking jobs post-slavery. Moving among them are newer immigrants. I’ve met lots of Jamaicans and people from Trinidad, and some Haitians. The most competent respiratory therapist in this unit I think is Haitian. The doctor for this unit is a Russian woman. and the social worker for the unit is Russian also, the VR counselor is Russian, and the aides for the ENT and the dentist are Russians too. There was a Russian language newspaper lying around. There are people from Spanish-speaking areas and bilingualism is widespread (I did fairly well in Spanish in high school and college and it’s coming back to me enough that I can usually get the gist of what’s being said en espanol). There are lots of Hindus and Pakistanis here. I’ve met two Arabic respiratory therapists; one is a big guy with a Goliath beard. One nurse I think is Korean. And LOTS are Filipino. It’s not uncommon to hear a nurse shouting something in Filipino in the distance. In this unit, the night nurses are almost always the same two Filipino women.

It’s endlessly interesting for me to meet people from different parts of the world every day. It’s also evolved how I think about immigration. I’ve heard a lot of anger back home that immigrants “won’t learn our language.” My time in New York City has already shown this complaint to be false. Everyone I’ve met who works in this hospital, despite being from all corners of the globe, has a good command of English. I’ve learned that, if necessary, any situation that requires English, will use a sort of “natural selection” to get English-speakers. The fact is, someone not fluent couldn’t last in a fast-paced, demanding hospital environment like this (in patient care at least) and those who adapt are the ones you see able to work here. This proves to me that people will gain fluency in English when they need to, language barriers naturally self-correct when necessary, and that all the fear-mongering about English being displaced and demands to ram “English as an official national language” down everyone’s throat are unjustified and look kind of dumb in light of what this hospital is actually like.

Yes, immigration can be problematic, especially when corporations use it as a weapon to shave wages to the bone, break unions, and displace locals economically (the practice in recent decades of laying off whole groups of local workers and bringing in Mexicans for below minimum wage to run entire factories has created acute resentment in the working class that may take generations to heal.) But that’s a problem of corporate scumbag behavior, not the immigrants’ fault.
Though it’s sort of a stereotype, I’ve found that many of the immigrants working here really are less complacent, more adaptive and want to work harder than the Americans I went to high school with
who often simply do not care. I think immigrants should be welcomed. And we need to reexamine our anti-immigration policies, because America is facing some serious demographic challenges. In short, we are on the precipice of a major collapse as waves of “baby boomers” retire and there are only a scant few from my own “millennial generation” able (or, frankly, willing) to replace their parents’ skill sets, and we don’t seem to want to let in more immigrants to fill those shoes.

I keep thinking, if you really hate immigrants, how would you hack it in a place as diverse as New York City? How would you even decide which group to oppose on a given day? Jamaicans? Mexicans? Are the Russians the real problem today? With so many ethnic groups, you’d need something akin to a medication day planner to efficiently manage your diet of hate.

On Sunday, hate Arabs, Monday and Tuesday hate Hispanics, Wednesday hate Indians, Thursday hate Haitians, Friday hate Jews and on Saturday hate Russians?? Is that how it would work? Heh!

“All of us are immigrants”

In New York City, I’m very aware I AM an immigrant too. And not just the fact that much of my family tree came from Europe to Ellis Island. I grew up in The Port City: Mobile, Alabama, and though it’s quite diverse too, it is lightyears apart culturally, socially and technologically. Since I’ve visited NYC before, I’m not feeling “culture shock,” per se, but it is like being in a whole new country (though a much needed change). I’ve often found myself starting sentences with “in my country, we don’t…” because they do things so differently here.

But regardless of location, I’m used to feeling like an alien. My weird background and unusual way of seeing things makes me feel like an immigrant from another planet a lot of the time. And I feel this place is right up my alien alley, what with this often random, sometimes bizarre hospital environment, and with me speaking with a thick ventilator accent which only one here (my girlfriend) can consistantly understand.
Yet. I can’t remember the last time I’ve felt so much happiness and hope as I do here.

I look forward to writing more observations from New York City soon!

All my best,


Jewish Funeral For Liviu Librescu

In my last post, I covered the death of Professor Liviu Librescu in the VT Massacre. Librescu, who survived a Nazi slavery camp during the Holocaust, was given a Jewish funeral today in Brooklyn. Full story

He’ll be buried in Israel.

I was moved by these photos.

The casket of Liviu Librescu is carried through the street in Brooklyn, New York, Wednesday, April 18, 2007.

Praying and crying

September 11: Also Very Far Away

An Addendum To My Previous 9/11 Blog

In my last 9/11 blog, I commented on how raw the event still feels to me. How close it feels. How fresh the wound still is.

But it is also so very far away.

Isn’t it amazing that the second-graders who were reading “The Pet Goat” to the president when the attacks happened are now teenagers?! Wow.

Schoolchildren recall 9/11 with Bush

It’s a common (though minor) misconception that Bush read to the children on 9/11. They read to him.
And yes, the president really is holding the book upside down. That’s not an altered photo. The book really is upside down.

Those children are now teenagers.

9/11 is distant in that people have moved on, the feeling of unity following the attacks was fleeting, quickly and crassly exploited, and is now only a memory.

That the media and many people are dwelling and memorializing mostly has to do with something deeply ingrained in the human animal insisting that 5 and other anniversaries with round, finger-count fufilling numbers (10, 15, 20, 25, etc.) are deeply significant. The fifth anniversary is getting wall-to-wall coverage whereas the fourth got nearly none.

My last 9/11 post,September 11: Still Too Raw For Me,” provoked some interesting responses from my MySpace readers. One mentioned that the elementary class she helps drew pictures of the WTC, and some of the kids had been taught to hate Muslims. Another comment said: “This isn’t a time to be sad. This is a time to be angry.”

And I totally can see that point. I have some anger too, that 9/11 has become more a political slogan than an event. The memory of 9/11, something sacred, has been so exploited it’s tragic. It’s now more a cynical political weapon than anything else. In that way, it’s now very distant and meaningless, just a soundbite. You want checks and balances on the president? “You’ve failed to learn the lessons of 9/11” Bush keeps repeating. He even held his political convention in NYC. And he has used 9/11 to justify torture, secret and indefinite imprisonment without trial, the new Orwellian Department of Homeland Security, warrantless wiretaps and his invasion of Iraq, even when it is now proven Saddam had no link to 9/11 at all. A Justice Dept. memo said it all:

“In both the War Powers Resolution and the Joint Resolution, Congress has recognized the President’s authority to use force in circumstances such as those created by the September 11 incidents. Neither statute, however, can place any limits on the President’s determinations as to any terrorist threat, the amount of military force to be used in response, or the method, timing, and nature of the response. These decisions, under our Constitution, are for the President alone to make.

Thus, the president has no boundaries, no checks on his power. For the War on Terror, anything goes. Warrants? Rule of law? Geneva Convention? “Rendered quaint,” Attorney General Gonzales wrote. And this is a sharp break from the American traditions of liberty we’re so accustomed to.
“They who would give up an essential liberty for temporary security, deserve neither liberty nor security” Benjamin Franklin is oft-quoted as saying. Sadly, the nonsensical preserving of “freedom” by taking away freedoms, abandoning the American ideal is what 9/11 has come to mean to many of us.

Right after we invaded Iraq, I was talking about how we were blowing up civilians too much, and one of my Alabamian nurses said “have we killed as many as they killed on 9/11 yet?” Bush had made it sound like THEY (Iraqis) had attacked us, and THEY (they’re all the same) had to pay. Even the score. And the ignorant masses lapped it up.

Well ironically on the fifth anniversary of 9/11, we’ve accrued 2,974 war dead in the unrelated Iraq war, just over the 2,973 lost to real terrorism on 9/11.

“And so here we are five years later. Fearmongering remains unceasing. So do tax cuts. So does the war against a country that did not attack us on 9/11. We have moved on, but no one can argue that we have moved ahead.”
Frank Rich, 9/10/2006

Keith Olbermann says it better than I ever could:

Terrorists did not come and steal our newly-regained sense of being American first, and political, fiftieth. Nor did the Democrats. Nor did the media. Nor did the people.
The President — and those around him — did that.
They promised bi-partisanship, and then showed that to them, “bi-partisanship” meant that their party would rule and the rest would have to follow, or be branded, with ever-escalating hysteria, as “morally or intellectually confused”; as “appeasers;” as those who, in the Vice President’s words yesterday, “validate the strategy of the terrorists.”

This was Olbermann’s most powerful commentary yet. I don’t do it justice with this snippet. Be sure to see his whole speech here.

We were so united after 9/11. We could’ve done anything with that unity. And it breaks my heart and makes me sick at myself to now be writing about it as just another slimy political wedge like the president’s made it.

That’s what makes it distant. That’s what makes it business as usual. That’s what tells us the world is not any different than before. It’s probably even worse with vile corruption.

Fight the vile with the holy. Fight the power by bringing more goodness into the world. Fight the power.


Filed Under: Politics and Government

September 11: Still Too Raw For Me

Anniversary of Terror

September 11, 2001 my grandmother woke me up and told me the country was under attack. I turned on the TV and saw the replays of the second plane flying into the tower. It had just hit the tower — I SAW IT. I know what I saw; planes full of jet fuel hit the world’s tallest buildings at high velocity. I saw civilians trapped above the fires hold hands and jump off. I saw office papers scatter over Manhattan. I saw nurses at St. Vincent’s Hospital stand idle as almost no injured trickled in; people either were crushed dead by the building or got out. I watched TV for weeks as families wept for missing loved ones with no remains to bury. I heard the eerie silence of the skies above, clear with no planes as flying was banned. I listened as our theology professor Dr. Wilson nearly burst into tears of rage and said he felt like quitting, describing how a student had exploited the tragedy with him to get out of extra class the week of 9/11.
Damn that student. Damn selfish, inhuman freaks.

Damn the people making their fortune writing their own twisted novels of the victims’ worst moments and passing it off as fact.

Damn the people making their fortune making movies about the tragedy just as the 9/11 orphans have learned to talk enough to ask “where’s daddy?”

Damn you Bush who used this horror as an excuse to invade unrelated Iraqis while you hold hands with the Saudi despot whose countrymen planned and executed this.

Damn you politicans and armchair pundits on both sides who cynically and repeatedly wrap yourselves in the memories of those lost to score partisan points.

And damn the terrorists who twisted the name of G-d to justify murdering nearly 3,000 while they simply were working to feed their loved ones.

I have so little to say. 9/11 is far too raw for me to make it another cynical “business as usual.” Has America truly lost its humanity?


Filed Under: Politics and Government