Doctors Muzzled – – And Not by N95 Masks

A few days ago, in the midst of a lockdown because of the coronavirus Corvid-19 epidemic, a devastating tornado struck my hometown of Jonesboro, Arkansas. In part because everyone had been forced to stay home, no lives were lost although The Mall at Turtle Creek, the virtual town center if you don’t count Walmart’s, was pretty much flattened, cars were crumpled, and a passing freight train was turned into shards.

But there were two other reasons no lives were lost. First, residents took all the precautions they could because they believed the local news media, which warned in advance of the coming tornado. I was prepared hours before in the relative safety of locked-down Manhattan because a friend of mine posted photos on Facebook of her beautiful spring flowers because she realized they would drown in the coming rain.

Secondly, people knew what protections to take. Porsha McCoy and four others, for example, huddled together in a bathroom. “We just protected each other, we didn’t have anything to cover ourselves, but each other,” she said. “We could feel things, like we was going to get blown away. By the time we opened our eyes all we could see is the sky.”
Killer storms are as well accepted as summer heat in Jonesboro. In 1968, a tornado killed 34 people and injured 300. Five years later, in 1973, another one smashed through a commercial district, destroyed five schools, injured 200, and mercifully killed only five people. 

After the tornado hit March 28, my relatives in Little Rock texted a video of the twister swirling through Jonesboro’s outskirts and setting off a fiery blast. This burst sent me to the Internet where I found a Jonesboro story from days before that made me teary. A local commercial landlord, Clay Young, told his tenants not to pay their April rent so they could pay their employees instead. Surely there were other such kindnesses in the U.S. last month, although I haven’t read or heard of them in the news. The inspiring stories that have overshadowed everything else concern the valor of nurses and doctors risking their own lives to serve those racked with the contagion in our ill-equipped, poorly prepared hospitals.  

 That is what makes a report from Bloomberg news that hospitals are threatening and firing doctors and nurses who tell the press about their working conditions and the state of patient care during the coronavirus pandemic. Equally alarming is a revelation from ProPublica that many staffing companies are cutting the pay and other compensation of emergency room doctors and nurses, despite the relief these businesses will receive from last week’s $2 trillion stimulus package that includes deferring payroll taxes, suspending reimbursement cuts, and receiving advance Medicare payments.

How have our hospitals sunk so low when they are led by top administrators so capable that in the New York metropolitan region their annual salaries each top $1 million, based on a 2016 survey? When this pandemic ends, we have to face how careless our nation has become, which includes the cost-saving short-sightedness of the hospital industry. Without public pressure, there will not be the needed storm of reform. Devastation, as the people of Jonesboro know, always comes again.

Please leave your thoughts in the box below.

Northwell, Check Your Messages

Our financial institutions were supposed to be too big to fail, but many failed anyway. Are New York hospitals now too big to succeed? In my relatively minor experience, yes they are. In the more disastrous cases of several friends, yes as well, but that would have been their story to tell.
Here’s what happened to me: Northwell Health took six days to send a refill prescription for eye drops to my pharmacy. On a Friday afternoon I phoned Northwell, worked my way through the dozen phone commands until I reached its “medication renewal” voice mailbox and left all my information. I knew nothing would be done until Monday. Wrong. Not until the following Thursday, after daily calls from me as well as my pharmacy, plus at least one fax, did I have my refill.
How to make this tedious story, which most New Yorkers have lived through several times, interesting? It is important because we usually let these things go. They happen to everyone and patients are so happy when the experience is over, or we are are still so sick, that we don’t have the energy to demand competent care.
Five days after my first call for a refill, on a Wednesday, I still had no response. I fought my way through Northwell’s phone system and reached a human being in my doctor’s office. She said they would send it to the pharmacy immediately. That afternoon, a woman with a Spanish accent too thick for me to truly understand phoned to say that the prescription was at Walgreens. I repeated everything she told me to verify that I had understood her. Later I phoned Walgreens pharmacy, confirmed that I had indeed reached the pharmacy, and the man I spoke with said my prescription was in. He volunteered that it was eye drops. Three hours later I went to pick them up. The story changed. Three pharmacists told me that the prescription had not been received. The manager said that no man was in the pharmacy at that time I phoned so no one could have said that. However, the man I spoke with offered me the information that it was eye drops. If he was somewhere else he has remarkable powers of ESP. I would like to contact him about the stock market.
The next morning, on day six, I again phoned my doctor’s office at Northwell and said that, despite what their office had told me the day before, no prescription had been phoned in. While I waited on hold I heard a commercial for Lenox Hill Hospital. I thought it was an act of God telling me to get away from Northwell, but no, it turns out that Northwell owns and operates Lenox Hill as well, part of the monopolistic, patient-harming trend of consolidation in our nation’s hospitals. This hurts patients (examples furnished upon request) but enriches hospital administrators, shareholders and maybe, somehow, physicians who keep their mouths shut about how bad care has become.
Anyway, a secretary swore they had already sent in the prescription, would do so again, and hopped off the line. Twenty minutes later, the sixth day after my initial request for a refill prescription from Northwell, someone texted me that the office had sent me a prescription. And reader, it had!!!
Here’s what worked: I do have a smartphone – don’t all patients? I am strong and healthy enough to walk up and down Second Avenue during heat advisories in fruitless visits to my pharmacy when promised prescriptions do not arrive. Also, I knew to refill my prescription well before my medications ran out. Next time I shall give them a month, instead of a week.
A Northwell Health factsheet says it is “more than 69,000 people looking at health care differently.” I did have a different experience than I expected. I lived, but someone else won’t.
Please put your thoughts and suggestions in the box below.

East Harlem Revives the Spirit

The magical “What You See Here Is Open” at Hunter East Harlem Gallery was delight enough to remove the taint of national news from my consciousness for a half hour. It is an exhibition of objects collected by a retired sanitation worker for three decades and pulses with history, life, and loss. Turns out one woman discovered a portrait of her mother among the treasures. Another visitor swears he found a photo of his dentist and her mother hanging on the wall.

That show and the streets reminded me that East Harlem throbs with the life and  heart that are draining from the rest of Manhattan.  Then on East 119thStreet another sign of grace appeared – La Casita Community Garden, funded by the trust of the late Geraldine Stutz, who was the fashion genius behind Henri Bendel in its heyday when it itself was a gallery of the art of fashion. Please add your comments to the box below.

Here’s what is to be seen in this near-secret garden:

A installation of objects by local artist Dominique Duroseau



La Casita Community Garden Gate

Sign above a Second Avenue store front

Q is for Questionable offers a telling post on what has seemed to be an inexplicable lack of arrival clocks on the Q line  but that is getting sorted. In the last week, Q trains have skipped the 72nd Street station; one train was stuck at 72nd Street on Sunday morning, effectively shutting down service until the MTA somehow got it moving; and erratic morning rush hour service caused such delays that the over-crowded platform became a safety hazard. The booth clerk announced she was dispensing vouchers so people could find other routes because the platform had to be cleared. (So don’t blame the trains, blame the platforms).

Two years in, the new two-mile, $4.45 billion Q is now fully integrated with the rest of the incompetence-plagued network. Like the rest of the system, it is great when it works.The next phase of the Second Avenue Subway is projected to cost $6 billion.

But let’s end on a high note – the 72nd Street Q station actually has a booth clerk. Did someone anticipate that there would be trouble?

Please post your thoughts in the comments box.

Damning the Amazon

Hamilton Nolan writes a great column in today’s Guardian. He says that if Amazon want to plop one of its headquarters in New York City it should pay to house our  63,000 homeless people. He also offers some great insights and context. Read it here.

Please comment on his Guardian site or below. Have a nice day!


Upgrade Subway Signals — Phase Out Phase II

This week’s Voice presents an excellent article by Aaron Gordon.

It says all that needs to be said. Here it is:

Maybe We Didn’t Need the Second Avenue Subway After All
The latest ridership numbers show that the MTA spent more than $300,000 for each new daily straphanger attracted by Cuomo’s much-heralded Upper East Side line

By Aaron Gordon July 18, 2018

All eyes were on Governor Cuomo when he celebrated the opening of the Second Avenue Subway in December 2016. Dennis Van Tine/AP Images
When the calendar flipped from 2016 to 2017, Governor Cuomo rode the subway. As you may recall, this was no ordinary subway trip: It was the inaugural run of the Q along its new route, down from the 96th Street terminus of the shiny, new Second Avenue Subway. You know, a ribbon cutting. Our governor loves ribbon cuttings.

With last week’s release of station-by-station ridership figures for 2017, we can finally learn the impact this long-awaited subway extension had on the system. As it turns out, the Second Avenue Subway is undoubtedly a benefit, but at $4.5 billion for just the three stations built so far, a very expensive one. And the stats also tell us much more about the problem the line was built to solve — and raise the question of whether that $4.5 billion would have been better spent elsewhere.

The Second Avenue Subway’s primary reason for existence was to lighten the load on the overburdened 4/5/6 Lexington Avenue line, the busiest subway corridor in North America after the Second and Third Avenue Els were torn down mid-century. This was a worthy goal, and to some degree, the new line accomplished this: The five Lexington Avenue stops closest to the subway extension — 96th Street, 86th Street, 77th Street, 68th Street–Hunter College, and Lexington Avenue–59th Street — saw 17,377,828 fewer swipes into those stations last year, or about 47,600 per day.

Meanwhile, the three new Second Avenue Subway stations experienced almost 21.7 million trips last year, or just a hair shy of 60,000 per day. After factoring in large ridership changes at other nearby stations — the Lexington Avenue–63th Street F/Q station saw a 1.3 million bump in trips, while the Fifth Avenue–59th Street N/R/W had 560,000 fewer — the total change in ridership after the Second Avenue line opened nets out to just a hair more than 5 million additional subway riders in 2017, or about 14,000 per day.

This is greater than officials projected in terms of ridership gained: MTA planners didn’t expect much new ridership from the Second Avenue Subway, knowing that it’s only two blocks from an existing subway. But in the grand scheme of New York City transit, it’s a pretty low number; it’s about the same number of riders who take the B36 bus between Coney Island and Sheepshead Bay each day.

But since construction began on the Second Avenue Subway in 2009, the subway’s performance has steadily declined to the point where it is now in crisis. The Second Avenue Subway’s opening was a short-lived respite of good news from the otherwise constant barrage of nightmarish headlines. State of Emergency, Subway Action Plan, declining performance, you know the rest.

At best, the Second Avenue Subway is the lone bright spot in an otherwise concerning trend of declining public transit ridership. Even with the increase in ridership on the Upper East Side thanks to the Second Avenue Subway, Manhattan still lost 10,821,930 subway trips last year. This ridership drop is almost certainly due to the increasingly poor service, which itself is a result of maintenance backlogs, antiquated technologies, and questionable management decisions.

As I have previously reported, while tunnel-boring machines were grinding their way underneath Second Avenue to relieve the 4/5/6, the MTA was installing unnecessary signal timers on the Lexington line that ended up reducing its capacity. The New York Times later found that in June and July of last year, during the average weekday rush hour window, 57 scheduled trains on the 4/5/6 simply do not run. Those ghost trains alone could have fit the number of riders who switched to taking the Second Avenue Subway.

Indeed, at the time the MTA was justifying the Second Avenue Subway, one of the key words involved was “overcrowding” — as in, crowding on the 4/5/6 was causing delays, and the only feasible way to address that was to build the Second Avenue line. This was the prevailing logic in 2009, and even for much of 2017 after the Second Avenue Subway was completed. Yet the new transit chief, Andy Byford, has since declared overcrowding is not, and never has been, the root cause of delays. Overcrowding is the result of delays, not the cause.

We know now that the Second Avenue Subway could not possibly have been the most cost-effective way to relieve crowding on the Lexington Avenue line. That would be upgrading the signals to Communications-Based Train Control, or CBTC. One of the first lines Byford wants to tackle is, in fact, the 4/5/6 from 149th Street–Grand Concourse in the Bronx to Nevins Street in Brooklyn. Doing so would allow the MTA to run trains much more efficiently, increase capacity, and turn those ghost trains into real trains.

This project alone would provide a benefit to Lexington Avenue line orders of magnitude greater than the Second Avenue Subway for a fraction of the cost. (Re-signaling the Queens Boulevard line from Kew Gardens–Union Turnpike to 50th Street is expected to cost $425 million; the Eighth Avenue line from 59th Street to High Street has a preliminary estimate of $375 million.) But the main holdup for Byford’s plan is he needs the money. Oh, if only he could have, say, $4.5 billion available, enough to upgrade most of the subway system to CBTC.

Most transit experts will tell you that thanks to decades of apathy the subway needs to build extensions and rapidly upgrade its existing infrastructure. No disagreement here; the best version of New York City is one where we can do both. But, as the last several decades and Byford’s ongoing efforts to secure funding illustrate, that isn’t the New York we have. Instead, the MTA is working on scraping together $6 billion for Phase II of the Second Avenue Subway, which will take it up to 125th Street — at that price tag, the MTA could almost certainly re-signal the entire subway system. The question isn’t why the Upper East Side can’t have nice things, but why, with so many dire, urgent needs across the system, the Upper East Side should be disproportionate benefactors.

In any case, the Second Avenue Subway extension has now been built, so we must do our best to enjoy it. The people who used to have a fifteen-minute walk to the subway but now have a mere ten-minute walk must savor those precious moments. The straphangers still taking the 4/5/6 ought to bask in the extra space they now have. Take an extra second to enjoy the world-class art in the new stations. Somebody has to, because Governor Cuomo won’t. He hasn’t ridden the subway since. After all, there haven’t been any ribbon cuttings.

For Want of An Apron

The other day as I was scrubbing paint brushes at the sink, a fellow art student of a certain age told me that she had never learned to be neat. She blamed it on not having attended kindergarten. That omission, she said, affected her son. Decades ago he took an admission test to a significant pre-school in Manhattan. A perfect score was obligatory, but he missed one word. The one he had missed was so simple that his failure indicated a developmental problem, so they called his mother in. They said he was the only student they had ever encountered who had no concept of the word “apron.” She explained his ignorance – there was no such item in the home – and the boy was registered.
“If they had asked him about Doric columns, he would have done fine,” she said. “I think of that every time I hear that minority students do poorly on entrance tests. Maybe, like my son, those kids don’t have all the same reference points as the schools.”

Please leave a comment in the box below.

Must-reading on NYC’s subways…

Kudos to the N.Y. Times for its investigation into how the city’s subway system became the dangerous disaster it is today. With so many examples to choose from, the reporters omitted my favorite horrific Metropolitan Transit Authority blunder – the $530 million “renovation” of the South Ferry station that opened in 2009 and was knocked out of service  by Hurricane Sandy three years later as a storm surge poured through its entrances and crippled the entire system. It turns out that those who designed and approved the upgrade early in the 21st century forgot that the South Ferry station was next to New York Harbor. The MTA team neglected to engineer safeguards against rising sea levels and inevitable storm surges.

Not to worry about missing that one — read about how Governor Andrew Cuomo forced the MTA to used $5 million of its budget to prop up three upstate state-run ski resorts that were adversely impacted by a warm winter.

Readers can pick their own favorite blunders from the newspaper’s fine reporting here.

Please comment in the box below.


Williamsburg Tickets Cyclists!

More cyclists than commercial truck drivers in North Brooklyn are receiving tickets, according to NYPD data. As Gwynn Hogan reports in DNA Info,  between January and the end of September, cyclists in Williamsburg were ticketed 1,160 times for violations like running red lights and riding the wrong way on a one-way street. This is compared to 463 tickets written to commercial trucks for violations like texting while driving or not wearing seatbelt. I think we are supposed to be appalled that law enforcement is harder on cyclists than commercial truck drivers, but I am glad that bikes are getting some attention. If cyclists want to break laws with impunity, they should pedal over to Manhattan. It seems to me that their luck is better there.

Please comment in the space below.

Cruising the Hamptons Film Festival

The films Zoglin reviews will be coming to the city soon.

Richard Zoglin

I just finished a busy weekend of filmgoing at the Hamptons International Film Festival. This annual Hamptons ritual — which celebrated its 25th anniversary this year— has always struck me as a bit of a superfluous stop on the film-festival circuit.  It overlaps with the higher-profile New York Film Festival, just a hundred miles to the west, and most of its big films are second helpings from more prominent festivals in Toronto, Cannes and elsewhere. Still, the festival always brings in a lot of interesting little films looking for attention (especially foreign ones and documentaries), draws an enthusiastic crowd of non-cineastes to its packed screenings, and is increasingly regarded by the film studios as a good place to generate buzz for their big fall releases. Nearly all the major Oscar nominees from last year were previewed at the Hamptons festival — including Moonlight, Manchester by the Sea and La La…

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