Making Sweat Sexy: Fitness Miami-Style

By Kerry Mack [Read more...]

Undiagnosed and Untreated: A Culture at Odds with Western Approach to Mental Illness

by Michael Wang

“I just felt like when I was relating my problems to the counselor, it felt like I was talking to a stranger,” said Edward.

Edward, a Chinese-American student, has been diagnosed with depression. Studies conducted throughout the past decade indicate that Edward (who requested that his last name not be published) is one of a very small number of Chinese-Americans who has sought professional, medical help for his mental illness.

Statistics compiled by the American Psychological Association show that Asian American college students have a higher rate of suicidal thoughts than their non-Asian counterparts, with the rate 12.44 per 100,000 for Asian Americans 20-24 years of age.

The New York University School of Medicine’s Institute of Community Health and Research and Mental Health Services Research have both found that in Chinese immigrant communities, the majority of Chinese Americans with mental illnesses go undiagnosed and untreated due to cultural norms and beliefs that clash with Western medical paradigms.

“I know she was a professional and all, but it was basically [the counselor’s] job to help me,” said Edward. “She was getting paid for it.”

Views differ significantly between East and West on how to treat and manage mental illnesses.  The Western model of psychotherapy of exploring negative thoughts would be counterproductive in the eyes of the Chinese. The Chinese believe it is detrimental for an individual to dwell on negative thoughts and feelings.

Huang Ai Ying, a registered nurse in China, lives in New York City and works in Chinese immigrant homes, taking care of the elderly or disabled.

“People view those with mental illnesses in a very negative way,” said Huang. “Families will try to keep it very quiet because they fear the shame that will come.”

Chinese immigrants and Chinese Americans forgo mental health care due to a variety of factors. One is a concept in Chinese culture that can be translated as “face.” Similar to pride or honor in Western culture, this concept can permeate Chinese life and influences an individual’s actions or inactions. “Face” is tied closely with the family name.

“Families who have a member with a mental illness usually hide from the community,” said Li Yan, a recent immigrant from Guangdong. “They tend to avoid talking about the mentally ill and sometimes they may not go out at all because they believe they can’t be seen.”

Chinese culture is family- and community-oriented. Family includes not just immediate family but all those with ties to the family name. Individuality is a much weaker concept, especially for the older generation. Failure or illness does not afflict just the individual but the family as a whole. This, in turn, affects the family’s standing within the larger community.

The differences in culture are particularly evident for Chinese immigrants and their children, with the children suffering an even greater sense of cultural confusion.

“There is a stigma that you try to avoid,” said Edward. “We try to avoid professional help because we were brought up into thinking that we can control our actions.”

A study published in Culture, Medicine, and Psychiatry described a family confining a schizophrenic son until his symptoms became unmanageable. They sought professional help only when the son became violent, and the family distanced itself from the son soon afterwards.

The problem is not a new one. A study published in 2001 in the journal Mental Health Services Research found that social stigma was the primary reason for not seeking medical help and that they tend to seek help within their own families to avoid having their name viewed negatively by others.

Depression and suicide are the two biggest mental health issues that affect the Chinese immigrant population. Statistics compiled by the Centers for Disease Control and Prevention show the national suicide rate for senior Asian / Pacific Islander women is 6.01 per 100,000. In New York City, that rate is 11.6 per 100,000, an official of the New York City Department of Health and Mental Hygiene told the City Council in 2006.

In 2005, there were 28 reported suicides among the Chinese immigrant population in New York City, according to the New York Coalition for Asian American Mental Health. The Office of Minority Health, an arm of the U.S. Department of Health and Human Services, suspects the actual number to be much higher.

Studies have shown that Chinese Americans tend to view mental illness as problems that can be solved through willpower and avoidance of suicidal thoughts. For example, in depression cases, the solution is to simply, don’t think the bad thoughts.

Some psychiatric patients like Edward may take professional advice with caution. “They probably never have experienced what it feels like to have a deviant state of mind,” Edward said.

Huang, who oversaw psychiatric patients as a nurse in China, said the belief system of the Chinese is detrimental to the success rate of any medicine or treatment for mental illness.

“By the time the patient is admitted, their circumstances have already advanced to the point where treatment becomes extremely difficult,” said Huang. “It’s just a headache for all those involved.”

Economy Hurts Filipino Nurses

By Roxanne Torres

Jennifer Cabero keeps a file up to date at the nurse's station at Bellevue Hospital.  Photo by Roxanne Torres

Jennifer Cabero keeps a file up to date at the nurse’s station at Bellevue Hospital.
Photo by Roxanne Torres

Two guards stood outside the main entrance of Bellevue Hospital in Manhattan, the oldest public hospital in the United States. As two Filipino nurses in their blue medical scrubs walked by, they nodded to the two men in a show of familiarity.

These nurses have been working in one of the city’s busiest hospitals for 23 years. Once, they were immigrants, part of the great influx of nurses coming from the Philippines, drawn by America’s nursing shortage. These two nurses earned work visas within three months of applying and promptly found employment.

Two decades later, the nursing shortage is still prominent. But while some Filipino nursing graduates wait roughly two years to earn nursing positions, others wait far longer, as their hopes and patience diminish, because a weak economy and budget cuts have curtailed hiring.

Jennifer Cabero, a 46-year-old registered nurse at Bellevue, was an immigrant Filipino nurse hired by an agency during the 1990s. “The agency that I applied for took care of all the visa processing and all other papers I needed in order to come to this country and everything was free,” she said, as she turned the combination to her locker in the nurses’ changing room. “Even airplane tickets were paid for by the recruiter.”

During the early 1990s, 61 percent of trained nurses in the Philippines found jobs in, and migrated to, other countries, according to the Philippine Nurses Association. Close to 2,000 Filipino nurses found jobs in the United States at that time, according to the Philippines Overseas Employment Administration.

The numbers continued to increase until 1996, when the number of nurses obtaining jobs in the United States dropped to 270. These nurses not only passed the nursing exam administered by the Commission of Graduates of Foreign Nursing School but had experience in hospitals in the Philippines, which is part of their collegiate training.

The global demand for highly skilled nurses began to grow in the 1970s, according to the International Migration of Health Workers. Filipino nurses saw an opportunity to work overseas in such countries as Saudi Arabia and the United States. During that time, American working visas were a trade-off for lower wages and what were seen as dangerous working conditions, especially after the discovery — and growing numbers — of HIV/AIDS cases. To address these conditions, Filipino nurses formed nursing organizations, such as Philippine Nurses Association of America, to unite and protect themselves.

As of 2012, about 2.7 million registered nurses were employed in the United States, and roughly 7.3 percent of those were Asians, including Filipinos, according to the Bureau of Labor Statistics.

In recent years, the tide has turned. After the financial crisis of 2008, many hospitals scaled back or closed, including St. Vincent’s Hospital in Greenwich Village, North General Hospital in Harlem, and St. John’s Queens Hospital.

Anna Pineda, an honors graduate of LaGuardia Community College, feels the constant disappointment of rejections. At age 46, Pineda managed to complete numerous college term papers, study for exams and work at two part-time jobs to pay her bills, all before attaining her citizenship. “It was hard for me because being out of school for 15 years and not being able to speak the language like you know, the kids in my class,” Pineda said. However, despite her status as a nursing graduate and American citizen, she is still unable to find a nursing position. “Most of my classmates who were younger got a job, but the ones like me, who are old, don’t,” Pineda said. “Though I know hospitals now can’t hire as many nurses,” because of budget cuts.

Gema Santos and Jennifer Cabero outside of a patient's room at Bellevue Hospital. Photo by Roxanne Torres

Gema Santos and Jennifer Cabero outside of a patient’s room at Bellevue Hospital.
Photo by Roxanne Torres

“Back then, there were 11 RNs working during the day shift,” said Aleth Abadilla, a 50-year-old staff nurse at Bellevue, referring to the years before the recession. “Now, we are happy to have six or seven.” Abadilla is not only sympathetic toward her fellow Filipino nurses who are unable to obtain working visas, but she is also feeling the immense pressure of having her responsibilities increase from the time she arrived in the 1990s. Both Cabero and Abadilla are no longer serving the usual one patient at a time; they now dash between at least three patients at a time.

While Pineda continues to pursue her goal of finding a nursing position, others simply give up. This is the case for Joseph Lopez, a 23-year-old graduate of LaGuardia. “I said that if I keep pursuing nursing without getting the requirements, I would just be wasting time,” said Lopez. Like many other Filipino nurses, Lopez  migrated to United States to study nursing and find a job in the field. But he arrived in 2005, a decade after the boom.  Now Lopez is pursuing a different medical career path as a physical therapist’s assistant.

But not all Filipino nurses in America are stuck with the choice of waiting or changing paths. “Instead of coming to the U.S., Filipino RNs explore the possibility of looking for employment in other countries like, the Arab and European countries,” said a nurse who asked that her name not be used. A 56-year-old RN, she was once an assistant director of nursing at a New York hospital. Like many others, she is very much aware of the cutbacks and their impact on the hiring process. “There was an influx of Filipino RNs coming to the U.S., then a few years later, due to the retirement of RNs, the shortage became a problem nationwide,” she said.

For Anna Pineda and those who refuse to see their journeys end, the future is not entirely doomed. “Perhaps in the next 10 years, America will be in great need of nurses again like before, because many will retire, including myself,” Jennifer Cabero said, as she tied  her shoelaces and pocketed her ID.

 

 

Organic in the Heights

By Antonio Viveros
[Read more...]

Never Giving Up

Article and photos by Lindsay Calleran

Trainer 2

A spinning class in progress.

YORKTOWN HEIGHTS, N.Y. — It’s early Friday morning in a packed spin class when the instructor, 21-year-old Ryan Dowd leaps onto a bike, sporting a giant henna tattoo of a diamond on his bicep. With a flick of his finger, Whitney Houston is screaming, “I’m Every Woman,” and they’re off.

“Are you ready? It’s only a bike!” he yells to men and women of all ages. “Fight it!”

Here, it’s only a bike. For Dowd, the real fight came 11 years ago when he was diagnosed with chronic renal failure, the final stage of kidney disease. Only a successful transplant could save his life.

His parents had taken him for a blood test after they noticed a tic in his eye. The next morning a doctor called with the shocking results. Dowd was only 10 years old. “I thought it was a huge misunderstanding,” he says. Doctors spent the next year and a half preparing his body for a transplant. After nearly a dozen surgical procedures, and 50 to 60 pills a day, Dowd learned his own mother was a perfect match.

On Aug. 6, 2003, Ryan, 12, underwent a kidney transplant. Ten to 25 percent of patients reject the new organ within the first 60 days, but a year later Dowd was able to celebrate his first anniversary with a slice of a kidney-shaped cake.

These days, it’s hard to imagine any of that as the music in the studio at Club Fit in Yorktown Heights, in Westchester County, transitions into Ricky Martin’s “Here We Go.” Dowd sings along. Long-time member Debbie Santavicca says she loves his style. “He gives you the most energy,” she says. “Others are very systematic. His classes are fun, good vibes. He’s different.”

“Different” is a word Dowd is used to. After the transplant, he returned to middle school feeling he had little in common with classmates. Those who had sent get-well cards now felt like strangers. “I didn’t speak to anyone,” he says. “I kept very much to myself. I had no friends.” Seeking comfort, Dowd relied on what he calls, “food escapism,” leading to rapid weight gain.

“The steroids change your body,” he says, “but they don’t make you gain a hundred pounds like I did.” A “healthy” snack for Ryan was a bag of romaine lettuce, a bottle of dressing, a box of croutons and a block of mozzarella cheese.

Suddenly Dowd at 15 years old weighed 225. He didn’t even notice until he saw a photograph of himself with his taller, slender brother. Wearing matching shirts, Ryan assumed they looked like twins – but the photo revealed a harsh truth. “I was gargantuan,” he says, “I didn’t know I looked like that. I just started bawling.”

Ryan Dowd

Ryan Dowd, a 21-year-old fitness trainer, has reinvented himself after a serious childhood illness.

Ryan desperately wanted to lose weight. He’d look at physically fit peers for inspiration. “That’d be good. I want that,’” he recalls saying — and he was determined to get there, but only by using shortcuts. “I’d run five or six miles a day and only eat something in the morning to sustain me.”

At 18, Dowd confidently left for college 50 pounds lighter but soon learned that looks weren’t enough. Having spent his pubescent years either in a hospital bed or in front of a mirror, Dowd had never developed a strong sense of self and quickly fell into a daily routine of trying to fit in. “It was ‘Groundhog Day,’” he says. “I wanted something to make sense,” but it never did.

After two semesters, Dowd bought a one-way ticket home. “I went to school rosy-cheeked,” he says. “I left chain-smoking, rail thin. Everyone said, ‘you look great now.’” But the result of Dowd’s over-exercising and under-eating while at school impressed everyone but himself. He was fixed on finding an identity based on positives — something that at 19 years old, he had still never known.

He began with a job as a receptionist at Club Fit. There, he was surrounded by instructors, trainers – and spin class. “I had taken it once when I was 225 pounds,” he says of indoor cycling. “I sat on the bike, approximately 16 seconds later I got off, got a tuna salad from the café and went home. I hated it.” But his first class as an adult was thrilling. Dowd left with the first clear vision he’d ever had: He wanted to be an instructor.

Dowd committed to taking two spinning classes a day, in addition to training by himself. Donna Berta, general manager of Club Fit and former spin instructor, said, “I remember him practicing. You’d look and he’d have his iPod in. He was serious about it.” Dowd soon received certification from an independent cycling center and applied for the position.

His timing was good. A long-time favorite spinning instructor resigned to pursue his own business, leaving behind a following desperately looking for someone to take his place. Very few believed that person was Ryan Dowd.

A 10-year club member, Paul Lonce, says he scoffed when he first heard that Dowd was being considered. “He had big shoes to fill, you know?” Lonce says. “I was saying, ‘him?’” But the gym was willing to give Dowd a shot — or at least an evaluation class.

The soundtrack? “Love Lockdown,” by Kanye West. The thumping hip-hop music may have been loud, but it was Dowd who commanded the attention that day. “It was amazing,” Berta said. “We felt he was strong enough to take over the class, even with the lack of experience. He can do it.”

Eighteen months later, Dowd’s class is filled with men and women, 17 to 70s, with a line outside the door, everyone looking up at Ryan, waiting for direction, encouragement and a chance to leave that class feeling like they worked hard for themselves.

Lonce voluntarily eats his own words. The man who once asked, “That kid?” now tries to catch his breath after class. “All you know when you get in there on that bike,” he says, “is that you’re gonna get the snot kicked out of you!”

Dowd is no longer the bed-ridden child, the insecure teen or the college freshman with a broken spirit, but he will always be a transplant recipient, awaiting the day when he’ll need another organ donation. “There’s no reason why I should be able to do this,” Dowd says.” “I can control my actions, but I’ll never be able to control how long my kidney keeps functioning.”

According to the National Kidney Federation, the average life span for a donated kidney from a living relative is 10 to 15 years. Dowd celebrated his ninth anniversary last Aug. 6, teaching three classes that day.

At first, his goal “was just to prove to myself that I could accomplish this dream, despite what I had been through, that I could break that cycle.” He stops, giggles for a moment.

“It’s true, I’ve broken three bikes in there.”

The Dog-Bicycle Conflict in Central Park

By Owen Diaz

In Central Park, dog owners and bicyclists have been getting in each other’s way, and the problem seems to be getting worse.

Under park rules, dogs are allowed to play off leash in 23 specified areas in the morning before 9 a.m. and after 9 p.m. So many dog owners go to the park early — but so do cyclists, many of whom prefer the early hours because there is less traffic in the park, and they want to exercise before they go to work.

Dogs off leash will occasionally dart into the 6.1-mile Park Drive that cyclists travel on, sometimes causing accidents.

Linda Wintner, who leads morning rides in the park for the New York Cycle Club, says she has been in one accident, witnessed another and seen many near-misses. Wintner says she was lucky because her accident occurred during her final lap, as she was traveling slower to cool down. Cyclists are not always without fault. The roadway, or “loop” as it is known, has traffic lights and crosswalks that many cyclists ignore. Amanda Lee, who walks her dog Arthur for an hour in the park every morning, says, “I try to wait for a break in the bikers to cross, but sometimes I’m standing there for minutes and one never comes. Then I just have to pick the best moment I can find, and go, often getting yelled at by a biker for doing so.”

What makes this conflict odd is how many members of both groups seem to agree on a solution for it. Since dogs are not going to the park to play on the paved loop, and cyclists are not allowed on the pathways through the rest of the park, the space where the two interact is a tiny percentage of the park. If the rules required dogs to be on leash when crossing the roadway—right now it is only suggested they be leashed—and bikers heeded the stoplights when people need to cross, fewer accidents would be likely to occur.

A Skateboard Entrepreneur Draws Inspiration From New York Food Trucks

By Sean Creamer

Tre TruckSkateboarding has enjoyed a boom in New York City during the last decade, as the Bloomberg administration has doubled the number of skate parks.

With new parks in Brooklyn, Queens and Manhattan new businesses have emerged to meet the rising demand, among them the so-called Tre Truck. On any given day, outside the parks, you’re likely to spot the plain silver-sided self-proclaimed “World’s Finest Mobile Skateboard Shop” parked at a nearby curb.

The Tre Truck is owned by Alex Ritondo, 21, a skateboarder and entrepreneur who drew his inspiration from the food trucks that can be found throughout the city. The Tre Truck travels from the Lower East Side skate park under the Manhattan Bridge to the newly constructed Far Rockaway skate park and to points in between.

The goal is to bring hard goods — the skateboard decks (the platform on which the boarder stands), trucks, the turning apparatus and wheels — directly to skaters at prices comparable to those in a moderately priced skate shops. At an average skate shop, decks usually go for about $60 and trucks for $40.

“Skateboarding has always been my passion,” says Ritondo, his brown shaggy hair tucked under a baseball cap. “I originally wanted to open a shop. Me and my friends always talked about it.”

With skate shops, as with many businesses, location is a key element. And “a good location for a skate shop is going to cost a lot of money,” adds Ritondo.

Rent on the Lower East Side, a popular skate location — the Lower East Side skate park, on Monroe Street, is a regular stop for Ritondo — ranges from $2,000 to $3,000 a month, according to Tungsten Properties, a commercial real estate company in Manhattan. (Most local skate shops pay $25,000 to $100,000 a year, or roughly $2,000 to $8,000 per month, according to ReferenceUSA.)

Then, too, in the last few years a few skate shops have closed, in part because of a weak economy, but also because gentrification has pushed the shops’ customer base—typically young 20-somethings—to other neighborhoods in the outer boroughs.

A graduate of Borough of Manhattan Community College with a degree in entrepreneurship, Ritondo skateboarded daily while at school and decided to reimagine the idea of the traditional skate shop to make his dream a reality.

A traditional skate shop acts as the headquarters for a community of skateboarders. The shop typically purchases merchandise wholesale from larger suppliers who supply similar shops all over the country.

The Internet has taken some business away from brick-and-mortar retailers. But for die-hard skateboarders, the local skate shop/hangout is still the preferred locale for buying equipment and accessories, including skateboard brand shirts, shoes and other items that define the lifestyle.

While Ritondo couldn’t afford to open a skate shop, he saw opportunity in the proliferation of new parks.

“I don’t think that Tre Truck would have been sustainable without the creation of all the skate parks,” says Steve Rodriguez, a skateboarding legend in New York City who also owns Five Boro Skateboards. “Tre Truck needs that concentrated audience to do enough business to make it worth it.”

Ritondo bought a used truck from a friend on Long Island with savings and help from his family. He also got help from some of the bigger players in the city’s skateboard industry.

For example, Michael Cohen, shop manager of the Shut Skateboards brand and flagship store in the Lower East Side, agreed to let Ritondo open an account to sell Shut Skateboards.

“It is a win-win situation, people will buy from the Tre Truck and then come to the store,” says Cohen who has known Ritondo for several years. “At the same time we get kids who come here and we will tell them to check out the Tre Truck at their local park.”

The Tre Truck, which has been operating since September, has brought in about $10,000 in revenue so far. Ritondo knows that he will need to increase sales substantially in order to stay in business. He is hoping one day to franchise the operation and have trucks operating throughout Long Island.

Then too, skateboarding is seasonal and there isn’t much business in the winter.

Despite these challenges, Ritondo wins praise from both competitors and customers. “We offer a lot more variety, but what they are doing is a cool idea,” says Lennon Ficalora, the owner of Wampum skate shop on the Lower East Side.

Skaters like Frank Nicado, a regular at the Chelsea Piers 62 skate park, are often on the lookout for Ritondo. “The Truck just always has what I need,” says Nicado. “When I lose a bolt or a bearing they are always willing to hook me up.”

At Chelsea Piers, the NHL Seems Very Far Away

By Alex Mikoulianitch

The year was 1994. The New York Rangers eliminated the New Jersey Devils, their cross-river rivals in the Eastern Conference finals, advancing to the Stanley Cup finals, where they beat the Vancouver Canucks for their only Stanley Cup since 1940.

For Elvis Tominovic that was enough to spark a passion in the young Croatian immigrant that would lead him to play for his country’s national team.

Paul Durante

Paul Durante, goalie for the Steiner Stars, follows the puck as it circles along the boards to his left. Photo by Carlos Mendoza.

And there his dream ended. Like Ivo Mocek, Tom Lambertson and Paul Durante, his teammates on the Steiner Stars of Chelsea Piers Division 1 adult league, their dreams of playing in the National Hockey League were not realized.

Even making the national team was long and arduous. From learning to skate, to learning the mechanics of the game and developing “hockey sense,” (the ability to make fast decisions on what to do when) Tominovic stood out. “Hockey was fun from the start, it was fast paced, lots of hitting and a lot of hard work,” Tominovic says. “It came to me naturally, even though I played it from sunrise till sunset as a kid. My first position was defense because I was a big kid growing up, and the coach put all the big kids on defense. I played defense until I was 14 and moved to Long Island, then the coaches put me at forward. I can play both defense and forward in men’s league.”

When he was young, Tominovic’s family wasn’t financially well off, and playing hockey is expensive, because of the cost of equipment.

For a good hockey stick, prices start near $100, and skates and protective equipment are far more. Because of his talent, Tominovic was helped by some of his coaches, and was able to get equipment and start training.

“The coaches started taking me under their wing and gave me old equipment to use and let my mother only pay half the fee for ice time,” he says. “Sometimes they allowed me to work at the rink in order to receive free ice time in return. Without their help I would have never played ice hockey.”

Tominovic developed into a strong, effective skater and played in college at SUNY Fredonia, in Division III of the National Collegiate Athletic Association. Succeeding there was the key to Tominovic’s invitation to play for Croatia’s national team.

Handshake

Opponents line up for a post-game handshake after the game at Chelsea Piers. Photo by Carlos Mendoza.

“I moved on to play for the Croatian National Team and from there they offered me a contract to play for Medvescak of Zagreb in Croatia,” he says. When he returned to the U.S., he played in the Eastern Professional Hockey League, a minor league. There, he realized that he didn’t have what it takes to make the NHL, that “the dream was fun, but hockey will not pay the bills.”

His teammate Paul Durante made it much closer to the NHL. Durante was a late bloomer; his mother didn’t want him to play hockey, saying he was a “china doll.” Only after his parents divorced was he able to play. “In order to get custody of me, my dad told me, ‘Hey Paul, if you come live with me I’ll let you play hockey’,” says Durante. “So I ended up playing hockey because my father wanted to spite my mother.”

He started to play ice hockey at the age of 11, though he says he “played street hockey since he could walk.”

Durante played in a bunch of junior leagues until he finally was invited to training camp by the NHL’s Hartford Whalers (now the Carolina Hurricanes). But injury intervened. While wrestling for his high school team, “I badly dislocated my shoulder and it ended my hockey career,” Durante says. “So I stopped playing when I was about 18 or 19.”

Another Chelsea Piers teammate, Tom Lambertson, came closer.

Growing up in Texas, he and his brother decided to stray from football and took up hockey. Living close to the rink helped.

From a young age, Lambertson attended a regional camp, played in high school, then at Buffalo State University, also in Division III. He left school and was noticed by a coach in the East Coast Hockey League.

The team was linked to the Montreal Canadiens, and some players who didn’t perform well in the NHL were demoted to where Lambertson was playing.

It was there that Lambertson concluded he wasn’t good enough to move on. Among the opponents he played against was Sidney Crosby, now with the Pittsburgh Penguins, who is among the three or four best players in the world when he’s healthy.

“He would just win the faceoff to himself, one guy would slash him on the hands and he would just be like ‘Okay, no,’ I’d try to grab him, he would be like ‘no’ and he’d go down the ice and score a goal,” Lambertson recalls.

Even though the players’ dreams didn’t turn into reality, playing at Chelsea’s Division 1 is more than enough now.

“You know it’s all about having fun,” said Mocek. “And I have that here, at men’s league.”

When a Child’s Fears After 9/11 Linger Into Adulthood

By Rocco Schirripa

Dollars and Sense logoOn Sept. 11, 2001, I was in my sixth-grade Italian class at I.S. 7 on Staten Island. When the World Trade Center was attacked, my teachers decided it was best not to tell us what had happened. We were young — most of us sixth graders were 11 that fall. And because we were on Staten Island, we were considered to be safe.

At first, I couldn’t tell anything was wrong. But as I look back on that day, I realize that Mr. Iacono, my Italian teacher, was at a rare loss for words and seemed shaky. I remember the phone in the classroom ringing and, when he picked it up, he didn’t say anything, which seemed strange at the time considering Mr. Iacono was known for being outgoing.

As the day wore on, we heard announcements over the school loudspeaker telling tens of kids at a time that their parents were coming to pick them up. At one point, I went to the bathroom, and while I was walking down the hall I saw my father waiting with other parents to pick their children up early. I looked at him, and it was the only time I ever saw fear in his eyes. My dad works for the M.T.A. as a manager. What I didn’t find out until later was that he had spent the morning sending buses downtown to pick up passengers — most of them covered in ash — from near the Twin Towers.

All of this could have been pretty traumatizing for a little boy. But what really got to me was the nonstop media coverage. I saw the constant footage of the tallest buildings in New York being attacked, on fire and collapsing. I saw people screaming and crying, even jumping out of buildings. All of a sudden, it hit me. The people who died in downtown Manhattan didn’t deserve to die, and the people who attacked the buildings wouldn’t have cared if I had been one of them.

That night I experienced the worst nightmare of my life. I woke up in a cold sweat, screaming.

Of course, I was one of the lucky ones. People lost fathers, mothers, husbands, wives, sons and daughters that day. I consoled friends who had suddenly lost a parent. I sometimes felt that I spent my adolescence looking over my shoulder.

In fact, it was common for young New Yorkers, even those who did not lose a parent, to be traumatized by the events of 9/11. Twenty-nine percent of children in New York City public school developed some sort of mental disorder as a result of Sept. 11; most affected were girls and children in grades four and five, according to a study published in the Journal of General Psychology. Other studies suggest that children’s mental stress dissipated in the months after the disaster.

For me, the nightmares eventually subsided. As I grew into adulthood, 9/11 became a distant memory. That is, until I transferred from Rider University, in Lawrenceville, N.J., to Baruch College, in the fall of 2010. It was not too soon after my transfer that I watched a documentary about 9/11, a collection of home videos that people took in Lower Manhattan that morning. That documentary and the everyday commute into Manhattan brought the fears and images of 9/11 rushing back into my life.

I was frightened all over again. I realized that an attack could happen again at any time. While there are some people who fall asleep at night in some parts of the world wondering if it is their last, in America, we have long felt safe and comfortable. Maybe too comfortable. Now I wonder if that normalcy is something that we take for granted.

Fear is like a shadow. It comes in different forms and serves different purposes. It is something that is so real — sometimes there, just behind us — but we can never truly feel or touch it.

The thing is, I don’t think fear is a bad thing. Out of fear came brotherhood. After Sept. 11, New Yorkers actually came closer together and became friends. I never thought there would be a time in my life when my neighbors would leave their doors open to each other. The fear actually seemed to bring out the best in many of us.

The biggest problem with fear is that for some people fear can dictate their lives. Fear can cripple people to the point of radicalism or harden them to the point of fascism. It can make people jump to a dangerous any-means-to-an-end mindset.

Franklin Delano Roosevelt said, “There is nothing to fear but fear itself.” This is a lesson that I think we are all still learning. Every day that I walk through Manhattan I remember what I saw on TV all those years ago and the crying people who lost their loved ones for no reason. When I take the Staten Island Ferry back home, I can see the new skyline taking shape as the new World Trade Center begins to rise above Lower Manhattan, filling the void. I realize that, no matter what, for the rest of my life I will always be looking over my shoulder, worrying about another attack.

But, I refuse to let fear cripple me. I will walk down the streets of New York City with my held high as a symbol of the hope we have as a city and as a challenge to make sure that an attack here never happens again.

Adding Insult to Injury: Automobile Accident Claims in New York City

By Carol A. Wood

New York State insurance laws provide medical coverage for victims of car crashes regardless of fault or state of residence. Yet these laws are not publicized and are little known. This article examines the lack of official guidance on handling a crash and its aftermath, and the unnecessary financial loss and risk of harm it causes.

Joseph Herzfeld

Joseph Herzfeld says the injury he received in a car crash, while minor, has never completely healed. Photo by Carol A. Wood.

Crash victims report that this uncertainty compounds the chaos and pain of a crash, and makes access to medical benefits and to full recovery a matter of chance rather than policy. The article suggests that public officials take simple, inexpensive steps to address the problem, such as publishing information on medical, legal and insurance procedures that crash victims need. Officials can similarly educate the public at large about what to do, and not do, at any of the 78,000 crashes in the city each year, to further reduce potential harm.

Riding her bike home from a Brooklyn cafe on a hot June afternoon, Sarah Phillips carefully signaled and waited before turning onto Prospect Place. Next thing she knew, she was in an ambulance, both right shinbones fractured. “Wherever you’re taking me, it has to be cheap,” the panicked, uninsured art student told paramedics.

Dan Finton, an uninsured bookseller, had his leg broken by a hit-and-run driver on Eighth Avenue in Manhattan one Saturday night. He says he had no idea how he was going to pay his medical bills. He engaged a lawyer, who told him about a state insurance program for hit-and-run victims — but hospital administrators said they knew nothing about the program.

A woman who asked to be named only as “Deborah,” a 30-something consultant, was crossing the street on the Upper East Side when a livery cab backed over her to get a parking space. A crowd of people gathered, urging her not to move. At the hospital, Deborah was diagnosed with a head injury; she was unable to remember her relatives’ names, let alone to navigate the insurance system. “Absolutely nobody explained these administrative things,” she says.

Severe traffic injuries by category

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ABOUT EVERY SEVEN MINUTES, a car crash occurs in New York City that’s serious enough to be reported to the authorities. Although fatalities have begun to fall lately, the number of car crashes and injuries continues to rise, according to the state’s latest full-year data. More than 11,000 pedestrians were injured in 78,000 NYC car crashes in 2010, up 6.1 percent from the previous year, along with 3,500 bicyclists — up 25 percent. And while the number of severe injuries has fallen, nondrivers account for a higher percentage of them — 36 percent in 2007, up from 30 percent of in 2002. (The city’s Department of Transportation did not respond to several requests for more recent figures.)

Under two state insurance laws, all of these pedestrians and cyclists are entitled to medical benefits, paid by the driver’s insurer or an industry fund. But frequently, the victims don’t know about the laws. That’s because no government authority publicizes their existence. And insurance companies aren’t required to explain the laws’ provisions until the crash victim files a claim.

Increasingly in New York, both city and state governments are taking bold steps to improve the safety of public streets. City efforts to tame traffic began more than a decade ago — including redesigns along the notorious Queens Boulevard — and intensified in 2008 under a new DOT commissioner, Janette Sadik-Khan, with widened sidewalks and expanded bikeways, among other projects.

The trend gained steam in August 2011, when the state enacted a “complete streets” law that requires roadway planners to “consider the needs of all users…including pedestrians, bicyclists, public transportation riders, motorists and citizens of all ages and abilities, including children, the elderly and the disabled.”

From a public safety standpoint, these measures have begun to reduce casualties and promise greater benefits in the future. Yet legions of current crash victims remain neglected, and neither the state nor the city ensure that they receive the benefits they’re entitled to.

The state and city could begin to correct this problem simply by making basic information available. Even small changes — such as identifying and linking the state insurance laws on the 311 and 511 information portals — would help.

The laws are these:

  • The “No-Fault Insurance Law” (NYIL 5101). Requires car owners to provide insurance coverage of at least $25,000 per person for bodily injury expenses, or $50,000 per crash, and $10,000 in property damage.
  • The “Motor Vehicle Accident Indemnification Act” (MVAIC [or EM-vayk]) (NYIL 5201). Provides medical benefits for victims of hit-and-run and uninsured drivers, and for other claimants denied or ignored by a driver’s No-Fault insurer. As “insurer of last resort,” this hard-to-pronounce and little-known program is funded by insurance carriers doing business in New York State.

Inadequate information

Map of most frequent crash locations

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The city’s emergency medical system is highly responsive. A phone call to 911 leads quickly to the dispatch of an ambulance to a car crash site. Hospital emergency rooms are required by federal law to stabilize any patients in trauma, regardless of their ability to pay.

But once the emergency is over — or if an injury doesn’t appear until later — the victim’s financial and medical outcomes are largely a matter of luck and his or her own resources. To find out what resources are available, you have to dig deep, long and hard.

As of early October 2011, a reporter found virtually no information on the websites of various government agencies and the five major New York auto insurers.

New York City’s front line of information, the 311 phone service, advises calling the 911 emergency line in case of a car crash. But its website and agents apparently don’t have any suggestions for after the crash. Asked what to do in a hypothetical accident, to ensure one’s legal rights and access to medical care, one 311 agent put a reporter on hold three times, then advised calling the NYC Bar Association’s lawyer referral service and the NYS Unified Courts. The agent, though quick-thinking, clearly had to improvise. The lawyer referral service would be useful to many victims. But knowing about No-Fault and MVAIC medical benefits is arguably more important — whether a lawyer is hired or not.

A spokesperson for 311 could not confirm that such information wasn’t available somewhere on the department’s vast website. But he added, “To the extent that we can make the site more accessible, we want to do that.”

Nor does any city website mention what to do in a car crash — not the NYPD, the Department of Transportation, or the Department of Health — apart from calling 911. By contrast, in tiny Waverly, Ill., with a population of 1,400, emergency instructions are posted prominently on its website (and quickly located under Home/Information/Car Accident Procedures).

New York City, however, is not responsible for overseeing car insurance. The state Department of Financial Services (DFS, until last October the Department of Insurance, or DOI) is. As of mid-September 2011, the department’s public website included only two hard-to-find mentions of the medical benefits available to pedestrians — buried in information for automobile owners. Additionally, their fractured phrasing makes them unlikely to surface on a Google search.

Searching the DFS site for “pedestrian” calls up a reference to a No-Fault FAQs page, which states that pedestrians should file a claim with the driver’s insurer, a household insurer, or MVAIC. This is accurate, but the claimant must figure out how to actually make the claim, and in a way that protects their interests. More useful would be step-by-step directions that could be easily found on the Auto Insurance home page.

NYC crash stats

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A DFS site search yields nothing for “bicyclist.” Bicyclists aren’t named in the law but are covered by it, the department confirmed in an email.

Asked how injured New Yorkers are supposed to learn of the medical benefits, the DFS responded that consumers should refer to its No-Fault FAQs page on the Web or call its consumer services bureau’s toll-free phone line on weekdays. The department noted that the driver’s insurer must provide this information — once the injured party presents it with a claim.

And there’s the Catch-22. Car crash victims must already know about the No-Fault and MVAIC programs in order to make a claim. But they must make a claim to be notified of the programs’ benefits.

Also, hit-and-run victims must report their crash to the police within 24 hours in order to qualify for MVAIC benefits. But if they’re struck on a Friday or Saturday night, and wait until Monday to phone the DFS for information, they’ll have already missed the reporting deadline.

Nor do insurers offer much help. Of the five largest auto insurers in New York, representing more than 50 percent of market share, none explains on its site how to make a No-Fault claim against an insured driver’s policy. Three require nonmembers to call an agent personally to make a claim; two allow claims to be submitted online, without explanation of the policies involved.

For the nonmember claimant, calling the insurer puts them at a legal disadvantage in discussing their case, especially if the caller has no other information about their rights under the No-Fault law.

Of the five insurers, only Geico describes No-Fault coverage on a glossary page. But it does so inaccurately, omitting mention of pedestrians and bicyclists. Progressive Group’s glossary mentions that pedestrians are covered under “personal injury protection” — a little-known name for No-Fault, which many people might not think to check; the entry omits bicyclists as well. Allstate discusses bicyclists among its informative tip sheets for drivers, but it says nothing of their right to make a claim in a crash.

The No-Fault law specifically entitles pedestrians and cyclists to “first-party” benefits. Yet claimants are in essence denied this parity by insurers’ strict control of information. Pointing to the inherent conflict, Scott Charnas, a plaintiff’s personal injury attorney, says, “It’s not in the insurer’s interest to inform the public as much as possible of their rights.”

The asymmetry puts New York City residents at a special disadvantage. An estimated 55 percent do not own automobiles, and often have little familiarity with the business.

Even if crash victims hire an attorney or possess unusual financial literacy they may not be able to penetrate the insurance system.

Laurie Cohen was in the crosswalk at Duane and Greenwich Streets when she felt a taxi hit her. She woke up as a good Samaritan was tying a tourniquet around her bleeding head and was taken by ambulance to the hospital with a head injury. But Cohen says her lawyer dropped her case when the self-insured cab company ignored his calls. Her health insurer rejected her medical claims as well. Because Cohen, a seasoned investigative reporter for The Wall Street Journal, had never heard about the state programs, she had no inkling that she should look into them.

Given the effective information blackout, how do ordinary people find out about these benefits? Two people interviewed for this article said they were told by ambulance workers or hospital staff. But most say they got no help.

Police are required to tell crash victims how to obtain an accident report, which in most cases is needed to file an insurance claim. (A state DMV form may also be used in some instances.) Several people interviewed said their responding officer did not tell them how to get a report, creating confusion and delays. But even if victim has the accident report in hand, without information on how to file a claim, the report is useless.

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