A Hospital Kept a Brain-Damaged Patient on Life Support to Boost Statistics. His Sister Is Now Suing for Malpractice.
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In 2018, Darryl Young was hoping for a new lease on life when he received a heart transplant at a New Jersey hospital after years of congestive heart failure. But he suffered brain damage during the procedure and never woke up.
The following year, a ProPublica investigation revealed that Young’s case was part of a pattern of heart transplants that had gone awry at Newark Beth Israel Medical Center in 2018. The spate of bad outcomes had pushed the center’s percentage of patients still alive one year after surgery — a key benchmark — below the national average. Medical staff were under pressure to boost that metric. ProPublica published audio recordings from meetings in which staff discussed the need to keep Young alive for a year, because they feared another hit to the program’s survival rate would attract scrutiny from regulators. On the recordings, the transplant program’s director, Dr. Mark Zucker, cautioned his team against offering Young’s family the option of switching from aggressive care to comfort care, in which no lifesaving efforts would be made. He acknowledged these actions were “very unethical.”
ProPublica’s revelations horrified Young’s sister Andrea Young, who said she was never given the full picture of her brother’s condition, as did the findings of a subsequent federal regulator’s probe that determined that the hospital was putting patients in “immediate jeopardy.” Last month, she filed a medical malpractice lawsuit against the hospital and members of her brother’s medical team.
The lawsuit alleges that Newark Beth Israel staff were “negligent and deviated from accepted standards of practice,” leading to Young’s tragic medical outcome.
Defendants in the lawsuit haven’t yet filed responses to the complaint in court documents. But spokesperson Linda Kamateh said in an email that “Newark Beth Israel Medical Center is one of the top heart transplant programs in the nation and we are committed to serving our patients with the highest quality of care. As this case is in active litigation, we are unable to provide further detail.” Zucker, who is no longer on staff at Newark Beth Israel, didn’t respond to requests for comment. His attorney also didn’t respond to calls and emails requesting comment.
Zucker also didn’t respond to requests for comment from ProPublica in 2018; Newark Beth Israel at the time said in a statement, made on behalf of Zucker and other staff, that “disclosures of select portions of lengthy and highly complex medical discussions, when taken out of context, may distort the intent of conversations.”
The lawsuit alleges that Young suffered brain damage as a result of severely low blood pressure during the transplant surgery. In 2019, when the federal Centers for Medicare and Medicaid Services scrutinized the heart transplant program following ProPublica’s investigation, the regulators found that the hospital had failed to implement corrective measures even after patients suffered, leading to further harm. For example, one patient’s kidneys failed after a transplant procedure in August 2018, and medical staff made recommendations internally to increase the frequency of blood pressure measurement during the procedure, according to the lawsuit. The lawsuit alleges that the hospital didn’t implement its own recommendations and that one month later, “these failures were repeated” in Young’s surgery, leading to brain damage.
The lawsuit also alleges that Young wasn’t asked whether he had an advance directive, such as a preference for a do-not-resuscitate order, despite a hospital policy stating that patients should be asked at the time of admission. The lawsuit also noted that CMS’ investigation found that Andrea Young was not informed of her brother’s condition.
Andrea Young said she understands that mistakes can happen during medical procedures, “however, it’s their duty and their responsibility to be honest and let the family know exactly what went wrong.” Young said she had to fight to find out what was going on with her brother, at one point going to the library and trying to study medical books so she could ask the right questions. “I remember as clear as if it were yesterday, being so desperate for answers,” she said.
Andrea Young said that she was motivated to file the lawsuit because she wants accountability. “Especially with the doctors never, from the outset, being forthcoming and truthful about the circumstances of my brother’s condition, not only is that wrong and unethical, but it took a lot away from our entire family,” she said. “The most important thing to me is that those responsible be held accountable.”
ProPublica’s revelation of “a facility putting its existence over that of a patient is a scary concept,” said attorney Jonathan Lomurro, who’s representing Andrea Young in this case with co-counsel Christian LoPiano. Besides seeking damages for Darryl Young’s children, “we want to call attention to this so it doesn’t happen again,” Lomurro said.
The lawsuit further alleges that medical staff at Newark Beth Israel invaded Young’s privacy and violated the Health Insurance Portability and Accountability Act, more commonly known as HIPAA, by sharing details of his case with the media without his permission. “We want people to be whistleblowers and want information out,” but that information should be told to patients and their family members directly, Lomurro said.
The 2019 CMS investigation determined that Newark Beth Israel’s program placed patients in “immediate jeopardy,” the most serious level of violation, and required the hospital to implement corrective plans. Newark Beth Israel did not agree with all of the regulator’s findings and in a statement at the time said that the CMS team lacked the “evidence, expertise and experience” to assess and diagnose patient outcomes.
The hospital did carry out the corrective plans and continues to operate a heart transplant program today. The most recent federal data, based on procedures from January 2021 through June 2023, shows that the one year probability of survival for a patient at Newark Beth is lower than the national average. It also shows that the number of graft failures, including deaths, in that time period was higher than the expected number of deaths for the program.
Andrea Young said she’s struggled with a feeling of emptiness in the years after her brother’s surgery. They were close and called each other daily. “There’s nothing in the world that can bring my brother back, so the only solace I will have is for the ones responsible to be held accountable,” she said. Darryl Young died on Sept 12, 2022, having never woken up after the transplant surgery.
A separate medical malpractice lawsuit filed in 2020 by the wife of another Newark Beth Israel heart transplant patient who died after receiving an organ infected with a parasitic disease is ongoing. The hospital has denied the allegations in court filing. The state of New Jersey, employer of the pathologists named in the case, settled for $1.7 million this month, according to the plaintiff’s attorney Christian LoPiano. The rest of the case is ongoing.
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Knitting helps Tom Daley switch off. Its mental health benefits are not just for Olympians
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Olympian Tom Daley is the most decorated diver in Britain’s history. He is also an avid knitter. At the Paris 2024 Olympics Daley added a fifth medal to his collection – and caught the world’s attention knitting a bright blue “Paris 24” jumper while travelling to the games and in the stands.
At the Tokyo Olympics, where Daley was first spotted knitting, he explained its positive impact on his mental health.
It just turned into my mindfulness, my meditation, my calm and my way to escape the stresses of everyday life and, in particular, going to an Olympics.
The mental health benefits of knitting are well established. So why is someone famous like Daley knitting in public still so surprising?
Africa Voice/Shutterstock Knitting is gendered
Knitting is usually associated with women – especially older women – as a hobby done at home. In a large international survey of knitting, 99% of respondents identified as female.
But the history of yarn crafts and gender is more tangled. In Europe in the middle ages, knitting guilds were exclusive and reserved for men. They were part of a respected Europe-wide trade addressing a demand for knitted products that could not be satisfied by domestic workers alone.
The industrial revolution made the production of clothed goods cheaper and faster than hand-knitting. Knitting and other needle crafts became a leisure activity for women, done in the private sphere of the home.
World Wars I and II turned the spotlight back on knitting as a “patriotic duty”, but it was still largely taken up by women.
During COVID lockdowns, knitting saw another resurgence. But knitting still most often makes headlines when men – especially famous men like Daley or actor Ryan Gosling – do it.
Men who knit are often seen as subverting the stereotype it’s an activity for older women.
Knitting the stress away
Knitting can produce a sense of pride and accomplishment. But for an elite sportsperson like Daley – whose accomplishments already include four gold medals and one silver – its benefits lie elsewhere.
Olympics-level sport relies on perfect scores and world records. When it comes to knitting, many of the mental health benefits are associated with the process, rather than the end result.
Daley says knitting is the “one thing” that allows him to switch off completely, describing it as “my therapy”. https://www.youtube.com/embed/6wwXGOki–c?wmode=transparent&start=0
The Olympian says he could
knit for hours on end, honestly. There’s something that’s so satisfying to me about just having that rhythm and that little “click-clack” of the knitting needles. There is not a day that goes by where I don’t knit.
Knitting can create a “flow” state through rhythmic, repetitive movements of the yarn and needle. Flow offers us a balance between challenge, accessibility and a sense of control.
It’s been shown to have benefits relieving stress in high-pressure jobs beyond elite sport. Among surgeons, knitting has been found to improve wellbeing as well as manual dexterity, crucial to their role.
For other health professionals – including oncology nurses and mental health workers – knitting has helped to reduce “compassion fatigue” and burnout. Participants described the soothing noise of their knitting needles. They developed and strengthened team bonds through collective knitting practices. https://www.youtube.com/embed/dTTJjD_q2Ik?wmode=transparent&start=0 A Swiss psychiatrist says for those with trauma, knitting yarn can be like “knitting the two halves” of the brain “back together”.
Another study showed knitting in primary school may boost children’s executive function. That includes the ability to pay attention, remember relevant details and block out distractions.
As a regular creative practice, it has also been used in the treatment of grief, depression and subduing intrusive thoughts, as well countering chronic pain and cognitive decline.
Knitting is a community
The evidence for the benefits of knitting is often based on self-reporting. These studies tend to produce consistent results and involve large population samples.
This may point to another benefit of knitting: its social aspect.
Knitting and other yarn crafts can be done alone, and usually require simple materials. But they also provide a chance to socialise by bringing people together around a common interest, which can help reduce loneliness.
The free needle craft database and social network Ravelry contains more than one million patterns, contributed by users. “Yarn bombing” projects aim to engage the community and beautify public places by covering objects such as benches and stop signs with wool.
The interest in Daley’s knitting online videos have formed a community of their own.
In them he shows the process of making the jumper, not just the finished product. That includes where he “went wrong” and had to unwind his work.
His pride in the finished product – a little bit wonky, but “made with love” – can be a refreshing antidote to the flawless achievements often on display at the Olympics.
Michelle O’Shea, Senior Lecturer, School of Business, Western Sydney University and Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Philosophy Gym – by Dr. Stephen Law
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If you’d like to give those “little gray cells” an extra workout, this book is a great starting place.
Dr. Stephen Law is Director of Philosophy at the Department of Continuing Education, University of Oxford. As such, he’s no stranger to providing education that’s both attainable and yet challenging. Here, he lays out important philosophical questions, and challenges the reader to get to grips with them in a systematic fashion.
Each of the 25 questions/problems has a chapter devoted to it, and is ranked:
- Warm-up
- Moderate
- More Challenging
But, he doesn’t leave us to our own devices, nor does he do like a caricature of a philosopher and ask us endless rhetorical questions. Instead, he looks at various approaches taken by other philosophers over time, and invites the reader to try out those methods.
The real gain of this book is not the mere enjoyment of reading, but rather in taking those thinking skills and applying them in life… because most if not all of them do have real-world applications and/or implications too.
The book’s strongest point? That it doesn’t assume prior knowledge (and yet also doesn’t patronize the reader). Philosophy can be difficult to dip one’s toes into without a guide, because philosophers writing about philosophy can at first be like finding yourself at a party where you know nobody, but they all know each other.
In contrast, Law excels at giving quick, to-the-point ground-up summaries of key ideas and their progenitors.
In short: a wonderful way to get your brain doing things it might not have tried before!
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Pasteurization: What It Does And Doesn’t Do
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Pasteurization’s Effect On Risks & Nutrients
In Wednesday’s newsletter, we asked you for your health-related opinions of raw (cow’s) milk, and got the above-depicted, below-described, set of responses:
- About 47% said “raw milk is dangerous to consume, whereas pasteurization makes it safer”
- About 31% said “raw milk is a good source of vital nutrients which pasteurization would destroy”
- About 14% said “both raw milk and pasteurized milk are equally unhealthy”
- About 9% said “both raw milk and pasteurized milk are equally healthy”
Quite polarizing! So, what does the science say?
“Raw milk is dangerous to consume, whereas pasteurization makes it safer: True or False?”
True! Coincidentally, the 47% who voted for this are mirrored by the 47% of the general US population in a similar poll, deciding between the options of whether raw milk is less safe to drink (47%), just as safe to drink (15%), safer to drink (9%), or not sure (30%):
Public Fails to Appreciate Risk of Consuming Raw Milk, Survey Finds
As for what those risks are, by the way, unpasteurized dairy products are estimated to cause 840x more illness and 45x more hospitalizations than pasteurized products.
This is because unpasteurized milk can (and often does) contain E. coli, Listeria, Salmonella, Cryptosporidium, and other such unpleasantries, which pasteurization kills.
Source for both of the above claims:
(we know the title sounds vague, but all this information is easily visible in the abstract, specifically, the first two paragraphs)
Raw milk is a good source of vital nutrients which pasteurization would destroy: True or False?
False! Whether it’s a “good” source can be debated depending on other factors (e.g., if we considered milk’s inflammatory qualities against its positive nutritional content), but it’s undeniably a rich source. However, pasteurization doesn’t destroy or damage those nutrients.
Incidentally, in the same survey we linked up top, 16% of the general US public believed that pasteurization destroys nutrients, while 41% were not sure (and 43% knew that it doesn’t).
Note: for our confidence here, we are skipping over studies published by, for example, dairy farming lobbies and so forth. Those do agree, by the way, but nevertheless we like sources to be as unbiased as possible. The FDA, which is not completely unbiased, has produced a good list of references for this, about half of which we would consider biased, and half unbiased; the clue is generally in the journal names. For example, Food Chemistry and the Journal of Food Science and Journal of Nutrition are probably less biased than the International Dairy Association and the Journal of Dairy Science:
FDA | Raw Milk Misconceptions and the Danger of Raw Milk Consumption
this page covers a lot of other myths too, more than we have room to “bust” here, but it’s very interesting reading and we recommend to check it out!
Notably, we also weren’t able to find any refutation by counterexample on PubMed, with the very slight exception that some studies sometimes found that in the case of milks that were of low quality, pasteurization can reduce the vitamin E content while increasing the vitamin A content. For most milks however, no significant change was found, and in all cases we looked at, B-vitamins were comparable and vitamin D, popularly touted as a benefit of cow’s milk, is actually added later in any case. And, importantly, because this is a common argument, no change in lipid profiles appears to be findable either.
In science, when something has been well-studied and there aren’t clear refutations by counterexample, and the weight of evidence is clearly very much tipped into one camp, that usually means that camp has it right.
Milk generally is good/bad for the health: True or False?
True or False, depending on what we want to look at. It’s definitely not good for inflammation, but the whole it seems to be cancer-neutral and only increases heart disease risk very slightly:
- Keep Inflammation At Bay ← short version is milk is bad, fermented milk products are fine in moderation
- Is Dairy Scary? ← short version is that milk is neither good nor terrible; fermented dairy products however are health-positive in numerous ways when consumed in moderation
You may be wondering…
…how this goes for the safety of dairy products when it comes to the bird flu currently affecting dairy cows, so:
Take care!
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Strong Curves – by Bret Contreras & Kellie Davis
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The title (and subtitle) is, of course, an appeal to vanity. However, the first-listed author is well-known as “The Glute Guy”, and he takes this very seriously, not just for aesthetic reasons but also for practical reasons.
After all, when it comes to posture and stability, a lot rests on our hips, and hips, well, they rest on our butt and thighs. What’s more, the gluteus maximus is the largest muscle in the human body, so really, is it a good one to neglect? Probably not, and your lower back will definitely thank you for keeping your glutes in good order, too.
That said, while it’s a focal point, it’s not the be-all-and-end-all, and this book does cover the whole body.
The book takes the reader from “absolute beginner” to “could compete professionally”, with clearly-illustrated and well-described exercises. We also get a strong “crash course” in the relevant anatomy and physiology, and even a chapter on nutrition, which is a lot better than a lot of exercise books’ efforts in that regard.
For those who like short courses, this book has several progressive 12-week workout plans that take the reader from a very clear starting point to a very clear goal point.
Another strength of the book is that while a lot of exercises expect (and require) access to a gym, there are also whole sections of “at home / bodyweight” exercises, including 12-week workout plans for such, as described above.
Bottom line: there’s really nothing bad that this reviewer can find to say about this one—highly recommendable to any woman who wants to get strong while keeping a feminine look.
Click here to check out Strong Curves, and rebuild your body, your way!
PS: at first glance, the cover art looks like an AI model; it’s not; that’s the co-author Kellie Davis, who also serves as the model through the book’s many photographic illustrations.
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How gender-affirming care improves trans mental health
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In recent years, a growing number of states have passed laws restricting or banning gender-affirming care for transgender people, particularly minors. As conversations about gender-affirming care increase, so do false narratives about it, with some opponents falsely suggesting that it’s harmful to mental health.
Despite widespread attacks against gender-affirming care, research clearly shows that it improves mental health outcomes for transgender people.
Read on to learn more about what gender-affirming care is, how it benefits mental well-being, and how you can access it.
What is gender-affirming care?
Gender-affirming care describes a range of medical interventions that help align people’s bodies with their gender identities. While anyone can seek gender-affirming care in the form of laser hair removal, breast augmentation, erectile dysfunction medication, or hormone therapy, among other treatments, most conversations about gender-affirming care center around transgender people, whose gender identity or gender expression does not conform to their sex assigned at birth.
Gender-affirming care for trans people varies based on age. For example, some trans adults seek hormone replacement therapy (HRT) or gender-affirming surgeries that help their bodies match their internal sense of gender.
Trans kids entering adolescence might be prescribed puberty blockers, which temporarily delay the production of hormones that initiate puberty, to give them more time to figure out their gender identities before deciding on next steps. This is the same medication given to cisgender kids—whose gender identities match the sex they were assigned at birth—experiencing early puberty.
What is gender dysphoria?
Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity. This can lead to a range of mental health conditions that affect their quality of life
Some trans people may manage gender dysphoria by wearing gender-affirming clothing, opting for a gender-affirming hairstyle, or asking others to refer to them by a name and pronouns that authentically represent them. Others may need gender-affirming care to feel at home in their bodies.
Trans people who desire gender-affirming care and have not been able to access it experience psychological distress, including depression, anxiety, self-harm, and suicidal ideation. The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People found that roughly half of trans youth “seriously considered attempting suicide in the past year.”
How does gender-affirming care improve mental health?
For trans adults, gender-affirming care can alleviate gender dysphoria, which has been shown to improve both short-term and long-term mental health. A 2018 study found that trans adults who do not undergo HRT are four times more likely to experience depression than those who do, although not all trans people desire HRT.
Extensive research has shown that gender-affirming care also alleviates gender dysphoria and improves mental health outcomes in trans kids, teens, and young adults. A 2022 study found that access to HRT and puberty blockers lowered the odds of depression in trans people between the ages of 13 and 20 by 60 percent and reduced the risk of self-harm and suicidal thoughts by 73 percent.
Both the Endocrine Society—which aims to advance hormone research—and the American Academy of Pediatrics recommend that trans kids and teens have access to developmentally appropriate gender-affirming care.
How can I access gender-affirming care?
If you’re a trans adult seeking gender-affirming care or a guardian of a trans kid or teen who’s seeking gender-affirming care, talk to your health care provider about your options. You can find a trans-affirming provider by searching the World Professional Association for Transgender Health directory or visiting your local LGBTQ+ health center or Planned Parenthood.
Some gender-affirming care may not be covered by insurance. Learn how to make the most of your coverage from the National Center for Transgender Equality. Find insurance plans available through the Marketplace that cover gender-affirming care in some states through Out2Enroll.
Some states restrict or ban gender-affirming care. Learn about the laws in your state by visiting the Trans Legislation Tracker.
Where can trans people and their families find mental health support?
In addition to working with a trans-affirming therapist, trans people and their families can find mental health support through these free services:
- PFLAG offers resources for families and friends of LGBTQ+ people. Find a PFLAG chapter near you.
- The Trevor Project’s hotline has trained counselors who help LGBTQ+ youth in crisis. Call the TrevorLifeline 1-866-488-7386 or text START to 678-678.
- The Trans Lifeline was created by and for the trans community to support trans people in crisis. You can reach the Trans Lifeline hotline at 1-877-565-8860.
For more information, talk to your health care provider.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health
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People have a pretty intuitive sense of what is healthy – standing is better than sitting, exercise is great for overall health and getting good sleep is imperative.
However, if exercise in the evening may disrupt our sleep, or make us feel the need to be more sedentary to recover, a key question emerges – what is the best way to balance our 24 hours to optimise our health?
Our research attempted to answer this for risk factors for heart disease, stroke and diabetes. We found the optimal amount of sleep was 8.3 hours, while for light activity and moderate to vigorous activity, it was best to get 2.2 hours each.
Finding the right balance
Current health guidelines recommend you stick to a sensible regime of moderate-to vigorous-intensity physical activity 2.5–5 hours per week.
However mounting evidence now suggests how you spend your day can have meaningful ramifications for your health. In addition to moderate-to vigorous-intensity physical activity, this means the time you spend sitting, standing, doing light physical activity (such as walking around your house or office) and sleeping.
Our research looked at more than 2,000 adults who wore body sensors that could interpret their physical behaviours, for seven days. This gave us a sense of how they spent their average 24 hours.
At the start of the study participants had their waist circumference, blood sugar and insulin sensitivity measured. The body sensor and assessment data was matched and analysed then tested against health risk markers — such as a heart disease and stroke risk score — to create a model.
Using this model, we fed through thousands of permutations of 24 hours and found the ones with the estimated lowest associations with heart disease risk and blood-glucose levels. This created many optimal mixes of sitting, standing, light and moderate intensity activity.
When we looked at waist circumference, blood sugar, insulin sensitivity and a heart disease and stroke risk score, we noted differing optimal time zones. Where those zones mutually overlapped was ascribed the optimal zone for heart disease and diabetes risk.
You’re doing more physical activity than you think
We found light-intensity physical activity (defined as walking less than 100 steps per minute) – such as walking to the water cooler, the bathroom, or strolling casually with friends – had strong associations with glucose control, and especially in people with type 2 diabetes. This light-intensity physical activity is likely accumulated intermittently throughout the day rather than being a purposeful bout of light exercise.
Our experimental evidence shows that interrupting our sitting regularly with light-physical activity (such as taking a 3–5 minute walk every hour) can improve our metabolism, especially so after lunch.
While the moderate-to-vigorous physical activity time might seem a quite high, at more than 2 hours a day, we defined it as more than 100 steps per minute. This equates to a brisk walk.
It should be noted that these findings are preliminary. This is the first study of heart disease and diabetes risk and the “optimal” 24 hours, and the results will need further confirmation with longer prospective studies.
The data is also cross-sectional. This means that the estimates of time use are correlated with the disease risk factors, meaning it’s unclear whether how participants spent their time influences their risk factors or whether those risk factors influence how someone spends their time.
Australia’s adult physical activity guidelines need updating
Australia’s physical activity guidelines currently only recommend exercise intensity and time. A new set of guidelines are being developed to incorporate 24-hour movement. Soon Australians will be able to use these guidelines to examine their 24 hours and understand where they can make improvements.
While our new research can inform the upcoming guidelines, we should keep in mind that the recommendations are like a north star: something to head towards to improve your health. In principle this means reducing sitting time where possible, increasing standing and light-intensity physical activity, increasing more vigorous intensity physical activity, and aiming for a healthy sleep of 7.5–9 hours per night.
Beneficial changes could come in the form of reducing screen time in the evening or opting for an active commute over driving commute, or prioritising an earlier bed time over watching television in the evening.
It’s also important to acknowledge these are recommendations for an able adult. We all have different considerations, and above all, movement should be fun.
Christian Brakenridge, Postdoctoral research fellow at Swinburne University Centre for Urban Transitions, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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