A Hospital Kept a Brain-Damaged Patient on Life Support to Boost Statistics. His Sister Is Now Suing for Malpractice.

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ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.

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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  • Life After Death? (Your Life; A Loved One’s Death)

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    The Show Must Go On

    We’ve previously written about the topics of death and dying. It’s not cheery, but it is important to tackle.

    Sooner is better than later, in the case of:

    Preparations For Managing Your Own Mortality

    And for those who are left behind, of course it is hardest of all:

    What Grief Does To Your Body (And How To Manage It)

    But what about what comes next? For those who are left behind, that is.

    Life goes on

    In cases when the death is that of a close loved one, the early days after death can seem like a surreal blur. How can the world go ticking on as normal when [loved one] is dead?

    But incontrovertibly, it does, so we can only ask again: how?

    And, we get to choose that, to a degree. The above-linked article about grief gives a “101” rundown, but it’s (by necessity, for space) a scant preparation for one of the biggest challenges in life that most of us will ever face.

    For many people, processing grief involves a kind of “saying goodbye”. For others, it doesn’t, as in the following cases of grieving the loss of one’s child—something no parent should ever have to face, but it happens:

    Dr. Ken Druck | The Love That Never Dies

    (with warning, the above article is a little heavy)

    In short: for those who choose not to “say goodbye” in the case of the death of a loved one, it’s more often not a case of cold neglect, but rather the opposite—a holding on. Not in the “denial” sense of holding on, but rather in the sense of “I am not letting go of this feeling of love, no matter how much it might hurt to hold onto; it’s all I have”.

    What about widows, and love after death?

    Note: we’ll use the feminine “widow” here as a) it’s the most common and b) most scientific literature focuses on widows, but there is no reason why most of the same things won’t also apply to widowers.

    We say “most”, as society does tend to treat widows and widowers differently, having different expectations about a respectful mourning period, one’s comportment during same, and so on.

    As an aside: most scientific literature also assumes heterosexuality, which is again statistically reasonable, and for the mostpart the main difference is any extra challenges presented by non-recognition of marriages, and/or homophobic in-laws. But otherwise, grief is grief, and as the saying goes, love is love.

    One last specificity before we get into the meat of this: we are generally assuming marriages to be monogamous here. Polyamorous arrangements will likely sidestep most of these issues completely, but again, they’re not the norm.

    Firstly, there’s a big difference between remarrying (or similar) after being widowed, and remarrying (or similar) after a divorce, and that largely lies in the difference of how they begin. A divorce is (however stressful it may often be) more often seen as a transition into a new period of freedom, whereas bereavement is almost always felt as a terrible loss.

    The science, by the way, shows the stats for this; people are less likely to remarry, and slower to remarry if they do, in instances of bereavement rather than divorce, for example:

    Timing of Remarriage Among Divorced and Widowed Parents

    Love after death: the options

    For widows, then, there seem to be multiple options:

    • Hold on to the feelings for one’s deceased partner; never remarry
    • Grieve, move on, find new love, relegating the old to history
    • Try to balance the two (this is tricky but can be done*)

    *Why is balancing the two tricky, and how can it be done?

    It’s tricky because ultimately there are three people’s wishes at hand:

    • The deceased (“they would want me to be happy” vs “I feel I would be betraying them”—which two feelings can also absolutely come together, by the way)
    • Yourself (whether you actually want to get a new partner, or just remain single—this is your 100% your choice either way, and your decision should be made consciously)
    • The new love (how comfortable are they with your continued feelings for your late love, really?)

    And obviously only two of the above can be polled for opinions, and the latter one might say what they think we want to hear, only to secretly and/or later resent it.

    One piece of solid advice for the happily married: talk with your partner now about how you each would feel about the other potentially remarrying in the event of your death. Do they have your pre-emptive blessing to do whatever, do you ask a respectable mourning period first (how long?), would the thought just plain make you jealous? Be honest, and bid your partner be honest too.

    One piece of solid advice for everyone: make sure you, and your partner(s), as applicable, have a good emotional safety net, if you can. Close friends or family members that you genuinely completely trust to be there through thick and thin, to hold your/their hand through the emotional wreck that will likely follow.

    Because, while depression and social loneliness are expected and looked out for, it’s emotional loneliness that actually hits the hardest, for most people:

    Longitudinal Examination of Emotional Functioning in Older Adults After Spousal Bereavement

    …which means that having even just one close friend or family member with whom one can be at one’s absolute worst, express emotions without censure, not have to put on the socially expected appearance of emotional stability… Having that one person (ideally more, but having at least one is critical) can make a huge difference.

    But what if a person has nobody?

    That’s definitely a hard place to be, but here’s a good starting point:

    How To Beat Loneliness & Isolation

    Take care!

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  • How Emotions Are Made – by Dr. Lisa Feldman Barrett

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve previously reviewed Dr. Barrett’s (also good) book Seven And A Half Lessons About The Brain, and this one is very different, and of more practical use:

    The main thrust of the book is: the bioessentialist model of emotions is flawed; there is also no Platonic perfect form of any given emotion, and in fact emotions are constructed by the brain as a learned adaptive response.

    She argues this from the dual vectors of on the one hand hard sciences of affective neuroscience and clinical psychology, and on the other hand sociology and anthropology.

    In the category of criticism: Dr. Barrett, a very well-known and well-respected cognitive neuroscientist, is not an expert on sociology and anthropology, and some of her claims there are verifiably false.

    However, most of the book is given over the psychophysiology, which is entirely her thing, and she explains it clearly and simply while backing everything up with mountains of data.

    The usefulness of this book is chiefly: if we understand that emotions are not innate and are instead constructed adaptive (and sometimes maladaptive) neurological responses to stimuli and associations, we can set about rewiring things a little in accord with what’s actually more beneficial to us. The book also outlines how.

    Bottom line: if you’d like to be able to not merely manage emotions as they are, but also prune and/or grow them from the stem up, then this book provides a robustly scientific approach for doing that.

    Click here to check out How Emotions Are Made, and get more discerning about yours!

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  • What Curiosity Really Kills

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    Curiosity Kills The Neurodegeneration

    Of the seven things that Leonardo da Vinci considered most important for developing and maintaining the mind, number one on his list was curiosity, and we’re going to be focussing on that today.

    In case you are curious about what seven things made Leonardo’s* list, they were:

    1. Curiosità: an insatiably curious approach to life and an unrelenting quest for continuous learning
    2. Dimostrazione: a commitment to test knowledge through experience, persistence, and a willingness to learn from mistakes
    3. Sensazione: the continual refinement of the senses, especially sight, as a means to enliven experience
    4. Sfumato: (lit: “gone up in smoke”) a willingness to embrace ambiguity, paradox, and uncertainty
    5. Arte/Scienza: the curated balance of art and science, imagination and logic
    6. Corporalità: the cultivation of physical grace, ambidexterity, and fitness
    7. Connessione: a recognition of and appreciation for the interconnectedness of phenomena (systems-based thinking)

    *In case you are curious why we wrote “Leonardo” and not “da Vinci” as per our usual convention of shortening names to last names, da Vinci is not technically a name, in much the same way as “of Nazareth” was not a name.

    You can read more about all 7 of these in a book that we’ve reviewed previously:

    How to Think Like Leonardo da Vinci: Seven Steps to Genius Every Day – by Michael J. Gelb

    But for now, let’s take on “curiosity”!

    If you need an extra reason to focus on growing and nurturing your curiosity, it was also #1 of Dr. Daniel Levitin’s list of…

    The Five Keys Of Aging Healthily

    …and that’s from a modern-day neuroscientist whose research focuses on aging, the brain, health, productivity, and creativity.

    But how do we foster curiosity in the age of Google?

    Curiosity is like a muscle: use it or lose it

    While it’s true that many things can be Googled to satisfy one’s curiosity in an instant…

    • do you? It’s only useful if you do use it
    • is the top result on Google reliable?
    • there are many things that aren’t available there

    In short: douse “fast food information” sources, but don’t rely on them! Not just for the sake of having correct information, but also: for the actual brain benefits which is what we are aiming for here with today’s article.

    If you want the best brain benefits, dive in, and go deep

    Here at 10almonds we often present superficial information, with links to deeper information (often: scholarly articles). We do this because a) there’s only so much we can fit in our articles and b) we know you only have so much time available, and/but may choose to dive deeper.

    Think of it in layers, e.g:

    • Collagen is good for joints and bones
    • Collagen is a protein made of these amino acids that also requires these vitamins and minerals to be present in order to formulate it
    • Those amino acids are needed in these quantities, of which this particular one is usually the weakest link that might need supplementing, and those vitamins and minerals need to be within this period of time, but not these ones at the exact same time, or else it will disrupt the process of collagen synthesis

    (in case you’re curious, we covered this here and here and offered a very good, very in-depth book about it here)

    Now, this doesn’t mean that to have a healthy brain you need to have the equivalent knowledge of an anatomy & physiology degree, but it is good to have that level of curiosity in at least some areas of your life—and the more, the better.

    Top tips for developing a habit of curiosity

    As you probably know, most of our endeavors as humans go best when they are habits:

    How To Really Pick Up (And Keep!) Those Habits

    And as for specifically building a habit of curiosity:

    1. Make a deal with yourself that when someone is excited to tell you what they know about something (no matter whether it is your grandkid, or the socially awkward nerd at a party, or whoever), listen and learn, no matter the topic.
    2. Learn at least one language other than your native language (presumably English for most of our readers). Not only does learning a language convey a lot of brain benefits of its own, but also, it is almost impossible to separate language learning from cultural learning, and so you will learn a lot about another culture too, and have whole new worlds opened up to you. Again, more is better, but one second language is already a lot better than none.
    3. Make a regular habit of going to your local library, and picking out a non-fiction book to take home and read. This has an advantage over a bookshop, by the way (and not just that the library is free): since library books must be returned, you will keep going back, and build a habit of taking out books.
    4. Pick a skill that you’d like to make into a fully-fledged hobby, and commit to continually learning as much about it as you can. We already covered language-learning above, but others might include: gardening (perhaps a specific kind), cooking (perhaps a specific kind), needlecraft (perhaps a specific kind), dance (perhaps a specific kind). You could learn a musical instrument. Or it could be something very directly useful, like learning to be a first responder in case of emergencies, and committing to continually learning more about it (because there is always more to learn).

    And when it comes to the above choices… Pick things that excite you, regardless of how practical or not they are. Because that stimulation that keeps on driving you? That’s what keeps your brain active, healthy, and sharp.

    Enjoy!

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  • Aging with Grace – by Dr. David Snowdon

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    First, what this book is not: a book about Christianity. Don’t worry, we didn’t suddenly change the theme of 10almonds.

    Rather, what this book is: a book about a famous large (n=678) study into the biology of aging, that took a population sample of women who had many factors already controlled-for, e.g. they ate the same food, had the same schedule, did the same activities, etc—for many years on end. In other words, a convent of nuns.

    This allowed for a lot more to be learned about other factors that influence aging, such as:

    • Heredity / genetics in general
    • Speaking more than one language
    • Supplementing with vitamins or not
    • Key adverse events (e.g. stroke)
    • Key chronic conditions (e.g. depression)

    The book does also cover (as one might expect) the role that community and faith can play in healthy longevity, but since the subjects were 678 communally-dwelling people of faith (thus: no control group of faithless loners), this aspect is discussed only in anecdote, or in reference to other studies.

    The author of this book, by the way, was the lead researcher of the study, and he is a well-recognised expert in the field of Alzheimer’s in particular (and Alzheimer’s does feature quite a bit throughout).

    The writing style is largely narrative, and/but with a lot of clinical detail and specific data; this is by no means a wishy-washy book.

    Bottom line: if you’d like to know what nuns were doing in the 1980s to disproportionally live into three-figure ages, then this book will answer those questions.

    Click here to check out Aging with Grace, and indeed age with grace!

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  • How To Nap Like A Pro (No More “Sleep Hangovers”!)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How To Be An Expert Nap-Artist

    There’s a lot of science to say that napping can bring us health benefits—but mistiming it can just make us more tired. So, how to get some refreshing shut-eye, without ending up with a case of the midday melatonin blues?

    First, why do we want to nap?

    Well, maybe we’re just tired, but there are specific benefits even if we’re not. For example:

    What can go wrong?

    There are two main things that can go wrong, physiologically speaking:

    1. We can overdo it, and not sleep well at night
    2. We can awake groggy and confused and tired

    The first is self-explanatory—it messes with the circadian rhythm. For this reason, we should not sleep more than 90 minutes during the day. If that seems like a lot, and maybe you’ve heard that we shouldn’t sleep more than half an hour, there is science here, so read on…

    The second is a matter of sleep cycles. Our brain naturally organizes our sleep into multiples of 20-minute segments, with a slight break of a few minutes between each. Consequently, naps should be:

    • 25ish minutes
    • 40–45 minutes
    • 90ish minutes

    If you wake up mid-cycle—for example, because your alarm went off, or someone disturbed you, or even because you needed to pee, you will be groggy, disoriented, and exhausted.

    For this reason, a nap of one hour (a common choice, since people like “round” numbers) is a recipe for disaster, and will only work if you take 15 minutes to fall asleep. In which case, it’d really be a nap of 45 minutes, made up of two 20-minute sleep cycles.

    Some interruptions are better/worse than others

    If you’re in light or REM sleep, a disruption will leave you not very refreshed, but not wiped out either. And as a bonus, if you’re interrupted during a REM cycle, you’re more likely to remember your dreams.

    If you’re in deep sleep, a disruption will leave you with what feels like an incredible hangover, minus the headache, and you’ll be far more tired than you were before you started the nap.

    The best way to nap

    Taking these factors into account, one of the “safest” ways to nap is to set your alarm for the top end of the time-bracket above the one you actually want to nap for (e.g., if you want to nap for 25ish minutes, set your alarm for 45).

    Unless you’re very sleep-deprived, you’ll probably wake up briefly after 20–25 minutes of sleep. This may seem like nearer 30 minutes, if it took you some minutes to fall asleep!

    If you don’t wake up then, or otherwise fail to get up, your alarm will catch you later at what will hopefully be between your next sleep cycles, or at the very least not right in the middle of one.

    When you wake up from a nap before your alarm, get up. This is not the time for “5 more minutes” because “5 more minutes” will never, ever, be refreshing.

    Rest well!

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  • Heart-Healthy Gochujang Noodles

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    Soba noodles are a good source of rutin, which is great for the heart and blood. Additionally, buckwheat (as soba noodles are made from) is healthier in various ways than rice, and certainly a lot healthier than wheat (remember that despite the name, buckwheat is about as related to wheat as a lionfish is to a lion). This dish is filled with more than just fiber though; there are a lot of powerful phytochemicals at play here, in the various kinds of cabbage, plus of course things like gingerol, capsaicin, allicin, and piperine.

    You will need

    • 14 oz “straight to wok” style soba noodles
    • 3 bok choi (about 7 oz)
    • 3½ oz red cabbage, thinly sliced
    • 10 oz raw and peeled large shrimp (if you are vegan, vegetarian, allergic to shellfish/crustaceans, or observant of a religion that does not eat such, substitute with small cubes of firm tofu)
    • 1 can (8 oz) sliced water chestnuts, drained (drained weight about 5 oz)
    • 2 tbsp gochujang paste
    • 2 tbsp low-sodium soy sauce
    • 1 tbsp sesame oil
    • 2 tsp garlic paste
    • 2 tsp ginger paste
    • 1 tbsp chia seeds
    • Avocado oil for frying (or another oil suitable for high temperatures—so, not olive oil)

    Note: ideally you will have a good quality gochujang paste always in your cupboard, as it’s a great and versatile condiment. However, you can make your own approximation, by blending 5 pitted Medjool dates, 1 tbsp rice wine vinegar, 2 tbsp tomato purée, 2 tsp red chili flakes, 1 tsp garlic granules, and ¼ tsp MSG or ½ tsp low-sodium salt. This is not exactly gochujang, but unless you want to go shopping for ingredients more obscure in Western stores than gochujang, it’s close enough.

    Method

    (we suggest you read everything at least once before doing anything)

    1) Mix together the gochujang paste with the sesame oil, soy sauce, garlic paste, and ginger paste, in a small bowl. Whisk in ¼ cup hot water, or a little more if it seems necessary, but go easy with it. This will be your stir-fry sauce.

    2) Slice the base of the bok choi into thin disks; keep the leaves aside.

    3) Heat the wok to the highest temperature you can safely muster, and add a little avocado oil followed by the shrimp. When they turn from gray to pink (this will take seconds, so be ready) add the sliced base of the bok choi, and also the sliced cabbage and water chestnuts, stirring frequently. Cook for about 2 minutes; do not reduce the heat.

    4) Add the sauce you made, followed 1 minute later by the noodles, stirring them in, and finally the leafy tops of the bok choi.

    5) Garnish with the chia seeds (or sesame seeds, but chia pack more of a nutritional punch), and serve:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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