A scene from the documentary Lenox Hill, based on the hospital of the same name in New York City. Courtesy of Netflix
A scene from the documentary Lenox Hill, based on the hospital of the same name in New York City. Courtesy of Netflix
A scene from the documentary Lenox Hill, based on the hospital of the same name in New York City. Courtesy of Netflix
A scene from the documentary Lenox Hill, based on the hospital of the same name in New York City. Courtesy of Netflix

My son and I were lucky to access the best of US health care


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It is an old chestnut to write about how America fails its citizens but the US is the only country where I have lived that doesn’t provide health care. It is the duality of a superpower that can spend a fortune on military hardware but cannot protect its most vulnerable people.

In France, I have a shiny green Carte Vitale – the card of the National Health Care Service. In the UK, I still have my old National Insurance card – red, pale blue, white – from the 1980s which granted me use of the National Health Service.

But when I arrived in America three years ago, the first thing I did was get a job that gave me insurance. Otherwise, I was told by everyone I knew, I could go bankrupt or be in debt my entire life if I broke a leg or got hit by a car.

Most people in the US have either private insurance or a combination of various state or federal programmes. But often these programmes don’t provide access to the best facilities. There is not much choice if you are poor: you take what you can get, which is why many poor people don’t go to the doctor.

There is also the question of dignity. Once, taking a sick relative on Medicaid – the nation’s public health insurance for people with low income – to a clinic, my sister overheard the doctor say to his nurse: “Give him no more than ten minutes. He’s on Medicaid.”

In the past five days, both my son and I were ill. We were treated in vastly different healthcare facilities. Yet both were excellent because of the compassion and dedication of the staff. Most nights during lockdown I leaned out of my window at 8pm and clapped, cheered and banged pans for the anonymous healthcare heroes saving lives. Now, in the past week, I know who they are.

My son had a serious mountain bike accident while we were on vacation in Wyoming. Although the “blood” wagon that brought him off the bike track, and the small emergency clinic were helpful, they could not do a complicated surgery. I had to haul my wounded child back to our home in New York City.

It was a long, painful journey, that could not have helped his broken bones. I struggled to soothe him and my own nerves at the same time.

Once back in New York, my private insurance card (generously provided by my employer) opened doors to the best orthopedic hospital in America to my son. One way to describe my son’s hospital is 'chic'.

While I was grateful my boy was in good hands, I was guiltily aware that this is a hospital for the one-percenters

The Hospital for Special Surgery was founded in 1863 for orthopedic woes. It is the official hospital of the New York Mets, Knicks, Giants and Red Bulls. It is ranked number one in the entire country, and many of the doctors travel to the Olympics with athletes.

The care was phenomenal – the skill and training of the surgeons, the concern of the nurses, the level of attention. At the same time, while I was grateful my boy was in good hands, I was guiltily aware that this is a hospital for the one-percenters.

Hospital for Special Surgery, New York City. Hohlfeld/ullstein bild via Getty Images
Hospital for Special Surgery, New York City. Hohlfeld/ullstein bild via Getty Images

The website says it does treat Medicare patients, but there is often a co-pay – or co-payment, where you pay a fixed amount for a health service. I don’t think Medicare is going to pay the hundreds of thousands of dollars spinal or other specialised surgery requires.

Nursing my son at home, unfortunately, I had my own medical mishap. A severe headache left me paralysed. I could barely walk. Frightened I had contracted Covid-19, I made my way to the neighbourhood walk-in urgent care. The doctor there was worried about my level of pain so she sent me straight to the emergency room or ER of Lenox Hill Hospital, which happens to be across the street from where I live.

For two years, Lenox Hill has annoyed me. I have lived with the constant sound of ambulances in the middle of the night. I come out my front door to jostle with doctors and nurses in scrubs smoking on their breaks. The Dunkin Donuts next door is always overcrowded with the staff, as is the Pick-a-Bagel.

But now I was their patient.

Lenox Hill is a legend in Manhattan, a doyenne of medical facilities. Built in the late 1800s by German doctors, it was renamed Lenox Hill in 1918, during the Spanish Flu pandemic.

In 2020, it was at the frontline of the coronavirus pandemic, receiving the first Covid-19 patient on March 7, and at one point treating nearly 300. Refrigerated trucks were lined up outside for the dead, and it became the symbol of the courage of healthcare workers worldwide.

Netflix made a documentary (called Lenox Hill) that follows the lives of four doctors and their patients, and which aired in June. The day I arrived at Lenox Hill, they were down to only two Covid-19 patients.

But the Lenox Hill ER was a far cry from the spotless corridors of the hospital for special surgery. Waiting for my son to emerge from his five-hour-long procedure, I sat in plush chairs with plenty of ports to plug in my computer and iPhone. A TV blasted CNN. There was a spiritual centre (for Muslims, Christians, Jews) and a Starbucks nearby.

A view of the Lenox Hill Hospital Emergency Room entrance, in New York City. Roy Rochlin/Getty Images
A view of the Lenox Hill Hospital Emergency Room entrance, in New York City. Roy Rochlin/Getty Images

The emergency room was full so I spent most of the day on a stretcher in a narrow corridor next to the laundry bins. Doctors, nurses, technicians and laundry workers who passed gaped down at me. It was a few days after Labour Day – the traditional end of US summer holidays – and for some reason, the place was insanely busy.

Still, I got all the care and tests I needed: a CAT scan, an MRI, a chest X-ray, a Covid-19 test (negative). In between, I lay on my stretcher and watched a stream of Victor Hugo-esque characters hobble through the door: injured, inebriated, homeless, delirious, bloody and wounded.

“To me, the ER is the front line,” Dr Mirtha Macri told Netflix in the first episode of Lenox Hill. “We take whoever, whatever… if you’re uninsured, if you’re insured, if you’re a criminal, anything you are, we put it to the side, and we just treat you.”

They all came through the door the day I spent in ER. The doctors and nurses treated everyone equally, patched them up, sent them for X-rays or gave them a sandwich and a ginger ale.

I compared them to the surgeons and nurses I met earlier at the Hospital for Special Surgery. Obviously, my respect and gratitude for patching up my broken son was huge. But it was these emergency doctors and nurses who were heroes to me. They had gone through the fire and survived. They had treated Covid-19 patients from the first day the virus hit Manhattan and they were still here.

I found it hard to imagine the trauma they had undergone these past few months, deciding who would be intubated, seeing patients die and living under the constant fear they would also catch the virus. They worked double shifts, ate doughnuts instead of proper meals and attended to patients for long, endless nights.

When they had a few moments for me, I was struck at their resilience and patience. They called me “honey” and “dear”. They never lost their tempers.

“Aren’t you tired?” I asked one of the nurses, who had come from Philadelphia during the pandemic to devote his services. He had been in the ER when I arrived at 8am. He was still there at 9pm.

“I forgot what tired is,” he replied cheerfully.

I stumbled out of the ER at night after 10 hours in the laundry room, bleary from medication and the many tests. My headache was nearly gone. The streets were dark, the ambulances double parked.

At home, my son was at his desk, his bones healing.

Before I went to sleep, I turned out my lights and looked across the road at Lenox Hill. The lights were on and inside, all night long, a parade of committed people were working. It made me feel safe. It made me feel better.

Janine di Giovanni is a Senior Fellow at Yale’s Jackson Institute for Global Affairs. Her last book is “The Morning They Came For US: Dispatches from Syria.” 

Quick pearls of wisdom

Focus on gratitude: And do so deeply, he says. “Think of one to three things a day that you’re grateful for. It needs to be specific, too, don’t just say ‘air.’ Really think about it. If you’re grateful for, say, what your parents have done for you, that will motivate you to do more for the world.”

Know how to fight: Shetty married his wife, Radhi, three years ago (he met her in a meditation class before he went off and became a monk). He says they’ve had to learn to respect each other’s “fighting styles” – he’s a talk it-out-immediately person, while she needs space to think. “When you’re having an argument, remember, it’s not you against each other. It’s both of you against the problem. When you win, they lose. If you’re on a team you have to win together.” 

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Tank warfare

Lt Gen Erik Petersen, deputy chief of programs, US Army, has argued it took a “three decade holiday” on modernising tanks. 

“There clearly remains a significant armoured heavy ground manoeuvre threat in this world and maintaining a world class armoured force is absolutely vital,” the general said in London last week.

“We are developing next generation capabilities to compete with and deter adversaries to prevent opportunism or miscalculation, and, if necessary, defeat any foe decisively.”

Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

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PULITZER PRIZE 2020 WINNERS

JOURNALISM 

Public Service
Anchorage Daily News in collaboration with ProPublica

Breaking News Reporting
Staff of The Courier-Journal, Louisville, Ky.

Investigative Reporting
Brian M. Rosenthal of The New York Times

Explanatory Reporting
Staff of The Washington Post

Local Reporting  
Staff of The Baltimore Sun

National Reporting
T. Christian Miller, Megan Rose and Robert Faturechi of ProPublica

and    

Dominic Gates, Steve Miletich, Mike Baker and Lewis Kamb of The Seattle Times

International Reporting
Staff of The New York Times

Feature Writing
Ben Taub of The New Yorker

Commentary
Nikole Hannah-Jones of The New York Times

Criticism
Christopher Knight of the Los Angeles Times

Editorial Writing
Jeffery Gerritt of the Palestine (Tx.) Herald-Press

Editorial Cartooning
Barry Blitt, contributor, The New Yorker

Breaking News Photography
Photography Staff of Reuters

Feature Photography
Channi Anand, Mukhtar Khan and Dar Yasin of the Associated Press

Audio Reporting
Staff of This American Life with Molly O’Toole of the Los Angeles Times and Emily Green, freelancer, Vice News for “The Out Crowd”

LETTERS AND DRAMA

Fiction
"The Nickel Boys" by Colson Whitehead (Doubleday)

Drama
"A Strange Loop" by Michael R. Jackson

History
"Sweet Taste of Liberty: A True Story of Slavery and Restitution in America" by W. Caleb McDaniel (Oxford University Press)

Biography
"Sontag: Her Life and Work" by Benjamin Moser (Ecco/HarperCollins)

Poetry
"The Tradition" by Jericho Brown (Copper Canyon Press)

General Nonfiction
"The Undying: Pain, Vulnerability, Mortality, Medicine, Art, Time, Dreams, Data, Exhaustion, Cancer, and Care" by Anne Boyer (Farrar, Straus and Giroux)

and

"The End of the Myth: From the Frontier to the Border Wall in the Mind of America" by Greg Grandin (Metropolitan Books)

Music
"The Central Park Five" by Anthony Davis, premiered by Long Beach Opera on June 15, 2019

Special Citation
Ida B. Wells

 

Results

1. New Zealand Daniel Meech – Fine (name of horse), Richard Gardner – Calisto, Bruce Goodin - Backatorps Danny V, Samantha McIntosh – Check In. Team total First round: 200.22; Second round: 201.75 – Penalties 12 (jump-off 40.16 seconds) Prize €64,000

2. Ireland Cameron Hanley – Aiyetoro, David Simpson – Keoki, Paul Kennedy – Cartown Danger Mouse, Shane Breen – Laith. Team total 200.25/202.84 – P 12 (jump-off 51.79 – P17) Prize €40,000

3. Italy Luca Maria Moneta – Connery, Luca Coata – Crandessa, Simone Coata – Dardonge, Natale Chiaudani – Almero. Team total 130.82/198.-4 – P20. Prize €32,000

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