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From 1st World to 3rd Pt#3: Tales from the Big Apple

The Lexington Express train suddenly came to a stop, the light went out.   It was dark, crowded, and suffocatingly hot inside the train that had many foreign tourists.    I heard someone said “Welcome to third-world America,” the whole train laughed.    We just left the 86th Street Subway-Lexington station on the Upper East side of Manhattan.    Half an hour ago, I was admiring the fashion exhibition “Heavenly Bodies:  Fashion and the Catholic Imagination” at the the Metropolitan Museum of Art.    It was exquisite with extraordinarily beautiful dresses with embroidery designs of angels, Adam & Eve rendering on Italian silk dresses designed by the most famous fashion names in the world like Chanel, Versace, Jean Claude Gaultier, Dolce Cabanna, etc  displayed among the world-class collection of the Metropolitan museum, one of the top museums in the world.     It’s truly a world-class experience.   Afterward, I walked through Fifth Avenue where some of the most expensive shops in the world are located and the streets of the Upper East side of Manhattan where they are many medical offices of dermatologists who keep the upper-crust New York residents of “certain ages" and "certain wealth" looking fabulous year-round.     The Upper East Side of Manhattan actually reminds me of the Parisian neighborhood of Saint-Germain-des-Pres that is popular with American expatriate since it also has many high-end cafes and patisseries such as Maison Kayser.    There is even the Serendipity 3 cafe where the super-rich can eat a sundae that costs a whopping $1000 with 24-karat gold flakes as toppings.    

The $1,000 ice-cream sundae at Serendipity 3 cafe, New York City (credit Secret Lives of the Super Rich | CNBC)

This train break-down experience in the middle of very rich neighborhood of New York city makes me wondering about whether the upper-crust residents of New York ever use the subway and whether they feel embarrassed about the sorry state of subway in New York city where it is dirty, run-down, full of homeless people.    It breaks down so often that now a New Yorker has to allocate at least half an hour extra per trip just in case the subway doesn’t work and they need to walk or take other form of transportation.    Billions of hours wasted per year due to the decaying infrastructure of New York city, the premiere city in the U.S.   The income inequality in the U.S. is shocking.   In many ways, the U.S. resembles other big cities in the third world, houses of billionaires are near shanty towns where desperate poverty exist side by side.    If it is this bad in this top American city, elsewhere it must be much worse and rightly so.    Right here in the San Francisco Bay area, BART is in the similar state of neglect and decay and our politicians like our Congresswoman Zoe Lofgren don’t particular care; in her 26-year in Congress, the only issue that she cares about is the interest of cheap labor lobbyists and the multinational corporations regarding the H-1B program and the illegal immigration.

in 2018, I spent 6 months in New York City doing my Pediatric, Geriatric, Emergency Medicine, and Internal Medicine Subspecialty at hospitals and Emergency room in some of New York City's poorest neighborhoods with a month of Cardiology at a Yale University School of Medicine affiliated hospital in Connecticut.    I was living near the hospitals where I rotated.   The neighborhoods are mostly minority.   I find it interesting that there are very few grocery stores in the neighborhoods, but plenty of liquor stores.   The neighborhood grocery stores are also surprisingly expensive given the low-income of the local residents and there aren't many healthy foods available in the stores.   What they have are junk foods like chips and sodas but few fresh vegetables.  I often took the Subway to Chinatown which is 45 minutes away where the prices are cheaper and the selections are much better.  American politicians sometimes talk about the "no-go zones" of Europe's suburbs, but having visited there many times (my uncle lived in the so called no-go zone just north of Paris), I think they don't know what they are talking about.    I find the American inner city neighborhoods much more dangerous.   In Europe, you might get robbed, but here in America, it's quite easy to get killed.     At night, I could hear gun shots nearby. 

Fifteen minutes into my first day of the Emergency Medicine rotation, I accompanied the ER doctor to do wound care for a patient who had been shot in his right thigh.  It was a bloody scene.    Luckily the bullet didn't cut through a major vessel, otherwise he could have bled to death.   In the next 4 weeks, I saw another patient with a gunshot wound on his back.    My experience is hardly unique.    My friend rotated at a nearby hospital and who wants to become an emergency doctor told me that he has learned so much rotating at these hospitals since he has seen so many gun-shot wounds and deaths during his time there.      He would be unlikely to see many gun-shot wounds if he has rotated at hospitals in richer neighborhoods.   I saw 2 gun-shot wounds during a 4-week rotation and my friend saw 4.    An Emergency doctor at a hospital in France probably saw none or at most 1-2 in his 30-year career there.    The gun violence in many poor neighborhoods in the U.S. is as bad as war zones in other countries.    In the 26+ years of Lofgren's in Congress, the U.S. has had quite a few gun violence incidents at schools, hospitals, night clubs, etc.    How many times have you heard our Congresswoman Lofgren expressed her concern and the need to do something about these incidents?    None whatsoever.    

This is a picture from Eric Curran (3rd year medical student) from his opinion piece on the New York Times, Feb 14, 2019.  

‘I Remember the First Time I Saw a Teenager Die’: Scenes from the trauma bay haunt those of us who work to save the victims of gun violence.

The trauma bay in the emergency department at Temple University Hospital after resuscitation efforts failed.Credit Eric Curran

For my Internal Medicine Sub-Specialty, I shadowed an Internist (Internal Medicine) doctor to look after the medical needs of patients in a psychiatric ward at a hospital.    It was an eye-opening experience.    The addiction and substance abuse in New York City is even worse than in Trump country.     There is a propaganda going on among American coastal elites to depict the addiction problem as a symptoms of Trump country where people are poor, uneducated, closed minded, etc.   I did my Psychiatry rotation in the heart of Trump country in the middle of America where I was assigned to a Substance Abuse ward and I’ve seen the serious problem of substance addiction there.   But it is a myth/propaganda to portray the problem as Trump's.    It also exists in the supposedly “enlightened, progressive” Democrats-run cities like New York City.   In case you don’t know, there are advertisements on New York subway that advise people to carry Naloxone.   Naloxone is an antidote for opioid overdose so in case you see someone in the subway on the verge of death due to opioid overdose, you can give him/her an injection of Naloxone.     I mentioned it to my friends in Europe and they are shocked.     For many years now, the opioid epidemic has swept across America from small towns in Trump country to Democrats’ coastal cities, How many times have you heard our local Congresswoman Zoe Lofgren mentioned about it or done something to fix it?      None whatsoever, she is too busy counting $$$ from the cheap labor lobbyists and the multinational corporations to care about something as opioid problem.    



New York 5h ago

NYC is in the middle of a transportation, housing and homeless problem that has gotten worse under this Mayor. What is the priority? Health Care for people in the country ILLEGALLY, of course. Who will pay for this service that most New Yorkers don't get to enjoy? The ever-shrinking Middle Class I am sure. 

The Democrats need to get their priorities in order. I fully support a sustainable system in which poor Americans get health care they cannot afford and I would even support Universal Health Care. What I do not support is diverting our tax dollars to benefit people who have no legal claim to be here at the expense of our own citizens. If the Republicans could come up with just one good candidate I would jump ship overnight. 

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NY 3h ago

Trump will win again in 2020 because of programs like this.

People will come from all over for "free" healthcare in NYC.

Middle class NYers paying skyrocketing Obamacare premiums...they do not count.

It is better to be illegal in NYC than a hard working middle class NYC resident.

The Democrats could not be more tone deaf.  Wow, just wow.

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And while I was doing my clinical rotations in New York City, I suddenly had floaters in my eyes and I checked with the hospital where I worked, they told me they don’t accept Obama care from out of state which I had and I might have to pay out of pocket.    I didn’t want to burden myself with thousands of dollars medical expense and I decided to wait until I came back to California to have it checked.     Just imagine that, I am as an American citizen with health insurance and an emergency medical need and I can’t get access to medical care while out of state.   But the illegal immigrants can have free health care in New York City at the cost of $100 million dollars per year paid for by mostly middle and lower-class American taxpayers in New York City who face a third-world subway system.   This is ridiculous.   I will propose Medicare for all at the federal level that will be accepted everywhere in the U.S. and it also solves the problem of the opioid epidemic where patients with problems are not being treated properly that have resulted in homelessness and overdosed deaths.


B. Brooklyn 2h ago

I wonder how many families victimized by gun violence, who have lost small grandchildren, daughters, and fathers, wouldn't have preferred that gang members were stopped and their guns confiscated.

At airports nowadays, probably because of the new scanners, I am stopped and frisked. It's for everyone's safety that it's done. 

If the stop-and-frisk policy did its job and is no longer needed, okay. But in my neighborhood and its near environs, we have shootings every week.

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doc New JerseyFeb. 14
Times Pick

I am a surgeon who trained in Philadelphia. These pictures Eric showed in his article aren't for their dramatic effect. They depict the average scene in a gunshot ER OR. It has the look of a slaughterhouse. I say that every politician who has taken money from the NRA should have to spend a night in a city ER. I'm sure that the ones in Washington DC could easily accommodate the members of the Senate and Congress. Then we will see if they think reasonable gun safety reform is needed. Even if you just look at the suicide rate in this country, you will see we have a gun problem. Is it a constitutional right to be able to blow your own brains out?

vladimir flagstaff, azFeb. 14

I've seen literally hundreds of images like this with my own eyes, spending over half of my career as an ER doc in inner city trauma centers. I now live in northern Arizona, where guns are glorified and gun control is considered unpatriotic by many, reflecting, I'm afraid, the sentiments of millions across this country. These millions will say the images are photoshopped or that they reflect improper use of guns or that the answer is arming the good guys with bigger guns, etc. ad nauseam. The only thing that will maybe change their minds is if they themselves or someone close to them are wounded or killed by the guns they so fervently worship. Sad state of affairs in this dystopian land called the United States of America.