The Jacobi Medical Center was rated worst in the country for patient safety

Is Jacobi Medical Center in the Bronx the worst hospital in the country? Consumer Reports thinks so. In a new report, the magazine ranked more than 1,000 hospitals in the nation based on the number of hospital-acquired infections, re-admissions within 30 days, and the quality of discharge and medication instructions.

Thirty New York metropolitan area-hospitals earned low scores for patient safety. Of the 10 New York hospitals with the lowest scores, three were in Brooklyn:  Wyckoff Heights Medical Center, Kings County Hospital Center and Coney Island Hospital.

But Jacobi Medical Center in the Bronx, a city run hospital, got the rap for being the worst in the country when ranked for patient safety, according to the magazine’s rankings.

The hospital disputed the findings. “Consumer Reports has taken the very complex question of patient safety and reduced it to four indicators that do not take into account the most recent data showing significant improvements in hospital acquired infections and readmissions. We are constantly reviewing our protocols and remain focused on prioritizing patient safety.” Jacobi Hospital said in a statement.

A nurse practitioner at the hospital for 25 years, Ramona Lamascola, also dismissed the report angrily. “It’s absolutely not the worst hospital in the United States,” she said. “I am angry because this is a general statement. How do you make a statement that it is the worst hospital in the United States unless you went to all the hospitals in the United States?”

Despite the brouhaha surrounding the report, patients visiting the hospital on Friday afternoon did not seem concerned about the report at all. Many praised the hospital.

David Ortiz, who has been coming to The Jacobi Medical Center for the past eight years, was very surprised that Jacobi was rated as the worst hospital in the nation and said the report would not stop him from coming here.

“They always treat me very well. They really care about their patients,” Ortiz said. “If I didn’t think they were good I would not have come here for 8 years.”

Michael Robinson,who works as a vendor and helps hire hospital staff members, also disagreed with the report.

“I don’t think the report is accurate at all. Their customer services are excellent!” said Robinson, who has been coming to Jacobi for two years. “It really hurts me when I see things like that. This hospital is the landmark of the community and it is the busiest hospital in NYC. I don’t think the report will affect them at all.”

Groups of friends try out different flavors of smoke at Lamoza, a new hookah lounge in Bay Ridge. (Alysia Santo/The Brooklyn Ink)

By Alysia Santo

Eighteen-year-old Vas Vasolo and nineteen-year-old Hani Kinani are spending the evening at this hookah bar in Bay Ridge to share the sweet flavored “double apple” smoke and to hang out with kids their own age.  “We come to this place because we know we won’t find a bunch of fourteen year olds,” says Vasolo, taking a bite of his cheese fries at The Village, a restaurant, bar, and hookah lounge on 3^rd Avenue.

Just a few years ago, they were the youngsters they are now trying to avoid. “We knew which places to go where they didn’t ID,” says Kinani. The hookah, a curvy water pipe with multiple hoses to smoke from, is often shared in social gatherings, particularly in the Arab world, where the apparatus is called a shisha. Yet these American teens now see it as a custom all their own. “It’s part of our culture and we’ve grown up with it,” says Vasolo.

Hookah bars or lounges are a growing trend among teens and young adults around the country. Often dimly lit with lights that look like something out of a disco, many lounges feature belly-dancing shows, Middle Eastern bands, bar food, and menus of smoke flavors such as berry blast, mango mist and orange cream.

These shops have proven difficult to control, and Bay Ridge community leaders say they have seen a surge of underage kids using the water pipes, without any way to stop it. At the first Bay Ridge community board meeting since spring, a power point presentation with pictures of hookahs and tobacco was discussed by community board member, Judie Grimaldi. After a summer long investigation by the board, she announced her conclusion, “We have learned that hookah bars fall through the cracks.”

Adel Adley, the manager of The Village, says this isn’t the case at most hookah lounges, “They look at it as something really bad is going on. It’s a very normal process,” he says. Adley says young people come to try it, but that they always check for ID. “Maybe its weird to the American community, but this is an international place. Everybody is curious about other nationalities and what they do.”

An American Lung Association Tobacco Trend Alert from February 2007 calls hookah smoking the first new tobacco trend of the century, and a study from the Journal of Pediatrics found that 23 percent of 18 to 24 year olds say they have smoked hookah.

A recent Florida study found that four percent of middle school students and 11 percent of high school students say they have tried it. With this heightened popularity, these water-pipe parlors are popping up all over the country. Approximately 300 hookah bars opened up between 2000 and 2004 in the United States, many near college campuses according to Smokeshop magazine, and these numbers are puffing on.

The Village opened for business a year ago to a mixed clientele of all ages and ethnicities. Weekends are packed, and the 20 hookahs at The Village are all in use, appearing like mini smoke stacks on the tables. Mounted to the wall is large TV that plays Egyptian music videos, or other music if a customer requests. There is a mix of ethnicities, from Chinese students to a group of middle eastern men playing cards.

Josephine Beckman, the district manager of Community Board 10, which includes Bay Ridge, says about 15 establishments have opened in the area in the past year, with five in just the past few months. Most of the hookah bars are clustered around 5^th avenue, which is the center of this area’s Arabic community.

Astoria also has a large number of hookah bars, says district manager Lucille Hartman, with at least a dozen concentrated in the heavily Arabic community along Steinway Street. According to Hookahbars.com, there are 20 in Manhattan. Complete numbers are hard to track, as many of these places are listed as coffee or tea shops and some do not have phone numbers.

Ramy Rezcalla wanted to share his Egyptian roots when he opened The Village a year ago. The front entrance serves as restaurant, with a separate entrance at the side to the hookah lounge. Rezcalla says he loses customers to the competition because it is his business’s policy to only serve people who are eighteen and up.

He described a scene last week when a reservation for fifteen showed up, and thirteen of them were underage. “We kicked them out. Then we see them around the block with like ten hookahs in front of them,” Rezcalla says.

Bay Ridge community leaders scoured the city and state laws for a way to regulate hookah smoking. District 43’s Councilman, Vincent Gentile, and members of his staff thought state and federal laws would apply. “We posed the question, can you enforce if an establishment is selling to minors under the clean air act, and the answer turned out to be no,” says Beckman, “We can’t use what is on the books because the word hookah is missing”, she says.

The community has stepped up its efforts since the complaints increased a year ago concerning underage patrons, as well as wafts of, what some neighbors call, “sickening” second hand clouds. This board is now working with Councilman Gentile’s office to propose new legislation for these smoke shops on the city level. A spokesperson for Gentiles office says that the legislation is in the brainstorming stages, and it is not clear when –or if– it will be introduced.

According to New York City’s Department of Health and Mental Hygiene, the law concerning “shisha” says only registered tobacco bars can sell flavored tobacco and they must retain the packaging if it is removed before sale to a customer. As with all tobacco products, it is supposed to be limited to those 18 and over, but there are no laws against inhaling smoke that is tobacco free.

A new hookah lounge on 5^th avenue, Elfeshawy, sells a smoke-able substance labeled, “Hydro: Herbal Molasses”. It says on its package that it is wild berry flavored, and tobacco and nicotine free. The owner, Mr. Hany just opened Elfeshawy at the end of September after an Italian restaurant that was here closed down. He says that he has heard about some places serving kids, but that he does not. Lora Borban, a 23-year-old waitress at Elfshawy, is puffing on her blue colored hookah cord as she explains. “Some people think that it makes you high, but it doesn’t have nicotine. I smoke for fun, whatever. But usually I smoke cigarettes if I really want to smoke,” she says.

Down the street from Elfeshawy is the lounge Tarboosh, which serves a tobacco-based hookah. “This consists of fruit mixed with honey. It’s .05 percent nicotine,” says Eddie Skaf, the Lebanese owner. The average American cigarette is 10 percent nicotine. Skaf says he always checks ID’s, and he welcomes regulation by the city, adding that in the seven years he has been open, his clientele has been mostly other Arabic members of his community, “It’s traditional, especially in the Islamic sector, who don’t drink.”

The water filtered smoke of a hookah pipe is considered by most smokers to be less dangerous than cigarettes. The World Health Organization has said this is a dangerous myth. A WHO report in 2005 concluded that a typical one-hour hookah session involves inhaling 100 times the amount of smoke that would be inhaled in a single cigarette session, which usually takes between five and seven minutes.

Adley says this report doesn’t hold up, since most people don’t inhale and it’s nothing like cigarettes, since they keep their use down to once or twice a week. Hani Kinani and Vas Vasolo agree. “We’re not addicted. It’s not an everyday thing,” says Kinani. Vasolo nods, saying, “I wish the younger kids would stop messing it up for everyone else.” Even if there is a crack down on hookah lounges, these teens don’t seem worried, “I have a hookah at home, so I can still do it,” Kinani says.

More on Youth Trends in Brooklyn:

Justin Bieber Mania

Pingpong reigns supreme in the Sunset Park Chinese community

Tight city budget deprives teens of summer career development opportunities

Dr. Betty Shabazz Health Center in East New York celebrated National Women’s Health Week with free health screenings and workshops May 11. The health fair helps to educate people in the community on how to take their medications, maintain regular doctor visits and ask the right questions when meeting with healthcare professionals, according to the Center’s Office Manager Maria Huertas.

“They’re not alone, we are here to service them and answer any questions,” she said of the community.

We talked with patients and staff at the Center and asked them about their biggest health concern.

Felicia Crespo, Patient

Robert Wheeler, Patient

Hafiz Maje, Doctor

Maria Huertas, Office Manager

Olivia Dordan, Outreach Consultant

Tamara Kee, Nurse Supervisor

NY1 reports residents can trade in their supplies of sugary drinks for gift certificates, redeemable for healthier, fresh food and produce.

The streets of Crown Heights are quiet, after a mumps outbreak

Orthodox Jews in Brooklyn are heading to immunization clinics around the city after a mumps outbreak—the largest U.S. outbreak in five years—has spread through the community.

Parents are already grappling with concerns about long-term effects of the disease. Mumps is rarely fatal, but it can lead to orchitis, or swelling of the testicles, which in rare cases leads to reduced fertility.

“I am very concerned,” said Toby Freund, a mother of seven in Boro Park, including two boys in their early 20s. “All my kids were vaccinated, but I’m most concerned about my older boys because mumps in adult males could cause problems and complications in fertility.

Orchitis is the most common side effect being reported, in about 35 cases, according to the Centers for Disease Control and Prevention. The risk is especially worrisome for the Orthodox Jewish community, where large families are valued.

“My gut feeling right now is to leave it alone,” said Freund, who has decided not to get her children the third shot of the vaccine. “But I am concerned, and it is an issue that’s spreading throughout the community.”

Irish scientist Niall Davis has researched the link between mumps and orchitis as it played out in Europe, where the Brooklyn mumps outbreak is thought to have originated.

According to a 2010 report he co-authored on the topic, the incidence of orchitis in the young men is as high as 40 percent.

“The risk of subfertility”—or impaired fertility—“from mumps orchitis is around 13 percent,” Davis said in an email.

If this holds true in the United States, there could be long-term religious and cultural implications for the affected men.

“If it turns out that these men’s fertility is affected on account of the mumps, it’s going to make it very difficult for them to marry,” said Jonathan Sarna, a professor of American Jewish History at Brandeis University. “One of the central commandments—indeed the first—is ‘Be fruitful and multiply.’ In the ultra-orthodox community that commandment is taken very, very seriously.”

This is especially true in orthodox Jewish communities, where there is a heavy dependence on matchmaking. “One of the things that the matchmakers will be looking at is, ‘Is it possible that this guy is sterile?’” Sarna said. “Matchmakers look at the health of the parents and all sorts of other factors. This would be a factor as well.”

The mumps virus spread to New York after a young boy was infected at a summer camp in Britain. The disease has spread quickly among men in their late teens and early 20s in the tight-knit Orthodox Jewish community.

The Centers for Disease Control said the disease has remained localized because of the insular nature of the religious Jewish community. The community has been tight-lipped about the outbreak. Local health clinics direct all requests for comment to the New York City Department of Health, and community leaders were also unavailable for comment.

According to a report published Thursday on the Web site of the Centers for Disease Control, mumps has been on the rise worldwide in the last several years, starting in Britain and Australia, where many children were not inoculated against the disease in the early 1980s due to a now-debunked medical hypothesis that the vaccine could lead to autism.

Over three-quarter of those infected in New York have received the recommended two doses of the vaccine, according to a press release by the New York City Department of Health. The vaccine is only 75 percent to 90 percent effective, according to the department. Pediatric clinics in Williamsburg and Crown Heights are offering a third vaccine for free this week.

Life is busy on the corner of Fulton Street and Nostrand Avenue in Bedford-Stuyvesant. People hurry in and out restaurants and stores. Cars rush by.  But planted firmly at the intersection the other day was a truck from Touchstone Health. It’s a Medicare approved Health Maintenance Organization with a prescription drug program with the government. It was if there was no other way to stand out and grab attention.

A white man in a red jacket and dark hat approached people as they came to the
intersection. He stood out like a sore thumb. He positioned a small table by the truck.
Applications to sign up with Touchstone Health and flyers filled the tabletop.

Medicare Truck in Bed-Stuy Taylor/ Brooklyn Ink

He was eager to talk to people about their healthcare coverage and would stop people by
yelling, “Miss!” Rarely would they actually stop.

Eventually he did manage to stop a woman long enough to ask, “Do you have health care?”

She looked at him with a puzzled look.  “No, they won’t give it to me,” she replied.

“You can get it with us if you make less than $27,000 a year,” he responded.

She smiled and explained that she was unemployed and had no income.

The man drew closer and asked, “What do you do for medicine?”

The woman, who spoke with an accent from the Islands, replied, “I just try to stay
healthy. They won’t give me anything until I turn 65.”

“You don’t qualify,” the man told her.

“That’s what I know,” she snapped back.

The man offered his pen as a token for taken the time to speak with him. She walked away
clutching the pen.

New medical evidence has surfaced that suggests a direct link between playing football and brain damage later in life. Autopsies of a number of former NFL linesmen showed signs of Alzheimer’s and other problems caused by years of hard tackles. High school players, of course, are not immune. It’s enough to terrify a mother.

So, as they stood watching their sons slip around in the rain, parents at Saturday’s PSAL City Championship division quarterfinal game between Fort Hamilton and Lincoln voiced a number of qualms. “I worry very much about head injuries,” said Catherine Scott as she watched her grandson, an offensive center for Lincoln, run onto the field. Linda Scott, his aunt, remembered seeing a particularly scary moment on TV recently in a college game. “Did you see that guy in the Florida game last week? He took a bad hit to the head and you could tell right away, the way he was posturing, it didn’t look good. Those moments, they’re scary.”

A parent watches the action at Sunday's Fort Hamilton game vs. Lincoln High. Photo: Roberts/Brooklyn Ink

“I’ve read all the recent stuff and I do worry about it,” said James Sullivan, a Bay Ridge native who was watching the game. “But I’m not sure high schools can do very much except hope for the best and try to be ready if there is a head injury, God forbid.”

Dr. Ellen Panzer, a chiropractor who treats sideline injuries at Canarsie High School football games on the weekends, said that head injuries are “definitely a big problem.” Panzer specifically mentioned the case of Ryne Dougherty, from New Jersey, as a story that raised concern for her. Dougherty, a junior linebacker at Montclair High School, had sustained a concussion during a Sept. 18 practice this year. After three weeks out, doctors cleared him to play. But in only his second game back, Oct. 11, Dougherty suffered a brain hemorrhage after making a hard tackle. He died two days later.

Some Brooklyn football programs are constrained by budget limitations, as Canarsie High School Head Coach Mike Camardese will tell you. “There’s a new helmet out that conforms to the head, called, I think, ‘Ultra.’ It’s like $300 a pop,” said Camardese. “I’d love to have each kid wearing that helmet, but I could afford to buy my team one. Or say somehow I get even ten of those great helmets, who do I give them to? All the parents would be angry. It comes down to safety and what you can and can’t afford.”

In addition to fancy helmets, some coaches wish for more comprehensive physicals. “I think there should be tests given before the season, neurological exams,” said New Utrecht’s head coach, Alan Balkin. “Then you give all the players the same test again when the season ends. But who has the resources for that. The basic physicals really can’t go that deep.”

One of the main problems, both at the NFL and high school level, seems to be that players repeatedly get hit and go right back in on the next play, figuring it to be just another part of the game. But experts say each of these could be a minor concussion that damages the brain. In the previous month alone, the potential risks of brain damage in football were reported in three major magazine pieces, one congressional hearing, and a number of highly prominent news outlets. A number of parents at the game mentioned being troubled by a story they had heard on National Public Radio, for example.

The congressional hearing was called for after doctors found, in ten deceased NFL players, the type of brain damage typically associated with boxers. Experts pointed to repeated concussions as the direct cause of dementia and other forms of mental illness in these former players. Meanwhile, doctors have estimated that every year, 1 in 10 high school football players suffers a concussion.

Players from Brooklyn Tech, which was defeated by Lincoln in the previous round, showed up at Fort Hamilton High on Sunday to watch the cheerleaders and the game. Photo: Roberts/Brooklyn Ink

Some coaches say they are beginning to watch out for this more than ever. “If a kid suffers a concussion,” said Fort Hamilton’s Coach Vince Laino, “I think the heightened awareness would make me think twice before putting him back into action.” Laino finds himself in an interesting position this season as both coach and parent; his son Frank is the team’s star quarterback.

Not all coaches are as careful about pulling kids if they appear to be dizzy. “I had a kid during the playoffs recently, in a soccer game actually, who had signs of a concussion,” said Sal Aprea of One on One physical therapy, a group that supplies trainers to New York City schools. “And the coach wanted to put him right back in the game in the worst way, but I told him they just had to wait. That tends to be the problem with football, is that kids get hit hard and want to just go right back in the game without stopping.”

Dr. Panzer pointed to the same issue. “Do I think that playing football is inherent to brain damage? No,” she said. “Do I think that there are coaches and players who take the game to a level they shouldn’t? Yes, at times.”

Still, awareness of the danger of concussions seems to be on the rise at the high school level. “At our meeting in June,” said Laino, “the PSAL did a big new thing on concussions. They gave a whole talk to us on what to look for. I found that to be very helpful.”

“We hold the kids out if we think there’s a concussion,” said Coach Camardese. “Not worth the kid’s health. We have that luxury though, because we’re not the NFL.”