Surgery Returns to NYU Langone Medical Center


Chang W. Lee/The New York Times


Senator Charles E. Schumer spoke at a news conference Thursday about the reopening of NYU Langone Medical Center.







NYU Langone Medical Center opened its doors to surgical patients on Thursday, almost two months after Hurricane Sandy overflowed the banks of the East River and forced the evacuation of hundreds of patients.




While the medical center had been treating many outpatients, it had farmed out surgery to other hospitals, which created scheduling problems that forced many patients to have their operations on nights and weekends, when staffing is traditionally low. Some patients and doctors had to postpone not just elective but also necessary operations for lack of space at other hospitals.


The medical center’s Tisch Hospital, its major hospital for inpatient services, between 30th and 34th Streets on First Avenue, had been closed since the hurricane knocked out power and forced the evacuation of more than 300 patients, some on sleds brought down darkened flights of stairs.


“I think it’s a little bit of a miracle on 34th Street that this happened so quickly,” Senator Charles E. Schumer of New York said Thursday.


Mr. Schumer credited the medical center’s leadership and esprit de corps, and also a tour of the damaged hospital on Nov. 9 by the administrator of the Federal Emergency Management Agency, W. Craig Fugate, whom he and others escorted through watery basement hallways.


“Every time I talk to Fugate there are a lot of questions, but one is, ‘How are you doing at NYU?’ ” the senator said.


The reopening of Tisch to surgery patients and associated services, like intensive care, some types of radiology and recovery room anesthesia, was part of a phased restoration that will continue. Besides providing an essential service, surgery is among the more lucrative of hospital services.


The hospital’s emergency department is expected to delay its reopening for about 11 months, in part to accommodate an expansion in capacity to 65,000 patient visits a year, from 43,000, said Dr. Andrew W. Brotman, its senior vice president and vice dean for clinical affairs and strategy.


In the meantime, NYU Langone is setting up an urgent care center with 31 bays and an observation unit, which will be able to treat some emergency patients. It will initially not accept ambulances, but might be able to later, Dr. Brotman said. Nearby Bellevue Hospital Center, which was also evacuated, opened its emergency department to noncritical injuries on Monday.


Labor and delivery, the cancer floor, epilepsy treatment and pediatrics and neurology beyond surgery are expected to open in mid-January, Langone officials said. While some radiology equipment, which was in the basement, has been restored, other equipment — including a Gamma Knife, a device using radiation to treat brain tumors — is not back.


The flooded basement is still being worked on, and electrical gear has temporarily been moved upstairs. Mr. Schumer, a Democrat, said that a $60 billion bill to pay for hurricane losses and recovery in New York and New Jersey was nearing a vote, and that he was optimistic it would pass in the Senate with bipartisan support. But the measure’s fate in the Republican-controlled House is far less certain.


The bill includes $1.2 billion for damage and lost revenue at NYU Langone, including some money from the National Institutes of Health to restore research projects. It would also cover Long Beach Medical Center in Nassau County, Bellevue, Coney Island Hospital and the Veterans Affairs hospital in Manhattan.


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Amid Fiscal Stalemate, How to Handle Tax Rate Uncertainty



So we’re left with no idea how much we’ll be paying in federal income taxes in 2013, and a wide range of possibilities for taxes on investments and estates and tax deductions for mortgage interest and charitable contributions. Plenty of people will spend the next several days feeling helpless, with one eye on the stock market and the other on Washington.


For all the uncertainty, though, we do know a bit about how things will change next year. For example, new taxes, some of which will help pay for Medicare, will affect a few million affluent households.


We also know that in all likelihood, whatever happens in Washington in the coming days or weeks won’t come close to solving the problem that tends to clear the room when you say it aloud: We are not collecting enough money to pay for the promises we’ve made to one another. It isn’t just Medicare, either. Many states have steadfastly refused to set aside the trillions of dollars they will need to cover benefits for public workers once they retire.


As for what you should do about all of this, the answer, for now, is probably nothing. In the short term, stock prices may decline and the economy may get the hiccups, but it’s foolish for amateurs to try to alter their investment portfolios to take advantage of the situation. Leave that to the hedge funds, and watch how many of them get it wrong.


In the long term, however, prepare to make the kind of attitude adjustment that can take a while to embrace. A decade or two from now, most of us will probably be paying more in taxes or getting fewer services from the government than we do now. Once that happens, you’ll need to earn more, save more, live on less or take better advantage of legal tax avoidance strategies.


In fact, you may want to try to do all of these things in the next couple of years, just to see which ones you can accomplish with the least amount of pain.


Here is what we do know will happen in 2013. First, there is a new tax of 0.9 percent on wages, other compensation and self-employment income above $200,000, if you’re single, or $250,000, if you’re married and filing your taxes jointly. This is on top of the existing Medicare tax.


Second, there is a new tax of 3.8 percent on investment earnings, including interest, dividends and capital gains, in addition to whatever the capital gains tax ends up being. It applies to single people with modified adjusted gross income of $200,000, or $250,000 for married couples filing jointly.


There is still some time to maneuver around the second tax. If you have winning investments you were planning to sell soon anyway, say for a down payment on a house, you might as well do it by Monday. That way, you can avoid the new tax if you’re certain you’ll be in the qualifying income category next year.


A few other changes: For now, you can generally take a tax deduction only for unreimbursed medical expenses that exceed 7.5 percent of your adjusted gross income. That floor will rise to 10 percent next year, except for people 65 and over, who won’t be subject to it until 2017.


Also, if you save money in a flexible spending account for health care expenses, 2013 will bring a $2,500 cap on what you can set aside each year while avoiding income taxes. Many people routinely saved $5,000 in the past.


In the next few weeks, we’ll presumably learn more about the new tax rates on income, capital gains, dividends and estates. A solution may come in stages, with a temporary patch now and the promise of a longer-term deal later.


But this is only the beginning, and if you want to read the Stephen King version of our collective fiscal story, there are a few sources to consult. You could start with the radical centrists at Third Way, a research group, who are the best splashers of cold water that I’ve read on the topic of the federal budget. They present some truly scary data while trying to persuade Democrats to accept cuts to Medicare and other programs.


In 2010, for instance, 11,712 people turned 25 each day, while just 6,670 turned 65. By 2030, 12,499 people will be turning 25 each day, but the number turning 65 will jump to 10,948. The 65-year-olds in 2030 will probably live longer than the people who turned 65 in 2010, and keeping them alive could cost a lot more.


The Pew Center on the States, using the states’ own actuarial data, estimates that there is a $1.38 trillion dollar gap between what governments have set aside to pay for public employees’ pensions and retiree health care costs and their actual obligations. Robert Novy-Marx, an assistant professor at the University of Rochester’s Simon Graduate School of Business, and Joshua D. Rauh, a professor at the Stanford Graduate School of Business, believe the shortfall in pension financing alone is actually $3 trillion to $4 trillion.


If states were to try to fill the gap solely by raising taxes, Mr. Novy-Marx and Mr. Rauh estimate that the cost per household in 2011 would have been $2,250 in New York, $2,000 in New Jersey and $1,994 in California — and we’d need to pay that amount every year for 30 years, with adjustments for inflation. Happy New Year!


These numbers boggle the mind, which is why you’re not seeing them in the newsletters that state legislators send to your home. Instead, lawmakers are trying to change the benefits promised to public employees. But even minor changes have led to lawsuits that could take a decade to resolve. By then, the obligations will probably have grown much larger.


Read enough of these reality checks, and a hazy sort of reckoning starts to take shape. It’s not clear how high taxes will go or how many services — from retiree health care to garbage removal — we may someday need to pay more for, or cover ourselves. But it’s going to cost you more money one way or the other, unless you’re in a truly low tax bracket.


That brings us to those legal tax avoidance maneuvers, which often benefit people who can save. Flexible spending accounts for medical costs will still save you hundreds of dollars in taxes each year, even with a $2,500 cap. A health savings account, the kind that pairs up with a high-deductible health insurance policy, can grow into a sizable pile if you save the money and use it in retirement instead of to pay out-of-pocket medical expenses now. And the fact that the affluent can still avoid capital gains taxes, and get an income tax break in many states, on hundreds of thousands of dollars of college savings via 529 plans is a minor miracle.


There is also the Roth individual retirement account, where even the low-six-figure set can put away money on which they’ve already paid income taxes, leave it there for decades in stocks and bonds, and pull it out without paying a dime of capital gains or other taxes.


That’s the story — for now, at least. In 30 or 40 years, if things are really grim, might the federal government try to tax withdrawals from Roth accounts with enormous balances? As we’re learning now, most great tax deals, like the mortgage interest deduction for beach houses and the tax-free health insurance benefits that many of us get from our employers, may not last forever.


We don’t have much control over what will happen in Washington or our state capitals next year, or 10 years from now. But most of us can probably find ways to earn a little more, save a little extra or spend a little less. Pick just one of those options, make it your New Year’s resolution and see if it helps you feel more in control of your financial destiny by this time next year.


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Deadly storm moves through Northeast, dumping snow, sleet, rain









A deadly winter storm that dropped twisters onto the South on Christmas Day raced across the Northeast on Thursday, and bringing with it heavy snowfall, high winds and more canceled flights.


Over the last two days, the storm has dropped heavy amounts of snow, sleet or rain on a vast swath of the country. High winds toppled trees, twisters tore up homes and icy roads became death traps.


On Thursday morning, the heaviest snow was falling across northern New York and into northern New England, the National Weather Service said. Coastal flood advisories were also in effect from Long Island to southern Maine.





PHOTOS: Northeast braces for winter storm


More than 700 flights had been canceled across the nation by noon EST on Thursday, mostly to and from airports currently or previously in the storm’s path, according to the airline monitoring website Flightstats.com.


A Southwest Airlines jet with 129 passengers and five crew members got stuck in the mud on New York’s Long Island after it swerved off a taxiway Thursday morning, the Associated Press said. There were no injuries and a Southwest spokesman said it was not clear if heavy overnight rain contributed to the incident.


The storm system has been blamed for at least 15 deaths so far, including those of two children who died Christmas Day when the car they were in crashed head-on into an SUV on an icy Arkansas road.


A number of other accidents contributed to the toll: An 18-year-old woman died after her car crashed into an oncoming snow plow on a Ohio highway; two people on a scooter lost control and died after slamming into a pickup truck in Evansville, Ind., and in northwest Pennsylvania, a man died in a car accident on an icy road, the Associated Press said.


On Wednesday night, a man was struck and killed while checking on a disabled vehicle near Allentown, Pa., the AP said, while Virginia and Kentucky each reported two fatal crashes.


Some areas of New York and Pennsylvania have seen more than a foot of snow since Christmas Day, the National Weather Service said. Snowfall has predominantly hit the interior portions of the Northeast, while coastal regions have dealt more with rain and high winds.


ALSO:


N.Y. news site stirs outrage after publishing gun owners' names


In note, N.Y. gunman wrote that 'killing people' was what he did best


Newtown desperately needed Christmas after the Sandy Hook massacre





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Freestyle BMX on the Moon? No, Something Very Much Like It



Red Bull has kicked loose a bunch of pics and video from its insane Ramparanoia, an invitation-only freestyle and dirt-jumping competition held in one of the coolest places ever — a pumice field 13,000 feet above sea level.


The Austrian energy drink juggernaut threw around a few boatloads of cash flying Ben Hannon, Aaron Ross, Daniel Dhers and seven other top-level riders to Campo de Piedra Pomez. It’s a surreal yet beautiful pumice field formed half a million years ago near Catamarca, Argentina. The moonscape includes kickers, quarterpipes, transfers and other formations of all shapes and sizes, and no two are the same.


Just the place for a freestyle competition, no? We can’t help but think the world is a better place because Red Bull does crazy stuff like this.


Everyone spent several hours flying aboard a puddle jumper to the wildly remote, and terribly inhospitable, locale, and then had one day to acclimate. The competition, held the week of Dec. 8, began the next day.


Hennon won in a competition where riders judged each other’s moves. “I feel honored to have been invited to this competition and I am happy to have won,” he said in a statement. “The experience was amazing — without a doubt Red Bull Ramparanoia helps to increase the level of BMX even more, because we really had to outdo ourselves to ride in a place far away from everything.”


Hennon won, but everyone agreed Daniel Dhers had the best move of the event: a perfectly executed “360 tail whip to barspin.”


The riders included Hennon, Dhers, Ross, Tobias Wicke, Sebastian Keep, Ruben Alcantara, Kevin Kalkoff, Gary Young, Martin Postigo and Iñaki Mazza. We’d love to be able to tell you who’s in each picture and what kind of move they’re making, but Red Bull didn’t provide much in the way of captions. If anyone can tell us what’s what in the pics, let us know in the comments.


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Christmas box-office haul paces Hollywood for record year






LOS ANGELES (Reuters) – A strong Christmas-day box office performance by musical “Les Miserables” and western “Django Unchained” put Hollywood on pace to set an all-time box office record with $ 10.8 billion in annual revenue, box-office tracker Hollywood.com said on Wednesday.


Universal Pictures‘ star-studded “Les Miserables” took in a weekday Christmas record of $ 18.2 million in the United States and Canada when it opened on Tuesday, according to studio estimates of weekday ticket sales.






Quentin Tarantino‘s spaghetti western “Django Unchained,” starring Jamie Foxx and Leonardo DiCaprio, hauled nearly $ 15 million for The Weinstein Co.


Studios “are definitely on the road to a record year with $ 10.8 billion expected (up 6 percent over last year and beating the previous record of $ 10.6 billion in 2009),” Hollywood.com analyst Paul Dergarabedian told Reuters in an email, adding that the number of tickets sold should climb 6 percent from 2011 to 1.36 billion.


Dergarabedian credits a successful marketing year for studios as a chief reason for the projected box-office record, as well as spring and summer smashes “The Hunger Games” and “The Avengers” helping boost revenue.


“It was not just the fact that most of the movies delivered, it was the timing of their release dates and the marketing was obviously effective as well with social media continuing to provide an outlet for the movie-going peer group to talk about their favorite flicks,” Dergarabedian said.


“The Hobbit: An Unexpected Journey,” based on the J.R.R. Tolkein classic fantasy novel, brought in $ 11.4 million on Christmas day after ruling the box office with nearly $ 37 million in sales over the weekend.


Billy Crystal family film “Parental Guidance” debuted in fourth place with about $ 6.4 million in Christmas sales while Tom Cruise’s “Jack Reacher,” which featured author Lee Child’s character in an investigation into a sniper shooting, was fifth with some $ 5.3 million.


“The Hobbit” was distributed by Time Warner Inc’s Warner Bros. Studio. News Corp’s 20th Century Fox released “Parental Guidance” and Paramount Pictures, a unit of Viacom, released “Jack Reacher.” Universal Pictures is owned by Comcast Corp.


(Reporting by Eric Kelsey; Edited by Ronald Grover and Andrew Hay)


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Home Tech: Devices to Monitor Physical Activity and Food Intake


STEP LIVELY Fitbit One pedometer clips onto your belt or pocket to record activity.







WHEN I received the results of a routine cholesterol test this summer, I was certain there had been some kind of mistake. I’m young, unstressed and healthy, or so I imagined. I work out, too, and most impartial observers — and some partial ones — would describe me as lean. Plus, I eat a nutritious diet, I swear. So why did my LDL levels surpass my I.Q. — or, for that matter, Einstein’s?




The facts were stark: My genes predisposed me to metabolic syndrome, my doctor told me. Like my forebears, I was on a fast path to heart disease and diabetes. My doctor ordered me to reduce my carbs and come up with a more stringent exercise plan. I’ve rarely monitored what I eat and how much exercise I get. I had no idea how to go about the logistics of it. How would I count my carbs? How would I track my fitness routine?


Of course, there are apps for that. I set out to scour the market for devices and programs to help me and any family member who wished to join me in my low-carb adventure improve our health. I found two kinds of technologies: fitness trackers to monitor physical activity, and P.C. and smartphone apps to track diet. I spent weeks testing several of them. And while I found a few to be quite helpful, they were all just short of fantastic.


I tried four high-end fitness gadgets: Nike’s FuelBand ($149), the Fitbit One ($99.95), Jawbone’s Up ($129.99) and the BodyMedia FIT wireless armband ($149). I also threw in a plain-Jane pedometer, the Omron HJ-720ITC, which I found for $31 at many stores online.


All of these devices work in a similar way. You attach them to your person (the FuelBand and Up fit around your wrist, the FIT goes around your upper arm, and the Fitbit and Omron pedometer can be placed in a pocket or clipped to your belt). Then, as you move, the devices measure your activity.


Unfortunately each device had major drawbacks. Even though I had gotten the proper size, I found that the Up and the FuelBand did not fit well around my wrist. They tapped against my desk while I typed, and they slid about uncomfortably when I washed the dishes. (They are both water-resistant.) BodyMedia’s FIT, meanwhile, is about the size of a man’s large wristwatch. Positioned directly against the skin around the upper arm, it is ungainly — I found it distracting when I was in a short-sleeve workout shirt, and strange-looking under a nice button-down shirt.


The pedometer and the Fitbit were easier to handle; I hardly noticed them crammed with my keys and phone in my pocket. On the other hand, because they are not wearable, I often forgot them on my bedside table, where they did no good.


Still, among these vast offerings, I found the Fitbit and the cheap Omron to be best. The Fitbit is an unobtrusive slab of plastic about the size of a U.S.B. thumb drive. Its software — which is available for Macs and Windows P.C.’s, as well as iOS and Android devices — is simple to learn and offers plenty of graphs and stats to track your progress. The most useful is a graph of your activity over the course of the day: you can see how many calories you burned while at work and alter your behavior accordingly. Maybe go for a brief walk after lunch?


(I was a big fan of Jawbone’s Up software, too, but I ultimately found it too limited: It works only on Apple’s iOS devices; the company has not yet made versions for P.C.’s or Android devices.)


The best thing about the Fitbit is its wireless syncing capability. It comes with a tiny receiver that plugs into your computer’s U.S.B. port; whenever your Fitbit is near your machine, it sends its data over the air, no physical docking required. It also syncs directly to your phone over Bluetooth. (You do have to plug your Fitbit in to charge it, but only rarely — you can go more than a week between charges.)


The Omron, by comparison, does not do wireless syncing, and its optional P.C. software is pretty basic. But paucity is its beauty. No setup is required. Just turn it on and leave it in your pocket. At the end of the day, peek at its screen — in large, readable type, it shows a single stat: how many steps you have walked that day. The Omron does not promise the world, but it delivers enough information to keep you healthy.


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Obama, Democrats, winning over public on 'fiscal cliff'








WASHINGTON -- Americans are increasingly doubtful that Congress and the White House will reach a budget deal as the deadline to the "fiscal cliff" approaches, according a new poll, though more said they still think a compromise will eventually be formed out of the fight.
 
According to Gallup, just 50% of those polled said they think President Obama and Congress are at least somewhat likely to reach a budget compromise, down from a high of 59% on Dec. 9. An increasing number, 48%, said they see no resolution before a deadline of Jan. 1.
 
The cliff, that self-imposed deadline set in place last year to force a deal on government expenditures and revenues, would institute broad spending cuts across government programs and allow President George W. Bush's tax cuts to expire. Both Republicans and Democrats have offered evolving proposals on how to avoid both actions.

PHOTOS: Notable moments of the 2012 presidential election
 

But as they have sparred back and forth, with House Speaker John Boehner's "Plan B" proposal notably failing prior to the shutdown in Washington for the Christmas holiday, Obama and his allies appear to be coming out on top, at least in the court of public opinion as measured by Gallup.
 
A majority of survey respondents, 54%, said they approve of the way that Obama has handled the negotiations, and 45% said they approve of Democratic leaders in Congress. Just 26% said they approve of Boehner and the Republican congressional leadership.
 
That's a sharp increase for Obama and the Democrats, 6% and 11%, respectively, since Gallup's last round of polling Dec. 15-16. Approval ratings for Boehner and the Republicans remained low, increasing by 1 point for the House speaker and decreasing by 3 points for his colleagues.
 
A majority of respondents, 68% to 22%, also said they favor compromise over strict adherence to principles in the budget negotiations.

QUIZ: How much do you know about the fiscal cliff?
 

Obama is scheduled to return to Washington by midday Thursday to restart negotiations, cutting short his holiday vacation to Hawaii. He will be met by the House and Senate, which are reconvening after the holiday, though neither chamber has any specific legislation laid out on their schedules.


The poll was conducted between Dec. 21 and 22 via telephone interviews with 1,076 people, with a margin of error of +/- 4 percentage points.


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Wired Science Space Photo of the Day: Really Hot Stars











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Britain’s royal family attends Christmas services






LONDON (AP) — Britain‘s royal family is attending Christmas Day church services — with a few notable absences.


Wearing a turquoise coat and matching hat, Queen Elizabeth II arrived at St. Mary Magdelene Church on her sprawling Sandringham estate in Norfolk. She was accompanied in a Bentley by granddaughters Beatrice and Eugenie.






Her husband, Prince Philip, walked from the house to the church with other members of the royal family.


Three familiar faces were missing from the family outing. Prince William is spending the holiday with his pregnant wife Kate and his in-laws in the southern England village of Bucklebury. Prince Harry is serving with British troops in Afghanistan.


Later Tuesday, the queen will deliver her traditional, pre-recorded Christmas message, which for the first time will be broadcast in 3D.


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Op-Ed Contributor: Our Failed Approach to Schizophrenia



TOO many pendulums have swung in the wrong directions in the United States. I am not referring only to the bizarre all-or-nothing rhetoric around gun control, but to the swing in mental health care over the past 50 years: too little institutionalizing of teenagers and young adults (particularly men, generally more prone to violence) who have had a recent onset of schizophrenia; too little education about the public health impact of untreated mental illness; too few psychiatrists to talk about and treat severe mental disorders — even though the medications available in the past 15 to 20 years can be remarkably effective.


Instead we have too much concern about privacy, labeling and stereotyping, about the civil liberties of people who have horrifically distorted thinking. In our concern for the rights of people with mental illness, we have come to neglect the rights of ordinary Americans to be safe from the fear of being shot — at home and at schools, in movie theaters, houses of worship and shopping malls.


“Psychosis” — a loss of touch with reality — is an umbrella term, not unlike “fever.” As with fevers, there are many causes, from drugs and alcohol to head injuries and dementias. The most common source of severe psychosis in young adults is schizophrenia, a badly named disorder that, in the original Greek, means “split mind.” In fact, schizophrenia has nothing to do with multiple personality, a disorder that is usually caused by major repeated traumas in childhood. Schizophrenia is a physiological disorder caused by changes in the prefrontal cortex, an area of the brain that is essential for language, abstract thinking and appropriate social behavior. This highly evolved brain area is weakened by stress, as often occurs in adolescence.


Psychiatrists and neurobiologists have observed biochemical changes and alterations in brain connections in patients with schizophrenia. For example, miscommunications between the prefrontal cortex and the language area in the temporal cortex may result in auditory hallucinations, as well as disorganized thoughts. When the voices become commands, all bets are off. The commands might insist, for example, that a person jump out of a window, even if he has no intention of dying, or grab a set of guns and kill people, without any sense that he is wreaking havoc. Additional symptoms include other distorted thinking, like the notion that something — even a spaceship, or a comic book character — is controlling one’s thoughts and actions.


Schizophrenia generally rears its head between the ages of 15 and 24, with a slightly later age for females. Early signs may include being a quirky loner — often mistaken for Asperger’s syndrome — but acute signs and symptoms do not appear until adolescence or young adulthood.


People with schizophrenia are unaware of how strange their thinking is and do not seek out treatment. At Virginia Tech, where Seung-Hui Cho killed 32 people in a rampage shooting in 2007, professors knew something was terribly wrong, but he was not hospitalized for long enough to get well. The parents and community-college classmates of Jared L. Loughner, who killed 6 people and shot and injured 13 others (including a member of Congress) in 2011, did not know where to turn. We may never know with certainty what demons tormented Adam Lanza, who slaughtered 26 people at an elementary school in Newtown, Conn., on Dec. 14, though his acts strongly suggest undiagnosed schizophrenia.


I write this despite the so-called Goldwater Rule, an ethical standard the American Psychiatric Association adopted in the 1970s that directs psychiatrists not to comment on someone’s mental state if they have not examined him and gotten permission to discuss his case. It has had a chilling effect. After mass murders, our airwaves are filled with unfounded speculations about video games, our culture of hedonism and our loss of religious faith, while psychiatrists, the ones who know the most about severe mental illness, are largely marginalized.


Severely ill people like Mr. Lanza fall through the cracks, in part because school counselors are more familiar with anxiety and depression than with psychosis. Hospitalizations for acute onset of schizophrenia have been shortened to the point of absurdity. Insurance companies and families try to get patients out of hospitals as quickly as possible because of the prohibitively high cost of care.


As documented by writers like the law professor Elyn R. Saks, author of the memoir “The Center Cannot Hold: My Journey Through Madness,” medication and treatment work. The vast majority of people with schizophrenia, treated or untreated, are not violent, though they are more likely than others to commit violent crimes. When treated with medication after a rampage, many perpetrators who have shown signs of schizophrenia — including John Lennon’s killer and Ronald Reagan’s would-be assassin — have recognized the heinousness of their actions and expressed deep remorse.


It takes a village to stop a rampage. We need reasonable controls on semiautomatic weapons; criminal penalties for those who sell weapons to people with clear signs of psychosis; greater insurance coverage and capacity at private and public hospitals for lengthier care for patients with schizophrenia; intense public education about how to deal with schizophrenia; greater willingness to seek involuntary commitment of those who pose a threat to themselves or others; and greater incentives for psychiatrists (and other mental health professionals) to treat the disorder, rather than less dangerous conditions.


Too many people with acute schizophrenia have gone untreated. There have been too many Glocks, too many kids and adults cut down in their prime. Enough already.


Paul Steinberg is a psychiatrist in private practice.



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