Fixing Public Housing: A Day Inside a $32 Billion Problem

The six brick buildings sit on a hill in West Harlem winding with spacious tree-lined paths. They tower high enough to give many of the 3,000 New Yorkers that reside there enviable views of Manhattan. And on each floor of the 20-story buildings, open terraces bathe residents in light and fresh air.

But inside the apartment units of the Manhattanville Houses, a development with one of the worst maintenance backlogs in the city, living conditions have deteriorated. Leaks, crumbling walls and peeling paint have become the norm.

After years of disinvestment, and amid a pervasive culture of cover-ups it admitted to in federal court in June, the New York City Housing Authority has struggled to keep pace with basic repairs in its 325 developments. The agency faces a daunting backlog of more than 170,000 open work orders for repairs, almost double the number housing officials say they can actually manage.

To see what saving the nation’s largest public housing system really means on the ground, The Times shadowed a Nycha superintendent at the Manhattanville Houses during a recent workday.

8:45 a.m.

John Sotomayor knocked on the door three times and then called out: “Housing!”

Mr. Sotomayor, a superintendent, waited patiently until Thomas Hickman opened the door. Mr. Hickman, 52, a film producer, had submitted several work order requests months ago to replace rotten kitchen cabinets he said had attracted mice.

“They had a family down there,” said Mr. Hickman, who lives in the three bedroom with his wife and bedridden mother-in-law. He said he waited in vain for Nycha to fix the problem: “They said they were coming and they never came.”

But now, in a flurry of activity, carpenters were replacing Mr. Hickman’s cabinets and plasterers had repaired the water-damaged wall behind them.

That sort of work typically takes months, not days.

For the past two months, Mr. Sotomayor has been overseeing a special program meant to speed up repairs and reduce the maintenance backlog at the Manhattanville Houses. The vast majority of open work orders at Nycha apartments require skilled trades workers like painters, plasterers, plumbers, carpenters and electricians.

The financially challenged agency, however, has struggled to hire enough of these workers, leading to interminable wait times for basic repairs. A resident with a damaged wall, for example, will wait an average of about 100 days for a plasterer and three months more for a painter to finish the job.

Under the new program, Nycha has targeted several dozen developments with the most extensive maintenance backlogs and concentrated teams of contractors and temporary skilled trades workers there to rapidly close individual work orders. The goal is to close 50,000 work orders within two years using $20 million the city allocated earlier this year.

9 a.m.

Mr. Sotomayor, 54, continued to crisscross the sprawling grounds of the development. A Long Island native, Mr. Sotomayor juggles the daily logistics of directly supervising repairs and ensuring his team meets its performance goals at a time when all eyes are on the troubled agency.

“It’s hard to make sure that nothing falls through the cracks,” Mr. Sotomayor said.

Next up was the home of Muhammed Aklas, who was grappling with leaks in almost every room of his five-bedroom apartment. Mr. Aklas, 62, a retired cook from Bangladesh, lives with his wife on the first floor — a curse in a rundown high rise.

“When something leaks all the way up on the 20th floor, odds are it’ll leak all the way down here,” Mr. Sotomayor said.

Mr. Aklas knew the problem well. “Flooding, flooding, flooding,” he said. “Anybody has a problem and we flood. It is nasty water.”

He and his wife would be moving to a two-bedroom soon, now that their eight children were grown — he hoped to a dryer apartment.

The leaks stem from the building’s troubled piping system, a problem many Nycha buildings share. Properly addressing it requires extensive capital investments the agency currently cannot afford, Cathy Pennington, the executive vice president of operations, said in an interview.

Indeed, the task ahead is enormous. Nycha’s efforts to reduce its maintenance backlogs are dwarfed by the staggering $32 billion the agency says it needs to address the underlying problems in its aging buildings.

“If you don’t get to the capital improvements you’re constantly chasing leaks,” Ms. Pennington said.

9:30 a.m.

Shirley Wright was waiting for Mr. Sotomayor. She had been waiting for more than a year.

That’s how long Ms. Wright, 70, had to fare with a massive hole in her bright yellow shower wall that was left by a worker who replaced her shower head but never returned to cover the basketball-size opening.

Mr. Sotomayor told her that the hole would be fixed that afternoon and that painters were scheduled to fix the damp, peeling paint in her kitchen and hallways later in the day.

“I’m glad it’s getting fixed,” Ms. Wright, a retired special education teacher, told him. “It just took so long.”

Both Mr. Aklas and Ms. Wright offered similar stories: They had reported the conditions for months, but every time they made a work order request, they said, the order would mysteriously get closed without any work getting done, a common complaint among residents.

In fact, a federal investigation found that during the Bloomberg administration, Nycha routinely closed work orders without doing any repairs in order to artificially lower the number of open maintenance requests.

Nycha officials, however, argue that tenants are often not home when workers show up for repairs. At least one tenant refused to let plasterers in for a scheduled repair during The Times’s visit.

9:50 a.m.

Three floors below, Orelis Rodriguez, 55, immediately recognized Mr. Sotomayor when she swung open her door. Mr. Sotomayor had spent the better part of the previous evening in her apartment fixing a toilet flange one of his workers had accidentally broken.

Workers had been scheduled to repair her kitchen cabinets, but soon discovered other issues in the two-bedroom apartment: a broken pipe, disintegrating kitchen walls, peeling paint — and the broken toilet. Mr. Sotomayor said he had expedited her repairs so they would be completed before a chemotherapy appointment she had the following week.

“Housing says they don’t have money and I feel bad for them,” Ms. Rodriguez, originally from the Dominican Republic, said in Spanish. “But I pay my rent.”

11 a.m.

Back at his makeshift command center, Mr. Sotomayor added meticulous, handwritten notes to a list detailing the 1,500 backlogged work orders at the Harlem development. In two months, his workers had gone through half of the list, or, as he calls it, “The Bible.” Then he filed some recently finished repair jobs, including a new apartment door that should have been installed a year ago.

A former engineer in the Navy, Mr. Sotomayor is a versatile fixer with a no-nonsense attitude. He has been at Nycha for more than 20 years, first as a maintenance worker and now as a superintendent. Mr. Sotomayor, who spends his spare time repairing and racing old hot rods, said he stopped seeking promotions within the agency a long time ago.

“I don’t like sitting behind a desk playing politics,” he said, his tattoo-covered arms stretched over the plastic folding table. “I prefer to be out on the field.”

He said his guiding principle in reducing the overwhelming number of backlogged repairs was to try to keep tenants happy:

“Tenants are already upset with Housing not addressing their concerns right off the bat. So I try to minimize the visits, do the work and get out.”

1 p.m.

But not all residents are satisfied.

Emma Barricelli, the president of the residents’ association at the Manhattanville Houses, said she was grateful Nycha had brought in backup. But the temporary program doesn’t address repairs submitted after late May. And she fears the backlog will grow again once Nycha shifts its temporary workers to other developments in about a month.

“They’ve been doing a hell of a lot of work,” Ms. Barricelli said, behind the desk in her office. “But it’s not fair for the residents.”

Ms. Barricelli, who has lived at the development for more than 50 years, was elected by residents to represent their interests. She knows the workers at the development by name and she has grown increasingly vocal as conditions have rapidly deteriorated.

“She’s keeping me on the hook,” Mr. Sotomayor said with a chuckle.

3 p.m.

Another resident, Bryan Thompson, said some of the permanent maintenance workers at the development remained as bad as ever.

A month ago, he said, his upstairs neighbor used a chemical drain opener twice to unclog a shower drain. The powerful acid ate through the pipe, which leaked constantly and stained his shower walls.

He said a maintenance worker showed up twice to assess the damage, then closed the work orders without attempting to repair it.

Mr. Thompson said he repeatedly called 311, Nycha’s borough office and the main headquarters to no avail. It wasn’t until Ms. Barricelli called Nycha for him, he said, that the agency sent a plumber to fix the leak earlier this week.

“I called a couple of people that I knew and they listened,” she said. “But it should have been considered an emergency repair and fixed immediately.”

Nycha has 5,000 fewer employees than it did 10 years ago, which has compounded the self-replicating maintenance woes at its developments. The 71 temporary skilled trades workers hired for the new program are helping, but officials acknowledge they aren’t enough.

“Do we want to hire more? Absolutely, yes we do,” Ms. Pennington said. “Do we have adequate funding to hire additional staff? Absolutely no.”

[1] https://www.nytimes.com/2018/07/26/nyregion/inside-public-housing-fix.html?partner=rss&emc=rss

Joshua Trees Destroyed in National Park During Shutdown May Take Centuries to Regrow

The partial government shutdown ended last week after 35 days, but conservationists have warned that its impact may be felt for hundreds of years in at least one part of the country: Joshua Tree National Park.

The Southern California park, which is larger than Rhode Island and famed for its dramatic rock formations and the spiky-leafed Joshua trees from which it takes it name, had only a skeleton crew of workers during the shutdown.

With most of its park rangers furloughed, vandals and inconsiderate guests ran amok. Gates and posts were toppled, new roads carved through the desert by unauthorized off-road drivers, and a small number of the park’s thousands of Joshua trees were outright destroyed, conservationists said.

Pictures posted to social media showed trees that were chopped down or that appeared to have been driven over by cars. The sensitive ecosystem of desert and craggy rock formations that surrounds them was littered with garbage and other telltale signs of illegal camping.

Most visitors to the park were well-behaved, said John Lauretig, a former park ranger who now runs Friends of Joshua Tree, a nonprofit group that organized a small army of volunteers to help clean the park during the shutdown.

“It was just a few vandals or people acting out of ignorance that caused these problems,” he said, reflecting on the broken trees. “Hopefully it’s not malice. Maybe they just didn’t see them.”

The volunteer cleanup crew, which numbered about 100 people, cleaned bathrooms and repaired broken gates and fences. But, unlike those tasks, replanting and growing the park’s namesake Dr. Seussian trees takes a very long time.

“Because these trees are so big and they grow so slowly, it can take hundreds of years for a tree to mature,” Mr. Lauretig said. “We say they grow an inch a year, and in a wet year it might grow five inches or a foot but in a dry year it might not grow at all.”

At a rally on Saturday near the park, Curt Sauer, the former park superintendent who retired in 2010, agreed.

“What’s happened to our park in the last 34 days is irreparable for the next 200 to 300 years,” he told the crowd, according to The Desert Sun, a local newspaper. Mr. Sauer did not respond to messages seeking comment, nor did David Smith, the park’s current superintendent.

An online guide to Joshua trees published by the National Park Service identified them by the scientific name Yucca brevifolia, a form of yucca plant that is a member of the Agave family.

That taxonomy means it can be tricky to determine their age or to estimate the length of time it might take to a replace a destroyed specimen, Mr. Lauretig said.

“They’re yucca plants, so they don’t grow with rings, like a tree, so you can’t count their age that way,” Mr. Lauretig said. “All we can do is make estimates.”

According to the park-service guide, the plants — which it says are valued for their “grotesque appearance” — tend to grow at a rate of one-half inch to three inches per year, so conservationists often use a Joshua tree’s height to guess its age.

That’s a not-insignificant margin of error, though, caused in part by the erratic nature of the tree’s growth: Young ones can grow quickly for the first five years of their lives, only to slow down or pause for the next several years, the park said.

In short, there are a lot of unknowns. Especially when the trees get to be tall.

“The tallest Joshua tree in the park looms a whopping 40 feet high, a grand presence in the Queen Valley forest,” the park said. “Some researchers think an average life span for a Joshua tree is about 150 years, but some of our largest trees may be much older than that.”

[1] https://www.nytimes.com/2019/01/29/us/joshua-tree-shutdown.html?partner=rss&emc=rss

Inside a Designer’s Theatrical Apartment and Studio in Rome

The furniture and object designer F. Taylor Colantonio, dressed in a red-trimmed poet’s blouse, gives a gentle shove to a fluted Doric column in his small, theatrically furnished loft in the Campo de’ Fiori neighborhood of Rome. The column wobbles loose from the wall, revealing itself suddenly to be light as Styrofoam, phony as a stage set. “Everything in my house is fake,” says Colantonio. “I’m a punk collector. It’s all fake.”

In addition to working on interior design projects for private clients, Colantonio, 30, creates surrealist objects, which range from coiled-rope vases to snakelike rebar candlesticks to transparent rugs. Championed by Alex Eagle, the owner of the Store, and the design dealer Jermaine Gallacher (who both sell his work in their London boutiques), his pieces are often offbeat interpretations of chintzy suburban décor and imitations of antiquity.

At his apartment’s towering picture window, a ceramic tiger — a flea market find as big as a real cub — stands guard, across from a daybed upholstered with hand-painted violet-striped linen. Colantonio composed an intricate savanna mural for the wall above — tropical creatures amid palms and yellow roses — rendered in the chalky children’s tempera paints he prefers. In the dining alcove, in front of a collection of modern ceramic vases inspired by ancient urns, is a black-and-cream vase of his own creation. It occupies a 19th-century walnut table and recalls a Greek kylix, but it flops, uncannily, to one side, its body made not of rigid and impermeable pottery, but of softly coiled machine-braided rope. “The wonkiness gives it personality and gesture,” Colantonio explains, lifting it by its squishy lollipop-like handles. The vase is a vase in idea only. A fake.

The great-grandson of an Italian immigrant, Colantonio was raised in the suburbs of Massachusetts, studied furniture design at RISD and moved to this loft in Rome two years ago, just after completing an artist’s residency in Puglia with a maestro of traditional papier-mâché. Though his works are still fabricated in factories in Rhode Island, rather than in local artisan workshops, Colantonio prefers to live in this ancient Italian city, where he can look to its Classical and Baroque architecture and the Surrealism of Giorgio De Chirico — whose own fake-filled home is nearby — rather than follow the currents of the contemporary design world. “As someone making things, it’s really nice to live in a cosmopolitan setting like Rome, but to be free of the present, to avoid all those trends and influences,” he says.

Colantonio crosses the Tiber River each day to his studio in the vibrant Trastevere neighborhood. The space once belonged to another lover of fakery — the impish artist Gino De Dominicis, who faked his own death in 1969 — but today it is strewn with Colantonio’s current projects. Among these are sheets of wallpaper inked to mimic the striped walls of a circus tent and a series of woven PVC lamps, their clear vinyl surfaces painted with swirls of colors in a homage to Carla Accardi, the Roman artist who helped pioneer the Arte Povera movement.

In the intimate glass-roofed space, Colantonio stands attaching cloth-covered electrical cables to the rainbow-colored cluster of lights at his tall wooden work table. To his back, a pair of six-foot-tall rope vases stand, slouching like sleepy sentinels; on a vintage armoire hang two blazers, hand-painted by Colantonio with the ancient columns and architecture that decorated De Chirico’s Ballets Russes costumes; on the floor lie a few of what he calls his “magic carpets” — seemingly pedestrian Persian throw rugs that are, in fact, made of transparent plastic and expose rather than cover the floor underneath. It’s a “material shift,” he says, “that removes the rugness of the object.”

“I’m interested in giving people a connection to an archetype, to something familiar,” says Colantonio. But there must always be a surprise, a shift that blurs the line between the suburban and the exotic, the mass-produced and the handmade, the authentic and the fake. “Familiarity is essentially trash, but it offers people the possibility to understand,” he says, as he flaps a stiff crystalline rug down on the floor, handling the unbending sheet as if it were actually supple textile. “I’m genuinely interested in the trash, but I’m looking for the sweet spot between familiarity and the avant-garde.”

[1] https://www.nytimes.com/2019/01/28/t-magazine/f-taylor-colantonio-designer-studio.html?partner=rss&emc=rss

Juicy Fish, Crisp Potatoes and Minimal Fuss

May I say there are few combinations better than fish and potatoes? I don’t think anyone could argue convincingly to the contrary.

Fish and chips are an obvious example of how good a pairing it is, and New England fish chowder would be decidedly one-dimensional without the world’s best-loved tuber in the picture.

This week I’m offering an easy, flavorful method for roasting any type of firm-fleshed fish fillet, in this case halibut, to served with roasted potatoes.

I tested the recipe with several types of fish. Cod fillets, though tasty, seemed too tender, and seemed to cry out for mashed potatoes and peas. Tilefish, grouper and monkfish, all firmer and meatier, were much better candidates. In the end, lean, sweet Pacific halibut was my preferred choice, but go with whatever looks best at the store.

The simple seasoning mimics one I often use for pork chops; it’s just salt and pepper, roughly chopped rosemary, garlic, crushed fennel seed and a drizzle of olive oil. (For that matter, it’s a seasoning mixture that makes nearly anything taste good.)

I’m a fan of any sort of roasted potato, and I love the addictive, golden “roasties” that accompany a Sunday dinner in Britain. They’re made with peeled parboiled potatoes, which are then roasted to crispness in hot fat. Though normally they accompany roast beef or lamb, they would be welcome with fish too.

But I had beautiful medium-size fingerling potatoes from the farmers’ market. Rather than peel them, I boiled them skin-on, split them lengthwise, coated them with olive oil and spread them cut side up in a shallow roasting pan in one layer. Into the oven they went.

A half-hour later, when the potatoes were nicely browned, I simply pushed them to the sides of the pan to make room for the halibut fillets, which were ready in about 15 minutes and emerged wonderfully aromatic.

All that remained to do was to chop a little parsley, lemon zest and rosemary to scatter over everything, adding a bright green subtly perfumed hit. Lemon wedges on the side gave diners the option of upping the citrus quotient.

[1] https://www.nytimes.com/2019/01/28/dining/halibut-potatoes-recipe.html?partner=rss&emc=rss

Caroline Elton Helps Doctors Heal Themselves

Caroline Elton, 61, the author of “Also Human: The Inner Lives of Doctors,” is a London-based psychologist with an unusual practice. Her patients are physicians unhappy in their work.

We spoke for two hours on a recent afternoon in New York City. An edited and condensed version our conversation follows.

You titled your book “Also Human.” Why?

My editor wanted to call it “Only Human.” I was adamant that it should be “Also Human.” I had written a book about the shared humanity of doctors and patients. Both are human!

We often hear about how the medical system — in both the U.K. and in the U.S. — dehumanizes the patient. But what about the physician? Medicine is such a psychologically demanding profession. We’ve lost sight of that.

When physicians come to my office, it’s often because the people around them have forgotten that doctors are also human. Given the stresses of their work, they often can’t be the doctors they wish to be. Sometimes, they tell me, they’d like to leave the profession altogether.

What are their stresses?

I see a lot of anxiety. I see doctors who often feel that they are tasked with making decisions that they haven’t been trained for. I see doctors unable to help because of the sheer numbers of sick people they must see every day.

A lot of my clients are young. We know that in the U.K. and in the U.S., there’s a high level of depression in the early years of practice. That trickles down to patient outcomes. Depressed doctors make more mistakes and have less satisfied patients. Depressed doctors have patients who are less likely to follow medical advice.

My clients worry about something going wrong and that they’ll be blamed. They are terrified of litigation.

What did they imagine their lives would be like when they opted to train in medicine?

Well, I think many people go into it thinking it’s going to be all glamorous. They are sometimes motivated by what I call the “George Clooney ‘E.R.’ effect,” envisioning a life where they’ll be saving lives, saving the day. Frequently, the complexity of being a physician and the exposure to suffering is daunting. I’ve had doctors say, “I didn’t realize there would be so many deaths.”

You cite doctors discouraged by unhappy interactions with their patients. Is this anything new?

Medicine is a different world since the internet. Patients can now get medical information themselves and that can lead to a lot of questioning of what the doctor is doing. My clients say that some patients can be overly demanding and sometimes even unrealistic about what can be done.

At the same time, some report bad working conditions. I’ve had doctors come to me because of on-the-job harassment related to their gender or race. My older clients often complain their younger colleagues can be dismissive of their knowledge and expertise. In sum, I see a lot of burnout.

What are you able to do for them?

The first thing is to determine whether their unhappiness is related to their working conditions or to some unresolved psychological issue.

In about six sessions, maybe eight, I try to help them find the smallest change for the greatest psychological gain.

Ditching one’s medical career is such a drastic step. We’ll ask if they can use their training in some other way. Could they go into research or administration? Could they move into a different specialty? If they are in a toxic work environment, could they be doing a comparable job in a different setting?

So my task is to find out what’s going on and then think about the sorts of changes that might be available. If the doctor is extremely depressed or suicidal, I’ll refer them to a psychiatrist.

Give us an example of a patient you helped.

I had a doctor who came from a Vietnamese background. His parents had a not very successful restaurant, working day and night and receiving frequent abuse from drunken patrons.

He was really bright and got into medical school, but he didn’t like working with patients — perhaps because of his parents’ situation. In the end, he decided to go into public health and not be a clinician. That kind of shift can work for some.

Similarly, I had a young woman come to me. She was training to become an oncologist and she had crashed her car twice. What was going on? When we talked, it turned out that her father had died of cancer when she was 7.

Her unresolved grief was coming to the fore in the clinic. She decided that being around cancer was like reopening an old wound. Eventually, she moved over to family medicine.

You write about counseling physicians who are disabled or ill. What are their special issues?

Well, doctors are not supposed to get sick. When it happens, healthy colleagues will sometimes try to push them out, because they don’t want to be reminded of their own vulnerabilities.

I had a client with a physical disability, and he was very good at his job. But a couple of his colleagues bullied him and made his work life intolerable. For him, the solution was to find another hospital to practice in.

I had another client, an obstetrician, who wanted children and was infertile. When fertility treatments failed, her colleagues minimized her distress and acted like she should “get over it,” an attitude they wouldn’t have with their patients. For a time, she considered leaving obstetrics.

As we talked, she realized that she liked the drama of childbirth and wanted to continue in her specialty. I encouraged her to speak to her colleagues. Together we developed a backup strategy: she could move over to emergency medicine. Just knowing that there was a Plan B made it possible to stay.

In both instances, I was able to help the doctors see that this wasn’t about them. The issue was a system that doesn’t allow physicians to feel they are also human and might, at some point, become patients themselves. The behavior was a defense against their own anxieties.

You’re not a big fan of “patient-centered” medicine. Why?

Because effective care is about a relationship between doctor and patient. At the heart of much human suffering is the feeling of being abandoned to it. A sick person needs a relationship with a doctor who cares, who is committed to trying to save them and who will stand with them so that they know they are not alone.

To do that, the doctor needs to feel that somebody is holding their well-being in mind. If medicine is about science, skill and a caring interaction, then we have to consider the needs of all parties.

As a psychologist supporting doctors, does your work ever get to you?

It can. There have been occasions when I saw too many distressed doctors and I was beginning to discern signs of burnout.

Fortunately, British psychologists have supervisors. Having someone I trust to talk with helped me.

Exercise helps, too. I go swimming in the Hampstead Ponds, even in the winter. There’s nothing like the shock of cold water to push out whatever is going on in one’s head.

[1] https://www.nytimes.com/2019/01/28/health/caroline-elton-helps-doctors-heal-themselves.html?partner=rss&emc=rss

How to Use ‘Do Not Disturb’ on Your Phone (While Still Letting Important Calls Through)

My family likes to text each other. A lot. So do my co-workers. Group texts and Slack messages constantly buzz day in and day out, and occasionally, texts and calls will come in while some of us are sleeping or busy — which leads to more texts, crying foul at those who have the nerve to wake us up.

Instead of fighting a losing battle against night texters and bosses who won’t stop messaging you after hours, you can use some of your phone’s built-in settings to silence those notifications, without worrying about missing the really important ones. Here’s how to configure Do Not Disturb mode to let calls through from certain people, at certain times, or only in case of emergency.

On the iPhoneImageThe Do Not Disturb settings screen on Apple’s iPhone enables you to set automatic quiet hours and allow calls from specific contacts.CreditWhitson Gordon

iPhone users have a plethora of options for Do Not Disturb mode, ensuring that only the important stuff gets through. Head to Settings > Do Not Disturb to customize it. In particular, you’ll probably want to adjust the following options:

  • Scheduled: Turn this on, and set it to whenever you go to bed and wake up. Notifications will still appear on the lock screen; they just won’t make noise. If you’d prefer to hide them from the lock screen as well, turn the Bedtime switch on — that way, they’ll only appear when you drag down the Notification Center, rather than tempting you to answer emails at 10 p.m.

  • Allow Calls From: By default, your iPhone will silence all calls when Do Not Disturb is on. With this setting, though, you can allow calls from your Favorite contacts, like your spouse or parents. Also, consider turning on Repeated Calls, too, which will allow calls through if it’s an emergency and the same person calls twice within three minutes. (But watch out for spam callers who try to get around it by calling multiple times in a row.)

Those are the crucial ones, though there are a few other handy settings in this menu, like auto-replying to text messages while you’re driving. Feel free to peruse the other settings while you’re here.

If you enabled the Allow Calls From setting, you’ll need to add contacts to your Favorites group. Open the iPhone’s Contacts app, tap on the person in question, and scroll down to Add to Favorites. Once you have the right people on your Favorites list and the above settings enabled, they’ll be able to call you even when Do Not Disturb is on.

iOS does allow you to allow text messages and iMessages from certain contacts, even though in most cases people will call you if it’s urgent. If you want to enable this feature, head to the contact’s info, press Edit, and under the Text Tone options, choose Emergency Bypass. You can also assign certain vibration patterns to your most important contacts so you don’t even need to look at your phone to know who’s texting. Just tap the Edit button, and under Text Tone, choose Vibration and assign something recognizable. This isn’t specific to Do Not Disturb, but it’s a handy feature that serves a similar purpose: helping you know when certain people are texting so you can judge when something is important and when it can probably wait.

On Android PhonesImageThe Do Not Disturb settings in Google’s Android mobile operating system let you customize vibrations for your contacts and allow repeat calls to come through even when your phone is set to silent.CreditWhitson Gordon

If your phone runs Google’s Android operating system, the Do Not Disturb settings may be laid out a bit differently depending on which phone you use. But here’s the gist of how they work, which should point you in the right direction.

First, open the Settings app and head to Sound > Do Not Disturb. From here, you can customize a few aspects of the feature, including:

  • Sound, vibration, and visuals: You probably want audible notifications turned off when Do Not Disturb is turned on, but you can allow your phone to continue lighting up when notifications come through — though I imagine most people would prefer to have this off.

  • Exceptions: This is the really useful part. Here, you can choose to allow calls or messages (or both) from your “starred” contacts, even when Do Not Disturb is on. This allows you to block most notifications but allow those from your spouse, mother or other important people. You can also allow “repeat callers” so that if someone calls you twice within 15 minutes — as would be common in emergency situations — it bypasses Do Not Disturb.

  • Schedule: Finally, this is where you can schedule Do Not Disturb to automatically turn on and off at specific times, like when you go to bed. You’ll absolutely want to enable this.

I highly recommend turning on an exception for repeat calls and starred contacts, letting you block most notifications in Do Not Disturb mode but allowing the ones you know won’t be sent unless they’re urgent or important. If you do that, make sure to star the right contacts in Android’s Contacts app — just tap on a contact to bring up their info, and tap the star in the upper right corner to mark them as important.

With these settings in place, you can feel much better about using Do Not Disturb liberally — not just at night, but during meetings, date night and whenever else you don’t want to be bothered.

Correction: An earlier version of this article suggested it may not be possible to filter text messages from certain contacts in Do Not Disturb on the iPhone. This version has been updated to note that it is possible, and include instructions on how to do so.

[1] https://www.nytimes.com/2019/01/24/smarter-living/how-to-use-do-not-disturb-iphone.html?partner=rss&emc=rss

When Should I Take an Antibiotic?

Q. I know that antibiotics don’t treat viruses, but at some point, isn’t it time to try one?

A. With the caveat that medical expertise is required to differentiate bacterial illnesses from viral ones, many common infections have features that can help you decide when an antibiotic might be appropriate.

In patients with bronchitis, the Centers for Disease Control and Prevention suggests that an antibiotic could be needed in patients who have a heart rate greater than 100 beats per minute or a fever greater than 100.4 degrees, or who are breathing more rapidly than 24 times per minute.

In patients with sinusitis, the American College of Physicians states that an antibiotic might be indicated when symptoms persist for more than 10 days; are severe; or are associated with three days of fever greater than 102.2 degrees, colored nasal discharge and facial pain. Antibiotics may also be needed in cases of “double sickening,” that is, worsening after several days of initial improvement.

In patients with sore throat, the Infectious Diseases Society of America recommends that antibiotics be used only in patients who have a positive strep test. Symptoms that suggest a viral sore throat — and hence do not require an antibiotic — include cough, runny nose and hoarse voice.

The American Academy of Pediatrics advises that ear infections may require an antibiotic in children older than 6 months who have severe pain, or more than 48 hours of pain, or a fever greater than 102.2 degrees.

Most respiratory infections, including the common cold, however, should not be treated with an antibiotic. The sneezing, runny nose, sore throat, cough, low-grade fever and headache of the common cold will not respond to an antibiotic.

This is also true for most cases of sinusitis, for acute bronchitis (a chest cold), and for most sore throats.

Prescribing antibiotics for viral infections is inappropriate. Yet, many doctors do this. Doctors in the United States write more than 150 million antibiotic prescriptions a year, one-quarter to one-half of which are probably inappropriate.

Such prescriptions bring unnecessary costs, preventable side effects and drug-resistant bacteria. For this reason, it is important to reserve antibiotics for infections that require them.

The best way to ensure that an antibiotic is right for you is to engage your doctor in shared decision-making. A doctor who understands your concerns and who knows your medical history will be less likely to hurry you out the door with an inappropriate prescription.

Do you have a health question? Ask Well

[1] https://www.nytimes.com/2019/01/25/well/live/when-should-i-take-an-antibiotic.html?partner=rss&emc=rss

To Fight Fatty Liver, Avoid Sugary Foods and Drinks

Ultimately, the low-sugar diet was not terribly restrictive. It was not low-carb, nor was it limited in calories. The children could eat fruit, starches and pasta, for example, and they were allowed to eat as much as they wanted. But the goal was to get their added sugar intake to less than 3 percent of their daily calories — less than the 5 to 10 percent limit for adults and children recommended by the World Health Organization.

After eight weeks, the low-sugar group had gotten their added sugar intake down to just 1 percent of their daily calories, compared to 9 percent in the control group. They also had a remarkable change in their liver health. They had a 31 percent reduction in liver fat, on average, compared to no change in the control group. They also had a 40 percent drop in their levels of alanine aminotransferase, or ALT, a liver enzyme that rises when liver cells are damaged or inflamed.

“As a practicing hepatologist, I see children weekly with fatty liver, and I would love to see this kind of improvement in my patients,” said Dr. Vos. “The exciting part was not only did the fat go down, but their liver enzymes also improved. That suggests that they also got a reduction in inflammation.”

The new study was funded in part by the Nutrition Science Initiative, a nonprofit research group that was co-founded by the science and health journalist Gary Taubes, a proponent of low-carb diets. The National Institutes of Health, the University of California, San Diego, Children’s Healthcare of Atlanta and Emory University also provided funding.

Dr. Joel E. Lavine, an expert who was not involved in the study, said it was cleverly done and demonstrated “some important points about what a major constituent of diet contributes to this problem in terms of liver fat and inflammation and cell injury.” He said the ubiquity of unhealthy foods makes such a diet difficult to follow, but that as a general rule doctors should advise patients and their families to check food labels for added sugars and to avoid or eliminate juices.

“The best diet, to make it very simple, is to shop the outside aisles in supermarkets and stay away from the middle aisles containing processed foods that come in boxes, cans and packages,” said Dr. Lavine, the chief of gastroenterology, hepatology and nutrition at Columbia University Irving Medical Center and the Morgan Stanley Children’s Hospital of NewYork-Presbyterian.

The members of the low-sugar group lost about three pounds during the study, which may have contributed to their improvements in liver health. But Dr. Jeffrey B. Schwimmer, an author of the study, said it was unlikely to account for the large changes.

[1] https://www.nytimes.com/2019/01/22/well/eat/to-fight-fatty-liver-avoid-sugary-foods-and-drinks.html?partner=rss&emc=rss

Escaping Homophobia to Live ‘Ordinary Lives With Extraordinary Love’

“Between the Blocks” began by chance: In 2013, the photographer Anna Liminowicz was visiting a friend in Gdansk, Poland, who was to be her subject for a photography assignment at the University of Warsaw. This friend had guests: Honorata, 41; her daughter Natalia, 19; and her partner, Agnieszka, 31. Anna immediately felt at home with them, drawn to their “rawness, warmth and honesty.” When the trio took a nap together on the couch, Anna took their picture.

Looking back, Ms. Liminowicz said she had been so focused on the story that she had intended to tell that “I nearly missed the beauty that was right in front of me. The ‘real’ subject was right there. When they woke up, I asked permission to do a project about them, and they invited me into their lives.” “Between the Blocks” was born in that moment of vulnerability and generosity.

Ms. Liminowicz has documented Honorata and Agnieszka’s lives ever since, as they have blended families, moved apartments and changed countries. The women, together since 2011, share similar Roman Catholic backgrounds in a conservative country where right-wing nationalism has been on the rise while the government has denied them the right to marry.

Still, Ms. Liminowicz is amazed by the family’s openness and directness. “They are without masks, without pretense,” she said. “Their intimacy is as verbal as it is physical: ‘I love you’ is not reserved for special occasions.” Beyond labels — or voyeuristic images — she was determined to show them as neither aberrant nor abhorrent, but sharing an admirable, enviable love. “I want to show them as ordinary people living ordinary lives with extraordinary love.”

Honorata had once planned to become a nun. She knew she was attracted to women, but was advised to sacrifice that part of herself. She began seeing a Catholic psychologist who was to “cure” her homosexuality. In her second session, she was given homework: to go and do something good for herself. “So I went and I did,” she said. “Never going back to that office was the best thing I could do for myself.”

Later, there would be a trip to England, a boy and a pregnancy. He wanted a marriage but not a child. She returned to Poland to give birth to Natalia amid scrutiny and judgment from friends and family. Honorata credits her daughter with giving her the strength to disregard that.

Like Honorata, Agnieszka spent some time trying to live a heterosexual life. She married and had a son, Antek, 10, but quickly divorced. For a long time, Agnieszka’s parents struggled to accept her sexuality. Ms. Liminowicz said that Agnieszka’s “stubbornness, strength and consistency made her parents accept her as she is.” Even though the couple are no longer churchgoers, Antek received his first holy communion. “It is the traditional Polish way,” Anna said. “And Honorata still believes in God — she hasn’t rejected the church the way it has rejected her.”

The couple’s lives are entwined professionally as well as domestically. They worked together in Gdansk, where the family (and frequent guests) shared a tiny, 200-square-foot apartment. In 2013, Honorata and Agnieszka moved to Kalisz, Poland, where each managed three sections of the same supermarket. There, they bought a three-room apartment, joking that it was “impossible to find each other” in their larger home.

The added job responsibilities did not come with more pay, and the couple found it difficult to save money. Honorata took side gigs (at a bar, for example) for more income, which meant less time with her family. The couple were ineligible for the Polish child benefit because they were not married; but as lesbians, they were not allowed to marry. In 2013, the Civil Union Proposal was rejected by the Polish legislature, and the steady rise of right-wing nationalism in Poland posed an increasing threat to the family’s basic dignity and humanity. “The state doesn’t recognize us,” said Honorata. “We are a whole family outside the system. I don’t want to live like this.”

So began their dream of immigrating to England, where they hoped to find better jobs and encounter less homophobia. Honorata moved first, in December 2016, spending six months on her own and starting once again from the bottom at a restaurant job. Agnieszka joined her (at home as well as at work) six months later, leaving Antek behind to live with her parents. Last fall, Antek rejoined his mothers and now attends an English school. Natalia stayed in Poland to live with her boyfriend and study law at the University of Gdansk. Hellos and goodbyes — the ache of missing one another — are a constant part of their familial landscape.

Ms. Liminowicz said she navigated the boundary between intimate access and privacy, with “mutual trust and respect” she shares with the family. She trusts them to be honest with her, and they trust that she will listen to them. Over the years, Ms. Liminowicz has become a de facto member of the family, living with them for a few days on each visit. She feels “a deep responsibility for how they are represented” in her work, she said, always endeavoring to show the humanity and dignity that the Polish government denied them.

In 2018, Ms. Liminowicz, a founder of InPRO Photography Collective, won the inaugural Krzysztof Miller Prize, which celebrated her “courage to look,” for her “Between the Blocks” photo project. If she has the courage to look, it is at least in part because of her subjects’ courage to let her look at them in all their quotidian joy and pain.

Ms. Liminowicz sees no end to this long-term project, which includes film footage and voice recordings in addition to still photography. Honorata and Agnieszka continue to dream of, and plan for, marriage, homeownership and another child. Ms. Liminowicz dreams alongside them, hoping she will be there to document their dreams-turned-reality. She will stop only when — or if — they ask her to.

[1] https://www.nytimes.com/2019/01/24/lens/poland-escaping-homophobia.html?partner=rss&emc=rss

How to Declutter and Organize Your Personal Tech in a Few Simple Steps

With a new year and a new Netflix show that features the Japanese organizing guru Marie Kondo on the art of “Tidying Up,” many of us are experimenting with how to simplify our lives by purging our homes of unwanted possessions.

But what about the stuff we don’t see?

Think about the digital junk we hoard, like the tens of thousands of photos bloating our smartphones or the backlog of files cluttering our computer drives, such as old work presentations, expense receipts and screenshots we have not opened in years.

In addition to the digital mess, tech hardware adds to the pile of junk that sparks no joy in our lives. Everyone has a drawer full of ancient cellphones, tangled-up wires and earphones that are never touched. And the things we do use every day, like charging cables strewn around the house, are an eyesore.

Why are people so terrible about tech hoarding? Cary Fortin, a professional organizer for the company New Minimalism, summed it up: “We don’t really think about the cost of holding on to things, but we think about the cost of needing it one day and not having it.”

Don’t fret, dear reader. As a technology critic who tests dozens of gadgets a year, I’m in a unique position of having to wrestle with extraordinary amounts of tech products and accessories every day. (Last year, I brought nine new smartphones, two tablets, four smart speakers and 14 power accessories into my home.) So here’s a guide to tidying up your technology physically and digitally, including tips from professional organizers.

How to declutter your power cables

The No. 1 culprit of tech clutter in every household, professional organizers say, is the power cable. Part of the problem is that we typically need different wires for products like smartphones, battery packs, cameras and laptops. These then accumulates into one tangled mess.

Here’s how to solve power cable overpopulation in a few simple steps:

Gather them all together and purge the ones you don’t need.

This sounds easier said than done, but here’s a good rule of thumb: “If you don’t know what it goes to, get rid of it,” said Marissa Hagmeyer, an organization consultant and co-owner of Neat Method. Among the wires you keep, if there are extras, cap them at two, such as two Micro USB cables, she said.

In the process, you may end up discarding a wire that you later need. But don’t beat yourself up. “You can buy a new one if it turns out you needed it,” Ms. Fortin said. That’s better than wasting space on something you might hypothetically need.

The same approach can be applied to other tech gadgets, like the obsolete smartphone that is living in your sock drawer. If you haven’t used it for six months, get rid of it. Unwanted tech accessories and gadgets can be discarded responsibly through donation centers or e-recycling programs like Best Buy’s.

Have a designated place for all your tech accessories.

Pick somewhere in your home where your various wires will live, like a closet, cabinet or drawer. From there, categorize the wires and give them compartments. I separate my different types of wires — earbuds, phone chargers, miscellaneous USB cables and computer chargers — into Ziploc bags and label them with a label maker. All the bags live in a drawer in my TV stand.

There are different approaches to organizing your power cables. Families with children could give each member a compartment. For example, put your son Joe’s iPhone charger, laptop charger and earbuds into one Ziploc bag and label it “Joe’s tech.”

This step is a must. “If you don’t have a dedicated place for your items, then you’re wasting your time finding them,” said Keith Bartolomei, a professional organizer for Zen Habitat.

Hide wires that live out in the open.

Even if you find a place to stash your spare cables, you probably have a few left plugged in all day. To tidy them up, there are methods to hide the wires or, at the very least, keep them off the floor.

Mr. Bartolomei recommends using twisty wires and rubber bands to keep wires wrapped around furniture, like desk legs. There are also products for bundling up and concealing wires, like fabric sleeves or boxes that cover your surge protector. My approach to keeping wires off the ground is to run them through magnetic buckles that clip onto a metal side table.

How to resist digital hoarding

Tidying up your digital media may not feel worthwhile because your files are not visible in the real world. Yet holding on to all the data takes up valuable space on devices while also making important files more difficult to find. The professionals recommended a process of purging and labeling what’s left. Here’s how it would work:

Do an annual clearance of the files you no longer need.

To streamline this process on a computer, open a folder and sort the files by when they were last opened. From there, you can immediately eliminate the files you have not opened in years.

On your smartphone, prune unnecessary apps that are taking up space. On iPhones, Apple offers the tool iPhone Storage, which shows a list of apps that take up the most data and when they were last used; on Android devices, Google offers a similar tool called Files. From here, you can home in on the data hogs and delete the apps you have not touched in months.

Manage your enormous photo library.

Eradicating photos is the most challenging process, the professional organizers agreed, because the thought of deleting your memories may be painful. But photos are some of the biggest data hogs of all, so some periodic maintenance is crucial.

Start by trimming out the easy ones: duplicate photos, blurry shots and old screenshots.

Then move on to the harder part: deleting the photos that were decent but not your favorites. Mr. Bartolomei said people could look at each photo and ask themselves a few questions: “Is this something you want to see again? Does it make you happy? Do you want to spend more time with this photo in the future?” If you answer no to any of those questions, the photo can probably go in the trash bin.

My approach to managing digital photos is to purge everything without doing any organization at all. I use Google Photos, which automatically backs each shot to the cloud, compiles photos into albums and includes a tool for removing images from the device. (I also back up all my photos to an external drive in case I ever become unhappy with Google Photos.) Then I erase all the photos from my iPhone every six months and pay Google $2 a month to manage thousands of my photos at full resolution.

Whatever approach you take, don’t skimp on tidying up your data. Even if it doesn’t use up physical room, it can still cause you harm.

“It takes up so much psychic space and brings up the same negative effect: anxiety,” Ms. Fortin said. “Since we all have our phones in our pockets, we’re toting our clutter around with us.”

[1] https://www.nytimes.com/2019/01/23/technology/personaltech/declutter-organize-personal-tech-few-simple-steps.html?partner=rss&emc=rss