Category: Commentary

I am not new to end-of-life care — as a nurse and someone who has worked in healthcare for most of my life, I have helped numerous friends, family, patients, and clients at the end of their lives.

Yet, the transition to long-term care for older adults is vastly different. Over the past few weeks, I have witnessed the demoralizing treatment of this firsthand as family members close to me have tried to manage their loved one’s urgent hospitalization and the fallout afterward; it was a wake-up call.

My 80-year-old relative was diagnosed with metastatic cancer seven years ago. During the pandemic, they had emergency surgery as their cancer spread to their spine and caused partial paralysis in their legs. The surgery was successful, and for a long time, medication kept the cancer contained. But last month, the paralysis began again, and they were back in the hospital requiring another urgent spinal surgery.

At first, their acute care was phenomenal. Then, as they became physiologically stable, and it became clear they couldn’t go home but would need long-term care, everything changed.

I watched as my family members, over the course of two weeks, grew increasingly overwhelmed, exasperated, and exhausted. They began to look as though they themselves were going to require hospitalization. The amount of information being thrown at them, in no coordinated way, was utterly overwhelming. In contrast, the lack of information being shared with them was similarly overwhelming and stupefying.

Though my family members were at their loved one’s bedside more than eight hours a day while in the hospital, and repeatedly asked the medical team to discuss any plans with them, their loved one’s healthcare proxy, the team continued to only relay pertinent information to the patient who was in excruciating pain, on pain meds, is hard-of-hearing, and was recovering from spine surgery and anesthesia .

Not surprisingly, the information rarely made it back to my family members. Not once during the week postsurgery, as they were trying to plan for the looming hospital discharge and the associated next steps, did that happen.

At no time did anyone from the surgical or oncology team discuss follow-up plans with my family members. This sparked a cascade of misinformation and omissions that became the foundation for the steep learning curve that is rehabilitation and long-term care in our healthcare industry.

Due to the progression of the cancer on the spine and the ensuing paralysis, my family’s loved one needed to go to acute rehab from the hospital, but what acute rehabs were available, where they were located, how long one can stay and then where they go afterward, how it would be decided, and how it would be paid for was a mystery for my family to decipher.

Their loved one would need to start radiation therapy once the surgical wound healed, but how they would be transported from the acute rehab to the medical center and when that would begin was also, apparently, for the family to figure out. At one point, my family member asked the social worker how transportation to the radiation appointment would work; the social worker shrugged their shoulders and told them to try an Uber.

An Uber, for a medically fragile, at the time stretcher-bound, individual. It would be funny if it were not contemptible.

As my family member’s loved one became more stable and progressed in their rehabilitation, their follow-up medical care became the next problem to be solved.

Oncology appointments were scheduled while at acute rehab; luckily, they could be done virtually. To our surprise, though, the acute rehab personnel would take no responsibility in assisting their patient in attending these medically necessary appointments. They refused to help turn on the iPad or log in to the medical portal for the appointment. Once again, it was the family’s responsibility to figure out how this would happen.

Ultimately, my family member had to physically go to the acute rehab to turn on the device and log their loved one into the portal. Dealing with an ill and injured loved one is hard enough while juggling your own life responsibilities, but requiring family members to drive 40 minutes (each way) in the middle of a weekday to an acute rehab facility with licensed medical providers — to assist the facility’s own patient with their necessary medical appointments because the facility’s licensed medical providers refuse — is yet another unnecessary and callous hurdle to make families jump.

In situations such as I have described, families have no control over some things, yet are expected to control the minutest details of others. Make it make sense.

I am not naive to the plethora of troubles that come with being sick, injured, low-income/low-resources, or elderly in this country.

I ran a nonprofit organization years ago that helped people pay for medical expenses. I worked with clients who were not only trying to keep their loved ones alive but were also trying to manage and pay for their care. I repeatedly witnessed how our healthcare industry put up every possible roadblock and hurdle; how loved ones became increasingly despondent.

In the U.S., there are over 61 million older adults, those aged 65 or older — this is 18% of the population. This number is expected to grow to 22% of the population by 2040. That will be close to one-quarter of the U.S. population. Yet, there is no coordinated system in place to help older adults and their families transition to long-term care and navigate the inevitable healthcare challenges they will face — let alone face them with grace and dignity.

The “not my problem” “hot potato” approach our healthcare industry has taken is criminal.

With nowhere else to turn to help my loved ones, I reached out to a colleague who specializes in palliative care. They provided helpful resources and echoed what seems to be the sentiment of many providers: “Our ‘system,’ it’s garbage.”

Many patients and families who have gone through this experience know this to be true. Yet, we continue to perpetuate, accept, or be resigned to a system that treats older adults and their families, as my colleague accurately stated, like garbage.

Which is mind-boggling, as most of us, if we are lucky (or unlucky, given the circumstances), will grow old. Most of us have relatives who will grow old. Almost all of us who grow old will need some long-term care — and yet, based on our experience and the experiences of so many others, there is no system in place.

None of the resources we eventually found came from any healthcare provider or social worker in either the hospital or the acute rehab.

None.

Only after using ChatGPT and reaching out to colleagues were we able to start putting the pieces together. ChatGPT recommended our local county aging corporation, which provided helpful resources for transportation and the Pennsylvania Elder Law hotline.

Through this whole process, we have remarked — and felt genuinely nauseated over — what other older adults who need long-term care do if they don’t have family support or financial resources. We are still at a loss.

But I am not about to shrug my shoulders or be resigned. I am not willing to place the burden back on the sick and aging, nor their families. I implore my healthcare colleagues to acknowledge the faults in the system, accept the burden of care, and do better.

Marion Leary is a nurse, public health advocate, and activist.

This Hanukkah, while Jews around the world prepare to light the menorah and bring light into the darkest days of winter, our celebration of hope and resilience remains in the shadow of Israel’s ongoing genocide of Palestinians in Gaza. And, nearly two months into a U.S.-brokered ceasefire, I am still protesting.

Hanukkah, which in Hebrew means dedication, tells the story of Jewish peoples’ resistance to an oppressive empire, and of a miracle that kept candles aflame for eight days and eight nights when there was only enough oil for one.

It is a story that resonates to this day, and it is in the spirit of hope, light, and miracles that I find myself rededicating to the struggle for Palestinian liberation.

The U.S.-brokered ceasefire went into effect on Oct. 10. Since then, Israel has continued near-daily attacks, killing at least 345 Palestinians and wounding another 889. While the agreement required Israel to lift its blockade on aid reaching Gaza, Israel continues to interfere with the free flow of humanitarian aid. Less than 25% of aid deliveries have made it to Gazans, who face increasingly dire circumstances.

While the United States and Israel insist the ceasefire holds and deny the well-documented violations of the ceasefire agreement, I find it difficult to describe the current conditions as anything other than a slower-paced extension of the genocide.

The need for our solidarity is no less urgent or crucial than it was last year or the year before.

What’s more, Israel’s genocidal campaign against Palestinians isn’t confined to Gaza. Tens of thousands of Palestinians have been forcibly expelled from the illegally occupied West Bank, actions that human rights groups have classified as war crimes. It is worth noting that the primary targets of this ethnic cleansing are the refugee camps set up in the 1950s to house Palestinians who were forcibly driven from their homes when the state of Israel was founded.

I have been in the movement for Palestinian liberation for decades through my work on the Rabbinic Council for Jewish Voice for Peace, the largest progressive Jewish anti-Zionist organization in the world. More recently, I joined over 400 other rabbis organizing as Rabbis for Ceasefire.

Because of my organizing, I know history didn’t start on Oct. 7, 2023. Palestinians have faced expulsion from their lands, destruction of their homes and civil infrastructure, and deadly violence since 1948. They enjoy fewer rights than their Jewish counterparts, lacking freedom of movement and access to land, jobs, and public services.

Many falsely proclaim that this system of violent occupation and the ongoing genocide are necessary for Jewish safety. The truth is that this is a desecration of Jewish values and an affront to our long tradition of resisting empire and seeking justice.

I reject the claim that Jewish safety relies on the subjugation of Palestinians, and am inspired by the growing anti-Zionist movement among American Jews. Just as the Hanukkah lights our ancestors lit were not extinguished, our struggle for Palestinian liberation burns brightly.

It doesn’t take a miracle, but it does require courage, rededication to fundamental human rights, and, for many, the willingness to shift positions and take accountability for the role of the United States in bankrolling and providing diplomatic cover for Israel’s genocide of Palestinians in Gaza.

One opportunity I implore our elected officials to take is to sign on to the Block the Bombs legislation, which prohibits the president from selling, transferring, or exporting certain defense articles or services to Israel, except in specified circumstances. I was heartened to see Rep. Dwight Evans recently sign onto the bill, joining 59 other legislators, including three from Pennsylvania.

This Hanukkah, I call on all of us to shine a light on Gaza and rededicate ourselves to Palestinian liberation. Only by keeping the flame of our solidarity alive can we hope to one day say, as in our Hanukkah story, “a great miracle happened there.”

Rabbi Linda Holtzman teaches at the Reconstructionist Rabbinical College. She is the organizer of Tikkun Olam Chavurah, a group that pursues social and political justice work together as a Jewish community.

For anyone trying to follow OpenAI’s latest corporate restructuring, here’s the breakdown from a professor of entrepreneurship who studies social enterprises.

The nonprofit OpenAI Foundation controls a for-profit company that just restructured into a public benefit corporation (OpenAI Group PBC). The company says this new form will “benefit everyone” by allowing OpenAI to cure diseases and build “resilient AI.”

Sounds noble, right? Stick with me, and I’ll explain what is really happening.

Let’s use the analogy of KPop Demon Hunters, a recent megahit movie by Netflix. It’s an age-old story in which it’s up to the brave to fight evil for the good of humanity, but this time told using catchy K-pop songs and pastel animations.

In the movie, the demons disguise themselves as a boy K-pop group, the Saja Boys. The girl K-pop group, HUNTR/X, are the saviors who need to slay the demons — but instead are dazzled by the Saja Boys’ talent and smooth dance moves. The Saja Boys end up sucking the souls of all humans and lead the population into misery as the girl group remains helpless to the boy group’s whims.

So in our analogy, OpenAI sees itself as HUNTR/X, and it is here to save the world from the demon, which in this scenario is artificial general intelligence (AGI).

Unlike today’s generative artificial intelligence (e.g., ChatGPT, Claude, Gemini), artificial general intelligence would actually think and reason like a human. Some data scientists see it as having the ability to become superior to human intelligence. (Think of Terminator’s Skynet, an AI that becomes self-aware and launches nuclear war against humans. Some call that science fiction fantasy, whereas others say it is a possibility.)

AGIs are not yet possible, but OpenAI, the maker of ChatGPT, wants to be the first to introduce them to the general market. So, like the girl group HUNTR/X, OpenAI sees itself as the savior by building “resilient” AI to harness the evil AGI.

To have the power to fight evil, HUNTR/X needed K-pop songs, whereas OpenAI just needs capital, and lots of it. For example, it just signed a $38 billion deal with Amazon. However, OpenAI is more like the Saja Boys than HUNTR/X, by disguising itself as a public benefit corporation that allows it to make profits while saying it is focusing on the public good.

It’s important to our story to know that a PBC is a for-profit corporate entity that legally commits to pursuing one or more declared public benefits in addition to generating profit for shareholders. Being a public company, it can raise funds through selling shares. By investing in a PBC, shareholders understand profits will be diverted to a public good.

OpenAI promises profits will flow back to its nonprofit, funding “AI resilience.”

It sounds altruistic until you realize: If it’s all for the public good, why does a nonprofit need to own the for-profit version of itself — and what is AI resilience anyway?

Back to our analogy: OpenAI wants to be the market leader in building out AGI (fight evil demons). It can’t do it without capital (catchy songs). Representing itself as a public benefit corporation (Saja Boys), it can collect the cash (human souls) that is then diverted to the nonprofit (demon king), which will control how AGI is used and marketed (rule the world).

“AI resilience” is OpenAI’s way of controlling the market. This is a form of “Big Tech extraction.“ Another benefit of this shell is that it pays less taxes as a nonprofit.

Some may say my analogy is too simplistic. I’ll counter that every “save the world” story needs a hero and a villain. The twist? The villain always insists they’re the hero. When a $500 billion company says it’s saving humanity, it’s worth asking why it needs a legal shell game to do so.

This is the same company being sued for copyright infringement and for lack of safeguards for suicidal ideation.

These are hardly the marks of altruism.

OpenAI isn’t HUNTR/X or even the Saja Boys. It’s the soul-stealing Gwi-Ma, the demon king who wins by pretending to deliver good.

Investors, beware: You’re being Gwi-Ma’d. Many will be OK with that. The rest should question the deception of Big Tech.

Rosanna Garcia is the endowed chair of innovation and entrepreneurship at Worcester Polytechnic Institute in Massachusetts and a public voices fellow on technology in the Public Interest with the OpEd Project.

On this date 56 years ago, I awoke in my tiny apartment on the South Side of Chicago and heard the news that changed the course of my life: Fred Hampton was dead.

Hampton, chairman of the Illinois Black Panther Party, had been killed that morning in what the Chicago police described as a “shootout” between them and members of the party at the group’s West Side headquarters.

Hampton was 21, a year younger than I was then. But he already was a magnetic, charismatic figure on the left, clearly destined for leadership beyond the Panthers and Illinois.

Precisely for that reason, Hampton had become a target of J. Edgar Hoover’s FBI in its effort to control and wipe out the Panthers, a group that he labeled “the greatest threat to the internal security of the country.”

I was a graduate student at the University of Chicago, looking for a purpose in life that academia was not providing. Suddenly, the death of Hampton — actually, the assassination of Hampton — gave me that purpose.

Just as many young Americans watched the events of Sept. 11, 2001, and felt compelled to join the military, I watched the aftermath of Hampton’s death and was moved to become a journalist.

I had been habituated to the importance of news since I was a child in rural East Texas, listening with my maternal grandfather to Gabriel Heatter’s quavering delivery of the news each evening on the radio.

In high school, I read and watched in terror as the Cuban missile crisis unfolded. And the year before my high school graduation, I watched faithfully as CBS’s Roger Mudd delivered daily reports on the progress through Congress of the Civil Rights Act of 1964.

But even as I progressed through college at the University of Notre Dame, it never occurred to me that a Black kid like me could become a journalist. And then came Dec. 4, 1969.

The Chicago media were all over the Hampton story, and I was into every news story and broadcast about the case.

One station broadcast a police reenactment of the raid and shootout.

Five daily newspapers — including the legendary Black publication the Chicago Daily Defender (which, a few years prior, had been led by an editor named Chuck Stone) — published editions virtually around the clock, constantly trying to advance the story.

Eventually, it became clear that there had been no “shootout” at all, but a shoot-in by the police. The clincher was a front-page photo in the Dec. 12 editions of the Chicago Sun-Times under a headline that read, “Those ‘bullet holes’ aren’t.”

The police had put out a similar photo earlier, claiming to show holes in a door caused by bullets fired from within the Panther apartment. The Sun-Times photo showed they were actually rusted nail heads.

What all of this demonstrated to me was the power of journalism to expose truth, to lay bare hidden facts for examination by citizens of a democracy. And after seeing it done, I knew I wanted to do it, too.

The Hampton case was the catalyst for my desire to do journalism, but there have been others.

Bob Woodward and Carl Bernstein inspired a whole generation of journalists with their coverage of Richard Nixon’s Watergate scandal.

And in cities and towns and hamlets all across the country, journalists have unearthed inconvenient truths that people in power would have preferred remained buried — and that undoubtedly inspired others who wanted to do the same.

Our current politics provide what some might call a “target-rich environment” for aggressive, probing journalism. The undeclared war against alleged Venezuelan drug runners on the high seas of the Caribbean is but the most obvious example.

But there are plenty of abuses short of lethal ones that cry out for investigation and exposure. In a world where those in power see disagreement as disloyalty, protest as terrorism, and constitutional mandates like due process as dispensable annoyances, the need for passionate, implacable, even clamorous, journalism endures. And will, I suspect, for at least another 56 years.

Don Wycliff, a former editorial page editor at the Chicago Tribune, is the author of “Black Domers: African-American Students at Notre Dame in Their Own Words” and the recently released memoir, “Before the Byline: A Journalist’s Roots.”

In the five-county Philadelphia region, nearly 34,000 veterans depend on U.S. Department of Veterans Affairs disability benefits. These benefits are not just a lifeline; they are a powerful economic engine that pumps nearly $955 million into our local economy every year.

But on Oct. 29, the U.S. Senate Veterans’ Affairs Committee held a hearing to “reform” the disability system, laying the groundwork to gut this vital support by using a false narrative that targets the very veterans who need it most.

The hearing was built around a proposal by Sen. Tommy Tuberville (R., Ala.) to create a commission similar to a Base Realignment and Closure (BRAC) procedure to fast-track changes, and by the testimony of one star witness, Daniel Gade.

Gade, a retired Army colonel, professor, and disabilities activist who was badly wounded in Iraq and is now running for a U.S. Senate seat in Virginia, argued that disability benefits “rob veterans of purpose” and that conditions like tinnitus and hypertension should not be compensated.

As a Navy veteran and a medical student, I was alarmed by the medical and data-driven inaccuracies used to justify this attack.

Questioning PTSD

Gade’s claim that PTSD is “curable,” and thus shouldn’t be permanently compensated, is medically false. As any first-year medical student knows, post-traumatic stress disorder is a chronic condition that, at best, can be managed into remission. It is not “cured.”

Gade’s dismissal of hypertension as a “lifestyle” condition is equally dangerous. As the Disabled American Veterans (DAV) has testified, hypertension is scientifically linked to military service and associated with common toxic exposures to Agent Orange and other toxic substances. These conditions are not lifestyle choices; they are the documented, latent wounds of military service.

The entire premise for this “reform” is based on a manufactured narrative of “massive fraud.” This is statistical fiction.

My research at Temple University involves analyzing large medical data sets, and the data here is clear: The fraud narrative is a myth. The DAV’s testimony confirmed that the VA sees “fewer than 200 fraud convictions annually” out of nearly “3 million claims.” That is a fraud conviction rate of less than 1/100th of 1%.

This isn’t just a national story. This rhetoric insults the 33,816 veterans in the Philadelphia region who receive these earned benefits.

If the committee truly wants to find waste, it should focus on real problems, which were detailed by the VA’s own watchdogs at the same hearing.

VA Inspector General Cheryl L. Mason focused her testimony on the real issue: predatory “claim sharks” and systemic management challenges, as outlined in an inspector general’s report on the Philadelphia office. The VA’s own data show its problems are internal, not with the veterans it serves.

Dangerous distraction

In other words, the “veteran fraud” narrative is a dangerous distraction from the real problem: a broken VA disability system. The Government Accountability Office (GAO) agreed, confirming that the system has been on its “High Risk List” since 2003 due to “longstanding challenges” concerning oversight and training.

This is where reform is needed. Don’t misplace blame on veterans for the VA’s own systemic failures.

While Sens. Dave McCormick and John Fetterman do not sit on the Veterans’ Affairs Committee, the financial stability of over 33,000 of their constituents, and nearly a billion dollars in our local economy, is on the line.

I urge them to publicly oppose this dangerous commission and demand Congress focus on the real problems: cracking down on the claim sharks who prey on veterans, and fixing the VA management failures the watchdogs have identified for decades.

Alyster Alcudia is a U.S. Navy veteran, a former nuclear submarine warfare officer, and a medical student in Philadelphia.