Friday, November 29, 2019

Gratitude

With Thanksgiving come and gone and the idea to give thanks, to be grateful or to be "blessed" (an expression I loathe thanks to the ever present use in Nashville) is a part of ones repertoire in the coming season.   I use privilege and in turn the concept of gratitude when it comes to that word and that state of being.   I am privileged financially and in turn it has enabled me to live well and for that I am grateful.  That is it when it comes to the idea of privilege the rest of the world only sees me in the sense of that aspect as the curiosity and interest I attract now is because of the way I live.  I have no other feature that a woman of 60 has.   We are past the age of sexual attraction, we are past our prime working age and if you have children you are entering the second phase of motherhood, which is grandparenting.

Funny I am more curious, more intelligent, more articulate, more interesting, funny, driven and passionate about most things than I was at age 30.  The woman at 30 was trying to find her way, confused, alone and utterly stupid.  I pretty much stayed that way until 40 and then the box of Pandora opened.  I realized I was in a marriage of one, I hated my chosen profession that I entered in at 35 to somehow meet an obligation or standard that we set for women and why I married to a man who I did not love but I liked and actually got on well with in a business sense but I never really cared about men but sex yes and I was curious and driven about that for most of that decade.  I was discreet, indiscreet and utterly consumed by it and by 50 it was taken from me when a boy of 22 decided to drug me and enable me to get behind a wheel of a car and nearly kill myself. Then my fate became the fate of others who had no interest in me but in what I could offer them financially or in scalps as that is what Prosecutors do - collect scalps.  The past seven years passed as one nightmare of the next reeling from Lawyer to Lawyer, to Courtroom to Courtroom.  Anger, rage and fear dominated me but determination had never left and that calling card was being thrown left and right.  When I landed in Nashville to finally fix my teeth that were deteriorating at a rapid clip thanks to the stress and age that were colliding like my car with that metal pole on the night of February 12, 2012, the night I died and was for whatever reason not allowed to.  So to prove the point I lived and like a Hurricane I blew my rage and anger through whatever I touched and I landed in Nashville in 2016 to find something better.  Well hurricanes are not known for settling well and that was the first warning as the after storm is what truly brings damage.

I chose Nashville because of many reasons and my dental care was only part of it. The ability to retain a drivers license and get it transferred to Tennessee was essential as they are not part of the interstate drivers commerce law.  And  as I suspected that I would lose my appeal regardless I needed to get a new identity and that the state also closes name change records was another.  I knew all of this before hand and I knew that a city of dreamers and aspiring singers are all those changing identities and dreams so I thought I could fit in with few questions asked.  They ask questions in Nashville  but they have to do with what brought you here, who are your people and what Church you belong so I had the answer to one as for the other two I had no idea that those are the most important and critical questions of which I had no answer.  It was my first lesson that I learned my new home was more complex that I believed and I realized I knew little of the South and the lessons it would teach me in the three years I resided there.

I am grateful that I am coming to the end of my time in Nashville for despite now living in Jersey City I have to return three more times to finish what I started and once again leaving my fate and care into the hands of others has done little to proving me right that it is a shitty idea to trust anyone in that aspect.  Sorry but no one has your best interests but you and you alone.  All the family one has may find that to be not true but there are just as many that have found that also to be less true.  Yet this time of year regardless of your beliefs you abandon them to travel near and far to somehow prove yourself right - regardless.

I don't need a day to share a meal I would love to simply have any day to share a meal with someone and briefly in Nashville I did.  I finally understood the concept of family and what it would be like to have a child and in that moment it enabled me to learn and understand the concept of unconditional love and for that I do express gratitude.  But then again in life's wisdom to remind me that entrusting my care and my soul to others is something that is not for me.  The betrayal of that friendship hurt me more than my Divorce, than my years of overcoming the hideous nightmare that began in 2012 and the loss of teeth and health.  I never thought one single person had that power and even my parent's deaths were not as devastating as for that I understood it was a part of life.  I had been careful to avoid such commitments as the genocide of the 80s in the Gay community took its toll. I had even avoided pets but when I was married and I found Emma that relationship with that dog was the longest I have ever had and not a day goes by where I do not think of her and of that love we shared.  It is in their DNA that dogs are compelled to love and for that I express gratitude but like all loves of one's lives that is not easy a replacement.

So yesterday at Yoga the theme was gratitude and again I pulled from the intention basket this:  I forgive those who have harmed me in my past and peacefully detach from them.

For me whose office door is posted a note from Confucius:  To be wronged is nothing unless you continue to remember it.

I choose to remember all of it, everyone and often find myself in a place where I cannot help myself from endlessly replaying the loop in my head how and why it all went wrong.  The night of the 12th I did not do anything wrong but I was poisoned and left for dead and it was again a Gay man who made sure I did not pass into this good night alone but the boy who walked up to the car and the one I am sure in passing as he commented to this hero "She is still alive" as he reached into the car for what purpose I doubt to check on my status and walked into the night was the boy who tried to kill me and from that point on I have always known he will do this again and he is not my responsibility nor one I need to think about in any way.  And I rarely do or did until Ethan.  And the night he read to me the passage from Deuteronomy about being God's Warrior and the hate that it filled my home with I thought once again I invited my death into my home and I was afraid, very afraid.  I could not believe that history was repeating itself and that this boy I loved as a son meant any of it but as time wore on I realized the depth and breadth of his ability to lie and if he would lie about this - this he claimed was the most essential core of his being - Religion and Faith - he would lie about anything.  I have no intention of even accidentally running into this boy on return visits and yet yesterday I reminded  myself that I was grateful for that relationship regardless how it ended for it ended badly.  But at least with no one in a hospital near death so at least that is an improvement; however, I can forgive and detach and move forward using that as a tool in my kit to remind myself once again why I do not trust others to be responsible for my well being.  Sorry folks but I am a loner, independent and I am fine on my own.  And sitting down to eat I was not lonely just alone and fine with it.

The day before I found a Farmer's Market and in my encounters with the vendors (all women) I shared how I found this place and how I ended up moving to the area and that it was the best unplanned and oddly random ways I find my way here as it seems that without the planning, the research and analytics that I do to even make the most routine of decisions brought me here to this place right now and that from this I will find a new place that I can call home and for the rest of my life never stop finding and discovering new places in this my new home.

So as I plan on returning to Nashville the next few months I plan on detaching and letting go of the anger and rage that I have still tucked in the back of my carry on.  I will throw it in the dumpster on my last day there. I often use that analogy as I frequently have said that most people seem to think that is where I belong.  I thought that in Seattle those years from 2012 to 2016 and that thought followed me right into Nashville. And I called the schools that that too leant itself to my rage and fear.   It was if I could never crawl out of it and have a life of one's own.   But how can you when so many there are in the same way all fighting to get out of where we were tossed.   But that is not my experience here, I have not met anyone here who has done the same and that may also be me as I am in a new place with a new beginning and that is my white light that had eluded me in the "vile".  That said it is critical that  I do want to remember those who were not that and I look forward to seeing them and hearing of their lives and their happiness and share mine.  And that seems to have met the maximum of the fingers on one hand.  A quote my mother used to say: "You should be able to count on one hand the people that matter."  And funny I can in this case.   And like many of the signs and markers that align the streets of Nashville I got an email from one of those and it made me smile and laugh with tears in a good way. The same tears that flowed when shared my story with the vendors at the market.  It reminds that I matter and that is all one wants in life - to matter.    But we often think it is that is which makes us  happy, our relationships to others,  and perhaps that is true but I did not come here to be "happy" as I cannot define that in that way.  Yes I want to matter and I try to matter in all my encounters with others no matter how brief but that comes from a place of security and confidence and that is what I feel now, confident.   And it was that which eluded me the last seven years and thankfully now it has found a resurgence.  Although like all things it too ebbs and flows but  it is from that I can move on and peacefully detach.  For without those experiences, those people, good or bad,  I would not have landed here and that is what matters, where one lands not where one came from or how, why and who brought them here.  I get those questions too but they are less sinister in tone and more of curiosity and interest.  (Although the money question is never far behind it is something I know as a woman of a certain age is always going to be asked) I never thought that in Nashville anyone actually gave a shit,  for it is too tribal, too nativist and too obsessed with money and religion to enable anyone to get to know anyone without reason.   And those I met in Nashville need to learn that the present matters more than the past and without the past we have no present and I live definitely in the present. And that was the greatest lesson I learned in my three years of existing for it was not living but without it I could not have existed and that is the balance of life. And funny that the place that defines itself on its hospitality could take lessons from the place thought of less about it and more about money.  Take it and reverse it for like all things here they are direct and to the point and perhaps that is what truly matters.  I matter but most importantly to myself and for that I am grateful.


 And suddenly you know.  It's time to start something new and trust the magic of beginnings.
                                                            - Meister Eckhart


Friday, November 22, 2019

Taking Out Trash

I have been trying to reconcile my feelings about living in Nashville for the last three years and attempting to find some good amidst the bad and that is getting tougher with each passing day living here in Jersey City. The most generous, professional and welcoming people I have ever met have been here and I cannot recall a single encounter with a random mover, post office employee or other service person that seems to remember my name, when I was here last and are generous with follow up or offers of assistance that is genuine and without financial obligations attached. True there were some okay none in the land of Hospitality.  Some disguised as such but I like to remind myself of those who said as I was leaving: "We can't wait to visit you in Jersey."   Really? Did you visit me here while I lived HERE.  Did you come by without some reason or intent or invite that included me doing most of the heavy lifting including paying or giving you something in exchange.  Right Ethan?

So when I read about these teacher in Alabama where the Prodigal Surrogate came from I laughed as none of it surprises me in the least as Nashville is not exempt from this. Welcome to the South where they put the SPIT in Hospitable.

I hated every minute there and looking back I was not wrong in my assessment that the people are garbage, the schools a dump and the kids are the trash they throw in them then the grow up to be the Adults they have recycled to become exactly what they are - trash talkers.  Welcome to the South.


East Nashville Teacher Resigns Amid Twitter Controversy
Posted: 5:26 PM, May 04, 2017  Channel 5 News


An East Nashville Magnet High School teacher was confronted by her students in the classroom about derogatory and insulting social media posts, which ultimately led to her resignation.

The teacher, Lyn Rushton, allegedly created a ghost Twitter account on which she posted multiple tweets about her students.

A tipster showed NewsChannel 5 screenshots of the tweets in question in which she called students out by name and made derogatory comments.

One of them said, "The ghettoness of some of my students just sickens me beyond belief." Another said, "I wish I could carry around a stamp at school to put "worthless a*******" across their heads."

Students confronted Rushton about the account and tweet while in class. The students can be heard yelling at her in a video which was posted on Facebook.

One of the tweets which named multiple students, poked fun at the length and pronunciation of their names.

"I don't want a name like everybody else! I love my name... I don't care if I walk into a job interview and they don't like my name because it's a black name. I love my name!" said one of the students.

Officials with Metro Nashville Public Schools told NewsChannel 5 Rushton took some sick days this week, and was scheduled to report to school Friday to be placed on administrative leave, but she resigned Thursday.

She talked to NewsChannel 5 and apologized for the comments she made.

"It was stupidity on my part," Rushton Said. "I'm definitely sorry for the words, absolutely, they're hurtful. They were wrong to say, and I am absolutely sorry for the words, for what I said."

Rushton resigned before Metro Schools could even investigate it. School officials released the following statement:

As part of the Tennessee Code of Ethics, teachers accept the responsibility to adhere to the highest ethical standards as part of what they do in schools every day – to serve students and the communities they live in.

Metro Schools is aware of certain social media posts of a former teacher at East Nashville Magnet High School. The posts do not reflect our values and are unacceptable.

The teacher has resigned and is no longer an employee of Metro Schools.

Rushton began teaching in the 2011-2012 school year


Teachers used racial slurs and speculated about students’ sex lives in leaked chat

Reis Thebault
The Washington Post
November 21, 2019 at 9:11 p.m. EST

The Alabama high school teachers had a boastful, explicit name for the group chat they used to gossip about and disparage students. After some of their messages leaked last week, those teachers now sport another dubious distinction: They’re suspended.

At least six teachers from Ashford High School in southeast Alabama were removed from the job on Monday, county officials told local news media. School leaders promised “repercussions” but have not yet announced what those will be.

In one text, reviewed by the Dothan Eagle newspaper and the television station WDHN, one of the teachers refers to a student by name, speculates on his sex life, then calls him the n-word before writing that he is “so slow he can’t walk and chew.”

The messages ignited a firestorm. Parents and students packed a recent school board meeting and have taken to social media to protest the racism, transphobia and meanness the teachers reportedly displayed in the messages.

The target of one of the messages, who identified himself to WDHN, said it wasn’t the first time he’s felt discriminated against within school walls.

“I don’t like this school, period,” said the student, who is black. “They’re racist, all of these folks are racist.”

A woman’s stepchildren saw her topless in her home. She may have to register as a sex offender.

The teachers have not been publicly identified, by name or by race, and Houston County Superintendent David Sewell said the school board intends to give the group “procedural due process” as they defend themselves from allegations of wrongdoing.

“I hate that it happened,” Sewell told the Eagle. “We try to put policies and procedures in place to make sure things like this don’t happen. We’ll go back and try to reinforce.”

But at the contentious school board meeting Monday, some parents criticized officials for not taking more action sooner.

“To sweep this under the rug — and you may not be doing that — it looks that way to me,” said Jimmy Weems, an Ashford High graduate, publicly addressing the board. “Whose hands are we turning our kids over to?

“Is that what we’ve stooped to?” Weems asked. “This is disturbing.”

Sewell replied: “I share your concerns.”

Her mom was being beaten, police say, so she called 911 and ordered pizza. The plan worked.

The board could take one of three actions, the Eagle reported: It could suspend the teachers without pay, fire them or reinstate them.

The state’s education department has also indicated it could step in and discipline the teachers if it feels the county has ignored serious transgressions.

“If there is an offense egregious enough, and the local system does not do anything, we do have the authority to examine someone’s teaching certificates,” agency spokesman Michael Sibley told the outlet WTVY.

Some students and parents have been clear: They want the teachers out. Classrooms, and a teacher’s confidence, are supposed to be safe places for students; instead, some now say they feel threatened.

“This is a real slap in the face,” Michael Johnson, an Ashford student, told WDHN. “Because you never know if someone comes to the school doing something they have no business doing; you know, the teacher might think in her head, ‘Well, I’m not going to protect this student the way I’m going to protect this one.'”

Some messages included a reference to a student who is quiet in class — “I guess she mime[s] sex?” one teacher wrote. The teachers also mentioned by name a transgender student and seemed to mock his identity. The student, who also spoke to WDHN, said that the teacher apologized but that the messages betray a dangerous lack of compassion — especially for students who may already feel marginalized.

“I’ve been scared, to say the least,” he said. “I never know what to expect with who I’m around. I’m always careful with what I say, how I introduce myself to certain people, because I never know how the reaction is going to be.”

The messages reportedly leaked after a teacher gave a student her phone during a recent school day. The student, according to WDHN, then saw the exchange and took a video of the ongoing conversation.

It’s unclear why the student had the teacher’s phone, but the screenshots quickly made their way to Facebook and spread from there.


Tuesday, November 19, 2019

Arms Up

In Western's they used to have the black hatted robber shout, "Arm's Up!" to allow the victims the chance to be decently robbed and of course he rode away in the dust without killing anyone as anyone who had their arms up were not threatening in the least as they could not get their weapon.

Last night on the NBC National news I watched Teachers be prepped and armed on how to take out a school shooter.  It was distressing to say the least.  Yes after a day trying to teach children already damaged, play armchair Social Worker, Psychologist, Nutritionist, Doctor, Teacher and of course perfect apolitical support mechanism for a crazy Principal, fellow Teacher or some other fuckwit who works in the schools let alone Parents who are either helicoptering over the school or utterly invisible seems like a good idea to whip out a  pistol at the end of the day and head for some target practice!

There was a shooting here in New Jersey last weekend at a football game (something that in Nashville is not shocking as every other week there is some child involved violence and almost all of it gun related if not in theft alone) and then a shooting in a Walmart parking lot in Oklahoma that seems to be connected to Domestic Violence but as it was only three individuals it does not fall under the category of a  mass shooting.  Then we have another shooting, death or some other accident appropriated to gun ownership happening right as I write this.  

Yes this gun issue is working out well into play in Congress who are more concerned about Russians, Ukrainians and other nefarious souls who are not actually killing people but doing what they do best - fucking with the system to erode Democracy.  And we play right into their hands. Arm's up! I surrender. 



Ten dead after California sees three mass shootings in four days

Shootings at high school, home and backyard party prompt renewed calls for action against gun violence

Sam Levin in Los Angeles
The Guardian
Mon 18 Nov 2019

Ten people were killed in three mass shootings in California in just four days, marking a particularly brutal wave of gun violence incidents in the state.

On Thursday morning, a 16-year-old student from Saugus high school in Santa Clarita, 30 miles north of Los Angeles, shot five classmates and then himself. Two of the victims, a 14-year-old boy and a 15-year-old girl, succumbed to their injuries, as did the gunman.

On Saturday morning, a gunman in San Diego killed his estranged wife and three of their children, boys ages three, five and 11. A fourth son, age nine, was on life support over the weekend, and the gunman also died from a self-inflicted gunshot wound.

The following night, four people were shot dead in Fresno, 200 miles north of LA, after a shooter entered a backyard party and fired into the crowd. The victims in the Sunday evening attack were men between the ages of 25 and 35, according to police, who said six others were injured and expected to survive.

Including the gunmen, 12 people died, and at least 10 others were injured in the three tragedies, with countless additional students, families and communities terrorized and traumatized by the attacks.

“The failure to protect our communities, families, and children is a waking nightmare that needs to end,” the former congresswoman Gabrielle Giffords said in a statement Monday. “If we don’t act, generations of Americans will expect gun violence to be a public safety threat that could change their lives no matter where they live.”

Giffords, a gun safety advocate and shooting survivor, released her statement following reports of yet another mass shooting at a Walmart, with police in Duncan, Oklahoma, saying three had been killed outside the store on Monday.

“We should refuse to live in a world where our children live in constant fear of gunfire. We should never accept this level of gun violence as normal,” she said.

The victims in the Saugus high school attack were Gracie Anne Muehlberger, a 15-year-old cheerleader, and Dominic Blackwell, a 14-year-old football player. The gunman, who used a .45-caliber pistol, carried out the shooting in just 16 seconds, according to authorities. Investigators have not released any information on the shooter’s motive.

In the San Diego murder-suicide, police said the mother was in the middle of a divorce with the shooter and that she had sought a restraining order a day before the tragedy. In Fresno the following day, roughly 35 people were gathered in a backyard watching a football game when someone opened fire. The suspect or suspects fled the scene, and investigators are working to determine the reason behind the killings.

The attacks highlighted the frequency of mass casualty incidents in the US, where major gun violence attacks are so common that these kinds of attacks often barely register as national news stories.

“There’s a moment where you just feel hopeless,” said Kasey Zahner, the San Diego group lead for Moms Demand Action, a gun safety organization. “It’s like, I’ve been working on this for how many years, and these incidents are still happening? I try to focus on all the good people who are working so hard so this doesn’t happen to another family.”

Zahner, who lives 15 minutes away from the site of the Saturday shooting and has two young children, said it was difficult to process: “It’s unimaginable … We are heartbroken.”

Everytown for Gun Safety, a not-for-profit organization for gun policy reform, said there had been more than 25 mass shootings this year and more than 220 since January 2009. The group defines mass shootings as cases in which four or more people are shot and killed, excluding the shooter. The group’s analysis of 173 mass shootings in recent years found that 59% of them happen in private homes.

Ari Freilich, state policy director with the Giffords Law Center to Prevent Gun Violence, noted that California had some of the strongest gun laws in the country and that research had shown Californians are significantly safer from gun violence than the rest of the country.

“Those protective laws tragically weren’t enough here,” he said, adding: “The news cycle will move on, and other communities unfortunately will be impacted by this, but for the families who are left with empty seats at their dinner tables for all of time … it is a brutal personal loss. It’s for them we do this work.”

What? I missed that.

Well another week filled with shootings which means more medical emergencies and long recoveries for those whom survived from their injuries and those whose injuries are no less visible but no less damaging and both with equal chance of finding recovery and help once they enter the medical industrial complex.  We already know about the outrageous costs involved and in turn the time and expertise required to treat the victims but are any of these Doctors and others any more qualified or better prepared to handle what this means?  All people are different and respond and heal and in turn demand and need individualized treatment and care and if you think you are getting that from your Physician that you believe has your best interest at heart think again.

Just my endless strum and drang with Vanderbilt constantly reminds me that despite having familiar faces and a well established treatment plan you will still hit road blocks and issues that no one in the medical field deals with well and in turn feels compelled to project and in turn blame you the patient for their failures.   I have no doubt the Intern who fucked up my Dental Implant if he knew (as they rotate every four months so I have never seen or spoken to him about that mistake but it was clearly pointed out to the next Intern who assisted the Surgeon during the corrective process) would blame me somehow for his fuck up it.  It is how they roll in the complex.

The below article discusses just how those biases and beliefs affect diagnosis and treatment.  This week it was revealed that heart surgery is often unnecessary when drugs can do the trick.  Shocking! I know, not really.  We have heard that many medications do not do what they are believed to do and we are already overmedicated and overprescribed from antibiotics to opioids.  And yet the costs of drugs continue to rise.   We already know people of color, those uninsured and of course women are often misdiagnosed and in turn arrested, dismissed or placed in confinement due to laws, regulations and of course White Male Physicians who just know better.  What.the.fuck.ever.




Your diagnosis was wrong. Could doctor bias have been a factor?

By Eve Glicksman
The Washington Post
November 18, 2019 at 4:26 p.m. EST

Doctors, like the rest of us, make mistakes. Every year, upward of 12 million Americans see a physician and come away with a wrong diagnosis. The top cause? Bad judgment, says David Newman-Toker, director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality’s Center for Diagnostic Excellence.

Newman-Toker found that judgment errors accounted for 86 percent of 55,377 medical malpractice claims he evaluated where misdiagnosis led to death or disability. The judgment blame bucket includes an assortment of knowledge gaps, inattentions, misinterpretations and what Angie Rosen believes led to the misdiagnosis of her stroke in August: implicit bias.

Implicit bias occurs when a well-intended physician’s unconscious assumptions get in the way of objectively gathering or assessing a patient. Rosen, 37, thinks that her age, gender and possibly her same-sex spouse were behind a doctor’s dismissal of her symptoms in a Philadelphia hospital emergency room.

Rosen experienced a terrible stabbing pain in the back of her head that became a migraine. Her left eye started drooping, her right side was numb, she couldn’t swallow. When she tried to walk to the bathroom, she felt as if she was intoxicated.

An ER doctor examined her, ordered tests and told her to go home. It was unlikely she had a stroke, he responded when she asked. Through a video consult, a neurologist concurred with his assessment.

Rosen insisted, however, she felt too ill to leave the hospital, and she was admitted. Two days later, the doctor said her returned studies did not indicate a stroke and discharged her.

Rosen’s migraine continued to rage, however. Her family took her to the Hospital of the University of Pennsylvania for another opinion. “Do you believe me?” she remembers asking the staff desperately. Within two hours, doctors determined she had suffered a stroke, admitted her and started treatment.

At home now, Rosen continues to make progress in physical therapy. It’s uncertain whether the treatment delay will prevent full recovery.

If you are having a stroke, there is about a 9 percent chance you will be misdiagnosed in the ER — a statistic that applies to all age groups when the patient is seen initially in the ER. But if you are young, female, a person of color or have limited education (less than a high school degree), your risk of misdiagnosis soars, Newman-Toker discovered.

Rosen, in the 18-to-45 age group, was seven times more likely than a 75-year-old to be misdiagnosed, his research showed. Simply being a woman raised the risk a doctor would miss her stroke by 30 percent.

Is implicit bias a gateway to health-care disparities? It’s hard to tease out whether some diagnostic errors are caused by racism or sexism, or simply a lack of knowledge about how certain diseases appear differently because of a person’s race, age or gender, says Newman-Toker, also a professor of neurology at the Johns Hopkins University School of Medicine. “Bias thrives in the void of expertise.”

Alyson McGregor, co-founder and director of the Sex and Gender in Emergency Medicine Division at the Warren Alpert Medical School of Brown University, maintains women get the short-shrift in health care.

“It’s the bias of a whole medical system,” McGregor says. “One-sex medicine,” she calls it, when physicians are trained to identify symptoms only as they appear in white men.

Add that to centuries of women’s medical complaints relegated to feminine hysteria. “Anxiety is a wastebasket diagnosis for the unknown,” says McGregor, which can happen when a woman’s symptoms don’t follow specific patterns learned in medical school.

Then, there’s race. African Americans with severe depression are four to nine times more likely to be misdiagnosed with schizophrenia compared to white Americans showing the same cluster of symptoms, says Stephen Strakowski, acting senior associate dean of research and a psychiatry professor at Dell Medical School at the University of Texas at Austin. As a result, they do not get the antidepressant or mood stabilizer they need and may suffer unnecessary side effects from schizophrenia medications.

In Strakowski’s studies, doctors consistently put more emphasis on the psychotic than the depressive or manic symptoms when evaluating black patients. “This almost certainly stems from unconscious bias,” he says, noting that the rate of schizophrenia is the same for all races.

People with mental illness may be affected the most by implicit assumptions overall, says Mark Graber, chief medical officer of the Society to Improve Diagnosis in Medicine. Physicians are focused on the patient’s mental health so they may not notice a heart problem. Or when the patient complains about abdominal pain, the doctors may tie it to depression or anxiety without testing.

So what’s a patient to do?

Doctors get the diagnosis right 9 out of 10 times, Graber says. Our brains are hard-wired to take shortcuts and this usually serves us well.

“It isn’t feasible to explore dozens of explanations for each symptom during an appointment,” says Thomas Yuen, on the faculty of the Family Medicine Residency Program at Crozer-Chester Medical Center in Upland, Pa., who has studied cognitive biases. Patients need to speak up if they think a doctor is missing something, he says.

By doing the legwork of gathering medical records yourself to bring to an appointment, you give the doctor more time to think, not generalize about symptoms, Newman-Toker says.

Keep in mind that attributing a symptom to stress or anxiety can be a default position when a doctor is stumped.

“Ask ‘What is the most worrisome thing this could be and why isn’t it that?’ ” Newman-Toker says. If your doctor can’t support an opinion or is dismissive, it’s a red flag that the diagnosis may be a gut reaction, he says.

Whenever you have doubts, “Ask the doctor if there can be more than one thing going on,” Newman-Toker adds. Obesity may cause back pain, for example, but if a doctor concludes that without looking further, that is unconscious bias.

And while you want to believe all is well, check your own blind spots. Don’t let a physician tell you there is nothing to worry about if a referral seems wiser. “Keep at it,” Graber says. “If you are not reassured, get a second opinion.” Likewise, revisit your doctor if symptoms persist; it could be a wrong diagnosis, not medicine that isn’t working.

Implicit bias in clinical settings is hard to measure and good data is lacking.

“[Bias] may be a bigger problem than we think,” Yuen says. “The final frontier [for physicians] could be our own judgment and emotions.”

Thursday, November 14, 2019

Kentucky Downs

As Kentucky has been in the news of late over the Governor's race I want to remind those who may not know that the former (and yes he is out despite his denial) Governor declared a "Take your Bible to School day." The same Governor who informed striking Teachers that they were enabling children to get raped and harmed due to their not being there. Well I guess he was wrong on that one.

Ever read Fahrenheit 411?  The Handmaids Tale? I have but they made great shows too.  Read and learn or watch but learn. Ignorance is not bliss it is ignorance and the South has a special hold on that coupled with arrogance.
A principal who banned LGBTQ books, calling them inappropriate, now faces child porn charges 
By Reis Thebault
The Washington Post
November 13, 2019

A Kentucky school principal who became infamous for his efforts to ban books with “homosexual content” from classrooms has been indicted on child pornography charges.

Phillip Todd Wilson, who used to run the Clark County Area Technology Center east of Lexington, is facing 17 counts of child pornography possession and distribution after state police arrested him in August. He was fired from the school shortly after his arrest, Kentucky Department of Education spokeswoman Jessica Fletcher said.

Wilson attracted police attention after someone told his facility’s school resource officer that the principal had sent them 15 pictures via social media and text messages, the Winchester Sun newspaper reported. In an interview with police, Wilson admitted to sending images to two females and authorities confiscated his cellphone and laptop.

Ten years ago, as principal of nearby Montgomery County High School, Wilson was at the center of a statewide and national debate over the censorship of books that featured LGBTQ characters and references to sex, suicide and drug use. Wilson and other school officials successfully barred at least four young-adult novels, arguing their explicit content was inappropriate for high school students.

After Wilson’s arrest, several authors of the banned books pointed at the dark irony.

“Books that help kids examine the violence, abuse and shame they’ve endured are very threatening to the people who commit those acts of violence, abuse, and shaming,” tweeted Laurie Halse Anderson, whose “Twisted” was among the targeted books.

Books that help kids examine the violence, abuse and shame they've endured are very threatening to the people who commit those acts of violence, abuse, and shaming.
— Laurie Halse Anderson (@halseanderson) August 28, 2019

“Deadline” by Chris Crutcher, “Lessons From a Dead Girl” by Jo Knowles and “Unwind” by Neal Shusterman were also banned.

In a Facebook post, Knowles wrote that she was a new author at the time.

“The press coverage was overwhelming,” she said. “I was horrified by the accusations he and the superintendent made.”

Books about LGBTQ issues are being challenged in schools and libraries across the country. In 2018, six of the 11 most frequently challenged and banned books included LGBTQ content, according to a report from the American Library Association. That number is up from the past two years, when four and five of the most-targeted books referenced LGBTQ issues.

The organization said it has “noticed a repressive push back by those who believe that a more diverse and just society poses a threat to their beliefs and their way of life.”

The report highlighted the particularly alarming case of a conservative religious activist in Iowa who was convicted of criminal mischief for burning four LGBTQ children’s books during a city’s Pride parade. Elsewhere, the report added, groups have filed lawsuits to stop Drag Queen Story Hours, which aim to teach children gender diversity and acceptance

In Loudoun County, Va., this year, newly installed “diverse classroom libraries” were meant to expose students to stories about young people of different cultures, races and religions. Books involving LGBTQ issues made up less than 5 percent of the new collection — yet those works have prompted a heated debate in the school district, with some parents calling them “sexual propaganda.”
School officials are now reviewing 10 books in the collection, at least four of which feature LGBTQ characters, and they’ll decide whether to keep or remove them.

Other parents, activists and the local chapter of the American Civil Liberties Union have implored the school district to reject calls to remove books.

“Purging certain books from school libraries because some parents do not like them is government action favoring the opinion of some parents over others,” read a letter the ACLU sent school officials last month. “Passing judgments, applying labels, and red-flagging educational materials that might prompt uncomfortable but insightful discussions are activities that do not belong in our public schools.”

I already experienced the crazy in Nashville with each school having to display the words IN GOD WE TRUST in visible entries in public schools, the hysteria over sex education while also falling well past triple digits when it came to sexual scandals and abuse. The endless sex and racial scandals in the State House and of course the movement to vouchers in public education to ultimately eliminate public school funding and education.  Nashville Government spent a great deal of time and energy on anti LGBQT issues and often backbend them but they are always there just simmering on the stove waiting for another opportunity to boil over.

The South shall rise again and by rising I mean their dicks as I have never been anywhere where the men are obsessed with sex and pussy and the women equally obsessed with how they make sure theirs is always open willing and ready for if not that may explain why Tennessee is number five in the nation for Domestic Violence. Teach your children well so that they may live by.




A Debtor's Prison

That is the state of medical care and the bills associated with the debt accumulated when an individual enters the medical industrial complex, emphasis on complex.

The story below is one of many about the problems individuals in America face daily when it comes to finding care, paying for care and the reality behind what it is like to become ill and need treatment be you insured or not.

The real issue in the election of 2020 is not the Ukraine nor Trump's crazy it is the issue surrounding medical care and insurance followed by taxes and the rising tide of inequality that has enabled this division in the tide that allows some access to care and to stability once that care is provided.  For the rich it is an easy fix for those not it is not.

I debated whether to sign up for medical insurance this year and with premiums topping 700 bucks a month for services I have never used other than a joke of a flu shot and some meds associated with my dental needs I decided I would be better off putting that money into an emergency fund that I could use in an emergency be it medical or otherwise.  And of course I get this whole concept of negotiation - or quid pro quo as the word of the week has taught us.  Yes you can negotiate medical care. 

To put it mildly we have a fucked up system of care.  The dental insurance industry is largely unregulated and covers very little and is a disaster when it comes to finding qualified capable individuals who can offer consistent appropriate care and treatment. Then we have vision care which runs the gamut from mall specialty sight providers to actual Doctors and licensed professionals who at least have some training and education to offer service. Add the absurd costs for frames and lenses it again puts basic care at the equivalent of a Jenga game where you are hoping  your pull will not crash the entire set up.

Add to the current state of affairs is now Google acquiring Ascension medical records giving them troves of personal data to mine like a coal miner in Kentucky back in the day and of course the move by Amazon and others to provide a quasi medical service from prescriptions to diagnosis all which again puts the consumer at risk to what kind of care and the legitimacy of the drugs being received. It is one thing to get a bogus pair of Air Jordan's another to get a drug that has the incorrect dosage or diagnosis.

Then we have the rise of the medical lawsuits for unpaid bills.  From low to high more and more hospitals are taking their patients to court and winning, garnishing wages, freezing accounts and placing liens on property to garner payment for the debt owed.

For the record I pay in Cashier's check when I pay medical bills so they don't have access to my account information, I have a post office box and no phone listed so that all bills and no calls come to my home while I finish my treatment at Vanderbilt.  I prepaid on my dental bill 5K when the estimate came and I was told it was a slush fund that is used to pay any and all debt in whatever department I used in the facility. No, no its not.  Even their own Doctors don't get medical billing.   I will not pay one more dime until they can provide a detailed accounting of the money, where it is, how it is being used and to where it is going.  They can in a well used phrase: Go fuck themselves.

This is the issue for 2020 MEDICARE FOR ALL.  However you want to express it, define it or understand it.  We need a Government run health care insurance provider whom you can opt in or not and for the rich they can still buy private insurance and all the accoutrements that it entitles them to have but basic care is a human right and frankly the access and availability of said care is non existent as it stands now.   No one should find themselves homeless to get needed care.  Yes sure you are an idiot and you do drugs and don't take care of yourself but ultimately let's find a way to get these people the help they need to ultimately care for themselves in a manner that is less reliant of other public services such as disability and welfare.  Imagine if that one case mentioned in the article was allowed to keep his job, to work and provide that his only debt was in basic needs he would be not a burden on society but on himself and those around him who could help him learn ways to live with less risk, have a healthy happy lifestyle that has the medications that he can use and need to survive without the risk of further decline - physically or financially.   Independence matters but right now we are all living in debtor's prisons just waiting for parole.


'I live on the street now': how the insured fall into medical bankruptcy

Having health insurance is often not enough to save Americans from massive debts when serious illness strikes

Michael Sainato
The Guardian
Thu 14 Nov 2019

It’s been over a dozen years since Susanne LeClair of West Palm Beach, Florida, was first diagnosed with cancer, she’s been fighting ever since. Now she, like many other Americans facing life-threatening illness, is bankrupt despite having health insurance.

Before her first cancer-related surgery, LeClair was told by the hospital they accepted her employer-based health insurance.

“I paid my $300 copay. After the surgery, I started receiving all these invoices and came to find out the only thing covered was my bed because the hospital was out of network,” said LeClair. “My bills were hundreds of thousands of dollars, so I had no choice but to file bankruptcy.”

LeClair is on the verge of having to file for bankruptcy a second time due to the mounting medical debt she has accrued for additional cancer-related surgeries, regular appointments, medications and supplies related to her recovery, despite having health insurance and paying as much as she can out of pocket for copays, deductibles and premiums to maintain insurance.

“My medical bills are at $52,000. I’ve done everything from credit cards to consolidation loans, I just keep simply paying one credit card with another interest-free one until I can pay the next one,” LeClair added. “It’s the side of cancer most people don’t understand or know about and it’s never-ending. It just keeps adding up and adding up and before you know it you’re back in debt that you can’t believe again.”

Bankruptcy can also make it difficult to find employment given that many employers will disqualify a candidate with a bankruptcy filing found from a background check.

According to a study published in February 2019, about 530,000 bankruptcies filed annually are because of debt accrued due to a medical illness. The study found that even the Obama administration’s landmark Affordable Care Act (known as Obamacare) has failed to change the proportion of bankruptcies caused by medical debts, with poor health insurance cited as one of the main culprits.

Republicans and Democrats are currently at loggerheads over Trump administration plans to further weaken Obamacare by making it easier for states to opt out of certain requirements and offer cheaper plans that could further exacerbate the situation. And health insurance has emerged as one of the signature issues of the 2020 election, and the fight for the Democratic presidential nomination with senators Bernie Sanders and Elizabeth Warren promising a total overhaul and Joe Biden and others pledging milder reforms. What all sides admit is that the current system is broken.

“Health insurance that we have today is a defective product,” said Dr David Himmelstein, distinguished professor of public health at City University of New York’s Hunter College and a lecturer in medicine at Harvard Medical School.

“A lot of people, a little over 60%, are filing bankruptcy at least in part because of medical bills. Most of them are insured. It’s clear that despite health insurance, there are many, many people incurring costs not being covered by their insurance,” said Himmelstein. “Medical debt is incredibly common, it’s the main cause of calls from collection agencies, and the vast majority of people with it have insurance,” said Himmelstein, lead author of the study Medical Bankruptcy: Still Common Despite the Affordable Care Act.

One out of every six Americans has an unpaid medical bill on their credit report, amounting to $81bn in debt nationwide, while about one in 12 Americans went without any medical insurance throughout 2018. Even as many Americans struggle to afford health insurance coverage in the first place, those that have it are not insulated from facing massive debt due to medical bills.

“I have insurance through my job but it has a high premium and high deductible. I have to pay $450 a month. When you think about living paycheck to paycheck, $450 is a lot of money. I’m barely making it. Some bills don’t get paid every month,” said Mary Cross of Detroit, Michigan, who has filed for bankruptcy twice since early 2013 when she was admitted to the hospital for pneumonia, required lung surgery and was diagnosed with sarcoidosis, an inflammatory disease.

“I’m currently struggling to stay afloat now due to having surgery this past January,” added Cross, 51. “I’ve been getting constant calls from the billing department at the hospital where I had surgery.”

In Savannah, Georgia, a 35-year-old man who requested to remain anonymous to avoid being associated with a bankruptcy, recently found himself homeless and jobless due to prolonged hospital stays and hundreds of thousands of dollars in medical debt.

A type 1 diabetic for years, he had to reduce his work hours for a cellular retail store when trouble regulating his blood sugar resulted in a toe amputation in April 2019.

“I had to cut my work hours so bills were harder to pay. But in July 2019 I was admitted to the hospital again and I was fired from my job because I was in the hospital. I lost my insurance. They amputated my leg, which means I still can’t work,” he said.

When he lost his job due to the prolonged hospital stay and leg amputation, his employer offered Cobra, a health insurance program for employees who lose their job or have a reduction in work hours, but he couldn’t afford it. He is currently working on trying to file bankruptcy to release the medical debt he’s accrued from amputations this year and he lost his house in October 2019 as a result.

“I have amassed over $400,000 in medical bills I need to pay, and still have at least six months before I get a disability hearing. So I owe over $400,000 in medical bills, have lost my house and I live on the street now, with no end in sight,” he said.

Just outside of Chicago, Illinois, Jessica Hillman filed for bankruptcy in 2016 due to medical debt accrued from battling a seizure disorder, despite having health insurance coverage for the majority of her treatment.

“I had thousands of dollars in various medical debt which made the majority of my claim. The last bill I got that really pushed me toward the bankruptcy was for a routine lab test that my insurance refused to approve because of a billing mistake. That bill was about a thousand dollars,” Hillman said. “I couldn’t work and had no way to pay these.”

At the time, Hillman was receiving several collection notices in the mail for past hospital stays and tests amounting to several thousand dollars, often having no knowledge of the bills that health insurance didn’t cover until receiving the collection notices.

“One of the biggest hurdles you face as a patient is just the sheer confusion of the process. You think you just show up and present your card, sometimes pay a copay, and that’s it. You don’t expect all these plan limitations and authorizations,” Hillman added. “What are you going to do if your authorization gets denied? You don’t really have a choice to not go get care. All these processes that are in the finest of fine print. And sometimes it feels like you are literally paying for nothing.”

Wednesday, November 13, 2019

Breathe Hard

For those not in the know most DUI cases are bullshit, they are cash cows to municipal systems and much like stop and frisk they jeopardize more minorities and yes women who are convicted and charged at higher rates.  Include in this that a conviction or even just a charge and can often enable localities to seize vehicles under civil asset forfeiture; Regardless this charge destroys lives forever in the same way any criminal charge does.

What many don't know is that DUI charges are for life. They can never be expunged or closed and even when appealed are usually lost as the statutes are written to manage to make even the most dubious of charges stick and also written in such a way that regardless of a Jury trial with expert testimony (costing thousands of dollars in addition to the absurd other fees and requirements) can place a person in bankruptcy fast.   This includes court fees, interlock devices (more fake bullshit) and alcohol classes or therapy which are also more bullshit.   Add to this the battalion of low end Attorneys (of which I count my former Attorney Kevin Trombold and Ted Vosk) who specialize in this which is largely plea bargaining down to lower charges that enable the rotating door of courts to continue to flow with the money train crashing into the station on an hourly basis.

Then we have the supposed science of junk and the many who define themselves as experts on the subject of driving while impaired you know the Cop with super senses who can smell booze and pot.  Sure.  And yes folks that means soon in states where Marijuana is legal they will create a super machine that can tell if you are high by your pupil dilation or some other bullshit that will create a new money train to crash into the courts sooner vs later.  All of it is bullshit.  All of it and this machine and the expert that has since passed but was the source for this article can confirm.  The writer Radley Balko has written extensively on the subject in varying books, journals and the Washington Post and he is one who grasps the absurdity of junk science and how it is used to convict the innocent on a regular basis.

Add to this the numerous stories as alluded to in the below article that have their own problem collecting and testing evidence.  Ah yes it explains oh so much for rape kits and other more technical crime scenes where evidence is critical to finding the right perpetrator and securing a legal proper conviction.  You know all those who have since had their convictions overturned due to this and those who have gone to their death because of it.

Cheers!



These Machines Can Put You in Jail. Don’t Trust Them.

Alcohol breath tests, a linchpin of the criminal justice system, are often unreliable, a Times investigation found.



By Stacy Cowley and Jessica Silver-Greenberg
The New York Times
Nov. 3, 2019

A million Americans a year are arrested for drunken driving, and most stops begin the same way: flashing blue lights in the rearview mirror, then a battery of tests that might include standing on one foot or reciting the alphabet.

What matters most, though, happens next. By the side of the road or at the police station, the drivers blow into a miniature science lab that estimates the concentration of alcohol in their blood. If the level is 0.08 or higher, they are all but certain to be convicted of a crime.

But those tests — a bedrock of the criminal justice system — are often unreliable, a New York Times investigation found. The devices, found in virtually every police station in America, generate skewed results with alarming frequency, even though they are marketed as precise to the third decimal place.

Judges in Massachusetts and New Jersey have thrown out more than 30,000 breath tests in the past 12 months alone, largely because of human errors and lax governmental oversight. Across the country, thousands of other tests also have been invalidated in recent years.

The machines are sensitive scientific instruments, and in many cases they haven’t been properly calibrated, yielding results that were at times 40 percent too high. Maintaining machines is up to police departments that sometimes have shoddy standards and lack expertise. In some cities, lab officials have used stale or home-brewed chemical solutions that warped results. In Massachusetts, officers used a machine with rats nesting inside.

Technical experts have found serious programming mistakes in the machines’ software. States have picked devices that their own experts didn’t trust and have disabled safeguards meant to ensure the tests’ accuracy.

The Times interviewed more than 100 lawyers, scientists, executives and police officers and reviewed tens of thousands of pages of court records, corporate filings, confidential emails and contracts. Together, they reveal the depth of a nationwide problem that has attracted only sporadic attention.

A county judge in Pennsylvania called it “extremely questionable” whether any of his state’s breath tests could withstand serious scrutiny. In response, local prosecutors stopped using them. In Florida, a panel of judges described their state’s instrument as a “magic black box” with “significant and continued anomalies.”

Even some industry veterans say the machines should not be de facto arbiters of guilt. “The tests were never meant to be used that way,” said John Fusco, who ran National Patent Analytical Systems, a maker of breath-testing devices.

Yet the tests have become all but unavoidable. Every state punishes drivers who refuse to take one when ordered by a police officer.

The consequences of the legal system’s reliance on these tests are far-reaching. People are wrongfully convicted based on dubious evidence. Hundreds were never notified that their cases were built on faulty tests.

And when flaws are discovered, the solution has been to discard the results — letting potentially dangerous drivers off the hook.

A man backed his car into an 83-year-old woman outside a liquor store and then failed field sobriety tests. Another man was stopped after vomiting out the window and veering “all over the road.” One more driver, with a suspended license, was pulled over and blew a 0.32 — a level of drunkenness that would leave most people unconscious.

All three were arrested and charged with driving drunk. All three had previous convictions for driving while intoxicated, according to police reports and court records. And all three were acquitted after Massachusetts was forced to throw out their breath tests — along with more than 36,000 others — in one of the largest exclusions of forensic evidence in American history.

The Deerfield River snakes through the woods of northwestern Massachusetts, and on a hot Sunday in July 2013 it was packed with rafters. Matthew Mottor arrived with more than a dozen friends and family members and two coolers of Blue Moon beer.

They spent hours tubing down the river and drinking before going ashore for a picnic. That’s when a drunk woman in the group caught the eye of a Massachusetts State Police trooper patrolling the area. The trooper, Steven Hean, told them to get their friend home. The party over, Mr. Mottor left his girlfriend and got a ride to his truck, a few miles upriver.

He pulled his gray Dodge Durango onto the winding road. He made it about 200 yards. Then he saw the flashing lights.

Trooper Hean wrote in a report that he stopped Mr. Mottor for driving 41 miles per hour in a 25 m.p.h. zone. Detecting “a strong odor” of liquor on Mr. Mottor’s breath, the trooper asked him to perform some field sobriety tests, including walking heel-to-toe.

Accidents years earlier had left Mr. Mottor with metal plates in his ankles and feet, court records show. “I explained to him that I’m not great at walking around on two feet on an everyday basis,” Mr. Mottor said. After passing two tests — reciting the alphabet and standing on one leg — he struggled to walk in a line. Trooper Hean brought out his breath tester.

Hand-held devices, like Trooper Hean’s Alco-Sensor IV, contain fuel cells that react to the alcohol in exhaled breaths and generate an electric current — the stronger the current, the higher the alcohol level. They are inexpensive and easy to maintain, but their results can be inconsistent. Older women sometimes have trouble producing enough breath to get the machines to work. Toothpaste, mouthwash and breath mints — even hand sanitizer and burping — may throw off the test results.

Tests from those portable machines are not admissible in court in most states (California is among the exceptions). But they often trigger an arrest, which leads to a test on another machine at the police station. That result determines whether someone is charged — and, often, whether they’re convicted.

By the side of River Road, Mr. Mottor blew a 0.13, far above the legal limit. That’s when the cuffs came out.

Attempts to prevent drunken driving predate the modern automobile.

In the late 19th century, Britain had outlawed being drunk while operating a “carriage, horse, cattle or steam engine.” In 1897, a London taxi driver named George Smith crashed his electric cab. He confessed to having had “two or three glasses of beer” and was fined 20 shillings. It is widely regarded as the first arrest for intoxicated driving.

Near the end of Prohibition, a biochemist invented a suitcase-sized machine with vials of chemicals and a balloon to blow into. Alcohol in the driver’s breath would trigger a reaction: the drunker the driver, the deeper the chemicals’ color. It was called the Drunkometer. But it was bulky and hard to use.

Two decades later, a police photographer and amateur chemist named Robert Borkenstein developed a similar but more portable machine. He named it the Breathalyzer.

Police departments around the country bought Mr. Borkenstein’s invention and versions developed by competitors. Then, in 1980, a fatal collision led to an overhaul of America’s drunken driving laws — and a sales boom for companies that made breath-testing devices.

Carime Lightner, 13, was walking to a church carnival in Fair Oaks, Calif., when a drunken driver slammed into her so hard she was knocked out of her shoes. The man had been arrested repeatedly for intoxicated driving.

Carime’s mother started Mothers Against Drunk Driving and launched one of the most effective citizen lobbying campaigns in history. States set stiffer penalties, including mandatory jail time in some cases, and made it illegal to drive with a blood-alcohol level above a designated mark.

The crackdown worked. In 1982, the year the National Highway Traffic Safety Administration began keeping records, some 21,000 people were killed in drunken-driving incidents. The number of deaths tumbled to around 10,500 in the most recent annual tally, even as the number of miles driven by Americans has nearly doubled.

In most of the country, the threshold for illegal drunkenness is 0.08 grams of alcohol per 100 milliliters of blood. The only way to measure that directly is to draw blood, which requires a warrant. Breath tests are simpler.

Testing machines can go for $10,000 or more, and some two dozen companies sell them in the United States. The biggest contracts, with state police crime labs, are worth millions.

A St. Louis company, Intoximeters, made the portable device used on Mr. Mottor. Dräger, a German company, owns the rights to the Breathalyzer name. CMI, based in Kentucky, is another industry leader.

“Our top priority is the quality and safety of our products,” said Brian Shaffer, a Dräger spokesman. “Our products provide the highest level of forensic and legal integrity.” He added, “Our advanced evidential breath alcohol testing instruments exceed the requirements of national and international regulatory agencies.”

Shirtless and still in swim trunks, Mr. Mottor arrived at the police barracks in Cheshire, Mass. He didn’t think he was drunk. But he was starting to panic.

He had left his phone in his S.U.V. and had no way to tell his girlfriend what had happened. He pictured her alone by the river, thinking he had driven into a ditch.

Mr. Mottor was escorted to the station’s breath-testing machine. It was larger, more sophisticated and in theory more reliable than Trooper Hean’s portable instrument, and its results were admissible in court. Trooper Hean asked Mr. Mottor to start blowing. Hoping it would help him get back to his girlfriend faster, he complied.

The Alcotest 9510, manufactured by Dräger, resembles a fax machine with a small hose. As a person breathes into the device, a beam of infrared light is shot through the sample. Chemicals, including the ethanol in alcoholic drinks, absorb light to varying degrees. By analyzing how much light is absorbed, the instrument can identify the type of chemical and the amount of it present.

Many machines, including the Alcotest 9510, also use a fuel-cell sensor — the same type of tool that is in portable devices. Each system is supposed to operate independently; if both return similar results, the theory goes, it’s an extra assurance that the measurement is accurate.

Mr. Mottor blew for about 10 seconds, the machine beeped, and a number flashed on its screen: 0.08.

He was charged with operating under the influence, which leads to the automatic revocation of driving privileges in Massachusetts. Trooper Hean confiscated Mr. Mottor’s license and called a truck to tow his S.U.V.

Breath-testing machines need less than a minute to run their calculations. What happens during those 60 seconds, though, has been the subject of years of courtroom fights.

Defense lawyers have repeatedly tried to forensically examine the machines, especially their software. Inspecting the code could reveal any built-in flaws or assumptions the devices use in their calculations.

But even procuring a machine is a challenge. Manufacturers won’t sell them to the public.

Jan Semenoff, a former police officer who works with defense lawyers, was once a CMI salesman and had a machine left over from those days. When he sent it in for a repair, CMI wiped the machine’s memory chip. “They turned the damn thing into a paperweight,” Mr. Semenoff said.

Courts in at least six states, including New York, have rebuffed defense lawyers’ attempts to get their hands on the machines’ code.

But in 2007, the New Jersey Supreme Court granted a request by defense lawyers and ordered Dräger to allow outside experts to analyze the software for the Alcotest 7110 machines in use statewide. The experts said it was littered with “thousands of programming errors,” according to their report to the court.

After reviewing the evidence, the court deemed the Alcotest 7110 “generally scientifically reliable.” But the state court also acknowledged the devices had “mechanical and technical shortcomings” that had the potential to produce the wrong result. Dräger said it quickly fixed the problems, but the state never rolled out the software update, court records show. Dräger now advertises the 7110 as the only device on the market whose software “has been reviewed by independent third parties and approved by a Supreme Court decision.”

None of that made a difference in other states, which employ a variety of machines and standards. Each state decides how rigorously it will test machines, and several have used devices that were deemed unreliable elsewhere.

In 2005, for example, Vermont’s toxicology lab scrutinized machines from four manufacturers. The lab rated CMI’s Intoxilyzer 8000 as “unsatisfactory” and found that it gave inaccurate results on “almost every test,” according to a lab technician’s report.

But the same device was already being used in Mississippi, and it would soon be deployed by other states, including Ohio and Oregon.

Florida, too, adopted the Intoxilyzer 8000, even after a test machine short-circuited and started to smoke, state records show.

When the state began setting up its new devices, technicians found they were returning inaccurately low results, according to court testimony. A CMI engineer diagnosed a problem with airflow, and he drilled a small hole in the exhaust valve to solve it.

The fix worked. CMI started boring holes in all the devices it sent to police departments in Florida, court records show.

When defense lawyers discovered the undisclosed change, they challenged its legality. The Collier County judge who heard the case in 2012 said he was “extremely concerned” about the modifications.

“A criminal defendant should not face conviction and possible incarceration based on secret undisclosed evidence,” he wrote in his ruling. Ultimately, that case and others led several Florida judges to stop allowing breath tests to be used in their courtrooms.

Defense lawyers in state courts across the country have sought to learn more about the devices being used to convict their clients. In two states, Washington and Massachusetts, they took aim at the instrument that Mr. Mottor blew into: Dräger’s Alcotest 9510.

When the State of Washington decided to spend more than $1 million to replace its aging machines in 2009, the state police chose the Alcotest 9510 despite a report by their own scientist that described the machines as “not yet ready for implementation.”

Before rolling out the machines, state officials debated whether to spend tens of thousands of dollars on an outside expert to evaluate the software. Fiona Couper, a state toxicologist, emailed her colleagues: “I think we throw caution to the wind and proceed without paying up front for an independent evaluation.” (In an email to The Times, Ms. Couper said that “it was too premature to evaluate the software at that time.” Court records show no evaluation was ever done.)

In 2015, a local judge granted a request from defense lawyers to review the software underpinning the state’s Alcotest machines. That task fell to a consulting company run by two veteran programmers and security experts, Robert Walker and Falcon Momot.

Mr. Walker had worked at Microsoft for more than a decade and was adept with Windows CE, the obsolete operating system powering the Alcotest 9510. Mr. Momot, a soft-spoken hacker with spiky facial piercings and a rainbow-colored mohawk, was known for his talent in hunting down complicated computer bugs and software vulnerabilities.

Dräger insisted on extraordinary security. It demanded that its software be reviewed on an isolated computer network and that the state police be able to inspect the testers’ equipment, according to court documents.

“I worked on the most confidential things that Microsoft does, and they don’t have any procedures like this,” Mr. Walker said in an interview.

After a couple weeks dissecting the Alcotest code, they wrote a nine-page draft report, “Defective Design = Reasonable Doubt.” They planned to dig further, but things went awry when they shared their report with defense lawyers at a convention.

Dräger sent Mr. Walker a letter demanding that he and Mr. Momot ask anyone with a copy of their report to destroy it — including the lawyers who hired them — and to stay silent about the instruments’ inner workings. Facing a giant company, Mr. Walker felt he had no choice but to comply. “I am an ant,” he said.

Mr. Shaffer, the Dräger spokesman, said the company was defending its intellectual property. “We really have nothing to hide, but we have something to protect,” he said.

Although Mr. Momot and Mr. Walker’s preliminary report never made it into court, a few copies survived. The Times obtained one from a defense lawyer.

The report said the Alcotest 9510 was “not a sophisticated scientific measurement instrument” and “does not adhere to even basic standards of measurement.” It described a calculation error that Mr. Walker and Mr. Momot believed could round up some results. And it found that certain safeguards had been disabled.

Among them: Washington’s machines weren’t measuring drivers’ breath temperatures. Breath samples that are above 93.2 degrees — as most are — can trigger inaccurately high results.

Washington had decided against spending more on a sensor that would check breath temperature and allow the software to adjust for it, according to Mr. Shaffer. He said Washington wasn’t alone; most of Dräger’s American clients skip the sensors.

The Washington State Patrol is “very confident in the accuracy and reliability of the Dräger 9510 breath test instrument,” said Sergeant Darren Wright, a spokesman. He added that the patrol did not believe that the breath temperature sensor was needed to produce accurate results.

Other states have disabled different safeguards.

In Minnesota, for example, officials found that the fuel-cell systems in their DataMaster devices often broke down, according to court testimony. Instead of fixing the problem, technicians simply turned off that portion of the machine in 2012. The effect was to eliminate an important quality-control check — one that had been a selling point when the machines were purchased.

The state's Bureau of Criminal Apprehension, which manages the testing program, said it “remains confident in the reliability of results obtained by DataMaster devices across Minnesota.”

His license revoked, Mr. Mottor relied on rides from family and friends to get to the restaurant in the Berkshire Mountains where he was a chef.

The consequences rippled outward. He and his girlfriend shelved plans to buy a house. He couldn’t sleep. He could no longer drive his 2-year-old daughter to play dates. He worried about going to jail and leaving his family unable to afford to heat their single-wide trailer.

“I think I took 10 years off my mother’s life,” Mr. Mottor said.

After three months, he was able to get his license reinstated while his case progressed. Mr. Mottor hired a lawyer to fight the charges. To pay that bill, he maxed out his credit cards, raided his retirement fund and borrowed money from nearly everyone he knew.

His lawyer planned his defense: Mr. Mottor had been entrapped by the state trooper, his foot injury explained why he failed the field sobriety test, and a phenomenon called “retrograde extrapolation” meant that Mr. Mottor’s blood-alcohol level might have been lower when he was on the road than when he was tested at the police station.

It didn’t occur to either of them to question the breath-testing device itself.

Questioning the device worked for Robert Friedlander — and set off a chain reaction that destabilized Colorado’s enforcement of drunken-driving laws.

On the night of May 30, 2016, a Colorado State Patrol officer pulled Mr. Friedlander over after seeing his Audi sedan swerving. At the station, he blew a 0.07 — below the threshold at which a driver is considered drunk, but high enough in Colorado for him to be charged with a lesser offense, impaired driving.

Mr. Friedlander, however, was adamant that he was not impaired — and that he had evidence to support his claim. Years earlier, he had been convicted of impaired driving, and he had carried around a small portable breath tester ever since.

That May night, Mr. Friedlander had been drinking at the Ameristar casino in Black Hawk. He tested himself and blew a 0.05, he said. Then, he said, he waited an hour, without drinking, before he hit the road.

As Mr. Friedlander fought the charges, his case uncovered widespread problems with how the state forensic lab had deployed its fleet of more than 160 new Intoxilyzer 9000s.

Before Colorado got those machines in 2013, a lab technician, Michael Barnhill, had tested devices from a number of manufacturers. He testified in Mr. Friedlander’s case that his manager ordered him to destroy records from those tests, as well as the manual for the Intoxilyzers, in case defense lawyers tried to subpoena the materials.

The Colorado lab was rushing to meet its deadline to get the machines up and running. But breath-testing devices are not operational right out of the box. Each machine needs to be calibrated using samples with known alcohol concentrations. The process can take an hour or more per machine.

Mr. Barnhill said lab records were faked to show that he had calibrated dozens of instruments that he had never touched. And to speed things up, the lab’s supervisor summoned assistants, including an intern, a CMI lawyer and a sales manager, to help.

“I had taken apart equipment before, but, you know, with my father and whatnot,” the intern, Adam Lopez, said in a deposition. “But never ever have I like done it on an instrument that is on a state level where it’s responsible for, you know, somebody’s prosecution.” He added: “There probably were some errors here and there.”

In addition, the lab’s former science director said in a sworn affidavit that her digital signature had been used without her knowledge on documents certifying that the Intoxilyzers were reliable. The lab kept using her signature after she left for another job.

The judge overseeing Mr. Friedlander’s case was appalled. The lab decided to “consciously disregard truth and accuracy,” he wrote. The judge ruled that Mr. Friedlander’s test was inadmissible unless the lab could prove its machine was producing sound results.

At that point, the prosecutor offered Mr. Friedlander a chance to plead guilty to the lesser charge of reckless driving. He took the deal.

Defense lawyers in Colorado seized on the ruling in Mr. Friedlander’s case to challenge breath test results in dozens of other cases. Most courts followed the judge’s lead and excluded the tests, but there was no statewide resolution, according to local lawyers.

Any problems have “long since been resolved,” said Scott Bookman, the laboratory director at the Colorado Department of Public Health and Environment. “I am fully committed to transparency and accuracy, and we will operate with those chief principles at the forefront of everything we do.”

Mr. Friedlander, however, is skeptical.

“I don’t condone drunken driving in the least little bit, but I was trying to follow the law,” he said. “The machines that they’re using really materially affect people, and these lab bureaucrats, running their little fiefdoms, didn’t seem to give a damn if they were accurate or not.”
HOME-BREWED CHEMICALS

Colorado wasn’t the only place where human mistakes caused a cascade of problems.

When Ilmar Paegle was hired to run the breath-testing program for the Metropolitan Police Department in Washington, D.C., his first order of business was to test its Intoxilyzers. Mr. Paegle, a retired United States Park Police officer, was stunned: Every machine was generating results that were 20 percent to 40 percent too high.

That discovery, in 2010, most likely meant that years of faulty tests had convicted innocent drivers.

Mr. Paegle’s predecessor, Kelvin King, who oversaw the program for 14 years, had routinely entered incorrect data that miscalibrated the machines, according to an affidavit by Mr. Paegle and a lawsuit brought by convicted drivers.

In addition, Mr. Paegle found, the chemicals the department was using to set up the machines were so old that they had lost their potency — and, in some cases, Mr. King had brewed his own chemical solutions. (Mr. King still works for the Metropolitan Police Department. A department spokeswoman said he was unavailable for comment.)

Mr. Paegle, believing the machines hadn’t been giving reliable results for at least a decade, pulled them out of service. He alerted the city’s attorney general, whose office prosecuted drunken-driving cases.

The city stopped using breath-test results in new prosecutions, but it only acknowledged problems in cases going back 18 months. The attorney general’s office determined that in that span, 350 people had been convicted based solely on results that were far too high. Lawyers for those drivers were notified that their clients could ask to have their cases reopened.

But more than 700 other people also had been convicted after receiving inflated test results. The attorney general’s office didn’t believe those convictions hinged on the breath tests, so it decided not to notify those defendants that their results had been incorrect.

The reality, though, was that most of those 700-plus cases had ended in guilty pleas by defendants who thought, wrongly, that prosecutors had infallible scientific evidence that they were drunk.

As Mr. Mottor’s case inched along in Massachusetts, a parallel legal fight was playing out: Lawyers representing hundreds of drunken-driving defendants were pelting the state’s courts with requests for more information on the Dräger Alcotest 9510. (Their cases were consolidated into a single action.)

In 2016 — three years after Mr. Mottor was pulled over — the state’s highest court ruled that Massachusetts had to hand over two Alcotest machines. The defense lawyers would be allowed to hire experts to test them.

The decision caused paralysis. Prosecutors froze thousands of cases until the review was finished.

The software experts and scientists who inspected the Alcotest 9510 machines found troubling mistakes, according to their reports to the court. In some circumstances — when the devices’ two testing methods produced substantially different results, for example — the machines were supposed to generate error messages and terminate the test. Instead, the devices printed a result. (Dräger blamed an error by its computer programmers, which it said has now been fixed.)

But the machines weren’t the only problem. The Massachusetts forensic lab, which for years had been plagued by scandals over faked drug test results and tampered evidence, lacked a written procedure to set up and test machines, the lab’s technical director testified.

The justice hearing the case, Robert A. Brennan, said the lab could not prove that it had followed a “scientifically sound methodology,” and in 2017 he threw out all of its breath test results from 2012 through 2014.

That was only the beginning. Lawyers soon discovered that the lab had hidden records of hundreds of failed calibrations. The discovery provoked a state investigation that blasted the lab’s leadership for “serious errors of judgment.”

Justice Brennan later expanded his previous order: No tests from the lab were admissible until it was accredited by a national board that oversees forensic labs. Eight years of tests — more than 36,000, according to defense lawyers — were suddenly off-limits.

Mr. Mottor’s trial finally got underway on Jan. 10, 2018. He and his lawyer didn’t realize that his breath test was among those that had been invalidated. It remained the state’s crucial piece of evidence.

His lawyer told the court about Mr. Mottor’s shaky balance and metal-filled feet, but the arguments didn’t resonate. The only thing that seemed to matter to the jury was the breath test.

“The .08 comes in, and to them that’s a conviction,” Mr. Mottor said. He was found guilty.

A couple of weeks later, he learned that his breath test never should have been part of the prosecution. He asked to have his case reopened.

When Mr. Mottor’s request was granted, the prosecutor made him an offer: Plead guilty to a lesser offense, and the drunken-driving charge would be dropped. In February, more than five years after his arrest, Mr. Mottor took the deal.

“Even the people in the clerk’s office were high-fiving me afterward,” he said. “They were happy that it was over.”

Since his arrest, Mr. Mottor has maintained a clean driving record. He is still paying off the roughly $30,000 he accrued in fines, court fees and legal bills.

Nearly 29,000 of the invalidated tests in Massachusetts were already used to convict drivers, state records show. This month, the state will begin informing those defendants that they can seek a new trial, and lawyers are bracing for a flood of requests.

So are lawyers in New Jersey, where more than 13,000 people were found guilty based on breath tests from machines that hadn’t been properly set up.

Between those two states, at least 42,000 convictions are at risk. Thousands of other defendants have already been acquitted in cases that prosecutors believe they would have won if they had been able to use their most powerful piece of evidence.

And recognition of the tests’ problems is spreading.

In Minnesota, a judge ruled last year that the state’s machines appeared to be rounding up results, falsely nudging some defendants over the legal limit. (A spokeswoman for the state’s testing program said the judge misunderstood the technology.)

In Washington State, where Dräger sent its cease-and-desist letter, D.U.I. lawyers are trying to consolidate a group of cases to challenge the reliability of the state’s machines.

And in courts around the country — including one last year in Queens County, N.Y. — judges continue to toss out individual cases when questions arise about the tests’ accuracy.

“If we are going to put people in jail and punish people, take their liberties away, take their licenses away, we have an obligation to be accurate,” said Joseph Bernard, the defense lawyer who helped Mr. Mottor get a new trial and is representing dozens of others in Massachusetts.

But there is a cost. Throwing out tens of thousands of faulty breath tests will inevitably let some dangerous drivers back on the road.

“Let’s not fool each other,” Mr. Bernard said. “I am not going to sit here and tell you that situation and that dynamic isn’t going to happen. Of course it’s going to happen. The question is, whose fault is it?”

Saturday, November 9, 2019

The End Zone

The biggest scam of the Trump nightmare is the tax breaks that provided Real Estate Developers with a tax break to develop in specific areas of a city called "Opportunity Zones."  The opportunity is that they get a ten year tax break in which to write off capital gains and hold their interest with little concern to overall use, income generation or even purpose or occupancy rates until they sell the building.  And as always property on land regardless of what sits on top is what determines value so having a structure sit vacant with overpriced under utilized facilities is not a problem, return on investment is.  And there are structured payments in line with expectations under conventional development that investors expect in REIT's or more structured lending packages. Not this one.

The current Congress in between Impeachment hearings are looking into the next Trump fraud to see how to circumvent this after reading about one of the more infamous fraudsters of another decade was brought to the forefront for his role in these capital plans.   Michael Milken was one of the 80s dynamos that gave us Trump and right there is a reason to hold suspect.  He, however, did time.

Chris Christie, the former Governor of my new current State home is another who is profiting from these vaguely needed high end luxury developments alighting my area where rents are Manhattan levels without the benefit of living in Manhattan.  But like the former Governor, they seem to be out of gas.  Maybe Trump was right to leave that lemon.

Here in Jersey they are called "Investment Opportunities" and you see the shiny key syndrome going on all over Jersey City as it was declared an "it" city like Nashville was five years ago but this is still Jersey with all the reputation, the commute issues among others that frankly have allowed some development to go through but like all things in Jersey, you don't mess with the people here or they will push back.  And this past week we saw them stand up to AirBnb and prohibit the unfettered growth in the fake home sharing business that is like WeWork only smart enough to have beards by having real people rent out homes or rooms to provide the face of the average host.  Wrong, wrong and more wrong as they too are largely investors and businesses that are buying or leasing properties with fake hosts posing on the site as the actual owner.  Gee Trevor in Nashville has a hell of a lot of properties and sure enough they found that in Jersey that was the case and they said, fuck that shit. Watch the growth of rentals add to an already large rental market with overpriced units aligning the landscape. The it city status was not something they ran amok on as they did in Nashville and again AirBnb rears its ugly head with the party house bullshit that led to a shooting.  In Nashville they have plenty of shootings in the street but its AirBnb that provides the security they need to keep those Bridezilla floats alive and chugging down the streets of the city.

Meanwhile across from my building they are erecting a 20 floor luxury build that was in the pipeline a little late for entry but if this is an "investment" it will pay back in the views that now blocked and the increased traffic to an already congested area.  Its all good that my view is partially gone as they are building more and more with other views and eventually all good things crash and this is one coming hard.  Let's hope rents fall instead of the buildings however.

But despite it the boon of apartments, storage units and other odd builds that rarely offer affordable housing or development that the everyman can use as Congress is finding.

Lawmakers Increase Criticism of ‘Opportunity Zone’ Tax Break

Congressional Democrats are calling for investigations and legislative fixes in the wake of reporting by The Times.

By Eric Lipton and Jesse Drucker
The New York Times
Nov. 6, 2019

Lawmakers are voicing mounting concerns about a federal tax incentive, known as an “opportunity zone,” that is supposed to encourage investors to pump money into the nation’s poorest neighborhoods.

Leading Democrats in the House and Senate have sent a flurry of letters demanding answers and action by federal agencies after recent New York Times articles detailed how wealthy investors and real estate developers, including those with ties to the Trump administration, are poised to profit on the initiative.

In August, The Times highlighted how tax-advantaged money was beginning to flow to development projects that were underway in affluent neighborhoods even before the opportunity-zone incentive was enacted as part of President Trump’s tax cuts at the end of 2017. The initiative enjoyed broad bipartisan support.

An article last month described how the financier Michael Milken, a longtime friend of Treasury Secretary Steven Mnuchin’s, is among the investors who stand to benefit from the way the Treasury Department is writing the rules governing the tax incentive.

Senator Ron Wyden of Oregon, the top Democrat on the Finance Committee, said he was introducing legislation this week that would eliminate hundreds of opportunity zones in relatively wealthy neighborhoods.

Other lawmakers have written letters, citing The Times’s reporting, to Mr. Mnuchin and called for investigations by the Treasury Department’s inspector general and the Government Accountability

The tax incentive is supposed to help struggling communities by attracting new businesses, housing and other real estate projects. If investors with capital gains — profits on stocks, real estate or other assets that have increased in value — invest them in one of nearly 8,800 opportunity zones, they get a discount on their capital gains tax bill, as well as the potential to avoid any future capital gains taxes if the new investment increases in value.

While the incentive has driven money into economically ailing cities including Erie, Pa., and Birmingham, Ala., much of the money has gone to projects that were already planned or being built in rapidly gentrifying neighborhoods in places like Houston, Miami and New Orleans.

Two Democrats and a Republican on the House Ways and Means Committee introduced a bill on Wednesday to require funds that invest in opportunity zones to file annual reports with the Treasury that disclose details of their development projects and any new businesses.

The bill would impose $500-a-day penalties for failure to file the report and require the Treasury to make the reports public. The Treasury also would have to release an annual report on job creation and poverty reduction attributable to the tax break.

“It’s our job to conduct oversight and ensure the zones work as intended everywhere,” said Representative Mike Kelly, Republican of Pennsylvania, a co-sponsor of the bill.

Mr. Wyden’s bill would go much further. It would make it harder for developments that were underway before the tax break to qualify for the incentive. It also would disqualify about 200 zones that are adjacent to low-income census tracts but are not themselves poor.

“We’re seeing examples that are enormously troubling” among designated zones, Mr. Wyden said in an interview, citing the Times articles. “I am proposing to terminate those zones until we get out in front of this.”

A number of industries are already not permitted to benefit from the tax break, including liquor stores, massage parlors and racetracks. Mr. Wyden’s bill would expand that prohibition to self-storage facilities and luxury housing, which have been popular destinations for opportunity-zone money.

Some of the loudest calls for changes in the tax incentive are coming from members of the Congressional Black Caucus, who in many cases represent poor urban areas that were supposed to see some of the biggest opportunity-zone investments.

Representatives Emanuel Cleaver II of Missouri and James E. Clyburn of South Carolina, both Democrats, said they were extremely disappointed with how the opportunity-zone initiative was playing out, though they acknowledged that the results might improve over time.

Mr. Cleaver said he had spent many weekends organizing meetings in his district to bring together business leaders and local officials to try to lure opportunity-zone dollars to distressed neighborhoods in Kansas City and Independence, Mo.

“We thought the companies would be beating on our doors, saying, ‘Please, please, we want to build this or build that,’” Mr. Cleaver said. “But it just hasn’t happened.”

Mr. Clyburn said that when a real estate project did come to his district, it was to serve college students, not poor residents.

“The program needs to be tweaked — or it needs to experience its funeral,” said Mr. Clyburn, the third-ranking House Democrat.

Representative Ron Kind, Democrat of Wisconsin, one of the original sponsors of opportunity-zone legislation, said he wanted to at least make sure that the measures forcing greater transparency were passed into law.

“There seems to be unanimity and bipartisan agreement that would be nice to move the reporting requirement bill forward,” he said in an interview.

But Mr. Kind said he was troubled by the heavy investment that appeared to be taking place so far in “shovel ready” real estate projects that would most likely have been built even without the tax break.

Lawmakers asked the Government Accountability Office, the investigative arm of Congress, to evaluate the tax break, including how various census tracts were designated as opportunity zones. And at least two House committees are planning to hold oversight hearings into the tax incentive.

On Monday, the top Democrats on the two congressional tax-writing committees, Mr. Wyden and Representative Richard E. Neal of Massachusetts, chairman of the Ways and Means Committee, wrote a letter to Mr. Mnuchin asking questions about The Times article on Mr. Milken and Mr. Mnuchin. The congressmen said it was “deeply troubling” that Mr. Milken appeared to receive special treatment.

Mr. Milken, in a five-page letter posted on his website after the article was published, said he had played no role in recommending to any government official that a county in Nevada where he had invested be designated an opportunity zone. He said he had never discussed his investment with Mr. Mnuchin.