Sexting among teens has become a dangerous trend.

Emma Mary Woodrich is a teen sexter.

Woodrich, 17, thinks of sexting as a hobby, not as something that could have serious legal consequences.

Sexting, or sending nude or semi-nude photos via cell phone or online, is a recent trend among teens and can result in serious legal consequences.

Woodrich is one of the lucky sexters.

“I’ve only been caught sexting one time when my mother found dirty messages on my phone, and I only got yelled at,” said the Chicago native. “I’ve never been caught by anyone else.”

Other teens haven’t been so lucky.

On January 15, the first sexting case went to court in Wyoming County, Pa. Three teen girls faced child pornography charges when they sent photos of themselves topless and wearing bras to two male classmates.

The photos didn’t surface until three months later, when one student’s phone was confiscated at school.

The three teen girls who sent the photos, all of whom were 14 or 15 years old, faced charges of creating, disseminating and possessing child pornography. The 16- and 17-year-old males who received the photos faced charges of possession of child pornography.

The Wyoming County District Attorney ordered the girls to take an education class on the dangers of sexting or else face felony charges. This set off a firestorm of controversy, as the girls’ parents claimed the ruling violated their Constitutional rights and sued the prosecution.

On March 17, the 3rd Circuit Court of Appeals ruled in the students’ favor, stating that the DA violated both the students’ First and Fourteenth Amendment rights by requiring them to take the class or be prosecuted.

But the courts declined to rule on the issue of sexting and whether it qualifies as child pornography or is protected under the First Amendment.

Why sexting?

Sexting, a common hobby embraced by the technology-infused Generation Z-ers, born between the mid-1990s to the early 2000s, has serious legal risks. In some states, teens convicted of sexting could be charged with a felony, face jail time or have to register as sex offenders for up to 10 years.

But that doesn’t stop them from continuing to send sexually charged photos to their peers.

“I think sexting has become such a huge trend because it’s really easy to do and also kind of fun,” Woodrich said. She began sexting when she was 16 years old. She said she sent sexts to boys she knew from school.

According to a study by the National Campaign to Prevent Teen and Unplanned Pregnancy, one in five teens has sent a nude or semi-nude photo of himself or herself via cell phone or e-mail, or posted photos on the Internet or on social networking sites such as Facebook.

While 28-year-old Grahm Grabiec isn’t a minor, he admits to sexting and said not knowing where the photos may end up is “part of the thrill.”

“I started sexting probably two years ago,” said Grabiec, of Pittsburgh, Pa. “I sext less now than I did a year ago, but I still do occasionally. I find it arousing.” He said he sends sexts to women he dates or is friends with but not to any one person, like a girlfriend.

Grabiec said he makes sure to steer clear of minors when sending or receiving sexually charged photos.

“I don’t mess with minors, and I am of age myself,” he said. “I think it is a crime if it involves minors, and not a hobby, but a pastime for consenting adults.”

But the truth is, Grabiec may not even know who is receiving his photos or whose photos he’s receiving. Grabiec is a member of a sexting group on Facebook, a group that boasts more than 1,000 members and has countless cell phone numbers posted on the its homepage. Many of the group’s members are minors.

Grabiec said several factors contribute to the popularity of sexting – the promiscuity of today’s society, low self esteem and “looser morals.” He said he has never been caught sending risqué photos but he acknowledges that sexting, even as an adult, is not without its risks.

“I was never caught, but surely some photos of me have been forwarded to people without my consent,” he said.

Sexting has definitely emerged as a serious issue among minors, said Pennsylvania State Representative Seth Grove, R-Dover Township, sponsor of his state’s sexting bill, which passed in April.

“It’s a huge issue. It’s national. I wouldn’t doubt that it’s in every single high school in every district,” he said. “Think back to high school: If a guy gets a picture of the hottest girl in the school, they’re gonna forward it on. And vice versa — if a girl gets a picture of the hottest guy, she’s going to do the same thing. They’re not thinking the long-term repercussions of it.”

An AIDS ribbon displayed on National AIDS Day. While many people lose their lives from AIDS, Michael Stone has lived with the disease for 27 years.

Michael Stone staggered to his apartment late at night, unlocked his door and trudged to the bathroom. He looked into the mirror, and saw an image that would change his life. His face had been partially paralyzed by several small strokes caused by cocaine abuse. His nose was caked with powder, and his whole body was coated in sweat.

He was living with AIDS, and he was trying to kill himself. He knew he had to stop.

“Something inside of me said, ‘This has got to give,’ ” Stone said. “I don’t know if it was a higher power, but something said, ‘There’s a better life for you.’ ”

Since that night in February 2006, Stone has cut off the use of drugs and alcohol. The 53-year-old Fresh Meadows, Queens, native was diagnosed with AIDS in 1983. Although he’s lived with the disease for 27 years, he said he’s only recently come to terms with what living with AIDS means.

“I would run from club to club, doing cocaine, drinking and, if a little weed came a long, that’s OK, too,” Stone said. “I think subconsciously I was trying to kill myself.”

Stone knew how to run from reality. He had mastered the technique in the early ’80s, when he convinced himself that he didn’t have HIV or AIDS, even after he developed thrush on the inside of his mouth. The infection is often a telltale sign of HIV contraction.

“My doctor kept telling me to get tested and I said, ‘Why bother? There’s no cure,’ ” Stone said. “In the back of my mind, I knew something was wrong. But if I found out I had the disease, then what’s going to happen?”

After several months of prodding, Stone’s doctor convinced him to take an HIV test. When the results were in, his doctor gave him the news over the phone.

“All of a sudden, I felt like a big disease,” Stone said. “I felt like a bomb around people.”

Michael Stone tells the story of how he first found out he had AIDS.
michael stone AIDS phone call

Stone’s doctor told him he had a T-cell count of seven. T-cells are used as an indicator of a person’s immune system. The lower the number of T-cells, the more damage the HIV virus has done to the body. Anyone with below a 200 T-cell count is considered to have AIDS.

“My doctor told me, ‘I can’t believe you’re still walking around,’ ” Stone said. “She let me know that I was very lucky to be alive.”

Stone was diagnosed just after doctors were starting to realize that AIDS was infectious.

Dr. David Posner worked at Lenox Hill Hospital on the Upper Eastside in the early ’80s. In 1982, the disease was known as Gay-Related Immune Deficiency, an ailment that continually perplexed Posner and his colleagues. What was at first a fascinating disease quickly turned into a devastating health crisis when AIDS started killing thousands of New Yorkers.

“It started to devastate the gay community,” Posner said. “People would die within a year or two of their diagnosis. It was a holocaust of death.”

Stone survived when AIDS was at its most lethal. He started taking a drug cocktail that kept the disease at bay while he continued to abuse drugs and alcohol. He also maintained a steady job, dressing windows at Lord & Taylor on Fifth Avenue in the Fashion District.

But Stone could not chase away his demons. Although AIDS had not claimed his life, Stone knew the disease would always be a part of his existence. That helped him justify his drug abuse.

“I felt like, if I die, fine — I die happy,” Stone said. “There’s no cure, so what’s the point?”

Stone also struggled to gain acceptance from his family. Other than his father and one of his three brothers, Stone said his relatives have not been supportive of his gay lifestyle. This is particularly true of Stone’s mother.

“She has a real problem with this whole gay thing,” Stone said. She always has, “since I was in 7th grade.”

In 2000, Stone broke both of his heels trying to get into his apartment on the second floor after he forgot his keys. He knew there was cocaine inside the house and his desperate need for the drug got the best of him, he said. He climbed to his window, but he couldn’t pull himself inside the apartment. He dangled, helplessly, until he finally decided to drop to the ground.

When he was released from the hospital, Stone’s mother offered to take him in and care for him at her home in Kew Gardens, Queens. Stone said he hoped his time at his mother’s house would help the two reconnect. But it turned out to be disastrous.

Although he was confined to a wheelchair, Stone said his mother refused to help him with chores such as cooking and washing the dishes. The two often bickered. Once when his nephews visited the house, Stone said his mother accused him of trying to give them AIDS.

“It was the worst experience of my life,” Stone said. “I don’t think any parent should treat their child that way.”

Stone points to his mother’s behavior as a sign that the stigma around AIDS and HIV is alive and well. He mentions a conversation he had with a nurse six months ago as further proof of the cloud that hovers over the disease.

“She saw on my chart that I had AIDS and she said, ‘Oh, that’s too bad. You seem like such a nice person,’ ” Stone said. “I was like, oh, what? Only bad people get AIDS? The stigma’s not as bad as it used to be, but it’s still there.”

While he said he would never automatically label a person with AIDS as a “bad person,” Posner said people must exercise personal responsibility to avoid contracting the virus.

“This is a disease that can be wiped out with behavioral changes,” Posner said. “A kid who’s 18 years old won’t take the same precautions as someone who was around when the epidemic first broke out. They weren’t there, so they don’t know how horrible it was.”

Dr. Monica Sweeney, assistant commissioner of the city Health Department’s Bureau of HIV/AIDS Prevention and Control, echoes Posner’s sentiments. She said the city’s health department must continue to work to educate people about safe sex. But, ultimately, it’s up to individuals to kill the disease.

“The government can’t be in the room with you to force you to put the condom on,” Sweeney said. “It’s not the government’s job to make that decision.”

Francisco Roque, director of community health at Gay Men’s Health Crisis in Chelsea, said an emphasis on individual choice makes it more likely for people to blame HIV on the people who carry the virus.

“People have a tendency to say, ‘What’s wrong with this person, or what’s wrong with that group?’ ” Roque said. “They say the information about AIDS is out there; condoms are available. So where’s the disconnect? Why are people engaging in risky behavior?”

Roque said the spread of HIV has as much to do with people’s social networks as anything else. For example, one in 10 gay men in New York have HIV.

“So simply by being a gay man living in New York, your chances of contracting HIV are higher than, say, a straight male,” Roque said. “It has to do with the social pool you’re swimming in. Some pools have greater instances of HIV.”

Roque said he’s had many conversations with people who can’t understand how people who now have HIV could behave so irresponsibly.

“I try to turn the conversation around and ask, ‘Have you ever had unprotected sex?’ ” Roque said. “Nine times out of 10, the answer is yes. Then I say, so what’s the difference between what these people are doing and what you’ve done in your life?”

Promoting safe sex is key to stopping the spread of HIV, Roque said, but so is irradiating the stigma that surrounds the virus.

“We have to address it so that people feel comfortable talking about HIV,” Roque said. “That way, people will realize the virus is in their social networks.”

Stone said dialogue is key to stopping AIDS in its tracks. That’s one of the reasons he started working at the AIDS Center of Queens County four years ago, shortly after the night he decided to quit drugs and alcohol.

Stone talks about how he battle back from two decades of drug and alcohol addiction.
michael stone recovering from addiction

“I tell people my story,” Stone said. “I let them know they’re not alone.”

Stone talks to people as much for his own good as for theirs. He said sharing his experiences has helped him stay sober and come to grips with his disease.

“Now I think of it as just something I have to be aware of and take care of,” Stone said. “It doesn’t mean my life is over. I just have to pay careful attention to my health.”

At 53, Stone must also contend with other health issues besides AIDS. He takes medicine for asthma and allergies. He also takes vitamins for energy, because he said the virus can sometimes leave him feeling exhausted.

“You sort of play this game where you think, ‘Is my back hurting because of the virus, or is it hurting because I’m 53?’ ” Stone said. “We all change, but it’s part of getting older as much as anything else.”

Stone explains what a day in his life feels like.
michael stone day in the life

Stone said the cocktail of drugs he takes to combat HIV has had relatively minor side effects such as stomach cramps and unusually vivid dreams.

“If I lay out all my medications and think about all the stuff I’m taking, I get depressed,” Stone said. “But I have to think of these medicines as my life force. If I don’t take them, I won’t exist anymore.”

Stone talks about how he came to terms with taking his AIDS medication.
michael stone coming to terms with the medicine

Stone said he reminds himself how fortunate he is to still be here after living with AIDS for 27 years and enduring more than two decades of drug and alcohol abuse.

“I know I’m very lucky to be alive,” Stone said. “I’m not sure why I’m still here, but maybe it’s so I can help people who are going through the same things I’ve experienced.”

Anna Lanza and Neal Figueroa sit outside Andrea's Hair Design in East Harlem. Photo by Sarah Tung

Local governments across the country, including New York City, are spending millions to promote environmentalism in low-income communities, from recycling to organic eating to energy conservation. But many of those who live in the communities say those programs feel distant and irrelevant to the daily realities of their lives.

“A lot of Spanish people really don’t care,” said Neal Figueroa, 17, of East Harlem. “Around here, it’s like a joke.” Figueroa said he and his friends frequently litter on the streets.

The New York City government is investing money for Green advertisement campaigns, programs and buildings, and more New Yorkers are taking steps to join the trend.

Posters encourage subway commuters to “Switch & Save” and programs such as the Manhattan Borough President’s Go Green initiatives aim to show that going green is for everyone — even those who think they can’t afford it. However, change has been slow for some families.

Waiting outside Andrea’s Hair Design in East Harlem for her hair appointment, Anna Lanza and her friends Sandra Martinez and Aramonita Seda talked about going green. The Puerto Rican women discussed one component of the environmentally friendly movement: organic foods.

“If you going to die, you going to die,” said Seda, a 53-year-old from Central Halrem. “Doesn’t matter if you eat organic.”

For Lanza, 50, it’s a matter of cost. She said she prefers to shop at corner stores and fruit stands because the food is cheaper.

“I can’t afford organic food,” she said. Lanza lives with her husband and four boys, ages 18, 17, 16 and 14, in East Harlem. Her family spends $1,000 per month on food, on top of paying for rent, utilities, credit cards and car payments. “We’re barely making it.”

But going green is not just about eating organic food, said Manhattan Deputy Borough President Rose Pierre-Louis. It is also about carbon footprinting, which is “the impact of how we’re currently living our lives (and how it affects the environment), whether it’s how we’re eating or about congestion.”

Going green refers to any environmentally friendly activity that conserves energy, reduces pollution and saves money. Reducing trash and saving money through sustainable practices, like reusing and recycling, is especially important in low-income communities.

For Lanza’s family, making the effort to go green by recycling seems like a waste of effort and time.

Lanza said it is difficult to recycle because many buildings in her neighborhood do not reinforce it. According to Pierre-Louis, it is the law for every building in New York City to recycle, but in Lanza’s apartment building, there is no recycling bin.

“I don’t mind going green,” she said. “I understand we have a lot of garbage. But they put it all in (the trash), so what’s the point?”

Lanza and her son, Figueroa, both believe environmentalism is too expensive for their family to afford. For example, Figueroa mentioned the extra expense buying trash bags for recycling — money that is wasted because the apartment building does not sort out recyclables from trash.

“It’ll all come down to the neighborhood you live in and your income. Nothing’s (going to) change,” Figueroa said. “I don’t (want to) learn about (going green). I don’t believe in all that stuff.”

Lanza agreed. Her husband makes about $40,000 a year, and she works part-time at American Greetings, earning about $18,000 a year. Her rent is $2,089 a month, and Section 8 pays for 30 percent of it. But even with a dual income and subsidized rent, it is difficult to make ends meet.

Additionally, Lanza now faces the extra financial burden of paying for college. Her oldest son, a high school senior, wants to go to a school that costs $45,000 a year.

To help those with income disparities go green, the borough president’s office created initiatives that work to develop agendas and leverage resources

A poster promoting the Go Green movement.

specific to each community.

A large part of the problem with living in one of these low-income neighborhoods is that “we get the burdens without any of the amenities,” said Elizabeth Yeampierre, president of the New York City Environmental Justice Alliance and executive director of United Puerto Rican Organization of Sunset Park.

These burdens include harmful emissions and the health problems that can arise because of them. Sunset Park and Red Hook, for example, are home to a sludge treatment plant; several power plants and waste transfer stations; three highways; and truck traffic — all of which contribute to pollution that can cause health problems like asthma, Yeampierre said.

Additionally, Yeampierre cited the lack of amenities, such as gardens or parks. Amenities are a key component to improving the physical well being of residents in low-income neighborhoods.

“When you have a community that’s struggling, the last thing they (want to) do is plant a tree for the sake of making their neighborhood look good,” she said. “Our kids don’t get enough exercise because there aren’t open spaces. For us, open space is really a quality of life issue.”

Go Green East Harlem has worked to help the community deal with its health burdens while providing more amenities. Since the first Go Green initiative was launched in 2007, Borough President Scott Stringer has spent at least $7.6 million to develop parks, playgrounds and an Asthma Center in East Harlem to help residents who suffer from the harmful effects of air pollution.

The Manhattan borough president’s office has improved access to healthy fruits and vegetables for people at all income levels, Yeampierre said.

“One of the things we’ve done in East Harlem, for example, is start the first ever weekend farmers’ market in East Harlem,” she said.

According to the Manhattan borough president’s office, poor neighborhoods are suffering health risks, such as obesity and diabetes, because of insufficient access to healthy foods.

“East Harlem … has the highest number of fast food restaurants per square mile than anywhere else in New York City,” Pierre-Louis said. “That gets into the issue of ‘food deserts’ meaning that within a close proximity of your home, to be able to access a green market or grocer is a challenge.”

Residents can now purchase fresh fruits and vegetables from vendors with their Electronic Benefit Transfer cards, an electronic system that allows card carriers to purchase products through government benefits.

Araceli Bandoja, 29, said she bought food from the farmers’ market at Franklin Plaza and was pleased with the low cost and high quality.

“It’s a little more cheap and more fresh, and they give a lot,” she said. The vegetables and fruits look “different” from those she bought at nearby neighborhood markets, but “in a good way.”

Still, not everyone knows these options are available in their neighborhoods. Lanza said she is not familiar with the Go Green East Harlem initiative and farmers’ market, but expressed an interest in affordable green options.

Yeampierre said there is a strong interest in low-income, ethnic neighborhoods to learn about going green — not because it may seem trendy, but because those communities recognize they are the ones who suffer most from environmental burdens.

Environmentalism refers to the consumer aspect of going green, which often comes with high price tags, according to Yeampierre. Products that are advertised as green or sustainable may not be affordable, but a sustainable lifestyle can help people save money—a concept many low-income families are already familiar with.

“Poor people are the most sustainable people there are,” Yeampierre said. “We’re the ones most likely to make food stretch or use our materials in creative ways because we’ve always had to do a lot with a little.” Shopping for old clothes at thrift stores, for example, is a sustainable practice.

This creativity with reusing cheap, available resources translates to environmental consciousness. Going green has to be relevant to their everyday lives and struggles, she said.

“That’s how we get communities to participate and get involved,” Yeampierre said. “All of them care about their children and the health of their elders.”

Not everyone in East Harlem is against the green movement.

“In our building, we are almost the only one family that recycle,” Bandoja said. “We like to live better to get a better future for our kids.”

Bandoja lives in an East Harlem housing project with her husband and two children. She has not heard about the Go Green East Harlem initiative, but her family tries to be green by recycling. She and her husband have taught their children about recycling and energy conservation. Her two sons, Axel and Oswaldo, are also learning about going green at school.

“You have to recycle the newspapers and bottles and any glass,” said 8-year-old Axel. “If we don’t recycle, the earth is not going to be healthy and clean.”

Take one Saturday in April at Coney Island, for instance. Gomez, 66, danced to electronic music and flaunted his getup for groups of wide-eyed tourists at the Astroland Pavilion.

He wore silver shoes; a pink ruffled prom dress, rainbow-colored sequined jacket and tattered blue cape; neon bangles and turquoise rings; and a police cap decorated with green feathers, a gold Chinese ornament, small Irish flag; and his parrot, Rosita, who was perched atop his head. His bushy beard was red, orange and yellow, like a flame, and he combed it with a white plastic fork he pulled from his purse. It matched the splotches of color on the ears and paws of his miniature poodle, Carino.

Gomez always wears ball gowns made of sequins and lace, dyes his beard florescent colors, and travels everywhere with his pets, which he carts around in a baby carriage. He refers to himself as Ms. Colombia, a tribute to his namesake country. Others refer to him as Jennifer Lopez’s Grandmother, La Paisa, Luz Clarita, Christopher Columbus’s Grandmother, The Queen of Queens, Monica Lewinsky or Michelle Obama.

Gomez travels to tourist destinations across New York City where he always makes a scene, and Coney Island was no exception. He gallivanted around the pavilion for two hours, stopping often to add layers of clothing, feed his pets and pose for photos. He arbitrarily charged some onlookers $1 for his picture.

“I think his costume is crazy,” said tourist Sandra Maldonavo, after she paid up. She laughed at him and shook her head as she walked away.

On first glance, it is easy to dismiss Gomez as nothing more than a sideshow performer, one-man circus or even as certifiably insane. But there is a method to his madness, and it’s saner than most bewildered passersby could even imagine.

Gomez has AIDS. And his colorful persona helps him cope with the disease.

“People think I’m crazy, but they don’t know what happened to me,” he said. “This is my strategy to stay alive.”

Gomez was diagnosed 22 years ago during a routine checkup. Doctors told him it was full blown AIDS, not even HIV, which is the precursor to AIDS.

He was in complete shock when he received the diagnosis because he had no symptoms — no fatigue, no weight loss, no fever, no lesions.

“I was destroyed, completely,” he said. “I never expected it even though I’m gay and (was) promiscuous.”

Gomez suspects he contracted the disease while studying abroad in Spain, a time when he took many sexual partners. While he had the support of his family, his mother was quick to assume he acquired AIDS because of his lifestyle.

He recalled his mother telling him, “God don’t like you because you are gay. That’s why you get the disease. If you were normal, you would never get the disease.”

Knowledge about effective AIDS treatment was limited in 1988. Gomez’s doctors prescribed AZT, the drug used to fight HIV, but told him death was inevitable. They gave him a year to live.

Gomez went numb. For weeks he stewed in misery, asking God, “Why me?”

After processing his diagnosis he decided he should enjoy what little time he had left. So he put on a costume.

“And I’ve been doing this for 22 years,” he said.

Gomez admits it is not easy all the time. He takes more than 20 medicines a day to suppress the disease and combat other ailments he has developed as a result of his weak immune system. He has osteoporosis, arthritis, neuropathy, diabetes and now he’s losing his eyesight. He makes trips to various doctors every two weeks.

Over the past two decades, Gomez has watched dozens of friends die from AIDS, and has attended more than 75 memorial services. Health providers say it is rare for AIDS patients to live more than 25 years with the disease.

Although he knows his days are numbered, Gomez refuses to give into depression. His outrageous outfits keep his spirits up and act as a distraction from reality. He is engaged in a game of mind control with the disease, and right now, he’s winning. If he sheds his costumes, he gives up control and the disease takes the upper hand.

“My personality is so strong and my mind is so powerful,” Gomez said. “Without my mind, I think I wouldn’t survive.”

AIDS organizations say positivity and self-expression are two key ingredients in keeping infected patients healthy. Many groups provide creative outlets for clients to cope with the disease. AIDS Service Center NYC in Manhattan offers weekly creative-writing workshops where clients are encouraged to write poetry. Their work is often published in the organization’s magazine, Situations.

“When you feel better about yourself, you take better care of yourself,” said ASC Executive Director Sharen Duke.

According to Duke, the better patients take care of themselves, the longer they live. Duke says organizations across New York City are now faced with an aging population of AIDS patients, many of whom are older than 50. She says 30 percent of ASC clients have lived with HIV/AIDS for at least 20 years.

She says medical advancements have helped people keep their T-cell count up, which is essential to maintaining a healthy immune system. She says patients are able to do this by taking fewer medications than in the past, which makes treatment more manageable day to day.

Even after three decades, the AIDS epidemic is still growing, especially among young gay men in their 20s, and women. According to the New York Department of Health and Mental Hygiene, New York City remains the epicenter of the AIDS crisis. It has the highest HIV/AIDS case rate in the country, more than Los Angeles, San Francisco, Miami and Washington, D.C. combined.

More than 1 million people who live in the city are infected with HIV. Even though the disease affects so many New Yorkers, Duke says there is still a stigma associated with it.

“It goes along with homophobia,” she said. “There is a perception that people with AIDS deserve what they get.”

Gomez does not let AIDS or his sexuality define him. Instead, he wants to be known for his ubiquity in New York City.

He has carved out a piece of local fame by having marched in every New York City parade including Manhattan’s Saint Patrick’s Day Parade, which doesn’t allow gay participation. This year he dodged police every five or 10 blocks, hopped the barricade, and danced up the parade route next to proud bagpipers and freckled schoolgirls.

“And every five, ten blocks they threw me out,” he said. “You see my personality? I don’t care.”

He calls 311 every night for an accurate schedule of the next day’s events, a method effective at keeping him in the limelight at locations across the city. When the events calendar is lean, he ventures to his favorite locations — Prospect Park, Central Park and Jacob Riis Park — to dance with the usual drummers, roller skaters and beach bums.

Gomez often visits three or four tourist attractions in one day. He is always in a hurry, charging up and down the streets he so easily makes his own. He is rarely at his Elmhurst, Queens, home. When he does return after his daily escapades, it is usually well past what people would characterize as a normal bedtime. And when his sister and 98-year-old father urge him to slow down and rest, he refuses.

“I do in one day what most people do in a week,” he said.

It is his attempt to make the most of the life he has left.

Everywhere he goes, someone recognizes him. Three teenage girls greeted him with, “Hello Ms. Colombia!” when they saw him on the Coney Island boardwalk. They stopped him and insisted on a photo. They giggled when Gomez put his parrot on one’s head and Carino in another’s arms.

Gomez has a habit of making strangers smile, and those who know him well say his mission is to make other people happy.

“He livens up everybody’s life,” said Minerva Figueroa, a friend for more than 30 years. “I’ve never seen him angry or upset. You have those negative people that give him a hard time, but he brightens everybody’s day.”

But once in a while, Gomez runs into people who disapprove of his colorful antics.

He says those familiar with his professional background are stunned and embarrassed by his behavior. Gomez was a lawyer in Colombia and earned a master’s degree in art from New York University. He was pursuing his Ph.D. in Spanish literature when he was diagnosed with AIDS.

“People ask me, ‘If you are so educated, why do you (dress like) this?’ ” he said. “It’s my attitude, my life choice, my decision.”

On Fifth Avenue in Manhattan recently, a woman rolled her eyes and clutched her young children’s hands as Gomez barreled past her with the baby carriage. The sideways look didn’t bother him, though. He makes a point to channel all negativity and express positivity instead. He grinned at the woman and swished his skirt back and forth like a 5-year-old girl showing off her party dress.

“Mamacita,” he crooned, “I don’t bother you; you don’t bother me.”

When each day is done and the costumes come off, the crowds disappear and the distractions are gone, Gomez is left in solitude. During these times, Gomez said, he fights the urge to think about the future.

“There is no tomorrow,” he said. “I live day by day. And I enjoy my days like it’s the last day of my life.”

Odell Tamias, president of the Jacob Riis Tenant Association. Photo by Rachel Wise

One morning in early April, an elderly woman awoke to find her stove was no longer working. The woman, who lives in Jacob Riis public housing in the East Village, contacted the maintenance call center to report the problem.

The operator told her the earliest they could fix her stove was May 29. And when she continued to follow up on the request, the operator told her to stop calling. That’s when Odell Tamias, president of the Jacob Riis Tenant Association, stepped in.

“That is unacceptable! You know how Spanish people like their coffee,” Tamias said with a chuckle, before a stern expression swept over her face. “Seriously, though. I don’t play. I really don’t.”

Odell Tamias explains her outrage over the operator’s response.
CallCenterProblems_OdellTamias

Odell Tamias, 67, has lived at Jacob Riis Houses for 43 years, but for the past five years, she’s served as president of the tenant association. Her job is to help tenants with any housing-related issues, on a volunteer basis.

“Basically, I’m the medium between housing and tenants. Someone has to stand up for them,” she said.

Jacob Riis is a public housing development comprising 19 buildings and 1,764 apartments. Its borders are East Sixth and East 13th streets, and Avenue D and F.D.R. Drive. And it is home to 4,305 residents.

Tamias was born and raised in Columbus, Ala., but moved to New York City when she was only 17. She worked odd jobs at factories in Long Island and Manhattan in the 1960s, and moved from place to place, usually staying with friends or family members.

“I didn’t become a prostitute or drug addict, thank God. I’m surprised. But you can’t change a person, especially from South,” Tamias said. “I was doing OK. I was never, like, homeless or anything like that.”

Odell Tamias explains her experience avoiding alcohol and drug use.
NoDrugs_OdellTamias

Then in 1967, Tamias got married and had a son. When her son was only 8 months old, she applied for housing and was accepted. She moved into Jacob Riis Houses — when rent was only $68 per month. Although she got divorced in 1972, she and her son continued living at Jacob Riis. And it didn’t take long before she became involved in the community.

“I have been living here for 43 years. … I was always involved when something happened,” she said. “When there was another president … I would volunteer my service.  I could not be doing nothing — I’m not like that. I have to be doing something.”

Before she became president, Tamias served as tenant patrol supervisor — a part-time job for which she received a small stipend. For 12 years, she was responsible for the safety of tenants at Jacob Riis. Every night, she patrolled the grounds and checked on tenants. After that, she became vice president of the TA.

The outside of the offices for the Jacob Riis Tenant Association. Photo by Rachel Wise

During her time as president, Tamias said she has done “what’s expected” of her but doesn’t think she’s done anything “special.” But history, and tenants, tells a different story.

“I think she’s great. Always friendly and happy to help,” said Maria, a 12-year resident of Jacob Riis who declined to give her full name. “I know when I’ve had a problem, she really helps to work it out. And she’s got a great spirit about her, too.”

One thing Maria pointed to is Tamias’ ability to build a sense of community among residents, specifically citing her organization of Family Day.

Every summer, Tamias is responsible for putting together a Family Day celebration.

“Politicians give us money, and housing gives us money. And we buy franks and burgers and ice cream. … And we have a DJ and clowns, and sometimes (a bounce house),” Tamias said.

But Tamias takes it a step further: She also provides gifts for all the children who come to Family Day, sometimes using her own money if funds run out.

“I buy book bags for the boys and girls for when they go back to school in September. I put everything in there: the pencils, the pens, the eraser — all kinds of little stuff for them,” Tamias said. As she continued to describe the day’s events, her excitement grew and her eyes lit up. “I love to just help, you know, just buy stuff for the kids.”

Odell Tamias talks about buying toys for children at Jacob Riis during the holiday seasons.
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In addition to community building, Tamias also has made great strides to improve the security at Jacob Riis. When she became aware of safety issues in the development — such as break-ins and robberies — she immediately took action.

“I did the petition to get surveillance cameras for every building,” she said. “I got over 600 people — 700 people (to sign). It’s supposed to keep out the undesirables.”

The “undesirables,” according to Tamias, are the “drug dealers” who invade the premises and stay with friends in several of the buildings.

“I have a whole apartment of drug dealers in my building — in my building,” she said. “I told the police, I told everybody. … There ain’t nothing much else I can do.”

Sibyl Colon, manager of Jacob Riis Houses, agrees with Tamias that drug addicts and dealers are a big issue in the community.

“(Tamias is) very proactive in trying to get rid of the drugs,” Colon said. “We have constant meetings with the police … and relay the information on.”

And while these drug problems are a source of frustration for Tamias, they’re not the only thing.

“The hardest part of my job is when (maintenance) stuff does not get done fast.  … That is what is bothering me. It’s the same thing, week after week,” Tamias said.

She said the problem stems from a lack of funding to hire the proper staff who knows how to fix the issues that plague Jacob Riis — “leaky walls, broken this, broken that,” according to Tamias.

“There’s a lot of work shortage here … because of the budget,” Tamias said. “They got the people that clean the grounds (working on) infrastructure problems. They need a contractor to come in and fix the leaks inside the wall because these people don’t know how to do that.”

Odell Tamias addresses the condition of Jacob Riis Houses.
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But all of this wouldn’t be as hard to handle, she said, if it weren’t for the issues tenants have when they contact the maintenance call center.

Tamias said she has seen dozens of apartments with various problems, but no matter what the problem is, she always hears the same response.

“They’ll tell you a month from now. I swear … it doesn’t matter what you call for, they’ll tell you a month from now,” she said.

Sometimes, Tamias admits, the issues she faces seem overwhelming.

“When I first came here it was beautiful. You know, nice, quiet. But now … it’s gone to the dogs, I think,” Tamias said. “It was like the nicest development in the whole Lower East Side … but now it changed. It has changed, trust me, over the years.”

Despite the problems, Tamias is determined to help Jacob Riis become the development she knew 43 years ago.

“She cares about her community. It’s a volunteer position, so you have to really care to do it,” said Sibyl Colon, manager of Jacob Riis. “She has definite leadership qualities, and the residents respond well to her.”

For more than 20 years, Tamias has served her community. But in only one month, Tamias’ reign could be up. The election for TA leaders is set for May, and the winners will be sworn in in June.

“At first, she wasn’t going to run again,” said Epifania “Fanny” Rodriguez, 62. Rodriguez is TA vice president and Tamias’ longtime friend. “But I told her she had to. She’s done a good job — she really has.”

When tenants and friends urged Tamias to run again, she gave in. She said she’d be happy to be president again, but for a shorter term.

Odell Tamias describes her decision to run for reelection.
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“Two years — I think I can deal with that, right? I don’t think I’ll drop dead in that time,” she said, erupting in laughter. “That’s all I can say. And if they still want me, they vote for me.”

Cindy Pratt slowly walked to the counter of Magic Soul Food and paid $8.75 for a hardy portion of chicken smothered in barbecue sauce, two ice cream scoops of macaroni and cheese, and wild rice. She gestured to the worker to open the white take-out tray so she could examine her meal.

Pratt grabbed a fork from the overflowing, nearby utensil bin and poked at the dripping leg and thigh to ensure they were not too small. Pratt shook her head up and down to illustrate her satisfaction and grabbed her meal to go. But it’s the roughly 1,200 calorie meals like this one that are stealing the lives of so many black people each year.

Pratt, like 1.3 million other black people, has diabetes — the seventh largest killer of blacks. The 43-year-old has been diagnosed with Type 2 diabetes when she was 33, although this type usually only affects people older than 40. Pratt was raised on soul food, and she thinks this has had a major effect on her health.

“I have been eating fried chicken, macaroni and cheese, and sweet potatoes ever since I can remember,” Pratt said. “And you wonder why I look like this?”

Pratt weighs in at 212 pounds at 5 foot 6 inches tall. She says she is very overweight, unhealthy and uncomfortable.

Soul food is stereotypically classified as most foods that black people cook and eat.

NYU journalism professor Pamela Newkirk, who has written and edited several books about the black community, said economics has always played a large role in the consumption of soul food.

“During slavery, the slaves were given the food that was discarded by their masters,” Newkirk said. “That’s how things like chitlins became food items.”

Chitlins, or chitterlings, are the intestines of a pig. They are often consumed in broth with a side of hot sauce or just eaten by themselves. Chitlins are about 375 calories per cup.

In most predominately black communities, there are soul-food restaurants on nearly every block. Bed-Stuy, which has the largest black population in Brooklyn, has dozens of soul food restaurants.

Magic Soul Food, on the corner of Decatur Street and Malcolm X Boulevard, is the same popular soul-food joint at which Pratt enjoys a meal no less than twice a week.

“We get anywhere from 200 to 300 orders a day,” restaurant owner John Sales said. “It helps that our customers are very loyal. Once you come here once, you’re hooked.”

Sales admitted that his food is very unhealthy, but complained that when he tried to provide more diverse options, the food went unsold.

“I tried to sell salads and low-carb burgers and stuff, but no one bought the stuff,” he said.

Magic Soul Food cooks their food in Crisco, which is hydrogenated vegetable oil, or pure trans fat.

Most soul-food restaurants still use products with trans fat because hydrogenated oil lasts long and gives the food flavor, but customers such as Pratt suffer because they get addicted to the taste.

In New York City, there has been a recent push to eliminate the unhealthiest foods when the trans-fat ban was passed in 2008. It gave restaurants until the summer of 2008 to eliminate artifical trans fats, but Magic Soul Food still uses some of the worst artery-clogging culprits.

Newkirk said people such as Pratt suffer from health problems because they were never exposed to healthy, good-tasting food because it is too expensive.

“Many African-Americans who eat soul food don’t eat it all the time, but poorer people do because it’s cheaper,” Newkirk said.

Although Pratt has been working as a nurse for more than a decade, she still struggles to feed her family of four.

When Pratt was a child, her mother cooked soul food for her all the time. Sunday dinner was a big deal in their household, and this is typically where the unhealthy eating took place.

“On Sundays, we had anything you could ever imagine!” Pratt said. “Mac and cheese, cornbread, yams, greens, fried chicken and fish. My mouth is watering just thinking about it all. Man, I miss those dinners, and I miss her, too.”

Pratt’s mother passed away just a few years ago of heart failure. Pratt is unsure whether her mother’s health was affected negatively by soul food, but she believes it’s possible.

“Each time my mother fed us, she ate, too, so I am sure all that bad food did something to her,” she said.

The phrase “soul-food diseases” is a running joke in the black community, but most people like Pratt say they are unsure whether the soul foods they eat have a direct, negative correlation to their health.

“I know that I have diabetes,” Pratt said. “But I haven’t been to the doctor in nearly a half a year because I do not know what else I have nor do I want to know.”

Newkirk believes that “soul-food diseases” can affect anyone who cannot afford healthy food or just choose to eat soul food, but it is not limited to black people.

“How people eat is not only determined by culture, but also (by) economics,” Newkirk said. “I think most poor people have to eat these types of foods. Fresh vegetables are expensive. It comes down to what you can buy to feed your entire family. And let’s face it — soul food is good. Everyone likes it, not just black people.”

Soul food has been a kind of comfort food for centuries and is now something Pratt cannot live without.

“I don’t think I can live without soul food or fried foods in general,” Pratt said. “I mean, I tried to eat healthy, but everything else just tastes nasty.”

Collage by West African women who are victims of female genital mutilation. Photo by Elisa Lagos

A woman relived the terror of witnessing her sister being circumcised against her will in their West African home. The experience still haunts her.

“I heard my sister scream when she was cut. She died two weeks later from the excision. Even now I can still hear her screaming,” the woman wrote.

Genital mutilation, also called female circumcision or cutting, is a brutal procedure that involves cutting the female reproductive organs — a procedure practiced mainly in African, Middle Eastern and Asian countries. The woman, who now lives in New York, is also a victim of this abuse.

Her words were a part of a unique, animated art display created by West African victims of female genital mutilation. The mural hung in the gallery of an obscure building in Lower Manhattan in the shadows of Wall Street and the historic Trinity Church.

The painting was actually a collage created by 8 women, who used the vibrant colors and figures to express their violent pasts and promising futures. From a distance, the red, purple and bright-orange work of art looked like a vivid image of life, but within the bright colors were words of pain, remembrance and hope.

In the collage, one woman described a haunting memory of her husband, a man with “an angry face with angry eyes. The butterfly with colors next to him is me taking my freedom,” she wrote.

Next to the mural stood a display of photographs depicting a woman’s hands and plants growing in the sunlight, while across the room was a painting of figures seemingly dancing to a drummer’s beat.

A painting by a victim of domestic violence. Photo by Elisa Lagos

The pieces were created by immigrant women who experienced domestic violence, from rape to beatings to genital mutilations. It is part of an ongoing arts program run by Sanctuary for Families, a non-profit group that helps victims of domestic abuse.

The exhibit, “From Oppression to Expression: Immigrant Experiences of Violence,” showcases some of the works by women who used art to communicate what they could not say in words. It was planned to coincide with Immigrant Week in New York, which was April 15-22, though the mural has since been removed.

“I think part of our holistic vision is to mobilize as many of the creative arts as possible. That whole model is being replicated in other places,” said Beth Silverman, clinical director at Sanctuary for Families. “I think whether it’s writing, journaling, drawing, we try to mobilize all of the senses in the creative process.”

Art therapy was first used in the 1940s to help traumatized soldiers returning from World War II. It has since been used to help people who lived through different traumatic experiences, such as domestic violence, to help maintain mental health and restore a sense of well being.

“It is easier for them to express themselves through drawing. When they draw, they draw what they’re thinking. It’s very healing,” said Sanctuary for Families employee Mariama, who declined to give her last name. “By drawing, it makes it easier and safer because when you express yourself you don’t have to put your name on. It’s anonymous.”

Like most abuse victims, immigrant women often feel trapped in abusive relationships, but — for immigrants — it is far more difficult for them to escape their abusers. Immigrant women tend to have less knowledge of U.S. laws, poor financial resources and a limited understanding of English, while abusers frequently use a woman’s legal status as a mechanism to retain control and keep her from going to authorities.

Despite laws that protect victims of crime regardless of legal status, many immigrant women do not know the law applies to them. The result is a growing number of women who stay in abusive relationships, sometimes with fatal consequences.

A 2005 survey in New York City found that 51 percent of homicide victims killed by their partners were immigrants.

Organizations, such as Sanctuary for Families, try to reach as many victims of domestic violence as they can around the city.

“We do a lot of out reach in the community,” Mariama said. “We are in hospitals; we are in court, family court or schools.”

Sanctuary for Families, in conjunction with New York City’s Office to Combat Domestic Violence, has opened a new Family Justice Center in the Bronx. There are also centers in Queens, Brooklyn and Manhattan.

“There are those who don’t believe in God,” she said when finished reciting. “There are those who don’t even believe in good. But that’s all right because there are those who do.”

Speaks, 54, has been ministering since she became homeless two decades ago. She said she grew up in a family that did not preach the word but was very spiritual. She referred to them as “faith walkers.”

“Thank God for the Lord,” she said, remembering back to the time she first found herself without a home. “He said, ‘Don’t worry about it,’ and that’s when my journey started.”

Faith in a higher power provides a constant source of strength to countless people living on the streets. For some, it reawakens an earlier commitment; for others, such as Charles Hauser, it is a newfound strength. It inspires others to establish organizations and run shelters that comfort the homeless as they face daily, unpredictable hardships.

The effectiveness of faith has even been proved scientifically.

The Centre for Evaluative Clinical Sciences at Dartmouth Medical School in New Hampshire conducted a study in 1999 to evaluate the relation between spirituality, and physical and mental health within a homeless population.

The study found two things — that spirituality appeared to play an important role in the lives of the homeless and that feeling close to God may be linked to better functional mental or emotional health in homeless people.

Speaks said God gave her the name “Arafa Speaks” when she became homeless 20 years ago. She ministers to people on the streets, in the subways and in shelters. She also advocates for the homeless and encourages people to stand up for themselves. She said “true religion” is helping those in need.

“What the churches and others have made the word of God into,” she said, “is not at all what God had planned for his word. He said, ‘Be doers of the word, not just hearers of the word or just preachers of the word.’ ”

When she isn’t ministering or advocating for the homeless, Speaks designs kente ribbons, writes poems and produces a newsletter entitled “Home-L.E.S. in America.” “L.E.S.” stands for the Lower East Side neighborhood.

Speaks said she grew up in a housing project in Canarsie, Brooklyn, but left in 1973. She traveled up and down the East Coast and eventually settled in Lincoln Park, a predominantly African-American community in Rockville, Md.

She said she was evicted from her apartment in Rockville in 1989 because her landlord claimed she violated zoning laws when she set up a sewing shop inside. Speaks has been living in and out of shelters ever since.

According to the New York City Department of Homeless Services, more than 37,000 people were sleeping in city shelters in December 2009.

While families comprise the fastest growing segment of the homeless population in New York City, the number of single homeless adults, such as Speaks, has also risen dramatically.

The Department of Homeless Services’ Daily Census for December 8, 2009, estimated more than 10,200 families and almost 7,000 single adults were sleeping in municipal shelters. Based on this data, the Coalition for the Homeless reports that homelessness in New York City has reached the highest level since the Great Depression of the 1930s.

But New York is not the only city in the U.S facing rising levels of homelessness.

The 2008 Hunger and Homelessness Report, produced by the U.S. Conference of Mayor’s Task Force, found that 19 out of the 25 U.S. cities surveyed for the study experienced an increase in homelessness from 2007 to 2008.

While the report cited lack of affordable housing, poverty and unemployment as the top three causes of homelessness for families, substance abuse, lack of affordable housing and mental illness were the three most common causes of homelessness for individuals.

Charles Hauser, 28, said he spent the past two years without a home, battling alcohol addiction and spending time in and out of prison.

He now resides at the Bowery Mission, a faith-based organization in New York City that serves those in need. Its mission is to “restore hope and life to people who are hungry and homeless.”

Originally from Monterrey, Calif., Hauser moved to North Carolina with his family when he was 12. In high school, he was awarded a scholarship to study art, which he has loved since childhood.

But Hauser said he began partying and getting into trouble; he lost the scholarship after getting arrested for selling drugs, possessing a handgun, driving without a license and carrying false identification.

He served time in a correctional institution and North Carolina state prison, and earned his high school equivalency diploma while he was incarcerated.

After being released, he returned to the same lifestyle.

Hauser said he arrived to New Jersey in early 2009 and came to New York soon after. He spent his first night in a construction site near Times Square. He said he continued to drink heavily and struggled to survive on the streets without a home or a job.

“It was terrifying,” he said. “Honestly, I was like, ‘I can’t believe I’ve ever come to this position.’ ”

After three weeks in New York, he was sent to Rikers Island, New York City’s jail facility, for stealing. He said he was sentenced to two-to-five years but only served four months before getting released.

Once back on the streets, he was selling drugs again to survive.

Hauser hadn’t forgotten about art school, though. He inquired at the Art Institute of New York and found out that he could attend, but would have to pay 10 percent of the tuition, which runs $30,000 per year, for the two-year associate’s degree program. Without a job, home and foundation, Hauser said that seemed nearly impossible.

After leaving the school that day, Hauser stopped at the Bowery Mission Soup Kitchen for a meal.

“I didn’t want to hear anything about God or church or anything like that. I kind of walked away,” he said. “But I couldn’t keep repeating that cycle.”

After being taken to the hospital by a police officer for intoxication, Hauser decided to return to the Bowery Mission for an emergency bed.

Since he returned to the mission, his life has changed dramatically. Hauser has a newfound spirituality that has given him hope for the future.

He recounted the day he asked for help from the pastor.

“I asked the man to pray for me, to open up a breakthrough somehow and to get me off the street,” he said.

Three hours later, Hauser’s father, whom he had not spoken to in five years, called him. Hauser still had the cell phone his sister bought him. His father offered to pay the tuition needed for his art school.

Hauser has been in the mission’s discipleship program since then and is making plans to attend art school. He hasn’t been drinking since he got to the Bowery, and he recently started writing a children’s book.

Eden Gordon, the Bowery Mission’s coordinator of public relations, said in an e-mail the faith-based discipleship program, which houses 82 men and is currently filled to capacity, provides education and job training, and graduates men from the six-month program every month.

The mission’s other program, compassionate care, provides food, clothing, showers, a medical clinic and shelter when outside temperatures drop below 40 degrees.

Pastor Reggie Stutzman, the director of compassionate care at the mission, said Hauser is fully rested, has gained weight and is not as depressed as he was when he first came to the mission.

“There’s a glitter in his eye again,” he said. “He has hope again.”

Stutzman said he believes that a relationship with God can help deliver people from problems such as mental illness and addiction, and brings healing into a person’s life.

Hauser said his faith helps him stay sober and cope with being homeless.

“It alleviates a lot of the worries, a lot of the stress,” he said, “because I have faith in something. I have hope and faith that everything’s going to work out. It’s just giving me all the tools I need to build my life back to the position I want it to be in.”

Arafa Speaks expressed gratitude for her own faith, too.

“I thank God for showing me how to not be afraid of humble beginnings,” she said, “and how to take every adversity and turn it into an awesome opportunity.”

Dr. Elliot DeHaan. Photo by Simon McCormack

Dr. Elliot DeHaan thought he knew what he was signing up for when he accepted an infectious-disease fellowship at Bellevue Hospital Center.

During his two years at Bellevue, DeHaan has diagnosed patients from Ecuador with neurocysticercosis — a parasitic infestation that attacks the brain — and patients from Latin America and the Caribbean with echinococcus — a disease caused by tapeworms that can produce cysts in the liver, spleen, kidney and bones.

One of DeHaan’s colleagues treated a patient from Argentina for Chagas disease, a parasitic infection caused by the feces of reduviid bugs. The infection is so rare in America, DeHaan said, tests for the disease had to be conducted at the Center for Disease Control and Prevention instead of through Bellevue’s in-house lab.

It’s not every day DeHaan encounters a patient with these ailments, but he said he regularly sees people with tuberculosis and malaria, which native-born patients rarely have.

These are diseases doctors don’t get much exposure to in other American hospitals — and that’s why DeHaan signed up.

He wanted to treat patients from all over the world and get experience of diagnosing and treating diseases uncommon among native-born Americans. Because Bellevue, on First Avenue near 27th Street, serves a large immigrant population, DeHaan said it was the perfect place to get a feel for the diseases that dot the globe.

But serving patients from a broad swath of countries presents two major obstacles, according to DeHaan. Doctors at Bellevue must overcome language barriers and gain the trust of unauthorized immigrants worried about being deported.

“There are specific challenges associated with treating immigrant patients,” DeHaan said. “Bellevue is one of the best places to learn about them.”

Bellevue doesn’t keep statistics on how many immigrant patients come through its doors, according to the hospital’s spokesman, Steve Bohlen. That’s because Bellevue doesn’t want to discourage illegal immigrants from visiting.

“We want them to come, so we don’t keep track of their documentation status or where they’re from,” Bohlen said. “We try to make sure no one is afraid to get treatment.”

DeHaan estimates that between 35 to 45 percent of his patients are immigrants. They hail primarily from Eastern Europe, Southeast and Central Asia, West Africa and Latin America.

While he takes a patient’s birthplace into account when attempting to diagnose their illness, DeHaan said it’s never the only factor he considers.

“It’s not just the particular country they’re from,” DeHaan said. “You want to go deeper.”

DeHaan explained how he might diagnose neurocysticercosis using the information about the patient’s symptoms and homeland.

“If you have a person who’s coming in with first-time seizures and he comes from a country where the disease is endemic, then you would want to do an MRI to check for neurocysticercosis,” DeHaan said. “But you don’t want to just assume that everyone who comes from a certain place has this certain disease.”

While a person’s birthplace can be helpful in determining their diagnosis, DeHaan said undocumented patients might not tell him where they’re from.

“Patients are going to be suspicious about whether the doctors are going to treat them, or if after they’re treated, they’re going to be deported,” DeHaan said. “The fact that you’re undocumented is going to affect your relationship with the medical-care provider.”

NYU Professor Robert Holzman co-authored a study that suggests undocumented patients may avoid hospital care because they’re afraid of being deported. His research found that, when compared to documented immigrants and native-born patients, undocumented immigrants at Bellevue endured symptoms of tuberculosis for a longer period of time before going to the hospital.

“We have no direct evidence on what the cause is,” Holzman said. “Our speculation is that people may have delayed seeking care because they feared revealing their undocumented status and that that might lead to deportation or other interactions with immigration officials.”

Holzman said doctors at Bellevue do not report patients’ immigration status to law enforcement. The Health and Hospitals Corporation, which runs Bellevue, has launched campaigns to let immigrant patients know their information is kept private. But, Holzman said, his study suggests greater outreach is needed to make the point clear.

“Finding this kind of a pattern in the people who get care suggests that maybe that information could be presented to the relevant communities in a more effective way than it has been,” Holzman said.

DeHaan said he must work especially hard to gain the confidence of undocumented patients.

“You have to assure them that anything they say is not going to be used against them,” he said. “You have to be aware that they may not be forthcoming.”

A Colombian undocumented worker who did not want to give his name was surprised to hear that Bellevue treats patients without asking for documentation. He works as a hot dog and pretzel street vendor in Williamsburg and moved to America three years ago. He said he is working on getting legal status, but he came to America illegally.

“That’s good to hear,” he said when told Bellevue doesn’t turn patients away. “I hope that’s true.”

He said he’s had no major health issues since venturing to the States, but he’s avoided seeing the doctor a couple times because he’d rather not risk being reported.

“If I had an emergency, I would go to the hospital no matter what,” he said. “But for smaller things, I would not want to get in trouble.”

While some immigrant patients struggle with issues of trust, DeHaan said others come up against a language barrier. Doctors at Bellevue rely on a 24-hour translation line to help them communicate with their patients.

“You always lose something when someone is translating for you,” DeHaan said. “But it’s obviously better than nothing, and it’s the best you can do in a lot of situations.”

While completing his residency in Boston, DeHaan said he experienced the pitfalls of relying on translation. The word “dizzy” in Cantonese is very similar sounding to the word for “sick,” DeHaan explained. As a result, some patients were unnecessarily prescribed medication for dizziness because they said they felt sick.

“You have to ask them (whether) the room (is) spinning,” DeHaan said. “You have to be more specific in your discussion with them and not just use terms that can be easily misconstrued.”

Holzman said doctors at Bellevue must also be aware of their patients’ cultural backgrounds when determining what they’re trying to communicate.

“Sometimes it’s difficult to interpret what people say without having some knowledge of the place where they’re from,” Holzman said. “You have to be alert to things that people say that will convey information that, if you didn’t have that alertness, would be meaningless to you.”

Hard-court bike polo players engage in a match at The Pit on the Lower East Side. Photo by Alexandra DiPalma

Bike polo mp3

Each Sunday in Sara D. Roosevelt Park in the Lower East Side, six athletes ride small bicycles, racing back and forth over a blacktop surface about the size of a tennis court. They are divided into teams, and most wear helmets, padding and hockey gloves. Each player wields a mallet, attempting to hit a small plastic ball into a goal while biking without crashing, falling or putting a foot to the ground.

They are playing hard-court bike polo, a variation on traditional horse polo. And while the sport is usually associated with high society and royalty, bike polo matches in Manhattan’s Lower East Side draw a more diverse following.

According to Doug Dalrymple, the unofficial promoter of New York City bike polo, interest in the sport has steadily increased in recent years. But despite its growing popularity, many New Yorkers still know little about hard-court bike polo.

“If I had to describe the game to someone who knew nothing about it, I’d say that it’s something like horse polo, with the feel of street hockey,” Dalrymple said. “On bikes.”

Dalrymple has been playing for more than five years. Now, he helps to organize league play and is responsible for running the club Web site.

“We have about 40 people who play regularly,” said Dalrymple. “But it’s not like we’re a legit club — you don’t have to pay to play with us; you don’t have to be a member. All you have to do is show up.”

The community’s loose attitude makes the sport accessible to newcomers, and the nature of the game attracts young players who cannot necessarily afford a horse. Players ride on souped-up bicycles and use homemade mallets. Rather than a 300-yard grass field at an exclusive polo club, hard-court bike polo is played on parking lots or basketball courts.

In New York, enthusiasts gather at an asphalt court called The Pit, between Chrystie and Grand streets. Large crowds come out every Tuesday, Thursday and Sunday to watch pick-up games played by bike polo veterans and rookies alike.

The Pit has been the location of several high-profile bike polo tournaments and is a well-known venue throughout the national bike-polo community. Just last week, a two-day tournament at The Pit drew bike polo teams from France, England, Germany, Switzerland, and all over the U.S. and Canada.

While the game might sound like some new-fangled extreme sport invented by urban youth, there is a great deal of history behind it.

“A lot of people think it’s a new thing, but bike polo has been around almost has long as bikes,” Dalrymple said. “It probably looked a lot different than this, considering bikes had just been invented, but the idea is still the same.”

First played in Ireland in 1891, traditional bicycle polo was played on a rectangular grass field and was included as a demonstration sport in the 1908 London Olympics.

Hard-court bike polo is different from the original game in that the rules are less formal and can be played in a wider variety of spaces, making it popular in urban environments where large grass fields don’t exist.

Most of the New York regular bike-polo players are men in their 20s and 30s, but there are a few die-hard players who are exceptions.

“We have college students and young people, but we’ve also got a few women, and our most senior player, Frank.” Dalrymple said. “I’m not sure anyone really knows how old he is.”

Frank Marcus, a middle-aged man who jokingly claims to be 25 years old, comes from his home in Long Island to practice each week. Like Dalrymple, he’s been playing for about five years and has no plans of stopping anytime soon.

“I just like to come out and enjoy the game,” Marcus said. “But sometimes I get in trouble for it. I got a few drinking tickets from the cops for having beer during the games.”

Marcus’ teammates tease him about the incident, and one of them caught the exchange on video and posted it to YouTube. Now Marcus is well known throughout the bike polo community for his run-ins with police.

“At the tournament last week, guys kept coming up to me and saying ‘You’re that guy who got the drinking ticket! You’re famous!’ ” Marcus said. “I still haven’t seen the video.”

Marcus and many of the other regular players have been dedicated to the game for several years, and they have the scars to show for it.

Ethan Benton, left, looks on as Phil 'Ram Man' Miarmi exposes his customized T-shirt. Photo by Alexandra DiPalma

Phil “Ram Man” Miarmi, 34, moved to New York in 2007 and first saw a bike polo match at The Pit within his first few days in the city. He immediately was hooked.

“I started playing right away,” Miarmi said, unzipping his jacket to reveal a custom-made T-shirt with “Ram Man” emblazoned across the front. “And it’s been painful ever since.”

Miarmi is notorious for his countless injuries, and his tendency to cause them on the court.

“The first time I was out there, I just remember smashing into everyone, going full speed into the wall and pieces of my bike flying in the air,” he recalled. “I just don’t care.”

He has marks from several injuries, including cuts, scrapes, blackened nails and even a bruise that he had to “drill a hole in to get the blood out.”

Miarmi is not the only one with battle scars. Ethan Benton, 33, from Brooklyn, has been on hiatus since his shoulder injury.

“I fell off my bike, then my arm fell out of the socket, then I moved my arm and nothing went back the way it was supposed to,” Benton said. “So I’ve been taking a little break.”

Phil 'Ram Man' Miarmi shows off one of his many bike-polo-related injuries. Photo by Alexandra DiPalma

Even the newcomers seem immune to the roughness of the game. Sara Wojcik, originally from New York, started playing bike polo in Poland a few months ago while she was living abroad. Wojcik and a few friends started a club in Warsaw when her mother agreed to sponsor them, providing mallet head material and balls.

“I came back to New York for a vacation, then I intentionally missed my flight back to Poland and went to my first polo tournament in Richmond, Virginia,” Wojcik said. “It was totally worth it, but it was very, very ‘bro.’ ”

Wojcik doesn’t mind being one of the only women in the scene. In New York, she has helped to organize a women’s bike polo night, or as they refer to it, “no bro polo.” Since skipping her flight back to Poland, Wojcik has had a lot of time to focus on the game.

“I’m still unemployed at the moment, so polo kind of rules my life,” Wojcik said, while bandaging her knuckles to cover a fresh cut. “It’s awesome and awful at the same time.”