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    Daniel Romanchuk’s Pre-Marathon Routine Includes Sandpaper

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    Many of the 50,000 entrants in the New York City Marathon have pre-race routines — carbo-loading, plenty of liquids and so on — but only a few of these routines include wrenches, Allen keys and sandpaper.Daniel Romanchuk checks the contents of his utility pouch in Central Park ahead of the NYC Marathon, Manhattan, 2024.Clark Hodgin for The New York TimesThose are just a few of the tools that the 40 or so professional wheelchair racers rely on to prepare for New York’s hilly and rough roads.Before every race, they tighten the various nuts and bolts on their chairs to make sure nothing rattles lose on the city’s streets and bridges. Tires are doubled checked to ensure they are properly inflated. Adhesives are applied to customized racing gloves.Clark Hodgin for The New York Times“I have a nice long list of everything I need,” said Daniel Romanchuk, who became in 2018 the first American and youngest athlete ever to win the men’s wheelchair division in New York. “I travel with every tool that I could possibly need.”Clark Hodgin for The New York TimesClark Hodgin for The New York TimesUnlike at the Olympics, where there are fix-it shops to help Paralympians in a pinch, there is no dedicated wheelchair repair shop at the New York City Marathon. But by necessity, the racers and their coaches have an intimate knowledge of their wheelchairs and come prepared with an array of tools to allow them to make fixes on the fly.Clark Hodgin for The New York TimesIn addition to wrenches and screwdrivers, racers pay close attention to their tires, making sure they are ready for New York’s potholes and bridges. The organizers provide cans of pressurized CO2 because racers cannot bring them on planes when they travel to New York. Mr. Romanchuk recently switched to tubeless tires, but other racers carry sealant to repair any punctures.Clark Hodgin for The New York TimesRacers also apply adhesive to their gloves, but there is a balance between adding too much and too little, especially if it rains and grips become slippery.Clark Hodgin for The New York Times“I did that in one race when I was expecting it to rain a lot and it barely did, and my glove would stick to the wheel,” Mr. Romanchuk said.The night before the race, officials meet in the athletes’ hotel to inspect every chair to ensure it meets race standards for things like wheel size.Clark Hodgin for The New York TimesRomanchuk inspects the bottom of his racing bikeClark Hodgin for The New York TimesClark Hodgin for The New York TimesThe next morning, the chairs are brought to the hotel lobby and loaded onto trucks and taken to start line. The racers then travel by bus to Staten Island, where they do their final preparations, including packing a few essential tools like an Allen key and small CO2 can to carry during the race.Daniel Romanchuk poses for a photo for his mother at the finish line on Friday before the race.Clark Hodgin for The New York Times More

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      Doctors, A.I. and Empathy for Patients

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      More from our inbox:Breast Cancer ScreeningWalz’s MisstepsMental Health Support for SchoolchildrenTo the Editor:Re “ChatGPT’s Bedside Manner Is Better Than Mine,” by Jonathan Reisman (Opinion guest essay, Oct. 9):Dr. Reisman notes that ChatGPT’s answers to patient questions have been rated as more empathetic than those written by actual doctors. This should not be a call for doctors to surrender our human role to A.I. To the contrary, we need to continue to improve our communication skills.For the past 25 years, I have been facilitating seminars in doctor-patient communication. The skills to communicate bad news listed by Dr. Reisman are exactly the techniques that we suggest to our medical students. However, doctors can avoid the temptation to surrender their “humanity to a script” as if it were “just another day at work.”Techniques are a valuable guide, but the real work consists of carefully listening to the responses and their emotional content, and crafting new words and phrases that speak to the unique patient’s confusion, fear and distress.In my experience, patients know when we are reciting a script, and when we are paying attention to their thoughts and feelings. Unlike A.I., and especially when conversations are matters of life and death, we can reach into the depths of our humanity to feel and communicate empathy and compassion toward our patients.Neil S. ProseDurham, N.C.To the Editor:Mention the words “A.I.” and “doctoring” to most physicians in the same sentence, and the immediate reaction is often skepticism or fear.As Dr. Jonathan Reisman noted in his essay, A.I. has shown a remarkable ability to mimic human empathy in encounters with patients. This is one reason many practicing physicians worry that A.I. may replace doctors eventually.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      School Absences Rise as Special Education Fails Students, Suit Says

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      A class-action lawsuit argues that the New York City school system falls short in helping students with emotional disabilities, leaving them to miss too many school days.New York City “regularly fails” to provide special education services to students with disabilities, leading to chronic absences, according to a class-action lawsuit filed Tuesday by the Legal Aid Society.The suit seeks to confront a pervasive problem in the city’s school system, the nation’s largest. Tens of thousands of children may struggle to attend class because of anxiety, clinical depression and other emotional disabilities, the suit says. These students have the right — enshrined in federal law — to have their needs accommodated by their public schools.But the city’s Education Department “has a pattern and practice” of falling short in providing evaluations, support services and robust plans to help these children attend class, according to the complaint. This failure results in a “systematic, wholesale denial of access to education,” the suit argues.H.B., a 16-year-old sophomore who is identified by his initials in the lawsuit to protect his privacy, says his anxiety makes it feel like he is watching his classes on “a really old TV” with the signal going in and out.When he was in sixth grade, his mother sought a special education plan — a legal document that outlines the support services and other accommodations to which a student is entitled. But it took almost the entire school year for him to receive one, the suit says.In the meantime, administrators at his middle school told him that if he needed to leave class to collect himself, he could sit with the guidance counselor. The counselor later reported his mother to child services for neglect, in a case that was eventually dismissed.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Ford and Mellon Foundations Name 2024 Disability Futures Fellows

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      The 20 recipients, including a Broadway composer, a Marvel video game voice actress and a three-time Pushcart Prize-nominated poet, are the initiative’s final cohort.The Ford and Andrew W. Mellon Foundations on Wednesday named the 2024 Disability Futures Fellows — the latest class of disabled writers, filmmakers, musicians and other creative artists who will receive unrestricted $50,000 awards.This year’s recipients include Gaelynn Lea, a folk artist and disability rights activist; Natasha Ofili, an actress and writer who in 2020 became one of the first Black deaf actors to portray a video game character — Hailey Cooper — in Marvel’s Spider-Man: Miles Morales; Warren Snipe, a.k.a. Wawa, a deaf rapper and actor who performed in sign language at the 2022 Super Bowl; and Kay Ulanday Barrett, a three-time Pushcart Prize-nominated poet and essayist whose work focuses on queer, transgender people of color.Lea said she almost missed an email telling her she got the award. “Because the email said, ‘We’re excited to offer you $50,000,’ it went to my spam,” Lea, 40, said in an interview. (She later received a follow-up email.)“It’s very validating that I’m doing this stuff I really care about, and now it’s being recognized,” added Lea, who won NPR Music’s Tiny Desk Contest in 2016, and composed and performed original music for a Broadway production of “Macbeth” starring Daniel Craig and Ruth Negga. Lea plans to use the award to fund the writing of a memoir to be published next year.The initiative, which is administered by United States Artists, named its inaugural class of fellows in 2020, with the goal of increasing the visibility of disabled artists and elevating their voices. (About one in four adults in the United States has a disability, according to the Centers for Disease Control and Prevention.) The second class was announced in 2022, and this is the last cohort in the program. The fellowship supports people at all stages of their careers.Elizabeth Alexander, the president of the Mellon Foundation, said in a statement that the program reflected the foundation’s support of the “work, experiences and visions of disabled artists — both in their individual practices and in the collective power they wield in the arts at large.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Overlooked No More: Lorenza Böttner, Transgender Artist Who Found Beauty in Disability

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      Böttner, whose specialty was self-portraiture, celebrated her armless body in paintings she created with her mouth and feet while dancing in public.This article is part of Overlooked, a series of obituaries about remarkable people whose deaths, beginning in 1851, went unreported in The Times.It was the weekend of the gay pride parade in New York City in 1984 when Denise Katz heard her doorbell ring. Surprised, she opened her door and was greeted by Lorenza Böttner, a transgender artist, who was wearing a wedding gown that she had customized to fit her armless body.“I’m here for the party!” Böttner said in her hybrid German-Chilean accent. Though Böttner had buzzed the wrong apartment, Katz invited her in anyway. “From that moment on, we didn’t part,” she said.That Katz worked in an art supply store and Böttner was a prolific artist was pure coincidence.Böttner in 1983. After she lost her arms in a childhood accident, her mother encouraged her to create art with her mouth and her feet.via Leslie-Lohman Museum of ArtThroughout her lifetime, Böttner created a multidisciplinary body of work with her feet and mouth that included painting, drawing, photography, dance and performance art. She made hundreds of paintings in Europe and America, dancing in public across large canvases while creating impressionistic brushstrokes with her footprints. In New York, she performed in front of St. Mark’s Church in-the-Bowery, and Katz, who would become her roommate, provided her with large pieces of paper and other supplies.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      How 2 Families Faced a Catastrophic Birth Defect

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      Ashlee Wiseman, a waitress at a Sizzler in Idaho Falls, Idaho, was 10 weeks pregnant when a nurse phoned with crushing news: a test of fetal DNA in her blood had found that her baby girl had trisomy 18, a catastrophic genetic abnormality, and was unlikely to survive.Devastated, she called her partner, Clint Risenmay, who was at work. He broke down in tears.Ashlee’s response was different.“A still small voice took over me,” she said. “I’m like, ‘I’m not going to listen to them. There has to be something that can help her. And there has to be someone who can help.’”A social media search led her to Dr. John Carey, a professor emeritus of pediatrics at the University of Utah, who has devoted his life to helping families dealing with trisomy 18. He supports pregnant women who chose abortion, but also helps couples who want to have babies with this rare condition, though most will be stillborn or die within a year.Ashlee and Clint were undeterred. They could do it, they assured Dr. Carey. They would lovingly care for a baby with complex medical needs.The consequences of trisomy 18 are dire. The babies have three copies of chromosome 18 instead of two and, as a result, have serious medical and developmental problems. Nearly all are unable to eat, walk or talk, and all have severe cognitive disabilities. They often need open-heart surgery and feeding and breathing tubes. Many women, after hearing what is in store, choose abortion.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      6 Books for Adults Living With ADHD

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      Psychiatrists, counselors and researchers shared their recommendations.Staying focused in a world of distractions can be incredibly challenging. But for people living with attention deficit hyperactivity disorder — a neurodevelopmental disorder often marked by difficulty maintaining attention, disorganization, hyperactivity and impulsivity — it can be even harder. Adults are diagnosed less often than children, but A.D.H.D. can still create problems at work and in friendships and romantic relationships.Books can be “the entree into understanding whether you should consider getting a diagnosis and evaluation for A.D.H.D.,” said Melissa Orlov, the founder of A.D.H.D. and Marriage, a website and consulting company that provides resources for couples living with the condition.Sharon Saline, author of “What Your A.D.H.D. Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life,” says the right book can combat misinformation. It can also help people close to someone with A.D.H.D. by providing a “toolbox for engaging with them, supporting them and loving them,” she said.To demystify the subject, we asked experts — psychiatrists, counselors and researchers — to recommend books on A.D.H.D., focused on adults.1. Taking Charge of Adult A.D.H.D., by Russell A. Barkley with Christine M. BentonThis book, first published in 2010, is full of information and practical tools from Dr. Barkley, “one of the leading, if not the leading expert on A.D.H.D. in the world,” Dr. Saline said. It’s a “combo workbook/info book, which is great for people to get a better sense of who they are,” she said.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Why Can’t My Friend Accept That My Disabled Son Has a Great Life?

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      Put off by pitying displays of concern for her son’s paralysis, a reader wonders how to handle a well-meaning friend whose support misses the mark.Our son was partly paralyzed in a sporting accident as a teenager. Now, years later, he lives a full life — with friends, a job, sports and lots of fun. Still, when we socialize with a certain friend, our son’s disability is her main concern: We get sad eyes, soft touches and pronouncements about how brave we are. I know she means to be supportive, but it makes me uncomfortable. When I respond that his paralysis is not as problematic as she thinks, she goes on and on about how inspirational he is. Sometimes, it casts a pall over the room. Obviously, I am not uncaring about my son’s situation, but he is more than his legs. How should I handle this?MOTHERI think there may be two issues here: Your friend’s well-intentioned compassion — which you kindly acknowledge — seems to have tipped into pity. That would make many of us bristle. Pity carries a whiff of superiority. And I second your objection to your friend’s (implicit) judgment that your son is somehow inferior because he’s paralyzed. He seems to be living a full and happy life!Now, we can manage this first issue pretty easily. But the challenge comes — in my experience — because your friend may be frightened by your son’s disability: She brings it up endlessly because she can’t imagine how she would cope in your position. The prospect may unnerve her.So I would be direct but gentle with her. When you have some time alone with her, say: “You seem so focused on my son’s disability. We’ve all had years to process his accident. And look at what a fulfilling life he leads. You may want to consider why his disability strikes such a deep chord in you.” As you aptly put it, we are all more than our challenges.Miguel PorlanTable-Side Chat, or Tip-Gouging Enterprise?In restaurants recently, several waiters have delivered meals to our table and then proceeded to talk to us the whole time we were eating. In retrospect, I realize they shared — in great detail — their hard-luck stories. I wonder if they do this in hopes of getting bigger tips. I know times are tough, and I want to be sympathetic. But restaurant meals are treats, and we’d like to be left alone to enjoy them. Any advice? We don’t want to be rude.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      New York Is Failing to Meet Wheelchair-Access Goal for Cabs, Suit Says

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      Officials had committed to making sure that 50 percent of the city’s taxi fleet could accommodate wheelchair users by 2023. A lawsuit says they have fallen short.Advocates for New Yorkers with disabilities have sued taxi regulators for falling short of complying with a legal settlement that required half of the city’s licensed taxis to be wheelchair-accessible.The suit argues that taxi regulators have shown that they have “no intention of even attempting” to meet the goal.On Wednesday, the group of advocates, which includes four nonprofits, filed a motion in U.S. District Court in Manhattan urging a judge to order the city to meet the requirement. Only 42 percent of active taxis can accommodate wheelchair users.“It is so disheartening that the city doesn’t want to be more than 50 percent accessible,” said Dan Brown, an attorney representing the plaintiffs. “The fact that they haven’t met the goal is really beyond disappointing and sad.”Jason Kersten, a spokesman for the city’s Taxi and Limousine Commission, said in a statement that the commission is “committed to accessibility.”“When you factor in our entire fleet, we now have almost three times the number of accessible vehicles than we did five years ago,” Mr. Kersten said. “We will keep working to make our fleet even more accessible.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More