Bits: In New Apps, Tools for Volunteering After Hurricane Sandy





LIKE many other New Yorkers horrified by the devastation of Hurricane Sandy, I leapt at the chance to volunteer and get the city back on its feet, particularly the hardest-hit sections of Staten Island, Brooklyn and Queens.




Yet it was hard to figure out how to sort through the various relief organizations and community-led efforts to donate money, supplies and my personal time.


For someone who is accustomed to procuring information quickly and efficiently with a few searches, taps and clicks, the chaos was bewildering. And some of the tools and services that we use in our everyday lives — Facebook, Twitter, simple e-mails and the like — were less effective in the mayhem that followed the storm.


In many kinds of disasters, it can be hard to sift through the dozens, or hundreds, of images and messages to determine where help is most needed — and who needs what. In addition, many of the neediest people are often left without cellular reception and access to a reliable Internet connection.


After a disaster, a top priority “is organizing information and being able to allocate resources,” said Mac Sims, who works at the Rain Agency, a digital advertising agency that has a New York office.


Not long after the hurricane hit, Mr. Sims’s company was among those that began organizing events known as hackathons, where programmers and engineers develop applications and services around a central need or theme.


George Shank, an interactive software developer who works with Mr. Sims, helped build a service called Sprout Help that relays information about where to send supplies and how to volunteer effectively.


“A lot of it stemmed from wanting to help but not being sure how to do it,” Mr. Shank said. “We heard stories of people going to fire stations to volunteer and being turned away.”


Although voice and data connections often succumb to power failures, many people can still send text messages over cellphone networks. Sprout takes advantage of that loophole. Volunteers could post fliers with information about how to send a text to Sprout to join the service, which doubles as a real-time alert system that fires off messages with information about where volunteers should go. Those in need can also send messages through Sprout outlining their location, and detailing the area’s needs, like fresh water or medical help.


Mr. Shank said the company wanted to recreate the effectiveness of posting a beacon for help on Facebook or Twitter, but one that would not become lost in the myriad other messages coursing through those systems at any given moment. Sprout, he said, is similar to a social network system like Facebook, but is “one that people would have access to during a disaster.”


Robert Grazioli and Eric Candino, who work at Rounded, a design agency in Syracuse, developed a service called HugoHelps that lets disaster victims search for places to stay after their homes have been flooded or stripped of basic utilities like electricity and heat.


Mr. Grazioli said they built their application after hearing that several friends were stranded in Lower Manhattan without a warm place to sleep.


“They were safe, but displaced,” he said. “We wanted to help them find better places to stay nearby that had power.”


Their application also delivers information via text message.


“Data is very difficult during a disaster, and we wanted to make sure people without smartphones could also use it too,” he said.


Currently, the application funnels information about nearby hotels, but Mr. Grazioli and Mr. Candino think that future iterations could relay details about shelters, free disaster housing and inexpensive rooms for rent.


NOT all such applications and tools developed were turned into full-fledged products. Instead, their makers hope that they can serve as guidelines for the types of services that could be deployed by government and relief organizations during future disasters or national crises.


Sasha Costanza-Chock, a professor of civic media at the Massachusetts Institute of Technology, says disaster preparedness is about more than stocking up on bottled water, packaged meals and fresh batteries. It’s also a matter of pooling technical resources to solve the problems that can arise quickly, like how to move supplies to those in need and relay reliable information about shelters and food.


In the hours before the hurricane struck, Mr. Costanza-Chock started Hurricane Hackers, an online hub where software engineers and developers could share ideas as the storm advanced.


“We were looking at ways to support and build together, even people from a distance who wanted to support relief efforts,” he said.


Mr. Costanza-Chock emphasized the importance of realistic ideas that can be deployed quickly.


“It’s easy to dream up fantastic solutions, but what works on the ground and will be useful in the moment are the ones that are the most successful,” he said. “Whether it is beautiful or not does not matter.”


In his experience, tools that are tied to a real need — grounded in an organization with people working on the scene, and limited to a specific geographic area — are those that have worked the best.


“The challenge is not to build the tools,” he said, “but rather, how do you capture the attention and energy that people have and plug it in?”


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Palestinian Death Toll Rises as Israel Presses Onslaught





GAZA CITY — After a night of sustained Israeli strikes by air and sea and a morning of rocket attacks on Israel, the Health Ministry here said on Monday that the Palestinian death toll in six days of conflict had risen to 91 with 700 wounded, including 200 children, as the assault ground on unrelentingly despite efforts toward a cease-fire.




The casualties — 19 people reported killed since midnight local time — included Palestinians killed in strikes by warplanes and a drone attack on two men on a motorcycle. Another drone attack killed the driver of a taxi hired by journalists and displaying “Press” signs, although it was not clear which journalists hired it, Palestinian officials said.


On Sunday, Israeli forces attacked two buildings housing local broadcasters and production companies used by foreign outlets. Israeli officials denied targeting journalists, but on Monday Israeli forces again blasted the Al Sharouk block used by many local broadcasters as well as Britain’s Sky News and the Al Arabiya channel.


The attack, apparently aimed at a computer shop on the third floor of the building, sparked a blaze that sent plumes of dark smoke creeping up the sides of the building. Video footage showed clouds of gray smoke billowing from the high-rise building as the missiles struck home.


An Israeli bomb pummeled a home deep into the ground here on Sunday, killing 11 people, including nine in three generations of a single family, in the deadliest single strike in six days of cross-border conflict. Members of the family were buried Monday in a rite that turned into a gesture of defiance and became a rally supporting Gaza’s militant Hamas rulers.


A militant leader said Tel Aviv, in the Israeli heartland, would be hit “over and over” and warned Israelis that their leaders were misleading them and would “take them to hell.”


The airstrikes further indicated that Israel was striking a wide range of targets. Three Israelis have been killed and at least 79 wounded by continued rocket fire into southern Israel and as far north as Tel Aviv.


Israel says its onslaught is designed to stop Hamas from launching the rockets, but, after an apparent lull overnight, more missiles hurtled toward targets in Israel, some of them intercepted by Israel’s Iron Dome defense system. Of five rockets fired on Monday at the southern Israeli city of Ashkelon, four were intercepted but one smashed through the concrete roof at the entrance to an empty school. There were no reports of casualties. Other rockets rained on areas along the border with Gaza. 


Later a second volley struck Ashkelon. Several rockets were intercepted, but one crashed down onto a house, causing damage but no casualties. News reports said 75 rockets had been fired by midafternoon.


On Sunday, a new blitz of Palestinian rockets totaled nearly 100 by nightfall, including two that soared toward the population center of Tel Aviv but were knocked out of the sky by Israeli defenses.


In a statement on Monday, the Israel Defense Forces said overnight targets included “underground rocket launchers, terror tunnels, training bases, Hamas command posts and weapon storage facilities.” But news reports said the strikes flattened two houses belonging to a single family, killing two children and two adults and injuring 42 people, while a shrapnel burst from another attack killed one child and wounded others living near the rubble of the former national security compound.


The latest exchanges offered a grim backdrop to Egyptian-led cease-fire efforts that have so far proved inconclusive. The United Nations secretary general, Ban Ki-moon, was set to join the effort in Cairo on Monday.


Brig. Gen. Yoav Mordechai, the spokesman for the Israel Defense Forces, said there had been a reduction of up to 40 percent in rocket fire from Gaza, while Israeli forces had launched 40 attacks on tunnels between Egypt and Gaza, both at the entrances and along the road leading to them, causing considerable damage.


He said six rocket launching teams and two men on motorcycles were hit, while the Israeli forces continued to intercept Palestinian radio signals to urge Gaza residents to steer clear of activists.


In the Israeli strike on Sunday morning, it took emergency workers and a Caterpillar digger more than an hour to reveal the extent of the devastation under the two-story home of Jamal Dalu, a shop owner. Mr. Dalu was at a neighbor’s when the blast wiped out nearly his entire family: His sister, wife, two daughters, daughter-in-law and four grandchildren ages 2 to 6 all perished under the rubble, along with two neighbors, an 18-year-old and his grandmother.


Fares Akram and Jodi Rudoren reported from Gaza City, and Alan Cowell from London. Reporting was contributed by Isabel Kershner from Ashkelon, Israel; Ethan Bronner, Myra Noveck and Irit Pazner Garshowitz from Jerusalem; Rina Castelnuovo from Ashdod, Israel; Peter Baker from Bangkok; and David D. Kirkpatrick from Cairo.



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The iEconomy: As Boom Lures App Creators, Tough Part Is Making a Living


Daniel Rosenbaum for The New York Times


Shawn and Stephanie Grimes’s efforts have cost $200,000 in lost income and savings, but their apps have earned less than $5,000 this year.







ROSEDALE, Md. — Shawn and Stephanie Grimes spent much of the last two years pursuing their dream of doing research and development for Apple, the world’s most successful corporation.




But they did not actually have jobs at Apple. It was freelance work that came with nothing in the way of a regular income, health insurance or retirement plan. Instead, the Grimeses tried to prepare by willingly, even eagerly, throwing overboard just about everything they could.


They sold one of their cars, gave some possessions to relatives and sold others in a yard sale, rented out their six-bedroom house and stayed with family for a while. They even cashed in Mr. Grimes’s 401(k).


“We didn’t lose any sleep over it,” said Mr. Grimes, 32. “I’ll retire when I die.”


The couple’s chosen field is so new it did not even exist a few years ago: writing software applications for mobile devices like the iPhone or iPad. Even as unemployment remained stubbornly high and the economy struggled to emerge from the recession’s shadow, the ranks of computer software engineers, including app writers, increased nearly 8 percent in 2010 to more than a million, according to the latest available government data for that category. These software engineers now outnumber farmers and have almost caught up with lawyers.


Much as the Web set off the dot-com boom 15 years ago, apps have inspired a new class of entrepreneurs. These innovators have turned cellphones and tablets into tools for discovering, organizing and controlling the world, spawning a multibillion-dollar industry virtually overnight. The iPhone and iPad have about 700,000 apps, from Instagram to Angry Birds.


Yet with the American economy yielding few good opportunities in recent years, there is debate about how real, and lasting, the rise in app employment might be.


Despite the rumors of hordes of hip programmers starting million-dollar businesses from their kitchen tables, only a small minority of developers actually make a living by creating their own apps, according to surveys and experts. The Grimeses began their venture with high hopes, but their apps, most of them for toddlers, did not come quickly enough or sell fast enough.


And programming is not a skill that just anyone can learn. While people already employed in tech jobs have added app writing to their résumés, the profession offers few options to most unemployed, underemployed and discouraged workers.


One success story is Ethan Nicholas, who earned more than $1 million in 2009 after writing a game for the iPhone. But he says the app writing world has experienced tectonic shifts since then.


“Can someone drop everything and start writing apps? Sure,” said Mr. Nicholas, 34, who quit his job to write apps after iShoot, an artillery game, became a sensation. “Can they start writing good apps? Not often, no. I got lucky with iShoot, because back then a decent app could still be successful. But competition is fierce nowadays, and decent isn’t good enough.”


The boom in apps comes as economists are debating the changing nature of work, which technology is reshaping at an accelerating speed. The upheaval, in some ways echoing the mechanization of agriculture a century ago, began its latest turbulent phase with the migration of tech manufacturing to places like China. Now service and even white-collar jobs, like file clerks and data entry specialists or office support staff and mechanical drafters, are disappearing.


“Technology is always destroying jobs and always creating jobs, but in recent years the destruction has been happening faster than the creation,” said Erik Brynjolfsson, an economist and director of the M.I.T. Center for Digital Business.


Still, the digital transition is creating enormous wealth and opportunity. Four of the most valuable American companies — Apple, Google, Microsoft and I.B.M. — are rooted in technology. And it was Apple, more than any other company, that set off the app revolution with the iPhone and iPad. Since Apple unleashed the world’s freelance coders to build applications four years ago, it has paid them more than $6.5 billion in royalties.


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The Neediest Cases: Emerging From a Bleak Life to Become Fabulous Phil





For years, Phillip Johnson was caught in what seemed like an endless trench of bad luck. He was fired from a job, experienced intensifying psychological problems, lost his apartment and spent time in homeless shelters. At one point, he was hospitalized after overdosing on an antipsychotic drug.




“I had a rough road,” he said.


Since his hospital stay two years ago, and despite setbacks, Mr. Johnson, 27, has been getting his life on track. At Brooklyn Community Services, where he goes for daily counseling and therapy, everybody knows him as Fabulous Phil.


“Phillip is a light, the way he evokes happiness in other people,” his former caseworker, Teresa O’Brien, said. “Phillip’s character led directly to his nickname.”


About six months ago, with Ms. O’Brien’s help, Mr. Johnson started an event: Fabulous Phil Friday Dance Party Fridays.


One recent afternoon at the agency, 30 clients and a few counselors were eating cake, drinking soft drinks and juice, and grooving for 45 minutes to Jay-Z and Drake pulsating from a boom box.


Mr. Johnson’s voice rose with excitement when he talked about the party. Clients and counselors, he said, “enjoy themselves.”


“They connect more; they communicate more,” he continued. “Everybody is celebrating and laughing.”


The leadership Mr. Johnson now displays seems to be a far cry from the excruciatingly introverted person he was.


As an only child living with his single mother in public housing in Bedford-Stuyvesant, Brooklyn, he said, he tended to isolate himself. “A lot of kids my age would say, ‘Come outside,’ but I would always stay in my room,” he said. He occupied himself by writing comic books or reading them, his favorites being Batman and Spiderman because, he said, “they were heroes who saved the day.”


After graduating from high school in 2003, he worked odd jobs until 2006, when he took a full-time position at a food court at La Guardia Airport, where he helped to clean up. The steady paycheck allowed him to leave his mother’s apartment and rent a room in Queens.


But the depression and bleak moods that had shadowed him throughout middle and high school asserted themselves.


“My thinking got confused,” he said. “Racing thoughts through my mind. Disorganized thoughts. I had a hard time focusing on one thing.”


In 2008, after two years on the job, Mr. Johnson was fired for loud and inappropriate behavior, and for being “unpredictable,” he said. The boss said he needed counseling. He moved back in with his mother, and in 2009 entered a program at an outpatient addiction treatment service, Bridge Back to Life. It was there, he said, that he received a diagnosis of schizophrenia and help with his depression and marijuana use.


But one evening in May 2010, he had a bout with insomnia.


He realized the antipsychotic medication he had been prescribed, Risperdal, made him feel tired, he said, so he took 12 of the pills, rather than his usual dosage of two pills twice a day. When 12 did not work, he took 6 more.


“The next morning when I woke up, it was hard for me to breathe,” he said.


He called an ambulance, which took to Woodhull Hospital. He was released after about a month.


Not long after, he returned to his mother’s apartment, but by February 2011, they both decided he should leave, and he relocated to a homeless shelter in East New York, where, he said, eight other people were crammed into his cubicle and there were “bedbugs, people lying in your bed, breaking into your locker to steal your stuff.”


In late spring 2011, he found a room for rent in Manhattan, but by Thanksgiving he was hospitalized again. Another stint in a shelter followed in April, when his building was sold.


Finally, in July, Mr. Johnson moved to supported housing on Staten Island, where he lives with a roommate. His monthly $900 Social Security disability check is sent to the residence, which deducts $600 for rent and gives him $175 in spending money; he has breakfast and lunch at the Brooklyn agency. To assist Mr. Johnson with unexpected expenses, a grant of $550 through The New York Times Neediest Cases Fund went to buy him a bed and pay a Medicare prescription plan fee for three months.


“I was so happy I have a bed to sleep on,” he said about the replacement for an air mattress. “When I have a long day, I have a bed to lay in, and I feel good about that.”


Mr. Johnson’s goals include getting his driver’s license — “I already have a learner’s permit,” he said, proudly — finishing his program at the agency, and then entering an apprenticeship program to become a plumber, carpenter or mechanic.


But seeing how his peers have benefited from Fabulous Phil Fridays has made him vow to remain involved with people dealing with mental illnesses or substance abuse.


He was asked at the party: Might he be like the comic-book heroes he loves? A smile spread across his face. He seemed to think so.


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The Neediest Cases: Emerging From a Bleak Life to Become Fabulous Phil





For years, Phillip Johnson was caught in what seemed like an endless trench of bad luck. He was fired from a job, experienced intensifying psychological problems, lost his apartment and spent time in homeless shelters. At one point, he was hospitalized after overdosing on an antipsychotic drug.




“I had a rough road,” he said.


Since his hospital stay two years ago, and despite setbacks, Mr. Johnson, 27, has been getting his life on track. At Brooklyn Community Services, where he goes for daily counseling and therapy, everybody knows him as Fabulous Phil.


“Phillip is a light, the way he evokes happiness in other people,” his former caseworker, Teresa O’Brien, said. “Phillip’s character led directly to his nickname.”


About six months ago, with Ms. O’Brien’s help, Mr. Johnson started an event: Fabulous Phil Friday Dance Party Fridays.


One recent afternoon at the agency, 30 clients and a few counselors were eating cake, drinking soft drinks and juice, and grooving for 45 minutes to Jay-Z and Drake pulsating from a boom box.


Mr. Johnson’s voice rose with excitement when he talked about the party. Clients and counselors, he said, “enjoy themselves.”


“They connect more; they communicate more,” he continued. “Everybody is celebrating and laughing.”


The leadership Mr. Johnson now displays seems to be a far cry from the excruciatingly introverted person he was.


As an only child living with his single mother in public housing in Bedford-Stuyvesant, Brooklyn, he said, he tended to isolate himself. “A lot of kids my age would say, ‘Come outside,’ but I would always stay in my room,” he said. He occupied himself by writing comic books or reading them, his favorites being Batman and Spiderman because, he said, “they were heroes who saved the day.”


After graduating from high school in 2003, he worked odd jobs until 2006, when he took a full-time position at a food court at La Guardia Airport, where he helped to clean up. The steady paycheck allowed him to leave his mother’s apartment and rent a room in Queens.


But the depression and bleak moods that had shadowed him throughout middle and high school asserted themselves.


“My thinking got confused,” he said. “Racing thoughts through my mind. Disorganized thoughts. I had a hard time focusing on one thing.”


In 2008, after two years on the job, Mr. Johnson was fired for loud and inappropriate behavior, and for being “unpredictable,” he said. The boss said he needed counseling. He moved back in with his mother, and in 2009 entered a program at an outpatient addiction treatment service, Bridge Back to Life. It was there, he said, that he received a diagnosis of schizophrenia and help with his depression and marijuana use.


But one evening in May 2010, he had a bout with insomnia.


He realized the antipsychotic medication he had been prescribed, Risperdal, made him feel tired, he said, so he took 12 of the pills, rather than his usual dosage of two pills twice a day. When 12 did not work, he took 6 more.


“The next morning when I woke up, it was hard for me to breathe,” he said.


He called an ambulance, which took to Woodhull Hospital. He was released after about a month.


Not long after, he returned to his mother’s apartment, but by February 2011, they both decided he should leave, and he relocated to a homeless shelter in East New York, where, he said, eight other people were crammed into his cubicle and there were “bedbugs, people lying in your bed, breaking into your locker to steal your stuff.”


In late spring 2011, he found a room for rent in Manhattan, but by Thanksgiving he was hospitalized again. Another stint in a shelter followed in April, when his building was sold.


Finally, in July, Mr. Johnson moved to supported housing on Staten Island, where he lives with a roommate. His monthly $900 Social Security disability check is sent to the residence, which deducts $600 for rent and gives him $175 in spending money; he has breakfast and lunch at the Brooklyn agency. To assist Mr. Johnson with unexpected expenses, a grant of $550 through The New York Times Neediest Cases Fund went to buy him a bed and pay a Medicare prescription plan fee for three months.


“I was so happy I have a bed to sleep on,” he said about the replacement for an air mattress. “When I have a long day, I have a bed to lay in, and I feel good about that.”


Mr. Johnson’s goals include getting his driver’s license — “I already have a learner’s permit,” he said, proudly — finishing his program at the agency, and then entering an apprenticeship program to become a plumber, carpenter or mechanic.


But seeing how his peers have benefited from Fabulous Phil Fridays has made him vow to remain involved with people dealing with mental illnesses or substance abuse.


He was asked at the party: Might he be like the comic-book heroes he loves? A smile spread across his face. He seemed to think so.


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Israeli Strike in Gaza Kills at Least 11, Including Children


Tyler Hicks/The New York Times


Residents in Gaza dug through the rubble of an apartment building hit by Israeli rockets.







GAZA CITY — Israeli forces killed at least 11 people, including several children, in a single airstrike that destroyed a home here on Sunday, as Israel pressed its bombardment of the Gaza Strip for a fifth day, deploying warplanes and naval vessels to pummel the coastal enclave.




The airstrike, which the Israeli military said was meant to kill a Palestinian militant involved in the recent rocket attacks, was the deadliest operation to date and would no doubt weigh on negotiations for a possible cease-fire. Among the dead were five women and four small children, The Associated Press reported, citing a Palestinian health official.


Two media offices were also hit on Sunday, and Prime Minister Benjamin Netanyahu of Israel warned of a “significant” expansion in the onslaught, which has already killed over 50 people, many of them civilians.


Speaking on Sunday from Bangkok, President Obama condemned missile attacks by Palestinian fighters in Gaza and defended Israel’s right to protect itself.


“There’s no country on earth that would tolerate missiles raining down on its citizens from outside its borders,” Mr. Obama said in his first public comments since the violence broke out. “We are fully supportive of Israel’s right to defend itself.”


The president also said that efforts were under way to address Israel’s security concerns and end the violence. “We’re going to have to see what kind of progress we can make in the next 24, 36, 48 hours,” Mr. Obama said.


Even as the diplomacy intensified on Sunday, the attacks continued in Gaza and Israel.


Mr. Netanyahu made his warning as militants in Gaza aimed at least one rocket at Tel Aviv, a day after Israeli forces broadened the attack beyond military targets, bombing centers of government infrastructure in Gaza, including the four-story headquarters of the Hamas prime minister.


“We are exacting a heavy price from Hamas and the terrorist organizations, and the Israel Defense Forces are prepared for a significant expansion of the operation,” Mr. Netanyahu told his cabinet at its routine Sunday meeting, referring directly to the of thousands of reservists who have been called up and the massing of armor on the Gaza border that many analysts have interpreted as preparations for a possible invasion.


“I appreciate the rapid and impressive mobilization of the reservists who have come from all over the country and turned out for the mission at hand,” Mr. Netanyahu said. “Reservist and conscript soldiers are ready for any order they might receive.”


His remarks were reported shortly after a battery of Israel’s Iron Dome defense shield, hastily deployed near Tel Aviv on Saturday in response to the threat of longer-range rockets, intercepted at least one aimed at the city on Sunday, Israeli officials said. It was the latest of several salvos that have illustrated Hamas’s ability to extend the reach of its rocket attacks.


Since Wednesday, when the escalation of the conflict began, Iron Dome has knocked 245 rockets out of the sky, the military said Saturday, while 500 have struck Israel.


The American-financed system is designed to intercept only rockets streaking toward towns and cities and to ignore those likely to strike open ground. But on Sunday a rocket fired from Gaza plowed through the roof of an apartment building in the southern Israeli city of Ashkelon. There were no immediate reports of casualties there.


In Gaza City, the crash of explosions pierced the quiet several times throughout the early morning.


Before the latest deadly strike involving civilians on Sunday, Hamas health officials had said the Palestinian death toll had risen to 53. One of the latest victims was a 52-year-old woman whose house in the eastern part of Gaza City was bombed around lunchtime.


A few hours earlier, a Hamas militant was killed and seven people were wounded in an attack on the Beach Refugee Camp, where Ismail Haniya, the Hamas prime minister, has a home. Those killed on Sunday included three children ages 1 through 5, the health officials said.


In Israel, 3 civilians have died and 63 have been injured. Four soldiers were wounded on Saturday.


The onslaught continued despite talks in Cairo that President Mohamed Morsi of Egypt said Saturday night could soon result in a cease-fire. Mr. Netanyahu said he would consider a comprehensive cease-fire if the launchings from Gaza stopped.


The attack on Mr. Haniya’s office, one of several on government installations, came a day after he hosted his Egyptian counterpart in the same building, a sign of Hamas’s new legitimacy in a radically redrawn Arab world.


Jodi Rudoren and Fares Akram reported from Gaza City. Reporting was contributed by Isabel Kershner, Carol Sutherland and Iritz Pazner Garshowitz from Jerusalem; Tyler Hicks from Gaza, Peter Baker from Bangkok, Alan Cowell from London, Michael Schwirtz from New York and David D. Kirkpatrick and Mayy El Sheikh from Cairo.



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Drug Shortages Are Becoming Persistent in U.S.


Paul Davis, the chief of a rural ambulance squad in southern Ohio, was down to his last vial of morphine earlier this fall when a woman with a broken leg needed a ride to the hospital.


The trip was 30 minutes, and the patient was in pain. But because of a nationwide shortage, his morphine supply had dwindled from four doses to just one, presenting Mr. Davis with a stark quandary. Should he treat the woman, who was clearly suffering? Or should he save it for a patient who might need it more?


In the end, he opted not to give her the morphine, a decision that haunts him still. “I just feel like I’m not doing my job,” said Mr. Davis, who is chief of the rescue squad in Vernon, Ohio. He has since refilled his supply. “I shouldn’t have to make those kinds of decisions.”


From rural ambulance squads to prestigious hospitals, health care workers are struggling to keep vital medicines in stock because of a drug shortage crisis that is proving to be stubbornly difficult to fix. Rationing is just one example of the extraordinary lengths being taken to address the shortage, which health care workers say has ceased to be a temporary emergency and is now a fact of life. In desperation, they are resorting to treating patients with less effective alternative medicines and using expired drugs. The Cleveland Clinic has hired a pharmacist whose only job is to track down hard-to-find drugs.


Caused largely by an array of manufacturing problems, the shortage has prompted Congressional hearings, a presidential order and pledges by generic drug makers to communicate better with federal regulators.


The problem peaked in 2011, when a record 251 drugs were declared in short supply. This year, slightly more than 100 were placed on the list, and workers say the battle to keep pharmacy shelves stocked continues unabated. The list of hard-to-find medicines ranges from basic drugs like the heart medicine nitroglycerin to a lidocaine injection, which is used to numb tissue before surgery.


A deadly meningitis outbreak caused by contamination at a large drug producer could worsen the situation, federal officials have warned. The Food and Drug Administration said that shortages of six drugs — medicines used during surgery and to treat conditions like congestive heart failure — could get worse after a big compounding pharmacy closed over concerns about drug safety. The pharmacy, Ameridose, shares some management with the New England Compounding Center, which is at the center of a meningitis outbreak that has claimed 33 lives.


“When you can’t treat basic things — cardiac arrest, pain management, seizures — you’re in trouble,” said Dr. Carol Cunningham, the state medical director for the Ohio Department of Public Safety’s emergency services division. “When you only have five tools in your toolbox and three of them are gone, what do you do?”


Dr. Margaret A. Hamburg, the F.D.A. commissioner, said in an interview this week that she was “guardedly optimistic” that the shortage crisis was abating. “I think there’s been an enormous amount of progress,” she said. “We’re seeing real change in the number of shortages that we’re able to recognize early.” More than 150 new shortages have been prevented this year, according to the agency.


But Erin Fox, who tracks supply levels for a broader range of drugs at the University of Utah, said once a drug became scarce, it tended to stay scarce. The university’s Drug Information Service was actively tracking 282 hard-to-find products by the end of the third quarter of this year, a record.


“The shortages we have aren’t going away — they’re not resolving,” she said. “But the good news is we’re not piling more shortages on top.”


In 2011, prompted by emotional pleas by cancer patients and others who said the drug shortage was threatening lives, President Obama issued an executive order requiring drug makers to notify the F.D.A. when a shortage appeared imminent. The agency also loosened some restrictions on importing drugs, and sped up approvals by other manufacturers to make certain medicines.


A law passed this summer contains several provisions aimed at improving the situation, including expediting approval of new generic medicines and requiring the agency’s enforcement unit to better coordinate with its drug-shortage officials before it takes action against a manufacturer.


Ralph G. Neas, the chief executive of the Generic Pharmaceutical Association, said fixing the drug shortage was complex and would take time, but was a top priority. “One shortage is one shortage too many,” he said. “One patient not getting a critical drug is one patient too many.”


Federal drug officials trace much of the drug shortage crisis to delays at plants that make sterile injectable drugs, which account for about 80 percent of the scarce medicines. Nearly a third of the industry’s manufacturing capacity is not running because of plant closings or shutdowns to fix serious quality issues. Other shortages have been caused by supply disruptions of the raw ingredients used to make the drugs, or by manufacturers exiting the market.


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Well: Meatless Main Dishes for a Holiday Table

Most vegetarian diners are happy to fill their plates with delicious sides and salads, but if you want to make them feel special, consider one of these main course vegetarian dishes from Martha Rose Shulman. All of them are inspired by Greek cooking, which has a rich tradition of vegetarian meals.

I know that Greek food is not exactly what comes to mind when you hear the word “Thanksgiving,” yet why not consider this cuisine if you’re searching for a meatless main dish that will please a crowd? It’s certainly a better idea, in my mind, than Tofurky and all of the other overprocessed attempts at making a vegan turkey. If you want to serve something that will be somewhat reminiscent of a turkey, make the stuffed acorn squashes in this week’s selection, and once they’re out of the oven, stick some feathers in the “rump,” as I did for the first vegetarian Thanksgiving I ever cooked: I stuffed and baked a huge crookneck squash, then decorated it with turkey feathers. The filling wasn’t nearly as good as the one you’ll get this week, but the creation was fun.

Here are five new vegetarian recipes for your Thanksgiving table — or any time.

Giant Beans With Spinach, Tomatoes and Feta: This delicious, dill-infused dish is inspired by a northern Greek recipe from Diane Kochilas’s wonderful new cookbook, “The Country Cooking of Greece.”


Northern Greek Mushroom and Onion Pie: Meaty portobello mushrooms make this a very substantial dish.


Roasted Eggplant and Chickpeas With Cinnamon-Tinged Tomato Sauce and Feta: This fragrant and comforting dish can easily be modified for vegans.


Coiled Greek Winter Squash Pie: The extra time this beautiful vegetable pie takes to assemble is worth it for a holiday dinner.


Baked Acorn Squash Stuffed With Wild Rice and Kale Risotto: Serve one squash to each person at your Thanksgiving meal: They’ll be like miniature vegetarian (or vegan) turkeys.


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Well: Meatless Main Dishes for a Holiday Table

Most vegetarian diners are happy to fill their plates with delicious sides and salads, but if you want to make them feel special, consider one of these main course vegetarian dishes from Martha Rose Shulman. All of them are inspired by Greek cooking, which has a rich tradition of vegetarian meals.

I know that Greek food is not exactly what comes to mind when you hear the word “Thanksgiving,” yet why not consider this cuisine if you’re searching for a meatless main dish that will please a crowd? It’s certainly a better idea, in my mind, than Tofurky and all of the other overprocessed attempts at making a vegan turkey. If you want to serve something that will be somewhat reminiscent of a turkey, make the stuffed acorn squashes in this week’s selection, and once they’re out of the oven, stick some feathers in the “rump,” as I did for the first vegetarian Thanksgiving I ever cooked: I stuffed and baked a huge crookneck squash, then decorated it with turkey feathers. The filling wasn’t nearly as good as the one you’ll get this week, but the creation was fun.

Here are five new vegetarian recipes for your Thanksgiving table — or any time.

Giant Beans With Spinach, Tomatoes and Feta: This delicious, dill-infused dish is inspired by a northern Greek recipe from Diane Kochilas’s wonderful new cookbook, “The Country Cooking of Greece.”


Northern Greek Mushroom and Onion Pie: Meaty portobello mushrooms make this a very substantial dish.


Roasted Eggplant and Chickpeas With Cinnamon-Tinged Tomato Sauce and Feta: This fragrant and comforting dish can easily be modified for vegans.


Coiled Greek Winter Squash Pie: The extra time this beautiful vegetable pie takes to assemble is worth it for a holiday dinner.


Baked Acorn Squash Stuffed With Wild Rice and Kale Risotto: Serve one squash to each person at your Thanksgiving meal: They’ll be like miniature vegetarian (or vegan) turkeys.


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Shortcuts: The Meaning in a Drawer Full of Old Family Snapshots


Eric Thayer/Reuters


A resident found photos as she sifted the debris of a house destroyed by Hurricane Sandy in Union Beach, N.J.







I WASN’T going to write about Hurricane Sandy. I was going to write about the changing nature of photographs and our relationship to them in this digital age.








Doug Mills/The New York Times

Picture-taking is now mainly digital, making prints of photos uncommon.






But as I began my research, I came across a Facebook page where lost photos from the storm were posted. Called “Union Beach — Photos and Misplaced Items,” the page shows photos of newborns and birthday parties, weddings and family gatherings.


Starting the morning after the storm devastated her community of Union Beach, N.J., Jeanette Van Houten and her niece have collected over a thousand photos and some photo albums. She is making it her mission to scan and post to Facebook as many as possible, including those turned into the fire department, police station and borough hall.


In addition, she was handed a drawerful of over a thousand family photos that must have been wrenched from a dresser.


About 60 photos have been claimed so far, and some professionals have offered to restore damaged photos free.


“These photos were passed down through families and they survived Sandy, even if the structures they were in didn’t,” Ms. Van Houten said. “They tell our story.”


With the Facebook page, Ms. Van Houten uses newer technology to help people reconnect with their old-fashioned snapshots. And seeing the photographs of mundane scenes and milestones on Facebook, along with the grateful comments from people who got back a bit of their lives, reminded me of both the fragility and strength of photos and their continuing importance in our lives. Judith Dupré, author of “Monuments: America’s History in Art and Memory” (Random House, 2007), and other books, teaches a class at her local library in Mamaroneck, N.Y., called “Stories from My Life,” for older residents. They use photos and stories to write about their lives.


“They bring in a basketful of photos,” Ms. Dupré said. “Each one of these photos contains a story — they’re like a key that opens the door to a life.”


And a printed photo “is a different species than a digital photo,” she said. “I don’t think anyone’s figured out the place of digital photos in terms of memory keeping.”


When an elderly aunt of hers died and left behind lots of photographs, Ms. Dupré said the family took them to the memorial service.


“We had a table and people could select and take what they wanted,” she said. “It was a very moving part of the memorial.”


Of course, even prints can lose their meaning and poignancy through the generations.


And in some cases, as with Hurricane Sandy, photos may be safer in cyberspace than in an album on a bookshelf — as long as you remember to upload them to a site like Flickr, Shutterfly, Snapfish or countless other photo sites available. (And make sure you know how long a site will keep your photos. Some, for example, require you to show some activity at least once a year.) That way, if you lose your hard drive, you don’t lose your photos.


But Ms. Dupré said she worried that photos that existed only online somewhere might die with the photographer.


“I don’t even know what my parents have in terms of digital photography,” she said. She said she put the password to her photos safely away with her will and other documents, so her children can access them.


Now I’m not trying to say that the old-fashioned way is the only way. Photography has constantly evolved. The Brownie camera, first sold by Kodak for $1 in 1900, radicalized photography by making it available to just about everyone.


But, and I know this largely a generational thing, I can’t help but wonder about the ubiquity of the cellphone photo. As Ms. Dupré said, “The infinite number of digital photos that can be taken has devalued the single image and made one-of-a-kind prints that much more precious.”


E-mail: shortcuts@nytimes.com



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