Jacqueline Kennedy Onassis meticulously curated the memory of her husband after he was assassinated, reimagining President John F. Kennedy as a fallen King Arthur in a modern-day Camelot.
Now some historians wonder if Laurene Powell Jobs is also trying to frame the legacy of her late husband, Steve Jobs, a complicated and transformational figure who was shadowed by his flaws as a father and belligerence as a boss.
Last month, Ms. Powell Jobs introduced the Steve Jobs Archive. It aspires to reinvent the personal archive much as Mr. Jobs, in his years running Apple, remade music with the iPod and communication with the iPhone.
Rather than offering up a repository of personal correspondence, notes and items for public research and inquiry, as other influential figures have done, Ms. Powell Jobs, who did not respond to requests for comments, said at a conference last month that the Steve Jobs Archive would be devoted to “ideas.” Those ideas are primarily Mr. Jobs’s philosophies about life and work.
Harvard Business School’s 25 greatest business leaders of the 20th century left behind personal archives that are open to the public in libraries or museums, including Henry Ford, Thomas Edison and Asa Candler, who built Coca-Cola.
Other iconic business founders such as Walt Disney, Sam Walton and Ray Kroc entrusted their papers to the companies they built, allowing those collections to become the cornerstone of corporate archives.
Walt Disney Company, make personal correspondence, notes, speeches and other items available to authors for research.
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“We don’t censor,” said Becky Cline, director of the Walt Disney archives. “We just vet.”
The new Jobs archive debuted with a minimalist website containing eight pieces of video, audio and writing that express what the archive calls Mr. Jobs’s “driving motivations in his own words.” The items, three-quarters of which were already public, can be accessed by clicking through maxims made famous by Mr. Jobs, including “make something wonderful and put it out there” and “pursue different paths.”
The next steps for the archive are shrouded in the kind of mystery associated with the way Mr. Jobs ran Apple. About all that’s been publicly disclosed is that Ms. Powell Jobs hired a documentary filmmaker to gather hundreds of oral histories about Mr. Jobs from former colleagues. Where that material will be stored and who will have access to it has not been revealed.
She married Mr. Jobs in 1991, two years after meeting him as a graduate student at Stanford. Since his death, she has used her estimated $16 billion fortune to fund the Emerson Collective, a philanthropic and commercial operation that owns The Atlantic magazine and funds an organization trying to reduce gun violence in Chicago.
During his life, Mr. Jobs admired and encouraged historians to preserve the history of his Silicon Valley predecessors such as Robert Noyce, who co-founded the chip maker Intel. But he put little value on his own history, and Apple has seldom commemorated product anniversaries, saying it focuses on the future, not the past.
Stanford spent years cataloging items such as photos of a barefoot Mr. Jobs at work, advertising campaigns and an Apple II computer. That material can be reviewed by students and researchers interested in learning more about the company.
Silicon Valley leaders have a tradition of leaving their material with Stanford, which has collections of letters, slides and notes from William Hewlett, who founded Hewlett-Packard, and Andy Grove, the former chief executive of Intel.
Mr. Lowood said that he uses the Silicon Valley archives to teach students about the value of discovery. “Unlike a book, which is the gospel and all true, a mix of materials in a box introduces uncertainty,” he said.
After Mr. Jobs’ death in 2011, Mr. Isaacson, the author, published a biography of Mr. Jobs. Some at Apple complained that the book, a best seller, misrepresented Mr. Jobs and commercialized his death.
Mr. Isaacson declined to comment about those complaints.
Four years later, the book became the basis for a film. The 2015 movie, written by Aaron Sorkin and starring Michael Fassbender, focused on Mr. Jobs being ousted from Apple and denying paternity of his eldest daughter.
according to emails made public after a hack of Sony Pictures, which held rights to the film. She and others who were close to Mr. Jobs thought any movie based on the book would be inaccurate.
“I was outraged, and he was my friend,” said Mike Slade, a marketing executive who worked as an adviser to Mr. Jobs from 1998 to 2004. “I can’t imagine how outraged Laurene was.”
In November 2015, a month after the movie’s release, Ms. Powell Jobs had representatives register the Steve Jobs Archive as a limited liability company in Delaware and California. She later hired the documentary filmmaker, Davis Guggenheim, to gather oral histories about Mr. Jobs from former colleagues and friends. She also hired Ms. Berlin, who was Stanford’s project historian for its Apple archives, to be the Jobs Archive’s executive director.
Mr. Guggenheim gathered material about Mr. Jobs while also working on a Netflix documentary about Bill Gates, “Inside Bill’s Brain.” Mr. Slade, who worked for both Mr. Jobs and Mr. Gates, said he sat for an interview about one executive, stopped to change shirts and returned to discuss the other one.
Ms. Berlin assisted Ms. Powell Jobs in gathering material. They collected items such as audio of interviews done by reporters and early company records, including a 1976 document that Mr. Jobs and Steve Wozniak, Apple’s co-founder, called their declaration of independence. It outlined what the company would stand for, said Regis McKenna, who unearthed the document in his personal collection gathered during his decades as a pioneer of Silicon Valley marketing and adviser to Mr. Jobs.
Ms. Powell Jobs also assembled a group of advisers to inform what the archive would be, including Tim Cook, Apple’s chief executive; Jony Ive, Apple’s former chief design officer; and Bob Iger, the former chief executive of Walt Disney and a former Apple board member.
Mr. Cook, Mr. Ive and Mr. Iger declined to comment.
Apple, which has its own corporate archive and archivist, is a contributor to the Jobs effort, said Ms. Berlin, who declined to say how she works with the company to gain access to material left by Mr. Jobs.
The archive’s resulting website opens with an email that Mr. Jobs sent himself at Apple. It reads like a journal entry, outlining all the things that he depends on others to provide, from the food he eats to the music he enjoys.
“I love and admire my species, living and dead, and am totally dependent on them for my life and well being,” he wrote.
The email is followed by a previously undisclosed audio clip from a 1984 interview that Mr. Jobs did with Michael Moritz, the journalist turned venture capitalist at Sequoia. During it, Mr. Jobs says that refinement comes from mistakes, a platitude that captures how Apple used trial and error to develop devices.
“It was just lying in the drawer gathering dust,” Mr. Moritz said of the recording.
It’s clear to those who have contributed material that the archive is about safeguarding Mr. Jobs’s legacy. It’s a goal that many of them support.
“There’s so much distortion about who Steve was,” Mr. McKenna said. “There needed to be something more factual.”
KYIV, Ukraine — Russian occupation officials were moving civilians out of Kherson on Wednesday, another sign that Moscow’s hold on the strategic southern Ukrainian city was slipping, as President Vladimir V. Putin of Russia sought to reassert control over that and other occupied regions by declaring martial law.
The move by Mr. Putin was an effort to tighten the Kremlin’s authority over Kherson and three other Ukrainian regions he recently claimed to annex, even as his army loses ground in those areas to Ukrainian forces and as Western allies dismiss the annexations as illegal.
As Russian proxy officials in Kherson said they would move as many as 60,000 civilians to the eastern side of the Dnipro River and shift its civilian administration there, they appeared to be girding for a battle for control of the region. Amid a weekslong Ukrainian counteroffensive, the pro-Kremlin leader in Kherson, Vladimir Saldo, said the relocations would protect civilians and help Russian forces fortify defenses to “repel any attack.”
Ukrainian officials dismissed the plans as “a propaganda show.” Andriy Yermak, the head of President Volodymyr Zelensky’s office, accused the Russian proxies of scaring civilians with claims that Ukraine would shell the city. He called it “a rather primitive tactic, given that the armed forces do not fire at Ukrainian cities — this is done exclusively by Russian terrorists.”
Ukrainian forces have been advancing gradually for weeks along both sides of the river in Kherson, a region that Moscow seized early in the war and has declared part of Russia. Since late August, Ukrainian troops have damaged bridges near the city of Kherson, making it harder for Moscow to resupply the thousands of troops it has stationed there.
Western analysts have suggested that the Russian positions in and around the city are untenable without the bridges, and U.S. officials have said that Russian commanders have urged a retreat from Kherson, only to be overruled by Mr. Putin. But Ukraine’s counteroffensive in the Kherson region has moved more slowly than its recent advances in the east, and it was far from clear whether its forces could soon mount a push to retake the city of Kherson.
On Tuesday, the general Mr. Putin appointed earlier this month to command the war in Ukraine, Sergei Surovikin, said he was ready to make “difficult decisions” about the military deployments in the Kherson region, without specifying what those decisions would entail.
Ukrainian officials have greeted the hints of a Russian pullback of at least civil administrators with caution, saying the announcements could be intended for internal Russian audiences, signaling commitment to protecting civilians or preparation for a Russian military action in the area. Videos released on Russian media showed lines of civilians apparently boarding ferries at a river port to evacuate to the eastern bank of the Dnipro.
The Kherson region spans both banks of the river, with the city of Kherson, the regional capital, lying on the western side. The western bank is an expanse of pancake-flat farmland crisscrossed by rivers and irrigation canals, and one of the most pivotal battlefields of the war.
Ukrainian troops had through the summer whittled away at Russian supply lines by firing American-provided precision guided rockets at the four bridges over the Dnipro River in areas Russia controls. All are now mostly destroyed.
In late August, Ukraine opened an offensive with ground troops, advancing in bloody, slow-moving combat through several dozen villages while driving the Russian forces backward, toward the Dnipro. The Russian announcements of evacuating civilians and the civil administration could signal a faltering of military defenses, presaging a Russian pullback from the western bank of the Dnipro River in what would be a major setback for Moscow — but could also be a ruse.
Mr. Saldo, a Ukrainian politician who had switched sides at the start of the full-scale Russian invasion, told the Russian state news agency RIA on Wednesday that all ministries would evacuate to the eastern bank. The occupation government earlier on Wednesday said it would evacuate from 50,000 to 60,000 civilians across the river and onward to the occupied peninsula of Crimea or into Russia. Residents risked artillery fire from the Ukrainian Army or flooding from the destruction of the Kakhovka hydroelectric dam on the Dnipro River, Mr. Saldo said.
Oct. 19, 2022
An earlier version of this article misidentified the location that Russian proxy officials in Kherson, Ukraine, said they would move as many as 60,000 civilians to. It is the eastern side of the Dnipro River, not the western side.
BUCHA, Ukraine — One woman was badly beaten and shot through the eye. Another, held captive by Russian soldiers, was found in a cellar, shot in the head. An 81-year-old grandmother was discovered hanging in her garden, perhaps killed, perhaps driven to suicide.
They were three victims among hundreds during the Russian occupation of Bucha in the spring. Bucha, a suburb of Ukraine’s capital, Kyiv, quickly became the main focus of atrocities by Russian soldiers before they withdrew from the area.
The crimes gained worldwide attention. But these women were unknown, their deaths unseen and unexplained.
reported at the time on the Russian brutality and came across these cases. So we went back to Bucha, the place of so many deaths, to learn about these three women — to find out about their lives and who they were.
We found that each woman, in her own way, was a fighter, struggling to survive weeks of hunger, cold, bombardment and shooting, yet tragically vulnerable to the ruthless violence of an occupying army.
Many of the circumstances of their last days remain unclear, but for their families and Ukrainian officials, there is no doubt that they were victims of Russia’s aggression against their country.
A chance trip turns tragic.
Oksana Sulyma, 34, was in Bucha only by chance.
A former public servant, she lived in Kyiv with her 5-year-old daughter, but had visited Bucha to stay with friends only 48 hours before the war began in February. Within days, Russian troops had stormed the wooded suburb and roads and transport links had been cut. Oksana was stuck, said Oleksiy, a childhood friend, who asked that only his first name be used for privacy.
She had grown up and lived much of her adult life in Bucha. Her grandmother lived in an apartment near the center of town. Oksana had moved to Kyiv only after divorcing her husband several years ago; she wanted to be closer to her parents, who helped look after her daughter.
Her mother, Larysa Sulyma, agreed to provide a few details of Oksana’s life for her to be remembered by.
“She was a very bright child,” her mother said. She learned French during an exchange visit to France, completed a degree in sociology at the National Aviation University in Kyiv, and later worked at the Ministry of Infrastructure.
“She was very vivacious,” her mother added. She shared photographs of her daughter on a beach in Crimea, where she used to vacation every year before Russia annexed the peninsula in 2014. “She loved life, she loved to travel.”
In early March, Russian troops set up bases and firing positions in Bucha and began to impose greater control on the streets. They searched houses, confiscated cellphones and began detaining people and killing.
The State of the War
Oksana was last seen by friends on March 10 at Shevchenko Square, her mother said. The square, marked by a statue of the Ukrainian poet Taras Shevchenko, is a popular meeting place.
Her mother posted a message on Facebook on March 15 expressing concern. Oksana had experienced mental health issues, and anxiety at the onset of the war may have exacerbated her condition, her mother wrote.
“Her behavior may have manifestations of anger, aggression or incompetence,” her post said. “If anyone knows her whereabouts, please call.”
An outing to find dog food.
Anna Noha, 36, had lived most of her life in Bucha and had no intention of leaving.
She had friends and family in the town, and even when her former partner and half sister fled the occupation in early March, she chose to stay. Anna hung out with friends in the basement of her two-story building, sometimes venturing into the streets, visiting her father and rescuing cats.
“She was very independent, very active,” said her stepmother, Tetyana Kopachova, 51. “At the same time, she was very kind, very helpful. She chopped wood all winter for me.”
Anna’s father and stepmother were dog breeders and kept 11 Central Asian sheepdogs in cages on their property in the center of town. Anna would come around to help.
She had always been a tearaway, her stepmother said. She married young, divorced, had a teenage daughter. She had served time in prison for dealing drugs, but had since given that up, her stepmother said.
Anna was also a survivor. Her former partner was abusive and she came over to their house for a couple of nights with a friend, nursing bruises, Ms. Kopachova said.
Her parents pressed her to stay, but she left again on March 13, promising to find dog food because they were running out. She never came back.
A strict grandmother, determined to stay.
Lyudmyla Shchehlova, 81, also did not want to leave Bucha. A retired epidemiologist, she had lived for almost 40 years in a cottage styled like a wood cabin, nestled amid pine trees.
The house had belonged to her husband, also a physician, and together they had raised a daughter, Olena, and later their grandson, Yevhen.
His grandfather was the soft one, Yevhen, 22, recalled in an interview. His grandmother was strict, “It was like good cop, bad cop,” he said laughing. “She taught me a lot,” he added.
Ms. Shchehlova was Russian by origin, and her bookshelves were full of Russian classics. Since her husband died a few years ago, she had lived alone, surrounded by her books and family photographs, with Ralph, a German shepherd, and a cat for company.
Her daughter, Olena, lived in a neighboring suburb, Irpin, and wanted her mother to join her there when the war started, but the roads were blocked by the fighting. Within days, the electricity and telephones went down. She tried to call her mother on March 7, her birthday, but could not reach her.
When the bombardment worsened sharply in their neighborhood, Olena and Yevhen fled on foot across a destroyed bridge toward Kyiv.
The last time Yevhen spoke to his grandmother, she was weeping but was happy that they were out of danger. “She said everything was fine,” he said.
Held captive in a potato cellar.
By mid-March, the atmosphere in Bucha was growing uglier. New Russian units had taken over control and reprisals against civilians grew.
For several days around March 18, a lot of killing occurred in Bucha.
Russian troops had occupied School No. 3 on Vokzalna Street, and they were firing mortars from empty land behind it. Soldiers smashed their armored vehicles through garden fences and camped in people’s homes.
At some point, Oksana Sulyma was apprehended and taken to a house on Vokzalna Street. The house backed up to School No. 3, which she had attended as a girl. Oksana was found there in April, imprisoned in a potato cellar, shot in the head. She was wearing only a fur coat.
The police found bullet casings by the trap door of the cellar and determined she was killed on March 17, a week after going missing. Her passport and ID card were later found by the Ukrainian police near the railway tracks.
Russian soldiers had been living in the house, sleeping on mattresses in the living room and heating water for washing. In a bedroom upstairs, women’s clothes and underwear were strewn about and the police found a used condom. An official familiar with the case said there was evidence that Oksana had been raped.
Seeking shelter, and bringing an abandoned cat.
Around the same time, Anna Noha moved to an apartment a few blocks away, just west of Vokzalna Street. Her windows had been blown out by the shelling and it was freezing, so a friend, Vladyslav, took her and a former classmate, Yuriy, to stay with his mother, Lyudmyla.
Anna brought coffee and tea with her and asked Lyudmyla if she could also bring an abandoned cat, a beautiful longhaired Siamese, that she had found.
“She seemed very kind,” said Lyudmyla, who asked that only her first name be used. “That’s why I gave her shelter.”
On the evening of March 18, the three friends cleaned the apartment and took out the trash, Lyudmyla said. They said they would have a smoke while they were outside. They never came back.
Lyudmyla later learned from neighbors that Russian troops had detained them by the trash bins and marched them with bags over their heads into the basement of a nearby 10-story building. Neighbors said Anna had shouted out “Glory to Ukraine.”
A week later, Lyudmyla was gathering firewood with a friend when she found their bodies. First she saw Anna and Yuriy, lying in the garden of an unoccupied house. Later she found her son, Vladyslav, inside a shed. They had been beaten and each was shot through an eye. Anna was so badly bludgeoned that her face was unrecognizable, Lyudmyla said.
“She was cheerful, strong,” Lyudmyla said of Anna. “Maybe she suffered for her outspokenness.”
Was it suicide? Friends and family say no.
By March 19, only two residents, Ms. Shchehlova, the 81-year-old retired epidemiologist, and Mariya, 84, a former factory worker, remained on their narrow lane.
Soldiers occupied a house at the end of the lane, Mariya said. “There were 15 of them in that gang and they made such trouble here,” she said. Someone stole bottles of alcohol from her fridge while she dozed in an armchair, she said.
A builder, Bogdan Barkar, 37, was out scouring for food one day and came across Ms. Shchehlova in the alley behind her house. “She had tears in her eyes,” he said. He sensed she was being threatened by someone. “Just come by in two days and see if I am alive or not,” she told him.
Some days later, Mariya said she heard Ms. Shchehlova arguing with someone and saw a strange man in her yard. But weak from hunger and fearful, Mariya did not intervene.
It was only days later when the Russians withdrew from Bucha that Mariya’s son came back and discovered Ms. Shchehlova hanging from a tree, a ladder propped against the trunk.
The police recorded it as a suicide, but few who knew Ms. Shchehlova believed she could have done it herself. She was religious and knew it to be a sin, said her neighbor Valentyn Melnyk.
Her grandson Yevhen cut the ropes down from the tree and said he doubted that she would have been able to tie them on the high branches. But he was resigned to his doubts.
“I am a realist,” he said. “How is it possible to find out what happened if all the neighbors left, and she was alone at that moment?”
The grief and loss remains overwhelming. His mother, a refugee in Sweden, wept at missing her mother’s funeral.
Anna Noha’s father, Volodymyr Kopachov, died on July 7, soon after burying his daughter. He lies beside her in Bucha City Cemetery in the section reserved for victims of the war.
Oksana Sulyma’s parents made separate visits to the cellar where she died. Weeping, her mother distributed sweets to the neighbors.
Ongsa and Phupha had enrolled at the day care center last year. Like many people from the province, Ms. Pimpa migrated elsewhere for work, leaving her children to live with their grandmother. Ms. Pimpa works at an office in Ayutthaya Province, about eight hours away by car, and said she made video calls to her sons everyday, visiting when she could.
She had just visited her twin boys last month, she added. “I didn’t think that would be the last time.”
The authorities themselves appeared to be far from answers on Friday, as they disclosed few new details of their investigation into Panya Kamrab, 34, the former police officer identified as the gunman. The attacker’s son appears to have been enrolled in the day care center, but not to have been there on Thursday.
Mr. Kamrab had a court appearance on Thursday that went normally, and his trial on the drug charge was scheduled to begin Friday, according to the national police chief, Gen. Damrongsak Kittipraphat.
But the police chief said that at about 4 a.m. on Thursday, Mr. Kamrab had an argument with his wife, apparently about whether she wanted to live with him, and she called her mother to ask to be picked up. After the massacre at the day care center, the gunman fatally shot himself at his own home, where his wife and son were also found dead.
It was not immediately clear whether the gunman first attacked the center or whether the rampage began at his home. The police said the gunman also shot at people as he fled the day care center.
Wasan Kanwilai, 30, was riding on his motorbike Thursday afternoon when a white Toyota pickup from the opposite side swerved into his lane. The vehicle was damaged, its front bumper falling down on one side, and Mr. Wasan followed — eventually spotting three bloodied people lying on the side of the road, either having been shot, run down or injured in some other way, their conditions unclear.
In 2018, senior executives at one of the country’s largest nonprofit hospital chains, Providence, were frustrated. They were spending hundreds of millions of dollars providing free health care to patients. It was eating into their bottom line.
The executives, led by Providence’s chief financial officer at the time, devised a solution: a program called Rev-Up.
Rev-Up provided Providence’s employees with a detailed playbook for wringing money out of patients — even those who were supposed to receive free care because of their low incomes, a New York Times investigation found.
nonprofits like Providence. They enjoy lucrative tax exemptions; Providence avoids more than $1 billion a year in taxes. In exchange, the Internal Revenue Service requires them to provide services, such as free care for the poor, that benefit the communities in which they operate.
But in recent decades, many of the hospitals have become virtually indistinguishable from for-profit companies, adopting an unrelenting focus on the bottom line and straying from their traditional charitable missions.
focused on investments in rich communities at the expense of poorer ones.
And, as Providence illustrates, some hospital systems have not only reduced their emphasis on providing free care to the poor but also developed elaborate systems to convert needy patients into sources of revenue. The result, in the case of Providence, is that thousands of poor patients were saddled with debts that they never should have owed, The Times found.
provide. That was below the average of 2 percent for nonprofit hospitals nationwide, according to an analysis of hospital financial records by Ge Bai, a professor at the Johns Hopkins Bloomberg School of Public Health.
Ten states, however, have adopted their own laws that specify which patients, based on their income and family size, qualify for free or discounted care. Among them is Washington, where Providence is based. All hospitals in the state must provide free care for anyone who makes under 300 percent of the federal poverty level. For a family of four, that threshold is $83,250 a year.
In February, Bob Ferguson, the state’s attorney general, accused Providence of violating state law, in part by using debt collectors to pursue more than 55,000 patient accounts. The suit alleged that Providence wrongly claimed those patients owed a total of more than $73 million.
Providence, which is fighting the lawsuit, has said it will stop using debt collectors to pursue money from low-income patients who should qualify for free care in Washington.
But The Times found that the problems extend beyond Washington. In interviews, patients in California and Oregon who qualified for free care said they had been charged thousands of dollars and then harassed by collection agents. Many saw their credit scores ruined. Others had to cut back on groceries to pay what Providence claimed they owed. In both states, nonprofit hospitals are required by law to provide low-income patients with free or discounted care.
“I felt a little betrayed,” said Bev Kolpin, 57, who had worked as a sonogram technician at a Providence hospital in Oregon. Then she went on unpaid leave to have surgery to remove a cyst. The hospital billed her $8,000 even though she was eligible for discounted care, she said. “I had worked for them and given them so much, and they didn’t give me anything.” (The hospital forgave her debt only after a lawyer contacted Providence on Ms. Kolpin’s behalf.)
was a single room with four beds. The hospital charged patients $1 a day, not including extras like whiskey.
Patients rarely paid in cash, sometimes offering chickens, ducks and blankets in exchange for care.
At the time, hospitals in the United States were set up to do what Providence did — provide inexpensive care to the poor. Wealthier people usually hired doctors to treat them at home.
wrote to the Senate in 2005.
Some hospital executives have embraced the comparison to for-profit companies. Dr. Rod Hochman, Providence’s chief executive, told an industry publication in 2021 that “‘nonprofit health care’ is a misnomer.”
“It is tax-exempt health care,” he said. “It still makes profits.”
Those profits, he added, support the hospital’s mission. “Every dollar we make is going to go right back into Seattle, Portland, Los Angeles, Alaska and Montana.”
Since Dr. Hochman took over in 2013, Providence has become a financial powerhouse. Last year, it earned $1.2 billion in profits through investments. (So far this year, Providence has lost money.)
Providence also owes some of its wealth to its nonprofit status. In 2019, the latest year available, Providence received roughly $1.2 billion in federal, state and local tax breaks, according to the Lown Institute, a think tank that studies health care.
a speech by the Rev. Dr. Martin Luther King Jr.: “If it falls your lot to be a street sweeper, sweep streets like Michelangelo painted pictures.”
Ms. Tizon, the spokeswoman for Providence, said the intent of Rev-Up was “not to target or pressure those in financial distress.” Instead, she said, “it aimed to provide patients with greater pricing transparency.”
“We recognize the tone of the training materials developed by McKinsey was not consistent with our values,” she said, adding that Providence modified the materials “to ensure we are communicating with each patient with compassion and respect.”
But employees who were responsible for collecting money from patients said the aggressive tactics went beyond the scripts provided by McKinsey. In some Providence collection departments, wall-mounted charts shaped like oversize thermometers tracked employees’ progress toward hitting their monthly collection goals, the current and former Providence employees said.
On Halloween at one of Providence’s hospitals, an employee dressed up as a wrestler named Rev-Up Ricky, according to the Washington lawsuit. Another costume featured a giant cardboard dollar sign with “How” printed on top of it, referring to the way the staff was supposed to ask patients how, not whether, they would pay. Ms. Tizon said such costumes were “not the culture we strive for.”
financial assistance policy, his low income qualified him for free care.
In early 2021, Mr. Aguirre said, he received a bill from Providence for $4,394.45. He told Providence that he could not afford to pay.
Providence sent his account to Harris & Harris, a debt collection company. Mr. Aguirre said that Harris & Harris employees had called him repeatedly for weeks and that the ordeal made him wary of going to Providence again.
“I try my best not to go to their emergency room even though my daughters have gotten sick, and I got sick,” Mr. Aguirre said, noting that one of his daughters needed a biopsy and that he had trouble breathing when he had Covid. “I have this big fear in me.”
That is the outcome that hospitals like Providence may be hoping for, said Dean A. Zerbe, who investigated nonprofit hospitals when he worked for the Senate Finance Committee under Senator Charles E. Grassley, Republican of Iowa.
“They just want to make sure that they never come back to that hospital and they tell all their friends never to go back to that hospital,” Mr. Zerbe said.
The Everett Daily Herald, Providence forgave her bill and refunded the payments she had made.
In June, she got another letter from Providence. This one asked her to donate money to the hospital: “No gift is too small to make a meaningful impact.”
Following a Script ‘Like Robots’
In 2019, Vanessa Weller, a single mother who is a manager at a Wendy’s restaurant in Anchorage, went to Providence Alaska Medical Center, the state’s largest hospital.
She was 24 weeks pregnant and experiencing severe abdominal pains. “Let this just be cramps,” she recalled telling herself.
Ms. Weller was in labor. She gave birth via cesarean section to a boy who weighed barely a pound. She named him Isaiah. As she was lying in bed, pain radiating across her abdomen, she said, a hospital employee asked how she would like to pay. She replied that she had applied for Medicaid, which she hoped would cover the bill.
After five days in the hospital, Isaiah died.
Then Ms. Weller got caught up in Providence’s new, revenue-boosting policies.
The phone calls began about a month after she left the hospital. Ms. Weller remembers panicking when Providence employees told her what she owed: $125,000, or about four times her annual salary.
She said she had repeatedly told Providence that she was already stretched thin as a single mother with a toddler. Providence’s representatives asked if she could pay half the amount. On later calls, she said, she was offered a payment plan.
“It was like they were following some script,” she said. “Like robots.”
Later that year, a Providence executive questioned why Ms. Weller had a balance, given her low income, according to emails disclosed in Washington’s litigation with Providence. A colleague replied that her debts previously would have been forgiven but that Providence’s new policy meant that “balances after Medicaid are being excluded from presumptive charity process.”
Ms. Weller said she had to change her phone number to make the calls stop. Her credit score plummeted from a decent 650 to a lousy 400. She has not paid any of her bill.
Susan C. Beachy and Beena Raghavendran contributed research.
Despite the finding, the death of Elijah McClain, a 23-year-old massage therapist, was still listed as undetermined, not a homicide.
A Black man died after a police encounter in a Denver suburb in 2019 because he was injected with a powerful sedative after being forcibly restrained, according to an amended autopsy report publicly released Friday.
Despite the finding, the death of Elijah McClain, a 23-year-old massage therapist, was still listed as undetermined, not a homicide, the report shows. McClain was put in a neck hold and injected with ketamine after being stopped by police in Aurora for “being suspicious.” He was unarmed.
The original autopsy report that was written soon after his death in August 2019 did not reach a conclusion about how he died or what type of death is was, such as if it was natural, accidental or a homicide. That was a major reason why prosecutors initially decided not to pursue charges.
But a state grand jury last year indicted three officers and two paramedics on manslaughter and reckless homicide charges in McClain’s death after the case drew renewed attention following the killing of George Floyd in 2020. It became a rallying cry during the national reckoning over racism and police brutality.
The five accused have not yet entered pleas and their lawyers have not commented publicly on the charges.
In the updated report, completed in July 2021, Dr. Stephen Cina, a pathologist, concluded that the ketamine dosage given to McClain, which was higher than recommended for someone his size, “was too much for this individual and it resulted in an overdose, even though his blood ketamine level was consistent with a ‘therapeutic’ blood concentration.”
He said he could not rule out that changes in McClain’s blood chemistry, like an increase in lactic acid, due to his exertion while being restrained by police contributed to his death but concluded there was no evidence that injuries inflicted by police caused his death.
“I believe that Mr. McClain would most likely be alive but for the administration of ketamine,” said Cina, who noted that body camera footage shows McClain becoming “extremely sedated” within a few minutes of being given the drug.
Cina acknowledged that other reasonable pathologists with different experience and training may have labeled such a death, while in police custody, as a homicide or accident, but that he believes the appropriate classification is undetermined.
Qusair Mohamedbhai, attorney for McClain’s mother, Sheneen McClain, declined a request for comment.
Dr. Carl Wigren, a forensic pathologist in Washington state, questioned the report’s focus on ketamine, saying all the available evidence — including a highly critical independent review of McClain’s death commissioned by Aurora last year — point to McClain dying as a result of compressional asphyxia, a type of suffocation, from officers putting pressure on his body while restraining him. He was struck by one passage in the city’s review citing the ambulance company’s report that its crew found McClain lying on the ground on his stomach, his arms handcuffed behind his back, his torso and legs held down, with at least three officers on top of him.
That scene was not captured on body camera footage, the report said, but much of what happened between police was not because the officers’ cameras came off soon after McClain was approached. The cameras did continue to record where they fell and captured people talking.
Just because McClain, who said he couldn’t breathe, could be heard making some statements on the footage, does not mean he was able to fully breathe, Wigren said. Ketamine, which slows breathing, could have just exacerbated McClain’s condition, but Wigren does not think it caused his death.
However, another pathologist, Dr. Deborah G. Johnson of Colorado, said McClain’s quick reaction to ketamine suggests that it was a cause of McClain’s death, but she said its use cannot be separated from the impact that the police restraint may have had. McClain may have had trouble breathing because of the restraint and having less oxygen in your system would make the sedative take effect more quickly, she said.
Both thought the death could have been labeled as a homicide — a death caused by the actions of other people — which they pointed out is a separate judgment from deciding whether someone should be prosecuted with a crime for causing it.
McClain got an overdose of ketamine, Johnson said, noting that the paramedics were working at night when it is hard to judge someone’s weight.
“Was that a mistake to send someone to prison for? I don’t think so,” she said.
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The updated autopsy was released Friday under a court order in a lawsuit brought by Colorado Public Radio, joined by other media organizations including The Associated Press. Colorado Public Radio sued the coroner to release the report after learning it had been updated, arguing that it should be made available under the state’s public records law.
Coroner Monica Broncucia-Jordan said she could not release it because it contained confidential grand jury information and that releasing it would violate the oath she made not to share it when she obtained it last year.
But Adams County District Judge Kyle Seedorf ordered the coroner to release the updated report by Friday, and a Denver judge who oversees state grand jury proceedings, Christopher Baumann, ruled Thursday that grand jury information did not have be redacted from the updated report.
Cina noted that the report was updated based on extensive body camera footage, witness statements and records that he did not have at the time of the original autopsy report, which were not made available to the coroner’s office at all or in their entirety before. Last year, Cina and Broncucia-Jordan received some material that was made available to the grand jury last year, according to court documents, but they did not say what exactly that material was.
McClain’s death fueled renewed scrutiny about the use of the ketamine and led Colorado’s health department to issue a new rule limiting when emergency workers can use it.
Last year, the city of Aurora agreed to pay $15 million to settle a lawsuit brought by McClain’s parents. The lawsuit alleged the force officers used against McClain and his struggle to survive it dramatically increased the amount of lactic acid in his system, leading to his death, possibly along with the large dose of ketamine he was given.
The outside investigation commissioned by the city faulted the police probe into McClain’s arrest for not pressing for answers about how officers treated him. It found there was no evidence justifying officers’ decision to stop McClain, who had been reported as suspicious because he was wearing a ski mask as he walked down the street waving his hands. He was not accused of breaking any law.
Police reform activist Candice Bailey had mixed emotions about seeing the amended autopsy.
“I do believe that it does get us a step closer to anything that is a semblance of justice,” said Bailey, an activist in the city of Aurora who has led demonstrations over the death of McClain.
But Bailey added that she is “extremely saddened that there is still a controversy around whether or not the EMTs and officers should be held responsible for what they did, and as to whether or not this was actually murder.”
AT THE KHERSON FRONT, Ukraine — The commander banged on the door furiously.
“I need help!” he shouted.
When Tetiana Kozyr opened up, the commander rushed in, carrying a young soldier on his shoulders. She said the young man was sunburned, thin and gravely wounded.
The Ukrainians were trying to recapture her village, the smallest dot on the most detailed military maps. Russian forces had just blown up three Ukrainian tanks. Flames leaped off the roofs of neighboring houses.
refused to let his commanders retreat from the city of Kherson, according to American officials.
recently said that Ukraine was losing 50 soldiers a day.
officially announced the beginning of the offensive. She fled a few days later and now lives in a displaced persons shelter in the city of Zaporizhzhia.
She said that when the commander first arrived with the wounded soldier, she panicked.
“I was yelling at him: ‘Why did you bring him here? The Russians will kill us all!’” she said.
But the commander just stepped through the doorway, desperate to find shelter. The village was on fire, in the middle of two armies blasting each other.
She shrunk back as her husband and the commander pressed bandages to the young man’s wounds. Shrapnel had sliced through his back and lungs. Her kitchen floor was soon covered in blood.
That night, she and her husband slept in their cellar. The commander curled up next to the wounded soldier on the kitchen floor.
When Ms. Kozyr stepped outside the next morning, to check on her calf and pigs, she passed by the kitchen and peered through the window.
The soldier’s hands were curled, his body stiff. He was dead.
She started crying at the memory of it, pulling a small rag out of her pocket and wiping her eyes. But she did not question the counteroffensive.
“It needed to be done,” she said. And then she repeated herself, a little more softly. “It needed to be done.”
Oleksandra Mykolyshyn and Oleksandr Chubko contributed reporting from Mykolaiv, Ukraine, and Thomas Gibbons-Neff from Pokrovsk, Ukraine.
Michael Carneal is seeking to be freed from his life sentence for fatally shooting three students and wounding five more at Heath High School in 1997.
A Kentucky man who killed three students and wounded five more in a school shooting 25 years ago will have to wait another week to learn his fate in a high-stakes hearing that could see him released or denied the chance to ever leave prison.
Michael Carneal was a 14-year-old freshman on Dec. 1, 1997, when he fired a stolen pistol at a before-school prayer group in the lobby of Heath High School, near Paducah, Kentucky. School shootings were not yet a depressing part of the national consciousness, and Carneal was given the maximum sentence possible at the time for someone his age — life in prison but with the possibility of parole. A quarter century later, in the shadow of Uvalde and in a nation disgusted by the carnage of mass shootings, Carneal, now 39, is trying to convince the parole board he deserves to be freed.
At a hearing on Tuesday, a two-person panel of the Kentucky Parole Board said they had not reached a decision and were referring his case to the full board, which meets on Monday. Only the full board has the power to order Carneal to serve out his full sentence without another chance at parole.
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Speaking on a videoconference from the Kentucky State Reformatory in La Grange, Carneal told the panel that at the time of the shooting, “I was hearing in my head to do certain things, but I should have known that stealing guns … was going to lead to something terrible.” He said that he has been receiving therapy and taking psychiatric medications in prison, however he admitted that he continues to hear voices. As recently as a couple of days ago, he heard voices telling him to jump off the stairs.
Parole Board Chair Ladeidra Jones told Carneal that his inmate file lists his mental health prognosis as “poor” and says that even with mental health services, he is still experiencing paranoid thoughts with violent imagery, she said.
Asked how the board could be assured that he would not act on those thoughts, he said that he has learned to ignore them and hasn’t acted on them for many years. Carneal said he would be able to do good in the world if he were released, but he did not offer any specific plans.
“It doesn’t have to be something grand,” he said. “Every little thing you do affects somebody. It could be listening to someone, carrying something. I would like to do something in the future that could contribute to society.”
Carneal said the shooting happened because of a combination of factors that included his mental health and immaturity, but he added that it was “not justified at all. There’s no excuse for it at all.”
His parole hearing began Monday with testimony from those injured and close family of those killed, several of whom had considered Carneal a friend.
Missy Jenkins Smith, who was paralyzed by one of Carneal’s bullets and uses a wheelchair, said there are too many “what ifs” to release him. What if he stops taking his medication? What if his medication stops working?
“Continuing his life in prison is the only way his victims can feel comfortable and safe,” she said.
Killed in the shooting were 14-year-old Nicole Hadley, 17-year-old Jessica James, and 15-year-old Kayce Steger. Jenkins Smith said it would be unfair to them and their loved ones for Carneal to be set free.
“They will forever be a 17 year old, a 14 year old, and a 15 year old — allowed only one full decade of life. A consequence of Michael’s choice,” she said.
Also testifying Monday was Christina Hadley Ellegood, whose younger sister Nicole was killed in the shooting. Ellegood has written about the pain of seeing her sister’s body and having to call their mom and tell her Nicole had been shot.
“I had no one to turn to who understood what I was going through,” she said Monday. “For me, it’s not fair for him to be able to roam around with freedom when we live in fear of where he might be.”
The two-person panel of the full parole board only has the option to release him or defer his next opportunity for parole for up to five years. Because they could not agree on those options, they sent the case to a meeting of the full board next Monday.
Hollan Holm, who was wounded that day, spoke Monday about lying on the floor of the high school lobby, bleeding from his head and believing he was going to die. But he said Carneal was too young to comprehend the full consequences of his actions and should have a chance at supervised release.
“When I think of Michael Carneal, I think of the child I rode the bus with every day,” he said. “I think of the child I shared a lunch table with in third grade. I think of what he could have become if, on that day, he had it somewhere in him to make a different choice or take a different path.”
As part of the plea agreement, she has agreed to reimburse law enforcement agencies for the costs of the search for her and her nonexistent kidnapper.
A Northern California mother of two was sentenced Monday to 18 months in prison for faking her own kidnapping so she could go back to a former boyfriend, which led to a three-week, multi-state search before she resurfaced on Thanksgiving Day in 2016.
Sherri Papini, 40, pleaded guilty last spring under a plea bargain that requires her to pay more than $300,000 in restitution.
Probation officers and Papini’s attorney had recommended that she spend a month in custody and seven months in supervised home detention. But Senior U.S. District Judge William Shubb said he opted for an 18-month sentence in order to deter others.
The judge said he considered the seriousness of the offense and “the sheer number of people who were impacted.”
Papini, who was emotional throughout the proceedings, quietly answered, “Yes, sir,” when the judge asked if she understood the sentence. Previously she was in tears as she gave a statement to the court accepting responsibility and admitting her guilt.
“As painful as it is,” Papini accepts her sentence as part of her recovery, defense attorney William Portanova said after the hearing.
Portanova previously said Papini was troubled and disgraced and that she should serve most of her sentence at home. Prosecutors, though, said it was imperative that she spend her full term in prison. The judge ordered her to report to prison Nov. 8.
“Papini’s kidnapping hoax was deliberate, well planned, and sophisticated,” prosecutors wrote in their court filing. And she was still falsely telling people she was kidnapped months after she pleaded guilty in April to staging the abduction and lying to the FBI about it, they wrote.
“The nation is watching the outcome of Papini’s sentencing hearing,” Assistant U.S. Attorneys Veronica Alegria and Shelley Weger wrote. “The public needs to know that there will be more than a slap on the wrist for committing financial fraud and making false statements to law enforcement, particularly when those false statements result in the expenditure of substantial resources and implicate innocent people.”
“Outwardly sweet and loving, yet capable of intense deceit … Ms. Papini’s chameleonic personalities drove her to simultaneously crave family security and the freedom of youth,” Portanova wrote in his responding court filing.
So “in pursuit of a non-sensical fantasy,” Portanova said the married mother fled to a former boyfriend in Southern California, nearly 600 miles south of her home in Redding. He dropped her off along Interstate 5 about 150 miles from her home after she said she wanted to go home.
Passersby found her with bindings on her body, a swollen nose, a blurred “brand” on her right shoulder, bruises and rashes across her body, ligature marks on her wrists and ankles, and burns on her left forearm. All of the injuries were self-inflicted and were designed to substantiate her story that she had been abducted at gunpoint by two Hispanic women while she was out for a run.
The wounds were a manifestation of her “unsettled masochism” and “self-inflicted penance,” Portanova wrote. And once she began, “each lie demanded another lie.”
Prosecutors said Papini’s ruse harmed more than just herself and her family. “An entire community believed the hoax and lived in fear that Hispanic women were roving the streets to abduct and sell women,” they wrote.
Prosecutors agreed to seek a sentence on the low end of the sentencing range in exchange for Papini’s guilty plea. That was projected to be between eight and 14 months in custody, down from the maximum 25 years for the two charges.
She has offered no rationale for her actions, which stumped even independent mental health experts who said her actions didn’t conform with any typical diagnosis.
“Papini’s painful early years twisted and froze her in myriad ways,” Portanova said in arguing for home confinement. With her deception finally revealed, he said, “It is hard to imagine a more brutal public revelation of a person’s broken inner self. At this point, the punishment is already intense and feels like a life sentence.”
But prosecutors said her “past trauma and mental health issues alone cannot account for all of her actions.”
“Papini’s planning of her hoax kidnapping was meticulous and began months in advance — it was not merely the reaction to a traumatic childhood,” they wrote.
After herarrestin March, Papini received more than $30,000 worth of psychiatric care for anxiety, depression and post-traumatic stress disorder. She billed the state’s victim compensation fund for the treatment, and now must pay it back as part of her restitution.
As part of the plea agreement, she has agreed to reimburse law enforcement agencies more than $150,000 for the costs of the search for her and her nonexistent kidnappers, and repay the $128,000 she received in disability payments since her return.
Pallbearers carried the coffin into Westminster Abbey, where around 2,000 people gathered to mourn her.
Britain and the world said a final goodbye to Queen Elizabeth II at a state funeral Monday that drew presidents and kings, princes and prime ministers — and crowds who massed along the streets of London to honor a monarch whose 70-year reign defined an age.
A day packed with events in London and Windsor began early when the doors of 900-year-old Westminster Hall were closed to mourners after hundreds of thousands had filed in front of her flag-draped coffin. Many had waited for hours in line, including through cold nights, to attend the lying in state in an outpouring of collective grief and respect.
“I felt like I had to come and pay my final respects to our majestic queen. She has done so much for us and just a little thank you really from the people,” said Tracy Dobson, who was among the last to join the line.
In a country known for pomp and pageantry, the first state funeral since Winston Churchill’s was filled with spectacle: 142 Royal Navy sailors drew the gun carriage carrying Elizabeth’s coffin to Westminster Abbey, with King Charles III and his sons, Princes William and Harry, walking behind as bagpipers played. Pallbearers carried the coffin into the abbey, where around 2,000 people ranging from world leaders to health care workers gathered to mourn her. Ahead of the service, a bell tolled 96 times — once a minute for each year of her life.
“Here, where Queen Elizabeth was married and crowned, we gather from across the nation, from the Commonwealth, and from the nations of the world, to mourn our loss, to remember her long life of selfless service, and in sure confidence to commit her to the mercy of God our maker and redeemer,” the dean of the medieval abbey, David Hoyle, told the mourners, as the funeral opened.
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It drew to a close with two minutes of silence observed across the United Kingdom. The attendees then sang the national anthem.
Monday has been declared a public holiday in honor of Elizabeth, who died Sept. 8 — and hundreds of thousands of people descended on central London to partake in the historic moment. Long before the service began, city authorities said viewing areas along the route of the funeral’s procession were full.
Millions more had been expected to tune into the funeral live on television, and crowds flocked to parks and public spaces across the U.K. to watch it on screens. Archbishop of Canterbury Justin Welby noted during the funeral that “few leaders receive the outpouring of love we have seen” for Elizabeth.
On the evening before, Charles issued a message of thanks to people in the U.K. and around the world, saying he and his wife Camilla, the queen consort, have been “moved beyond measure” by the large numbers of people who have turned out to pay their respects to the queen.
Following the funeral, the coffin — accompanied by units of the armed forces in dress uniforms and members of her family — was brought through the capital’s streets.
At Wellington Arch near Hyde Park, it will be placed in a hearse to be driven to Windsor Castle — where Elizabeth spent much of her time — for another procession before a committal service in St. George’s Chapel. She will be laid to rest with her late husband, Prince Philip, at a private family service.
U.S. President Joe Biden was among leaders to pay their respects at the queen’s coffin on Sunday as thousands of police, hundreds of British troops and an army of officials made final preparations for the funeral.
President Biden called Queen Elizabeth II “decent” and “honorable” and “all about service” as he signed the condolence book, saying his heart went out to the royal family.
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People across Britain paused for a minute of silence at 8 p.m. Sunday in memory of the only monarch most have ever known. At Westminster Hall, the constant stream of mourners paused for 60 seconds as people observed the minute of reflection in deep silence.
In Windsor, rain began to fall as the crowd fell silent for the moment of reflection. Some camped overnight outside the castle in order to reserve the best spots to view the queen’s coffin.
Jilly Fitzgerald, who was in Windsor, said there was a sense of community among the mourners as they prepared to wait hours to see the procession carrying the queen’s coffin.
“It’s good to be with all the people who are all feeling the same. It’s like a big family because everyone feels that … the queen was part of their family,” she said.