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Who Protects the Innocent? The Mental Health Crisis Playing Out in Times Square

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There is a question New York seems increasingly afraid to ask because asking it sounds insufficiently compassionate: When did someone else’s mental illness become everybody else’s responsibility to endure?

I am in in Times Square most every day. I take New York City buses. I walk these streets and like millions of New Yorkers, I have found myself trapped in public spaces with people screaming, threatening, striking out at invisible enemies, terrorizing passengers or behaving so erratically that everyone around them begins calculating where the nearest exit is. We have normalized it. Don’t engage. Move away. Change subway cars. Get off the bus. Don’t make eye contact. Give the person space. Why is the burden perpetually placed upon the person who is simply trying to get home or on about their business?

On August 31, Erin Piacenti was doing exactly that. She was 32 years old, a lawyer and vice president at Bank of America, and had just returned to work after five months of maternity leave. She was walking through Times Square after work when Pamela Cisneros, 49, stabbed her in the abdomen in what police described as a random and unprovoked attack. Cisneros had also stabbed 68-year-old Tak Kam, who survived. Piacenti did not. She left behind a husband and a five-month-old daughter.

Almost immediately, much of the story has became about the mental illness of the woman who killed her. Cisneros had suffered from serious mental-health problems for decades, according to her father. In 2019, she reportedly attempted to jump in front of a subway train. Afterward, her father began taking her to monthly hospital appointments where she received injections that he said kept her stable. In April, according to his account, she told him she could handle those appointments herself and stopped allowing him to accompany her. It remains unclear whether she continued receiving treatment.

That history explains something. It does not resurrect Erin Piacenti. That distinction has become dangerously blurred. Mental illness may explain why someone behaves irrationally. It may explain why someone cannot regulate behavior or distinguish reality from delusion. But an explanation does not make the consequences disappear for everybody else.

Erin Piacenti’s daughter will not grow up with her mother. Her husband does not somehow lose less of his wife because the attack was committed by someone with a history of mental illness. Tak Kam was not stabbed less deeply because his attacker was psychiatrically troubled. Their suffering counts too.

Yet increasingly, when something like this happens, our cultural reflex is to move almost immediately toward the suffering of the person who caused the catastrophe. What happened to her? Why wasn’t she receiving treatment? What trauma had she experienced? What diagnosis did she have? Those may be legitimate questions, but there is another question that deserves considerably more attention: Who was responsible for making sure a person known to be dangerously unstable did not reach the point where complete strangers became responsible for surviving her?

That responsibility cannot belong to a woman walking home from work. It cannot belong to a tourist coming out of the subway or passengers trapped on a bus. It cannot perpetually belong to police officers who encounter someone at the very end of a psychiatric collapse and are expected to solve in seconds what families, doctors, hospitals and institutions have failed to solve over years.

Cisneros ultimately approached police carrying two knives, refused repeated commands to drop them and continued toward officers even after Tasers were deployed. Officers shot and killed her. By the time the episode ended, an innocent woman was dead, another innocent person was wounded, Cisneros herself was dead and police officers had been placed in a confrontation that never should have reached that point.

There is also something we have become extraordinarily reluctant to discuss: families have responsibilities. Yes, an adult has rights. Yes, families cannot simply control another adult. Yes, serious psychiatric illness can make treatment extremely difficult, and relatives themselves can become exhausted, frightened and overwhelmed. Family cannot simply disappear from the discussion when someone has a known history of profound instability.

In this case, Cisneros’ father appears to have tried. He accompanied his daughter to treatment and helped make sure she received medication. When she said she could handle those appointments herself, he believed she had turned a corner. That makes this particular case more complicated, but it also exposes the enormous hole in the system. What is a family supposed to do when an adult relative with a history of serious psychiatric instability refuses help? Who follows up when someone receiving treatment that has apparently kept her stable suddenly stops appearing? At what point does somebody have the authority—and the responsibility—to say this person is not capable of simply being left alone?

We have created a remarkable vacuum of responsibility. The individual is mentally ill, therefore her responsibility may be diminished. The family cannot force treatment. Doctors face legal restrictions. Police frequently cannot intervene until particular thresholds are crossed. Everyone else is instructed to avoid confrontation and protect themselves. Responsibility evaporates precisely when it becomes most necessary, and somewhere inside that maze stands an ordinary person who never volunteered to participate in any of it. Sometimes that person ends up dead.

Times Square magnifies the problem because everybody comes through here. Workers, tourists, families, performers, hustlers, homeless people, people struggling with addiction and people experiencing profound psychiatric distress are compressed into a few blocks of public space. Those of us who actually live and work here know the choreography. You notice the person screaming before you reach the corner. You watch someone’s hands. You move farther down the platform. You decide whether to board the subway car. You quietly change seats on the bus. That is not prejudice. It is self-preservation.

We do not owe another human being the surrender of our own safety because that person is ill. We can acknowledge mental illness without making innocent strangers responsible for enduring its consequences.

Erin Piacenti had spent five months at home with her baby. Four days before her death, she wrote publicly about how grateful she was for that time. On her first day back at work, she walked through Times Square and never made it home. Her daughter is now five months old and motherless.

Erin Piacenti did not cause any of this. Neither did Tak Kam. Neither do the millions of New Yorkers who board buses, enter subway cars and walk through Times Square every day.

Mental illness needs treatment there is no denying it, but the public is entitled to something as well, and we have become strangely apologetic about saying it. We have the right to go home alive.

Suzanna, co-owns and publishes the newspaper Times Square Chronicles or T2C. At one point a working actress, she has performed in numerous productions in film, TV, cabaret, opera and theatre. She has performed at The New Orleans Jazz festival, The United Nations and Carnegie Hall. She has a screenplay and a TV show in the works, which she developed with her mentor and friend the late Arthur Herzog. She is a proud member of the Drama Desk and the Outer Critics Circle and was a nominator. Email: suzanna@t2conline.com

Events

The Algonquin Hotel Thinks Pink: A Toast to Hope, Broadway and Breast Cancer Awareness

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The legendary Midtown landmark brings cocktails, cabaret and a little Sondheim sophistication to a cause that touches millions.

There is something wonderfully New York about turning a cocktail into a cause, especially when the setting is The Algonquin Hotel, where literary legends once traded barbs over lunch and the city’s theatrical elite have long felt at home. This October, the historic Midtown institution is trading its familiar Blue Bar glow for a decidedly rosier hue, celebrating Breast Cancer Awareness Month with cocktails, cabaret, live entertainment and fundraising benefiting the American Cancer Society’s Making Strides Against Breast Cancer.

The centerpiece is a cocktail with a Broadway pedigree: Sunday in the Park, a playful nod to Stephen Sondheim’s Sunday in the Park with George. Like its theatrical inspiration, this is an exercise in color and composition, though the canvas is considerably smaller and considerably more delicious.

The cocktail reimagines the classic Cosmopolitan with E11EVEN Vodka, Combier liqueur d’orange, Re’al Lychee Syrup Purée and fresh lime juice, finished with ripe raspberries. Available throughout October at The Blue Bar Restaurant & Lounge, it offers guests an opportunity to raise a glass while raising funds, with a portion of each sale benefiting the American Cancer Society’s Making Strides Against Breast Cancer initiative.

Behind the pink lighting and beautifully garnished cocktails is a reality that deserves attention. According to the American Cancer Society’s 2026 estimates, approximately 321,910 American women will be diagnosed with invasive breast cancer this year, and 42,140 will die from the disease. About one in eight women will develop breast cancer during her lifetime, making it one of the most consequential health concerns facing women in the United States.

The numbers are sobering, but they also tell a story of remarkable medical progress. More than four million breast cancer survivors are living in America today, and when invasive breast cancer is diagnosed before it has spread beyond the breast, the five-year relative survival rate exceeds 99 percent. When the disease has spread to distant parts of the body, that figure falls to approximately 32 percent.

These statistics underscore the importance of timely screening, access to treatment and continued research. They also explain why Breast Cancer Awareness Month is about considerably more than wearing pink.

Throughout October, The Algonquin will host weekly happy hours from 5 to 8 p.m., featuring specially created pink cocktails and live entertainment. The musical lineup includes Rocco of The Snow, Broadway performers and cabaret evenings, giving the hotel’s fundraising efforts an appropriately theatrical flourish.

For a property whose history is inseparable from New York’s cultural life, the marriage of entertainment and philanthropy feels particularly fitting. The Algonquin’s legendary Round Table once attracted writers, critics and performers whose conversations helped define an era of American wit and sophistication. Nearly a century later, the hotel continues to understand the appeal of gathering people around a table, although this October the conversation carries an additional purpose.

The initiative also arrives during a fresh chapter for the landmark hotel. Following the completion of its renovation in June 2026, The Algonquin has introduced refreshed menus at The Blue Bar, bringing renewed energy to one of Midtown’s most recognizable gathering places while preserving the character that has made it a New York institution.

Making Strides Against Breast Cancer, the American Cancer Society’s nationwide fundraising movement, supports the fight against breast cancer through research, advocacy and services for people affected by the disease. The Algonquin’s month-long programming offers New Yorkers and visitors an inviting way to participate, whether by enjoying a cocktail, attending a performance or simply joining a conversation that could encourage someone to take their health more seriously.

There is, of course, an important distinction between awareness and action. Pink ribbons and illuminated buildings may draw attention, but access to screening, early diagnosis, effective treatment and compassionate support are what change lives. A diagnosis does not arrive with a convenient calendar date, and the need for help does not disappear when October ends.

Still, there is something to be said for an evening that combines pleasure with purpose. At The Algonquin, a cocktail can be an occasion for generosity, a cabaret performance can bring people together, and a familiar Midtown landmark can remind us that the most meaningful traditions are those that continue to serve the present.

Sondheim understood that art could reveal the extraordinary within the ordinary. This October, The Algonquin is offering its own interpretation: a little pink, a little music and a toast to the lives worth fighting for.

For more information, visit The Algonquin Hotel or learn about the American Cancer Society’s Making Strides Against Breast Cancer.

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Pedestrian Accident Attorney in San Diego: 9 Questions to Ask Before Hiring One

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Most people hire the first firm that answers the phone. That is understandable after a serious injury, and it is also how good claims end up undervalued. Consultations in San Diego are free and firms expect to be interviewed, so treat the meeting as one. These nine questions separate a firm that genuinely handles pedestrian claims from one that treats yours like a rear-end collision with a bigger hospital bill.

Question 1: How many pedestrian cases have you handled, specifically?

Car crash volume does not translate. Pedestrian claims turn on sight lines, lighting, crossing behavior, and vehicle speed rather than skid marks and property damage. Listen for: real examples and named corridors. Firms with a dedicated pedestrian accident attorney in San Diego practice, such as HHJ Trial Attorneys, cite specific county data, including the eight corridors where roughly 30 percent of these crashes happen. Long-established firms such as CaseyGerry can point to decades of similar files.

Question 2: Will you retain a reconstruction expert, and when?

Vehicle damage is repaired, video is overwritten, and signal timing records get purged. Listen for: a firm that talks about preservation letters and scene inspection in the first weeks, not after the demand is rejected.

Question 3: Who will actually work on my file?

You may meet a partner and never speak to one again. Listen for: a named attorney and a named case manager, plus a straight answer on response times.

Question 4: How will you handle the claim that I crossed outside a crosswalk?

Since the Freedom to Walk Act took effect in 2023, crossing outside a crosswalk is no longer routinely ticketed in California, but insurers still raise it to argue comparative fault and cut the payout. Listen for: a concrete plan, usually driver speed analysis, visibility distance, and whether the driver was distracted.

Question 5: Could a government entity share responsibility?

Faded markings, a burned-out streetlight, an obstructed sign, or a badly timed signal can put the city or county in the case. Listen for: awareness that claims against public entities generally require a government claim within six months, not the usual two years.

Question 6: Have you looked at my own auto policy?

Many pedestrians never think of this. In California, uninsured and underinsured motorist coverage on your own auto policy applies when you are struck as a pedestrian, and it often covers household family members too. Listen for: a firm that asks for your declarations page at the first meeting.

Question 7: What exactly are your fees and costs?

Under Business and Professions Code 6147, a contingency agreement must be in writing, must state the rate, must explain how costs affect your net recovery, and must state that the fee is not set by law and is negotiable. An agreement missing those elements is voidable by the client. Listen for: a clear percentage, whether it rises if suit is filed, and who advances expert costs.

Question 8: How do my medical bills get handled meanwhile?

Unpaid bills going to collections while a case is pending is one of the most common complaints injured people have. Listen for: a firm that coordinates health insurance, hospital liens, and treatment on a lien basis where needed, and that explains how those liens get negotiated down before you see your share.

Before you sign anything

Take the fee agreement home and read it. Ask for the answers to questions 5, 6, and 7 in writing. Interview two firms rather than one, since the difference in approach usually becomes obvious side by side.

Pedestrian injuries are among the most severe on San Diego roads, and the first offer rarely reflects future surgeries, lost earning capacity, or long-term care. HHJ Trial Attorneys and the other established firms in the county all offer free consultations, so asking these nine questions costs you nothing but an hour. Ask them before the insurer’s deadline pressure starts, not after.

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Events

Alice + Olivia Thinks Pink as Stacey Bendet Kicks Off Breast Cancer Awareness Month

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Madison Avenue turned decidedly pink Thursday night as Alice + Olivia founder Stacey Bendet brought together fashion, cocktails, music and a little retail temptation for something considerably more important than another fashionable New York soirée: the opening of Breast Cancer Awareness Month and a monthlong initiative benefiting the Breast Cancer Research Foundation.

Stacey Bendet, Emily Rockefeller Photo BFA

Bendet hosted the evening at Alice + Olivia’s Madison Avenue flagship alongside Emily Rockefeller and Dr. Elizabeth Comen, with Jenny Mollen, BCRF’s Donna McKay, Jennifer Rubio, Julie Macklowe, Sofia Karvela, Natalie Mackey, Dani Stahl, Ebony Wiggins, Carolyn Angel and Aqua Parios among those joining the celebration. Cancer survivor, philanthropist and advocate Quiana Parks supplied the music, giving the evening a particularly personal connection to the cause.

Stacey Bendet Photo BFA

Because philanthropy needn’t be dreary, there was plenty to play with. Guests could customize purchases with embroidery, head to the charm bar to create pink phone charms, sip Bricoleur Vineyards Isla Rose Brut Rosé, LALO Tequila cocktails and The Macklowe Pink Manhattans, and indulge in appropriately pink sweets. If Breast Cancer Awareness Month has an official color, Bendet clearly saw no reason not to run with it.

Photo BFA

The evening was more than pink for pink’s sake. Fifteen percent of net proceeds benefited BCRF and its work supporting breast cancer research, while the party launched Alice + Olivia’s larger October campaign. Through October 31, customers who donate to BCRF at an Alice + Olivia boutique or online will receive 15 percent off a purchase.

Photo BFA

Bendet has also given two Alice + Olivia favorites a limited-edition pink treatment for the campaign. The signature Willa Blouse arrives in blush silk crepe de chine with vivid hot-pink detailing, while the Dollie Cardigan also gets its own pink moment. Twenty dollars from the sale of each piece will benefit BCRF. The Willa, priced at $395, is particularly clever: polished enough to survive long after October, while still making its point.

Eleanor Chromy Photo BFA

New York is only the beginning. The initiative heads next to Chicago with Giuliana Rancic before moving west, where Bendet will be joined by Paris Hilton and Kathy Hilton for the Los Angeles celebration. For the Hiltons, the partnership carries an especially personal meaning: Kathy Hilton’s mother, Kathleen Richards, died from breast cancer in 2002.

Stacey Bendet, Julie Macklowe Photo BFA

There is always a danger during Breast Cancer Awareness Month that the pink ribbon becomes so familiar we stop seeing what it represents. That is where an evening like this works best. The fashion gets people through the door, the cocktails keep things festive and the shopping makes participation easy—but the money goes toward research into a disease that continues to alter families everywhere.

Eleanor Chromy, Jennifer Rubio, Johanna Stitt Photo BFA

On Thursday night, however, there was no reason purpose couldn’t arrive wearing fabulous clothes.

Shop pink. Give back. And if you’re going to make a statement, Madison Avenue isn’t a bad place to make it.

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Is Invisalign the Right Fit for Every Type of Smile?

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Clear aligners have changed how many people think about straightening teeth, yet they are not a universal answer. Invisalign can work well for mild crowding, small gaps, and many bite concerns, but success depends on tooth position, bone support, gum health, and patient follow-through. Before choosing any orthodontic option, a person needs a careful exam, a realistic treatment plan, and clear expectations about daily wear.

A qualified dentist can assess spacing, bite depth, jaw relationship, and tooth rotation before recommending invisalign treatment in Las Vegas as a possible option. This step matters because clear trays move teeth through planned pressure, and some smiles need attachments, refinements, or a different orthodontic method for stable results.

What Invisalign Can Usually Correct

Invisalign is often effective for mild to moderate crowding. Crowding happens when teeth compete for limited space, which can make brushing and flossing harder. Aligners can create controlled movement over time, helping teeth sit in a cleaner, more balanced position.

Small gaps may also respond well. Spaces can appear because of tooth size, gum changes, habits, or natural growth patterns. A digital treatment plan helps show whether closing those spaces will also protect the bite.

Many bite issues can see an improvement with aligners. Overbites, underbites, crossbites, and open bites vary in severity. Some respond predictably, while others need extra planning because jaw position affects more than tooth alignment.

Where Invisalign May Have Limits

Some smiles need more force or control than clear trays can provide alone. Severe rotations, large vertical movements, and major bite changes may be harder to manage. In those cases, braces or combined treatment may offer better control.

Gum and bone health also matter. Teeth move through bone, so active gum disease must be treated first. If support is weak, movement may need to be slower, limited, or avoided.

Restorations can affect planning. Crowns, bridges, implants, and veneers do not move the same way natural teeth do. A dentist must account for those details before approving aligner therapy.

Daily Wear Makes a Major Difference

Clear aligners are removable, which is useful for meals and cleaning. That benefit also creates responsibility. Most plans require trays to stay in for 20 to 22 hours each day. Wearing them less can slow progress or affect the final position.

Consistency matters more than many people expect. Teeth need steady pressure to move predictably. Skipping hours, leaving trays out during social events, or changing sets too early can disrupt the plan.

Cleaning habits are part of the process. Aligners should be removed for food and most drinks other than water. Brushing before reinserting trays helps reduce staining, odor, and plaque buildup.

Age Is Rarely the Main Factor

Adults can often use Invisalign if their gums, teeth, and bone are healthy. While there is no strict upper age limit, the better question is whether the mouth can handle this movement safely.

Teenagers may also be suitable candidates, but discipline matters. A teen who keeps trays in as directed may do well. One who often forgets them may get poor results, even with a good plan.

Younger children usually need a growth and development exam first. Some may require early orthodontic care before aligners become practical later.

Comfort, Speech, and Lifestyle

Most people feel pressure when starting a new set of trays. That sensation usually fades after the teeth begin adapting. Sharp pain, sores, or trays that do not seat properly should be checked.

Speech may sound slightly different at first. A mild lisp can occur while the tongue adjusts to the plastic. Practice and regular wear usually help speech return to normal.

Diet changes are limited because trays come out during meals. Still, frequent snacking can become inconvenient because teeth should be cleaned before aligners go back in.

How Dentists Decide Candidacy

A proper screening includes photographs, digital scans, dental X-rays, bite evaluation, and gum assessment. These records help determine whether aligners can move teeth safely and predictably.

The dentist also reviews goals. A person who wants a small cosmetic change may have a shorter plan. Someone with bite problems may need more stages and refinements.

Cost and timeline should be discussed early. Treatment length often depends on case difficulty, tray wear, and how teeth respond. Clear estimates help patients make informed choices.

Invisalign can be a strong fit for many smiles, but it is not right for every case. The best candidates have healthy gums, realistic goals, and the discipline to wear trays as directed. More complex movement may require another orthodontic approach or added steps. 

A complete dental evaluation is the most reliable way to match the treatment to the smile, protect oral health, and support a stable result.



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Business

Inside MDL 3181: Key Issues in Spinal Stimulator Injury Claims

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Every year, thousands of people turn to spinal cord stimulators hoping for relief from pain that has taken over their daily lives, only to face new complications instead. As of July 2025, at least 24 federal lawsuits tied to Boston Scientific’s spinal cord stimulator devices were pending across nine districts nationwide, now centralized under MDL No. 3181 in the Central District of California before Judge Josephine L. Staton. Families in St. Louis, MO, and beyond have reported injuries ranging from lead migration and unexpected shocks to infections, nerve damage, and the need for revision surgery, each carrying its own physical, emotional, and financial toll.

For residents weighing their legal options, understanding how a Boston Scientific spinal cord stimulator lawsuit fits into this growing litigation is crucial. These claims touch on several forms of personal injury, from device malfunction and “failure to warn” to long-term disability and diminished quality of life. As the MDL moves through its early stages, let’s take a closer look at the key issues shaping these cases.

What MDL 3181 Covers

People researching Boston Scientific spinal cord stimulator lawsuits may encounter references to MDL 3181. This federal proceeding concerns product liability allegations involving spinal stimulation systems. On June 5, 2026, the Judicial Panel on Multidistrict Litigation transferred qualifying cases to the Central District of California before Judge Josephine L. Staton. Each action remains separate for damages, settlement, or trial.

Why Centralization Matters

Multidistrict litigation places cases with shared factual questions before one court for pretrial management. That arrangement can limit duplicated discovery and conflicting rulings. Counsel may examine engineering files, warning materials, adverse event reports, and expert opinions through coordinated procedures. Centralization does not create a class action. Every patient keeps an individual claim, personal evidence, and separate damage calculation.

Product Identification Is Essential

A claimant must establish which implanted system was used. Operative notes may identify the pulse generator, leads, model number, serial code, implantation date, or removal date. Hospital records, billing files, physician notes, and patient implant cards can fill missing details. If product identity remains uncertain, proving a connection between the device and injury becomes more difficult.

  • Common Device Allegations

Reported problems may include lead migration, fractured components, lost stimulation, unexpected shocks, burning sensations, charging failures, or limited pain relief. Some patients undergo revision surgery, treatment for infection, or explantation after symptoms worsen. Each allegation depends on the device, procedure, and the patient’s medical history. Evidence must connect the claimed harm to a defect, inadequate warning, or recognized legal theory.

The Main Liability Questions

Several questions may shape a product claim. 

  • Did a manufacturing error affect the implanted component? 
  • Did the design create an unreasonable risk? 
  • Were physicians and patients given adequate safety information? 
  • Did company records reveal earlier reports of failure? 

Answers may depend on testing data, internal communications, adverse event submissions, physician testimony, and technical evidence.

Medical Proof Can Drive the Case

Medical records should show the patient’s condition before implantation, during treatment, and after symptoms developed. Physicians may need to separate device-related harm from the underlying illness that prompted stimulation therapy. Imaging studies, diagnostic tests, surgical notes, medication changes, and removal records can establish timing. A consistent sequence strengthens causation evidence. Missing records may provide grounds for a defense challenge.

Shared Evidence and Individual Evidence

The coordinated proceeding may address common proof concerning product development, testing, warnings, and reported malfunctions. Individual evidence remains equally important. Patients may have varying symptom severity, surgical history, employment impact, care requirements, and recovery outlook. Hence, two people with similar implants may still face different damages because their health conditions and financial losses are not the same.

Possible Damages

A successful claim may seek compensation for medical bills, future treatment, lost wages, reduced earning capacity, physical pain, emotional distress, and diminished daily activities. Additional surgery or long-term care may increase documented losses. Recovery amounts depend on evidence and applicable state law. No uniform payment applies to every claimant, and the litigation has not established liability or guaranteed compensation.

Steps for Potential Claimants

Patients should preserve implant cards, operative reports, imaging results, billing statements, prescription records, and provider communications. A dated personal timeline can record symptoms, programming changes, emergency visits, failed therapy, and later procedures. Only qualified clinicians should make treatment decisions. Filing periods typically differ by state, injury type, and discovery date, making prompt legal review important when protecting available rights.

Litigation Status

MDL 3181 remains active. The June 2026 transfer order established a federal structure for coordinated pretrial proceedings involving spinal stimulation product claims. The court has not found the manufacturer liable, and allegations remain contested. New filings, court orders, expert disclosures, and settlement discussions may alter future procedures. 

MDL 3181 provides a shared process for examining evidence linked to spinal cord stimulation systems. Each patient must still prove injury, a product connection, a legal basis, and a measurable loss. Complete records can clarify device identity, symptom timing, treatment needs, and financial consequences. Patients considering legal action may benefit from preserving documents and consulting counsel familiar with medical device claims, clinical evidence, and applicable filing deadlines.



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