Meri Pintas, 30, center, harvests coca leaves with her children in the Yungas region of Bolivia. Bolivia, the world’s third-largest cocaine producer, has advanced its own unorthodox approach toward controlling the growing of coca, which veers markedly from the wider war on drugs and includes high-tech monitoring of thousands of legal coca patches intended to produce coca leaf for traditional uses.
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Police using Twitter to offer virtual ridealongs
Label: TechnologySIOUX FALLS, S.D. (AP) — Riding side by side as a police officer answers a call for help or investigates a brutal crime during a ridealong gives citizens an up close look at the gritty and sometimes dangerous situations officers can experience on the job.
But a new approach to informing the public about what officers do is taking hold at police departments across the United States and Canada 7/8— one that is far less dangerous for citizens but, police say, just as informative.
With virtual ridealongs on Twitter, or tweetalongs, curious citizens just need a computer or smartphone for a glimpse into law enforcement officers‘ daily routines.
Tweetalongs typically are scheduled for a set number of hours, with an officer — or a designated tweeter like the department’s public information officer— posting regular updates to Twitter about what they are seeing as they perform their normal on-duty routine. The tweets, which also include photos and links to videos of the officers, can encompass an array of activities — everything from an officer responding to a homicide to a noise complaint.
Police departments say virtual ridealongs reach a wider range of people at once and help add transparency to the job.
“People spend hard-earned money on taxes to allow the government to provide services. That’s police, fire, water, streets, the whole works, and there should be a way for those government agencies to let the public know what they’re getting for their money,” said Steve Allender, chief of the Rapid City Police Department in South Dakota, which started offering tweetalongs several months ago after watching departments like those in Seattle, Kansas City, Mo., and Las Vegas do so.
On the Wednesday before Thanksgiving, Tarah Heupel, the public information officer for the Rapid City Police Department, rode alongside Street Crimes Officer Ron Terviel as he patrolled Rapid City. Heupel posted regular updates every few minutes about what Terviel was doing, including the officer citing a woman for public intoxication, responding to a call of three teenagers attempting to steal cough syrup and body spray from a store and locating a man who ran from the scene of an accident. Photos were included in some of the tweets.
Michael Taddesse, a 34-year-old university career specialist in Arlington, Texas, has done several ridealongs with police and regularly follows multiple departments that conduct tweetalongs.
“I think the only way to effectively combat crime is to have a community that is engaged and understands what’s going on,” he said.
Ridealongs where “you’re out in the elements” are very different than sitting behind a computer during a tweetalong and the level of danger is “dramatically decreased,” he said. But in both instances, the passenger gains new information about the call, what laws may or may not have been broken and what transpires, he added.
For police departments, tweetalongs are just one more way to connect directly with a community through social media.
More than 92 percent of police departments use social media, according to a survey of 600 agencies in 48 states conducted by the International Association of Chiefs of Police’s Center for Social Media. And Nancy Kolb, senior program manager for IACP, called tweetalongs a “growing trend” among departments of all sizes.
There is no set protocol and departments are free to conduct the tweetalong how they see fit, she said.
In Ontario, Canada, the Niagara Regional Police Service conducted their first virtual ridealong in August over a busy eight-hour Friday night shift. The police department‘s followers were able to see a tweet whenever the police unit was dispatched to one of the more than 140,000 calls received that night.
Richard Gadreau, the social media officer for the police department, said officers routinely take people out on real ridealongs, but there is a waiting list and preference is given to people interested in becoming an officer.
With tweetalongs, many calls also mean many tweets. Kolb said departments are cognizant of cluttering peoples’ Twitter feeds.
That’s why the Rapid City Police Department decided to create a separate account for the tweetalong, Allender said.
Kolb also said officers are careful not to tweet personal or sensitive information. Officers typically do not tweet child abuse or domestic abuse cases, and they usually only tweet about a call after they leave the scene to protect officers and callers.
But Allender, the chief of police in Rapid City, said tweetalongs also show some of the more outrageous calls police deal with on a regular basis — like the kid who breaks out the window of a police car while the officer is standing on the sidewalk.
“Real life is funnier than any comedy show out there and not to make fun of people, embarrass them or humiliate them, but people do funny things,” Allender said. “… I mean, that guy deserves a little bit of ridicule, and everyone who would be watching would agree. That’s just good clean fun to me.”
___
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McElroy has concussion, Sanchez to start for Jets
Label: LifestyleFLORHAM PARK, N.J. (AP) — The New York Jets' wacky quarterback situation took yet another twist.
Greg McElroy has a concussion — which he didn't reveal until Thursday — and will be replaced by Mark Sanchez as the New York Jets' starting quarterback in the season finale at Buffalo on Sunday.
Coach Rex Ryan walked into his news conference before practice, took the podium and opened with: "You're not going to believe this."
McElroy, preparing to make his second NFL start in place of the benched Sanchez, was lifting weights Thursday morning and started experiencing headaches, Ryan said. McElroy went to the team's training staff and then revealed he was suffering concussion-like symptoms after being sacked 11 times in the Jets' 27-17 loss to San Diego last Sunday.
McElroy and head trainer John Mellody then went to Ryan to tell the coach the news.
"We come to find out that Greg wasn't exactly truthful with our training staff after the game," said Ryan, who acknowledged he was "stunned" to hear it. "He never disclosed that he had symptoms after the game to our trainers. Right now, he's being evaluated for a concussion."
Ryan said there was no way he would play McElroy against the Bills and the third-stringer will "definitely be out." McElroy had been listed on the injury report Wednesday with a mild abdominal strain, but was a full participant in practice and was expected to play without any issues.
"I admire his courage and everything else, but you have to be truthful and I think that's the lesson learned here with the medical staff," Ryan said. "The fact he really wanted to play, I understand the competitive side of Greg and all that, but the most important thing is the health of the players.
"Obviously, I feel fortunate that something like this showed up without him going out there and putting himself in harm's way."
Ryan chose to start Sanchez over Tim Tebow because the team has just two practices and a walkthrough to prepare before the game.
"Mark has had success earlier in the season against Buffalo and he's very familiar with them," Ryan said. "That's the reason I'm going with Mark."
After finding out about McElroy's condition, Ryan spoke with both Sanchez and Tebow to tell them of his decision.
"Obviously, Tim's not happy with that, as you'd expect," Ryan said.
Sanchez was benched for the first time in his four-year career after turning the ball over five times at Tennessee on Dec. 17. McElroy leapfrogged Tebow on the depth chart to start against the Chargers.
The news comes on the heels of some tension between Ryan and Tebow last week, when the popular backup quarterback told the coach he was "disappointed" at not getting the start and wanted to play "regular quarterback." ESPN New York first reported Sunday that Tebow asked out of the wildcat, and a person with knowledge of the situation confirmed that to The Associated Press. But Tebow insisted Wednesday that he did not ask out of doing anything and acknowledged that Ryan might have misinterpreted what he said.
The two met again last Friday to clear the air, and Tebow reiterated that he was willing to do anything the team asked him to do. Tebow will be the No. 2 quarterback on Sunday at Buffalo, and could play — but it won't be as the starter.
"Obviously, he'd like a shot at it," Ryan said, "but with the situation the way it is, it's a short window, really, to get the preparation time in and I just think it's best for our football team."
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Online: http://pro32.ap.org/poll and http://twitter.com/AP_NFL
New York’s Mental Health System Thrashed by Services Lost to Storm
Label: Health
Marcus Yam for The New York Times
Dr. Richard Rosenthal, physician in chief of behavioral services for Continuum hospitals, at St. Luke’s-Roosevelt Hospital Center.
When a young woman in the grip of paranoid delusions threatened a neighbor with a meat cleaver one Saturday last month, the police took her by ambulance to the nearest psychiatric emergency room. Or rather, they took her to Beth Israel Medical Center, the only comprehensive psychiatric E.R. functioning in Lower Manhattan since Hurricane Sandy shrank and strained New York’s mental health resources.
The case was one of 9,548 “emotionally disturbed person” calls that the Police Department answered in November, and one of the 2,848 that resulted in transportation to a hospital, a small increase over a year earlier.
But the woman was discharged within hours, to the shock of the mental health professionals who had called the police. It took four more days, and strong protests from her psychiatrist and caseworkers, to get her admitted for two weeks of inpatient treatment, said Tony Lee, who works for Community Access, a nonprofit agency that provides supportive housing to people with mental illness, managing the Lower East Side apartment building where she lives.
Psychiatric hospital admission is always a judgment call. But in the city, according to hospital records and interviews with psychiatrists and veteran advocates of community care, the odds of securing mental health treatment in a crisis have worsened significantly since the hurricane. The storm’s surge knocked out several of the city’s largest psychiatric hospitals, disrupted outpatient services and flooded scores of coastal nursing homes and “adult homes” where many mentally ill people had found housing of last resort.
One of the most affected hospitals, Beth Israel, recorded a 69 percent spike in psychiatric emergency room cases last month, with its inpatient slots overflowing. Instead of admitting more than one out of three such cases, as it did in November 2011, it admitted only one out of four of the 691 emergency arrivals this November, records show. Capacity was so overtaxed that ambulances had to be diverted to other hospitals 15 times in the month, almost double the rate last year, in periods typically lasting for eight hours, officials said.
Dr. Richard Rosenthal, physician in chief of behavioral services for Continuum Health Partners, Beth Israel’s parent organization, said he was proud of how much Continuum’s hospitals had done to handle psychiatric overflow since storm damage shuttered Bellevue Hospital Center, the city’s flagship public hospital; NYU Langone Medical Center; and the Veterans Affairs Hospital. But these days, he said, as he walks on Amsterdam Avenue between Continuum’s Roosevelt hospital on West 59th Street and its St. Luke’s hospital on West 114th Street, he notices more mentally ill people in the streets than he has seen in years.
“When you have the most vulnerable folks, all you need is one chink in the system and you lose them,” Dr. Rosenthal said. “Whether they lost their housing, or the outpatient services they usually go to were closed and they were lost to follow-up, they have become disconnected, with predictable results.”
Similar patterns are playing out in Brooklyn, where Maimonides Medical Center has been overwhelmed with mental health emergencies from the Coney Island vicinity since Coney Island Hospital, one of the city’s largest acute care psychiatric hospitals, suspended operations, hospital officials said.
“Triage has reached a different level: You have to get sicker to get in,” said Dr. Andrew Kolodny, the chairman of psychiatry at Maimonides, citing a 56 percent increase in psychiatric emergency room visits there from Oct. 26 to Dec. 7, compared with the same period last year, and a 24 percent rise in admissions. The increase in admissions was possible only with emergency permission from the state to exceed licensed limits.
“Not only is there decreased capacity, because Bellevue and Coney Island are off line,” Dr. Kolodny added, “but there’s increased demand because the storm or the loss of their residence has been a stressor for mental illness.”
The storm battered a mental health system that still relies heavily on private nursing homes and substandard adult homes to house people with mental illness. Such institutions have a sordid history of neglect and exploitation, and the courts have repeatedly found that their overuse by the state isolated thousands of people in violation of the Americans With Disabilities Act.
Plans are under way to increase supportive housing — dwellings where mentally ill people can live relatively independently, with support services. But even before Hurricane Sandy, the expansion fell far short of demand.
The storm underscored the fragility of the system. Many disabled evacuees who were sent first to makeshift school shelters lost access to the psychiatric medications that kept their symptoms at bay, Dr. Kolodny said. Even those lucky enough to have the drugs they need are at greater risk of relapse as they experience crowded living conditions. “If they’re now sleeping in a gym with 100 people, that can tip them over the edge and start making them really paranoid,” he said.
On Staten Island, where the chief of psychiatry at Richmond University Medical Center says psychiatric resources have been stretched to the limit, clergy members report that mentally ill people transferred to a large adult home in New Brighton from one that was washed away in Far Rockaway, Queens, are now showing up at church rectories, begging for socks and underwear.
“It’s heartbreaking, because they just found us by chance,” said Margaret Moschetto, a missionary at the Church of Assumption-St. Paul in New Brighton. “They were just walking around the neighborhood. They really didn’t know where they were.”
Egypt’s Hamdeen Sabahi vs. Islamists and Free Markets
Label: World
CAIRO — Hamdeen Sabahi was the most popular leader in the fight against Egypt’s new Islamist-backed constitution. Now he is preparing for his next battle: against Islamist leaders’ plans for Western-style free-market reforms.
Do not listen to your allies in the Muslim Brotherhood, Mr. Sabahi said he warned President Mohamed Morsi, of the Brotherhood’s political arm, in a private meeting a few weeks ago. “Because the Brotherhood’s economic and social thought is the same as Mubarak’s: the law of the markets,” Mr. Sabahi said he had told Mr. Morsi, referring to Hosni Mubarak, the former president. “You will just make the poor poorer, and they will be angry with you just as they were with Mubarak.”
Mr. Sabahi, 58, a leftist in the style of another former president, Gamal Abdel Nasser, frightens most economists. He is an outspoken opponent of free-market economic moves in general as well as of a pending $4.5 billion loan from the International Monetary Fund that economists say is urgently needed to avert a catastrophic currency collapse.
But to the dismay of some Western diplomats, Mr. Sabahi is emerging as an increasingly salient voice in Egyptian politics, in part because of the bruising race to ratify the Islamist-backed charter. Both sides now expect the anti-Islamist opposition to reap big gains in the coming parliamentary vote, set to be held in two months against the backdrop of a simultaneous debate over the I.M.F. loan.
Among Egypt’s opposition figures, Mr. Sabahi has the biggest base of support in the streets. After campaigning as a dark horse in the spring’s presidential election, he missed the runoff by fewer than a million votes, finishing the first round almost neck and neck with Mr. Morsi.
Economic overhaul now poses a critical test of Egypt’s fragile democracy. Without enough trust in government, the changes to the systems of taxes or subsidies needed to reduce the deficit could easily stir new unrest in the streets, just as such moves have in the past. But if Mr. Morsi expects his opponents to hold their fire just because economists say the need is dire, Mr. Sabahi said, the president should think again.
“Why support him, for what?” Mr. Sabahi said in an interview in the borrowed offices of an Egyptian film director, decorated with pictures of President Nasser but also of Che Guevara. “Is he a democratic ruler, is he a revolutionary? Is he a model of a president, so I want him to succeed?”
Mr. Sabahi, 58, known for writing poetry and quoting Arab literature and for his blow-dried hair, was one of the few non-Islamist politicians willing to endure imprisonment alongside the members of the Muslim Brotherhood in the struggle against Egypt’s autocracy, giving him a unique credibility among more secular leaders.
But after missing the presidential runoff this year, Mr. Sabahi declined to endorse either Mr. Morsi or his opponent, Ahmed Shafik, a former Mubarak prime minister. It was a choice between “tyranny in the name of the state” and “tyranny in the name of religion,” Mr. Sabahi said at the time in a television interview.
Mr. Sabahi argued in the interview that although Mr. Morsi won election democratically, he has failed to govern as a democrat. “He is kicking away the ladder he climbed,” Mr. Sabahi said, arguing that Mr. Morsi’s decree setting his authority above the courts, if only for a month, ended his credibility as a democrat.
The resulting discord between the Islamists and their opponents has postponed the I.M.F. loan and helped bring Egypt closer than ever to economic collapse. State media on Tuesday described a “dollarization frenzy” gripping the country as people raced to sell Egyptian pounds. The currency is at its lowest level in the past eight years.
Since Mr. Mubarak’s ouster, Egypt’s hard currency reserves have fallen to $15 billion from $43 billion as it has struggled to prop up the pound, and economists say the government now urgently needs a cash infusion of about $14 billion in order to stay afloat. The $4.5 billion I.M.F. loan is expected to act as a seal of approval for others, after the I.M.F. concludes Egypt is at least on a path to greater balance.
If that loan does not come through soon, “the risk is a disaster,” said Heba Handoussa of the Economic Research Forum. “We can’t afford to wait.”
There are other more Western-friendly faces of the opposition, like Mohamed ElBaradei, the former United Nations diplomat, and Amr Moussa, the former foreign minister. But neither has Mr. Sabahi’s following at the grass roots, and he speaks for a segment of the Egyptian public deeply suspicious of free markets and, especially, the I.M.F. A popular singer, El Manawahly, has even recorded a song and music video opposing the loan. “Oh monetary fund / Show me how to industrialize, plant and kneel.”
Ouch, Charlie! YouTube Sensation Kids Talk Christmas Toys
Label: TechnologyThe infamous “Charlie Bit My Finger” video has surpassed half a billion views on YouTube — not bad for a 56-second clip of a one-year-old kid biting his older brother’s finger.
Charlie and Harry, now six and eight, returned to the web earlier this year with a new series through Viral Studios. The mini-episodes focus on the boys and their younger brother, Jasper, as they talk about toys, viral videos and — of course — biting things.
[More from Mashable: 8 Festive Christmas Tumblrs, Presented by Santa Dogs]
Mashable sat down for a Skype interview with the three boys last week. Unfortunately, the Internet connection wasn’t the greatest — Harry twice referred to me as a “man made out of boxes” because of the spotty video quality — but they were still able to talk about what toys they were most excited about this holiday season. Check ‘em out below:
[More from Mashable: Now and Then: 10 Awesome Past and Present Pics]
Charlie’s Pick: Playmobil Large Pirate Ship
Price: $ 95.50
Image courtesy of Playmobil
Harry’s Pick: Thomas & Friends Take-n-Play The Great Quarry Climb
Price: $ 19.99
Image courtesy of Fisher-Price
Jasper’s Pick: Turbo Snake Remote Control
Price: £38.45 (only available in the U.K.)
Image courtesy of Amazon
You can catch all the episodes on the “Charlie Bit Me!” series on their YouTube page. Which toys or gadgets did you score this year? Tell us below.
BONUS: 10 Gifts for People You Hate
1. 50 Used Toilet Paper Rolls
Price: $ 19.99 Mother Earth appreciates a little holiday upcycling. Your mother-in-law, on the other hand, may not. Cheaper DIY alternative: Your own toilet paper rolls.
Click here to view this gallery.
Image courtesy of Viral Studios
This story originally published on Mashable here.
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James leads Heat over Thunder in Finals rematch
Label: LifestyleMIAMI (AP) — Kevin Durant and Russell Westbrook combined to score 54 points, more than any set of teammates had managed in a game against Miami all season.
Oklahoma City needed them to score at least three more.
That didn't happen, and an NBA Finals rematch went just as last year's title series did — to the Heat.
LeBron James had 29 points, nine assists and eight rebounds, Dwyane Wade scored 21, and the Heat survived a frantic finish to beat the Thunder 103-97 on Tuesday night, a game where Durant and Westbrook both missed potential tying 3-pointers in the final seconds.
"A great game to play," Thunder coach Scott Brooks said, "and a great game to coach."
For the Heat, it was just a little greater.
Mario Chalmers scored a season-high 20 for the Heat, who were 19 for 19 from the foul line, the second-best effort in franchise history behind only a 30-for-30 game in Boston on March 24, 1993. Chris Bosh added 16 points for Miami, which has beaten the Thunder five straight times dating to last June's title series.
"Felt a little bit like a different month," Heat coach Erik Spoelstra said. "Regardless of what your script is coming into the game, when you play this team, it's not going to go according to script. They're too good."
It's the first losing streak of the season for the Thunder, who had been 4-0 after losses. Serge Ibaka and Kevin Martin each scored 15 for Oklahoma City.
The game had a little of everything — a fast start by the reigning champions, a one-handed dunk by James on an offensive rebound that will be added to his copious highlight reel, a scrum after a hard foul that led to double-technicals on Wade and Ibaka early in the fourth, an easy rally by the Thunder from an early double-digit deficit, and even workout partners in Durant and James barking back and forth in the final minutes.
Such was the intensity that James slumped over the scorer's table with 1:08 left, exhausted.
"I'm tired as hell right now," James said — and that was more than an hour after the game ended.
With good reason. On an emotional day, there was a wild finish.
Wade lost the ball on an ill-advised, behind-the-back dribble, and the turnover set up Durant for a two-handed dunk that got the Thunder within 96-95 with 44.1 seconds remaining.
Needing a stop on the next trip, the Thunder instead forgot to play defense. Kendrick Perkins and Ibaka both were confused on the ensuing Miami possession, and Bosh was left alone to take a pass from James and throw down a dunk that restored Miami's three-point edge.
"We went over and helped," Durant said. "We just needed to help on the backside. There was miscommunication but we still had a chance to go into overtime."
Two chances, actually.
Oklahoma City got within one when Durant made a jumper over James, but no closer. Ray Allen's two free throws with 15.6 seconds left made it 100-97, and Miami's last three points came from the line. Durant missed a 3-pointer that James contested, Westbrook wound up with a second chance that Wade defended, and the Thunder guard smacked a nearby table arguing that he was fouled.
"Part of the game," Westbrook said.
While the stars were stars, the Heat got help from one unexpected source. Chalmers was making everything, even unintended plays. Allen lost possession on what looked to be a pass to no one, but Chalmers picked up the bouncing ball on the right wing, whirled and made a 3-pointer — putting Miami up 86-79 with 8:14 left.
In the end, that cushion was necessary.
"I got going early," Chalmers said, "and I stuck with it."
The Heat came out flying, opening a quick 13-2 lead after making six of their first seven shots. About all that didn't go right for the Heat early on was James committing a foul, the first time he was called for a personal since Dec. 8.
It happened 4:03 into the game — 254 minutes and 7 seconds of on-court time since his last one — when James fouled Ibaka on a dunk attempt.
Chalmers had 12 points, matching his season high, in the opening quarter alone, and that was also Miami's lead after his layup for a 15-3 edge. When Durant headed to the bench after being called for his second personal, plus a technical, with 2:08 left in the first, the Heat led 27-16.
But even with Durant out, Oklahoma City scored the last eight points of the quarter, six coming from the line. The Thunder shot 17 of the game's first 18 free throws and finished with a 38-19 edge in tries from the stripe.
The Heat were held to two points in the first 5:05 of the third, and the Thunder grabbed the lead for the first time. Durant connected on a baseline jumper while falling out of bounds and getting fouled by James. The resulting free throw gave Oklahoma City a 58-56 edge.
With that, the back-and-forth began, and Miami found a way.
"Both teams really played up to the billing," Wade said. "An excellent basketball game."
NOTES: James scored at least 20 points for the 30th straight regular-season game and 46th overall. ... Wade is 7-1 on Christmas, and James has won six straight on the holiday. ... Miami's Mike Miller became the 48th active player to reach 10,000 points. ... The Thunder have used the same starting lineup for all 27 games. ... James passed Bernard King for 39th on the NBA career scoring list. ... Attendance was 20,300, the largest crowd for a Heat home game since they moved into AmericanAirlines Arena.
Is the Cure for Cancer Inside You?
Label: Health
Claudia Steinman saw her husband’s BlackBerry blinking in the dark. It had gone untouched for several days, in a bowl beside his keys, the last thing on anybody’s mind. But about an hour before sunrise, she got up to get a glass of water and, while padding toward the kitchen, found an e-mail time-stamped early that morning — “Sent: Monday, Oct. 3, 2011, 5:23 a.m. Subject: Nobel Prize. Message: Dear Dr. Steinman, I have good news for you. The Nobel Assembly has today decided to award you the Nobel Prize in Physiology or Medicine for 2011.” Before she finished reading, Claudia was hollering at her daughter to wake up. “Dad got the Nobel!” she cried. Alexis, still half-asleep, told her she was crazy. Her father had been dead for three days.
Steinman: Photograph by Ingbert Grüttner/Rockefeller University. Dendritic cell: Rockefeller University Press.
Ralph Steinman in 1983. He would become his most compelling experiment.
Dendritic cell: Rockefeller University Press.
The cell Steinman hoped would save his life looks something like a sea anemone or a ruffled shrimp dumpling.
The Nobel Foundation doesn’t allow posthumous awards, so when news of Ralph Steinman’s death reached Stockholm a few hours later, a minor intrigue ensued over whether the committee would have to rescind the prize. It would not, in fact; but while newspapers stressed the medal mishap (“Nobel jury left red-faced by death of laureate”), they spent less time on the strange story behind the gaffe. That Steinman’s eligibility was even in question, that he’d been dead for just three days instead of, say, three years, was itself a minor miracle.
In the spring of 2007, Steinman, a 64-year-old senior physician and research immunologist at Rockefeller University in New York, had come home from a ski trip with a bad case of diarrhea, and a few days later he showed up for work with yellow eyes and yellow skin — symptoms of a cancerous mass the size of a kiwi that was growing on the head of his pancreas. Soon he learned that the disease had made its way into nearby lymph nodes. Among patients with his condition, 80 percent are dead within the first year; another 90 percent die the year after that. When he told his children about the tumor over Skype, he said, “Don’t Google it.”
But for a man who had spent his life in the laboratory, who brought copies of The New England Journal of Medicine on hiking trips to Vermont and always made sure that family vacations overlapped with scientific symposia, there was only one way to react to such an awful diagnosis — as a scientist. The outlook for pancreatic cancer is so poor, and the established treatments so useless, that any patient who has the disease might as well shoot the moon with new, untested therapies. For Steinman, the prognosis offered the opportunity to run one last experiment.
In the long struggle that was to come, Steinman would try anything and everything that might extend his life, but he placed his greatest hope in a field he helped create, one based on discoveries for which he would earn his Nobel Prize. He hoped to reprogram his immune cells to defeat his cancer — to concoct a set of treatments from his body’s own ingredients, which could take over from his chemotherapy and form a customized, dynamic treatment for his disease. These would be as far from off-the-shelf as medicines can get: vaccines designed for the tumor in his gut, made from the products of his plasma, that could only ever work for him.
Steinman would be the only patient in this makeshift trial, but the personalized approach for which he would serve as both visionary and guinea pig has implications for the rest of us. It is known as cancer immunotherapy, and its offshoots have just now begun to make their way into the clinic, and treatments have been approved for tumors of the skin and of the prostate. For his last experiment, conducted with no control group, Steinman would try to make his life into a useful anecdote — a test of how the treatments he assembled might be put to work. “Once he got diagnosed with cancer, he really started talking about changing the paradigm of cancer treatment,” his daughter Alexis says. “That’s all he knew how to do. He knew how to be a scientist.”
First, Steinman needed to see his tumor. Not an M.R.I. or CT scan, but the material itself. The trouble was that most people with his cancer never have surgery. If there’s cause to think the tumor has spread — and there usually is — it may not be worth the risk of having it removed, along with the bile duct, the gallbladder, large portions of the stomach and the duodenum. Luckily for Steinman, early scans showed that his tumor was a candidate for resection. On the morning of April 3, 2007, less than two weeks after his diagnosis, he went in for the four-hour procedure at Memorial Sloan-Kettering Cancer Center, just across the avenue from his office at Rockefeller University.
No Easy Route If Assad Opts to Go, or Stay
Label: World
BEIRUT, Lebanon — President Bashar al-Assad of Syria sits in his mountaintop palace as the tide of war licks at the cliffs below.
Explosions bloom over the Damascus suburbs. His country is plunging deeper into chaos. The United Nations’ top envoy for the Syrian crisis, Lakhdar Brahimi, met with Mr. Assad in the palace on Monday in an urgent effort to resolve the nearly two-year-old conflict.
How Mr. Assad might respond to Mr. Brahimi’s entreaty depends on his psychology, shaped by a strong sense of mission inherited from his iron-fisted father and predecessor, Hafez al-Assad; his closest advisers, whom supporters describe as a hard-line politburo of his father’s gray-haired security men; and Mr. Assad’s assessment, known only to himself, about what awaits him if he stays — victory, or death at the hands of his people.
From his hilltop, Mr. Assad can gaze toward several possible futures.
East of the palace lies the airport and a possible dash to exile, a route that some say Mr. Assad’s mother and wife may have already taken. But the way is blocked, not just by bands of rebels, but by a belief that supporters say Mr. Assad shares with his advisers that fleeing would betray both his country and his father’s legacy.
He can stay in Damascus and cling to — even die for — his father’s aspirations, to impose a secular Syrian order and act as a pan-Arab leader on a regional and global stage.
Or he can head north to the coastal mountain heartland of his minority Alawite sect, ceding the rest of the country to the uprising led by the Sunni Muslim majority. That would mean a dramatic comedown: reverting to the smaller stature of his grandfather, a tribal leader of a marginalized minority concerned mainly with its own survival.
Mr. Brahimi was closemouthed about the details of his meeting, but has warned in recent weeks that without a political solution, Syria faces the collapse of the state and years of civil war that could dwarf the destruction already caused by the conflict that has taken more than 40,000 lives.
A Damascus-based diplomat said Monday that Mr. Assad, despite official denials, was “totally aware” that he must leave and was “looking for a way out,” though the timetable is unclear.
“More importantly,” said the diplomat, who is currently outside Syria but whose responsibilities include the country, “powerful people in the upper circle of the ruling elite in Damascus are feeling that an exit must be found.”
Yet others close to Mr. Assad and his circle say any retreat would clash with his deep-seated sense of himself, and with the wishes of increasingly empowered security officials, whom one friend of the president’s has come to see as “hotheads.”
Mr. Assad believes he is “defending his country, his people, and his regime and himself” against Islamic extremism and Western interference, said Joseph Abu Fadel, a Lebanese political analyst who supports Mr. Assad and met with government officials last week in Damascus.
Analysts in Russia, one of Syria’s staunchest allies, say that as rebels try to encircle Damascus and cut off escape routes to the coast, the mood in the palace is one of panic, evinced by the erratic use of weapons: Scud missiles better used against an army than an insurgency, naval mines dropped from the air instead of laid at sea.
But even if Mr. Assad wanted to flee, it is unclear if the top generals would let him out alive, Russian analysts say, since they believe that if they lay down arms they — and their disproportionately Alawite families — will die in vengeance killings, and need him to rally troops.
“If he can fly out of Damascus,” Semyon A. Bagdasarov, a Middle East expert in Moscow, said — at this, he laughed dryly — “there is also the understanding of responsibility before the people. A person who has betrayed several million of those closest to him.”
Many Syrians still share Mr. Assad’s belief that he is protecting the Syrian state, which helps explain how he has held on this long. At a lavish lunch hosted by a Lebanese politician outside Beirut in September, prominent Syrian backers of Mr. Assad — Alawites, Sunnis and Christians — spoke of the president, over copious glasses of Johnnie Walker scotch, as the bulwark of a multicultural, modern Syria.
Pagano back to coach Colts after cancer treatment
Label: LifestyleINDIANAPOLIS (AP) — Chuck Pagano stepped to the podium Monday, hugged his team owner, thanked his family for its support and wiped a tear from his eye.
He might, finally, turn out the lights in his office, too.
Nearly three months to the day after being diagnosed with leukemia, the Colts' first-year coach returned to a team eager to reunite with a boss healthy enough to go back to work.
"I told you my best day of my life was July 1, 1989," Pagano said, referring to his wedding date. "Today was No. 2. Getting to pull up, drive in, get out of my car, the key fob still worked. I was beginning to question whether it would or not. When I asked for Bruce to take over, I asked for him to kick some you-know-what and to do great. Damn Bruce, you had to go and win nine games? Tough act to follow. Tough act to follow. Best in the history of the NFL. That's what I have to come back to."
The comment turned tears into the laughter everyone expected on such a festive occasion.
For Pagano and the Colts, Monday morning was as precious as anyone could have imagined when Pagano took an indefinite leave to face the biggest opponent of his life, cancer.
In his absence, all the Colts was win nine of 12 games, make a historic turnaround and clinch a playoff spot all before Sunday's regular-season finale against Houston, which they pegged as the day they hoped to have Pagano back. If all goes well at practice this week, Pagano will be on the sideline for the first time since a Week 3 loss to Jacksonville.
Pagano endured three rounds of chemotherapy to put his cancer in remission.
That Pagano's return came less than 24 hours after Indy (10-5) locked up the No. 5 seed in the AFC and the day before Christmas seemed fitting, too.
"I know Chuck is ready for this challenge. In speaking to his doctor multiple times, I know that the time is right for him to grab the reins, get the head coaching cap on and begin the journey," owner Jim Irsay said. "It's been a miraculous story. It really is a book. It's a fairytale. It's a Hollywood script. It's all those things but it's real."
The reality is that he's returning to a vastly different team than the one he turned over to Arians, his long-time friend and first assistant coaching hire.
Back then, the Colts were 1-2 and most of the so-called experts had written them off as one of the league's worst teams. Now, they're ready to show the football world that they can be just as successful under Pagano as they were under Arians, who tied the NFL record for wins after a midseason coaching change.
Pagano also has changed.
The neatly-trimmed salt-and-pepper hair and trademark goatee that were missing in November have slowly returned, and the thinner man who appeared to be catching his breath during a postgame speech in early November, looked and sounded as good as ever Monday.
He repeatedly thanked fans for their prayers and letters, the organization and his family for their unwavering help and promised to provide comfort and support to other people who are facing similar fights. During one poignant moment that nearly brought out tears again, Pagano even recounted a letter sent to him by a 9-year-old child who suggested he suck on ice chips and strawberry Popsicles in the hospital and advised him to be nice to the nurses regardless of how he felt — and he never even paused.
"I feel great, my weight is back, my energy is back and again, it's just a blessing to be back here," Pagano said.
In the minds of Colts players and coaches, Pagano never really left.
He continually watched practice tape and game film on his computer, used phone calls and text messages to regularly communicate with players and occasionally delivered a pregame or postgame speech to his team.
"He texted me and called me so much, it was like he was standing there in my face every day," said receiver Reggie Wayne, who has been friends with Pagano since the two were working together at the University of Miami.
But the Colts found plenty of other ways to keep Pagano's battle in the forefront.
They began a fundraising campaign for leukemia research, calling it Chuckstrong. Players had stickers with the initials CP on their locker room nameplates, and Arians wore an orange ribbon on his baseball cap during games. Orange is the symbolic color for leukemia. At one point, nearly three dozen players shaved their heads to show their ailing coach they were with him.
That's not all.
Arians and first-year general manager Ryan Grigson decided to leave the lights on in Pagano's office until he returned. Pagano noted the team even installed plastic clips to make sure those lights were not mistakenly turned off while he was gone. Those clips were removed when Pagano arrived Monday morning.
And Arians said nobody sat in the front seat of the team bus.
"He's always been our head coach," Arians said.
So after getting medical clearance from his oncologist, Dr. Larry Cripe, to return with no restrictions, Pagano couldn't wait to get to the office Monday morning.
Arians arrived at 7 a.m., three hours early for the scheduled team meeting. By then, Pagano had already driven past the inflatable Colts player with the words "Welcome Back Chuck" printed on its chest and was back in his office preparing for the Texans.
Players showed up a couple of hours later, and when the torch was passed from Arians back to Pagano, players gave their returning coach a standing ovation that Wayne said was well-deserved.
All Pagano wants to do now is emulate the success Arians and his players have had this season.
"I asked him (Arians) if he would lead this team and this ballclub and this organization and take over the reins," Pagano said. "What a masterful, masterful job you did Bruce. You carried the torch and all you went out and did was win nine ballgames. You got us our 10th win yesterday and you got us into the playoffs. You did it with dignity and you did it with class. You're everything that I always knew you were and more."
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