new york times Archives - Page 3 of 9

May 24, 2012

Paul Krugman is my hero

Paul Krugman says call it what it is: a depression. “A recession is when things are going down; a depression is when things are down, and stay that way for a long time.”

Krugman offered this opening comment to a sell-out crowd in San Francisco, where he was highlighting a Commonwealth Club event and promoting his new book, End This Depression Now. Ending this depression now is entirely possible, if you believe Nobel Prize-winner Krugman, and this writer believes Paul Krugman. Aside from in-house economist Bud Johns, who has accurately foretold so many economic events as to be spooky even if he hasn’t yet won a Nobel Prize, Krugman is the only living person able to make economic sense to my mathematically-challenged right-brained self. During his San Francisco talk he ticked off enough data to paint the picture — and it is not a pretty picture. Krugman compared the problematic impasse to a family car that had broken down. Its battery was dead. A new battery would make it run. But the man of the house refused to recognize the bad battery or consent to getting a new one, suggesting instead that the rest of the family just walk or take the bus. “You have a problem,” Krugman noted, “but the problem isn’t with the battery.”

So how to fix it? Before offering the answer, Krugman said first we have to understand that “government workers” aren’t the evil bureaucrats in Washington, but are the teachers, firefighters, service workers everywhere who are out of work, with their numbers threatening to be increased. Then he listed steps he would recommend:

First, a huge infusion of money (none of this timid stuff, which Krugman reminds us is what had FDR triggering a double-dip depression in the late 1930s) from the feds to the states, so they can start re-hiring those teachers and public sector workers.

Second: debt relief, starting with mortgage debt and soon extending to other areas like student loans.

Third — then we get into monetary policy, and not even Bud Johns and Paul Krugman can explain that to yours truly in adequately simplified terms.

So the national debt remains staggering and everybody worries about what we’re bequeathing our grandchildren. At least we might keep the country afloat, mass desperation relieved and families together, and that would be something to bequeath.

Paul Krugman did not approve this over-simplified message. But he still gets my vote.

California/Health/Lifestyle/Medicine/New York/seniors/USA/Women

July 20, 2010

Early cancer tests, surgeries questioned

by Fran Johns

Was this mastectomy necessary? It’s a question few breast cancer survivors want to ask, and one that few are likely to answer absolutely. But after years of aggressive emphasis on early diagnosis and treatment, some previous imperatives are being called into question. Noting that breast biopsy has long been considered the “gold standard,” a report in today’s New York Times addresses the new rethinking:

As it turns out, diagnosing the earliest stage of breast cancer can be surprisingly difficult, prone to both outright error and case-by-case disagreement over whether a cluster of cells is benign or malignant, according to an examination of breast cancer cases by The New York Times.

Advances in mammography and other imaging technology over the past 30 years have meant that pathologists must render opinions on ever smaller breast lesions, some the size of a few grains of salt. Discerning the difference between some benign lesions and early stage breast cancer is a particularly challenging area of pathology, according to medical records and interviews with doctors and patients.

Diagnosing D.C.I.S. “is a 30-year history of confusion, differences of opinion and under- and overtreatment,” said Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville. “There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin.”

Much of the current finger-pointing is toward pathologists, where their money comes from, whether they are ‘certified’ or not and in general, how good a job they do.

In 2006, Susan G. Komen for the Cure, an influential breast cancer survivors’ organization, released a startling study. It estimated that in 90,000 cases, women who receive a diagnosis of D.C.I.S. or invasive breast cancer either did not have the disease or their pathologist made another error that resulted in incorrect treatment.

After the Komen report, the College of American Pathologists announced several steps to improve breast cancer diagnosis, including the certification program for pathologists.

For the medical community, the Komen findings were not surprising, since the risk of misdiagnosis had been widely written about in medical literature. One study in 2002, by doctors at Northwestern University Medical Center, reviewed the pathology in 340 breast cancer cases and found that 7.8 percent of them had errors serious enough to change plans for surgery.

This space has argued occasionally for reconsideration of yearly mammograms and for longer, stronger consideration of other options before a mastectomy is performed. Especially in the case of older women.

Would I insist on further studies or opt for less radical treatment if I were diagnosed with breast cancer today? Probably. Can I undo the mastectomy I had at 72? Not exactly. Second-guessing is beside the point for someone who is healthy and fit, but asking questions won’t ever hurt.

Earliest Steps to Find Breast Cancer Are Prone to Error – NYTimes.com.

California/Environment/Health/Lifestyle/Medicine/New York/seniors/USA/World Affairs

July 2, 2010

Best city for geezers? NY lays claim

by Fran Johns

Landscape photo of Statue of Liberty in the af... — Image via Wikipedia

New York City seems to be all aglow in being named by the World Health Organization to its Global Network of Age-friendly cities. As Clyde Haberman reported about the event in the July 1 New York Times,

“It makes us members of a club of people who are struggling, in their own and perhaps much different ways, with learning about and thinking about and approaching this issue,” said Linda I. Gibbs, the deputy mayor for health and human services. “It’s really a lovely recognition.”

One reason for the acknowledgment was a plan that city officials and the New York Academy of Medicine announced last year to improve life for older New Yorkers. All sorts of ideas were put forth, on matters like transportation, housing, health care, job training, nutrition and cultural activities. To a large degree, it was more a wish list than a concrete program. But at least it showed that the city was thinking about issues that will only become more dominant.

Like other cities, New York has a population that is aging, if you will forgive a somewhat meaningless word that we are stuck with. After all, everyone is aging. It’s called living. The only people not aging are dead.

WHO says, of its Global Nework of Age-friendly Cities, that the problem lies with the fact that too many of us are aging and not dying.

Populations in almost every corner of the world are growing older. The greatest changes are occurring in less-developed countries. By 2050, it is estimated that 80% of the expected 2 billion people aged 60 years or over will live in low or middle income countries. The Network aims to help cities create urban environments that allow older people to remain active and healthy participants in society.

To that end, the Network got off the ground a few years ago, and now lists a few cities across the globe as having been accepted for membership. This week’s bulletin (excerpted above and below) lists the Big Apple as the first U.S. member, although the PDF of member cities also lists Portland, and one has to wonder how Portland’s going to feel about all of New York’s hoopla.

The WHO Age-friendly Cities initiative began in 2006 by identifying the key elements of the urban environment that support active and healthy ageing. Research from 33 cities, confirmed the importance for older people of access to public transport, outdoor spaces and buildings, as well as the need for appropriate housing, community support and health services. But it also highlighted the need to foster the connections that allow older people to be active participants in society, to overcome ageism and to provide greater opportunities for civic participation and employment.

The Global Network builds on these principles but takes them a significant step further by requiring participating cities to commence an ongoing process of assessment and implementation. Network members are committed to taking active steps to creating a better environment for their older residents.

A few years ago (2006) the Sperling’s Best Places people came out with a “Best Cities” list about which do the best job of caring for their aging folks. The “Best Cities for Seniors” study examined the state of senior care in the 50 largest metropolitan areas in the United States.

“This is different from the usual studies of retirement living,” said Bert Sperling, the study’s primary author. “When we first retire, we have the energy for traveling and sightseeing. At some point, we will all need specialized resources and facilities to help us cope with aging. That’s what this study examines.”

This unique new study, produced in partnership with Bankers Life and Casualty Company, identifies cities that offer the best resources for less active seniors. The study analyzed nearly 50 categories such as various senior living facilities, comprehensive medical care, specialized transportation services, and a significant senior population.

Top Ten Cities for Seniors

Portland, OR

Seattle, WA

San Francisco, CA

Pittsburgh, PA

Milwaukee, WI

Philadelphia, PA

New York, NY

Boston, MA

Cincinnati, OH

Chicago, IL

Haberman takes issue with that ‘Senior’ word along with the ‘aging’ word. “What does that make the rest of the populace — juniors?” This space (an unabashed fan of Sperling’s #3 city — sorry, #7; but you’re my #2) concurs. But Great Geezer Towns probably wouldn’t cut it with WHO.

California/Health/Lifestyle/Medicine/New York/seniors/USA/Women

June 25, 2010

Life: does longevity trump quality?

by Fran Johns

“We have to get out of the way,” she said; “make room for other, new people on the planet.” Accomplished author/editor Cyra McFadden, at a recent dinner party, was talking about a group of women scientist friends’ excitement over discoveries they have made which show promise of extending life a fraction longer. Cyra was in fierce, though silent, disagreement.

It may be time for those of us who disagree with the rampant prolong-life-at-all-costs theories to stop being silent.

Americans are, in fact (as reported in Epoch Times below, and elsewhere) living longer all the time. Sometimes that’s just fine, especially if we’re in reasonable health. But what if we’re not? What if we’d just as soon be getting on with whatever follows this temporary time on earth? Millions and millions of people are living for hours, days or extended months and years in circumstances they would not choose simply because we have created a culture that says we must be kept alive no matter what.

Average life expectancy continues to increase, and today’s older Americans enjoy better health and financial security than any previous generation. Key trends are reported in “Older Americans 2008: Key Indicators of Well-Being,” a unique, comprehensive look at aging in the United States from the Federal Interagency Forum on Aging-Related Statistics.

“This report comes at a critical time,” according to Edward Sondik, Ph.D., director of the National Center for Health Statistics. “As the baby boomers age and America’s older population grows larger and more diverse, community leaders, policymakers, and researchers have an even greater need for reliable data to understand where older Americans stand today and what they may face tomorrow.”

Where do we stand right now? Well, the same source that says we’re living longer and enjoying better health and financial security (hmmmm on the financial security business) reveals that Americans are “engaging in regular leisure time physical activity” on these levels: ages 45-64: 30%; ages 75-84: 20%; geezers 85 and over: 10%. Hello? Better health and financial security, just no leisure time physical activity? Could it bear some relationship to obesity factors in the same data: 30+% for men, 40+% for women?

Does living well need to be assessed in the compulsion to live long? Why not? Everyone should have the right to live at whatever weight and whatever level of inaction he or she chooses. But the system is weighted toward keeping us alive under all conditions, and bucking the system is not easy. A poignant, wrenching tale of her father’s slow decline and death — and her mother’s refusal to go down that same path — was recently told by California writer/teacher Katy Butler in the New York Times Sunday Magazine.

Almost without their consent, Butler’s gifted, educated parents had their late years altered to match the system’s preferences:

They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Given the limitless sources of victimization floating around, we should not have to add just-try-to-keep-them-alive-forever health care to the list.

My husband and I, having long ago signed advance directives with additional specific issues sheets (“If this happens, do that; if that happens, don’t do this,” etc) recently got them out and talked things over again, a very good thing to do for EVERYbody over 18. We will add dementia provisions to the existing documents while we can remember to do that (the closest you can come to avoid being warehoused in a memory-loss facility for umpteen years.) We are clear, and our friends and family understand, about having no interest in hanging onto life in a greatly diminished state if such an opportunity presents itself; for increasing thousands, it presents itself every day.

All this being said, there’s still a reasonable chance that I’ll be out of town one day when I’m in my 80s (which aren’t that far off), get wiped out by a speeding cyclist and picked up in a seriously mangled state by the paramedics, taken to a hospital that’s not Kaiser (which has all my directives on file,) miraculously brought into some heavily-sedated state of being because the hospital doesn’t consult Kaiser or the living will registry (which also has my directives) and kept alive by assorted mechanisms. By the time my husband or children get there to insist everything be unplugged — which of course will involve long hours and possibly court action — hundreds of thousands of dollars will have been needlessly spent.

I consider myself a highly valuable member of society, and my life a gift from God. But would those dollars not be better spent on a few kids needing specialized care?

Epoch Times – Americans Are Living Longer, According to Federal Report.

California/Health/Literature/Media/Medicine/seniors/USA

June 7, 2010

Is technology addiction messing with your brain?

by Fran Johns

my brains - let me show you them — Image by Liz Henry via Flickr

This is your life? Beginning at breakfast — or perhaps earlier, in the bathroom — one sizable screen with multiple streams of news, stock reports and data updates across the bottom; tweets in a box on the left; the iPhone nearby holding stacked up e-mails, IMs and calls that went into the mailbox? If so, you are not alone. As a matter of fact, it seems almost no one is alone, or disconnected from technological communications, any more. In the words of New York Times writer Matt Richtel, “This is your brain on computers.”

Scientists say juggling e-mail, phone calls and other incoming information can change how people think and behave. They say our ability to focus is being undermined by bursts of information.

These play to a primitive impulse to respond to immediate opportunities and threats. The stimulation provokes excitement — a dopamine squirt — that researchers say can be addictive. In its absence, people feel bored.

The resulting distractions can have deadly consequences, as when cellphone-wielding drivers and train engineers cause wrecks. And for millions of people … these urges can inflict nicks and cuts on creativity and deep thought, interrupting work and family life.

While many people say multitasking makes them more productive, research shows otherwise. Heavy multitaskers actually have more trouble focusing and shutting out irrelevant information, scientists say, and they experience more stress.

Richtel follows a family of four through their technology-addicted lives: they go on an oceanside vacation, but soon are all on their electronic devices; one day at the beach is mercifully unplugged. But on routine days, few moments are unplugged.

“And scientists are discovering,” Richtel reports, that even after the multitasking ends, fractured thinking and lack of focus persist. In other words, this is also your brain off computers.”

“The technology is rewiring our brains,” said Nora Volkow, director of the National Institute of Drug Abuse and one of the world’s leading brain scientists. She and other researchers compare the lure of digital stimulation less to that of drugs and alcohol than to food and sex, which are essential but counterproductive in excess.

Technology use can benefit the brain in some ways, researchers say. Imaging studies show the brains of Internet users become more efficient at finding information. And players of some video games develop better visual acuity.

More broadly, cellphones and computers have transformed life. They let people escape their cubicles and work anywhere. They shrink distances and handle countless mundane tasks, freeing up time for more exciting pursuits.

For better or worse, the consumption of media, as varied as e-mail and TV, has exploded. In 2008, people consumed three times as much information each day as they did in 1960. And they are constantly shifting their attention. Computer users at work change windows or check e-mail or other programs nearly 37 times an hour, new research shows.

The nonstop interactivity is one of the most significant shifts ever in the human environment, said Adam Gazzaley, a neuroscientist at the University of California, San Francisco.

“We are exposing our brains to an environment and asking them to do things we weren’t necessarily evolved to do,” he said. “We know already there are consequences.”

We just don’t fully understand what those consequences might be. This space worries. Couldn’t we get our adrenaline the old-fashioned way?

Your Brain on Computers – Attached to Technology and Paying a Price – NYTimes.com.

California/crime/Health/Law/Lifestyle/Politics & Causes/Religion/seniors/teens/USA/Women

June 3, 2010

Abortion foes are winning, folks

by Fran Johns

WASHINGTON - JANUARY 22: A pro-choice advocat... — Image by Getty Images via @daylife

Will women in the U.S. soon be unable to have a safe, legal abortion? That scary possibility becomes more likely every day. Does anyone really understand the pre-Roe v Wade horrors which abortion foes want to see returned? Not really. That’s because huge numbers of women who could have told the horror stories died at the hands of back-alley abortionists, and those of us who did survive are dying off fast, unheard.

This space welcomes writer John Leland’s front page article in today’s New York Times to the voices crying in the wilderness — just in case someone other than Nancy Keenan might care to listen.

At least 11 states have passed laws this year regulating or restricting abortion, giving opponents of abortion what partisans on both sides of the issue say is an unusually high number of victories. In four additional states, bills have passed at least one house of the legislature.

In a flurry of activity last week, Gov. Haley Barbour of Mississippi signed a bill barring insurers from covering abortion in the new insurance exchanges called for under the federal health care overhaul, and the Oklahoma Legislature overrode a veto by Gov. Brad Henry of a bill requiring doctors who perform abortions to answer 38 questions about each procedure, including the women’s reasons for ending their pregnancies.

It was the third abortion measure this session on which the Legislature overrode a veto by Mr. Henry.

At least 13 other states have introduced or passed similar legislation this year. The new laws range from an Arizona ban on coverage of abortion in the state employees’ health plan to a ban in Nebraska on all abortions after 20 weeks, on the grounds that the fetus at that stage can feel pain.

Fetal pain is a subject of debate in the medical community, and the United States Supreme Court has recognized the government’s right to ban abortions only after a fetus becomes viable, which is more than a month later.

“Fetal pain” is just one ploy; its determination can easily go from 20 weeks backward to ban the morning-after pill. Other ploys? Forcing a pregnant woman to look at ultrasound pictures, prohibiting a physician from discussing fetal abnormalities with his/her patient, and “in Utah, after a pregnant 17-year-old paid a man $150 to beat her in an effort to induce a miscarriage, legislators passed a law that would allow a woman in such circumstances to be charged with homicide.”

Unwanted pregnancies happen. When they do, the man involved can simply walk away, as countless millions have done and will continue to do. Why, then, should so many men purporting to have such omnipotent wisdom be empowered to eliminate a woman’s right to choose what happens to her body?

It’s going to get worse. Unless people — and that includes males of the species who still have brains and some concern for the future of womankind — start paying attention, and standing up to the fundamentalists of all stripes, the U.S. Conference of Catholic Bishops and the religious factions who claim authority over all women, it’s going to get worse than many people in today’s society can even begin to imagine.

Opponents of Abortion Advance Cause at State Level – NYTimes.com.

California/crime/Lifestyle/Media/seniors/teens/USA/Women

June 1, 2010

When citizen cops turn bad

by Fran Johns

In my small, neighborhood park there is a regular assortment of runners and walkers, picnic groups, dog-walkers, grandfathers pushing strollers, homeless guys and tennis players. On any given day you can hear voices speaking Russian, Chinese, English or a lovely range of other languages. And always there are children — with moms, dads, nannies or other supervisors — stumbling around makeshift mini-baseball diamonds in the meadow or tumbling noisily around the playground. It is, in short, exactly what an ideal neighborhood park should be. Its neighborhood, within a few surrounding miles, is home to the low-ish income, middle income and affluent.

And apparently at least one over-anxious mom. Recently she spotted a man she perceived to be a potential threat. The incident was reported in a San Francisco Chronicle op ed piece by former editor and now columnist/blogger Phil Bronstein, who says he used to take his own son there. (Bronstein is not among the low-ish or middle incomes.)

A worried mom took (the man’s) photo with her phone and messaged it around with a detailed description and a warning. “He does not have children and pretends he does and is there to do pull-ups,” she wrote.

The e-mail, originally intended for a small pool of officials and families, went wide in an expanding spiral onto lots of electronic doorsteps. That’s the way it works on the Web.

“Hope someone goes Woodsman on him,” one commenter wrote.

“There were people who wanted to suspend the Constitution,” investigating police Capt. Rich Correia at the Richmond station told me about some lynch-mob sentiment. “It’s interesting how people feed off the Internet, how fast it gets around and how much people can amplify it. Folks made all sorts of assumptions about (things) they didn’t know.”

In this case, the mix of digital citizen vigilance, child safety concerns and viral networking caused a train wreck with a definite victim. And it wasn’t a kid.

San Francisco blog SFist ran the headline “Potential Child Predator” with the photo the mom took. KTVU-TV broadcast the guy’s easily identifiable portrait and kept it on the screen throughout its story. “Take a look at the picture of this man,” said the reporter. “There’s obviously concern he’s some kind of predator.”

Except he isn’t.

What he is, unfortunately, is a marked man. Tried and convicted in the courts of the internet and public communications. The cops identified him, went to his house, determined there was no danger (he was “unguarded, cooperative and surprised at being the subject of a police investigation”) and that the poor guy was doing nothing but exercises in the park. The blog and the TV people took down his photo, but you have to wonder if the original mom apologized, or if he will feel very welcome in the park now.

A somewhat different go-after-the-bad-guys story was reported today by New York Times writer Dan Frosch, this one about Justin Kurtz, a hapless Kalamazoo, Michigan college student whose properly parked car was towed from its parking lot and it cost him $118 to get it back. Anyone who’s ever had a car towed can identify with the rage that then prompted Kurtz to start a Facebook page called “Kalamazoo Residents against T&J Towing.” But after 800 people signed up in sympathetic outrage, T&J filed a defamation suit seeking $75,000 in damages. I’m rooting for Justin and his friends (having been towed under less-than-happy circumstances myself), but the whole business will likely end up costing another unnecessary load of pain and anguish — and possibly, more than $118.

The question is, how far are we ready to trust cyberspace? In the case of the Mountain Lake Park non-pervert, the hysteria continued despite fast action by the cops.

People trusted the social network far more than they did the seasoned and reputationally impressive police captain. “After 30 years on the force,” he says, “it’s hard to accept that people believe Internet chatter more than they do reaching me on the phone.”

In this case, social media was not a new and improved town crier. Instead, the hysterical tendencies that understandably surround kids’ security led to what Correia called “long e-mails of inference and innuendo like the opening act of ‘The Crucible,”’ Arthur Miller’s play about witch hunts.

As a friend of mine with kids who lives near Mountain Lake Park and got copies of the e-mail from multiple people noted, “It’s often easier to share than to deliberate. Were we deputized, or just weaponized?”

In the emerging world, you can think you’re a citizen journalist, but you’re really a citizen cop. And in the Mountain Lake Park case, people also became citizen prosecutor, judge and jury.

Viral campaigns are hard to undo, but maybe we should try. What if T&J were to return their ill-gotten $118, enabling Justin to create a new Facebook page about what a fine business they are? Their tarnished reputation could then be restored to its former glory, if towing companies have glory, for a pittance.

With the non-pervert, it’s not that simple. But maybe the over-zealous mom will take the trouble to contact him and apologize. It would be a start, although I’m not holding my breath. If I see him, however, I’m apt to be extra kind and pleasant, and then people will probably talk. As long as they don’t put us on Facebook.

‘Pervert’ in the park isn’t what he seems.

California/Health/New York/seniors/Women

May 24, 2010

Illness, loss and words of comfort

by Fran Johns

New York Times Personal Health writer Jane Brody last week noted another chapter in the wrenching drama she has shared with readers, first with the cancer diagnosis of her husband, lyricist Richard Engquist, and later following his death on March 18. In the new essay Brody tells of condolences received from friends and strangers. The writing, she says, has been therapeutic.

But one piece of therapy I never expected was the feedback from readers, friends and acquaintances: many hundreds of condolence letters, e-mail messages and comments on The New York Times’s Well blog.

Whether in a card, note, letter, phone message, hug or pat on the shoulder, some people seem to know instinctively how to show they care and will remember the deceased. What stands out most in these messages is their deeply personal quality. People who knew my husband in various walks of life (especially his advocacy for his beloved Prospect Park and his career as a writer for the musical theater) saw him in ways that had escaped me, because I was too close to have their perspective. By sharing these details, they have rounded out my memories of a life shared and separate from his — memories I will cherish for the rest of my life.

Brody gives examples of the many messages about her husband that brought comfort, and offers thanks for the fact that those unwanted messages — “Surely you’ll meet someone else;” “I know how you feel, my dog died last year” — had not arrived.

There’s one thing often of great comfort to someone who’s suffered a loss that Brody doesn’t include and that doesn’t occur to everyone. It’s the reminder of what the survivor meant to the now-deceased, one of the easiest ways to write a quick, meaningful condolence note. I learned it many years ago from someone I never met. Her Army officer brother, to whom I’d been pinned (an emblem of commitment in those olden days; I’ve no idea if such customs still exist) was killed in Korea. I could not travel across the country for the funeral, all of the sympathy and support was rightfully going to his family, but I felt bereft and unconsoled. Then I got a two-line note. “Dave said you could always make him smile,” she wrote; “and that will always make us smile.”

Thoughtful people have reinforced the knowledge of how much such a thought can mean. “Your mother was so proud of you because —.” Happily, in this fast-moving world the snail-mail sympathy note seems to survive. And I suppose even the e-mail condolence is better than nothing. If you’re stumped for a note you could be writing, try it this way.

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