Syria President Bashar Assad makes clear he won't step down









BEIRUT — Ignoring mounting casualties and dwindling support, Syrian President Bashar Assad made clear to the world Sunday in his first public address in half a year that he has no intention of relinquishing power and that he, not anyone else, would dictate the end for Syria's 21-month-old civil war.


Assad unveiled his own peace plan, with cosmetic similarities to a settlement proposal championed by internationally sponsored peace envoy Lakhdar Brahimi, but he declared he had no partner for negotiations in the Syrian opposition, whom he continued to brand as killers and terrorists.


Assad's dismissive attitude and strict terms for settlement offered little hope for a diplomatic breakthrough. It was a reminder of how intractable the conflict has become, with the U.N. estimating last week that more than 60,000 people had died.





Syria's cities are scenes of carnage, with rebels and government security forces battling across provinces and major cities from Aleppo to Idlib to Damascus, the capital. Opposition forces, which the West has not agreed to arm, have not proved strong enough to exhaust Assad, but neither has the autocratic 12-year leader been able to stamp them out.


Assad, like Brahimi, called for a new cease-fire, reconciliation talks and some form of transitional government. But Assad sketched out a far more complicated vision, beginning with a dialogue with the opposition leading to a new national charter, approved by a referendum. That would be followed by an expanded government, including those in the talks, that would oversee the drafting of a constitution. The charter would also be approved by a national referendum, and then national elections would be held.


And where Brahimi has pushed for meaningful compromise between the rebels and the president, Assad continued to insist that all groups play according to his terms.


He put the onus on rebels for an end to fighting, announcing that his troops would honor a cease-fire only after the opposition stopped fighting and foreign countries stopped funding them, in what amounted to a swipe at Persian Gulf countries, Turkey and Western nations. His plan also appeared to go against the grain of Brahimi's call for both sides to put down their arms. By Sunday evening, Brahimi's office had no comment on Assad's address.


The international community, including Russia, the United States and regional players like Turkey, has endorsed the Brahimi plan's broad contours. But Russia and the West have clashed over Assad's future. Washington has insisted Assad must go, while Moscow has not, at least at this point, abandoned him, a stance also held by Iran, Syria's closest regional ally.


Assad, speaking at Damascus' Opera House, dismissed the opposition as "slaves" to the West, playing on the image of a deeply dysfunctional group including exiles with little influence in Syria and Al Nusra Front, an Al Qaeda-affiliated organization that has become the most feared and valued fighting force among the rebels and their umbrella Free Syrian Army.


The speech was similar to his past promises of reform that have proved jarringly empty. In February, in the midst of the civil conflict, Assad called for and won passage of a new constitution, which he said enshrined freedom of speech and multiparty elections. Months earlier, he had repealed a decades-old emergency law. But in real time, his security forces continued to detain opponents, shell neighborhoods and besiege cities.


On Sunday, standing somberly in front of a photo collage of people who reportedly have been killed in the civil warfare, Assad presented himself as a Syrian patriot, the only one capable of holding the nation together. Supporters packing the theater pumped their fists and yelled, "God, Bashar and our army." He basked in the adulation and at times waved to the crowd.


Even with the death toll soaring and the territory under his control plummeting, Assad appeared to cling to the hope that those Syrians who have grown weary of the unrelenting conflict and the rise of radical Islamists would turn to him.


"We chose the political option from the beginning through its primary way, dialogue. We chose this to move Syria forward. But with whom are we talking? With extremists who only believe in the language of killing and terrorism?" Assad said.


Assad also papered over his government's hard-nosed tactics of airstrikes, artillery shelling and detention of opposition suspects, calling them a necessity for the nation's defense.


"They call it a revolution when it has no relationship to a revolution. A revolution needs intellectuals and is based on thought. Where is the thinker?" Assad said. "The revolution is usually that of the people, not of those who are imported to revolt against the people. It is a revolution against the interests of the people, so by God, are these revolutionaries?"


Opposition leaders swiftly slammed Assad's proposals. "For us as people on the ground, the situation hasn't changed, and during his speech 20 people died," activist Amer Shami said from Damascus by Skype.


But Assad's speech appeared aimed at a terrified Syrian population no longer certain of whom it should support and fearful their country could splinter. The days of spring 2011, when peaceful protesters called for government reform was long ago eclipsed by an armed insurgency, and Assad appears to bet even some in the opposition could be persuaded to return to his fold.


"Roughly speaking about 30% of Syrians want to hang Assad, another 30% support him, and then there are another 30% who long for peace and security and want to get on with their lives and are increasingly worried with how the rebels are behaving," said Syria expert Patrick Seale, author of the definitive biography of the current leader's father and predecessor as president, Hafez Assad.


"A good slice of the opposition will hate his speech and say they need to continue fighting, but it may plant doubt in the minds of some, that they will have to go to negotiations with Assad," Seale said.


One Syrian activist said the rebel movement has veered so far into Islamist ideology that by contrast Assad sounds almost moderate. "Assad's speech sounds more like the national voice, the one worried about the country from intervention and Islamization. For any neutral listener, his speech will sound 'right' compared to the opposition," said the activist, who goes by the name Nadja, in a Skype interview.


"He is talking about fighting against Islamists, Afghanis and Chechens and Libyans and so on," Nadja said. "I wouldn't want him to make peace with terrorists because I don't want the country to fall in their hands. But I don't want him to stay in power either. He killed so many people."


Even if Assad does seek to carry out his peace plan, it is hard to believe he is capable of success. He has consistently failed to follow through on his reform efforts, and at times has seemed beholden to the different interests in his government, from the security apparatus to family, who have lacked any enthusiasm for reform.


"Assad is only the front man for the institutions of the country, the security apparatus, the [Baath] party and minorities," Seale said. "It is not a one-man show."


ned.parker@latimes.com


Special correspondents Nabih Bulos and Alaa Hassan in Beirut contributed to this report.





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Analysts predicting slow start for ‘ultra-HD’ TVs






LAS VEGAS (AP) — Ultra high definition TVs are set to be the talk of International CES, the gadget show kicking off this week, but they aren’t likely to account for much of the market even four years down the road.


That is the conclusion of analysts of the show’s host, a day before TV makers such as Samsung, LG and Sony attempt to wow conference attendees with their latest models.






Ultra-HD TVs, with four times as many pixels as HD TVs, are expected to account for only 1.4 million units sold in the U.S. in 2016, or about 5 percent of the entire market. Sales in the rest of the world are expected to be smaller.


The analysts blamed high prices and low availability for the slow start.


Gadgets News Headlines – Yahoo! News





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NBC execs say it's not a 'shoot-'em-up' network


PASADENA, Calif. (AP) — NBC executives said Sunday they are conscious about the amount of violence they air in the wake of real-life tragedies like the Connecticut school shooting, but have made no changes in what has gone on the air or what is planned.


NBC isn't a "shoot-'em-up" network, said network entertainment President Jennifer Salke.


The level of violence on television, in movies and video games has been looked at as a contributing factor — along with the availability of guns and a lack of mental health services — in incidents such as the Dec. 14 attack in a Newtown, Conn., school where 20 first-graders and six educators were killed.


Like many in Hollywood, NBC questioned a link between what is put on the air and what is happening in society.


"It weighs on all of us," said NBC Entertainment Chairman Robert Greenblatt. "Most of the people at this network have children and really care about the shows that we're putting out there. It's always something that's been on our mind but this brought it to the forefront."


NBC hasn't needed to take any tangible steps like minimizing violence in its programming or deemphasizing guns, Salke said, because NBC didn't have much violence on the air. It might be different "if we were the 'shoot-'em-up' network, she said.


She didn't name such a network, but said violence might be an issue on a network that airs many crime procedural shows. That's a staple of CBS' lineup. Greenblatt, who was head of Showtime when the "Dexter" series about a serial killer was developed, said CBS' "Criminal Minds" is "worse than 'Dexter' ever was."


Within an hour after both executives spoke, NBC showed reporters at a news conference highlights of its show "Revolution" that included a swordfight, a standoff between two men with guns, a bloodied man, a building blown up with a flying body and a gunfight.


Later clips of the upcoming series "Deception" featured several shots of a bloodied, dead body.


NBC also is developing a drama, "Hannibal," based on one of fiction's most indelible serial killers, Hannibal Lecter. An airtime for the show hasn't been scheduled, but it could come this spring or summer.


Salke said there is more violence in Fox's upcoming drama "The Following," also about a serial killer, than there will be in "Hannibal." Much of the violence in the upcoming NBC show, created by former "Heroes" producer Bryan Fuller, is implied and not gratuitous.


"We respect the talent and like what he is doing, so we are standing behind him," Salke said. She said there's been a spate of programs about creepy killers because they've been such indelible characters.


Greenblatt said he wasn't trying to be glib, but one of the best tonics for people upset about real-life violence is to watch an episode of NBC's "Parenthood." He said it's a great example of a family that loves each other and grapples with many issues.


"Ultimately, I think you feel good at the end of the day," he said.


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Drug-Testing Company Tied to N.C.A.A. Draws Criticism





KANSAS CITY, Mo. — A wall in one of the conference rooms at the National Center for Drug Free Sport displays magazine covers, each capturing a moment in the inglorious history of doping scandals in sports.







Steve Hebert for The New York Times

The National Center for Drug Free Sport, in Kansas City, Mo., tries to deter doping with programs for high school, college and professional leagues.








Monica Almeida/The New York Times

Don Catlin, formerly of U.C.L.A.’s Olympic Analytical Lab, has raised questions about drug testing at colleges.






The images show Ben Johnson, the sprinter who lost his 1988 Olympic gold medal after testing positive; and Barry Bonds, the tarnished home run king; and Lyle Alzado, one of the first pro football players to admit to steroid use.


“People always assume that it’s the athletes at the top of their sport or the top of their game that are using,” said Frank Uryasz, Drug Free Sport’s founder and president. “But I can assure you that’s not the case. There’s always that desire to be the best, to win. That permeates all level of sport — abuse where you just wouldn’t expect it.”


Over the past quarter-century, athletes like Johnson, Bonds and Alzado stirred widespread concern about doping in sports.


Professional leagues without drug-testing programs have put them in; leagues with drug-testing programs have strengthened them. Congress and medical experts have called on sports officials at all levels to treat doping like a scourge.


It was in this budding American culture of doping awareness that Uryasz found a niche business model. He has spent the past decade selling his company’s services to the country’s sports officials.


The company advises leagues and teams on what their testing protocols should look like — everything from what drugs to test for to how often athletes will be tested to what happens to the specimens after testing. It also handles the collection and testing of urine samples, often with the help of subcontractors.


Drug Free Sport provides drug-testing programs for high school, college and professional leagues.


A privately held company with fewer than 30 full-time employees, it counts among its clients Major League Baseball, the N.F.L., the N.B.A., the N.C.A.A. and about 300 individual college programs.


Many, if not all, of the players on the field Monday night for the Bowl Championship Series title game between Alabama and Notre Dame have participated in a drug-testing program engineered by Drug Free Sport.


Uryasz says his company’s programs provide substantial deterrents for athletes who might consider doping.


Critics, however, question how rigorous the company’s programs are. They say Drug Free Sport often fails to adhere to tenets of serious drug testing, like random, unannounced tests; collection of samples by trained, independent officials; and testing for a comprehensive list of recreational and performance-enhancing drugs.


The critics, pointing to a low rate of positive tests, question Drug Free Sport’s effectiveness at catching athletes who cheat. Since the company began running the N.C.A.A.’s drug-testing program in 1999, for example, the rate of positive tests has been no higher than 1 percent in any year — despite an N.C.A.A. survey of student-athletes that indicated at least 1 in 5 used marijuana, a banned substance. (The N.C.A.A. tests for marijuana at championship competitions but not in its year-round program.)


Uryasz said the rate of positive tests was not meaningful. “I don’t spend a lot of time on the percent positive as being an indicator of very much,” he said.


Independent doping experts contend that having a contract with Drug Free Sport allows sports officials to say they take testing seriously without enacting a truly stringent program.


Don Catlin, the former head of U.C.L.A.’s Olympic Analytical Lab, best known for breaking the Bay Area Laboratory Co-operative doping ring, oversaw the testing of many of Drug Free Sport’s urine samples when he was at U.C.L.A. He said the work by Drug Free Sport and similar companies could be used to mislead fans.


“The problem with these schools is they all want to say they’re doing drug testing, but they’re not really doing anything I would call drug testing,” he said.


A Company’s Origins


Uryasz said he became interested in working with student-athletes while tutoring them as an undergraduate at Nebraska. After he graduated, he earned an M.B.A. from Nebraska and worked in health care administration in Omaha. He said he heard about an opening at the N.C.A.A. through a friend.


Driven in part by scandals in professional sports, the N.C.A.A. voted at its 1986 annual convention to start a drug-testing program.


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'Texas Chainsaw 3D' is strong No. 1; 'Promised Land' disappoints









"Texas Chainsaw 3D" easily sliced through the competition at the box office this weekend — not that its rivals were particularly threatening.


As the only new film to hit theaters nationwide, the reboot of the 1974 horror flick only had to contend with a handful of movies that have been out for weeks. Still, the low-budget movie did better than expected, collecting a robust $23 million during its opening weekend, according to an estimate from distributor Lionsgate.


Heading into the weekend, pre-release audience polling suggested that "The Hobbit: An Unexpected Journey" would claim No. 1 for the fourth consecutive weekend, while "Chainsaw" looked poised to finish second with around $16 million. Instead, Peter Jackson's film grossed $17.5 million, raising its domestic total to $263.8 million.





PHOTOS: All-time box office leaders


Meanwhile, both "Django Unchained" and "Les Misérables crossed the $100-million milestone. Since being released on Christmas Day, Quentin Tarantino's film has sold $106.4 million, while the film version of the Broadway musical is up to $103.6 million. The continued performance of the movies helped to start the year off on a positive note, as ticket sales were up 7% compared with the same weekend in 2012.


"Texas Chainsaw 3D" is the sixth film to feature the villain Leatherface since the original horror film was released almost four decades ago. The new movie posted the second-highest opening of any "Chainsaw" film — not adjusting for inflation — behind 2003's "The Texas Chainsaw Massacre," the Jessica Biel film which ultimately sold a strong $80.6 million.


Financed by Avi Lerner's Millennium Pictures for about $20 million, "Texas Chainsaw 3D" is being distributed by Lionsgate. The movie — which has notched only a 23% fresh rating on the review aggregation site Rotten Tomatoes — received an average grade of C+ from opening-weekend moviegoers, according to market research firm CinemaScore. However, horror films often receive poor CinemaScores and still go on to do good business at the box office.


The film attracted a young audience, 64% of whom were under the age of 25. Of those in that age group, 1 out of 3 said the main reason they showed up to see the film was because the musical artist Trey Songz had a role in it. "Chainsaw" is the first film the 28-year-old Grammy nominee has starred in, and he has been heavily promoting the picture to his 5.6-million Twitter followers in recent weeks.


PHOTOS: Horror movie locations around Los Angeles


Also this weekend, the Matt Damon-John Krasinski collaboration "Promised Land" got off to a bad start. The environmental picture, which was co-written by and stars the actors, expanded from 25 theaters to 1,676 locations but brought in a lackluster $4.3 million.


The Focus Features production about a town with natural gas reserves only cost the studio and co-financier Participant Media about $15 million to produce. But with middling reviews and a B CinemaScore, it's a long shot that the film will end up being a hit even given its modest budget.


Another film that expanded this weekend was "The Impossible," the $40-million production about a family in the aftermath of the 2004 Thailand tsunami. Playing in 572 locations, the Summit Entertainment release collected a so-so $2.8 million. However, the picture is faring far better overseas. Already a hit in Spain, where its filmmaker hails from, the movie debuted in the United Kingdom this weekend and grossed $6.4 million. Overall, the movie has grossed $81.2 million abroad and $3.4 million in the U.S. and Canada.



ALSO:


The wizardry behind "The Impossible's" tsunami


'Texas Chainsaw 3D' to get nicked by 'Hobbit' at the box office


"Texas Chainsaw 3D" director: Leatherface abused, stunted, lethal






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Venezuela contemplates next move with Hugo Chavez absent









CARACAS, Venezuela — The nerves of Venezuelans are sure to be tested in the coming week as the country seeks answers not only to the mystery of President Hugo Chavez's medical condition and prognosis but also to the debate over constitutional requirements should he be unable to take the oath of office Thursday to start a fourth term.


On Saturday, Chavez confidant and former army comrade Diosdado Cabello was reelected as National Assembly president, a key position that would make him the leader in any process to call a new election to replace Chavez if the fiery socialist dies or is deemed "permanently incapacitated."


Chavez has not been seen or heard from since he left Venezuela in early December for Cuba, where he underwent his fourth surgery to treat pelvic cancer. In sporadic and thinly detailed medical updates, officials have said he has encountered postoperative problems, including "respiratory insufficiency," that have dimmed his chances of being present for his inauguration.





After being reelected to his assembly post by his fellow lawmakers, Cabello said Chavez did not need to be sworn in Thursday to retain his presidential powers because he has permission from the National Assembly to be absent from the country.


"If Chavez isn't here by Jan. 10, the constitution establishes that he can be sworn in before the Supreme Court, although it doesn't specify how or when," Cabello said. "The president received unanimous permission from the assembly to be absent, and that is still in effect."


Constitutional law expert Carlos Ayala agreed that Chavez can be granted two oath-taking postponements for a total of 180 days in the event he is "temporarily incapacitated." But he said Venezuelans are entitled to proof that Chavez is alive, is tending to his duties and has a positive prognosis.


"The citizenry has a legitimate right to know the facts surrounding the mental and physical condition of the head of state," said Ayala, a professor at Andres Bello Catholic University in Caracas. "If he cannot exercise his duties and obligations under the constitution, then that leads to constitutional consequences."


If Chavez is so ill that he cannot competently carry out his duties, then he could be declared "permanently incapacitated." That would trigger a constitutional requirement for the National Assembly president to call a new presidential election within 30 days, Ayala said.


On Friday, Vice President Nicolas Maduro — whom Chavez has designated as his political heir and preferred successor — said the 58-year-old president was "resting and recuperating" and emerging from what he previously said was a "delicate postoperative phase."


But other pronouncements have been less positive. Communications and Information Minister Ernesto Villegas said last week that Chavez was experiencing "respiratory insufficiency," raising the possibility that Chavez is on a respirator or even comatose.


Luis Salamanca, a constitutional law expert at Central University of Venezuela, said "reading between the lines" of official announcements "verifies that things are getting worse."


Political consultant and commentator Ricardo Sucre said the Chavez government seems to be trying to frame the oath-taking as a "mere formality." If that interpretation is accepted, it would enable the government to defer the constitutional requirement to clarify the president's condition and, in a worst-case scenario, to avoid starting the wheels turning for a new presidential election.


Some opposition figures are openly questioning why the Chavez government has not decided to seek a postponement of the swearing-in under a "temporary incapacitation" provision if, in fact, Chavez's prognosis is one of recovery and not imminent death.


If Chavez is deathly ill, his successors will try to "draw out the process as long as possible to consolidate their power and take advantage of Chavez's image to better appropriate it for themselves," Sucre said.


Although Chavez won reelection in October in convincing fashion against opposition candidate Henrique Capriles, the chances of success in another election against Capriles are much less certain for any Chavez successor, including Maduro or Cabello.


Miguel Tinker Salas, a professor at Pomona College, said opposition politicians should be careful not to create the impression that they are trying to gain power "on the possible disability or death of the leader they were unable to defeat in life."


"There is no harm in letting the process unfold and waiting to see if Chavez regains his health or not," Tinker Salas said. "The people of Venezuela freely elected Chavez in October 2012, and their decision on this matter should be respected."


Special correspondents Kraul reported from Bogota, Colombia, and Mogollon from Caracas.





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We Salute the First Baby Senator






We realize there’s only so much time one can spend in a day watching new trailers, viral video clips, and shaky cell phone footage of people arguing on live television. This is why every day The Atlantic Wire highlights the videos that truly earn your five minutes (or less) of attention. Today:


RELATED: Claire McCaskill and How to Attack the Opponent You’re Rooting For






Here’s our suggestion to improve the (already pretty hilarious) swearing-in process for U.S. Senators: Each new member of Congress must bring a cute baby.


RELATED: Rand Paul Doesn’t Want You to Go to Jail for Smoking Pot


RELATED: Larry David’s Two-Minute Guide to Etiquette


Apparently the BBC has decided to market a line of lunch boxes specifically made for hungry polar bears. They are still working out the kinks: 


RELATED: Homer Simpson, Fox News Pundit; Books After Dark


RELATED: Bo Obama Stays On Message; Sarah Palin Can See HBO in Her House


The Golden Globes will be bittersweet this year. Don’t get us wrong — we’re really excited to watch Amy Poehler and Tina Fey entertain us. But we’ll also be also really sad when this thing is over because it means the end of these promos:


And finally, it’s Friday. And it’s time to dance. Enjoy your weekend. 


Wireless News Headlines – Yahoo! News





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Poet-performer Jayne Cortez dies in NY at age 78


NEW YORK (AP) — Jayne Cortez, a forceful poet, activist and performance artist who blended oral and written traditions into numerous books and musical recordings, has died. She was 78.


The Organization of Women Writers of Africa says Cortez died of heart failure in New York on Dec. 28. She had helped found the group and, while dividing her time between homes in New York and Senegal, was planning a symposium of women writers to be held in Ghana in May.


Cortez was a prominent figure in the black arts movement of the 1960s and '70s that advocated art as a vehicle for political protest. She cited her experiences trying to register black voters in Mississippi in the early '60s as a key influence.


A native of Fort Huachuca, Ariz., she was raised in the Watts section of Los Angeles. She loved jazz since childhood and would listen to her parents' record collection. Musicians including trumpeter Don Cherry would visit her home and through them she met her first husband, Ornette Coleman, one of the world's greatest jazz artists. They were married from 1954 to 1964.


Her books included "Scarifications" and "Mouth On Paper," and she recorded often with her band the Firespitters, chanting indictments of racism, sexism and capitalism. Its members included her son, drummer Denardo Coleman, and several other members of Ornette Coleman's electronic Prime Time band, guitarist Bern Nix and bassist Al McDowell.


Cortez, who described herself as a "jazz poet," performed all over the world and her work was translated into 28 languages. At the time of her death, she was living with her second husband, the sculptor Melvin Edwards.


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The New Old Age: Murray Span, 1922-2012

One consequence of our elders’ extended lifespans is that we half expect them to keep chugging along forever. My father, a busy yoga practitioner and blackjack player, celebrated his 90th birthday in September in reasonably good health.

So when I had the sad task of letting people know that Murray Span died on Dec. 8, after just a few days’ illness, the primary response was disbelief. “No! I just talked to him Tuesday! He was fine!”

And he was. We’d gone out for lunch on Saturday, our usual routine, and he demolished a whole stack of blueberry pancakes.

But on Wednesday, he called to say he had bad abdominal pain and had hardly slept. The nurses at his facility were on the case; his geriatrician prescribed a clear liquid diet.

Like many in his generation, my dad tended towards stoicism. When he said, the following morning, “the pain is terrible,” that meant agony. I drove over.

His doctor shared our preference for conservative treatment. For patients at advanced ages, hospitals and emergency rooms can become perilous places. My dad had come through a July heart attack in good shape, but he had also signed a do-not-resuscitate order. He saw evidence all around him that eventually the body fails and life can become a torturous series of health crises and hospitalizations from which one never truly rebounds.

So over the next two days we tried to relieve his pain at home. He had abdominal x-rays that showed some kind of obstruction. He tried laxatives and enemas and Tylenol, to no effect. He couldn’t sleep.

On Friday, we agreed to go to the emergency room for a CT scan. Maybe, I thought, there’s a simple fix, even for a 90-year-old with diabetes and heart disease. But I carried his advance directives in my bag, because you never know.

When it is someone else’s narrative, it’s easier to see where things go off the rails, where a loving family authorizes procedures whose risks outweigh their benefits.

But when it’s your father groaning on the gurney, the conveyor belt of contemporary medicine can sweep you along, one incremental decision at a time.

All I wanted was for him to stop hurting, so it seemed reasonable to permit an IV for hydration and pain relief and a thin oxygen tube tucked beneath his nose.

Then, after Dad drank the first of two big containers of contrast liquid needed for his scan, his breathing grew phlegmy and labored. His geriatrician arrived and urged the insertion of a nasogastric tube to suck out all the liquid Dad had just downed.

His blood oxygen levels dropped, so there were soon two doctors and two nurses suctioning his throat until he gagged and fastening an oxygen mask over his nose and mouth.

At one point, I looked at my poor father, still in pain despite all the apparatus, and thought, “This is what suffering looks like.” I despaired, convinced I had failed in my most basic responsibility.

“I’m just so tired,” Dad told me, more than once. “There are too many things going wrong.”

Let me abridge this long story. The scan showed evidence of a perforation of some sort, among other abnormalities. A chest X-ray indicated pneumonia in both lungs. I spoke with Dad’s doctor, with the E.R. doc, with a friend who is a prominent geriatrician.

These are always profound decisions, and I’m sure that, given the number of unknowns, other people might have made other choices. Fortunately, I didn’t have to decide; I could ask my still-lucid father.

I leaned close to his good ear, the one with the hearing aid, and told him about the pneumonia, about the second CT scan the radiologist wanted, about antibiotics. “Or, we can stop all this and go home and call hospice,” I said.

He had seen my daughter earlier that day (and asked her about the hockey strike), and my sister and her son were en route. The important hands had been clasped, or soon would be.

He knew what hospice meant; its nurses and aides helped us care for my mother as she died. “Call hospice,” he said. We tiffed a bit about whether to have hospice care in his apartment or mine. I told his doctors we wanted comfort care only.

As in a film run backwards, the tubes came out, the oxygen mask came off. Then we settled in for a night in a hospital room while I called hospices — and a handyman to move the furniture out of my dining room, so I could install his hospital bed there.

In between, I assured my father that I was there, that we were taking care of him, that he didn’t have to worry. For the first few hours after the morphine began, finally seeming to ease his pain, he could respond, “OK.” Then, he couldn’t.

The next morning, as I awaited the hospital case manager to arrange the hospice transfer, my father stopped breathing.

We held his funeral at the South Jersey synagogue where he’d had his belated bar mitzvah at age 88, and buried him next to my mother in a small Jewish cemetery in the countryside. I’d written a fair amount about him here, so I thought readers might want to know.

We weren’t ready, if anyone ever really is, but in our sorrow, my sister and I recite this mantra: 90 good years, four bad days. That’s a ratio any of us might choose.


Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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Vast cache of Kaiser patient details was kept in private home









Federal and state officials are investigating whether healthcare giant Kaiser Permanente violated patient privacy in its work with an Indio couple who stored nearly 300,000 confidential hospital records for the company.


The California Department of Public Health has already determined that Kaiser "failed to safeguard all patients' medical records" at one Southern California hospital by giving files to Stephan and Liza Dean for about seven months without a contract. The couple's document storage firm kept those patient records at a warehouse in Indio that they shared with another man's party rental business and his Ford Mustang until 2010.


Until this week, the Deans also had emails from Kaiser and other files listing thousands of patients' names, Social Security numbers, dates of birth and treatment information stored on their home computers.





The state agency said it was awaiting more information from Kaiser on its "plan of correction" before considering any penalties.


Officials at the U.S. Department of Health and Human Services began looking into Kaiser's conduct last year after receiving a complaint from the Deans about the healthcare provider's handling of patient data, letters from the agency show. Kaiser said it hadn't been contacted by federal regulators, and a Health and Human Services spokesman declined to comment.


Kaiser said it remained confident that this patient information was never disclosed or accessed inappropriately. It said that some employees were disciplined because company policies were not followed and that it had informed regulators of the steps it had taken to ensure this type of incident didn't happen again.


"Kaiser Permanente is committed to protecting the medical and personal privacy of its patients," spokesman John Nelson said. "In retrospect, we certainly wish we'd never done business with Mr. Dean."


Even with tougher government oversight of medical privacy in recent years, this case underscores how confidential patient information remains vulnerable in the hands of big healthcare institutions and legions of outside contractors.


"Kaiser has shown extraordinary recklessness in this situation," said Beth Givens, director of the Privacy Rights Clearinghouse in San Diego. "Healthcare companies have to make sure their contractors adhere to ironclad security practices."


Federal and state laws impose strict standards on anyone dealing with patient information. The privacy rule of the federal Health Insurance Portability and Accountability Act, known as HIPAA, bans the unauthorized disclosure of individuals' medical records and requires healthcare providers and vendors, such as billing and storage companies, to protect the information.


Despite those rules, personal medical information of 21 million people nationwide has been improperly exposed since 2009, according to federal data. Last year, Blue Cross Blue Shield of Tennessee agreed to pay $1.5 million to resolve allegations it violated federal law after 57 computer hard drives with patient information were stolen from an outside facility.


In October, Kaiser sued the Deans in Riverside County Superior Court, accusing them of violating their contract by not returning all of its patient information two years ago when Kaiser picked up the paper records.


In court filings, Kaiser said the Deans put patient data at risk by leaving two computer hard drives in their garage with the door open. In response, Stephan Dean moved them to a spare room. On a recent day they sat next to a red recliner where Ziggy, the family's black-and-white cat, curled up for a nap. Dean said those hard drives contained spreadsheets on thousands of Kaiser patients, prepared at the company's request.


At one point, Dean told Kaiser he was planning to contact patients about the whereabouts of their medical information because he felt Kaiser hadn't taken proper precautions. The company sought a temporary restraining order against Dean, barring him from disclosing any confidential information. A Superior Court judge granted Kaiser's request until Thursday, when another hearing is scheduled.


Dean, 47, got his foot in the door at Kaiser from his previous work labeling paper folders for courthouses, hospitals and doctors.


But the demand for folders was slipping as hospitals and doctors used computers more. Kaiser was at the forefront of this as it invested billions of dollars in its HealthConnect system, which it bills as the largest private-sector electronic health record in the world. Kaiser, with more than 9 million customers, is the nation's largest nonprofit insurer and hospital system.


Dean said his small business, Sure File Filing Systems, got a big break when Kaiser acquired the Moreno Valley Community Hospital in 2008. The company needed to organize and clear out thousands of old patient files and it gave the job to the Deans, Kaiser records show.


In August 2008, the Deans started packing up thousands of files from Moreno Valley and moving them to the warehouse in Indio.


Hospital clerks routinely messaged Dean asking him to pull records on specific patients, emails sent by Kaiser to Sure File show. Dean said some Kaiser employees would put the patient's full name in the subject line of the email, and other messages listed the patient's Social Security number, date of birth, doctors' names and treatment dates. One message started, "Good Morning Sure File," and requested adoption records for a child.


Dean said Kaiser showed little concern for patient privacy in handling those requests. Only one out of more than 600 emails from Kaiser was password-protected with encryption, he said. Many medical providers use such technology so information isn't visible to others.





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