Rescuer Appears for New York Downtown Hospital





Manhattan’s only remaining hospital south of 14th Street, New York Downtown, has found a white knight willing to take over its debt and return it to good health, hospital officials said Monday.




NewYork-Presbyterian Hospital, one of New York City’s largest academic medical centers, has proposed to take over New York Downtown in a “certificate of need” filed with the State Health Department. The three-page proposal argues that though New York Downtown is projected to have a significant operating loss in 2013, it is vital to Lower Manhattan, including Wall Street, Chinatown and the Lower East Side, especially since the closing of St. Vincent’s Hospital after it declared bankruptcy in 2010.


The rescue proposal, which would need the Health Department’s approval, comes at a precarious time for hospitals in the city. Long Island College Hospital, just across the river in Cobble Hill, Brooklyn, has been threatened with closing after a failed merger with SUNY Downstate Medical Center, and several other Brooklyn hospitals are considering mergers to stem losses.


New York Downtown has been affiliated with the NewYork-Presbyterian health care system while maintaining separate operations.


“We are looking forward to having them become a sixth campus so the people in that community can continue to have a community hospital that continues to serve them,” Myrna Manners, a spokeswoman for NewYork-Presbyterian, said.


Fred Winters, a spokesman for New York Downtown, declined to comment.


Presbyterian’s proposal emphasized that it would acquire New York Downtown’s debt at no cost to the state, a critical point at a time when the state has shown little interest in bailing out failing hospitals.


The proposal said that if New York Downtown were to close, it would leave more than 300,000 residents of Lower Manhattan, including the financial district, Greenwich Village, SoHo, the Lower East Side and Chinatown, without a community hospital. In addition, it said, 750,000 people work and visit in the area every day, a number that is expected to grow with the construction of 1 World Trade Center and related buildings.


The proposal argues that New York Downtown is essential partly because of its long history of responding to disasters in the city. One of its predecessors was founded as a direct result of the 1920 terrorist bombing outside the J. P. Morgan Building, and the hospital has responded to the 1975 bombing of Fraunces Tavern, the 1993 and 2001 attacks on the World Trade Center, and, this month, the crash of a commuter ferry from New Jersey.


Like other fragile hospitals in the city, New York Downtown has shrunk, going to 180 beds, down from the 254 beds it was certified for in 2006, partly because the more affluent residents of Lower Manhattan often go to bigger hospitals for elective care.


The proposal says that half of the emergency department patients at New York Downtown either are on Medicaid, the program for the poor, or are uninsured.


NewYork-Presbyterian would absorb the cost of the hospital’s maternity and neonatal intensive care units, which have been expanding because of demand, but have been operating at a deficit of more than $1 million a year, the proposal said.


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DealBook Column: Mary Jo White, Nominee for S.E.C.'s 'New Sherrif,' Has Worn Banks' Hat

“You don’t want to mess with Mary Jo.”

That’s what President Obama said about his pick to run the Securities and Exchange Commission, Mary Jo White. The nomination of Ms. White, a former prosecutor who took on the terrorists behind the bombing of the World Trade Center in 1993 and the Mafia boss John Gotti, was meant to signal that the S.E.C. would be getting tough on Wall Street. CBS called her “Wall Street’s new sheriff.” The Wall Street Journal said she would be “putting a tougher face on an agency still tainted by embarrassing enforcement missteps in the run-up to the financial crisis.” The New York Times said her appointment represented a “renewed resolve to hold Wall Street accountable.”

Hold on.

While Ms. White is a decorated prosecutor, she has spent the last decade vigorously defending — and billing by the hour — Wall Street’s biggest banks, as a rainmaking partner at the white-shoe law firm Debevoise & Plimpton. The average partner at the firm was paid $2.1 million a year, according to American Lawyer; but she was no average partner, very likely being paid at least double that. Her husband, John W. White, is a corporate partner at Cravath, Swaine & Moore. He counts JPMorgan Chase, Credit Suisse and UBS as clients. The average partner at Cravath makes $3.1 million. He, too, was a former official at the S.E.C. — he left Cravath to run the corporate division of the S.E.C. starting in 2006 just in time for the run-up to the financial crisis. He left in November 2008, a month after the bank bailouts, to return to Cravath.

It seems Mr. and Ms. White have made a fine art of the revolving door between government and private practice.

So how conflicted is Ms. White? Let’s count the ways.

They are well documented: she was JPMorgan Chase’s go-to lawyer for many of the cases brought against it relating to the financial crisis. She was arm-in-arm with Kenneth D. Lewis, Bank of America’s former chief executive, keeping him out of trouble when the New York attorney general accused Mr. Lewis of defrauding investors by not disclosing the losses at Merrill Lynch before completing Bank of America’s acquisition of the firm. (And empirically, Mr. Lewis did keep crucial information about the deal from investors.)

This is what she had to say about Mr. Lewis, in a court filing submitted on his behalf: “Some have looked to assign blame for every aspect of the financial crisis, even where there is no evidence of misconduct. This case is a product of that dynamic and does not withstand either legal or factual scrutiny.” It was a refrain she often made about her clients related to the financial crisis.

And then there was Senator Bill Frist, the Republican from Tennessee, whom she successfully represented when the S.E.C. and the Justice Department started an investigation into whether he was involved in insider trading in shares of HCA, the hospital chain. She persuaded them to shut down the investigation.

She also worked with Siemens, the German industrial giant, when it pleaded guilty to charges of bribery, paying a record $1.6 billion penalty.

And then, of course, there was John Mack. She worked for the board of Morgan Stanley during a now well-publicized 2005 investigation into insider trading that ended soon after she made a phone call to the S.E.C. Using her connections at the top of the agency, she dialed up Linda Thomsen, then the commission’s head of enforcement, to find out whether Mr. Mack, who was being considered for Morgan Stanley’s chief executive position, was being implicated. He ultimately wasn’t. As the Huffington Post pointed out in a recent article about Ms. White, Robert Hanson, an S.E.C. supervisor, later testified, “It is a little out of the ordinary for Mary Jo White to contact Linda Thomsen directly, but that White is very prestigious and it isn’t uncommon for someone prominent to have someone intervene on their behalf.”

All of Ms. White’s previous engagements create not only an “optics” problem, but a practical, on-the-job problem. She will most likely need to recuse herself from just about anything related to her previous work.

“I will not for a period of two years from the date of my appointment participate in any particular matter involving specific parties that is directly and substantially related to my former employer or former clients, including regulations and contracts,” is the language in an ethics pledge that she will have to agree to follow.

Some appointees, including Mary L. Schapiro, the former chairwoman of the S.E.C., recused themselves from any involvement in work that was related to a previous employer even after the two-year moratorium. Gary Gensler, the chairman of the Commodity Futures Trading Commission, recused himself from the investigation into MF Global because of his previous employment at Goldman Sachs, where Jon Corzine was the firm’s head, even though it had been years since the two had worked together.

And then there is the issue of Mr. White’s husband, who will have a continuing role at Cravath, one of the most pre-eminent firms in the country, whose clients include some of the nation’s largest corporations.

“This president has adopted the toughest ethics rules of any administration in history,” said Amy Brundage, a White House spokeswoman, “and this nominee is no exception. As S.E.C. chair, Mary Jo White will be in complete compliance with all ethics rules.”

None of these conflicts gets at another potential problem for Ms. White. The job of chairwoman of S.E.C. isn’t simply about enforcement; she has a deputy for that. The biggest challenge anyone who takes the job will have to confront over the next several years will be executing and enforcing provisions of Dodd-Frank and working to regulate electronic trading — something that even the most sophisticated financial professionals, let alone a lawyer, often have a tough time understanding. She has zero experience in this area.

Of course, there can always be a value to inviting a onetime rival onto the team.

“I believe she is one of those people who will understand that her public role will be very, very different than her role as a defense lawyer,” Dennis M. Kelleher of Better Markets, a watchdog group, told me. “I don’t think she’s going to be like so many others who don’t get that they have a very different role when they hold high public office.

“No question, she’s said some things that are controversial and questionable,” Mr. Kelleher said. “Moreover, I hope and expect that she will be asked publicly about them in the confirmation process and that she will have convincing answers.”

Of course, if she is confirmed, we must all hope that she can put her previous client relationships behind her and work for her new client — us.

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Letter From Washington: Changing the Path to the Presidency







WASHINGTON — Imagine if the 2012 election had turned out this way: President Barack Obama won the popular vote by five million votes and almost 4 percentage points, taking seven of the eight largest states, as he did, yet the Republican candidate, Mitt Romney, took the oath of office last week.




Such a scenario might not be far-fetched if some Republican politicians in statehouses around the country get their way.


U.S. presidential elections are decided by the Electoral College. Each state gets one elector for each senator, or two apiece, plus additional electors based on the number of congressional districts it has. With the exception of two states, Maine and Nebraska, electors are awarded on a winner-take-all basis; 270 of a total of 538 are necessary to become president.


Individual states set the rules for these electors; the current system, by most accounts, has worked well. Three times — twice in the 19th century and then in 2000 — the Electoral College victor lost the popular vote.


Now, Republican state legislators in as many as a half-dozen states where they control the governmental machinery even though their state was carried by the Democratic candidate in the past couple of presidential elections want to change the system and tilt it decidedly in their party’s favor. They would do this by scrapping the winner-take-all rule and awarding electors by congressional districts.


“This would amount to a legal subversion of democracy to game the system for political advantage,” says the legal scholar Walter Dellinger, who served as U.S. solicitor general under President Bill Clinton.


That’s not a frivolous alarm. Republican legislators, with tacit support from their governors, in Pennsylvania, Michigan and Wisconsin are advocating this. The party’s national chairman, Reince Priebus, is keeping a low profile and signaling encouragement.


To gauge the potential effect, consider what would have happened if these states, along with Virginia, Florida and Ohio, where Republicans also control the statehouses, had divided electoral votes this way in the most recent presidential election.


Mr. Obama carried all these states, sweeping 106 electoral votes. But Mr. Romney won two-thirds of the congressional districts; if all else had been equal, the Republican would have carried the Electoral College, becoming the first president who was trounced in the popular vote.


Scratching your head? Some of this maneuvering is a result of redistricting or gerrymandering of congressional districts, a process largely controlled by Republicans after their big victories in 2010. Also, Democrats tend to congregate in the same districts, while Republicans are more diffuse.


Two examples: Mr. Obama won Pennsylvania by five points and Michigan by nine points, clear-cut by any standard. Yet Mr. Romney carried 13 of the 18 congressional districts in Pennsylvania and 10 of the 14 in Michigan and would have won a substantial majority of delegates in both states that he lost decisively.


Allotting presidential electors by congressional district would increase the incentives for partisan gerrymandering, already a factor in congressional dysfunction.


There is a longstanding and substantive debate over whether presidents should be decided by the Electoral College or the popular vote. That flared anew when George W. Bush won the presidency 12 years ago even though Al Gore won the popular vote.


Supporters of a change say it would create a genuine national election. Last autumn, Mr. Obama and Mr. Romney focused almost all their resources and time in eight states, all carried by the president. In a general election, voters in places like San Diego, Houston, New Orleans and Buffalo, New York, only lay eyes on candidates who are in town for a quick-hit fund-raiser.


Defenders of the Electoral College dismiss this argument, claiming the present system strikes a political balance between states and regions that the Founding Fathers envisioned. A direct popular election, they contend, would depersonalize the campaign, turning into nothing more than incessant money-grabbing and television advertising. The focus last time was on a handful of states; Mr. Romney and Mr. Obama had to spend considerable time meeting real voters in Columbus, Ohio, or the Washington and Denver suburbs.


Either the current Electoral College or a decision by popular vote, if the prolonged ballot counting in some states could be remedied, would produce a winner with legitimacy. The controversy over Mr. Bush’s election in 2000 wasn’t related to the system but whether he really won Florida, which gave him the Electoral College victory.


Still, changing to a popular vote probably would require a constitutional amendment with approval by two-thirds of both houses of Congress and three-quarters of the states. It’s not going to happen.


What might stop these attempts is if smart Republicans realize how manipulative it looks, and that it could come back to bite them; that’s the view of the former party chairman and ex-governor of Mississippi, Haley Barbour. And such a system would dilute the clout of the states that adopt it, which is why Governor Bob McDonnell of Virginia is opposing any change.


If this sort of political coup had been pulled off earlier, instead of celebrations on the streets of Washington during the presidential inauguration last week, there would have been protests.


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Tiger headed toward another win at Torrey


SAN DIEGO (AP) — The Pacific air was so cold at the end of a 10-hour day at Torrey Pines that Tiger Woods thrust both hands in the front pockets of his rain pants as he walked off the course at the Farmers Insurance Open.


It was a fitting image. Woods made a marathon day look like he was out for a stroll.


Staked to a two-shot lead going into the third round of this fog-delayed tournament, Woods drove the ball where he was aiming and was hardly ever out of position. Even with a bogey on the final hole — the easiest on the back nine — Woods still had a 3-under 69 and expanded his lead by two shots.


In the seven holes he played in the fourth round later Sunday afternoon, Woods hit the ball all over the course and still made three birdies to add two more strokes to his lead.


Thanks to the fog that wiped out an entire day of golf on Saturday, the Farmers Insurance Open didn't stand a chance of finishing on Sunday.


Woods just made it look like it was over.


He had a six-shot lead with 11 holes to play going into the conclusion of the final round on Monday. The two guys chasing him were Brandt Snedeker, the defending champion, and Nick Watney, who won at Torrey Pines in 2008. Neither was waving a white flag. Both understood how much the odds were stacked against them.


"I've got a guy at the top of the leaderboard that doesn't like giving up leads," Snedeker said. "So I have to go catch him."


"All we can do tomorrow is go out and try to make him think about it a little bit and see what happens," Watney said.


And then there was Erik Compton, a two-time heart transplant recipient who had a birdie-eagle finish in the third round that put him in third place through 54 holes, still five shots behind Woods. Someone asked Compton about trying to chase Woods. He laughed.


"I'm trying to chase myself," he said.


Woods was at 17-under par for the tournament, and more than just a six-shot lead was in his corner.


He finished the third round at 14-under 202, making it the 16th time on the PGA Tour that he had at least a four-shot lead going into the final round. His record on the PGA Tour with the outright lead after 54 holes is 38-2, the exceptions being Ed Fiori in 1996 when Woods was a 20-year-old rookie and Y.E. Yang in the 2009 PGA Championship.


Woods attributed his big lead to the "whole package."


"I've driven the ball well, I've hit my irons well, and I've chipped and putted well," he said. "Well, I've hit good putts. They all haven't gone in."


Woods has a good history of Monday finishes, starting with Torrey Pines. It was on this course along the coast north of La Jolla that Woods won a 19-hole playoff against Rocco Mediate to capture the 2008 U.S. Open for his 14th major.


He also won the Pebble Beach National Pro-Am on a Monday in 2000 when he rallied from seven shots behind with seven holes to play. He won his lone title in The Players Championship on a Monday, along with a five-shot win in the Memorial in 2000, and a scheduled Monday finish in the Deutsche Bank Championship outside Boston.


Woods even gets to sleep in.


A Monday finish because of weather typically resumes in the morning so players can get to the next tournament. CBS Sports, however, decided it wanted to televise the conclusion, and so play won't begin until 2 p.m. EST. That decision might have been based on Woods being headed toward victory — just a hunch.


Woods already has won seven times at Torrey Pines, including the U.S. Open. That matches his PGA Tour record at Bay Hill and Firestone (Sam Snead won the Greensboro Open eight times, four each on a different course).


The tournament isn't over, and Woods doesn't see it that way.


"I've got to continue with executing my game plan. That's the idea," he said. "I've got 11 holes to play, and I've got to play them well."


He seized control with his 69 in the third round that gave him a four-shot lead, and he might have put this away in the two hours he played before darkness stopped play.


He badly missed the first fairway to the left, but had a gap through the Torrey pines to the green and had a two-putt par. He missed his next shot so far to the left that the ball wound up in the first cut of the adjacent sixth fairway. He still managed a simple up-and-down for par.


After a 10-foot birdie on the par-3 third, Woods couldn't afford to go left off the tee again because of the PGA Tour's largest water hazard — the Pacific Ocean. So he went miles right, beyond a cart path, a tree blocking his way to the green. He hit a cut shot that came up safely short of the green, and then chipped in from 40 feet for birdie.


"I was able to play those holes in 2-under par," Woods said. "And then I hit three great drives right in a row."


One of them wasn't that great — it was in the right rough, the ball so buried that from 214 yards that Woods hit a 5-wood. It scooted down the fairway and onto the green, setting up a two-putt birdie the stretched his lead to six shots. And after another good drive, the horn sounded to stop play. Because it was due to weather, Woods was able to finish the hole, and he two-putted for par.


Eleven holes on Monday were all that were keeping him from his 75th career win on the PGA Tour, and delivering a message to the rest of golf that there could be more of this to follow no matter what the golf course.


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Well: Keeping Blood Pressure in Check

Since the start of the 21st century, Americans have made great progress in controlling high blood pressure, though it remains a leading cause of heart attacks, strokes, congestive heart failure and kidney disease.

Now 48 percent of the more than 76 million adults with hypertension have it under control, up from 29 percent in 2000.

But that means more than half, including many receiving treatment, have blood pressure that remains too high to be healthy. (A normal blood pressure is lower than 120 over 80.) With a plethora of drugs available to normalize blood pressure, why are so many people still at increased risk of disease, disability and premature death? Hypertension experts offer a few common, and correctable, reasons:

¶ About 20 percent of affected adults don’t know they have high blood pressure, perhaps because they never or rarely see a doctor who checks their pressure.

¶ Of the 80 percent who are aware of their condition, some don’t appreciate how serious it can be and fail to get treated, even when their doctors say they should.

¶ Some who have been treated develop bothersome side effects, causing them to abandon therapy or to use it haphazardly.

¶ Many others do little to change lifestyle factors, like obesity, lack of exercise and a high-salt diet, that can make hypertension harder to control.

Dr. Samuel J. Mann, a hypertension specialist and professor of clinical medicine at Weill-Cornell Medical College, adds another factor that may be the most important. Of the 71 percent of people with hypertension who are currently being treated, too many are taking the wrong drugs or the wrong dosages of the right ones.

Dr. Mann, author of “Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure,” says that doctors should take into account the underlying causes of each patient’s blood pressure problem and the side effects that may prompt patients to abandon therapy. He has found that when treatment is tailored to the individual, nearly all cases of high blood pressure can be brought and kept under control with available drugs.

Plus, he said in an interview, it can be done with minimal, if any, side effects and at a reasonable cost.

“For most people, no new drugs need to be developed,” Dr. Mann said. “What we need, in terms of medication, is already out there. We just need to use it better.”

But many doctors who are generalists do not understand the “intricacies and nuances” of the dozens of available medications to determine which is appropriate to a certain patient.

“Prescribing the same medication to patient after patient just does not cut it,” Dr. Mann wrote in his book.

The trick to prescribing the best treatment for each patient is to first determine which of three mechanisms, or combination of mechanisms, is responsible for a patient’s hypertension, he said.

¶ Salt-sensitive hypertension, more common in older people and African-Americans, responds well to diuretics and calcium channel blockers.

¶ Hypertension driven by the kidney hormone renin responds best to ACE inhibitors and angiotensin receptor blockers, as well as direct renin inhibitors and beta-blockers.

¶ Neurogenic hypertension is a product of the sympathetic nervous system and is best treated with beta-blockers, alpha-blockers and drugs like clonidine.

According to Dr. Mann, neurogenic hypertension results from repressed emotions. He has found that many patients with it suffered trauma early in life or abuse. They seem calm and content on the surface but continually suppress their distress, he said.

One of Dr. Mann’s patients had had high blood pressure since her late 20s that remained well-controlled by the three drugs her family doctor prescribed. Then in her 40s, periodic checks showed it was often too high. When taking more of the prescribed medication did not result in lasting control, she sought Dr. Mann’s help.

After a thorough work-up, he said she had a textbook case of neurogenic hypertension, was taking too much medication and needed different drugs. Her condition soon became far better managed, with side effects she could easily tolerate, and she no longer feared she would die young of a heart attack or stroke.

But most patients should not have to consult a specialist. They can be well-treated by an internist or family physician who approaches the condition systematically, Dr. Mann said. Patients should be started on low doses of one or more drugs, including a diuretic; the dosage or number of drugs can be slowly increased as needed to achieve a normal pressure.

Specialists, he said, are most useful for treating the 10 percent to 15 percent of patients with so-called resistant hypertension that remains uncontrolled despite treatment with three drugs, including a diuretic, and for those whose treatment is effective but causing distressing side effects.

Hypertension sometimes fails to respond to routine care, he noted, because it results from an underlying medical problem that needs to be addressed.

“Some patients are on a lot of blood pressure drugs — four or five — who probably don’t need so many, and if they do, the question is why,” Dr. Mann said.

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Stanley Karnow, Historian and Journalist, Is Dead at 87





Stanley Karnow, a Pulitzer Prize-winning historian and journalist who produced acclaimed books and television documentaries about Vietnam and the Philippines in the throes of war and upheaval, died on Sunday at his home in Potomac, Md. He was 87.




The cause was congestive heart failure, said Mr. Karnow’s son, Michael.


For more than three decades Mr. Karnow was a correspondent in Southeast Asia, working for Time, Life, The Saturday Evening Post, The Washington Post, NBC News, The New Republic, King Features Syndicate and the Public Broadcasting Service. But he was best known for his books and documentaries.


He was in Vietnam in 1959, when the first American advisers were killed, and lingered long after the guns fell silent, talking to fighters, villagers, refugees, North and South Vietnamese political and military leaders, the French and the Americans, researching a people and a war that had been little understood.


The result was the 750-page book “Vietnam: A History,” published in 1983, and its companion, a 13-hour PBS documentary, “Vietnam: A Television History.” Unlike many books and films on Vietnam in the 1960s and ’70s and the nightly newscasts that focused primarily on America’s role and its consequences at home and abroad, Mr. Karnow addressed all sides of the conflict and traced Vietnam’s culture and history.


“Vietnam: A History” was widely praised and a best seller. The documentary, with Mr. Karnow as chief correspondent, was at the time the most successful ever produced by public television, viewed by an average of nearly 10 million people a night through 13 episodes. It won six Emmy Awards, as well as Peabody, Polk and duPont-Columbia awards.


Six years later, Mr. Karnow delivered his second comprehensive book and television examination of a Southeast Asian nation. The book, “In Our Image: America’s Empire in the Philippines” (1989), was a panorama of centuries of Filipino life under Spanish and American colonial rule, followed by independence under sometimes corrupt American-backed leaders. It won the 1990 Pulitzer Prize for history.


Narrated by Mr. Karnow, the three-part PBS documentary “The U.S. and the Philippines: In Our Image” traced America’s paternalistic colonial rule in the Philippines, the shared suffering of Filipinos and Americans under a cruel Japanese occupation in World War II, and Manila’s postwar independence under regimes nominally democratic but repressive, corrupt or indifferent to the miseries of its people.


Mr. Karnow also wrote “Mao and China: From Revolution to Revolution” (1972) and was a co-author of or contributor to books based on his years in Asia, including “Asian-Americans in Transition” (1992), “Passage to Vietnam” (1994), “Mekong” (1995) and “Historical Atlas of the Vietnam War” (1995).


Early in his career he lived in Paris for a decade, and in 1997 he published a memoir, “Paris in the Fifties.” A nostalgic reporter’s notebook of life among the cafe philosophers, berated musicians and pseudo-revolutionary artistes, it danced with digressions about taxes, restaurants, the guillotine, Hemingway, Charles de Gaulle and the Devil’s Island penal colony.


In its range, learning and appetite for fun, Bernard Kalb, the former CBS reporter and Mr. Karnow’s friend since Vietnam, told The Associated Press in 2009, the memoir was vintage Karnow. “Stanley has a great line about how being a journalist is like being an adolescent all your life,” he said.


Stanley Karnow was born in Brooklyn on Feb. 4, 1925, the son of Harry and Henriette Koeppel Karnow. He grew up in a city with more than a dozen daily newspapers and decided early that he wanted to become a reporter. He served in the Army Air Forces in World War II. After graduating from Harvard with a bachelor’s degree in 1947, he sailed for France, intending to spend the summer. He stayed for a decade.


This article has been revised to reflect the following correction:

Correction: January 28, 2013

An earlier version of this article misstated the year in which Stanley Karnow was a Nieman Fellow at Harvard University. It was 1958, not 2002. The article also misspelled the name of the Nieman Fellowship.



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IHT Rendezvous: The Clinton Doctrine of American Foreign Policy

The partisan political theater, of course, was top-notch. Sen. Rand Paul’s declaration that he would have fired Hillary Rodham Clinton; her angry rebuttal of Sen. Ron Johnson’s insistence that the Obama administration misled the American people about the Benghazi attack; Sen. John McCain’s continued outrage at the slapdash security the State Department provided its employees.

Beneath the posturing, though, ran larger questions: what strategy does the United States have to counter the militant groups running rampant across North and West Africa? And what kind of secretary of state has Ms. Clinton been? In her last Congressional hearing in that position, Ms. Clinton expressed exasperation with Washington’s political trench warfare.

“We’ve got to get our act together,” she said.

Ms. Clinton has been a very good but very cautious secretary of state, many analysts say – one who, for the most part, kept her distance from Afghanistan, Israel-Palestine and other seemingly intractable conflicts.

One State Department official, while praising Ms. Clinton’s tenure, nonetheless looked forward to the arrival of Sen. John Kerry, her designated successor: “I came to admire Clinton as secretary of state, her focus on women and innovation in particular,” the official told me. “But am really happy to have someone in the job who does not retain political ambitions.”

In a recent assessment of Clinton’s tenure, Michael O’Hanlon of the Brookings Institution argued that she had enjoyed some success, including restoring the United States’ image abroad, but she made no historic breakthroughs, he said.

Mr. O’Hanlon argued that Ms. Clinton’s famed work ethic paid off. She made few mistakes, no major gaffes and did not “needlessly antagonize” friends or enemies. O’Hanlon called Ms. Clinton’s role in the administration’s “pivot to Asia” and tough stance toward China arguably “her greatest and most memorable contribution.”

The problem, as last week’s hearing showed, is that the Middle East and the threat of terrorism continue to dominate American foreign policy. Even as the United States becomes more energy independent, terrorist attacks like the kidnappings in a remote oil facility in Algeria will make headlines and influence markets. And barring a massive shift in American domestic politics, Israel’s security will continue to be viewed as a vital interest of the United States.

Ms. Clinton, to her credit, made forty trips to Europe that helped produce crippling new sanctions on Iran. Last fall, she helped broker a ceasefire between Israel and Hamas in Gaza. But she failed to personally engage in Israeli-Palestinian peace talks.

To be fair, the Obama White House may have limited her options. After promising more open debate than occurred under President George W. Bush, the Obama White House tightly controlled the formulation of American foreign policy. Critics have also accused Mr. Obama of being overly cautious in foreign affairs.

With the exception of the Libya intervention and the raid that killed Osama bin Laden, Mr. Obama was “coolly calculating and reluctant to engage” in his first-term foreign policy, The Economist magazine recently argued.

Mr. Obama, of course, is trying to avoid the over-reach his predecessor displayed in Iraq. He also faces enormous fiscal pressures at home. But there is a risk that the pendulum is swinging too far toward a smug isolationism in Washington.

As Ms. Clinton departs, worrying trends are emerging in the way America engages with the world. The new U.S. weapon of choice is the drone strike – a tactic that carries zero political risk at home but spreads anti-Americanism abroad.

Complex foreign policy problems that threaten American security are increasingly seen as “entanglements” best avoided. And there is a convenient view that there are no “good guys” in the power struggles now unfolding in the post-Arab-Spring Middle East.

The potential lesson of the bruising political battle over Benghazi is simple: Take few risks, turn embassies into bunkers and avoid political firestorms at home. In her testimony, Ms. Clinton passionately argued against that approach.

Declaring Somalia and Colombia success stories, she said the United States could counter militancy in Africa and the Middle East by working with regional organizations and training local security forces. U.S. funding and training of an African Union Mission in Somalia, or AMISOM, Ms. Clinton said, had slowly succeeded in driving back al-Shabaab and other Islamist forces. In Colombia, the government has driven back FARC rebels and narco-traffickers.

There have been setbacks and the efforts in both countries are imperfect. But local security forces trained and funded by the international community slowly gained ground in painstaking efforts over many years.

“What we have to do is recognize that we’re in for a long-term struggle here,” Ms. Clinton said at the hearing. “And that means we’ve got to pay attention to places that historically we have not chosen to or had to.”

During their heated exchange, Mr. McCain criticized Ms. Clinton and the Obama administration for not doing enough to train Libya’s security forces. Secretary Clinton replied that House Republicans had put a hold on the funding the administration requested to train Libyans.

“If this is a priority and we are serious about trying to help this government stand up security forces,” she said, “then we have to work together.”

Ms. Clinton is right. And so is Mr. McCain. Congressional politicking hinders the State Department. And the State Department executed terribly in Benghazi. But Ms. Clinton, who I have criticized in the past, won the day.

“We are in a new reality,” she said, referring to the change sweeping across the Middle East. “We are trying to makes sense of events that nobody had predicted but that we’re going to have to live with.”

Ms. Clinton called for the United States to show “humility” abroad and stop making national security issues “political footballs” at home. She said a Cold War style bipartisan agreement should be reached to launch a long-term American effort to strengthen local security forces and promote democracy across Africa and the post-Arab-Spring Middle East.

“Let’s be smart and learn from what we’ve done in the past,” she said. “Put forth a policy that wouldn’t go lurching from administration to administration but would be a steady one.”

“We have more assets than anyone in the world,” Ms. Clinton added, “but I think we’ve gotten a little bit off track in trying to figure out how best to utilize them.”

A “little bit off track” is a euphemism for partisanship endangering national security. If the U.S. doesn’t get its act together, expect more Benghazis.

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In New Orleans, an unwelcome mat for Goodell


NEW ORLEANS (AP) — An effigy of NFL Commissioner Roger Goodell dangles from the front porch of a New Orleans home that is otherwise festively decorated with Saints paraphernalia.


With restaurants and bars gearing up for an influx of Super Bowl XLVII visitors, the "Refuse to Serve Roger Goodell" page on Facebook had 107 likes as of Friday.


A portrait of Goodell covers the bull's-eye on the dart board at Parkview Tavern.


And floats in the unabashedly lowbrow Krewe du Vieux parade in the French Quarter last weekend displayed larger-than-life likenesses of Goodell in acts that defy polite description.


New Orleans is celebrating the return of Saints coach Sean Payton after a season of NFL banishment as a result of the "bountygate" scandal — when the team ran a pay-for-hits program. But Goodell, who suspended Payton and other current and former Saints players and coaches last year for their roles in the system, is being ridiculed here with a vehemence usually reserved for the city's scandal-scarred politicians.


"They believe he completely used the Saints as an example of something that was going on league-wide," said Pauline Patterson, co-owner of Finn McCool's, an Irish Bar in the Mid-City neighborhood where the words "Go To Hell Goodell" are visible over the fireplace.


Some of Goodell's critics say the disarray resulting from what they believe were unfair suspensions led to the Saints' 7-9 performance this year — and a missed chance to make history.


"We had a real shot of being the first team in history to host the Super Bowl in our own stadium," Parkview Tavern owner Kathy Anderson said. "He can't give that back to us."


Goodell suspended the coaches and players after an investigation found the Saints had a performance pool offering cash rewards for key plays, including big hits. The player suspensions eventually were overturned, but the coaches served their punishments.


Mayor Mitch Landrieu is among those saying that people in this city, known for its hospitality and history, should mind their manners and remember the not-too-distant past.


"Roger Goodell has been a great friend to New Orleans, and it's a fact that he's one of the people instrumental to making sure that the Saints stayed here after Hurricane Katrina," Landrieu said in a statement. It was a reference to the days after the storm, when 80 percent of the city was underwater and the damaged Superdome became a shelter for thousands of the displaced.


Then-Commissioner Paul Tagliabue and his second-in-command, Goodell, are credited with working to keep the team from abandoning New Orleans for San Antonio.


"If not for Roger Goodell, we would not have this Super Bowl," Landrieu added. "And we will need him since we want to host another one."


Saints quarterback Drew Brees said the game is validation of everything the city's gone through to rebuild after Hurricane Katrina.


"There's no question, yeah. And I think people will see that when they come down, as soon as people come down that haven't been there in a while," Brees said Friday while in Hawaii for the Pro Bowl. "The city knows how to entertain, knows how to treat people right. The tourism industry's huge, so we're excited to host this big game. Obviously it's the biggest sporting event in the world, and the city will be ready for it."


But some are in no mood to back off when it comes to Goodell.


Anderson said she understands city leaders' desire to put their best foot forward, but that it also is important for Saints fans to be able to vent.


"Whether I have Roger Goodell's face on my dart board is not going to change anybody's mind about the Super Bowl," Anderson said.


People should not take the barbs too seriously, said Lynda Woolard, a Saints fan who has been tracking some of the barbs on social media. "Nobody's saying there should be violence against the man," Woolard said.


"It's tongue-in-cheek," Patterson agreed.


Still, some diehards are ready to put it all behind them.


Patrick Brower, owner and manager of the Dirty Coast T-shirt shop, said Friday that he's pushing black-and-gold wear at his shop, choosing to unify Saints fans without bashing the commissioner.


"We've got to look forward here," Brower said. "The more time we spend in the past, it's just not beneficial."


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Well: Ask Well: Squats for Aging Knees

You are already doing many things right, in terms of taking care of your aging knees. In particular, it sounds as if you are keeping your weight under control. Carrying extra pounds undoubtedly strains knees and contributes to pain and eventually arthritis.

You mention weight training, too, which is also valuable. Sturdy leg muscles, particularly those at the front and back of the thighs, stabilize the knee, says Joseph Hart, an assistant professor of kinesiology and certified athletic trainer at the University of Virginia, who often works with patients with knee pain.

An easy exercise to target those muscles is the squat. Although many of us have heard that squats harm knees, the exercise is actually “quite good for the knees, if you do the squats correctly,” Dr. Hart says. Simply stand with your legs shoulder-width apart and bend your legs until your thighs are almost, but not completely, parallel to the ground. Keep your upper body straight. Don’t bend forward, he says, since that movement can strain the knees. Try to complete 20 squats, using no weight at first. When that becomes easy, Dr. Hart suggests, hold a barbell with weights attached. Or simply clutch a full milk carton, which is my cheapskate’s squats routine.

Straight leg lifts are also useful for knee health. Sit on the floor with your back straight and one leg extended and the other bent toward your chest. In this position, lift the straight leg slightly off the ground and hold for 10 seconds. Repeat 10 to 20 times and then switch legs.

You can also find other exercises that target the knees in this video, “Increasing Knee Stability.”

Of course, before starting any exercise program, consult a physician, especially, Dr. Hart says, if your knees often ache, feel stiff or emit a strange, clicking noise, which could be symptoms of arthritis.

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J. Richard Hackman, an Expert in Team Dynamics, Dies at 72





J. Richard Hackman, a Harvard psychology professor whose fieldwork sometimes took him to the cockpit of an airliner to observe the crew in a nearly five-decade quest to determine the dynamics of teamwork and effective leadership, died on Jan. 8 in Boston. He was 72.




The cause was lung cancer, his wife, Judith Dozier Hackman, said.


Dr. Hackman, the author or co-author of 10 books on group dynamics, was the Edgar Pierce professor of social and organizational psychology at Harvard.


In one of his best-known books, “Leading Teams: Setting the Stage for Great Performances” (2002), he replaced the popular image of the powerful “I can do it all” team leader with that of someone who, as he wrote, had the subtle skills “to get a team established on a good trajectory, and then to make small adjustments along the way to help members succeed.”


The conditions for a successful team effort — among them “a compelling direction, an enabling team structure, a supportive organizational context and expert team coaching” — “are easy to remember,” Dr. Hackman wrote.


“The challenge,” he continued, “comes in developing an understanding of those conditions that is deep and nuanced enough to be useful in guiding action, and in devising strategies for creating them even in demanding or team-unfriendly organizational circumstances.”


Besides tracking the interplay of pilots, co-pilots and navigators aboard civilian and military planes, Dr. Hackman observed corporate boards, sports teams, orchestra players, telephone-line repair crews, hospital workers and restaurant kitchen staff members.


And in recent years, for his 2011 book, “Collaborative Intelligence,” he was allowed to observe interactions within the American intelligence, defense, law-enforcement and crisis-management communities.


“Although my main aspiration has been to provide guidance that will be useful to team leaders and members,” he wrote, “there are no ‘one-minute’ prescriptions here — creating, leading and serving on teams is not that simple.”


Anita Woolley, a professor of organizational behavior and theory at the Tepper School of Business at Carnegie Mellon University in Pittsburgh, said, “The key thing about Dr. Hackman’s work is that it stands in contrast to some of the more popular models of leadership that focused very much on style or how leaders behave, versus what they do.”


Rather than viewing pay as a prime motivator for good performance, she continued, “he focused on features of people’s jobs that made them more intrinsically satisfied: the freedom to determine how they conduct their work, having a variety of tasks, having knowledge of the ultimate outcomes of their work, knowing how their work affects or is received by other people.”


He also liked to overturn some of the received wisdom about teamwork. In a 2011 article for The Harvard Business Review, Dr. Hackman listed “Six Common Misperceptions About Teamwork.” Among them was this:


“Misperception No. 2: It’s good to mix it up. New members bring energy and fresh ideas to a team. Without them, members risk becoming complacent, inattentive to changes in the environment, and too forgiving of fellow members’ misbehavior.


“Actually: The longer members stay together as an intact group, the better they do. As unreasonable as this may seem, the research evidence is unambiguous. Whether it is a basketball team or a string quartet, teams that stay together longer play together better.”


John Richard Hackman was born in Joliet, Ill., on June 14, 1940, the only child of J. Edward and Helen Hackman. His father was an oil pipeline engineer, his mother a schoolteacher.


Dr. Hackman received a bachelor’s degree in mathematics from MacMurray College in Jacksonville, Ill., in 1962, and a doctorate in psychology from the University of Illinois in 1966. He soon joined the psychology and administrative sciences department faculties at Yale, where he taught until 1986, when he moved to the psychology and business departments at Harvard.


Besides his wife, who is an associate dean at Yale, he is survived by two daughters, Julia Beth Proffitt and Laura Dianne Codeanne, and four grandchildren.


After Dr. Hackman died, The Harvard Crimson wrote that for years he had “devoted countless hours to improving one team in particular — the Harvard women’s basketball squad, for which he volunteered as an honorary coach.”


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