China's smog taints economy, health









BEIJING — When a thick quilt of smog enveloped swaths of China earlier this month, it set in motion a costly chain reaction for the world's No. 2 economy.


Authorities canceled flights across northern China and ordered some factories shut. Hospitals were flooded with hacking patients.


A fire in an empty furniture factory in eastern Zhejiang province went undetected for hours because the smoke was indistinguishable from the haze. In coastal Shandong province, most highways were closed for fear that low visibility would cause motorists to crash. And in Beijing, the local government urged residents to remain indoors and told construction sites to scale back activity.








Photos: Smog in China


"These are emergency measures that have the same economic impact as a strike or severe weather," said Louis Kuijs, a Hong Kong-based economist with the Royal Bank of Scotland and formerly of the World Bank. "They're very painful."


Residents in the capital have taken to mocking their famously filthy air and its attendant health hazards with the expression "Beijing cough." Meanwhile, Shanghai's Environmental Protection Bureau has introduced a cartoon mascot to communicate daily air quality on its website: a pig-tailed girl who bursts into tears when smog reaches hazardous levels.


But economists say China's smog is no joke. As air pollution continues to obscure China's cities, the cost to the nation in lost productivity and health problems is soaring. The World Bank estimates sickness and early death sapped China of $100 billion in 2009, or just under 3% of gross domestic product. China is now home to seven of the 10 most-polluted cities in the world, according to a report by the Asian Development Bank and Beijing's Tsinghua University.


A study by Greenpeace and Peking University's School of Public Health put the cost of healthcare to treat pollution-related ailments in Beijing, Shanghai, Guangzhou and Xian at more than $1 billion last year.


Beijing resident Zhang Jian takes his 2-year-old son to a doctor regularly to treat the toddler's chronic sinus infection.


"It's definitely related to the pollution," said Zhang, 35, who wore a disposable mask at an overcrowded children's hospital recently. "My son snores and his nose is blocked constantly. It's a problem because he's too young to clear his nose like adults."


The doctor's visit and treatment cost Zhang about $320 — nearly a week's pay for the IT professional.


The Beijing government says it's considering a host of emergency measures to clear the air. Among them: limiting vehicle usage, spraying building sites to reduce dust and restricting outdoor barbecue grills.


Even China's next premier, Li Keqiang, weighed in recently on the issue. "This is a problem accumulated over a long period of time, and solving the problem will also require a long time. But we need to take action."


China's smog crisis is not unlike those experienced in London and Los Angeles in the 1950s. Public outcry ultimately led to cleaner air and tougher environmental regulations.


Environmental activists hope the same happens in China. The official response in recent weeks has raised optimism that authorities will begin addressing pollution more openly.


Until recently, state media was loathe to use the word "pollution," opting instead for the euphemism "fog."


But popular pressure is building, making it harder for policymakers to ignore the foul air in many of China's largest cities.


After the staggeringly bad bout of air pollution in the middle of this month, micro-bloggers took to posting pictures of themselves online wearing masks.


Some held handwritten signs that read, "I don't want to be a human vacuum cleaner."


The phrase became the top-trending topic on the Twitter-like Sina Weibo, attracting several million hits.





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Crazy Alien Weather: Lightning-Filled Rocket Dust Storms of Mars



Scientists have modeled the internal workings of lightning-filled “rocket dust storms” on Mars that rise at speeds 100 times faster than ordinary storms and inject dust high into the Martian atmosphere.


The Red Planet is a very dry and dusty place, with global storms that sometimes obscure the entire surface. Satellites orbiting Mars have seen persistent dust layers reaching very high altitudes, as much as 30 to 50 km above the ground, though scientists are at a loss to explain exactly how the dust got there.


Using a high-resolution model, researchers have shown that a thick blob-like dust pocket inside a storm may become heated by the sun, causing the surrounding atmosphere to warm quickly. Because hot air rises, these areas will shoot skyward super fast, much like a rocket launching into space, hence “rocket dust storms.”


“The vertical transport was so strong we want to come up with a kind of spectacular name, to give an idea of the very powerful rise,” said planetary scientist Aymeric Spiga from the Institut Pierre Simon Laplace in Paris, France, who is lead author on a paper describing the phenomena in the Journal of Geophysical Research: Planets on Jan. 14.



These speedily rising dust blobs can soar from near the surface to 30 or 40 km into the atmosphere in a matter of hours at speeds in excess of 10 meters per second (22 mph). This is far faster than the typical convection speeds in a dust storm of 0.1 meters per second (0.2 mph). Since the dust particles rub up against one another and create friction, the rocket dust storms may become charged with electrostatic forces, which could which could trigger fantastic lightning bolts.


Spiga and his team used detailed models of winds and dust on Mars to determine exactly how these rocket dust storms behave. Most previous models of Mars’ climate simulate large-scale global dust storms with fairly coarse resolution and so have not noticed the rocket storms. The team seeded their model with data from a dust storm observed by the OMEGA instrument aboard ESA’s Mars Express orbiting satellite and watched the rise of rocket storms.



Similar dust storms can’t happen on Earth. This is mainly because Mars’ atmosphere is about 100 times thinner than our own, meaning that it gets quickly and efficiently heated when dust particles absorb sunlight and then emit thermal radiation.


But a comparable phenomenon occurs in grey cumulonimbus thunderstorm clouds on Earth. The large accumulations of water particles in such clouds release latent heat, causing strong vertical motions and an extensive tall structure. Spiga’s team has used this Earthly analogy in the rocket dust storm’s more technical name, conio-cumulonimbus, from the Greek conious, which means dust.


“But I prefer to call them rocket dust storms,” Spiga said. “Then everyone knows what I’m talking about.”


Other researchers are impressed with the physical modeling done in the work. “I was a little surprised that such a small dust disturbance could remain intact over such long distances,” said planetary atmospheres scientist Scot Rafkin from the Southwest Research Institute in Boulder, Colorado. The mechanism could help explain how long-lasting layers of dust climb so high in the Martian atmosphere, he says. 


Because they appear to be relatively rare, it may take a while to track down more rocket dust storms. But Spiga is hopeful they will be found by orbiting satellites, which may even image the lightning flashes inside them.


Video: Spiga, Aymeric, et al. “Rocket dust storms and detached dust layers in the Martian atmosphere,” JGR:Planets, DOI: 10.1002/jgre.20046


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Lorne Michaels comedy pilot lands at NBC






LOS ANGELES (TheWrap.com) – “Saturday Night Live” boss Lorne Michaels is broadening his relationship with NBC via a new comedy pilot.


The untitled project will star stand-up comic (and “SNL” writer) John Mulaney, and is loosely based on his life.






Mulaney will also write and executive-produce the project, with Michaels, Andrew Singer, Dave Becky and David Miner also executive-producing.


The project will be produced by Universal Television, Broadway Video and 3 Arts Entertainment.


Last month, Michaels – along with “Up in the Air” director Jason Reitman and “Girls” co-executive producer Bruce Eric Kaplan – sold a comedy pilot, “People in New Jersey,” to HBO. That project centers around an adult brother and sister who puzzle over the big and small mysteries of life while living in New Jersey.


TV News Headlines – Yahoo! News





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Religious Groups and Employers Battle Contraception Mandate


Shawn Thew/European Pressphoto Agency


President Obama, with his health secretary, Kathleen Sebelius, offering a compromise on the contraception mandate last year.







In a flood of lawsuits, Roman Catholics, evangelicals and Mennonites are challenging a provision in the new health care law that requires employers to cover birth control in employee health plans — a high-stakes clash between religious freedom and health care access that appears headed to the Supreme Court.




In recent months, federal courts have seen dozens of lawsuits brought not only by religious institutions like Catholic dioceses but also by private employers ranging from a pizza mogul to produce transporters who say the government is forcing them to violate core tenets of their faith. Some have been turned away by judges convinced that access to contraception is a vital health need and a compelling state interest. Others have been told that their beliefs appear to outweigh any state interest and that they may hold off complying with the law until their cases have been judged. New suits are filed nearly weekly.


“This is highly likely to end up at the Supreme Court,” said Douglas Laycock, a law professor at the University of Virginia and one of the country’s top scholars on church-state conflicts. “There are so many cases, and we are already getting strong disagreements among the circuit courts.”


President Obama’s health care law, known as the Affordable Care Act, was the most fought-over piece of legislation in his first term and was the focus of a highly contentious Supreme Court decision last year that found it to be constitutional.


But a provision requiring the full coverage of contraception remains a matter of fierce controversy. The law says that companies must fully cover all “contraceptive methods and sterilization procedures” approved by the Food and Drug Administration, including “morning-after pills” and intrauterine devices whose effects some contend are akin to abortion.


As applied by the Health and Human Services Department, the law offers an exemption for “religious employers,” meaning those who meet a four-part test: that their purpose is to inculcate religious values, that they primarily employ and serve people who share their religious tenets, and that they are nonprofit groups under federal tax law.


But many institutions, including religious schools and colleges, do not meet those criteria because they employ and teach members of other religions and have a broader purpose than inculcating religious values.


“We represent a Catholic college founded by Benedictine monks,” said Kyle Duncan, general counsel of the Becket Fund for Religious Liberty, which has brought a number of the cases to court. “They don’t qualify as a house of worship and don’t turn away people in hiring or as students because they are not Catholic.”


In that case, involving Belmont Abbey College in North Carolina, a federal appeals court panel in Washington told the college last month that it could hold off on complying with the law while the federal government works on a promised exemption for religiously-affiliated institutions. The court told the government that it wanted an update by mid-February.


Defenders of the provision say employers may not be permitted to impose their views on employees, especially when something so central as health care is concerned.


“Ninety-nine percent of women use contraceptives at some time in their lives,” said Judy Waxman, a vice president of the National Women’s Law Center, which filed a brief supporting the government in one of the cases. “There is a strong and legitimate government interest because it affects the health of women and babies.”


She added, referring to the Centers for Disease Control and Prevention, “Contraception was declared by the C.D.C. to be one of the 10 greatest public health achievements of the 20th century.”


Officials at the Justice Department and the Health and Human Services Department declined to comment, saying the cases were pending.


A compromise for religious institutions may be worked out. The government hopes that by placing the burden on insurance companies rather than on the organizations, the objections will be overcome. Even more challenging cases involve private companies run by people who reject all or many forms of contraception.


The Alliance Defending Freedom — like Becket, a conservative group — has brought a case on behalf of Hercules Industries, a company based in Denver that makes sheet metal products. It was granted an injunction by a judge in Colorado who said the religious values of the family owners were infringed by the law.


“Two-thirds of the cases have had injunctions against Obamacare, and most are headed to courts of appeals,” said Matt Bowman, senior legal counsel for the alliance. “It is clear that a substantial number of these cases will vindicate religious freedom over Obamacare. But it seems likely that the Supreme Court will ultimately resolve the dispute.”


The timing of these cases remains in flux. Half a dozen will probably be argued by this summer, perhaps in time for inclusion on the Supreme Court’s docket next term. So far, two- and three-judge panels on four federal appeals courts have weighed in, granting some injunctions while denying others.


One of the biggest cases involves Hobby Lobby, which started as a picture framing shop in an Oklahoma City garage with $600 and is now one of the country’s largest arts and crafts retailers, with more than 500 stores in 41 states.


David Green, the company’s founder, is an evangelical Christian who says he runs his company on biblical principles, including closing on Sunday so employees can be with their families, paying nearly double the minimum wage and providing employees with comprehensive health insurance.


Mr. Green does not object to covering contraception but considers morning-after pills to be abortion-inducing and therefore wrong.


“Our family is now being forced to choose between following the laws of the land that we love or maintaining the religious beliefs that have made our business successful and have supported our family and thousands of our employees and their families,” Mr. Green said in a statement. “We simply cannot abandon our religious beliefs to comply with this mandate.”


The United States Court of Appeals for the 10th Circuit last month turned down his family’s request for a preliminary injunction, but the company has found a legal way to delay compliance for some months.


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Diner’s Journal Blog: PepsiCo Will Halt Use of Additive in Gatorade

PepsiCo announced on Friday that it would no longer use an ingredient in Gatorade after consumers complained.

The ingredient, brominated vegetable oil, which was used in citrus versions of the sports drink to prevent the flavorings from separating, was the object of a petition started on Change.org by Sarah Kavanagh, a 15-year-old from Hattiesburg, Miss., who became concerned about the ingredient after reading about it online. Studies have suggested there are possible side effects, including neurological disorders and altered thyroid hormones.

The petition attracted more than 200,000 signatures, and this week, Ms. Kavanagh was in New York City to tape a segment for “The Dr. Oz Show.” She visited The New York Times on Wednesday and while there said, “I just don’t understand why they can’t use something else instead of B.V.O.”

“I was in algebra class and one of my friends kicked me and said, ‘Have you seen this on Twitter?’ ” Ms. Kavanagh said in a phone interview on Friday evening. “I asked the teacher if I could slip out to the bathroom, and I called my mom and said, ‘Mom, we won.’ ”

Molly Carter, a spokeswoman for Gatorade, said the company had been testing alternatives to the chemical for roughly a year “due to customer feedback.” She said Gatorade initially was not going to make an announcement, “since we don’t find a health and safety risk with B.V.O.”

Because of the petition, though, Ms. Carter said the company had changed its mind, and an unidentified executive there gave Beverage Digest, a trade publication, the news for its Jan. 25 issue.

Previously, a spokesman for PepsiCo had said in an e-mail, “We appreciate Sarah as a fan of Gatorade, and her concern has been heard.”

Brominated vegetable oil will be replaced by sucrose acetate isobutyrate, an emulsifier that is “generally recognized as safe” as a food additive by the Food and Drug Administration. The new ingredient will be added to orange, citrus cooler and lemonade Gatorade, as well Gatorade X-Factor orange, Gatorade Xtremo citrus cooler and a powdered form of the drink called “glacier freeze.”

Ms. Carter said consumers would start seeing the new ingredient over the next few months as existing supplies of Gatorade sell out and are replaced.

Health advocates applauded the company’s move. “Kudos to PepsiCo for doing the responsible thing on its own and not waiting for the F.D.A. to force it to,” said Michael Jacobson, executive director of the Center for Science in the Public Interest.

Mr. Jacobson has championed the removal of brominated vegetable oil from foods and beverages for the last several decades, but the F.D.A. has left it in a sort of limbo, citing budgetary constraints that it says keep it from going through the process needed to formally ban the chemical or declare it safe once and for all.

Brominated vegetable oil is banned as a food ingredient in Japan and the European Union. About 10 percent of drinks sold in the United States contain it, including Mountain Dew, which is also made by PepsiCo; some flavors of Powerade and Fresca from Coca-Cola; and Squirt and Sunkist Peach Soda, made by the Dr Pepper Snapple Group.

PepsiCo said it had no plans to remove the ingredient from Mountain Dew and Diet Mountain Dew, both of which generate more than $1 billion in annual sales.

Heather White, executive director at the Environmental Working Group, said of PepsiCo’s decision, “We can only hope that other companies will follow suit.” She added, “We need to overhaul how F.D.A. keeps up with the latest science on food additives to better protect public health.”

Ms. Kavanagh agreed. “I’ve been thinking about ways to take this to the next level, and I’m thinking about taking it to the F.D.A. and asking them why they aren’t doing something about it,” she said. “I’m not sure yet, but I think that’s where I’d like to go with this.”


This post has been revised to reflect the following correction:

Correction: January 26, 2013

An earlier version of this article misspelled the surname of the 15-year-old who started a petition on Change.org to end the use of brominated vegetable oil in Gatorade. She is Sarah Kavanagh, not Kavanaugh.

A version of this article appeared in print on 01/26/2013, on page B1 of the NewYork edition with the headline: PepsiCo Will Halt Additive Use In Gatorade.
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Court rules Obama recess appointments unconstitutional









WASHINGTON — A federal appeals court, dealing a defeat to President Obama, has sharply limited the chief executive’s power to bypass the Senate and to make temporary “recess” appointments to fill vacant slots in government agencies.


The Court of Appeals for the D.C. Circuit, in a 3-0 ruling,  said the president can make recess appointments only when the Senate has formally adjourned between sessions of Congress, not when lawmakers leave Washington for a brief break.


The Obama administration is almost certain to appeal the decision to the Supreme Court. But if the ruling stands, it strengthens the power of the Senate’s Republican minority at the expense of Obama and the Democrats.





PHOTOS: President Obama’s second inauguration


During his first term, Senate Republicans, led by Minority Leader Mitch McConnell (R-Ky), refused to approve Obama’s nominees for several agencies, including the National Labor Relations Board and the new Consumer Financial Protection Agency created in the wake of the Wall Street collapse of 2008. McConnell could rely on the filibuster rule by which the minority can block a vote by the majority.


In response, Obama invoked his power under the Constitution “to fill up all vacancies that may happen during the recess of the Senate.” Obama used this authority last January to appoint several new members to the National Labor Relations Board, ensuring the group had the necessary three members to make decisions. In addition to the NLRB appointments, Obama also installed Richard Cordray as director of the Consumer Financial Protection Bureau at the same time.


Business groups and Senate Republicans challenged the move, arguing the Senate was not truly in recess last January when it was out of session for several days.


In Friday’s decision, Chief Judge David Sentelle ruled for the challengers and said a “recess” refers to the break when Congress formally adjourns after a two-year session.


“An interpretation of 'the Recess' that permits the President to decide when the Senate is in recess would demolish the checks and balances inherent in the advice-and-consent requirement, giving the President free rein to appoint his desired nominees at any time he pleases, whether that time be a weekend, lunch, or even when the Senate is in session and he is merely displeased with its inaction. This cannot be the law,” said Sentelle, an appointee of President Reagan. He was joined by Judges Karen Henderson and Thomas Griffith, who are also Republican appointees.


PHOTOS: President Obama’s past


Cordray’s appointment is being challenged in U.S. District Court in Washington, D.C., in a separate lawsuit by a Texas bank and two free-market advocacy groups. They also claim the appointment was unconstitutional because the Senate was not in a formal recess. The suit is pending.


On Thursday, Obama renominated Cordray to the five-year term as director of the 2-year-old agency. Cordray’s recess appointment expires at the end of the year.


Obama said Thursday that Cordray was qualified for the position, but “he wasn’t allowed an up or down vote in the Senate, and as a consequence, I took action to appoint him on my own.”


Staff writer Jim Puzzanghera contributed to this report.


Follow Politics Now on Twitter and Facebook


david.savage@latimes.com





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Smartphone Sorcery: The Best Fantasy RPGs for Mobiles



Get your spell-caster on, explore castles, and lop off heads. Lop off lots of heads.





Battle for Wesnoth


Position your elven archers so they can take down orcs on horseback. Send scouts across the river and behind enemy lines. You’ve got to fight if you’re going to rule the land of Wesnoth. If you’re new to the moving-pieces-around-a-map strategy genre, this isn’t the place to start. Our army was wiped out during the tutorial.


WIRED Complex gameplay will keep you coming back for months.


TIRED Learning curve is more of a vertical line.


$3.99 iOS | $3.99 Android | Battle for Wesnoth





Final Fantasy 3


Previous mobile ports of classic Final Fantasy games have been pretty uneven. (The iOS version of the original is downright brutal.) But this 3-D remake feels great. You can tap anywhere on the screen to advance the turn-based battles, meaning you can plow through them as easily as if you were holding a controller. And for a touchscreen game that lasts 40 hours, comfort is key.


WIRED Simple, natural controls. Amazing orchestral soundtrack.


TIRED Graphics pulled from Nintendo DS are a waste of a retina display.


$16.99 iOS (iPad) $15.99 (iPhone, iPod) | $15.99 Android | Final Fantasy III




App Guide 2012 bug



Zenonia 4


You won’t understand what’s going on with the swords-and-sorcery story line if you jump right into the fourth iteration of this action RPG (it involves time travel and your future self), but who cares when slashing up monsters and going on quests is this much fun? It’s free to play, which means you can spend real-life cash to buy upgrades like powerful helmets and pickaxes without having to grind.


WIRED Vibrant graphics. Satisfying thwack when you strike enemies.


TIRED Only one control option.


Free iOS | Free Android | Zenonia 4





Chrono Trigger


This time-traveling, dimension-hopping romp is one of the most beloved RPG adventures of the classic console era. But it doesn’t quite make the leap to mobile unscathed. The controls are imprecise at best, and the graphics, ported over from the Super Nintendo, look blurry instead of pixel-crisp. Still, it’s a fantastic game with wonderful writing and music.


WIRED A polished, thrilling, classic RPG for your phone.


TIRED Lackluster port job. Messy control scheme.


$9.99 iOS | Chrono Trigger





Mage Gauntlet


This action role-player features 16-bit-styled pixel artwork that makes it look like a long-lost vintage game. You’re an apprentice magician looking to pick up the tools of the trade while taking down bad guys, and you can alternate hacking and slashing with magic spells that you find along the way. It’s generally difficult to control characters using touchscreens, but Mage Gauntlet’s scheme is nearly perfect.


WIRED Old-school charisma. Satisfying hack-and-slashery. Funny dialog.


TIRED Enemy designs aren’t as appealing.


$2.99 iOS | Mage Gauntlet




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Booker winner Mantel says play next “logical step”






LONDON (Reuters) – Double Booker prize-winning author Hilary Mantel said the characters in her historical novels about the rise of Thomas Cromwell will take the next “logical step” to a stage adaptation at the Royal Shakespeare Company (RSC) this year.


Mantel said in a video interview on the RSC website this week that she has always longed to give “solid form” to her depictions of Cromwell, Henry VIII and Anne Boleyn in her “Wolf Hall” and “Bring Up the Bodies” books.






“From the moment I started writing Wolf Hall the characters were fighting to be off the page,” Mantel said in the video.


The 60-year-old Mantel said she was delighted to have playwright Mike Poulton, whose works have garnered some of the theatre world’s top awards, recreate her novels for the stage.


“He’s the man who knows about the stagecraft,” she said. “I’m the one who knows the characters inside out.”


The first woman and first Briton to win the Booker twice for her novels set in Henry VIII’s court said she has been inspired by the RSC since the age of 15 when she went alone to its Stratford-upon-Avon home and watched four plays in three days.


“It was a shaping experience, so it really is a dream come true for me to have the opportunity to see the RSC present my plays,” she said.


Mantel is working on a third novel in the trilogy.


The RSC also said on Wednesday that David Tennant will star in the title role of “Richard II” in winter 2013, making his return five years after a turn as Hamlet which earned him a best Shakespearean performance trophy at the Critics’ Circle Theatre Awards in 2009.


“Both plays will be directed by Royal Court Associate Director Jeremy Herrin, making his RSC directing debut,” RSC Artistic Director Gregory Doran said.


The world premiere of “Wendy & Peter Pan” by Ella Hickson and directed by Jonathan Munby will round out the winter season, the RSC said.


Tickets for the RSC’s winter 2013 season, which begins in October 2013 and runs until March 2014 will go on sale for members on February 11 and for the wider public on March 18, the RSC said.


(Reporting by Paul Casciato; editing by Patricia Reaney)


Celebrity News Headlines – Yahoo! News





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Living With Cancer: The Good Patient Syndrome

I remember when being good seemed strategic.

After the technician took out a pad to draw an inscrutable diagram, I nodded and pretended to recognize a squiggle at the center of what looked like a snail. I discussed my oncologist’s research projects, instead of complaining about pain. Generally I answered a nurse’s opening query — “So how are you?”– with a cheery “Good! How are you?” Grumbles about waiting interminably for a scan in a freezing room never rolled off my tongue. When an interventional radiologist managed to remove two stents from my body, I didn’t fault the surgeon who left them there to trigger a massive infection followed by an allergic response to antibiotics: I sent a thank you note to the radiologist.

What was wrong with me? Outside the medical sphere, I am prone to impatience, candor and bouts of argumentative fervor. Had feminine socialization kicked in? As a girl, I was trained to be courteous to people in positions of authority and to revere the saving knowledge of physicians. But men also exhibit symptoms of the good patient syndrome.

Indeed, Anatole Broyard preached its virtues in his book “Intoxicated by My Illness,” although his version was less compliant, more ironic than mine. “If a patient expects a doctor to be interested in him, he ought to try to be interesting. When he shows nothing but a greediness for care, nothing but the coarser forms of anxiety, it’s only natural for the doctor to feel an aversion.” Following this logic, Broyard embarked upon an impersonation: “I never act sick. A puling person is not appealing.” He therefore set out to charm his physicians — to distinguish himself from boring, easily forgotten patients. I did this too, adding a pinch of obedience, a dash of gratitude, and a smidgen of eccentricity to the mix. One doesn’t want to be just any old patient; patients are replaceable.

Since illness had never intoxicated me, why was I behaving like Broyard? The short answer is terror: these people could hurt me.

Were I to seem boring or easily forgotten, should I appear crabby or disagreeable, I might get neglected or, in my anxious imagination, harmed. Not consciously neglected or intentionally harmed, of course, because doctors and nurses have dedicated themselves to helping people whose sickness often makes them boring and disagreeable. But neglected or harmed nonetheless. Like most patients, I am keenly aware that the medical staff at most facilities are overloaded. It is easy to get left for hours unattended on a gurney or starved and freaked when surgeries are perpetually postponed or distressed and bruised when the bindings on limbs are roughly or hastily applied.

But of course adopting the role of model patient does not provide a solution. Much of the caretaking in hospitals remains out of the control of our personal physicians and nurses. And in any case, too much ingratiating docility can be dangerous to a patient’s health.

If I had persisted in asking my surgeon about the fate of the stents that he had implanted in my body, he might have remembered to remove them. If I had not followed to the letter the dosage he prescribed of a heavy-duty antibiotic, especially as I began to get sick to my stomach and dizzy, I might not have had the full-body breakdown of an allergic reaction. Earlier still, if I had insisted on better bowel preps before my first abdominal surgery, or a postponement, maybe the stents and infection and the allergic reaction to antibiotics would never have happened.

Even before that, if I had challenged my general practitioner who diagnosed indigestion, maybe my cancer would have been found at an earlier stage. If my grandmother had wheels, she’d be an omnibus: that’s a family joke.

So much for the magical thinking that good patients receive the best care. Being a submissive or dutiful patient doesn’t always pay off. Who exactly was I being good for? Sometimes it’s good to be bad.

Was I good for nothing? When I was at my most puling and unappealing and too sick to be good, with pain so overwhelming that I had to be taken to my oncologist’s examining room in a wheelchair, she placed her hand on my knee and kept it there while explaining how she would take care of me. Though I could not look her in the eye, though I could not speak for groaning, I took her point. I had foisted the good patient role on myself. She had always seen through the pose to the mortally sick human being. Why else would I be here, I realized.

At that moment I resolved to renounce or rectify my goodness. I don’t always succeed.


Susan Gubar is a distinguished emerita professor of English at Indiana University and the author of “Memoir of a Debulked Woman,” which explores her experience with ovarian cancer.

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Wealth Matters: What the Small Player Can Expect When Using a Lobbyist


Robert Caplin for The New York Times


Domenic Rom, a senior vice president at Technicolor, a postproduction company for film and television, became part of a group of similar companies that wanted to lobby for a tax credit.







IF there is one thing most small-business owners have in common, it is that they have far less ability than big corporations to affect what happens to them politically.




Few small-business owners — the kind of people who accumulate wealth through a service or manufacturing business and are working at it every day — have the deep pockets of a major corporation. Consider what Amgen, the world’s largest biotechnology company, did to help win an exemption in the so-called fiscal cliff bill to extend its patent on a profitable dialysis drug for two more years at a great cost to Medicare. It sent its 74 lobbyists in Washington to meet with — and direct contributions to — a host of politicians who worked in its favor.


But even if small businesses can’t buy the kind of influence that a huge company like Amgen can, that does not mean they cannot buy influence at all. Still, as in other aspects of life, you get what you pay for.


Entrepreneurs would want to hire a lobbyist for a fairly straightforward reason: they have an issue they want addressed or changed and they have reached the point where they feel they need to act. What is more difficult is acting on that impulse effectively, knowing it could cost a lot of money.


Lawrence E. Scherer, a founder of State and Broadway, a lobbying firm in New York, said a typical retainer for a small-business client would be around $5,000 a month, but the assignment could last for a year or more. Suri Kasirer, once an aide to former Gov. Mario Cuomo of New York and president of Kasirer Consulting, said her typical retainer was $10,000 to $20,000 a month, with a three-month minimum.


“For small-business owners, the idea of having a lobbyist interact with a government is so novel and so out of their scope that $5,000 a month could seem daunting,” Mr. Scherer said. “But as government has more issues in front of it, it could be a cheap date.”


People who have success lobbying state and local governments — since the federal government is beyond the budget of individuals — tend to fall into three categories: they want something changed, they want something new or they want access.


Avik Kabessa, chief executive of Carmel Car and Limousine Service in New York City, said he became part of a group of livery car owners in 2008 that lobbied the state to establish a workers’ compensation fund for livery drivers and to repeal a sales tax on livery fares.


He said it took a year and a half for the lobbying efforts to work. The costs were split among members of the group, called the Livery Round Table. (Livery companies fall between higher-end black car and limousine services and city taxis.)


“I wish we had the expertise, knowledge and contacts to have been able to do this ourselves,” he said. “But just as you would go to a doctor when you’re sick, you go to a lobbyist for your legislative affairs.”


Ms. Kasirer is working on a similar case with a group of small-business owners who do not often work well together. She is representing seven expediters — companies that are paid by contractors and developers to handle getting various building permits in New York City. She said new rules could end their business.


“We were approached by a few of them, and we said ‘Let’s get as many of them together as we could,’ ” she said. “They realized that ultimately they could be put out of business or their business could be so severely handicapped that they would have to lay off people.”


For small-business owners, forming an ad hoc group and putting aside any competitive business interest to get something greater for their industry is important. So, too, is having the patience and the willingness to accept something short of their goal and then go back for more.


Domenic Rom, a senior vice president at Technicolor, a postproduction company for film and television, became part of a group of similar companies that wanted to lobby for a tax credit. While New York offered tax credits for shooting a film or television show in the state, it did not offer similar credits to the postproduction part of the industry, which includes editing, sound design and adding computer-generated effects.


Mr. Rom said the 14 companies created the Post New York Alliance and each paid $5,000 in dues. They began lobbying in 2009, working with Mr. Scherer. By the next year, they received a 10 percent tax credit for postproduction work.


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