Let’s start with a simple medical fact: Chemotherapy doesn’t cure people who have very advanced Stage 4 lung or colon cancer.
Chemo can be quite effective at earlier stages. Even in late-stage disease, it may relieve symptoms for a while; it might help someone with tumors in his lungs breathe more easily, for example. Chemo can extend life for weeks or months.
It can also make the recipient feel nauseated, wiped out and generally lousy, and require him to spend more time in clinics and hospitals than a dying person might choose to. But it can’t banish cancer. Many aspects of medical prognosis and treatment are uncertain. Not this one.
Such patients’ doctors have almost certainly told them their cancer is incurable. Those who opted for chemotherapy anyway had to sign consent forms spelling out the potential side effects. Yet Dr. Jane Weeks, a research oncologist at Dana-Farber Cancer Institute in Boston, knew from previous studies that cancer patients can develop unrealistic ideas about their odds of survival.
So as she and her co-authors began analyzing results from the first representative national study of patients with advanced cancer, all undergoing chemotherapy, to see what they thought about its effects, Dr. Weeks expected many — perhaps a third of them — to get it wrong.
She was staggered to see how mistaken she was.
Nearly 1,200 patients or their surrogates were interviewed within months of a diagnosis of Stage 4 colon or lung cancer. They answered a number of questions during these telephone interviews, but the key one was: “After talking with your doctors, how likely did you think it was that chemotherapy would cure your cancer?” The only correct answer: “Not at all likely.”
But a great majority chose one of the other responses indicating some likelihood of cure or else said they didn’t know. The study, just published in The New England Journal of Medicine, found that 69 percent of lung cancer patients and 81 percent of those with colon cancer misunderstood the purpose of the very treatment they’d been undergoing.
The misperception was significantly higher among African-Americans, Asians and Hispanics than among whites — but not because of education levels, the usual variable in studies of health knowledge. “It suggests that this reflects cultural differences,” Dr. Weeks said.
Strangely, the patients who responded inaccurately also were more likely to highly rate their communications with doctors. Those who grasped that chemo wasn’t curative were, in effect, penalizing the doctors who helped them reach that understanding.
In a way, Dr. Weeks said, this makes sense. It reflects what researchers call optimism bias — or what Dr. Douglas White, a University of Pittsburgh bioethicist, has called “the powerful desire not to be dead.”
These were not very elderly people. The bulk were ages 55 to 69. Only about a quarter of colon cancer patients and about a third of those with lung cancer were over age 70.
“It’s completely understandable that patients want to believe the chemo will cure them,” Dr. Weeks said. “And it’s understandable that physicians hesitate to take away that false hope.”
But this confusion can have unhappy consequences. For patients to make truly informed decisions, “they need to understand the outcomes,” Dr. Weeks said. “If they’re missing this critical fact, that can’t happen.”
People often hit rough times during weeks of chemotherapy. Common side effects include nausea and vomiting, diarrhea and fatigue; there are many trips to hospitals for IV drugs, X-rays and blood tests. “They’ll soldier on if they think it will cure them,” Dr. Weeks said. “Any of us would.”
But if these patients might respond differently if they understand that chemo is meant to make them feel better but may have the opposite effect, or that it may buy them another 10 to 12 weeks (a reasonable average for lung cancer) or maybe a year (for colon cancer) but won’t prevent their deaths.
Moreover, “if patients think chemo has a chance of curing them, they’ll be less likely to have end-of-life discussions early on,” Dr. Weeks said. “And they pay a price for that later” — if they enter hospice care much too late or die in hospitals instead of at home, as many prefer.
Possibly, at the time of the initial discussions, these patients recognized that chemo didn’t equal cure, she hypothesized. Then, they and their doctors began to focus on doing something, and they stopped seeing their cancer as incurable.
But realism — as palliative care doctors know — doesn’t have to mean despair. “A really good physician can communicate effectively and still maintain patient trust and confidence,” Dr. Weeks said.
“We have the tools to help patients make these difficult decisions,” two Johns Hopkins physicians, Dr. Thomas J. Smith and Dr. Dan Longo, wrote in an editorial published with the study. “We just need the gumption and incentives to use them.”
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
How small-business issues are shaping politics and policy.
President Obama may have won a decisive reelection victory, but it is John Boehner, the Republican speaker of the House, who is making the rounds and claiming a mandate. And everywhere he goes, he’s talking about what would happen to small businesses if the Bush-era tax cuts on the wealthiest Americans are allowed to expire. To ABC News’s Diane Sawyer, Mr. Boehner said, “Raising taxes on small-business people is the wrong prescription given where our economy is.” He told USA Today, “Raising taxes on small businesses will kill jobs in America. It is as simple as that.”
In a statement to reporters the day after the election, Mr. Boehner made what some observers described as a concession: House Republicans would consider new revenue as part of a deal to avert the “fiscal cliff.” But he then explained that the new revenue could not come from higher tax rates. “In the New Testament, a parable is told of two men. One built his house on sand; the other built his house on rock,” he said. “The foundation of our country’s economy — the rock of our economy — has always been small businesses in the private sector. I ran one of those small businesses, and I can tell you: raising small businesses’ taxes means they don’t grow.”
To support the claim, Mr. Boehner turned to the same controversial Ernst & Young study on which Mitt Romney relied in the first presidential debate in Denver.
Of course, this view is no less controversial now than it was at the time of that debate. Since the debate, we’ve learned about a September report (pdf) from the nonpartisan, and respected, Congressional Research Service, which surveyed the historical record and found that “the reduction in the top tax rates have had little association with saving, investment, or productivity growth” — but “appear to be associated with the increasing concentration of income at the top of the income distribution.” The Congressional Research Service withdrew the report after Republican senators complained.
Then, last week, a report from the Congressional Budget Office seemed to suggest that raising the tax rates on the wealthiest Americans would have little effect on economic output in the fourth quarter of 2013.* Extending the top tax rates would cost the economy 200,000 jobs, according to the C.B.O., an estimate well below the 700,000 jobs that Ernst & Young predicted would be lost. In fact, the C.B.O. figures show that while raising taxes (on everybody) amounts to about two-thirds of the total deficit reduction in 2013, it has a much smaller effect on gross domestic product, the measurement for output. (The C.B.O. report relies in part on economic modeling, much like the Ernst & Young study, meaning that the C.B.O.’s assumptions about the relationship between taxes and economic output informed the results.)
And Agenda readers who own small businesses have weighed in as well. Jed Horovitz in New Jersey wrote, “Each year, I decide how much money to re-invest in my company and how much to take out. Because I pay taxes on my profit, I always look for productive ways to invest in my company first. Spending pretax money makes sense. If my taxes were lower, I would take more money out and just put it in the bank.”
Carol Gillen, who described herself as “the wife and bookkeeper of a small-business owner” in New York, said, “Demand drives hiring, not the personal income tax of the owner.”
But The Agenda would like to hear from more business owners. We want to take a close look at how you and your companies would be affected by increasing the top tax rates, including how it might affect hiring and investment plans. It would be an intensive profile — we would want to talk through specifics on revenue, income, taxes and investments. (We have made the same request to the National Federation of Independent Business and the S Corporation Association of America, both of which strongly oppose any income tax increase.)
It’s a lot to ask, we know, but it’s an important issue. If you own such a company and have employees — making you a job-creator — and you’re game, please drop us a line to let us know you’re interested.
*More precisely, the C.B.O. report said that extending all of the Bush tax cuts and fixing the Alternative Minimum Tax so that it does not reach deeper into the middle class would add about 1.4 percent to the nation’s gross domestic product in the fourth quarter of 2013. Meanwhile, fixing the Alternative Minimum Tax and extending all of the Bush tax cuts except for wealthier Americans would add about 1.3 percent to G.D.P., so the additional G.D.P. attributed to extending the tax cuts for the top two tax brackets amounts to one-tenth of 1 percent.
Terry Smith collapsed face-down in a pool of his own vomit.
Lynn Blunt snored loudly as her lungs slowly filled with fluid.
Summer Ann Burdette was midway through a pear when she stopped breathing.
Larry Carmichael knocked over a lamp as he fell to the floor.
Jennifer Thurber was curled up in bed, pale and still, when her father found her.
Karl Finnila sat down on a curb to rest and never got up.
These six people died of drug overdoses within a span of 18 months.
But according to coroners' records, that was not all they had in common. Bottles of prescription medications found at the scene of each death bore the name of the same doctor: Van H. Vu.
After Finnila died, coroner's investigators called Vu to learn about his patient's medical history and why he had given him prescriptions for powerful medications, including the painkiller hydrocodone.
Investigators left half a dozen messages. Vu never called back, coroner's records state.
Over the next four years, 10 more of his patients died of overdoses, the records show. In nine of those cases, painkillers Vu had prescribed for them were found at the scene.
Vu, a pain specialist in Huntington Beach, described himself as a conscientious, caring physician. He declined to comment on individual cases, citing confidentiality laws, but he said he treats many "very, very difficult patients" whose chronic pain is sometimes complicated by substance abuse and depression, anxiety or other mental illness.
"Every single day, I try to do the best I can for every single patient," he said in an interview. "I can't control what they do once they leave my office."
Prescription drug overdoses now claim more lives than heroin and cocaine combined, fueling a doubling of drug-related deaths in the United States over the last decade.
Health and law enforcement officials seeking to curb the epidemic have focused on how OxyContin, Vicodin, Xanax and other potent pain and anxiety medications are obtained illegally, such as through pharmacy robberies or when teenagers raid their parents' medicine cabinets. Authorities have failed to recognize how often people overdose on medications prescribed for them by their doctors.
A Los Angeles Times investigation has found that in nearly half of the accidental deaths from prescription drugs in four Southern California counties, the deceased had a doctor's prescription for at least one drug that caused or contributed to the death.
Reporters identified a total of 3,733 deaths from prescription drugs from 2006 through 2011 in Los Angeles, Orange, Ventura and San Diego counties.
An examination of coroners' records found that:
In 1,762 of those cases — 47%— drugs for which the deceased had a prescription were the sole cause or a contributing cause of death.
A small cadre of doctors was associated with a disproportionate number of those fatal overdoses. Seventy-one — 0.1% of all practicing doctors in the four counties — wrote prescriptions for drugs that caused or contributed to 298 deaths. That is 17% of the total linked to doctors' prescriptions.
When it came out that CIA Director David Petraeus had an affair with his hagiographer, I got punked. “It seems so obvious in retrospect. How could you @attackerman?” tweeted @bitteranagram, complete with a link to a florid piece I wrote for this blog when Petraeus retired from the Army last year. (“The gold standard for wartime command” is one of the harsher judgments in the piece.) I was so blind to Petraeus, and my role in the mythmaking that surrounded his career, that I initially missed @bitteranagram’s joke.
But it’s a good burn. Like many in the press, nearly every national politician, and lots of members of Petraeus’ brain trust over the years, I played a role in the creation of the legend around David Petraeus. Yes, Paula Broadwell wrote the ultimate Petraeus hagiography, the now-unfortunately titled All In. But she was hardly alone. (Except maybe for the sleeping-with-Petraeus part.) The biggest irony surrounding Petraeus’ unexpected downfall is that he became a casualty of the very publicity machine he cultivated to portray him as superhuman. I have some insight into how that machine worked.
The first time I met Petraeus, he was in what I thought of as a backwater: the Combined Armed Center at Fort Leavenworth. It’s one of the Army’s in-house academic institutions, and it’s in Kansas, far from the battlefields of Iraq and Afghanistan. In 2005, Petraeus ran the place, and accepted an interview request about his tenure training the Iraqi military, which didn’t go well. Petraeus didn’t speak for the record in that interview, but over the course of an hour, he impressed me greatly with his intelligence and his willingness to entertain a lot of questions that boiled down to isn’t Iraq an irredeemable shitshow. Back then, most generals would dismiss that line of inquiry out of hand, and that would be the end of the interview.
One of Petraeus’ aides underscored a line that several other members of the Petraeus brain trust would reiterate for years: “He’s an academic at heart,” as Pete Mansoor, a retired Army colonel who served as Petraeus’ executive officer during the Iraq surge, puts it. There was a purpose to that line: it implied Petraeus wasn’t particularly ambitious, suggesting he was content at Fort Leavenworth and wasn’t angling for a bigger job. I bought into it, especially after I found Petraeus to be the rare general who didn’t mind responding to the occasional follow-up request.
So when Petraeus got command of the Iraq war in 2007, I blogged that it was all a tragic shame that President Bush would use Petraeus, “the wisest general in the U.S. Army,” as a “human shield” for the irredeemability of the war. And whatever anyone thought about the war, they should “believe the hype” about Petraeus.
I wasn’t alone in this. Petraeus recognized that the spirited back-and-forth journalists like could be a powerful weapon in his arsenal. “His ability to talk to a reporter for 45 minutes, to flow on the record, to background or off-the-record and back, and to say meaningful things and not get outside the lane too much — it was the best I’ve ever seen,” Mansoor reflects. It paid dividends. On the strength of a single tour running the 101st Airborne in Mosul, Newsweek put the relatively unknown general on its cover in 2004 under the headline CAN THIS MAN SAVE IRAQ? (It’s the first of three cover stories the magazine wrote about him.) Petraeus’ embrace of counterinsurgency, with its self-congratulatory stylings as an enlightened form of warfare that deemphasized killing, earned him plaudits as an “intellectual,” unlike those “old-fashioned, gung-ho, blood-and-guts sort of commander[s],” as Time’s Joe Klein wrote in 2007. This media narrative took hold despite the bloody, close-encounter street fights that characterized Baghdad during the surge.
That March, I was embedded with a unit in Mosul when I learned Petraeus was making a surprise visit to its base. The only time he had for an interview was during a dawn workout session with company commanders, I was told, but if I was willing to exercise with everyone else, sure, I could ask whatever I wanted. The next morning, Petraeus came out for his five-mile run and playfully asked: “What the hell is Spencer Ackerman doing in Mosul?” It’s embarrassing to remember that that felt pretty good, but it did. And sure enough, while I sweated my way through a painful run — I had just quit smoking and was in terrible shape — he calmly parried my wheezed questions. I only later realized I didn’t gain any useful or insightful answers, just a crazy workout story that I strained to transform into a metaphor for the war. (“‘This tires you out that day, but it gives you stamina over the long run,’ he noted. ‘And this is about stamina. It’s absolutely grueling.’” Ugh.)
There was another element at work: counterinsurgency seemed to be working to reduce the tensions of Iraq’s civil war, as violence came down dramatically that summer. So when I got the occasional push-back email from Petraeus’ staff that my reporting was too negative or too ideological, I feared they had a point. And I got exclusive documents from them that — surprise, surprise — not only vindicated Petraeus but made the general seem driven by data and not ideology.
To be clear, none of this was the old quid-pro-quo of access for positive coverage. It worked more subtly than that: the more I interacted with his staff, the more persuasive their points seemed. Nor did I write anything I didn’t believe or couldn’t back up — but in retrospect, I was insufficiently critical. And his staff never cut off access when they disagreed with something I’d written. I didn’t realize I was thinking in their terminology, even when I wrote pieces criticizing Petraeus. A 2008 series I wrote on counterinsurgency was filled with florid descriptions like “Petraeus is no stranger to either difficulty or realism.”
Politicians and the press treated Petraeus as a conquering hero. Tom Ricks, then the Washington Post’s senior military correspondent, wrote that Petraeus’ “determination” was the “cornerstone of his personality,” and portrayed the success of surge as that determination beating back the insurgents and the nay-sayers. “The soldiers and marines told us they feel that they now have a superb commander in Gen. David Petraeus,” wrote Brookings Institutions analysts Michael O’Hanlon and Kenneth Pollack after a return from Iraq. “They are confident in his strategy, they see real results, and they feel now they have the numbers needed to make a real difference.” John McCain hugged Petraeus so closely during his 2008 campaign that Post columnist Jackson Diehl dubbed the general “McCain’s Running Mate.”
But by the time President Obama tapped Petraeus to run the Afghanistan war in 2010, something had changed. Petraeus’ mouth was saying “counterinsurgency,” with its focus on protecting civilians from violence, but in practice, he was far more reliant on air strikes and commando raids. He was even touting enemy body counts as measurements of success, which was completely antithetical to counterinsurgency doctrine, and his staff’s insistance that nothing had changed sounded hollow.
But then there was Broadwell to spin the shift away. On Ricks’ blog, she described the complete flattening of a southern Afghan village called Tarok Kolache, confidently asserting that not only was no one killed under 25 tons of U.S. air and artillery strikes, but that the locals appreciated it. Danger Room’s follow-up reporting found that the strikes were even more intense: two other villages that the Taliban had riddled with bombs, were destroyed as well. But Broadwell, who was traveling around Afghanistan and working on a biography of Petraeus, didn’t grapple with the implications of Petraeus shifting away from counterinsurgency, let alone the fortunes of the Afghanistan war.
Broadwell didn’t have a journalistic background, and it seemed a bit odd that she was visibly welcomed into Petraeus’ inner circle. At a Senate hearing Petraeus testified at last year, for instance, I met Broadwell for the first time in person, and noted that she sat with Petraeus’ retinue instead of with the press corps. Some of Petraeus’ old crew found it similarly strange. “I never told General Petraeus this, but I thought it was fairly strange that he would give so much access to someone who had never written a book before,” Mansoor recalls.
At the same time, consider this passage from All In:
Far beyond his influence on the institutions and commands in Iraq and Afghanistan, Petraeus also left an indelible mark on the next generation of military leaders as a role model of soldier-scholar statesman. … Creative thinking and the ability to wrestle with intellectual challenges are hugely important in counterinsurgency but also any campaign’s design and execution, he felt; and equipping oneself with new analytical tools, civilian and academic experiences, and various networks had been invaluable for him and — he hoped — for those whom he’d mentored and led.
The uncomfortable truth is that a lot of us who’ve covered Petraeus over the years could have written that. It’s embarrassingly close to my piece on Petraeus’ legacy that @bitteranagram tweeted. And that’s not something you should fault Petraeus for. It’s something you should fault reporters like me for. Another irony that Petraeus’ downfall reveals is that some of us who egotistically thought our coverage of Petraeus and counterinsurgency was so sophisticated were perpetuating myths without fully realizing it.
None of this is to say that Petraeus was actually a crappy officer whom the press turned into a genius. That would be just as dumb and ultimately unfair as lionizing Petraeus, whose affair had nothing to do with his military leadership or achievements. ”David Petraeus will be remembered as the finest officer of his generation, and as the commander who turned the Iraq War around,” emails military scholar Mark Moyar. But it is to say that a lot of the journalism around Petraeus gave him a pass, and I wrote too much of it. Writing critically about a public figure you come to admire is a journalistic challenge.
Conversations with people close to Petraeus since his resignation from the CIA have been practically funereal. People have expressed shock, and gotten occasionally emotional. It turns out, Mansoor sighed, “David Petraeus is human after all.” I wonder where anyone could have gotten the idea he wasn’t.
LOS ANGELES (Reuters) – The new James Bond movie “Skyfall” dominated movie box offices with $ 87.8 million in ticket sales in its U.S. and Canadian debut over the weekend for the biggest Bond opening ever, according to studio estimates released on Sunday.
“Skyfall,” starring Daniel Craig as the famous super-spy, finished ahead of last weekend’s winner, family film “Wreck-It Ralph.” The animated Walt Disney Co movie about a videogame character grabbed $ 33.1 million from Friday through Sunday.
In third place, the Denzel Washington drama “Flight” earned $ 15.1 million. The movie tells the story of an airline captain who saves his plane from crashing but is accused of drinking before the flight.
Sony Corp’s movie studio released “Skyfall.” “Flight” was distributed by Paramount Pictures, a unit of Viacom Inc.
(Reporting by Lisa Richwine; Editing by Will Dunham)
Three days before his death last week at 88, Darrell Royal told his wife, Edith: “We need to go back to Hollis” — in Oklahoma. “Uncle Otis died.”
“Oh, Darrell,” she said, “Uncle Otis didn’t die.”
Royal, a former University of Texas football coach, chuckled and said, “Well, Uncle Otis will be glad to hear that.”
The Royal humor never faded, even as he sank deeper into Alzheimer’s disease. The last three years, I came to understand this as well as anyone. We had known each other for more than 40 years. In the 1970s, Royal was a virile, driven, demanding man with a chip on his shoulder bigger than Bevo, the Longhorns mascot. He rarely raised his voice to players. “But we were scared to death of him,” the former quarterback Bill Bradley said.
Royal won 3 national championships and 167 games before retiring at 52. He was a giant in college football, having stood shoulder to shoulder with the Alabama coach Bear Bryant. Royal’s Longhorns defeated one of Bryant’s greatest teams, with Joe Namath at quarterback, in the 1965 Orange Bowl. Royal went 3-0-1 in games against Bryant.
Royal and I were reunited in the spring of 2010. I barely recognized him. The swagger was gone. His mind had faded. Often he stared aimlessly across the room. I scheduled an interview with him for my book “Courage Beyond the Game: The Freddie Steinmark Story.” Still, I worried that his withering mind could no longer conjure up images of Steinmark, the undersize safety who started 21 straight winning games for the Longhorns in the late 1960s. Steinmark later developed bone cancer that robbed him of his left leg.
When I met with Royal and his wife, I quickly learned that his long-term memory was as clear as a church bell. For two hours, Royal took me back to Steinmark’s recruiting trip to Austin in 1967, through the Big Shootout against Arkansas in 1969, to the moment President Richard M. Nixon handed him the national championship trophy in the cramped locker room in Fayetteville. He recalled the day at M. D. Anderson Hospital in Houston the next week when doctors informed Steinmark that his leg would be amputated if a biopsy revealed cancer. Royal never forgot the determined expression on Steinmark’s face, nor the bravery in his heart.
The next morning, Royal paced the crowded waiting room floor and said: “This just can’t be happening to a good kid like Freddie Steinmark. This just can’t be happening.”
With the love of his coach, Steinmark rose to meet the misfortune. Nineteen days after the amputation, he stood with crutches on the sideline at the Cotton Bowl for the Notre Dame game. After the Longhorns defeated the Fighting Irish, Royal tearfully presented the game ball to Steinmark.
Four decades later, while researching the Steinmark book, I became close to Royal again. As I was leaving his condominium the day of the interview, I said, “Coach, do you still remember me?” He smiled and said, “Now, Jim Dent, how could I ever forget you?” My sense of self-importance lasted about three seconds. Royal chuckled. He pointed across the room to the message board next to the front door that read, “Jim Dent appt. at 10 a.m.”
Edith and his assistant, Colleen Kieke, read parts of my book to him. One day, Royal told me, “It’s really a great book.” But I can’t be certain how much he knew of the story.
Like others, I was troubled to see Royal’s memory loss. He didn’t speak for long stretches. He smiled and posed for photographs. He seemed the happiest around his former players. He would call his longtime friend Tom Campbell, an all-Southwest Conference defensive back from the 1960s, and say, “What are you up to?” That always meant, “Let’s go drink a beer.”
As her husband’s memory wore thin, Edith did not hide him. Instead, she organized his 85th birthday party and invited all of his former players. Quarterback James Street, who engineered the famous 15-14 comeback against Arkansas in 1969, sat by Royal’s side and helped him remember faces and names. The players hugged their coach, then turned away to hide the tears.
In the spring of 2010, I was invited to the annual Mexican lunch for Royal attended by about 75 of his former players. A handful of them were designated to stand up and tell Royal what he meant to them. Royal smiled through each speech as his eyes twinkled. I was mesmerized by a story the former defensive tackle Jerrel Bolton told. He recalled that Royal had supported him after the murder of his wife some 30 year earlier.
“Coach, you told me it was like a big cut on my arm, that the scab would heal, but that the wound would always come back,” Bolton said. “It always did.”
Royal seemed to drink it all in. But everyone knew his mind would soon dim.
The last time I saw him was June 20 at the County Line, a barbecue restaurant next to Bull Creek in Austin. Because Royal hated wheelchairs and walkers, the former Longhorn Mike Campbell, Tom’s twin, and I helped him down the stairs by wrapping our arms around his waist and gripping the back of his belt. I ordered his lunch, fed him his sandwich and cleaned his face with a napkin. He looked at me and said, “Was I a college player in the 1960s?”
“No, Coach,” I said. “But you were a great player for the Oklahoma Sooners in the late 1940s. You quarterbacked Oklahoma to an 11-0 record and the Sooners’ first national championship in 1949.”
He smiled and said, “Well, I’ll be doggone.”
After lunch, Mike Campbell and I carried him up the stairs. We sat him on a bench outside as Tom Campbell fetched the car. In that moment, the lunch crowd began to spill out of the restaurant. About 20 customers recognized Royal. They took his photograph with camera phones. Royal smiled and welcomed the hugs.
“He didn’t remember a thing about it,” Tom Campbell said later. “But it did his heart a whole lot of good.”
Jim Dent is the author of “The Junction Boys” and eight other books.
SACRAMENTO — State corrections officials are poised to drop the arrest warrants of thousands of parole violators, releasing them from state supervision at a time when their detention would complicate efforts to ease crowding in state and county lockups.
The Department of Corrections and Rehabilitation intends to begin a massive review next week of more than 9,200 outstanding warrants, starting with individuals who were convicted of nonviolent crimes and absconded from supervision. Over the next eight months, parole field offices across the state will be given lists of missing felons, 200 at a time, to review and determine if retaining them on parole "would not be in the interest of justice."
The mass purge is an attempt to ease the burden on counties in July, when the state hands off responsibility for parole revocations to local courts, said agency spokesman Jeffrey Callison. Weeding out cases that are years old, or of parolees nobody is looking for, will make it easier to focus on those who pose a threat, he said.
It will not, Callison said, "allow some paroles to 'get off the hook.' "
"I have been told that discharging people is not the point of the exercise," he said Friday.
Which is exactly the claim of some victims' advocates who are infuriated by the state's so-called warrant review project.
"It's mass amnesty for felons," said Assemblyman Jim Nielsen (R-Gerber), a vocal opponent of Gov. Jerry Brown's plans to ease state prison crowding by shifting responsibility for low-level offenders to counties.
When inmates are released from state prison, they are required to report to a parole officer. When a felon does not appear, or disappears later, an arrest warrant is issued. With low-level offenders now serving time in county jails, the state's parole population is shrinking dramatically because those released from jail go to county probation, not state parole.
But the same law that shifted responsibility for low-level offenders also requires county courts to take over most revocation hearings for parole violators. The warrant review will remove many of those potential cases.
The plan calls for parole agents to review about 7,000 warrants against low-level offenders to determine if those parolees have violent offenses or multiple felonies, belong to gangs or committed new crimes. Agents will then decide whether to drop the warrant and release the felon from parole.
Once that review is completed, the agency may undertake a similar study of outstanding warrants against missing parolees who committed serious or violent offenses, indicating that they too might be released from state supervision.
Sexual offenders are excluded from the reviews.
Callison said the state has no idea how many parolees may be released from supervision. Nielsen, former chairman of the Board of Prison Terms, estimated it would be 70%.
"This is as close as just letting people go as we've come," said Todd Gillam, a Northern California parole agent and vice president of the Parole Agent Assn. of California.
Gillam said the mass reviews overlook the value of leaving outstanding warrants in law enforcement computer systems, especially for routine matters such as traffic stops. "The warrant is a warning, to alert the officer that this guy is a problem," he said.
Gillam and others said parole agents are under pressure to release felons from state supervision as soon as possible.
Those criticisms come as the corrections department reacted to a report in the Fresno Bee on Friday that the man who killed two people at a chicken processing plant in Fresno earlier this week, then killed himself, was released from parole over the objections of his parole agent. The gunman, Lawrence Jones, was freed from prison in June 2011 and discharged from parole in May, even though his parole agent deemed him a danger.
The state corrections department "greatly regrets the tragedy," spokesman Luis Patino said, "but it must be noted that Jones had been out in the community for almost a full year and a half when he apparently committed this heinous crime.... Neither CDCR, nor any other law enforcement agency, can guarantee that someone will not commit a crime out in the community once they have been released from prison."
The newspaper's report also came on the same day that the governor named a new state parole chief: Daniel Stone, a longtime agency employee and former parole officer. Stone's appointment over the Division of Adult Parole requires state Senate confirmation.
Epic fantasy has become the literature of more. We equate it with more pages than the average book, more books than the average series. There are more characters, more maps, more names and more dates. The stories and the worlds are bigger to contain all of this more. And when all the books have been devoured, the fans want more.
For my just-released anthology, Epic: Legends of Fantasy, I compiled a collection of stories that demonstrate the heights the subgenre is capable of attaining; including works by George R. R. Martin, Brandon Sanderson, Patrick Rothfuss, Robin Hobb, Tad Williams, Ursula K. Le Guin and other legends of the field, the anthology attempts to survey all that is epic in the short form and bring the best of it to you in a single volume.
In this exclusive excerpt from the anthology, Mary Robinette Kowal presents a tale that exemplifies what epic fantasy is all about.
By Mary Robinette Kowal
Light dappled through the trees in the family courtyard, painting shadows on the paving stones. Li Reiko knelt by her son to look at his scraped knee.
“I just scratched it.” Nawi squirmed under her hands.
Her daughter, Aya, leaned over her shoulder studying the healing. “Maybe Mama will show you her armor after she heals you.”
Nawi stopped wiggling. “Really?”
Reiko shot Aya a warning look, but her little boy’s dark eyes shone with excitement. Reiko smiled. “Really.” What did tradition matter? “Now let me heal your knee.” She laid her hand on the shallow wound.
“Ow.”
“Shush.” Reiko closed her eyes and rose in the dark space behind them.
In her mind’s eye, Reiko took her time with the ritual, knowing it took less time than it appeared. In a heartbeat, green fire flared out to the walls of her mind. She dissolved into it as she focused on healing her son.
When the wound closed beneath her hand, she sank to the surface of her mind.
“There.” She tousled Nawi’s hair. “That wasn’t bad, was it?”
“It tickled.” He wrinkled his nose. “Will you show me your armor now?”
She sighed. She should not encourage his interest in the martial arts. His work would be with the histories that men kept, and yet…”Watch.”
Pulling the smooth black surface out of the ether, she manifested her armor. It sheathed her like silence in the night. Aya watched with obvious anticipation for the day when she earned her own armor. Nawi’s face, full of sharp yearning for something he would never have, cut Reiko’s heart like a new blade.
“Can I see your sword?”
She let her armor vanish into thought. “No.” Reiko brushed his hair from his eyes. “It’s my turn to hide, right?”
- - -
Halldór twisted in his saddle, trying to ease the kink in his back. When the questing party reached the Parliament, he could remove the weight hanging between his shoulders.
With each step his horse took across the moss-covered lava field, the strange blade bumped against his spine, reminding him that he carried a legend. None of the runes or sheep entrails he read before their quest had foretold the ease with which they fulfilled the first part of the prophecy. They had found the Chooser of the Slain’s narrow blade wrapped in linen, buried beneath an abandoned elf-house. In that dark room, the sword’s hard silvery metal — longer than any of their bronze swords — had seemed lit by the moon.
Lárus pulled his horse alongside Halldór. “Will the ladies be waiting for us, do you think?”
“Maybe for you, my lord, but not for me.”
“Nonsense. Women love the warrior-priest. ‘Strong and sensitive.’” He snorted through his mustache. “Just comb your hair so you don’t look like a straw man.”
A horse screamed behind them. Halldór turned, expecting to see its leg caught in one of the thousands of holes between the rocks. Instead, armed men swarmed from the gullies between the rocks, hacking at the riders. Bandits.
Halldór spun his horse to help Lárus and the others fight them off.
Lárus shouted, “Protect the Sword.”
At the Duke’s command, Halldór cursed and turned his horse from the fight, galloping across the rocks. Behind him, men cried out as they protected his escape. His horse twisted along the narrow paths between stones. It stopped abruptly, avoiding a chasm. Halldór looked back.
Scant lengths ahead of the bandits, Lárus rode, slumped in his saddle. Blood stained his cloak. The other men hung behind Lárus, protecting the Duke as long as possible.
Behind them, the bandits closed the remaining distance across the lava fields.
Halldór kicked his horse’s side, driving it around the chasm. His horse stumbled sickeningly beneath him. Its leg snapped, caught between rocks. Halldór kicked free of the saddle as the horse screamed. He rolled clear. The rocky ground slammed the sword into his back. His face passed over the edge of the chasm. Breathless, he recoiled from the drop.
As he scrambled to his feet, Lárus thundered up. Without wasting a beat, Lárus flung himself from the saddle and tossed Halldór the reins. “Get the Sword to Parliament!”
Halldór grabbed the reins, swinging into the saddle. If they died returning to Parliament, did it matter that they had found the Sword? “We must invoke the Sword!”
Lárus’s right arm hung, blood-drenched, by his side, but he faced the bandits with his left. “Go!”
Halldór yanked the Sword free of its wrappings. For the first time in six thousand years, the light of the sun fell on the silvery blade bringing fire to its length. It vibrated in his hands.
The first bandit reached Lárus and forced him back.
Halldór chanted the runes of power, petitioning the Chooser of the Slain.
Time stopped.
- - -
Reiko hid from her children, blending into the shadows of the courtyard with more urgency than she felt in combat. To do less would insult them.
“Ready or not, here I come!” Nawi spun from the tree and sprinted past her hiding place. Aya turned more slowly and studied the courtyard. Reiko smiled as her daughter sniffed the air, looking for tracks. Her son crashed through the bushes, kicking leaves with each footstep.
As another branch cracked under Nawi’s foot, Reiko stifled the urge to correct his appalling technique. She would speak with his tutor about what the woman was teaching him. He was a boy, but that was no reason to neglect his education.
Watching Aya find Reiko’s initial footprints and track them away from where she hid, Reiko slid from her hiding place. She walked across the courtyard to the fountain. This was a rule with her children; to make up for the size difference, she could not run.
She paced closer to the sparkling water, masking her sounds with its babble. From her right, Nawi shouted, “Have you found her?”
“No, silly!” Aya shook her head and stopped. She put her tiny hands on her hips, staring at the ground. “Her tracks stop here.”
Reiko and her daughter were the same distance from the fountain, but on opposite sides. If Aya were paying attention, she would realize her mother had retraced her tracks and jumped from the fountain to the paving stones circling the grassy center of the courtyard. Reiko took three more steps before Aya turned.
As her daughter turned, Reiko felt, more than heard, her son on her left, reaching for her. Clever. He had misdirected her attention with his noise in the shrubbery. She fell forward, using gravity to drop beneath his hands. Rolling on her shoulder, she somersaulted, then launched to her feet as Aya ran toward her.
Nawi grabbed for her again. With a child on each side, Reiko danced and dodged closer to the fountain. She twisted from their grasp, laughing with them each time they missed her. Their giggles echoed through the courtyard.
The world tipped sideways and vibrated. Reiko stumbled as pain ripped through her spine.
Nawi’s hand clapped against her side. “I got her!”
Fire engulfed Reiko.
The courtyard vanished.
- - -
Time began again.
The sword in Halldór’s hands thrummed with life. Fire from the sunset engulfed the sword and split the air. With a keening cry, the air opened and a form dropped through, silhouetted against a haze of fire. Horses and men screamed in terror.
When the fire died away, a woman stood between Halldór and the bandits.
Halldór’s heart sank. Where was the Chooser of the Slain? Where was the warrior the sword had petitioned?
A bandit snarled a laughing oath and rushed toward them. The others followed him with their weapons raised.
The woman snatched the sword from Halldór’s hands. In that brief moment, when he stared at her wild face, he realized that he had succeeded in calling Li Reiko, the Chooser of the Slain.
Then she turned. The air around her rippled with a heat haze as armor, dark as night, materialized around her body. He watched her dance with deadly grace, bending and twisting away from the bandits’ blows. Without seeming thought, with movement as precise as ritual, she danced with death as her partner. Her sword slid through the bodies of the bandits.
Halldór dropped to his knees, thanking the gods for sending her. He watched the point of her sword trace a line, like the path of entrails on the church floor. The line of blood led to the next moment, the next and the next, as if each man’s death was predestined.
Then she turned her sword on him.
Her blade descended, burning with the fire of the setting sun. She stopped as if she had run into a wall, with the point touching Halldór’s chest.
Why had she stopped? If his blood was the price for saving Lárus, so be it. Her arm trembled. She grimaced, but did not move the sword closer.
Her face, half-hidden by her helm, was dark with rage. “Where am I?” Her words were crisp, more like a chant than common speech.
Holding still, Halldór said, “We are on the border of the Parliament lands, Li Reiko.”
Her dark eyes, slanted beneath angry lids, widened. She pulled back and her armor rippled, vanishing into thought. Skin, tanned like the smoothest leather stretched over her wide cheekbones. Her hair hung in a heavy, black braid down her back. Halldór’s pulse sang in his veins.
Only the gods in sagas had hair the color of the Allmother’s night. Had he needed proof he had called the Chooser of the Slain, the inhuman black hair would have convinced him of that.
He bowed his head. “All praise to you, Great One. Grant us your blessings.”
- - -
Reiko’s breath hissed from her. He knew her name. She had dropped through a flaming portal into hell and this demon with bulging eyes knew her name.
She had tried to slay him as she had the others, but could not press her sword forward, as if a wall had protected him.
And now he asked for blessings.
“What blessings do you ask of me?” Reiko said. She controlled a shudder. What human had hair as pale as straw?
Straw lowered his bulging eyes to the demon lying in front of him. “Grant us, O Gracious One, the life of our Duke Lárus.”
This Lárus had a wound deep in his shoulder. His blood was as red as any human’s, but his face was pale as death.
She turned from Straw and wiped her sword on the thick moss, cleaning the blood from it. As soon as her attention seemed turned from them, Straw attended Lárus. She kept her awareness on the sounds of his movement as she sought balance in the familiar task of caring for her weapon. By the Gods! Why did he have her sword? It had been in her rooms not ten minutes before playing hide and seek with her children.
Panic almost took her. What had happened to her Aya and Nawi? She needed information, but displaying ignorance to an enemy was a weakness, which could kill surer than the sharpest blade. She considered.
Their weapons were bronze, not steel, and none of her opponents had manifested armor. They dressed in leather and felted wool, but no woven goods. So, then. That was their technology.
Straw had not healed Lárus, so perhaps they could not. He wanted her aid. Her thoughts checked. Could demons be bound by blood debt?
She turned to Straw.
“What price do you offer for this life?”
Straw raised his eyes; they were the color of the sky. “I offer my life unto you, O Great One.”
She set her lips. What good would vengeance do? Unless… “Do you offer blood or service?”
He lowered his head again. “I submit to your will.”
“You will serve me then. Do you agree to be my bound man?”
“I do.”
“Good.” She sheathed her sword. “What is your name?”
“Halldór Arnarsson.”
“I accept your pledge.” She dropped to her knees and pushed the leather from the wound on Lárus’s shoulder. She pulled upon her reserves and, rising into the healing ritual, touched his mind.
He was human.
She pushed the shock aside; she could not spare the attention.
- - -
Halldór gasped as fire glowed around Li Reiko’s hands. He had read of gods healing in the sagas, but bearing witness was beyond his dreams.
The glow faded. She lifted her hands from Lárus’s shoulder. The wound was gone. A narrow red line and the blood-soaked clothing remained. Lárus opened his eyes as if he had been sleeping.
But her face was drawn. “I have paid the price for your service, bound man.” She lifted a hand to her temple. “The wound was deeper…” Her eyes rolled back in her head and she slumped to the ground.
Lárus sat up and grabbed Halldór by the shoulder. “What did you do?”
Shaking Lárus off, Halldór crouched next to her. She was breathing. “I saved your life.”
“By binding yourself to a woman? Are you mad?”
“She healed you. Healed! Look.” Halldór pointed at her hair. “Look at her. This is Li Reiko.”
“Li Reiko was a Warrior.”
“You saw her. How long did it take her to kill six men?” He pointed at the carnage behind them. “Name one man who could do that.”
Would moving her be a sacrilege? He grimaced. He would beg forgiveness if that were the case. “We should move before the sun sets and the trolls come out.”
Lárus nodded slowly, his eyes still on the bodies around them. “Makes you wonder, doesn’t it?”
“What?”
“How many other sagas are true?”
Halldór frowned. “They’re all true.”
- - -
The smell of mutton invaded her dreamless sleep. Reiko lay under sheepskin, on a bed of straw ticking. The straw poked through the wool fabric, pricking her bare skin. Straw. Her memory tickled her with an image of hair the color of straw. Halldór.
Long practice kept her breath even. She lay with her eyes closed, listening. A small room. An open fire. Women murmuring. She needed to learn as much as possible, before changing the balance by letting them know she was awake.
A hand placed a damp rag on her brow. The touch was light, a woman or a child.
The sheepskin’s weight would telegraph her movement if she tried grabbing the hand. Better to open her eyes and feign weakness than to create an impression of threat. There was time for that later.
Reiko let her eyes flutter open. A girl bent over her, cast from the same demonic mold as Halldór. Her hair was the color of honey, and her wide blue eyes started from her head. She stilled when Reiko awoke, but did not pull away.
Reiko forced a smile, and let worry appear on her brow. “Where am I?”
“In the women’s quarters at the Parliament grounds.”
Reiko sat up. The sheepskin fell away, letting the cool air caress her body. The girl averted her eyes. Conversation in the room stopped.
Interesting. They had a nudity taboo. She reached for the sheepskin and pulled it over her torso. “What is your name?”
“Mara Halldórsdottir.”
Her bound man had a daughter. And his people had a patronymic system — how far from home was she? “Where are my clothes, Mara?”
The girl lifted a folded bundle of cloth from a low bench next to the bed. “I washed them for you.”
“Thank you.” If Mara had washed and dried her clothes, Reiko must have been unconscious for several hours. Lárus’s wound had been deeper than she thought. “Where is my sword?”
“My father has it.”
Rage filled Reiko’s veins like the fire that had brought her here. She waited for the heat to dwindle, then began dressing. As Reiko pulled her boots on, she asked, “Where is he?”
Behind Mara, the other women shifted as if Reiko were crossing a line. Mara ignored them. “He’s with Parliament.”
“Which is where?” The eyes of the other women felt like heat on her skin. Ah. Parliament contained the line she should not cross, and they clearly would not answer her. Her mind teased her with memories of folk in other lands. She had never paid much heed to these stories, since history had been men’s work. She smiled at Mara. “Thank you for your kindness.”
As she strode from the room she kept her senses fanned out, waiting for resistance from them, but they hung back as if they were afraid.
The women’s quarters fronted on a narrow twisting path lined with low turf and stone houses. The end of the street opened on a large raised circle surrounded by stone benches.
Men sat on the benches, but women stayed below. Lárus spoke in the middle of the circle. By his side, Halldór stood with her sword in his hands. Sheltering in the shadow by a house, Reiko studied them. They towered above her, but their movements were clumsy and oafish like a trained bear. Nawi had better training than any here.
Her son. Sudden anxiety and rage filled her lungs, but rage invited rash decisions. She forced the anger away.
With effort, she returned her focus to the men. They had no awareness of their mass, only of their size and an imperfect grasp of that.
Halldór lifted his head. As if guided by strings his eyes found her in the shadows.
He dropped to his knees and held out her sword. In mid-sentence, Lárus looked at Halldór, and then turned to Reiko. Surprise crossed his face, but he bowed his head.
“Li Reiko, you honor us with your presence.”
Reiko climbed onto the stone circle. As she crossed to retrieve her sword, an ox of a man rose to his feet. “I will not sit here, while a woman is in the Parliament’s circle.”
Lárus scowled. “Ingolfur, this is no mortal woman.”
Reiko’s attention sprang forward. What did they think she was, if not mortal?
“You darkened a trollop’s hair with soot.” Ingolfur crossed his arms. “You expect me to believe she’s a god?”
Her pulse quickened. What were they saying? Lárus flung his cloak back, showing the torn and blood-soaked leather at his shoulder. “We were set upon by bandits. My arm was cut half off and she healed it.” His pale face flushed red. “I tell you this is Li Reiko, returned to the world.”
She understood the words, but they had no meaning. Each sentence out of their mouths raised a thousand questions in her mind.
“Ha.” Ingolfur spat on the ground. “Your quest sought a warrior to defeat the Troll King.”
This she understood. “And if I do, what price do you offer?”
Lárus opened his mouth but Ingolfur crossed the circle.
“You pretend to be the Chooser of the Slain?” Ingolfur reached for her, as if she were a doll he could pick up. Before his hand touched her shoulder, she took his wrist, pulling on it as she twisted. She drove her shoulder into his belly and used his mass to flip him as she stood.
She had thought these were demons, but by their actions they were men, full of swagger and rash judgment. She waited. He would attack her again.
Ingolfur raged behind her. Reiko focused on his sounds and the small changes in the air. As he reached for her, she twisted away from his hands and with his force, sent him stumbling from the circle. The men broke into laughter.
She waited again.
It might take time but Ingolfur would learn his place. A man courted death, touching a woman unasked.
Halldór stepped in front of Reiko and faced Ingolfur. “Great Ingolfur, surely you can see no mortal woman could face our champion.”
Reiko cocked her head slightly. Her bound man showed wit by appeasing the oaf’s vanity.
Lárus pointed to her sword in Halldór’s hands. “Who here still doubts we have completed our quest?” The men shifted on their benches uneasily. “We fulfilled the first part of the prophecy by returning Li Reiko to the world.”
What prophecy had her name in it? There might be a bargaining chip here.
“You promised us a mighty warrior, the Chooser of the Slain,” Ingolfur snarled, “not a woman.”
It was time for action. If they wanted a god, they should have one. “Have no doubt. I can defeat the Troll King.” She let her armor flourish around her. Ingolfur drew back involuntarily. Around the circle, she heard gasps and sharp cries.
She drew her sword from Halldór’s hands. “Who here will test me?”
Halldór dropped to his knees in front of her. “The Chooser of the Slain!”
In the same breath, Lárus knelt and cried, “Li Reiko!”
Around the circle, men followed suit. On the ground below, women and children knelt in the dirt. They cried her name. In the safety of her helm, Reiko scowled. Playing at godhood was a dangerous lie.
She lowered her sword. “But there is a price. You must return me to the heavens.”
Halldór’s eyes grew wider than she thought possible. “How, my lady?”
She shook her head. “You know the gods grant nothing easily. They say you must return me. You must learn how. Who here accepts that price for your freedom from the trolls?”
She sheathed her sword and let her armor vanish into thought. Turning on her heel, she strode off the Parliament’s circle.
- - -
Halldór clambered to his feet as Li Reiko left the Parliament circle. His head reeled. She hinted at things beyond his training. Lárus grabbed him by the arm. “What does she mean, return her?”
Ingolfur tossed his hands. “If that is the price, I will pay it gladly. Ridding the world of the Troll King and her at the same time would be a joy.”
“Is it possible?”
Men crowded around Halldór, asking him theological questions of the sagas. The answers eluded him. He had not cast a rune-stone or read an entrail since they started for the elf-house a week ago. “She would not ask if it were impossible.” He swallowed. “I will study the problem with my brothers and return to you.”
Lárus clapped him on the back. “Good man.” When Lárus turned to the throng surrounding them, Halldór slipped away.
He found Li Reiko surrounded by children. The women hung back, too shy to come near, but the children crowded close. Halldór could hardly believe she had killed six men as easily as carding wool. For the space of a breath, he watched her play peek-a-boo with a small child, her face open with delight and pain.
She saw him and shutters closed over her soul. Standing, her eyes impassive, she said. “I want to read the prophecy.”
He blinked, surprised. Then his heart lifted; maybe she would show him how to pay her price. “It is stored in the church.”
Reiko brushed the child’s hair from its eyes, then fell into step beside Halldór. He could barely keep a sedate pace to the church.
Inside, he led her through the nave to the library beside the sanctuary. The other priests, studying, stared at the Chooser of the Slain. Halldór felt as if he were outside himself with the strangeness of this. He was leading Li Reiko, a Warrior out of the oldest sagas, past shelves containing her history.
Since the gods had arrived from across the sea, his brothers had recorded their history. For six-thousand unbroken years, the records of prophecy and the sagas kept their history whole.
When they reached the collections desk, the acolyte on duty looked as if he would wet himself. Halldór stood between the boy and the Chooser of the Slain, but the boy still stared with an open mouth.
“Bring me the Troll King prophecy, and the Sagas of Li Nawi, Volume I. We will be in the side chapel.”
Still gaping, the boy nodded and ran down the aisles.
“We can study in here.” He led the Chooser of the Slain to the side chapel. Halldór was shocked again at how small she was, not much taller than the acolyte. He had thought the gods would be larger than life.
He had hundreds of questions, but none of the words.
When the acolyte came back, Halldór sent a silent prayer of thanks. Here was something they could discuss. He took the vellum roll and the massive volume of sagas the acolyte carried and shooed him out of the room.
Halldór’s palms were damp with sweat as he pulled on wool gloves to protect the manuscripts. He hesitated over another pair of gloves, then set them aside. Her hands could heal; she would not damage the manuscripts.
Carefully, Halldór unrolled the prophecy scroll on the table. He did not look at the rendering of entrails. He watched her.
She gave no hint of her thoughts. “I want to hear your explanation of this.”
A cold current ran up his spine, as if he were eleven again, explaining scripture to an elder. Halldór licked his lips and pointed at the arc of sclera. “This represents the heavens, and the overlap here,” he pointed at the bulge of the lower intestine, “means time of conflict. I interpreted the opening in the bulge to mean specifically the Troll King. This pattern of blood means — ”
She crossed her arms. “You clearly understand your discipline. Tell me the prophecy in plain language.”
“Oh.” He looked at the drawing of the entrails again. What did she see that he did not? “Well, in a time of conflict — which is now — the Chooser of the Slain overcomes the Troll King.” He pointed at the shining knot around the lower intestine. “See how this chokes off the Troll King. That means you win the battle.”
“And how did you know the legendary warrior was — is me?”
“I cross-referenced with our histories and you were the one that fit the criteria.”
She shivered. “Show me the history. I want to understand how you deciphered this.”
Halldór thanked the gods that he had asked for Li Nawi’s saga as well. He placed the heavy volume of history in front of Li Reiko and opened to the Book of Fire, Chapter I.
- - -
In the autumn of the Fire, Li Reiko, greatest of the warriors, trained Li Nawi and his sister Aya in the ways of Death. In the midst of the training, a curtain of fire split Nawi from Aya and when they came together again, Li Reiko was gone. Though they were frightened, they understood that the Chooser of the Slain had taken a rightful place in heaven.
Reiko trembled, her control gone. “What is this?”
“It is the Saga of Li Nawi.”
She tried phrasing casual questions, but her mind spun in circles. “How do you come to have this?”
Halldór traced the letters with his gloved hand. “After the Collapse, when waves of fire had rolled across our land, Li Nawi came across the oceans with the other gods. He was our conqueror and our salvation.”
The ranks of stone shelves filled with thick leather bindings crowded her. Her heart kicked wildly.
Halldór’s voice seemed drowned out by the drumming of her pulse. “The Sagas are our heritage and charge. The gods have left the Earth, but we keep records of histories as they taught us.”
Reiko turned her eyes blindly from the page. “Your heritage?”
“I have been dedicated to the service of the gods since my birth.” He paused. “Your sagas were the most inspiring. Forgive my trespasses, may I beg for your indulgence with a question?”
“What?” Hot and cold washed over her in sickening waves.
“I have read your son Li Nawi’s accounts of your triumphs in battle.”
Reiko could not breathe. Halldór flipped the pages forward. “This is how I knew where to look for your sword.” He paused with his hand over the letters. “I deciphered the clues to invoke it and call you here, but there are many — ”
Reiko pushed away from the table. “You caused the curtain of fire?” She wanted to vomit her fear at his feet.
“I — I do not understand.”
“I dropped through fire this morning.” And when they came together again, Li Reiko was no more. What had it been like for Aya and Nawi to watch their mother ripped out of time?
Halldór said, “In answer to my petition.”
“I was playing hide and seek with my children and you took me.”
“You were in the heavens with the gods.”
“That’s something you tell a grieving child!”
“I — I didn’t, I — ” His face turned gray. “Forgive me, Great One.”
“I am not a god!” She pushed him, all control gone. He tripped over a bench and dropped to the floor. “Send me back.”
“I cannot.”
Her sword flew from its sheath before she realized she held it. “Send me back!” She held it to his neck. Her arms trembled with the desire to run it through him. But it would not move.
She leaned on the blade, digging her feet into the floor. “You ripped me out of time and took me from my children.”
He shook his head. “It had already happened.”
“Because of you.” Her sword crept closer, pricking a drop of blood from his neck. What protected him?
Halldór lay on his back. “I’m sorry. I didn’t know…I was following the prophecy.”
Reiko staggered. Prophecy. A wall of predestination. Empty, she dropped to the bench and cradled her sword. “How long ago…?”
“Six thousand years.”
She closed her eyes. This was why he could not return her. He had not simply brought her from across the sea like the other “gods.” He had brought her through time. If she were trapped here, if she could never see her children again, it did not matter if these were human or demons. She was banished in Hell.
“What do the sagas say about my children?”
Halldór rolled to his knees. “I can show you.” His voice shook.
“No.” She ran her hand down the blade of her sword. Its edge whispered against her skin. She touched her wrist to the blade. It would be easy. “Read it to me.”
She heard him get to his feet. The pages of the heavy book shuffled.
- - -
Halldór swallowed and read, “This is from the Saga of Li Nawi, the Book of the Sword, Chapter Two. ‘And it came to pass that Li Aya and Li Nawi were raised unto adulthood by their tutor.’”
A tutor raised them, because he, Halldór, had pulled their mother away. He shook his head. It had happened six thousand years ago.
“‘But when they reached adulthood, each claimed the right of Li Reiko’s sword.’”
They fought over the sword, with which he had called her, not out of the heavens, but from across time. Halldór shivered and focused on the page.
“‘Li Aya challenged Li Nawi, saying Death was her birthright. But Nawi, on hearing this, scoffed and said he was a Child of Death. And saying so, he took Li Reiko’s sword and the gods smote Li Aya with their fiery hand, thus granting Li Nawi the victory.’”
Halldór’s entrails twisted as if the gods were reading them. He had read these sagas since he was a boy. He believed them, but he had not thought they were real. He looked at Li Reiko. She held her head in her lap and rocked back and forth.
For all his talk of prophecies, he was the one who had found the sword and invoked it. “‘Then all men knew he was the true Child of Death. He raised an army of men, the First of the Nine Armies, and thus began the Collapse — ‘”
“Stop.”
“I’m sorry.” He would slaughter a thousand sheep if one would tell him how to undo his crime. In the Saga of Li Nawi, Li Reiko never appeared after the wall of fire. He closed the book and took a step toward her. “The price you asked…I can’t send you back.”
Li Reiko drew a shuddering breath and looked up. “I have already paid the price for you.” Her eyes reflected his guilt. “Another hero can kill the Troll King.”
His pulse rattled forward like a panicked horse. “No one else can. The prophecy points to you.”
“Gut a new sheep, bound man. I won’t help you.” She stood. “I release you from your debt.”
“But, it’s unpaid. I owe you a life.”
“You cannot pay the price I ask.” She turned and touched her sword to his neck again. He flinched. “I couldn’t kill you when I wanted to.” She cocked her head, and traced the point of the blade around his neck, not quite touching him. “What destiny waits for you?”
“Nothing.” He was no one.
She snorted. “How nice to be without a fate.” Sheathing her sword, she walked toward the door.
He followed her. Nothing made sense. “Where are you going?” She spun and drove her fist into his midriff. He grunted and folded over the pain. Panting, Reiko pulled her sword out and hit his side with the flat of her blade. Halldór held his cry in.
She swung again, with the edge, but the wall of force stopped her; Halldór held still. She turned the blade and slammed the flat against his ribs again. The breath hissed out of him, but he did not move. He knelt in front of her, waiting for the next blow. He deserved this. He deserved more than this.
Li Reiko’s lip curled in disgust. “Do not follow me.”
He scrabbled forward on his knees. “Then tell me where you’re going, so I will not meet you by chance.”
“Maybe that is your destiny.” She left him.
Halldór did not follow her.
- - -
Li Reiko chased her shadow out of the parliament lands. It stretched before her in the golden light of sunrise, racing her across the moss-covered lava. The wind, whipping across the treeless plain, pushed her like a child late for dinner.
Surrounded by the people in the Parliament lands, Reiko’s anger had overwhelmed her and buried her grief. Whatever Halldór thought her destiny was, she saw only two paths in front of her — make a life here or join her children in the only way left. Neither were paths to choose rashly.
Small shrubs and grasses broke the green with patches of red and gold, as if someone had unrolled a carpet on the ground. Heavy undulations creased the land with crevices. Some held water reflecting the sky, others dropped to a lower level of moss and soft grasses, and some were as dark as the inside of a cave.
When the sun crossed the sky and painted the land with long shadows, Reiko sought shelter from the wind in one of the crevices. The moss cradled her with the warmth of the earth.
She pulled thoughts of Aya and Nawi close. In her memory, they laughed as they reached for her. Sobs pushed past Reiko’s reserves. She wrapped her arms around her chest. Each cry shattered her. Her children were dead because Halldór had decided a disemboweled sheep meant he should rip her out of time. It did not matter if they had grown up; she had not been there. They were six‑thousand years dead. Inside her head, Reiko battled grief. Her fists pounded against the walls of her mind. No. Her brain filled with that silent syllable.
She pressed her face against the velvet moss wanting the earth to absorb her.
She heard a sound.
Training quieted her breath in a moment. Reiko lifted her head from the moss and listened. Footsteps crossed the earth above her. She manifested her armor and rolled silently to her feet. If Halldór had followed her, she would play the part of a man and seek revenge.
In the light of the moon, a figure, larger than a man, crept toward her. A troll. Behind him, a gang of trolls watched. Reiko counted them and considered the terrain. It was safer to hide, but anger still throbbed in her bones. She left her sword sheathed and slunk out of the crevice in the ground. Her argument was not with them.
Flowing across the moss, she let the uneven shadows mask her until she reached a standing mound of stones. The wind carried the trolls’ stink to her.
The lone troll reached the crevice she had sheltered in. His arm darted down like a bear fishing and he roared with astonishment.
The other trolls laughed. “Got away, did she?”
One of them said, “Mucker was smelling his own crotch is all.”
“Yah, sure. He didn’t get enough in the Hall and goes around thinking he smells more.”
They had taken human women. Reiko felt a stabbing pain in her loins; she could not let that stand.
Mucker whirled. “Shut up! I know I smelled a woman.”
“Then where’d she go?” The troll snorted the air. “Don’t smell one now.”
The other lumbered away. “Let’s go, while some of ‘em are still fresh.”
Mucker slumped and followed the other trolls. Reiko eased out of the shadows. She was a fool, but would not hide while women were raped.
She hung back, letting the wind bring their sounds and scents as she tracked the trolls to their Hall.
The moon had sunk to a handspan above the horizon as they reached the Troll Hall. Trolls stood on either side of the great stone doors.
Reiko crouched in the shadows. The night was silent except for the sounds of revelry. Even with alcohol slowing their movement, there were too many of them.
If she could goad the sentries into taking her on one at a time she could get inside, but only if no other trolls came. The sound of swordplay would draw a crowd faster than crows to carrion.
A harness jingled.
Reiko’s head snapped in the direction of the sound.
She shielded her eyes from the light coming out of the Troll Hall. As her vision adjusted, a man on horseback resolved out of the dark. He sat twenty or thirty horselengths away, invisible to the trolls outside the Hall. Reiko eased toward him, senses wide.
The horse shifted its weight when it smelled her. The man put his hand on its neck, calming it. Light from the Troll Hall hinted at the planes on his face. Halldór. Her lips tightened. He had followed her. Reiko warred with an irrational desire to call the trolls down on them.
She needed him. Halldór, with his drawings and histories, might know what the inside of the Troll Hall looked like.
Praying he would have sense enough to be quiet, she stepped out of the shadows. He jumped as she appeared, but stayed silent.
He swung off his horse and leaned close. His whisper was hot in her ear. “Forgive me. I did not follow you.”
He turned his head, letting her breathe an answer in return. “Understood. They have women inside.”
“I know.” Halldór looked toward the Troll Hall. Dried blood covered the left side of his face.
“We should move away to talk,” she said.
He took his horse by the reins and followed her. His horse’s hooves were bound with sheepskin so they made no sound on the rocks. Something had happened since she left the Parliament lands.
Halldór limped on his left side. Reiko’s heart beat as if she were running. The trolls had women prisoners. Halldór bore signs of battle. Trolls must have attacked the Parliament. They walked in silence until the sounds of the Troll Hall dwindled to nothing.
Halldór stopped. “There was a raid.” He stared at nothing, his jaw clenched. “While I was gone…they just let the trolls — ” His voice broke like a boy’s. “They have my girl.”
Mara. Anger slipped from Reiko. “Halldór, I’m sorry.” She looked for other riders. “Who came with you?”
He shook his head. “No one. They’re guarding the walls in case the trolls come back.” He touched the side of his face. “I tried persuading them.”
“Why did you come?”
“To get Mara back.”
“There are too many of them, bound man.” She scowled. “Even if you could get inside, what do you plan to do? Challenge the Troll King to single combat?” Her words resonated in her skull. Reiko closed her eyes, dizzy with the turns the gods spun her in. When she opened them, Halldór’s lips were parted in prayer. Reiko swallowed. “When does the sun rise?”
“In another hour.”
She turned to the Hall. In an hour, the trolls could not give chase; the sun would turn them to stone. She unbraided her hair.
Halldór stared as her long hair began flirting with the wind. She smiled at the question in his eyes. “I have a prophecy to fulfill.”
- - -
Reiko stumbled into the torchlight, her hair loose and wild. She clutched Halldór’s cloak around her shoulders.
One of the troll sentries saw her. “Hey. A dolly.”
Reiko contorted her face with fear and whimpered. The other troll laughed. “She don’t seem taken with you, do she?”
The first troll came closer. “She don’t have to.”
“Don’t hurt me. Please, please…” Reiko retreated from him. When she was between the two, she whipped Halldór’s cloak off, tangling it around the first troll’s head. With her sword, she gutted the other. He dropped to his knees, fumbling with his entrails as she turned to the first. She slid her sword under the cloak, slicing along the base of the first troll’s jaw.
Leaving them to die, Reiko entered the Hall. Women’s cries mingled with the sounds of debauchery.
She kept her focus on the battle ahead. She would be out-matched in size and strength, but hoped her wit and weapon would prevail. Her mouth twisted. She knew she would prevail. It was predestined.
A troll saw her. He lumbered closer. Reiko showed her sword, bright with blood. “I have met your sentries. Shall we dance as well?”
The troll checked his movement and squinted his beady eyes at her. Reiko walked past him. She kept her awareness on him, but another troll, Mucker, loomed in front of her.
“Where do you think you’re going?”
“I am the one you sought. I am Chooser of the Slain. I have come for your King.”
Mucker laughed and reached for her, heedless of her sword. She dodged under his grasp and held the point to his jugular. “I have come for your King. Not for you. Show me to him.”
She leapt back. His hand went to his throat and came away with blood.
A bellow rose from the entry. Someone had found the sentries. Reiko kept her gaze on Mucker, but her peripheral vision filled with trolls running. Footsteps behind her. She spun and planted her sword in a troll’s arm. The troll howled, drawing back. Reiko shook her head. “I have come for your King.”
They herded her to the Hall. She had no chance of defeating them, but if the Troll King granted her single combat, she might escape the Hall with the prisoners. When she entered the great Hall, whispers flew; the number of slain trolls mounted with each rumor.
The Troll King lolled on his throne. Mara, her face red with shame, serviced him.
Anger buzzed in Reiko’s ears. She let it pass through her. “Troll King, I have come to challenge you.”
The Troll King laughed like an avalanche of stone tearing down his Hall. “You! A dolly wants to fight?”
Reiko paid no attention to his words.
He was nearly twice her height. Leather armor, crusted with crude bronze scales, covered his body. The weight of feast hung about his middle, but his shoulders bulged with muscle. If he connected a blow, she would die. But he would be fighting gravity as well as her. Once he began a movement, it would take time for him to stop and begin another.
Reiko raised her head, waiting until his laughter faded. “I am the Chooser of the Slain. Will you accept my challenge?” She forced a smile to her lips. “Or are you afraid to dance with me?”
“I will grind you to paste, dolly. I will sweep over your lands and eat your children for my breakfast.”
“If you win, you may. Here are my terms. If I win, the prisoners go free.”
He came down from his throne and leaned close. “If you win, we will never show a shadow in human lands.”
“Will your people hold that pledge when you are dead?”
He laughed. The stink of his breath boiled around her. He turned to the trolls packed in the Hall. “Will you?”
The room rocked with the roar of their voices. “Aye.”
The Troll King leered. “And when you lose, I won’t kill you till I’ve bedded you.”
“Agreed. May the gods hear our pledge.” Reiko manifested her armor.
As the night-black plates materialized around her, the Troll King bellowed, “What is this?”
“This?” She taunted him. “This is but a toy the gods have sent to play with you.”
She smiled in her helm as he swung his heavy iron sword over his head and charged her. Stupid. Reiko stepped to the side, already turning as she let him pass.
She brought her sword hard against the gap in his armor above his boot. The blade jarred against bone. She yanked her sword free; blood coated it like a sheath.
The Troll King dropped to one knee, hamstrung. Without waiting, she vaulted up his back and wrapped her arms around his neck. Like Aya riding piggyback. He flailed his sword through the air, reaching for her. She slit his throat. His bellow changed to a gurgle as blood fountained in an arc, soaking the ground.
A heavy ache filled her breast. She whispered in his ear. “I have killed you without honor. I am a machine of the gods.”
Reiko let gravity pull the Troll King down, as trolls shrieked. She leapt off his body as it fell forward.
Before the dust settled around him, Reiko pointed her sword at the nearest troll. “Release the prisoners.”
- - -
Reiko led the women into the dawn. As they left the Troll Hall, Halldór dropped to his knees with his arms lifted in prayer. Mara wrapped her arms around his neck, sobbing.
Reiko felt nothing. Why should she, when the victory was not hers? She withdrew from the group of women weeping and singing her praises.
Halldór chased her. “Lady, my life is already yours but my debt has doubled.”
He reminded her of a suitor in one of Aya’s bedtime stories, accepting gifts without asking what the witchyman’s price would be. She knelt to clean her sword on the moss. “Then give me your firstborn child.”
She could hear his breath hitch in his throat. “If that is your price.”
Reiko raised her eyes. “No. That is a price I will not ask.”
He knelt beside her. “I know why you can not kill me.”
“Good.” She turned to her sword. “When you fulfill your fate let me know, so I can.”
His blue eyes shone with fervor. “I am destined to return your daughter to you.”
Reiko’s heart flooded with pain and hope. She fought for breath. “Do not toy with me, bound man.”
“I would not. I reviewed the sagas after you went into the Hall. It says ‘and the gods smote Li Aya with their fiery hand.’ I can bring Li Aya here.”
Reiko sunk her fingers into the moss, clutching the earth. Oh gods, to have her little girl here — she trembled. Aya would not be a child. There would be no games of hide and seek. When they reached adulthood, each claimed the right of Li Reiko’s sword…how old would Aya be?
Reiko shook her head. She could not do that to her daughter. “You want to rip Aya out of time as well. If Nawi had not won, the Collapse would not have happened.”
Halldór brow furrowed. “But it already did.”
Reiko stared at the women, and the barren landscape beyond them. Everything she saw was a result of her son’s actions. Or were her son’s actions the result of choices made here? She did not know if it mattered. The cogs in the gods’ machine clicked forward.
“Are there any prophecies about Aya?”
Halldór nodded. “She’s destined to — ”
Reiko put her hand on his mouth as if she could stop fate. “Don’t.” She closed her eyes, fingers still resting on his lips. “If you bring her, promise me you won’t let her know she’s bound to the will of the gods.”
He nodded.
Reiko withdrew her hand and pressed it to her temple. Her skull throbbed with potential decisions. Aya had already vanished into fire; if Reiko did not decide to bring her here, where would Aya go?
Her bound man knelt next to her, waiting for her decision. Aya would not forgive Reiko for yanking her out of time, anymore than Reiko had forgiven Halldór.
His eyes flicked over her shoulder and then back. Reiko turned to follow his gaze. Mara comforted another girl. What did the future hold for Halldór’s daughter? In this time, women seemed to have no role.
But times could change. Watching Mara, Reiko knew which path to choose if she were granted free will.
“Bring Aya to me.” Reiko looked at the sword in her hand. “My daughter’s birthright waits for her.”
LOS ANGELES (TheWrap.com) – Clear Channel Media, The Madison Square Garden Company and The Weinstein Company are joining together to produce a benefit concert to raise money for victims of Hurricane Sandy.
The concert, titled “12-12-12,” will feature live music, although the producers did not reveal who would be performing. The roster should be an A-list one though, given that this is the same group of corporate entities that backed “The Concert for New York City,” a star-studded affair with the likes of The Who and Billy Joel on hand to raise money for 9/11.
The concert for Sandy Relief will be held on December 12, 2012, at Madison Square Garden in New York, and the money raised will be dispensed through the Robin Hood Relief Fund.
Hurricane Sandy slammed into the Eastern Seaboard last week, leaving 110 people dead and more than 1 million without power. Damage from the storm is estimated to be between $ 30 billion to $ 50 billion in economic losses.
“12-12-12″ will be produced by James Dolan, executive chairman of The Madison Square Garden Company; John Sykes, president of Clear Channel Entertainment Enterprises; and Harvey Weinstein, co-founder and chairman of The Weinstein Company.
In a joint statement, the producers said: “The Concert for New York City was a night filled with emotion, courage and tremendous hope when we came together as a city following the 9/11 attack. Once again, our city, as well as millions of our neighbors in the tri-state area, are in desperate need of our assistance as they recover from Hurricane Sandy and rebuild their lives. We have no doubt that the event we are planning will be filled with unforgettable music, entertainment and that uniquely American spirit of community, compassion and generosity.”
Let’s talk about the emotional aftermath of the storm that left tens of thousands of older people on the East Coast without power, bunkered down in their homes, chilled to the bone and out of touch with the outside world.
Let’s name the feelings they may have experienced. Fear. Despair. Hopelessness. Anxiety. Panic.
Linda Leest and her staff at Services Now for Adult Persons in Queens heard this in the voices of the older people they had been calling every day, people who were homebound and at risk because of medical conditions that compromise their physical functioning.
“They’re afraid of being alone,” she said in a telephone interview a few days after the storm. “They’re worried that if anything happens to them, no one is going to know. They feel that they’ve lost their connection with the world.”
What do we know about how older adults fare, emotionally, in a disaster like that devastating storm, which destroyed homes and businesses and isolated older adults in darkened apartment buildings, walk-ups and houses?
Most do well — emotional resilience is an underappreciated characteristic of older age — but those who are dependent on others, with pre-existing physical and mental disabilities, are especially vulnerable.
Most will recover from the disorienting sense that their world has been turned upside down within a few weeks or months. But some will be thrown into a tailspin and will require professional help. The sooner that help is received, the more likely it is to prevent a significant deterioration in their health.
The best overview comes from a November 2008 position paper from the American Association for Geriatric Psychiatry that reviewed the effects of Hurricane Katrina and other disasters. After Katrina, “the elderly had the highest mortality rates, health decline and suicide rates of any subgroup,” that document notes. “High rates of psychosomatic problems were seen, with worsening health problems and increased mortality and disability.”
This is an important point: Emotional trauma in older adults often is hard to detect, and looks different from what occurs in younger people. Instead of acknowledging anxiety or depression, for instance, older people may complain of having a headache, a bad stomachache or some other physical ailment.
“This age group doesn’t generally feel comfortable talking about their feelings; likely, they’ll mask those emotions or minimize what they’re experiencing,” said Dr. Mark Nathanson, a geriatric psychiatrist at Columbia University Medical Center.
Signs that caregivers should watch out for include greater-than-usual confusion in an older relative, a decline in overall functioning and a disregard for “self care such as bathing, eating, dressing properly and taking medication,” Dr. Nathanson said.
As an example, he mentioned an older man who had “been sitting in a cold house for days and decided to stop taking his water pill because he felt it was just too much trouble.” Being distraught or distracted and forgetting or neglecting to take pills for chronic conditions like diabetes or heart disease can have immediate harmful effects.
Especially at risk of emotional disturbances are older adults who are frail and advanced in age, those who have cognitive impairments like Alzheimer’s disease, those with serious mental illnesses like schizophrenia or major depression, and those with chronic medical conditions or otherwise in poor physical health, according to the geriatric psychiatry association’s position paper.
A common thread in all of the above is the depletion of physical and emotional reserves, which impairs an older person’s ability to adapt to adverse circumstances.
“In geriatrics, we have this idea of the ‘geriatric cascade’ that refers to how a seemingly minor thing can set in motion a functional, cognitive and psychological downward spiral” in vulnerable older adults, said Dr. Mark Lachs, chief of the division of geriatrics at Weill Cornell Medical College. “Well, the storm was a major thing — a very large disequilibrating event — and its impact is an enormous concern.”
Of special concern are older people who may be in the early stages of Alzheimer’s disease or other types of dementia who are living alone. For this group, the maintenance of ordinary routines and the sense of a dependable structure in their lives is particularly important, and “a situation like Sandy, which causes so much disruption, can be a tipping point,” Dr. Lachs said.
Also of concern are older people who may have experienced trauma in the past, and who may suffer a reignition of post-traumatic stress symptoms because of the disaster.
Most painful of all, for many older adults, is the sense of profound isolation that can descend on those without working phones, electricity or relatives who can come by to help.
“That isolation, I can’t tell you how disorienting that can be,” said Bobbie Sackman, director of public policy for the Council of Senior Centers and Services of New York City. “They’re scared, but they won’t tell you because they’re too proud and ashamed to ask for help.”
The best remedy, in the short run, is the human touch.
“Now is the time for people to reach out to their neighbors in high-rises or in areas where seniors are clustered, to knock on doors and ask people how they are doing,” said Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in the Bronx.
Don’t make it a one-time thing; let the older person know you’ll call or come by again, and set up a specific time so “there’s something for them to look forward to,” Dr. Kennedy said. So-called naturally occurring retirement communities with large concentrations of older people should be organizing from within to contact residents who may not be connected with social services and find out how they’re doing, he recommended.
In conversations with older adults, offer reassurance and ask open-ended questions like “Are you low on pills?” or “Can I run out and get you something?” rather than trying to get them to open up, experts recommended. Focusing on problem-solving can make people feel that their lives are being put back in order and provide comfort.
Although short-term psychotherapy has positive outcomes for older adults who’ve undergone a disaster, it’s often hard to convince a senior to seek out mental health services because of the perceived stigma associated with psychological conditions. Don’t let that deter you: Keep trying to connect them with services that can be of help.
Be mindful of worrisome signs like unusual listlessness, apathy, unresponsiveness, agitation or confusion. These may signal that an older adult has developed delirium, which can be extremely dangerous if not addressed quickly, Dr. Nathanson said. If you suspect that’s the case, call 911 or make sure you take the person to the nearest hospital emergency room.
This is a safe place to talk about all kinds of issues affecting older adults. Would you be willing to share what kinds of mental health issues you or family members are dealing with since the storm so readers can learn from one another?
