U.S. Use of Mexican Battery Recyclers Is Faulted





United States companies are sending spent lead batteries to recycling plants in Mexico that do not meet American environmental standards, according to an environmental agency created under the North American Free Trade Agreement, putting Mexican communities at risk.




In a blistering report submitted this week, the agency, the Commission for Environmental Cooperation, notes that the United States does not fully follow procedures common among developed nations that treat international battery shipments as hazardous waste. It faults environmental agencies on both sides of the border for lapses in regulation and enforcement. Cross-border trade in lead batteries increased by up to 525 percent from 2004 to 2011, the report said.


The report, which has been circulating in draft form, has been forwarded to the governments of the United States, Canada and Mexico, which have 60 days to object to its publication. An estimated 20 percent of lead acid batteries from the United States now go to Mexico for recycling, according to trade statistics.


“There needs to be better coordination between government agencies and better cross-border tracking,” said Evan Lloyd, who was the agency’s executive director until late last year and oversaw the yearlong study.


The report highlighted a number of shortcomings: Customs data on the number of batteries crossing the border did not mesh with counts by the United States Environmental Protection Agency. Though the E.P.A. requires notice of batteries leaving the United States, there was no effort to make sure that they had arrived at qualified recyclers in Mexico. The data that battery companies sent to the E.P.A. about exports consisted of “piles of paper,” Mr. Lloyd said, and it was never amassed into an electronic database that would be “useful to regulators.”


Almost all lead acid batteries used in the United States are recycled to extract the lead for reuse because lead is a dangerous pollutant and because it is a valuable commodity. Lead batteries are used in vehicles, cellphone towers and wind turbines.


Since 2008, new United States limits on lead pollution have made domestic recycling complicated and costly. That has helped propel the recycling trade to Mexico, both legally and illegally, environmental groups say, because that country has less stringent limits for lead pollution, and far less vigorous enforcement.


“There’s a pretty consistent pattern suggesting that exports are the direct result of U.S. emissions standards,” said Perry Gottesfeld, executive director of Occupational Knowledge International, which has led the campaign against lead poisoning internationally. Mr. Gottesfeld noted that a Mexican plant owned by a major American recycler, Johnson Controls Inc., puts out more than 30 times as much lead emissions as its newest plant in the United States.


“What Mexico needs to do is to get its recycling up to U.S. standards, and the U.S. needs to do a much better job of tracking batteries overseas,” he said. In an e-mail, Johnson Controls, based in Milwaukee, said it was “modernizing and reinvesting” in the Mexican facility, acquired in 2005, “to reduce its environmental footprint.”


The report was initiated in response to a report by Occupational Knowledge International and Fronteras Comunes, a Mexican environmental group, as well as to an investigative article in The New York Times, Mr. Lloyd said. Soil collected by The Times in a school playground near a recycling plant outside Mexico City was found to have lead levels five times those allowed in the United States.


Lead poisoning causes high blood pressure, kidney damage and abdominal pain in adults, and serious developmental delays and behavioral problems in young children. When batteries are broken for recycling, the lead is released as dust and, during melting, as lead-laced emissions.


In the United States, recyclers operate in highly mechanized, tightly sealed plants, with smokestack scrubbers and extensive monitors to detect lead release. Plants in Mexico vary greatly in safety standards, and in some, the recycling process is little more than men with hammers smashing batteries and melting down their contents in furnaces.


In recent months, there have been new efforts to curb the flow of batteries south of the border, though many battery makers have fought that. In response to a draft of the report released late last year, Battery Council International, an industry group, said it opposed “the creation of additional burdensome certification programs.”


Last year, the United States General Services Administration, which is responsible for federal vehicles, asked ASTM International, an independent standards agency, to explore a voluntary standard for battery recycling.


But that effort came to naught after the proposal was voted down at an open meeting attended by representatives from industry, government and environmental groups in December. Of the 103 people at the meeting, 49 worked for Johnson Controls.


This article has been revised to reflect the following correction:

Correction: February 9, 2013

An earlier version of this article misstated part of the name of an American recycler cited by Perry Gottesfeld, executive director of Occupational Knowledge International, as the owner of a Mexican plant that puts out more than 30 times as much lead emissions as the company’s newest plant in the United States. The American recycling company is Johnson Controls Inc., not Johnson Controls International.



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Big Bear locked down amid manhunt









The bustling winter resort of Big Bear took on the appearance of a ghost town Thursday as surveillance aircraft buzzed overhead and police in tactical gear and carrying rifles patrolled mountain roads in convoys of SUVs, while others stood guard along major intersections.


Even before authorities had confirmed that the torched pickup truck discovered on a quiet forest road belonged to suspected gunman Christopher Dorner, 33, officials had ordered an emergency lockdown of local businesses, homes and the town's popular ski resorts. Parents were told to pick up their children from school, as rolling yellow buses might pose a target to an unpredictable fugitive on the run.


By nightfall, many residents had barricaded their doors as they prepared for a long, anxious evening.





PHOTOS: A tense manhunt amid tragic deaths


"We're all just stressed," said Andrea Burtons as she stocked up on provisions at a convenience store. "I have to go pick up my brother and get him home where we're safe."


Police ordered the lockdown about 9:30 a.m. as authorities throughout Southern California launched an immense manhunt for the former lawman, who is accused of killing three people as part of a long-standing grudge against the LAPD. Dorner is believed to have penned a long, angry manifesto on Facebook saying that he was unfairly fired from the force and was now seeking vengeance.


Forest lands surrounding Big Bear Lake are cross-hatched with fire roads and trails leading in all directions, and the snow-capped mountains can provide both cover and extreme challenges to a fugitive on foot. It was unclear whether Dorner was prepared for such rugged terrain.


Footprints were found leading from Dorner's burned pickup truck into the snow off Forest Road 2N10 and Club View Drive in Big Bear Lake.


San Bernardino County Sheriff John McMahon said that although authorities had deployed 125 officers for tracking and door-to-door searches, officers had to be mindful that the suspect may have set a trap.


"Certainly. There's always that concern and we're extremely careful and we're worried about this individual," McMahon said. "We're taking every precaution we can."


PHOTOS: A fugitive's life on Facebook


Big Bear has roughly 400 homes, but authorities guessed that only 40% are occupied year-round.


The search will probably play out with the backdrop of a winter storm that is expected to hit the area after midnight.


Up to 6 inches of snow could blanket local mountains, the National Weather Service said.


FULL COVERAGE: Sweeping manhunt for rampaging ex-cop


Gusts up to 50 mph could hit the region, said National Weather Service meteorologist Mark Moede, creating a wind-chill factor of 15 to 20 degrees.


Extra patrols were brought in to check vehicles coming and going from Big Bear, McMahon said, but no vehicles had been reported stolen.


"He could be anywhere at this point," McMahon said. When asked if the burned truck was a possible diversion, McMahon replied: "Anything's possible."


Dorner had no known connection to the area, authorities said.


Craig and Christine Winnegar, of Murrieta, found themselves caught up in the lockdown by accident. Craig brought his wife to Big Bear as a surprise to celebrate their 28th wedding anniversary. Their prearranged dinner was canceled when restaurant owners closed their doors out of fear.





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Sandboxr's Animation Interface Offers Completely Customizable 3-D Printed Figurines



Walt Disney invented feature animation by painting on plastic cels, Pixar reinvented the artform with computer graphics, and now Sandboxr is bringing animation to life with 3-D printers.


Animation fans, using Sandboxr’s web-based software via laptop or tablet, can digitally pose character models, change their scale, give them accessories, create scenes, and then 3-D print their custom-built result for less than the cost of a movie ticket.


3-D printed figurines already exist — MyRobotNation and FigurePrints offer similar services, allowing gamers to print models from World of Warcraft and Minecraft. But the interfaces for those sites have limited character flexibility, usually just a set of predefined poses and options. “Services like that are the tip of the iceberg,” says founder Berk Frei. “We’re trying to be the rest of the iceberg.”


What makes Sandboxr unique is how users experience some of the creative flexibility a professional animator does. All of the Sandboxr models are “rigged” — each model has a skeleton that a customer can pose like a doll, then print a souvenir of the experience. And, unlike the animators at movie studios, Sandboxr customers don’t have to learn complicated modeling software. The company has built an engine that lets people experiment with character poses using sliders to create sophisticated, animated poses, simply.


Frei is also passionate about taking the grunt work out of the process. “When I’m getting something ready for 3-D printing it’s not an easy process,” he says. “The printers choke on models with holes, multiple meshes, all these things that look visually impressive. Shelling models to reduce waste materials and adding drain holes takes a lot of time, but we’ve automated all of that. You’re going to save a lot of time using Sandboxr to post-process models.”


These automated features will do a lot to keep costs competitive with services like Shapeways. According to Frei, a 3.5-inch figure will cost approximately $20 to $25 and a 2.5-inch model will cost around $12, but final pricing is still to be determined.


To ensure that there are plenty of options for customers, the platform will be open to 3-D artists. Independent animators and toy designers will be able to post their characters and let fans interact with them in new and exciting ways. Frei says they’re also getting an “overwhelming” response from established videogame companies. “Game companies are excited for us to exist. They’ve made a game and the content already exists. We use the same model files and textures as they do to build the game so it’s an easy transition. Ultimately, we provide a store front that doesn’t cost anything to create and an infinite amount of inventory.”


The response has been so potent, Frei is looking into purchasing 40 ZCorp 3-D printers to keep up with initial demand. “We’ve decided we’re going to get capital equipment and build out our infrastructure, which is a bigger risk, but also gives us the ability to provide lower cost prints.”


For now, the site is in private beta, a Kickstarter campaign is imminent, but for those in the Salt Lake City area, the first Sandboxer project is on view at The Leonardo, a contemporary science museum.



Beyond the lively product, Sandboxr marks an important change in the industry. Most first-generation companies focused on 3-D printing were founded by engineers and focused on developing new, better hardware.


Frei and Sandboxr represent a new wave where designers are driving the technology in new directions increasingly through software. “Working with 3-D printing companies wasn’t that cool of an experience,” he says. “You’re just dropping your file off.”


Frei was introduced to 3-D printing while working as a CG animator in an arts-focused coworking space. He immediately understood the implications of the technology and had a vast library of digital content that could be printed. He also saw a huge problem. “You need to be a sophisticated designer to do anything cool with a 3-D printer,” says Frei. “My idea was to bridge the gap between an everyday person and 3-D printers.”


After evaluating systems from all the major manufacturers Frei found them lacking. He immediately got to work pitching investors on his software concept and recruited a team of engineers and 3-D artists to build the service. ”First and foremost I was thinking what a designer toy artist could do with Sandboxr,” says Frei. “Artists can collaborate with their fans.”


Frei also sees a big future for the product beyond games.


“We’re 3-D artists and game designers, but we built the system with customization in mind so that it can be interacted with in interesting ways,” he says. “I’ll be surprised what they’ll use it for — maybe cool jewelry, wedding cake toppers, who knows. I just want people to feel like they can be Tony Stark from Iron Man. They can design something in their computer and build it.”


All images: Courtesy of Sandboxr


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Katie Holmes takes fashion line crosstown






NEW YORK (AP) — Katie Holmes and her business partner and stylist Jeanne Yang joined the New York Fashion Week frenzy last season with a show at Lincoln Center, only to leave it behind this time around.


It wasn’t all the people, or even the paparazzi, that drove them away. It was their own clothes. Their look, which they describe as one of careful artistry and potential heritage pieces that women will keep a lifetime, is a little too quiet for all the splash, they said.






“We wanted to tell the full story behind the frivolity,” said Yang, adding: “It’s a quiet approach.”


Holmes and Yang sat down at a hotel on the opposite side of Manhattan with a handful of fashion journalists on Thursday, the opening day of fashion week, to walk them personally through 15 looks Holmes called their favorites.


Katharine Hepburn‘s practical-yet-chic look of the 1940s, Donna Karan‘s use of the shoulders and back as erogenous zones, Halston’s glamorous sportswear and Chanel’s mastery of seaming and studs were all in their minds as they built the pieces and outfits.


“We’re not trying to be trendy … but we’re trying to make high-quality pieces you’ll wear over and over again,” Holmes said.


Holmes was wearing an A-line shirtdress in the blue-and-black plaid that was dominant in the collection, while Yang wore one of the slouchy blazers that has become a key piece for the label, founded in 2009.


For fall, they’ll offer a peplum top with a suede waist band and maxi skirt in the same plaid. Holmes suggested that outfit for a dinner out. Swap the shirt for a tank top for brunch and a blouse to go to the theater. Yang said she hoped a customer would “feel smart” in a white cashmere-silk boucle sweaterdress with a strip of white silk at the hem.


Holmes, meanwhile, was partial to the baggy suede caramel-colored pants that hit just above the ankle, worn with a bow-neck blouse in a deep shade of lipstick pink.


The duo made a point of noting that 70 percent of production of Holmes & Yang happens in New York and the other 30 percent in Los Angeles.


___


Follow Samantha Critchell on Twitter at http://twitter.com/AP_Fashion


Entertainment News Headlines – Yahoo! News





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The New Old Age: The Executor's Assistant

I’m serving as executor for my father’s estate, a role few of us are prepared for until we’re playing it, so I was grateful when the mail brought “The American Bar Association Guide to Wills and Estates” — the fourth edition of a handbook the A.B.A. began publishing in 1995.

This is a legal universe, I’m learning, in which every step — even with a small, simple estate that owes no taxes and includes no real estate or trusts — turns out to be at least 30 percent more complicated than expected.

If my dad had been wealthy or owned a business, or if we faced a challenge to his will, I would have turned the whole matter over to an estate lawyer by now. But even then, it would be helpful to know what the lawyer was talking about. The A.B.A. guide would help.

Written with surprising clarity (hey, they’re lawyers), it maps out all kinds of questions and decisions to consider and explains the many ways to leave property to one’s heirs. Updated from the third edition in 2009, the guide not only talks taxes and trusts, but also offers counsel for same-sex couples and unconventional families.

If you want to permit your second husband to live in the family home until he dies, but then guarantee that the house reverts to the children of your first marriage, the guide tells you how a “life estate” works. It explains what is taxable and what isn’t, and discusses how to choose executors and trustees. It lists lots of resources and concludes with an estate-planning checklist.

In general, the A.B.A. intends its guide for the person trying to put his or her affairs in order, more than for family members trying to figure out how to proceed after someone has died. But many of us will play both these parts at some point (and if you are already an executor, or have been, please tell us how that has gone, and mention your state). We’ll need this information.


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

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DealBook: Helping Start-Ups With Local Support and National Networks

When Will Fuentes planned an extended business trip to Seattle last year, he tapped into the local chapter of a national networking group there. Within hours, Mr. Fuentes, who founded the Arlington, Va., software company Lemur Retail, had secured a work space, introductions and even restaurant recommendations via the group, the Startup America Partnership.“Before I flew out there, I already had five or six meetings set up with potential clients and other key contacts, as well as one potential acquirer,” Mr. Fuentes said.

A couple of years ago, entrepreneurs would have needed several trips to make similar connections outside their own cities. Even in this era of social networks and venture conferences, start-ups are still surprisingly disconnected on a national level.

“Each region has its ties, but in many cases, entrepreneurs are operating in silos,” said Carolynn Duncan, the chief executive of Portland Ten, a mentoring program for early-stage companies, mainly in Oregon. “An entrepreneur in Oregon doesn’t have an easy way to network with entrepreneurs in Washington D.C.”

Startup America, a nonprofit organization with an all-star cast of deep-pocketed backers, is trying to bridge the gap. The organization, which was started in January 2011 as the brainchild of AOL’s co-founder, Steve Case, and the Ewing Marion Kauffman Foundation, wanted to bring a private-sector support to start-ups — without financial strings attached.

“Supporting start-ups throughout the country is the only way to make sure the American economy is firing on all cylinders,” said Mr. Case, who is the chairman of the partnership.

Start-ups are a crucial driver for job creation in the United States. From March 1994 to March 2010, businesses less than one year old created 3.9 million jobs a year on average, according to the Bureau of Labor Statistics, though that number has declined during the recent economic weakness.

The Small Business Administration and United States Chamber of Commerce have long been a resource for start-ups, but these government agencies have a broad mandate. There is a “growing recognition,” said Mr. Case, that high-growth start-ups — those with the potential to be national or international companies — have different needs and requirements than traditional small businesses.

Startup America’s initial focus was to provide support to start-ups through deals on goods and services, like 40 percent off FedEx shipping and free flights on American Airlines. But the group quickly realized that start-ups needed more practical help, like sharing best practices and networking.

Soon after the partnership’s start, entrepreneurs around the country starting contacting Startup America, asking how they could create their own networks and reach out to counterparts in other states. “Most of these regions were already coming up with their own initiatives or thinking about them,” said the organization’s chief executive, Scott Case, a founder and former chief technology officer of Priceline.com (and no relation to Steve Case). “We’re helping to stitch together all these parts.”

Taking cues from the entrepreneurs, Startup America has turned its attention to building such a network. Nearly 12,000 members are now affiliated with local Startup America initiatives in 30 states. The partnership expects to add another 10 states this year.

Each Startup America region is spearheaded by local “champions” who come together several times a year at national conferences, communicate via Google groups and have access to an online “idea center” where they can brainstorm about, say, bringing in outside capital or hosting a start-up conference. These envoys are all “founder types” at different stages of their careers, Scott Case said. “Some have exited companies and are looking to continue to feed that creative drive. Others understand that if they can strengthen their community, they can strengthen their own company.”

Brooks Bell, founder of an eponymous 22-employee digital consulting business based in Raleigh, N.C., became involved with the partnership in 2011 after realizing that many potential clients considered her area a backwater. “I realized that was impacting my company’s brand, too,” she said.

Mrs. Bell pointed out that other national groups, like Entrepreneurs’ Organizations, offer resources for high-growth companies. Yet, their emphasis is typically on supporting individuals rather than elevating the region and networking nationally. “They also tend to focus on early-stage companies,” she said. Until Startup America, she added, “there weren’t a lot of opportunities for early-stage companies to interact with funded companies.”

Though Startup America regions work off the same blueprint, each takes a slightly different approach. In Maryland, the staff and champions volunteer virtually. Startup Tennessee partnered with the Entrepreneur Center in Nashville, which runs a nonprofit incubator program. Startup Colorado works out of Silicon Flatirons, a center for law, technology and entrepreneurship at the University of Colorado Law School, and finds partners to finance specific projects.

Although the regional chapters operate independently, they benefit from the credibility of a national organization. “It’s helping elevate our start-ups nationally and get them in front of audiences we never would have,” said Andy Stoll, an entrepreneur in the Iowa City, Iowa, area, where rebuilding from the floods in 2008 has helped generate a boom in start-up activity.

“To have the opportunity to sit in a room with their board and have Steve Case ask me, ‘What are the three things that those of us at this table can do to really help support the Indiana community?’ is amazing and a humbling experience,” said Michael Coffey, a partner at DeveloperTown, an Indianapolis design and development firm that works with companies of all sizes.

In the end, it’s all about business.

Aaron Schwartz, a co-founder of the San Francisco-based Modify Watches, initially joined Startup America for the discounts. Now, he’s also tapping into the partnership to network, including finding corporate clients who order custom watches and vendors. “I now have a contact in Tennessee who has offered to look into manufacturing our watches there,” he said

Mr. Fuentes of Lemur Retail found two potential clients, both national chains, through his connections in Seattle last year; he’s currently in talks with those companies. He’s also helping his Northwest counterparts make inroads in the Washington area. He likens the experience to a fraternity or alumni organization of entrepreneurs.

“When people contact me from my high school or college, I pick up the phone,” he said. “This is no different.”

A version of this article appeared in print on 02/08/2013, on page B5 of the NewYork edition with the headline: Helping Start-Ups With Local Support and National Networks.
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Manhunt underway for ex-LAPD officer suspected of shooting 3 cops









A manhunt involving multiple law enforcement agencies was underway early Thursday after three police officers were shot -- one fatally -- in Riverside County. Authorities believe that the suspect is a former Los Angeles police officer already wanted in connection with two Orange County slayings.

The suspect, Christopher Jordan Dorner, 33, wrote an online manifesto threatening to harm police officials and their families, authorities said, and he is considered "armed and extremely dangerous."


The California Highway Patrol issued a "blue alert" for nine Southern California counties. Officials said Dorner is believed to be driving a 2005 blue or gray Nissan Titan, with California license plate 8D83987 or 7X09131. Police said they believe he may be switching between the two license plates. Dorner is described as a black male, 33 years old, 6 feet tall, weighing 270 pounds with black hair and brown eyes. His last known address is in La Palma.





Members of the public were warned to stay away from him if they spot him, and to call 911 immediately.


The first shooting occurred about 1:30 a.m. in Corona, where two Los Angeles Police Department officers were on "protection detail" for someone mentioned in the suspect's manifesto, officials said. One officer suffered a grazing head wound during a shootout and Dorner fled the scene, police said.


A short time later, two Riverside officers were involved in a shooting with a suspect at the corner of Magnolia Avenue and Arlington Avenue in Riverside, according to Riverside Police Officer Bryan Galbreath.


Sources told The Times that the officers were in a patrol unit and ambushed by the suspect.


One police officer was killed, the other seriously wounded, Galbreath said.


He said said there were no other officers who witnessed the shooting, and that it's only a possibility that Dorner was involved.

Irvine police on Wednesday night named Dorner as the suspect in the double slaying in the parking lot of an upscale Irvine apartment complex Sunday. Law enforcement sources said police have placed security at the homes of LAPD officials named in the manifesto and believe that Dorner has numerous weapons.


In the online postings on his Facebook page, Dorner specifically named the father of Monica Quan, the Cal State Fullerton assistant basketball coach who was found dead Sunday, along with her fiance, Keith Lawrence.


Randy Quan, a retired LAPD captain, was involved in the review process that ultimately led to Dorner’s dismissal.


A former U.S. Navy reservist, Dorner was fired in 2009 for allegedly making false statements about his training officer.


Dorner said in his online postings that being a police officer had been his life’s ambition since he served in the Police Explorers program. Now that had been taken away from him, he said, and he suffered from severe depression and was filled with rage over the people who forced him from his job.


Dorner complained that Randy Quan and others did not fairly represent him at the review hearing.


“Your lack of ethics and conspiring to wrong a just individual are over. Suppressing the truth will leave to deadly consequences for you and your family. There will be an element of surprise where you work, live, eat, and sleep,” he wrote, referring to Quan and several others.


“I never had the opportunity to have a family of my own, I'm terminating yours,” he added.


The online postings indicated that Quan served as Dorner’s representative in the review hearing. Of Quan, Dorner wrote: “He doesn't work for you, your interest, or your name. He works for the department, period. His job is to protect the department from civil lawsuits being filed and their best interest which is the almighty dollar. His loyalty is to the department, not his client.”


In the document, he threatens violence against other police officers: “The violence of action will be high. ... I will bring unconventional and asymmetrical warfare to those in LAPD uniform whether on or off duty.”


In his postings, Dorner seemed to allude to the Irvine slaying.


“I know most of you who personally know me are in disbelief to hear from media reports that I am suspected of committing such horrendous murders and have taken drastic and shocking actions in the last couple of days,” he wrote.


“Unfortunately,” he added, “this is a necessary evil that I do not enjoy but must partake and complete for substantial change to occur within the LAPD and reclaim my name.”


Quan, 28, and Lawrence, 27, had recently become engaged and moved into the condominium complex near Concordia University, where they had played basketball and received their degrees, authorities said. Lawrence worked as a campus officer at USC.


Dorner’s LAPD case began when he lodged a complaint against his field training officer, Sgt. Teresa Evans. He accused her of kicking a suspect named Christopher Gettler. An LAPD Board of Rights found that the complaint was false and terminated his employment for making false statements. He appealed the action.


He testified that he graduated from the Police Academy in February 2006 and left for a 13-month military deployment in November 2006.


“This is my last resort,” he wrote online. “The LAPD has suppressed the truth and it has now led to deadly consequences.”


Dorner said it was the LAPD’s fault that he lost his law enforcement and Navy careers, as well as his relationships with family and close friends. Dorner wrote that he began his law enforcement career in February 2005 and that it ended in January 2009. His Navy career began in April 2002 and ended this month.


“I lost everything,” he said, “because the LAPD took my name and knew I was innocent.”



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The UFO Is Fake in Animator's YouTube Prank — But So Is Everything Else


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CBS Films Moves Up Robert De Niro-Michael Douglas Comedy ‘Last Vegas’






LOS ANGELES (TheWrap.com) – CBS Films on Wednesday has moved up the release date for “Last Vegas,” its comedy starring Michael Douglas and Robert De Niro, from December 20 to Nov 1.


The move positions the film – about four old friends who decide to throw a Las Vegas bachelor party for the only one of them who has remained single – as counter-programming to Summit’s young adult sci-fi film “Ender’s Game.”






Its original slot buried it in a busy date that included the Paramount comedy “Anchorman: The Legend Continues,” as well as two dramas, Sony’s “Monuments Men” and Disney’s “Saving Mr Banks,” and the Fox family adventure “Walking with Dinosaurs.”


Morgan Freeman, Kevin Kline and Mary Steenburgen co-star in “Last Vegas.” Directed by Jon Turteltaub (“National Treasure”), Dan Fogelman wrote the original screenplay. It’s being produced by Laurence Mark and Amy Baer. Good Universe’s Nathan Kahane and Nicole Brown will executive produce. Matt Leonetti will co-produce.


Executive vice president of production Maria Faillace and creative executive Alex Ginno are overseeing the project for CBS Films.


TV News Headlines – Yahoo! News





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Well: Think Like a Doctor: A Confused and Terrified Patient

The Challenge: Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.

The Presenting Problem:

A 55-year-old man who is recovering from a devastating injury in a rehabilitation facility suddenly becomes confused, frightened and paranoid.

The Patient’s Story:

The patient, who was recovering from a terrible injury and was too weak to walk, had been found on the floor of his room at the extended care facility, raving that there were people out to get him. He was taken to the emergency room at the Waterbury Hospital in Connecticut, where he was diagnosed with a urinary tract infection and admitted to the hospital for treatment. Doctors thought his delirium was caused by the infection, but after 24 hours, despite receiving the appropriate antibiotics, the patient remained disoriented and frightened.

A Sister’s Visit:

The man’s sister came to visit him on his second day in the hospital. As she walked into the room she was immediately struck by her brother’s distress.

“Get me out of here!” the man shouted from his hospital bed. “They are coming to get me. I gotta get out of here!”

His brown eyes darted from side to side as if searching for his would-be attackers. His arms and legs shook with fear. He looked terrified.

For the past few months, the man had been in and out of the hospital, but he had been getting better — at least he had been improving the last time his sister saw him, the week before. She hurried into the bustling hallway and found a nurse. “What the hell is going on with my brother?” she demanded.

A Long Series of Illnesses:

Three months earlier, the patient had been admitted to that same hospital with delirium tremens. After years of alcohol abuse, he had suddenly stopped drinking a couple of days before, and his body was wracked by the sudden loss of the chemical he had become addicted to. He’d spent an entire week in the hospital but finally recovered. He was sent home, but he didn’t stay there for long.

The following week, when his sister hadn’t heard from him for a couple of days, she forced her way into his home. There she found him, unconscious, in the basement, at the bottom of his staircase. He had fallen, and it looked as if he may have been there for two, possibly three, days. He was close to death. Indeed, in the ambulance on the way to the hospital, his heart had stopped. Rapid action by the E.M.T.’s brought his heart back to life, and he made it to the hospital.

There the extent of the damage became clear. The man’s kidneys had stopped working, and his body chemistry was completely out of whack. He had a severe concussion. And he’d had a heart attack.

He remained in the intensive care unit for nearly three weeks, and in the hospital another two weeks. Even after these weeks of care and recovery, the toll of his injury was terrible. His kidneys were not working, so he required dialysis three times a week. He had needed a machine to help him breathe for so long that he now had to get oxygen through a hole that had been cut into his throat. His arms and legs were so weak that he could not even lift them, and because he was unable even to swallow, he had to be fed through a tube that went directly into his stomach.

Finally, after five weeks in the hospital, he was well enough to be moved to a short-term rehabilitation hospital to complete the long road to recovery. But he was still far from healthy. The laughing, swaggering, Harley-riding man his sister had known until that terrible fall seemed a distant memory, though she saw that he was slowly getting better. He had even started to smile and make jokes. He was confident, he had told her, that with a lot of hard work he could get back to normal. So was she; she knew he was tough.

Back to the Hospital:

The patient had been at the rehab facility for just over two weeks when the staff noticed a sudden change in him. He had stopped smiling and was no longer making jokes. Instead, he talked about people that no one else could see. And he was worried that they wanted to harm him. When he remained confused for a second day, they sent him to the emergency room.

You can see the records from that E.R. visit here.

The man told the E.R. doctor that he knew he was having hallucinations. He thought they had started when he had begun taking a pill to help him sleep a couple of days earlier. It seemed a reasonable explanation, since the medication was known to cause delirium in some people. The hospital psychiatrist took him off that medication and sent him back to rehab that evening with a different sleeping pill.

Back to the Hospital, Again:

Two days later, the patient was back in the emergency room. He was still seeing things that weren’t there, but now he was quite confused as well. He knew his name but couldn’t remember what day or month it was, or even what year. And he had no idea where he was, or where he had just come from.

When the medical team saw the patient after he had been admitted, he was unable to provide any useful medical history. His medical records outlined his earlier hospitalizations, and records from the nursing home filled in additional details. The patient had a history of high blood pressure, depression and alcoholism. He was on a long list of medications. And he had been confused for the past several days.

On examination, he had no fever, although a couple of hours earlier his temperature had been 100.0 degrees. His heart was racing, and his blood pressure was sky high. His arms and legs were weak and swollen. His legs were shaking, and his reflexes were very brisk. Indeed, when his ankle was flexed suddenly, it continued to jerk back and forth on its own three or four times before stopping, a phenomenon known as clonus.

His labs were unchanged from the previous visit except for his urine, which showed signs of a serious infection. A CT scan of the brain was unremarkable, as was a chest X-ray. He was started on an intravenous antibiotic to treat the infection. The thinking was that perhaps the infection was causing the patient’s confusion.

You can see the notes from that second hospital visit here.

His sister had come to visit him the next day, when he was as confused as he had ever been. He was now trembling all over and looked scared to death, terrified. He was certain he was being pursued.

That is when she confronted the nurse, demanding to know what was going on with her brother. The nurse didn’t know. No one did. His urinary tract infection was being treated with antibiotics, but he continued to have a rapid heart rate and elevated blood pressure, along with terrifying hallucinations.

Solving the Mystery:

Can you figure out why this man was so confused and tremulous? I have provided you with all the data available to the doctor who made the diagnosis. The case is not easy — that is why it is here. I’ll post the answer on Friday.


Rules and Regulations: Post your questions and diagnosis in the comments section below.. The correct answer will appear Friday on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

Correction: The patient’s eyes were brown, not blue.

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