The Lede Blog: Malala Yousafzai, Pakistani Girl Shot by Taliban Militants, Speaks in New Videos

Last Updated, 4:54 p.m. Speaking on camera for the first time since she survived an assassination attempt by the Pakistani Taliban last year, the young activist Malala Yousafzai began with the words, “Today you can see that I’m alive.” The 15-year-old, who was shot in the head as she left school in Pakistan’s Swat Valley four months ago, promised that she would continue to be an outspoken advocate of the right for “every girl, every child, to be educated.”

In the brief statement, the young advocate attributed her survival to the prayers of her supporters and urged them to contribute to a fund established in her name to further the cause of education for girls. “Because of these prayers, God has given me this new life,” Ms. Yousafzai said. “And this is a second life; this is a new life. And I want to serve, I want to serve the people.”

A video statement from Malala Yousafzai, a young Pakistani activist who was shot in the head by Taliban militants.

The English-language statement was recorded just before Ms. Yousafzai underwent surgery at the Queen Elizabeth Hospital in Birmingham, England, over the weekend to repair damage to her skull caused by the bullet fired into her head at point-blank range in October.

On Monday, the hospital released more video of the young patient, speaking to one of her doctors after the five-hour operation to reconstruct her skull and implant a device to restore hearing to her left ear.

Video of Malala Yousafzai speaking to a doctor in Birmingham, England after an operation on Saturday.

“I’m feeling alright and I’m happy that the operations, both the operations, were successful,” she told Dr. Mav Manji, a critical care specialist at Queen Elizabeth Hospital. Asked about the future, she said, “My mission is the same, to help people, and I will do that.” She also expressed her gratitude to the doctors in Pakistan and Britain who cared for her. “God gave me a new life,” she said, “because of the prayers of people and because of the talent of doctors.”

At a news conference on Monday, Dr. Anwen White, the neurosurgeon who led the reconstructive surgery, and Dr. Dave Rosser, the hospital’s medical director, explained that the titanium cranioplasty, which involved repairing the missing area of her skull with a specially molded titanium plate, “went very well.” (Video of the news conference was posted online by Britain’s Channel 4 News and the hospital uploaded images of the surgery in progress to YouTube.)

An update posted on the hospital’s Web site explained that, after the skull surgery, “Malala then had a cochlear implant fitted – a small, complex electronic device that provides a sense of sound to someone who is profoundly deaf or severely hard of hearing. The cochlear implant is to restore hearing to her left ear after she was left deaf in that ear by the bullet.”

As Fatima Manji of Britain’s Channel 4 News reports, the activist also recorded statements in Urdu and Pashto, languages spoken in Pakistan and Afghanistan. In the Urdu version, Ms. Manji notes, the girl said, “I would be willing to sacrifice myself again.”

The video statement was produced for the Vital Voices Global Partnership, a nongovernmental organization based in Washington “that identifies, trains and empowers emerging women leaders,” which will administer the new “Malala Fund,” in cooperation with the young activist and her family.

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TIMESCAST: Super Bowl Ads Recall Days Gone By

February 4, 2013

TimesCast Media+Tech: The successes and failures of this year’s Super Bowl ads. | Ang Lee on the technology behind “Life of Pi.” | An interactive project encourages action against human trafficking.

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Well: Expressing the Inexpressible

When Kyle Potvin learned she had breast cancer at the age of 41, she tracked the details of her illness and treatment in a journal. But when it came to grappling with issues of mortality, fear and hope, she found that her best outlet was poetry.

How I feared chemo, afraid

It would change me.

It did.

Something dissolved inside me.

Tears began a slow drip;

I cried at the news story

Of a lost boy found in the woods …

At the surprising beauty

Of a bright leaf falling

Like the last strand of hair from my head

Ms. Potvin, now 47 and living in Derry, N.H., recently published “Sound Travels on Water” (Finishing Line Press), a collection of poems about her experience with cancer. And she has organized the Prickly Pear Poetry Project, a series of workshops for cancer patients.

“The creative process can be really healing,” Ms. Potvin said in an interview. “Loss, mortality and even hopefulness were on my mind, and I found that through writing poetry I was able to express some of those concepts in a way that helped me process what I was thinking.”

In April, the National Association for Poetry Therapy, whose members include both medical doctors and therapists, is to hold a conference in Chicago with sessions on using poetry to manage pain and to help adolescents cope with bullying. And this spring, Tasora Books will publish “The Cancer Poetry Project 2,” an anthology of poems written by patients and their loved ones.

Dr. Rafael Campo, an associate professor of medicine at Harvard, says he uses poetry in his practice, offering therapy groups and including poems with the medical forms and educational materials he gives his patients.

“It’s always striking to me how they want to talk about the poems the next time we meet and not the other stuff I give them,” he said. “It’s such a visceral mode of expression. When our bodies betray us in such a profound way, it can be all the more powerful for patients to really use the rhythms of poetry to make sense of what is happening in their bodies.”

On return visits, Dr. Campo’s patients often begin by discussing a poem he gave them — for example, “At the Cancer Clinic,” by Ted Kooser, from his collection “Delights & Shadows” (Copper Canyon Press, 2004), about a nurse holding the door for a slow-moving patient.

How patient she is in the crisp white sails

of her clothes. The sick woman

peers from under her funny knit cap

to watch each foot swing scuffing forward

and take its turn under her weight.

There is no restlessness or impatience

or anger anywhere in sight. Grace

fills the clean mold of this moment

and all the shuffling magazines grow still.

In Ms. Potvin’s case, poems related to her illness were often spurred by mundane moments, like seeing a neighbor out for a nightly walk. Here is “Tumor”:

My neighbor walks

For miles each night.

A mantra drives her, I imagine

As my boys’ chant did

The summer of my own illness:

“Push, Mommy, push.”

Urging me to wind my sore feet

Winch-like on a rented bike

To inch us home.

I couldn’t stop;

Couldn’t leave us

Miles from the end.

Karin Miller, 48, of Minneapolis, turned to poetry 15 years ago when her husband developed testicular cancer at the same time she was pregnant with their first child.

Her husband has since recovered, and Ms. Miller has reviewed thousands of poems by cancer patients and their loved ones to create the “Cancer Poetry Project” anthologies. One poem is “Hymn to a Lost Breast,” by Bonnie Maurer.

Oh let it fly

let it fling

let it flip like a pancake in the air

let it sing: what is the song

of one breast flapping?

Another is “Barn Wish” by Kim Knedler Hewett.

I sit where you can’t see me

Listening to the rustle of papers and pills in the other room,

Wondering if you can hear them.

Let’s go back to the barn, I whisper.

Let’s turn on the TV and watch the Bengals lose.

Let’s eat Bill’s Doughnuts and drink Pepsi.

Anything but this.

Ms. Miller has asked many of her poets to explain why they find poetry healing. “They say it’s the thing that lets them get to the core of how they are feeling,” she said. “It’s the simplicity of poetry, the bare bones of it, that helps them deal with their fears.”


Have you written a poem about cancer? Please share them with us in the comments section below.

Read More..

Well: Expressing the Inexpressible

When Kyle Potvin learned she had breast cancer at the age of 41, she tracked the details of her illness and treatment in a journal. But when it came to grappling with issues of mortality, fear and hope, she found that her best outlet was poetry.

How I feared chemo, afraid

It would change me.

It did.

Something dissolved inside me.

Tears began a slow drip;

I cried at the news story

Of a lost boy found in the woods …

At the surprising beauty

Of a bright leaf falling

Like the last strand of hair from my head

Ms. Potvin, now 47 and living in Derry, N.H., recently published “Sound Travels on Water” (Finishing Line Press), a collection of poems about her experience with cancer. And she has organized the Prickly Pear Poetry Project, a series of workshops for cancer patients.

“The creative process can be really healing,” Ms. Potvin said in an interview. “Loss, mortality and even hopefulness were on my mind, and I found that through writing poetry I was able to express some of those concepts in a way that helped me process what I was thinking.”

In April, the National Association for Poetry Therapy, whose members include both medical doctors and therapists, is to hold a conference in Chicago with sessions on using poetry to manage pain and to help adolescents cope with bullying. And this spring, Tasora Books will publish “The Cancer Poetry Project 2,” an anthology of poems written by patients and their loved ones.

Dr. Rafael Campo, an associate professor of medicine at Harvard, says he uses poetry in his practice, offering therapy groups and including poems with the medical forms and educational materials he gives his patients.

“It’s always striking to me how they want to talk about the poems the next time we meet and not the other stuff I give them,” he said. “It’s such a visceral mode of expression. When our bodies betray us in such a profound way, it can be all the more powerful for patients to really use the rhythms of poetry to make sense of what is happening in their bodies.”

On return visits, Dr. Campo’s patients often begin by discussing a poem he gave them — for example, “At the Cancer Clinic,” by Ted Kooser, from his collection “Delights & Shadows” (Copper Canyon Press, 2004), about a nurse holding the door for a slow-moving patient.

How patient she is in the crisp white sails

of her clothes. The sick woman

peers from under her funny knit cap

to watch each foot swing scuffing forward

and take its turn under her weight.

There is no restlessness or impatience

or anger anywhere in sight. Grace

fills the clean mold of this moment

and all the shuffling magazines grow still.

In Ms. Potvin’s case, poems related to her illness were often spurred by mundane moments, like seeing a neighbor out for a nightly walk. Here is “Tumor”:

My neighbor walks

For miles each night.

A mantra drives her, I imagine

As my boys’ chant did

The summer of my own illness:

“Push, Mommy, push.”

Urging me to wind my sore feet

Winch-like on a rented bike

To inch us home.

I couldn’t stop;

Couldn’t leave us

Miles from the end.

Karin Miller, 48, of Minneapolis, turned to poetry 15 years ago when her husband developed testicular cancer at the same time she was pregnant with their first child.

Her husband has since recovered, and Ms. Miller has reviewed thousands of poems by cancer patients and their loved ones to create the “Cancer Poetry Project” anthologies. One poem is “Hymn to a Lost Breast,” by Bonnie Maurer.

Oh let it fly

let it fling

let it flip like a pancake in the air

let it sing: what is the song

of one breast flapping?

Another is “Barn Wish” by Kim Knedler Hewett.

I sit where you can’t see me

Listening to the rustle of papers and pills in the other room,

Wondering if you can hear them.

Let’s go back to the barn, I whisper.

Let’s turn on the TV and watch the Bengals lose.

Let’s eat Bill’s Doughnuts and drink Pepsi.

Anything but this.

Ms. Miller has asked many of her poets to explain why they find poetry healing. “They say it’s the thing that lets them get to the core of how they are feeling,” she said. “It’s the simplicity of poetry, the bare bones of it, that helps them deal with their fears.”


Have you written a poem about cancer? Please share them with us in the comments section below.

Read More..

DealBook: Suit to Accuse S.&P. of Fraud in Mortgage Bond Ratings

The Justice Department, along with state prosecutors, plans to file civil charges against Standard & Poor’s Ratings Service, accusing the firm of fraudulently rating mortgage bonds that led to the financial crisis, people briefed on the plan said Monday.

A suit against S.&P. — expected to filed this week — would be the first the government has brought against the credit ratings agencies related to the financial crisis, despite continued questions about the agencies’ conflicts of interest and role in creating a housing bubble.

Several state prosecutors are expected to join the federal suit. The New York State attorney general is conducting a separate investigation, an official in that office said. The official declined to say whether New York State’s action involved other ratings agencies besides Standard & Poor’s.

Up until last last week, the Justice Department had been in settlement talks with S.&P., these people said. But the negotiations broke down after the Justice Department said it would seek a settlement in excess of “10 figures,” or at least $1 billion, these people said. Such an amount would wipe out the profits of S.&P.’s parent, the McGraw-Hill Company, for an entire year. McGraw-Hill earned $911 million last year.

During settlement negotiations, the Justice Department held out the threat of a criminal case against S.&P., the people said. Ultimately, the government plans to bring a civil suit, which has a lower burden of proof than a criminal case.

The case is expected to be brought in California, these people said. The state suffered disproportionately during the housing bubble, and the government is hoping the venue will yield more sympathetic jurors.

The case is focusing on about 30 collateralized debt obligations, an exotic type of mortgage security. According to S&P, the mortgage securities were created in 2007 at the height of the housing boom.

Prosecutors, according to the people, have uncovered troves emails by S&P, employees, which the government considers damaging. Portions of those emails are likely to be disclosed in the government’s complaint against S&P, these people said.

In a statement on Monday, S.&P. said it had received notice from the Justice Department over a pending lawsuit. The ratings agency argued any such legal action would be baseless, since it downgraded plenty of mortgage-backed investments, including in the two years leading up to the financial crisis. It also contended that other observers of the debt markets, including government officials, believed at the time that any problems within the housing sector could be contained.

“A D.O.J. lawsuit would be entirely without factual or legal merit,” the agency said in its statement. “With 20/20 hindsight, these strong actions proved insufficient – but they demonstrate that the D.O.J. would be wrong in contending that S.&P. ratings were motivated by commercial considerations and not issued in good faith.”

Shares of McGraw-Hill closed down nearly 14 percent on Monday, at $50.30.

Mary Williams Walsh contributed reporting.

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IHT Rendezvous: The Face of America's Illegal Immigration

WASHINGTON — In my latest Letter From Washington, I write about the “Kumbaya” moment that immigration reform seems to be enjoying — and the certainty that it will not last as the hard work of writing laws gets underway. But who are the illegal immigrants?

Page Two

Posts written by the IHT’s Page Two columnists.

The U.S. Department of Homeland Security estimates that in 2011, the last year for which there are estimates, 6.8 million of the 11.5 million undocumented immigrants in the United States were from Mexico. The Pew Hispanic Center, which often has the most reliable immigration data, says the number has dropped to 6.1 million, from 7 million five years before.

The combined effects of the economic slowdown in the United States, with fewer jobs, and much more aggressive border-control efforts and stepped-up deportations by the Obama administration explain the decline.

After Mexico, El Salvador, Guatemala and Honduras are the countries of origin of the largest numbers of unauthorized immigrants, with more than 1.5 million combined, according to the Homeland Security figures. Next are four Asian countries — China, the Philippines, India and South Korea — which accounted for a little more than 1 million between them.

Not surprisingly, the government estimates that the majority of these immigrants live in California, Texas and Florida. Next, however, are two non-border states: New York and Illinois, with more than 500,000 each.

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Slipstream: Consumer Data Protection Laws, an Ocean Apart





OVER the years, the United States and Europe have taken different approaches toward protecting people’s personal information. Now the two sides are struggling to bridge that divide.




On this side of the Atlantic, Congress has enacted a patchwork quilt of privacy laws that separately limit the use of Americans’ medical records, credit reports, video rental records and so on. On the other side, the European Union has instituted more of a blanket regulatory system; it has a common directive that gives its citizens certain fundamental rights — like the right to obtain copies of records held about them by companies and institutions — that Americans now lack.


Even so, United States officials maintain that the divergent approaches are equal. “The sum of the parts of U.S. privacy protection is equal to or greater than the single whole of Europe,” says Cameron F. Kerry, general counsel of the Commerce Department. He is overseeing an agency effort to help develop voluntary, enforceable codes of conduct for industry groups, like app developers, whose collection and use of consumer data are now unregulated.


Europe begs to differ.


“Yes, we share the basic idea of privacy,” says Peter Hustinx, Europe’s data protection supervisor. “But there is a huge deficit on the U.S. side.”


Alas, the data-control divide appears to be widening.


A year ago, the European Commission proposed comprehensive reforms to strengthen online privacy rights — changes that could have big repercussions for American technology companies and marketers that operate in the European Union. American officials, trade groups and tech executives have responded by taking frequent treks to Brussels and other cities, where they have urged regulators and legislators to reconsider the one-regulation-fits-all-data approach. What’s at stake, American industry representatives say, is nothing less than a free and commerce-friendly Internet.


“The ecosystem of the Internet is very delicate,” says Kevin Richards, senior vice president of federal government affairs at TechAmerica, a trade group that represents companies like Google and Microsoft. “It’s not wise to have an overly broad, prescriptive, one-size-fits-all approach that would hinder or undermine the ability of companies to innovate in a global economy.”


European Union members already have data protection laws in place, based on a directive from 1995 that laid out principles for the collection of personal information. The proposed new rules would strengthen some existing provisions. They would standardize data protections across the 27 member states. They would also provide some new rights, such as “data portability” — the right of consumers to easily transfer their text files, photographs and videos from one social network, or e-mail or cloud storage service, to another. And they would subject companies that violate the rules to penalties of up to 2 percent of their annual global revenue.


Asked for comment, Viviane Reding, the vice president of the European Commission and the architect of the proposed regulation, said in a statement: “The main problem is that our rules predate the digital age and it became increasingly clear in recent years that they needed an update.” She continued: “That is why I have proposed a root-and-branch reform of the E.U.’s data protection rules — currently under discussion in the European Parliament and the Council of the E.U. — that will both protect citizens’ rights and facilitate business in the digital age.”


BUT some provisions seem too rigid to United States officials and trade groups. They argue that the American approach — sector-specific privacy laws, in addition to industry self-regulation and enforcement by the Federal Trade Commission — is more nimble.


“We hope that Europe will move in the direction of those multistakeholder standards, and not standards which are not flexible and don’t move at Internet speed,” says Mr. Kerry, who has taken at least four trips to European cities in the last year to discuss these issues.


From the perspective of some European legislators, however, United States representatives seem more interested in protecting commerce than consumers. The full-court American effort may have backfired, they say, pushing some European officials toward even broader measures. Last month, Jan Philipp Albrecht, a representative of the European Parliament who reviewed the draft regulation, proposed additional rights for citizens — like the right not to be subject to consumer profiling.


“My impression is that the U.S. Chamber of Commerce and the Commerce Department are mostly just following the interests of Silicon Valley,” he says. “This leads to heavy pressure on the European regulator, I can say.”


But Mr. Kerry says the United States must make its views known if the systems are to work in concert.


“I know that some people have raised eyebrows at our involvement; I make no apologies,” Mr. Kerry says. “We in the United States and countries and businesses around the world are stakeholders in this process. This has an important impact on the global economy.”


The solution to this trans-Atlantic clash may simply be American ingenuity.


Last year, President Barack Obama proposed a “Consumer Privacy Bill of Rights” that would give Americans many of the same baseline protections that the draft European rule proposes to reinforce. These include the right of access to records that companies hold about them, the right to correct those records and the right to have limits on the personal data that companies collect and keep. Administration officials said they would work with Congress on legislation based on those rights and to extend oversight to industries not currently covered by federal privacy laws.


A coalition of more than a dozen American advocacy groups said it would send a letter on Monday to senior Obama administration officials, seeking a meeting to ensure that American policy makers’ efforts in Europe “are not averse to the views expressed by the president.” The coalition includes the Electronic Privacy Information Center and the Center for Digital Democracy.


“Does the Obama administration really want to be on the opposite side of the European effort to upgrade and modernize its privacy law which is at its core about the protection of a fundamental freedom?” asks Marc Rotenberg, executive director of the Electronic Privacy Information Center.


European officials hold out hope that Congress will enact baseline consumer privacy protections for Americans.


“This development — which is much welcomed in Europe — shows that we have much in common,” Ms. Reding of the European Commission said in her statement, speaking of the privacy bill of rights. “Convergence is springing up and synergies are possible.”


E-mail: slipstream@nytimes.com.



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Concerns About A.D.H.D. Practices and Amphetamine Addiction


Before his addiction, Richard Fee was a popular college class president and aspiring medical student. "You keep giving Adderall to my son, you're going to kill him," said Rick Fee, Richard's father, to one of his son's doctors.







VIRGINIA BEACH — Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates.










Matt Eich for The New York Times

MENTAL HEALTH CLINIC Dominion Psychiatric Associates in Virginia Beach, where Richard Fee was treated by Dr. Waldo M. Ellison. After observing Richard and hearing his complaints about concentration, Dr. Ellison diagnosed attention deficit hyperactivity disorder and prescribed the stimulant Adderall.






It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning, “You’re going to kill him.”


It was where, after becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall. He hanged himself in his bedroom closet two weeks after they expired.


The story of Richard Fee, an athletic, personable college class president and aspiring medical student, highlights widespread failings in the system through which five million Americans take medication for A.D.H.D., doctors and other experts said.


Medications like Adderall can markedly improve the lives of children and others with the disorder. But the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers. These efforts are facilitated by a segment of doctors who skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects.


Richard Fee’s experience included it all. Conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.


Very few people who misuse stimulants devolve into psychotic or suicidal addicts. But even one of Richard’s own physicians, Dr. Charles Parker, characterized his case as a virtual textbook for ways that A.D.H.D. practices can fail patients, particularly young adults. “We have a significant travesty being done in this country with how the diagnosis is being made and the meds are being administered,” said Dr. Parker, a psychiatrist in Virginia Beach. “I think it’s an abnegation of trust. The public needs to say this is totally unacceptable and walk out.”


Young adults are by far the fastest-growing segment of people taking A.D.H.D medications. Nearly 14 million monthly prescriptions for the condition were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to the data company I.M.S. Health. While this rise is generally attributed to the maturing of adolescents who have A.D.H.D. into young adults — combined with a greater recognition of adult A.D.H.D. in general — many experts caution that savvy college graduates, freed of parental oversight, can legally and easily obtain stimulant prescriptions from obliging doctors.


“Any step along the way, someone could have helped him — they were just handing out drugs,” said Richard’s father. Emphasizing that he had no intention of bringing legal action against any of the doctors involved, Mr. Fee said: “People have to know that kids are out there getting these drugs and getting addicted to them. And doctors are helping them do it.”


“...when he was in elementary school he fidgeted, daydreamed and got A’s. he has been an A-B student until mid college when he became scattered and he wandered while reading He never had to study. Presently without medication, his mind thinks most of the time, he procrastinated, he multitasks not finishing in a timely manner.”


Dr. Waldo M. Ellison


Richard Fee initial evaluation


Feb. 5, 2010


Richard began acting strangely soon after moving back home in late 2009, his parents said. He stayed up for days at a time, went from gregarious to grumpy and back, and scrawled compulsively in notebooks. His father, while trying to add Richard to his health insurance policy, learned that he was taking Vyvanse for A.D.H.D.


Richard explained to him that he had been having trouble concentrating while studying for medical school entrance exams the previous year and that he had seen a doctor and received a diagnosis. His father reacted with surprise. Richard had never shown any A.D.H.D. symptoms his entire life, from nursery school through high school, when he was awarded a full academic scholarship to Greensboro College in North Carolina. Mr. Fee also expressed concerns about the safety of his son’s taking daily amphetamines for a condition he might not have.


“The doctor wouldn’t give me anything that’s bad for me,” Mr. Fee recalled his son saying that day. “I’m not buying it on the street corner.”


This article has been revised to reflect the following correction:

Correction: February 3, 2013

An earlier version of a quote appearing with the home page presentation of this article misspelled the name of a medication. It is Adderall, not Aderall.



Read More..

Concerns About A.D.H.D. Practices and Amphetamine Addiction


Before his addiction, Richard Fee was a popular college class president and aspiring medical student. "You keep giving Adderall to my son, you're going to kill him," said Rick Fee, Richard's father, to one of his son's doctors.







VIRGINIA BEACH — Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates.










Matt Eich for The New York Times

MENTAL HEALTH CLINIC Dominion Psychiatric Associates in Virginia Beach, where Richard Fee was treated by Dr. Waldo M. Ellison. After observing Richard and hearing his complaints about concentration, Dr. Ellison diagnosed attention deficit hyperactivity disorder and prescribed the stimulant Adderall.






It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning, “You’re going to kill him.”


It was where, after becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall. He hanged himself in his bedroom closet two weeks after they expired.


The story of Richard Fee, an athletic, personable college class president and aspiring medical student, highlights widespread failings in the system through which five million Americans take medication for A.D.H.D., doctors and other experts said.


Medications like Adderall can markedly improve the lives of children and others with the disorder. But the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers. These efforts are facilitated by a segment of doctors who skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects.


Richard Fee’s experience included it all. Conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.


Very few people who misuse stimulants devolve into psychotic or suicidal addicts. But even one of Richard’s own physicians, Dr. Charles Parker, characterized his case as a virtual textbook for ways that A.D.H.D. practices can fail patients, particularly young adults. “We have a significant travesty being done in this country with how the diagnosis is being made and the meds are being administered,” said Dr. Parker, a psychiatrist in Virginia Beach. “I think it’s an abnegation of trust. The public needs to say this is totally unacceptable and walk out.”


Young adults are by far the fastest-growing segment of people taking A.D.H.D medications. Nearly 14 million monthly prescriptions for the condition were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to the data company I.M.S. Health. While this rise is generally attributed to the maturing of adolescents who have A.D.H.D. into young adults — combined with a greater recognition of adult A.D.H.D. in general — many experts caution that savvy college graduates, freed of parental oversight, can legally and easily obtain stimulant prescriptions from obliging doctors.


“Any step along the way, someone could have helped him — they were just handing out drugs,” said Richard’s father. Emphasizing that he had no intention of bringing legal action against any of the doctors involved, Mr. Fee said: “People have to know that kids are out there getting these drugs and getting addicted to them. And doctors are helping them do it.”


“...when he was in elementary school he fidgeted, daydreamed and got A’s. he has been an A-B student until mid college when he became scattered and he wandered while reading He never had to study. Presently without medication, his mind thinks most of the time, he procrastinated, he multitasks not finishing in a timely manner.”


Dr. Waldo M. Ellison


Richard Fee initial evaluation


Feb. 5, 2010


Richard began acting strangely soon after moving back home in late 2009, his parents said. He stayed up for days at a time, went from gregarious to grumpy and back, and scrawled compulsively in notebooks. His father, while trying to add Richard to his health insurance policy, learned that he was taking Vyvanse for A.D.H.D.


Richard explained to him that he had been having trouble concentrating while studying for medical school entrance exams the previous year and that he had seen a doctor and received a diagnosis. His father reacted with surprise. Richard had never shown any A.D.H.D. symptoms his entire life, from nursery school through high school, when he was awarded a full academic scholarship to Greensboro College in North Carolina. Mr. Fee also expressed concerns about the safety of his son’s taking daily amphetamines for a condition he might not have.


“The doctor wouldn’t give me anything that’s bad for me,” Mr. Fee recalled his son saying that day. “I’m not buying it on the street corner.”


This article has been revised to reflect the following correction:

Correction: February 3, 2013

An earlier version of a quote appearing with the home page presentation of this article misspelled the name of a medication. It is Adderall, not Aderall.



Read More..

Iceland, Prosecutor of Bankers, Sees Meager Returns


Ilvy Njiokiktjien for The New York Times


"Greed is not a crime. But the question is: where does greed lead?" said Olafur Hauksson, a special prosecutor in Reykjavik.







REYKJAVIK, Iceland — As chief of police in a tiny fishing town for 11 years, Olafur Hauksson developed what he thought was a basic understanding of the criminal mind. The typical lawbreaker, he said, recalling his many encounters with small-time criminals, “clearly knows that he crossed the line” and generally sees “the difference between right and wrong.”




Today, the burly, 48-year-old former policeman is struggling with a very different sort of suspect. Reassigned to Reykjavik, the Icelandic capital, to lead what has become one of the world’s most sweeping investigation into the bankers whose actions contributed to the global financial crisis in 2008, Mr. Hauksson now faces suspects who “are not aware of when they crossed the line” and “defend their actions every step of the way.”


With the global economy still struggling to recover from the financial maelstrom five years ago, governments around the world have been criticized for largely failing to punish the bankers who were responsible for the calamity. But even here in Iceland, a country of just 320,000 that has gone after financiers with far more vigor than the United States and other countries hit by the crisis, obtaining criminal convictions has proved devilishly difficult.


Public hostility toward bankers is so strong in Iceland that “it is easier to say you are dealing drugs than to say you’re a banker,” said Thorvaldur Sigurjonsson, the former head of trading for Kaupthing, a once high-flying bank that crumbled. He has been called in for questioning by Mr. Hauksson’s office but has not been charged with any wrongdoing.


Yet, in the four years since the Icelandic Parliament passed a law ordering the appointment of an unnamed special prosecutor to investigate those blamed for the country’s spectacular meltdown in 2008, only a handful of bankers have been convicted.


Ministers in a left-leaning coalition government elected after the crash agree that the wheels of justice have ground slowly, but they call for patience, explaining that the process must follow the law, not vengeful passions.


“We are not going after people just to satisfy public anger,” said Steingrimur J. Sigfusson, Iceland’s minister of industry, a former finance minister and leader of the Left-Green Movement that is part of the governing coalition.


Hordur Torfa, a popular singer-songwriter who helped organize protests that forced the previous conservative government to resign, acknowledged that “people are getting impatient” but said they needed to accept that “this is not the French Revolution. I don’t believe in taking bankers out and hanging them or shooting them.”


Others are less patient. “The whole process is far too slow,” said Thorarinn Einarsson, a left-wing activist. “It only shows that ‘banksters’ can get away with doing whatever they want.”


Mr. Hauksson, the special prosecutor, said he was frustrated by the slow pace but thought it vital that his office scrupulously follow legal procedure. “Revenge is not something we want as our main driver in this process. Our work must be proper today and be seen as proper in the future,” he said.


Part of the difficulty in prosecuting bankers, he said, is that the law is often unclear on what constitutes a criminal offense in high finance. “Greed is not a crime,” he noted. “But the question is: where does greed lead?”


Mr. Hauksson said it was often easy to show that bankers violated their own internal rules for lending and other activities, but “as in all cases involving theft or fraud, the most difficult thing is proving intent.”


And there are the bankers themselves. Those who have been brought in for questioning often bristle at being asked to account for their actions. “They are not used to being questioned. These people are not used to finding themselves in this situation,” Mr. Hauksson said. They also hire expensive lawyers.


The special prosecutor’s office initially had only five staff members but now has more than 100 investigators, lawyers and financial experts, and it has relocated to a big new office. It has opened about 100 cases, with more than 120 people now under investigation for possible crimes relating to an Icelandic financial sector that grew so big it dwarfed the rest of the economy.


To help ease Mr. Hauksson’s task, legislators amended the law to allow investigators easy access to confidential bank information, something that previously required a court order.


Parliament also voted to put the country’s prime minister at the time of the banking debacle on trial for negligence before a special tribunal. (A proposal to try his cabinet failed.) Mr. Hauksson was not involved in the case against the former leader, Geir H. Haarde, who last year was found guilty of failing to keep ministers properly informed about the 2008 crisis but was acquitted on more serious charges that could have resulted in a prison sentence.


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