British Soldier Killed by Afghan Soldier

KABUL, Afghanistan — A British soldier who was helping to build new quarters for the Afghan National Army at a small base in southern Afghanistan was fatally shot by an Afghan soldier in the first insider attack of 2013, military officials said Tuesday.

The attacker, who struck on Monday evening, also shot and wounded six other British soldiers in the engineering regiment, three of them seriously, before being killed, Afghan and British officials said.

During the attack, which occurred at Camp Hazrat, a joint patrol base in the Nahr-e-Seraj District of Helmand Province, several Afghan soldiers were also shot at but were not wounded, said Maj. Gen. Sayed Maluk, the commanding general of the Afghan Army’s 215 Corps, in a statement to the British Forces Broadcasting Service, an arm of the British Defense Ministry.

“It was the British team that sustained injuries,” General Maluk said. “Unfortunately, they were engineering personnel and they were building billeting for the A.N.A.”

He said the Afghan Army was doing everything it could to prevent such attacks. Until 2011, insider attacks, also known as “green on blue” attacks, were a relatively minor problem for the Western military forces in Afghanistan.

But last year, 62 international troops and civilian contractors died in attacks by Afghan forces. Two additional attacks are still under investigation.

Many in the military see the escalation as a game changer that requires Western troops to stay at arm’s length from the Afghans they are supposed to be training and mentoring.

At one point late last summer, Gen. John R. Allen, the commander for international forces in Afghanistan, temporarily suspended joint patrols unless they were approved at the highest levels because of the risk.

Members of NATO units were required to carry weapons with a loaded magazine, and each unit assigned some troops as “guardian angels” to protect fellow soldiers from insider attacks during meetings with Afghans as well as on patrol.

The Afghan Defense Ministry overhauled its screening process for new recruits and rescreened those already deployed.

“Prior to this incident happening we have done almost everything that we can,” General Maluk said.

He said Afghan soldiers have been told by religious leaders inside the corps that the coalition forces “are not invaders, they are our friendly forces; they are not here to invade, but rather they are here to help us reconstruct this country.”

“But to them, the enemy is the enemy,” he said.

The Taliban claimed responsibility for arranging the infiltration into the Afghan Army of the soldier responsible for Monday’s shooting.

A Taliban spokesman, Qari Yusuf, said that the attacker’s name was Mohammed Qasim and that Mr. Qasim had “fulfilled his blessed duty.”

Mr. Qasim, who was between 23 and 25 years old and was known as Sheik Mohammed by his fellow soldiers, was a reticent young man who came from eastern Afghanistan, said Col. Abdul Saboor, an officer with the 215 Corps.

The sequence of events that led to the attack are still unclear, but it seems that the attacker, Mr. Qasim, was on guard duty in a tower as punishment for an infraction and initially began shooting at his Afghan compatriots. It is not clear if Mr. Qasim intended to kill them or whether it was a ploy to draw the British troops closer so that he could target them more easily.

Alissa J. Rubin reported from Kabul, and Taimoor Shah from Kandahar, Afghanistan. Sangar Rahimi contributed reporting from Kabul.

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American Delegation Arrives in North Korea on Controversial Private Trip

David Guttenfelder/Associated Press

Eric Schmidt, Google's executive chairman, arrived in Pyongyang on Monday.

SEOUL, South Korea — Bill Richardson, the former governor of New Mexico, led a private delegation including Eric Schmidt, Google’s executive chairman, to North Korea on Monday, a controversial trip to a country that is among the most hostile to the Internet.

Kim Kwang Hyon/Associated Press

Bill Richardson with journalists on Monday after arriving in Pyongyang, North Korea. Mr. Richardson, who has visited the North several times, called his trip a private humanitarian mission.

Mr. Richardson, who has visited North Korea several times, called his four-day trip a private humanitarian mission and said he would try to meet with Kenneth Bae, a 44-year-old South Korean-born American citizen who was arrested on charges of “hostile acts” against North Korea after entering the country as a tourist in early November.

“I heard from his son who lives in Washington State, who asked me to bring him back,” Mr. Richardson said in Beijing before boarding a plane bound for Pyongyang. “I doubt we can do it on this trip.”

In a one-sentence dispatch, the North’s state-run Korean Central News Agency confirmed the American group’s arrival in Pyongyang, calling it “a Google delegation.”

Mr. Richardson said his delegation planned to meet with North Korean political, economic and military leaders, and to visit universities.

Mr. Schmidt and Google have kept quiet about why Mr. Schmidt joined the trip, which the State Department advised against, calling the visit unhelpful. Mr. Richardson said Monday that Mr. Schmidt was “interested in some of the economic issues there, the social media aspect,” but did not elaborate. Mr. Schmidt is a staunch proponent of Internet connectivity and openness.

Except for a tiny portion of its elite, North Korea’s population is blocked from the Internet. Under its new leader, Kim Jong-un, the country has emphasized science and technology but has also vowed to intensify its war against the infiltration of outside information in the isolated country, which it sees as a potential threat to its totalitarian grip on power.

Although it is engaged in a standoff with the United States over its nuclear weapons and missile programs and habitually criticizes American foreign policy as “imperial,” North Korea welcomes high-profile American visits to Pyongyang, billing them as signs of respect for its leadership. It runs a special museum for gifts that foreign dignitaries have brought for its leaders.

Washington has never established diplomatic ties with North Korea, and the two countries remain technically at war after the 1950-53 Korean War ended in a truce.

But Mr. Richardson’s trip comes at a particularly delicate time for Washington. In the past weeks, it has been trying to muster international support to penalize North Korea for its launching last month of a long-range rocket, which the United States condemned as a violation of United Nations Security Council resolutions banning the country from testing intercontinental ballistic missile technology.

North Korea has often required visits by high-profile Americans, including former Presidents Jimmy Carter and Bill Clinton, before releasing American citizens held there on criminal charges. Mr. Richardson, who is also a former ambassador to the United Nations, traveled to Pyongyang in 1996 to negotiate the release of Evan Hunziker, who was held for three months on charges of spying after swimming across the river border between China and North Korea.

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Gaps Seen in Therapy for Suicidal Teenagers

Most adolescents who plan or attempt suicide have already gotten at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled teenagers, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study, posted online Tuesday by the journal JAMA Psychiatry, found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems that include attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and about a third of them had made a suicide attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.

The study suggests that effective treatment for severely suicidal teenagers must address not just mood disorders, but also behavior problems that can lead to impulsive acts, experts said. According to the Centers for Disease Control and Prevention, 1,386 people between the ages of 13 and 18 committed suicide in 2010, the latest year for which numbers are available.

“I think one of the take-aways here is that treatment for depression may be necessary but not sufficient to prevent kids from attempting suicide,” said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, who was not involved in the study. “We simply do not have empirically validated treatments for recurrent suicidal behavior.”

The report said nothing about whether the therapies given were state of the art, or carefully done, said Matt Nock, a professor of psychology at Harvard and the lead author; and it is possible that some of the treatments prevented suicide attempts. “But it’s telling us we’ve got a long way to go to do this right,” Dr. Nock said. His co-authors included Ronald C. Kessler of Harvard, and researchers from Boston University and Children’s Hospital Boston.

Margaret McConnell, a consultant in Alexandria, Va., said that her daughter Alice, who killed herself in 2006, at the age of 17, was getting treatment at the time. “I think there might have been some carelessness in the way the treatment was done,” Ms. McConnell said, “and I was trusting a 17-year-old to manage her own medication; we found out after we lost her that she wasn’t taking it regularly.”

In the study, researchers surveyed 6,483 adolescents from the ages of 13 to 18 and found that 9 percent of male teenagers and 15 percent of female teenagers experienced some stretch of having persistent suicidal thoughts. Among girls, 5 percent made suicide plans and 6 percent made at least one attempt (some were unplanned).

Among boys, 3 percent made plans and 2 percent carried out attempts – which tended to be more lethal than girls’ attempts.

(Suicidal thinking or behavior was virtually unheard-of before age 10.)

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias, or generalized anxiety disorder. Those with an added behavior problem – attention-deficit disorder, substance abuse, explosive anger – were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and attempts in people with so-called borderline personality disorder, who are highly prone to self-harm, among others.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments – talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use – was more effective that regular therapies.

“But that’s just one study, and it’s small,” Dr. Brent said. “We can treat components of the overall problem, but that’s about all.”

Ms. McConnell said that her daughter’s depression seemed mild and that there was no warning that she would take her life. “I think therapy does help a lot of people, if it’s handled right,” she said.

Read More..

Gaps Seen in Therapy for Suicidal Teenagers

Most adolescents who plan or attempt suicide have already gotten at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled teenagers, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study, posted online Tuesday by the journal JAMA Psychiatry, found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems that include attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and about a third of them had made a suicide attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.

The study suggests that effective treatment for severely suicidal teenagers must address not just mood disorders, but also behavior problems that can lead to impulsive acts, experts said. According to the Centers for Disease Control and Prevention, 1,386 people between the ages of 13 and 18 committed suicide in 2010, the latest year for which numbers are available.

“I think one of the take-aways here is that treatment for depression may be necessary but not sufficient to prevent kids from attempting suicide,” said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, who was not involved in the study. “We simply do not have empirically validated treatments for recurrent suicidal behavior.”

The report said nothing about whether the therapies given were state of the art, or carefully done, said Matt Nock, a professor of psychology at Harvard and the lead author; and it is possible that some of the treatments prevented suicide attempts. “But it’s telling us we’ve got a long way to go to do this right,” Dr. Nock said. His co-authors included Ronald C. Kessler of Harvard, and researchers from Boston University and Children’s Hospital Boston.

Margaret McConnell, a consultant in Alexandria, Va., said that her daughter Alice, who killed herself in 2006, at the age of 17, was getting treatment at the time. “I think there might have been some carelessness in the way the treatment was done,” Ms. McConnell said, “and I was trusting a 17-year-old to manage her own medication; we found out after we lost her that she wasn’t taking it regularly.”

In the study, researchers surveyed 6,483 adolescents from the ages of 13 to 18 and found that 9 percent of male teenagers and 15 percent of female teenagers experienced some stretch of having persistent suicidal thoughts. Among girls, 5 percent made suicide plans and 6 percent made at least one attempt (some were unplanned).

Among boys, 3 percent made plans and 2 percent carried out attempts – which tended to be more lethal than girls’ attempts.

(Suicidal thinking or behavior was virtually unheard-of before age 10.)

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias, or generalized anxiety disorder. Those with an added behavior problem – attention-deficit disorder, substance abuse, explosive anger – were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and attempts in people with so-called borderline personality disorder, who are highly prone to self-harm, among others.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments – talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use – was more effective that regular therapies.

“But that’s just one study, and it’s small,” Dr. Brent said. “We can treat components of the overall problem, but that’s about all.”

Ms. McConnell said that her daughter’s depression seemed mild and that there was no warning that she would take her life. “I think therapy does help a lot of people, if it’s handled right,” she said.

Read More..

DealBook: Dish Network Makes Bid for Clearwire

Not so fast, Sprint.

On Tuesday, Dish Network made an unsolicited bid for the wireless network operator Clearwire, trumping a previous offer by its majority shareholder, Sprint Nextel.

Under the proposal, Dish Network is bidding $3.30 a share, 11 percent more than Sprint. The bid by Dish Network values Clearwire at roughly $2.4 billion.

Sprint, which owns more than 50 percent of Clearwire, contends that the rival’s bid is “inferior.” In response to the offer, Sprint outlined that the Dish Network proposal was “illusory” and “not viable,” given the conditions of its current deal with Clearwire.

“Sprint believes its agreement to acquire Clearwire, which offers Clearwire shareholders certain and attractive value, is superior to the highly conditional DISH proposal,” Sprint said in a statement.

Dish Network and Sprint are vying for access to viable spectrum.

Dish Network have been steadily acquiring spectrum assets in recent years. In 2011, Dish Network bought the satellite operator DBSD North America out of bankruptcy, gaining access to broadband spectrum. Last month, the company won a critical regulatory ruling, gaining the right to convert some satellite airwaves for cellphone service.

With Clearwire, Sprint is hoping to expand its next generation of data services. Sprint is building out its Long Term Evolution, or LTE, network, which can support the latest smartphones like the iPhone 5.

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Oil Sand Industry in Canada Tied to Higher Carcinogen Level

Todd Korol/Reuters

An aerial view of a tar sands mine in Alberta, where cancer-causing compounds have been rising according to a study.

OTTAWA — The development of Alberta’s oil sands has increased levels of cancer-causing compounds in surrounding lakes well beyond natural levels, Canadian researchers reported in a study released on Monday. And they said the contamination covered a wider area than had previously been believed.

For the study, financed by the Canadian government, the researchers set out to develop a historical record of the contamination, analyzing sediment dating back about 50 years from six small and shallow lakes north of Fort McMurray, Alberta, the center of the oil sands industry. Layers of the sediment were tested for deposits of polycyclic aromatic hydrocarbons, or PAHs, groups of chemicals associated with oil that in many cases have been found to cause cancer in humans after long-term exposure.

“One of the biggest challenges is that we lacked long-term data,” said John P. Smol, the paper’s lead author and a professor of biology at Queen’s University in Kingston, Ontario. “So some in industry have been saying that the pollution in the tar sands is natural, it’s always been there.”

The researchers found that to the contrary, the levels of those deposits have been steadily rising since large-scale oil sands production began in 1978.

Samples from one test site, the paper said, now show 2.5 to 23 times more PAHs in current sediment than in layers dating back to around 1960.

“We’re not saying these are poisonous ponds,” Professor Smol said. “But it’s going to get worse. It’s not too late but the trend is not looking good.” He said that the wilderness lakes studied by the group were now contaminated as much as lakes in urban centers.

The study is likely to provide further ammunition to critics of the industry, who already contend that oil extracted from Canada’s oil sands poses environmental hazards like toxic sludge ponds, greenhouse gas emissions and the destruction of boreal forests.

Battles are also under way over the proposed construction of the Keystone XL pipeline, which would move the oil down through the western United States and down to refineries along the Gulf Coast, or an alternative pipeline that would transport the oil from landlocked Alberta to British Columbia for export to Asia.

The researchers, who included scientists at Environment Canada’s aquatic contaminants research division, chose to test for PAHs because they had been the subject of earlier studies, including one published in 2009 that analyzed the distribution of the chemicals in snowfall north of Fort McMurray. That research drew criticism from the government of Alberta and others for failing to provide a historical baseline.

“Now we have the smoking gun,” Professor Smol said.

He said he was not surprised that the analysis found a rise in PAH deposits after the industrial development of the oil sands, “but we needed the data.” He said he Hs not entirely expected, however, to observe the effect at the most remote test site, a lake that is about 50 miles to the north.

Asked about the study, Adam Sweet, a spokesman for Peter Kent, Canada’s environment minister, emphasized in an e-mail that with the exception of one lake very close to the oil sands, the levels of contaminants measured by the researchers “did not exceed Canadian guidelines and were low compared to urban areas.”

He added that an environmental monitoring program for the region announced last February 2012 was put into effect “to address the very concerns raised by such studies” and to “provide an improved understanding of the long-term cumulative effects of oil sands development.”

Earlier research has suggested several different ways that the chemicals could spread. Most oil sand production involve large-scale open-bit mining. The chemicals may become wind-borne when giant excavators dig them up and then deposit them into 400-ton dump trucks.

Upgraders at some oil sands projects that separate the oil bitumen from its surrounding sand are believed to emit PAHs. And some scientists believe that vast ponds holding wastewater from that upgrading and from other oil sand processes may be leaking PAHs and other chemicals into downstream bodies of water.

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American Delegation Arrives in North Korea on Controversial Private Trip

David Guttenfelder/Associated Press

Eric Schmidt, Google's executive chairman, arrived in Pyongyang on Monday.

SEOUL, South Korea — Bill Richardson, the former governor of New Mexico, led a private delegation including Eric Schmidt, Google’s executive chairman, to North Korea on Monday, a controversial trip to a country that is among the most hostile to the Internet.

Kim Kwang Hyon/Associated Press

Bill Richardson led a private delegation to North Korea on Monday.

Mr. Richardson, who has visited North Korea several times, called his four-day trip a private humanitarian mission and said he would try to meet with Kenneth Bae, a 44-year-old South Korean-born American citizen who was arrested on charges of “hostile acts” against North Korea after entering the country as a tourist in early November.

“I heard from his son who lives in Washington State, who asked me to bring him back,” Mr. Richardson said in Beijing before boarding a plane bound for Pyongyang. “I doubt we can do it on this trip.”

In a one-sentence dispatch, the North’s state-run Korean Central News Agency confirmed the American group’s arrival in Pyongyang, calling it “a Google delegation.”

Mr. Richardson said his delegation planned to meet with North Korean political, economic and military leaders, and to visit universities.

Mr. Schmidt and Google have kept quiet about why Mr. Schmidt joined the trip, which the State Department advised against, calling the visit unhelpful. Mr. Richardson said Monday that Mr. Schmidt was “interested in some of the economic issues there, the social media aspect,” but did not elaborate. Mr. Schmidt is a staunch proponent of Internet connectivity and openness.

Except for a tiny portion of its elite, North Korea’s population is blocked from the Internet. Under its new leader, Kim Jong-un, the country has emphasized science and technology but has also vowed to intensify its war against the infiltration of outside information in the isolated country, which it sees as a potential threat to its totalitarian grip on power.

Although it is engaged in a standoff with the United States over its nuclear weapons and missile programs and habitually criticizes American foreign policy as “imperial,” North Korea welcomes high-profile American visits to Pyongyang, billing them as signs of respect for its leadership. It runs a special museum for gifts that foreign dignitaries have brought for its leaders.

Washington has never established diplomatic ties with North Korea, and the two countries remain technically at war after the 1950-53 Korean War ended in a truce.

But Mr. Richardson’s trip comes at a particularly delicate time for Washington. In the past weeks, it has been trying to muster international support to penalize North Korea for its launching last month of a long-range rocket, which the United States condemned as a violation of United Nations Security Council resolutions banning the country from testing intercontinental ballistic missile technology.

North Korea has often required visits by high-profile Americans, including former Presidents Jimmy Carter and Bill Clinton, before releasing American citizens held there on criminal charges. Mr. Richardson, who is also a former ambassador to the United Nations, traveled to Pyongyang in 1996 to negotiate the release of Evan Hunziker, who was held for three months on charges of spying after swimming across the river border between China and North Korea.

Read More..

Reliving the Nightmare of Plague, 10 Years Later

Jakob Schiller for The New York Times

Survivors Lucinda Marker and John Tull at home a decade after having the plague.

It was November 2002, little more than a year after planes had been flown into the World Trade Center and anthrax mailings had killed five Americans. New York City was still on edge, in a state of high alert for suspected terrorists.

Suddenly all eyes were on a middle-aged married couple from Santa Fe, N.M., on a brief vacation to New York, who had the remarkably ill luck to come down with the city’s first case of bubonic plague in more than a century. Television news trucks surrounded Beth Israel Medical Center North, where they had dragged themselves after being stricken in their hotel room with rampaging fevers, headaches, extreme exhaustion and mysterious balloonlike swellings.

It took just over a day for public health officials to dispel fears about bioterrorism; there had been no unusual rise in the number of very high fevers that could have suggested an attack.

It turned out that the couple, Lucinda Marker and John Tull, had been bitten by fleas infected with Yersinia pestis, the bacterium that causes plague. Their home state, New Mexico, accounts for more than half of the average seven cases of plague in the country every year. (In 2012, just one case was reported in the state.)

“It was an absolute fluke,” Ms. Marker, now 57, said during a recent visit to New York. “Just rotten luck.”

Like most people who contract the disease and are quickly treated with antibiotics, she recovered in a few days. But 10 years later, her husband is still badly scarred.

In the days after they were bitten, Mr. Tull, a burly, athletic lawyer — a former prosecutor who volunteered with search-and-rescue teams — developed septicemic plague, as the infection spread throughout his body.

His temperature rose to 104.4, his blood pressure plummeted to 78/50. His kidneys were failing, and so much clotted blood collected in his hands and feet that they turned black.

Mr. Tull was put into a medically induced coma. When he was brought out of it, nearly three months later, he found out that both his legs had been amputated below the knee to drain the deadly infection. The surgery that saved his life radically changed it, but did not dampen his resilient spirit.

Even before he was released from the hospital to begin a long rehabilitation, he vowed he would once again be hiking on the rustic trails above his home.

Today Mr. Tull, 63, drives his own car, sometimes takes over the controls of a private plane, and goes on an annual trout-fishing trip to Colorado with friends. But he has not been able to hike that trail.

“That is one of the things I miss most,” Mr. Tull, now retired and receiving a disability pension, said in a telephone interview from his home. “Every single hour of every single day, the plague affects our lives, but about the only time I really get angry these days is when, because of my physical condition, there is something I want to do but can’t.”

He has appeared in several television documentaries, speaking to medical researchers around the world and dealing with a posse of journalists as his very private ordeal has been played out in public.

“Basically Lucinda and I surrendered our privacy to the press and the people who make documentaries,” Mr. Tull said. “But you know what? That didn’t bother us a bit. Lucinda had been an actress and I had been a trial lawyer. We were used to it.”

Ms. Marker, who has started to write about their ordeal, says that after 10 years she is coming to terms with it emotionally and psychologically. Yet many aspects of their case still puzzle medical experts.

In particular, no one knows why she was so easily cured while he nearly died.

Bubonic plague is transmitted by fleas that feed off pack rats, ground squirrels and prairie dogs in the mountains of New Mexico and several other states. According to the Centers for Disease Control and Prevention, the disease probably came to the United States around 1900, in Asian rats that escaped from ships in the port of San Francisco.

Initially, plague was restricted to cities. The worst outbreak came in 1907, after the San Francisco earthquake. Vermin control programs prevented further outbreaks, but fleas hitched onto other animals in the wild.

Dr. Paul Ettestad, public health veterinarian for the New Mexico Department of Health, said prairie dogs became an “amplification host,” carrying the disease to their burrows and spreading it throughout their territory. Today, the easternmost limit of the plague roughly corresponds to the 100th meridian, which passes through central Texas. Known as the plague line, is it also the extent of the prairie dog population.

Read More..

Reliving the Nightmare of Plague, 10 Years Later

Jakob Schiller for The New York Times

Survivors Lucinda Marker and John Tull at home a decade after having the plague.

It was November 2002, little more than a year after planes had been flown into the World Trade Center and anthrax mailings had killed five Americans. New York City was still on edge, in a state of high alert for suspected terrorists.

Suddenly all eyes were on a middle-aged married couple from Santa Fe, N.M., on a brief vacation to New York, who had the remarkably ill luck to come down with the city’s first case of bubonic plague in more than a century. Television news trucks surrounded Beth Israel Medical Center North, where they had dragged themselves after being stricken in their hotel room with rampaging fevers, headaches, extreme exhaustion and mysterious balloonlike swellings.

It took just over a day for public health officials to dispel fears about bioterrorism; there had been no unusual rise in the number of very high fevers that could have suggested an attack.

It turned out that the couple, Lucinda Marker and John Tull, had been bitten by fleas infected with Yersinia pestis, the bacterium that causes plague. Their home state, New Mexico, accounts for more than half of the average seven cases of plague in the country every year. (In 2012, just one case was reported in the state.)

“It was an absolute fluke,” Ms. Marker, now 57, said during a recent visit to New York. “Just rotten luck.”

Like most people who contract the disease and are quickly treated with antibiotics, she recovered in a few days. But 10 years later, her husband is still badly scarred.

In the days after they were bitten, Mr. Tull, a burly, athletic lawyer — a former prosecutor who volunteered with search-and-rescue teams — developed septicemic plague, as the infection spread throughout his body.

His temperature rose to 104.4, his blood pressure plummeted to 78/50. His kidneys were failing, and so much clotted blood collected in his hands and feet that they turned black.

Mr. Tull was put into a medically induced coma. When he was brought out of it, nearly three months later, he found out that both his legs had been amputated below the knee to drain the deadly infection. The surgery that saved his life radically changed it, but did not dampen his resilient spirit.

Even before he was released from the hospital to begin a long rehabilitation, he vowed he would once again be hiking on the rustic trails above his home.

Today Mr. Tull, 63, drives his own car, sometimes takes over the controls of a private plane, and goes on an annual trout-fishing trip to Colorado with friends. But he has not been able to hike that trail.

“That is one of the things I miss most,” Mr. Tull, now retired and receiving a disability pension, said in a telephone interview from his home. “Every single hour of every single day, the plague affects our lives, but about the only time I really get angry these days is when, because of my physical condition, there is something I want to do but can’t.”

He has appeared in several television documentaries, speaking to medical researchers around the world and dealing with a posse of journalists as his very private ordeal has been played out in public.

“Basically Lucinda and I surrendered our privacy to the press and the people who make documentaries,” Mr. Tull said. “But you know what? That didn’t bother us a bit. Lucinda had been an actress and I had been a trial lawyer. We were used to it.”

Ms. Marker, who has started to write about their ordeal, says that after 10 years she is coming to terms with it emotionally and psychologically. Yet many aspects of their case still puzzle medical experts.

In particular, no one knows why she was so easily cured while he nearly died.

Bubonic plague is transmitted by fleas that feed off pack rats, ground squirrels and prairie dogs in the mountains of New Mexico and several other states. According to the Centers for Disease Control and Prevention, the disease probably came to the United States around 1900, in Asian rats that escaped from ships in the port of San Francisco.

Initially, plague was restricted to cities. The worst outbreak came in 1907, after the San Francisco earthquake. Vermin control programs prevented further outbreaks, but fleas hitched onto other animals in the wild.

Dr. Paul Ettestad, public health veterinarian for the New Mexico Department of Health, said prairie dogs became an “amplification host,” carrying the disease to their burrows and spreading it throughout their territory. Today, the easternmost limit of the plague roughly corresponds to the 100th meridian, which passes through central Texas. Known as the plague line, is it also the extent of the prairie dog population.

Read More..

Frequent Flier: When Even 4 Hours of Layover Time Isn’t Enough

William Boutelle cycling on Lismore Isle in Scotland. He is  a psychiatrist at ServiceNet, which provides clinical services in Northampton, Mass.

Q. How often do you fly for business?

A. About twice a month, mostly domestic.

Q. What’s your least favorite airport?

A. Philadelphia International. Something always gets messed up there, without fail.

Q. Of all the places you’ve been, what’s the best?

A. The Greek islands. I love the people, their sense of independence, the ambience and, let’s face it, the islands are great for a beer on the beach.

Q. What’s your secret airport vice?

A. I don’t know if it’s a vice, but I try to always book a layover in Denver. There’s a great restaurant in the airport where I can get the best filet mignon. It’s my red meat quota until I get another chance to fly through there.

I WORKED for more than 30 years for the government as a psychiatrist with the Department of Veterans Affairs system. I flew all the time for meetings and other bureaucratic events. I now work in the private sector as a psychiatrist, and still fly for business about  twice a month.

I don’t like flying much. If I could take a train, that’s what I would do.  I don’t mind talking to seatmates, but I don’t advertise what I do. I might say I’m a doctor, and if they ask me what kind, I’ll usually answer “a pretty good one.”  I don’t want to get into a discussion about psychiatry when I’m trapped in a plane.

I’ve had my share of flying misadventures, but nothing like one recent experience where everything that could go wrong, did.

My wife and I were coming home  from Scotland. We booked plenty of time between our flight from Edinburgh to London and then on to Boston. We booked through a  British carrier, but the  London-to-Boston leg was subcontracted to an American carrier. We were feeling very hopeful that everything was going to go smoothly. That is, until we  got to the airport and saw the plane we were supposed to board was empty. Other travelers were gathering, so we figured that we were in the right place. After about  90 minutes, we found out the delay was caused by fog at Heathrow.

We finally boarded, but then we sat on the runway for another hour because we couldn’t take off because of the backup at Heathrow. We started with a four-hour cushion of time between leaving Scotland, landing in London and then going to Boston. So much for that, and even more time was eaten up as we  circled Heathrow because of continued congestion.

We finally landed, but then had to wait for an open gate, and then found out we had to be bused to a terminal. By the time we got to Heathrow Terminal 5, our Boston flight was gone.

We went to the flight connections desk, where about 2,000 people were in line ahead of us. I called the American carrier whose flight we missed and was told that since it wasn’t a simple round-trip booking, I would have to buy another ticket to get home. I refused, and was told to call  the British carrier with whom I booked the ticket originally.

They told me that we could get on a flight offered by the same American carrier I had just spoken with. Fine by me. It was leaving in 90 minutes. I asked what gate the flight was departing from. It was Terminal 3. It took 45 minutes to get there, only to find out bookings for the flight had closed.

I’m pretty sure tears of frustration were streaming down my face as I explained we had just been sent there from Terminal 5. They found our names, which was great, but we still had to clear security, and then make it to the gate. I was beat up at this point, but we finally boarded our flight home only to discover that we left a backpack at security. The attendant gave me 10 minutes to run back to security and then run back to the plane.

I’m 72 years old. I thought I was going to die, but somehow ran the mini-marathon. When I finally sat down on the plane, we were delayed another 30 minutes. I drank wine. We landed in Boston. My luggage was lost. It did arrive one week later, dirty laundry still intact. After that ordeal, I figured someone might have at least washed it.

 

 

By William Boutelle, as told to Joan Raymond. E-mail: joanraymond@nytimes.com

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