Saturday, March 31, 2012

Why Nations Fail

By THOMAS L. FRIEDMAN

I’M reading a fascinating new book called “Why Nations Fail.” The more you read it, the more you appreciate what a fool’s errand we’re on in Afghanistan and how much we need to totally revamp our whole foreign aid strategy. But most intriguing are the warning flares the authors put up about both America and China.

Co-authored by the M.I.T. economist Daron Acemoglu and the Harvard political scientist James A. Robinson, “Why Nations Fail” argues that the key differentiator between countries is “institutions.” Nations thrive when they develop “inclusive” political and economic institutions, and they fail when those institutions become “extractive” and concentrate power and opportunity in the hands of only a few.

“Inclusive economic institutions that enforce property rights, create a level playing field, and encourage investments in new technologies and skills are more conducive to economic growth than extractive economic institutions that are structured to extract resources from the many by the few,” they write.

“Inclusive economic institutions, are in turn supported by, and support, inclusive political institutions,” which “distribute political power widely in a pluralistic manner and are able to achieve some amount of political centralization so as to establish law and order, the foundations of secure property rights, and an inclusive market economy.” Conversely, extractive political institutions that concentrate power in the hands of a few reinforce extractive economic institutions to hold power.

Acemoglu explained in an interview that their core point is that countries thrive when they build political and economic institutions that “unleash,” empower and protect the full potential of each citizen to innovate, invest and develop. Compare how well Eastern Europe has done since the fall of communism with post-Soviet states like Georgia or Uzbekistan, or Israel versus the Arab states, or Kurdistan versus the rest of Iraq. It’s all in the institutions.

The lesson of history, the authors argue, is that you can’t get your economics right if you don’t get your politics right, which is why they don’t buy the notion that China has found the magic formula for combining political control and economic growth.

“Our analysis,” says Acemoglu, “is that China is experiencing growth under extractive institutions — under the authoritarian grip of the Communist Party, which has been able to monopolize power and mobilize resources at a scale that has allowed for a burst of economic growth starting from a very low base,” but it’s not sustainable because it doesn’t foster the degree of “creative destruction” that is so vital for innovation and higher incomes.

“Sustained economic growth requires innovation,” the authors write, “and innovation cannot be decoupled from creative destruction, which replaces the old with the new in the economic realm and also destabilizes established power relations in politics.”

“Unless China makes the transition to an economy based on creative destruction, its growth will not last,” argues Acemoglu. But can you imagine a 20-year-old college dropout in China being allowed to start a company that challenges a whole sector of state-owned Chinese companies funded by state-owned banks? he asks.

The post-9/11 view that what ailed the Arab world and Afghanistan was a lack of democracy was not wrong, said Acemoglu. What was wrong was thinking that we could easily export it. Democratic change, to be sustainable, has to emerge from grassroots movements, “but that does not mean there is nothing we can do,” he adds.

For instance, we should be transitioning away from military aid to regimes like Egypt and focusing instead on enabling more sectors of that society to have a say in politics. Right now, I’d argue, our foreign aid to Egypt, Pakistan and Afghanistan is really a ransom we pay their elites not to engage in bad behavior. We need to turn it into bait.

Acemoglu suggests that instead of giving Cairo another $1.3 billion in military aid that only reinforces part of the elite, we should insist that Egypt establish a committee representing all sectors of its society that would tell us which institutions — schools, hospitals — they want foreign aid to go to, and have to develop appropriate proposals.

If we’re going to give money, “let’s use it to force them to open up the table and to strengthen the grass-roots,” says Acemoglu.

We can only be a force multiplier. Where you have grass-roots movements that want to build inclusive institutions, we can enhance them. But we can’t create or substitute for them. Worse, in Afghanistan and many Arab states, our policies have often discouraged grass-roots from emerging by our siding with convenient strongmen. So there’s nothing to multiply. If you multiply zero by 100, you still get zero.

And America? Acemoglu worries that our huge growth in economic inequality is undermining the inclusiveness of America’s institutions, too. “The real problem is that economic inequality, when it becomes this large, translates into political inequality.” When one person can write a check to finance your whole campaign, how inclusive will you be as an elected official to listen to competing voices?

NYT

30 Years After Falklands War, Visible Scars Remain

By THE ASSOCIATED PRESS

STANLEY, Falkland Islands (AP) — Thirty years after Argentina and Britain spilled blood over these remote islands in the South Atlantic, the scars of war are still being scratched raw.

Argentina's occupation of the islands it claims as "Las Malvinas" lasted just 74 days, but the trauma extends well beyond the families of the 907 people killed.

Islanders still live among land mines the Argentines planted; only light-footed penguins can step onto the beautiful white-sand beach just outside town where troops came ashore on April 2, 1982. Islanders still feel they need an extensive military garrison, with warships and a nuclear submarine circling somewhere in the deep, to protect them from their Latin American neighbor.

Arriving planes and cruise ships make some islanders worry whether Argentines on board will make trouble. Each day they steel themselves for news of another attempt to isolate them economically and diplomatically, part of the Argentine government's intensifying campaign to pressure Britain to concede sovereignty.

Islanders will turn out for a march by the Falkland Islands Defense Force on Sunday, remembering the day their local militia mobilized just ahead of the invasion, while Argentines hold vigil at their Monument to the Fallen, in Ushuaia, capital of the country's southernmost province. On Monday, President Cristina Fernandez will be in Ushuaia as well, leading rallies nationwide that honor the veterans as heroes and press her country's claim.

"Although 30 years is quite a while, on the other hand it's yesterday. As soon as you start making threats all that comes back again. It makes people nervous, it puts people on edge. We don't believe they'll use military force, but the other things they are doing aren't helpful," said Tony Smith, an islander who gives tours and laments the hardening positions on both sides. "Nearly every Argentine I've met has been perfectly all right," he says.

Argentines also see themselves as victims. Many focus their anger on Britain's historical role as the world's leading colonial power, even though the islands are no longer a colony, and blame the 1982 war on the military junta that led Argentina at the time, even though taking the islands by force had considerable popular support.

Polls show most remain convinced that "Las Malvinas" have always been Argentine, and are cheered by President Cristina Fernandez's current campaign. But looking deeper can be painful because her nationalist speeches only seem to push the islands farther from reach.

"It's a very emotional subject for us. We still teach our children that the Malvinas are Argentine. I still hope they will be," said Marcelo Pozzo, 49, who was a 19-year-old conscript sailor when he survived the sinking of the Argentine Navy's light cruiser General Belgrano by British torpedoes.

"We don't know what the presidency is trying to accomplish," said Pozzo. "It should be trying to build ties, but the islanders don't want to be close to Argentina. They want to live in peace."

For Pozzo and other Argentine war veterans, emotions are even more complicated because they were drafted by a military focused on eliminating leftist "subversives" at home, then sent into a war they were unprepared for. Soldiers were abused by their own officers during the occupation, sometimes left nearly starving as supplies rotted on the docks, or freezing in foxholes in clothes meant for northern Argentina's subtropics.

Gustavo Pirich remembers the blows he received from a superior officer for stealing food from a warehouse in desperation. Officers ate the meat and potatoes, leaving the troops with nothing but watery gruel, said Pirich, who testified that such abuses are still-prosecutable war crimes — a question now before Argentina's Supreme Court.

Pirich still suffers from trench foot, caused by prolonged exposure of the feet to damp, cold and unsanitary conditions, as well as the panic attacks and irritability that come with post-traumatic stress syndrome. He acknowledges that "one day I looked with great love at an open window," but says he overcame suicidal thoughts through years of therapy and medication.

"We were very young, completely innocent. Nobody thought we were going to war. We didn't know what war was," said Pozzo, now a systems engineer, describing the harrowing experience of surviving the sinking that killed 323 fellow sailors.

After their surrender that June 14, a day islanders now celebrate as "Liberation Day," the Argentines returned to a country ashamed, and many had experiences familiar to U.S. Vietnam War veterans. There were no ticker-tape parades; nobody wanted to remember the humiliation.

"In the early years there was neglect, a lack of attention. To see a war veteran was to see living proof of a mistake," said Dario Volonte, another Belgrano sinking survivor and now a renowned operatic tenor who credits Eastern religion for helping him avoid suicide.

It took more than ten years before the veterans were granted monthly war pensions. The first mental health clinic focused on their care opened just last month, too late for the 439 veterans, by the president's count, who committed suicide after the war. The only government mental health survey of veterans, in 1995, found that more than 80 percent still suffered from anxiety and irritability, and 58 percent said they were frequently depressed.

"As with other facts of national history, the episode of the Malvinas war remains one of those hazy things that nobody wants to examine too closely," said psychologist Maria Cristina Solano, who ran the survey. "But there still remain survivors, and traces of things that keep it from being forgotten."

Hundreds of the 649 Argentine and 255 British soldiers who were killed, along with three elderly islanders whose house was hit by friendly British fire, were buried on the island in separate cemeteries. Because many Argentine soldiers lacked dogtags, nearly half of their graves are inscribed with the words: "known only to God."

Argentine Justice Minister Julio Alak recently promised veterans to identify the remains through DNA, saying "It's not possible that 30 years after the conflict there are still 123 Argentine heroes without a name, forgotten in anonymity."

Pozzo is against it, saying too many corpses were blown to pieces. "It would be very hard for the people to see that," he said.

John Smith, an islander whose book "74 days" details the suffering of the occupying troops, said "it would serve no useful purpose at all."

"They're resting there thinking they've got a complete son or husband buried in the Falklands, but in actual fact, they might not be as complete as you'd imagine," Smith said.

Many islanders interviewed ahead of the anniversary still have sympathy for the Argentine troops they met during the occupation, while scorning their officers.

The Argentines had arrived thinking that they'd be welcomed, and that Britain would let Argentina take over without a fight. They handed out fliers saying: "People of the Malvinas: You have been liberated from the illegal colonial government. The People and Armed Forces of Argentina embrace you as brothers. JOIN US IN FORGING A GREAT FUTURE FOR THE ISLANDS."

"The poor soldiers who arrived in 1982 honestly thought they were here to liberate a poor Argentine population from under the hell of the wicked Brits," recalled Jan Cheek, a member of the islands' legislative assembly.

Instead, Prime Minister Margaret Thatcher mobilized an armada that traveled 8,000 miles (13,000 kilometers) and quickly drove the Argentines to surrender. The military force that remains has enabled the islands to diversify from a sheep-farming backwater into a potential offshore oil hub that could make the islanders the world's richest people.

That infuriates Argentines who see an imperial enemy dominating the developing world's resources again. And it has islanders feeling more suspicious than ever that their neighbor wants to take over everything they've built.

"Given the macho mentality that exists in Argentina, that attitude will always exist there," said Dick Sawle, another legislative assembly member. "Their intention would only be to destroy what we already have. They would want to take it and claim it and destroy it."

___

Associated Press writer Debora Rey in Buenos Aires contributed to this report. Follow Michael Warren on Twitter at http://twitter.com/mwarrenap

NYT

30 Years After Falklands War, Visible Scars Remain - NYTimes.com

30 Years After Falklands War, Visible Scars Remain - NYTimes.com:

'via Blog this'

A Wary Mexico Sizes Up Contenders for the Presidency


Macuspana, Tab. Andres Manuel Lopez Obrador, candidate of the Progressive Movement, vowed to "liberate" the people of Mexico from the crisis that is, to win the race. Day / Carlos Ramos Mamahua
Josefina Vázquez Mota, the candidate for the National Action Party, greeted supporters in Mexico City.
By DAMIEN CAVE
GUADALAJARA, Mexico — It is essentially a battle, cynical commentators joke, between the Pretty Boy, the Quinceañera Doll and the Tired Has-Been.
Mexico’s presidential campaign has begun, and the disdain seeping from these common descriptions of the three main candidates reflects what experts say are low expectations. Mexican voters, polls show, have been losing faith in democracy as their nation teeters between modern success and violent failure.
This is a country of conflicting messages, of economic growth and decapitated heads. It is the United States’ third-largest trading partner and a majority middle-class country, but one held back by corruption, impunity, poverty, red tape, monopolies and a culture of discomfort with confrontation.
Whoever wins on July 1 will inherit a Mexico disillusioned and stuck, caught between forces of the past that resist change and the frustration of those who have begun to expect more from their leaders.
Crime in particular requires immediate attention. More than 50,000 people have died in drug-related killings since late 2006, and the justice system is a farce: more than 98 percent of crimes go unpunished, according to studies of government data.
“Mexico is at a crossroads in terms of dealing with organized crime,” said Pamela K. Starr, an expert on Mexican politics at the University of Southern California. Referring to the current president, Felipe Calderón, she said: “It’s quite clear that the government absolutely must confront organized crime, and it’s absolutely clear that the Calderón strategy hasn’t worked.”
The country’s oil sector also needs an overhaul to turn around the money-losing, state-owned monopoly, Pemex, and bring in private investment to develop new reserves. Meanwhile, declining illegal immigration to the United States has the potential to alter the dynamics of American-Mexican relations.
Most voters, accustomed to unresponsive government after decades of single-party rule, do not expect even most of these challenges to be addressed.
And yet, the candidates’ first official campaign events on Friday revealed more than might have been expected — about their sales pitches and personalities, at least. Policy proposals were less forthcoming. But this year’s race is shorter because of new laws (which even ban negative campaign ads), so for all three contenders the past few days were the start of a three-month sprint to Election Day, during which they must answer the core questions of their candidacies.
Enrique Peña Nieto, the telegenic front-runner sometimes called the Pretty Boy (or Gel Boy because of his styled hair), needs to persuade voters that he represents a new, corruption-free Institutional Revolutionary Party, or P.R.I., the party that ruled Mexico from 1929 to 2000. But can he prove he is not just a handsome meringue atop an old authoritarian party?
Josefina Vázquez Mota, a former education secretary under the current president, has perhaps a greater challenge. She has been called the Quinceañera Doll because she is always smiling, but her party — the P.A.N., or National Action Party — has been in charge for 12 years, a time of rising violence and continued corruption. Can she convince Mexicans that she represents a break from her party and become the country’s first female president?
And even for Andrés Manuel López Obrador, a liberal former mayor of Mexico City who lost the last election in 2006 by 0.6 percentage points, the past and future compete. The oldest of the candidates, sometimes called the Tired Has-Been, he must answer the question of whether he has put aside the radical populism of his last campaign to govern as a moderate.
Much Hope, Few Details
Green neon glow sticks and oversize beach balls flew through the air — along with some young supporters who crowd-surfed on the outstretched arms of their friends and fellow fans, who all wore white in well-organized solidarity.
“It’s the color of hope,” said Ricardo Sánchez, 21, smiling with a bunch of friends just steps from a mariachi band. “We’ve got a lot of hope in this guy.”
Even before Mr. Peña Nieto, 45, appeared at 12:01 a.m. on Friday, the first moment he could legally begin campaigning, the rally in Guadalajara, Mexico’s second-largest city, felt more like a victory party than a campaign kick-off. Thousands of supporters filled one of the city’s main squares to hear a speech that was heavy on promises and light on details about how those goals would be achieved.
Criticizing blights like poverty, insecurity and corruption, offering change and “light and hope” (the cue for supporters to point their flashlights in the air), Mr. Peña Nieto played to the crowd’s emotions. “Many people’s lives are afflicted by worry,” he said. “And what’s worse, they’re living in fear.”
He pledged to make Mexico safe and prosperous. And with a big smile, he praised Mexican women for their strength, then publicly signed a poster listing his major promises.
It was part of an expansive, orchestrated show of confidence. Rallies for P.R.I. candidates were also held at midnight in other major cities. And over the Easter holiday, the party plans to set up dozens of sports kiosks nationwide giving out inflatable soccer goals, soccer balls, hats and other party paraphernalia.
Some analysts described the campaign as a throwback to the classic giveaway politics of what the novelist Mario Vargas Llosa once called “the perfect dictatorship” because the P.R.I. maintained control with mass mobilizations, not ideology, through the cover of democratic elections. Others, however, said that over the last 12 years when it was out of power, the P.R.I. has come to recognize that with Mexico more democratic, the party can fulfill its promise of effective government only with a landslide victory, not just for president but also in the legislature.
“The modern P.R.I. understands that it needs legislative leaders in congress who actually know how to deal with legislation and know how to persuade members and bargain with others,” said Jorge I. Domínguez, a Latin American studies professor at Harvard.
Indeed at least for now, Mr. Peña Nieto seems to be benefiting from the fact that to many people he looks nothing like the P.R.I. of old — even though he is a wealthy former governor of Mexico State, with P.R.I. leaders for relatives.
“He is good-looking,” said María Alonzo Barragán, 52, as the candidate moved through the crowd. “But he is also honest, responsible and hard-working.”
Promising a Difference
Ms. Vázquez Mota also started her campaign early Friday, with a smaller rally at her party headquarters in Mexico City, where she immediately argued that the P.R.I.’s years of control “are still holding us back.” Her campaign slogan — “Josefina Diferente, Presidenta 2012” — also signaled to voters, perhaps with a wink, that she was not like those other guys in her party, Mr. Calderón and his predecessor, Vicente Fox.
She is not just a woman, her campaign suggests. She is a woman who understands struggle, having grown up in a shabby one-story home that she visited for breakfast on Friday morning. And, her first day on the trail aimed to show she is a woman ready to listen.
“What would you like to see different?” she asked again and again on Friday, in a classroom of second graders at the school she attended as a child. “If we work hard, all dreams are possible.”
Speaking to the adults, mostly women, she also made clear that while Mr. Peña Nieto was most comfortable speaking in platitudes, she preferred to address issues that hit closer to home. Her promises were those that she, as a working mother of three, knew they wanted to hear: a full school day with afternoon activities so that children could play sports, learn an instrument, read more books and do their homework; a little more help so that overtaxed families could “share time together.”
That message sounded fresh and appealing to some.
“If you know how to run a house, why can’t you run a country?” said Laura Rodríguez, 35, a single mother of three, who said she had been persuaded on the spot to vote for Ms. Vázquez Mota. “Men are always first; where is the space for women, who are always left behind?”
And yet, if Ms. Vázquez Mota, 51, can win only by proving how different she really is, are after-school programs enough? Luis de la Calle, an economist and a former under secretary of international trade, said Ms. Vázquez Mota and Mr. López Obrador could overcome Mr. Peña Nieto’s strong lead only by making bold proposals. “The average Mexican is a lot more modern than our politicians,” he said. “The average Mexican is willing to hear more about Mexican taboos like reforming the energy sector or really changing the tax system.”
The four points in Ms. Vázquez Mota’s platform sounded a lot like the five promises of Mr. Peña Nieto. Both candidates emphasized the need for a more transparent, functioning justice system, for jobs, for improving Mexico’s image abroad.
The difference, some of Ms. Vázquez Mota’s supporters said, was that she could be trusted to follow through. “How many years of the P.R.I. did we have?” Ms. Rodríguez asked. “I trust that Josefina will change the direction of things.”
Measured Populism
Workers. Love. And change.
Mr. López Obrador, 59, wearing no tie or sport coat, pounded the podium while sweating profusely under a scorching sun in his hometown of Macuspana, in Tabasco State, on Friday, as if he were determined to disprove his recent admission that he has “less vigor” now, during his second run for president.
The other candidates, he said, “represent the same thing.” Only his campaign represented the alternative of “honesty, justice and love, lots of love.”
Tabasco and other southern states gave Mr. López Obrador lots of love in 2006. Poverty is worse in the region than in other places, and voters are more open to the leftist ideas of Mr. López Obrador and his Party of the Democratic Revolution. But even in friendly territory, he seemed to sway between his brand of populism and the more moderate approach that analysts say he must adopt to climb from third place, where he has stagnated for months in opinion polls.
He has toned down his campaign slogan, from “For the good of everyone, the poor come first,” to the less confrontational “Real change is in your hands.” He also pledged to revitalize the economy by focusing on the working class, suggesting that he saw work, perhaps even more than government aid, as a vital tool for lifting Mexicans from poverty.
He still refuses to acknowledge his loss in 2006, insisting it was fraud. He told voters that one of the country’s biggest challenge was to make sure that the election results can be trusted.
The families of crime victims may have other priorities, but the crowd of thousands in Tabasco said they would stand with him, even it meant a repeat of the street protests that nearly shut down Mexico City after he disputed the 2006 results. “The whole country is willing to unite in defending the ballot boxes,” said Francisca Policroniades, 72.
That message may not be the most persuasive. “Andrés Manuel still carries a lot of negatives from dragging on the last campaign,” said María Elena Morera, of the nonpartisan civic group Citizens for a Common Cause. “He kept campaigning for a long time after that, and that generated a lot of wear and tear that’s not a problem for the other candidates.”
The real test for all three candidates will come with undecided voters, who make up nearly a third of the electorate, polls say. Whether they vote may say more about the state of Mexican democracy than whoever wins.
“A great leap forward,” Ms. Starr said, “demands that Mexican society suddenly comes to accept the reality that in a democracy you have a right and a responsibility to hold your leaders responsible.”

Elisabeth Malkin contributed reporting from Mexico City, and Karla Zabludovsky from Macuspana, Mexico.
NYT

Do We Live Inside a Black Hole, or Professor Frampton Has Been Taking Too Much of a Good Thing?


"Carney had long been jealous, he said, because Frampton had earned tenure much more quickly and because Carney’s academic accomplishments were paltry compared to his own.
“I am one of the most published physicists, and really he hasn’t done much that is of interest,” Frampton said."

The Strange Case of the American Physicist Jailed in Argentina - Ideas Market - WSJ

The Strange Case of the American Physicist Jailed in Argentina - Ideas Market - WSJ:

'via Blog this'

Friday, March 30, 2012

Taking Responsibility for Death

By SUSAN JACOBY

I WAS standing by my 89-year-old mother’s hospital bed when she asked a doctor, “Is there anything you can do here to give me back the life I had last year, when I wasn’t in pain every minute?” The young medical resident, stunned by the directness of the question, blurted out, “Honestly, ma’am, no.”

And so Irma Broderick Jacoby went home and lived another year, during which she never again entered a hospital or subjected herself to an invasive, expensive medical procedure. The pain of multiple degenerative diseases was eased by prescription drugs, and she died last November after two weeks in a hospice, on terms determined by explicit legal instructions and discussions with her children — no respirators, no artificial feeding, no attempts to buy one more day for a body that would not let her turn over in bed or swallow without agony.

The hospice room and pain-relieving palliative care cost only about $400 a day, while the average hospital stay costs Medicare over $6,000 a day. Although Mom’s main concern was her comfort and dignity, she also took satisfaction in not running up Medicare payments for unwanted treatments and not leaving private medical bills for her children to pay. A third of the Medicare budget is now spent in the last year of life, and a third of that goes for care in the last month. Those figures would surely be lower if more Americans, while they were still healthy, took the initiative to spell out what treatments they do — and do not — want by writing living wills and appointing health care proxies.

As the aging baby boom generation places unprecedented demands on the health care system, there is little ordinary citizens can do — witness the tortuous arguments in the Supreme Court this week over the constitutionality of the Affordable Care Act — to influence either the cost or the quality of the treatment they receive. However, end-of-life planning is one of the few actions within the power of individuals who wish to help themselves and their society. Too few Americans are shouldering this responsibility.

Of course many people want more aggressive treatment than my mother. And advance directives aren’t “death panels”; they can also be used to ensure the deployment of every tool of modern medicine. They can be changed or withdrawn at any time by a mentally competent person.

But public opinion polls consistently show that most Americans, like my mother, worry about too much rather than too little medical intervention. In a Pew Research Center poll released in 2006, only 22 percent said a doctor should always try to save a patient’s life, while 70 percent believed that patients should sometimes be allowed to die. More than half said they would tell their doctor to end treatment if they were in great pain with no hope of improvement.

Yet only 69 percent had discussed end-of-life care with a spouse; just 17 percent, or 40 percent of those over 65, had done so with their children. One-third of Americans had a living will and even fewer have taken the more legally enforceable measure of appointing a health care proxy to act on their behalf if they cannot act for themselves.

The latter omission is especially disturbing because by 2030, more than 8.5 million Americans will be over 85 — an age at which roughly half will suffer from Alzheimer’s disease or some other form of irreversible dementia. For many members of the baby boom generation — more likely to be divorced and childless than their parents — there may be no legal next of kin.

Without advance directives, even a loving child may be ignorant of her parent’s wishes. My mother remained conscious and in charge of her care until just a few days before she died, but like most women over 85, she was a widow. My younger brother died of pancreatic cancer two weeks before she did. It was an immense comfort to me, at a terrible time, to have no doubts about what she wanted.

My mother drew up her directives in the 1980s, when she was a volunteer in the critical care lounge of her local hospital. She once watched, appalled, as an adult daughter threw a coffeepot at her brother for suggesting that their comatose mother’s respirator be turned off. Because the siblings could not agree and the patient had no living will, she was kept hooked up to machines for another two weeks at a cost (then) of nearly $80,000 to Medicare and $20,000 to her family — even though her doctors agreed there was no hope.

The worst imaginable horror for my mother was that she might be kept alive by expensive and painful procedures when she no longer had a functioning brain. She was equally horrified by the idea of family fights around her deathbed. “I don’t want one of you throwing a coffeepot at the other,” she told us in a half-joking, half-serious fashion.

There is a clear contradiction between the value that American society places on personal choice and Americans’ reluctance to make their own decisions, insofar as possible, about the care they will receive as death nears. Obviously, no one likes to think about sickness and death. But the politicization of end-of-life planning and its entwinement with religion-based culture wars provide extra, irrational obstacles to thinking ahead when it matters most.

As someone over 65, I do not consider it my duty to die for the convenience of society. I do consider it my duty, to myself and younger generations, to follow the example my mother set by doing everything in my power to ensure that I will never be the object of medical intervention that cannot restore my life but can only prolong a costly living death.

Susan Jacoby is the author of “Never Say Die: The Myth and Marketing of the New Old Age.”

NYT

Love That Endured Alzheimer’s Ends in 2 Deaths - NYTimes.com

Love That Endured Alzheimer’s Ends in 2 Deaths - NYTimes.com:

'via Blog this'


Walter O. Snelling - Wikipedia, the free encyclopedia

Walter O. Snelling - Wikipedia, the free encyclopedia:

'via Blog this'

The Life Report: Charles Darwin Snelling

The following Life Report was submitted in response to my column of Oct. 28, in which I asked readers over 70 to write autobiographical essays evaluating their own lives.
A Love Story and Redemption
Sometimes, one has a story inside that just has to be put down on paper. In this case, a very personal story and a love story. One does not embark on such an exercise without considerable trepidations. Life stories and love stories are so personal. Still, I had a friend who always said, “What is most personal is most general,” meaning that the things that each of us thinks is unique in ourselves may, more often than not, be part of the universal experience, or at least the universal awareness.
To get to my love story, I will have to drag my reader through a hundred years of family history and 80 years of my own. I’m sorry to burden the reader with slogging through all this, but I can’t get to where I want to go unless I do.
I am my father’s son; same genes and chromosomes. We have shared the same interests in knowledge, in science, in innovation, and in invention. We have shared the same desire to make the world a little better place because of our work. Oh yes, his career was much more significant and contributing than mine. He had more inventions, better inventions, and had a pivotal role in vital developments, some of which affect our lives very much after more than 100 years. This is a story, not about the similarities of my father’s and my lives, but the differences. This is a story about how my wife Adrienne changed my life so that it would be so very different from my father’s life. This is a story about how my life became, for me at least, much more human, much more satisfying, and much happier than it otherwise would have been. It is a love story.
Prologue:
My father, Dr. Walter O. Snelling, PhD, was born on December 13, 1880, the product of two very distinguished families: the Snelling’s, New England Protestants who arrived in America in 1649 one step ahead of Cromwell, the bastard, because they were royalist and Cromwell had a price on their heads; and the Horner’s, my grandmother’s family, who were Philadelphia Quakers. Indeed, my grandmother, Alice West Horner Snelling Moque, was remarkable for her age. She was a college graduate in the 1870s, studied the law and medicine, and was a leading suffragette, editor of the leading suffragette magazine “La Pot Boullie” (the boiling pot), and an author. She was the first woman who was ever invited to address the American Medical Association, which she did, and her address is recorded in their proceedings, The Journal of the American Medical Association.
My father was a remarkable man. He was well educated. He was a graduate of Colombian University, Yale University and Harvard University, and received his PhD from George Washington University in 1904. Guess what, there were only 167 PhDs granted in the entire country in 1904! A truly educated man was a rarity.
My father went on to be a great scientist. He had 150 patents. A dozen of them were truly valuable. He invented high-pressure, high-temperature oil cracking, the patent of which he sold to John D. Rockefeller for $200,000 in 1910. Multiply that by 50 in today’s dollars. Prior to my father’s invention, the relatively new oil industry took whatever came out of the ground and distilled it. They really only wanted “coal oil” or kerosene in the beginning, and then later gasoline. They didn’t get too much of either. When they finished distilling what they wanted from the crude oil, they dumped the heavy fractions on the ground or in rivers! And they burned off the light fractions as flares. My father discovered that if you took the leftover gunks from the first distillation and put them in a very strong retort and heated them at very high pressure and temperature, the gunks reformed themselves into pretty much what had come out of the ground in the first place, like new crude oil. His reformed material could be re-distilled to get another batch of kerosene and gasoline. This could be done a couple of times. Most of the gasoline in the world was made by my father’s process for a few years. Then along came Houdry with catalytic reforming. He basically took my father’s process and added a catalyst. Of course, that was a much better process than my father’s. After Houdry, you could make almost as much of anything as you wanted, and his process replaced my father’s almost immediately.
In 1912 my father identified propane in the waste gasses, which was burned off as waste in those days, and discovered that he could recover it and it could be put in a pressure bottle, as a liquid, with a regulator and piped into the house as a gas main. Now, in those days 90% of the lighting was gas light. So my father founded the propane industry, giving people beyond the gas mains good lighting for the first time. Of course, no one used propane in those days for gas stoves and furnaces, as they do now. Next year the propane industry will be celebrating, big time, my father’s founding of the propane industry with his patents and the founding of the American Gasol Company, which he sold to Mr. Frank Phillips of Phillips Petroleum Company in 1914 for $50,000. You can also multiply that by 50 if you like. Unfortunately, my father did not believe in inheritance; he knew too many Harvard bums, as he used to say, so he gave all his money away, and I had to start over!
So I was born into a prosperous, educated, intellectual and comfortable family. My father married my mother, Marjorie, in 1918 when he was 38 and she was 18. I was raised in a beautiful mansion next to a park. From all outward appearances, you would think that I had a charmed life, but that was not the case. It looked that way from the outside, of course. We had Packard’s and 16 cylinder-Chryslers. We traveled at least six weeks every year. But things were not what they seemed.
In the 1930s and 1940s a man of my father’s stature could do no wrong. He was world-famous. He was in Who’s Who in America when only five people in the entire Lehigh Valley were. He was Mein Herr Doctor. He was wealthy. But he was also a perfectionist beyond all imagination. He had nine children. Each of us was expected to be, not good, but perfect. I have previously written about our summer trips.
They consisted of a lecture in the morning from the good Doctor, for us to write an essay in the afternoon and, depending on my father’s evaluation of the essay, dinner or no dinner.
Dinner conversations at home were formal. No talk about the weather, no talk about school, just talks about serious subjects. And each of us was expected to participate without question or exception. In stark truth, my dad was a martinet; abusive and a bully.
My father, I am sure, intended to be a loving and good father. The problem was he simply didn’t have a clue about how to be a loving and good father. His perfectionist instincts overruled everything else. Love was measured, very measured. If you got an A+, I love you. If you got a B; maybe I love you; if you got a C; I certainly don’t love you, nor should I. What should have been fun, work and achievement, were made onerous and hateful chores. No joy in Mudville.
My response to all this was to escape to prep school at Phillips Academy at Andover. Andover is an exceptional place and, besides all the wonderful things that other students also found there, I found a haven. Never did I return to the parental roof.
Now, the upbringing that I had did not make me into a comfortable or normal human being, sorry to say. First of all (and humility has no great place in this essay, as I am trying to be honest), I often knew more than other people did, and I am sure that I was overbearing about it. Secondly, I was a very eccentric student. Because I hated work and responsibility so much as I did, I never, never really studied in the normal sense. If I liked something, I devoured it, became an expert in it and got A’s. If I didn’t like something, I didn’t pay any attention to it, regardless of the consequences.
Parenthetically, nothing drives schoolmasters crazier. If you’re brilliant and always perform well, they love you and admire you. If you are dull and incompetent, they feel sorry for you. But if you are brilliant where you feel like being brilliant and disdainful where you feel like being disdainful, they hate you. You are giving them the finger, and they know it.
At University I was my old self. They wanted me to take prerequisites, which I didn’t feel like taking. They wanted me to concentrate in one curriculum or another, which I didn’t feel like doing. I solved this problem by saying that I would not be a candidate for a degree and that I would take what I wanted when I wanted. And that’s what I did. It really annoys professors and departments when you take courses without the required prerequisites. It really annoys professors and departments when you study mechanics, but you don’t want to bother to learn to build bridges. It really annoys professors and departments when you study physics, but you don’t bother learning how to design chips. And it bothers everybody if you study whatever you damn well please, a lot of science, but also plenty of history, literature and economics.
I did end up getting a degree though because of a wonderful and sympathetic Dean. Actually, to the amusement of some, I have since picked up an honorary doctorate along the way, but, as we all know, they don’t count.
The short synopsis of how I got a degree is that what I was actually doing was taking a survey course in science and the arts. There was no such program at the time at my university. But the Dean knew that in a few years the university was going to give not one but two degrees (a BS and an AB) for the work that I had done. He also knew that I had so annoyed the establishment at the university that they were never going to reward me by letting me get away with breaking the rules. Thanks to Dean Leith, he saw to it that I got a degree. Since I promptly started my own company, no one has ever seen my degree! Amid all questions of my checkered educational history, I have been a trustee of my wife Adrienne’s alma mater, Cedar Crest College, these past 30 years.
Now to the good part, the love story:
When I was a sophomore I went on a double date, to a Cedar Crest College sophomore prom, with a girl whom I had never seen before, and who was, shall we say, not to my liking. At our table was a simply marvelous young lady: ravishingly beautiful, bright, well-groomed, well-spoken, mannerly, disciplined and circumspect. Her name was Adrienne Celeste Angeletti.
What a wonder. She was, unfortunately, on the arm of the Yalie who had come to Cedar Crest College for the dance as her date. That Adrienne was the girl that I wanted, the girl that I needed to bring into my life, and the girl that I had to marry became very clear to me quite soon. So I began an energetic pursuit of this sweet young lady. She was a psych major and she used to say that I was her case study! She was diligent and very suspicious of my undisciplined ways. I pursued her with all the vigor at my command. First I had to get rid of the Yalie, and I did. Adrienne was studious, so I had to pretend to study. She used to go with a blanket and her books into Trexler Park to study. I would bring my blanket, books and notebooks to pester her. ―”You’re not studying,” she would say, to which I would retort: “I’m studying you.” Not a good answer, according to her. Usually we would make a treaty. Adrienne would study that afternoon if I would go away and leave her alone and be profligate, and then we would meet for dinner. Perfect!
To cut a long story short, I wooed and won this wonderful lady. We were married on March 21, 1951, the first day of our spring break, and rushed off to Bermuda for a quick honeymoon. Of course, sophomores did not get married in those days. Cedar Crest College was a United Church of Christ College with a PhD minister as President. He wasn’t amused, but it wasn’t against the rules either. Ten months later (that’s right, not seven months, not eight months, not nine months, but 10 months later) our first child was born, Adrienne C. Snelling II (Penny). We bought a little tract house in Alton Park, halfway between Cedar Crest College and Lehigh University. We arranged our classes so that one of us would always be there to take care of Penny. Adrienne took one year off to be a mother, and then finished her senior year and graduated from college, although she was by then well pregnant with our second child, Jonathan C. Snelling, when she marched in the academic procession to get her degree. The President was apoplectic that a pregnant lady would be marching, though there were no rules against it, fearing that some of the parents there might fear the worst for their little darlings.
Now seems the right time to tell you a little about Adrienne’s family. Her family was quite different than mine, but no less remarkable. Her father, Adrian William Angeletti, always called “Will,” was an Italian immigrant who arrived in the United States at Ellis Island when he was 12 years old in 1913. He spoke no English when he arrived. Here is how it came to pass that he came to America. Will’s father, born in Rome, was a skilled marble craftsman. In the late 19th century he was employed by the famous German pencil family, Eberhard Faber, to help build a great castle outside Nuremburg Germany. Will’s father spent a few years in Germany and decided that he wanted to go to America to make a new life for himself and his family So, he did go to America in 1909 and worked at his trade, without his family, until he had the money to bring his family over to America.
Will Angeletti practiced the marble trade, starting off in the Bronx, New York City, with his father and then went on his own, starting his own business, the Angeletti Marble Company. Such was Will’s skill, industry and ability, that in no time, Depression and World War II notwithstanding, Will became one of the principal interior marble contractors in New York City. Will did the interior marble work at such exciting buildings as the UN building, CBS building, the World Trade Towers and many other great New York City projects. Indeed, every time you see a world statesman at the podium in the UN General Assembly great hall, you will notice the really beautiful green marble behind the podium. Will’s work. Indeed, he did such a good job that he got to know Secretary General Trygve Lie. The Secretary General, himself, took a beautiful photo of Will at the podium as though Will were addressing the General assembly, and gave it to Will. It hangs, to this day, in the living room of our guest house.
During World War II, Will managed to keep his business healthy by building mausoleums for the Catholic Church in the New York area. Such were Will’s skills that he prospered in his new country and through the most difficult of times. In 1940 Will moved his family to Westchester County New York in a lovely suburban setting near the Village of Hartsdale. Adrienne’s mother was half-Irish and half-Scots and her family had arrived in this country in the last half of the 19th century. Her name was Marjorie Somerville. Adrienne’s mother died of breast cancer when Adrienne was only 12 years old, so I never met her mother. Adrienne was promptly enrolled in Good Council Academy, in White Plains New York, a Catholic convent boarding school. Then, Adrienne went to Cedar Crest College, in Allentown Pennsylvania, where I was lucky enough to meet her. We were married in the Hitchcock Memorial Church in Scarsdale, New York.
Although I never knew Adrienne’s mother, I did get to know an uncle and a few cousins. The uncle, Dr. John Somerville, was a professor of philosophy at Hunter College in New York City. He was famously left-wing! He was an avowed socialist and pacifist, to put it generously, who spent several years living in the Soviet Union under Stalin. He wrote several books, the most interesting of which was “The Philosophy of Peace”. Dr. John Somerville essentially recommended that the appropriate solution to the Cold War was capitulation on our part! While we were civil to one another, his and my views on the world could not have been further apart. Most of our discussions and correspondence were political. Neither one of us was able to convince the other, no surprise.
When I met Adrienne she was as well spoken as anyone I ever met, with a wonderful vocabulary, beautiful unaccented diction and perfect grammar. When I found out that her father was a recent immigrant I could hardly believe the perfection of her assimilation.
I worried about how my family would react to my choice of a bride. No doubt about it, my family had a distinctly north Europe preference. In all the family’s European travels they always involved only England, Scotland, Denmark, Holland Germany and Switzerland. Never did we set foot in a “Latin” country. I need not have worried. Everybody in the family took to Adrienne with warmth and enthusiasm. Indeed, just before were married, my mother told her “don’t worry, Adrienne, if there’s ever any trouble, we will take your side!” I believed it. But there never was any trouble.
Let me tell a quick funny story on Nordic versus Latin. I first took Adrienne to Europe in 1955. When I was planning that trip she asked me where we were going. I told her, of course, “well, North Europe.” “Why not Italy,” she asked? “Oh, I answered, we never go to Latin countries.” “We are going to Italy,” she responded! And so we did, along with the North. Thus began a lifelong love affair with Florence, Venice, Milan and Lake Como.
Adrienne was never rude or abrasive but often firm and determined. The first year we were married, as summer was approaching, I asked Adrienne “where shall we travel this summer?” “What on earth are you talking about,” she answered. “Don’t you travel in the summer,” I asked. Her response: “you are a married man now; get a job you lazy bum.” Which I wasn’t, but still, I got a job.
The love affair was only beginning. Adrienne was teaching me something about which I never had even a clue. She was teaching me about unconditional love! I could hardly imagine such a thing. The lady loved me, good or bad. She did not measure her love for me by performance. She discouraged me from being bad, and encouraged me to be good, but she loved me just as much, good or bad. Who could imagine such a thing?
We had a child every two years with a total of 10 years and five children. Adrienne, when she wasn’t taking care of me, was nobly taking care of our five children. And she was teaching me to be a parent. I was deeply inculcated in the Walter O. Snelling school of parenting. It’s all I knew. But Adrienne would look at me in horror when I would think of being a Walter O. Snelling parent and say, “You are not going to do that to my children!!” It wasn’t easy, but over the years she made some progress with me. And she was always an adoring, loving, generous and giving mother. Thank goodness. It should have been no surprise, because she was always an adoring, loving, generous and giving wife.
So we lived a charmed life together. Really charmed! Now, I do not wish for our accomplishments to be presented in a way that comes off boastful. Truly, that is not my intention. I just really want to present our charmed life together as it really seemed to me. I became an entrepreneur and a pretty successful one. Not perfect, mind you, but pretty good. Ups and downs, but more ups than downs.
My first venture was in the field of artificial insemination of dairy cattle, using semen carefully frozen to -320 degrees F by a process I developed and patented. We sold our products all over the world, and within 10 years the average dairy cow, bred to the best bulls, gave twice as much milk as before. This process was a great boon to the world. In due time I sold this company (Frozen Semen Products Company) to Union Carbide Corporation. Cryo-Therm, Inc. (in the applied thermodynamics business) was the next company. Innovations followed. Patented products developed at Cryo-Therm were sold to 3M (energy storage electric heat baseboard); to Armstrong Cork Co. (continuously molded urethane pipe insulation); to the Melpar Division of Westinghouse Airbrake (our military division, and several patents); and to New Brunswick Scientific (our Fermentation Design Corp.).
Busy, busy, but still we had time for a great life together. Indeed, we are right now nearing the end of our 61st year of marriage. Not bad. Adrienne was always modest and conservative. One day she told me, you can have any two houses you want, but not four. I’m a nomad, and I don’t know which way to head for the bathroom at night half the time. So, gone were Aspen and St Croix.
I was collecting antique wooden boats when I got out one of the old Packard’s that I had saved from my courting days and had stored in a barn. It was a 1937 12-cylinder Packard convertible coupe, spare wheels on the side, with a rumble seat and golf bag doors and a luggage rack on the back. What are you going to do with that Packard, my sweetie asked. “Why, I’m going to restore it,” I answered. Well, said Adrienne, “you can have antique boats and a wife, or you can have antique cars and a wife, or you can have antique cars and antique boats, but what you can’t have is antique cars and antique boats and a wife!” The Packard went away.
Still, we had a great life. Adrienne has traveled on every continent and we have enjoyed and treasured so many wonderful places in the world that we love. We had real freedom and mobility. We flew together, in our twin, more than a million miles without a Band-Aid or a scratch.
When woman’s lib came along with a vengeance, Adrienne’s friends began casting gentle aspersions at the fact that she was a stay-at-home housewife, and with help at home. Get out and do something, they urged. So Adrienne became a wonderful, prize-winning fine arts photographer. She took the pictures for and did the art editing for two books. In due time Governor Tom Ridge appointed her to membership on the Pennsylvania Council for the Arts. She served on many a board, as she was supposed to.
But most important to our charmed life was our five children. They are good and happy children. One lawyer, one businessman, one banker, one artist and one doctor, all good and happy people. We have 11 grandchildren. Such a joy! Watching them prosper, go to prep school, graduate from college and university, and take up their professions is all so glorious.
My career has been somewhat unusual because so much of it has been spent in public service. My father always said that you should spend the first 25 years of your life getting ready, the second 25 years of your life doing well for yourself, and the third 25 years of your life putting back into the pot. In my case, by the time I was 40 I had sold my businesses and was on to public service and entrepreneurship. A group of five of us started an enterprise venture capital fund. It was fabulously successful. Meanwhile I was doing other things which weren’t so successful, like building a new town, a financial disaster; then, much better, running a great orchard as well as a series of stores and a chain of restaurants – lots of fun and interesting. Finally, back again to real estate development.
My public service career began when I was 21 and was elected a Republican ward committeeman. In 1969 I was elected to the Allentown City Council and elected by that Council four times as its president. In the mid-70s I became finance chairman of the Republican Party in Pennsylvania. I am proud to have helped to raise money to elect several great governors, senators, congressmen and presidents. Along the way I have received four presidential appointments, some of them significant. In my 70th year, I was appointed by the President to the Board of Directors of The Metropolitan Washington Airports Authority (which manages Reagan and Dulles Airports, plus the Dulles toll road). And in due time, I was elected by that board to be their chairman, a post I still hold. At 80 I was still working 24/7. A nice way, if I do say so myself, to bow out.
So, if this has been a charmed life, and I think it has, why is there need for redemption, an important part of my title? Now, it is not easy to sit in judgment of one’s own life. Adrienne and I have made our marriage work, and work well. As she always says, good marriages are not made in heaven; they’re made by hard work. And work hard at her marriage is something at which Adrienne has always excelled. She has, for these some 60 years, been steadfastly loving, sweet, kind, generous and forgiving.
There’s no doubt in my mind that I was not an easy husband. I was impatient, demanding, headstrong, willful and cantankerous. Parenthetically, I have several books in my library given to me by smiling children, all of which have the description curmudgeon in their titles. My mantelpieces and library shelves have three or four lovely ceramic and plaster gargoyles. (You know, that mystical demon always portrayed munching on a human thighbone? Were my children telling me something?!)
Redemption:
Six years ago tragedy struck our household. My dear, sweet Adrienne was diagnosed with Alzheimer’s disease. This relentless wasting disease destroys the mind. I have now seen many people with Alzheimer’s, and it is a terrible disease. Many, besides losing their memories and their cognitive abilities, also get downright ugly and hostile. Not my sweetie. Although she is a very, very sick puppy, she remains to this day a sweet, happy, loving and generous person. How lucky for both of us. To have such an affliction in the household is a very learning experience. Some people quite promptly disappear from your life. But others, indeed most, rally around in caring and support. It’s quite touching.
So, here comes the redemption. It never occurred to me for a moment that it would not be my duty and my pleasure to take care of my sweetie. After all, she took care of me in every possible way she could for 55 years. The last six years have been my turn, and certainly I have had the best of the bargain. So I have dug in with the will. Adrienne likes to be with me so, everywhere I go Adrienne goes as well. We have wonderful helpers here in Allentown, at Estrellita, and in Washington. Certainly they have helped me enormously, but real care for a loved one with Alzheimer’s cannot be delegated. I did not need to be told that; I felt it in my bones.
Truly, I’ve been simply amazed at the support I have received, indeed, more than support, downright approval and approbation from onlookers. How often people have said to me, sweetly and lovingly, “ten years ago we never would have believed in our wildest imagination that you would care for Adrienne the way you do.” That half makes me feel good, and it half makes me feel terrible. I’m glad that they think I’m doing the right thing, but I’m very sorry that they didn’t think that I would.
It’s not noble, it’s not sacrificial, and it’s not painful. It’s just right in the scheme of things. After all, this lady rescued me from a fate worse than death, and for a long, long time. What I am doing for her pales beside all that she has done for me for more than half a century. We continue to make a life together, living together in the full sense of the word; going about our life, hand in hand, with everyone lending a hand, as though nothing was wrong at all.
Andover was not only a refuge and intellectual haven for me; it was a place where values, human and personal values, were first and foremost. My Andover experience came at just the right time in my life, and the values I was exposed to there have been with me all of my life.
Nearly 250 years ago, Paul Revere designed and engraved, at Phillips Academy, Andover’s Great Seal. It shows a beehive with a swarm of busy bees. On the sun is written “Non Sibi,” in Latin “Not for self alone.” The motto, also in Latin, is “Finis Origine Pendet,” “The Beginning Foretells the End.”
So it is. Sixty-one years ago, a partner to our marriage who knew how to nurture, nurtured a partner who needed nurturing. Now, sixty-one years later, a partner who is learning how to nurture is nurturing a partner who needs nurturing.
NYT

Zora Neale Hurston - Wikipedia, the free encyclopedia

Zora Neale Hurston - Wikipedia, the free encyclopedia:

'via Blog this'

Walking While Black: Killing of Trayvon Martin Evokes Memories of Civil Rights Martyr Emmett Till

Walking While Black: Killing of Trayvon Martin Evokes Memories of Civil Rights Martyr Emmett Till:

'via Blog this'

AMLO For President!

Macuspana, Tab. Andres Manuel Lopez Obrador, candidate of the Progressive Movement, vowed to "liberate" the people of Mexico from the crisis that is, to win the race. Day / Carlos Ramos Mamahua

Hoodies in Barcelona!

La Jornada

Next Mexican President?

Puberty Before Age 10: A New ‘Normal’?

Ainsley, who began showing signs of puberty at age 6, and her mother.

By ELIZABETH WEIL

One day last year when her daughter, Ainsley, was 9, Tracee Sioux pulled her out of her elementary school in Fort Collins, Colo., and drove her an hour south, to Longmont, in hopes of finding a satisfying reason that Ainsley began growing pubic hair at age 6. Ainsley was the tallest child in her third-grade class. She had a thick, enviable blond-streaked ponytail and big feet, like a puppy’s. The curves of her Levi’s matched her mother’s.

“How was your day?” Tracee asked Ainsley as she climbed in the car.

“Pretty good.”

“What did you do at a recess?”

“I played on the slide with my friends.”

In the back seat, Ainsley wiggled out of her pink parka and looked in her backpack for her Harry Potter book. Over the past three years, Tracee — pretty and well-put-together, wearing a burnt orange blouse that matched her necklace and her bag — had taken Ainsley to see several doctors. They ordered blood tests and bone-age X-rays and turned up nothing unusual. “The doctors always come back with these blank looks on their faces, and then they start redefining what normal is,” Tracee said as we drove down Interstate 25, a ribbon of asphalt that runs close to where the Great Plains bump up against the Rockies. “And I always just sit there thinking, What are you talking about, normal? Who gets pubic hair in first grade?”

Fed up with mainstream physicians, Tracee began pursuing less conventional options. She tried giving Ainsley diindolylmethane, or DIM, a supplement that may or may not help a body balance its hormones. She also started a blog, the Girl Revolution, with a mission to “revolutionize the way we think about, treat and raise girls,” and the accompanying T.G.R. Body line of sunscreens and lotions marketed to tweens and described by Tracee as “natural, organic, craptastic-free products” containing “no estrogens, phytoestrogens, endocrine disrupters.”

None of this stopped Ainsley’s body from maturing ahead of its time. That afternoon, Tracee and Ainsley visited the office of Jared Allomong, an applied kinesiologist. Applied kinesiology is a “healing art” sort of like chiropractic. Practitioners test muscle strength in order to diagnose health problems; it’s a refuge for those skeptical and weary of mainstream medicine.

“So, what brings you here today?” Allomong asked mother and daughter. Tracee stroked Ainsley’s arm and said, wistfully, “Precocious puberty.”

Allomong nodded. “What are the symptoms?”

“Pubic hair, armpit hair, a few pimples around the nose. Some budding.” Tracee gestured with her hands, implying breasts. “The emotional stuff is getting worse, too. Ainsley’s been getting super upset about little things, crying, and she doesn’t know why. I think she’s cycling with me.”

Ainsley closed her eyes, as if to shut out the embarrassment. The ongoing quest to understand why her young body was turning into a woman’s was not one of Ainsley’s favorite pastimes. She preferred torturing her 6-year-old brother and playing school with the neighborhood kids. (Ainsley was always the teacher, and she was very strict.)

“Have you seen Western doctors for this?” Allomong asked.

Tracee laughed. “Yes, many,” she said. “None suggested any course of action. They left us hanging.” She repeated for Allomong what she told me in the car: “They seem to have changed the definition of ‘normal.’ ”

For many parents of early-developing girls, “normal” is a crazy-making word, especially when uttered by a doctor; it implies that the patient, or patient’s mother, should quit being neurotic and accept that not much can be done. Allomong listened intently. He nodded and took notes, asking Tracee detailed questions about her birth-control history and validating her worst fears by mentioning the “extremely high levels” of estrogen-mimicking chemicals in the food and water supply. After about 20 minutes he asked Ainsley to lie on a table. There he performed a lengthy physical exam that involved testing the strength in Ainsley’s arms and legs while she held small glass vials filled with compounds like cortisol, estrogen and sugar. (Kinesiologists believe that weak muscles indicate illness, and that a patient’s muscles will test as weaker when he or she is holding a substance that contributes to health problems.)

Finally, he asked Ainsley to sit up. “It doesn’t test like it’s her own estrogens,” Allomong reported to Tracee, meaning he didn’t think Ainsley’s ovaries were producing too many hormones on their own. “I think it’s xeno-estrogens, from the environment,” he explained. “And I think it’s stress and insulin and sugar.”

“You can’t be more specific?” Tracee asked, pleading. “Like tell me what crap in my house I can get rid of?” Allomong shook his head.

On the ride back to Fort Collins, Tracee tried to cheer herself up thinking about the teenage suffering that Ainsley would avoid. “You know, I was one of those flat-chested girls at age 14, reading, ‘Are You There God? It’s Me, Margaret,’ just praying to get my period. Ainsley won’t have to go through that! When she gets her period, we’re going to have a big old party. And then I’m going to go in the bathroom and cry.”

In the late 1980s, Marcia Herman-Giddens, then a physician’s associate in the pediatric department of the Duke University Medical Center, started noticing that an awful lot of 8- and 9-year-olds in her clinic had sprouted pubic hair and breasts. The medical wisdom, at that time, based on a landmark 1960 study of institutionalized British children, was that puberty began, on average, for girls at age 11. But that was not what Herman-Giddens was seeing. So she started collecting data, eventually leading a study with the American Academy of Pediatrics that sampled 17,000 girls, finding that among white girls, the average age of breast budding was 9.96. Among black girls, it was 8.87.

When Herman-Giddens published these numbers, in 1997 in Pediatrics, she set off a social and endocrinological firestorm. “I had no idea it would be so huge,” Herman-Giddens told me recently. “The Lolita syndrome” — the prurient fascination with the sexuality of young girls — “created a lot of emotional interest. As a feminist, I wish it didn’t.” Along with medical professionals, mothers, worried about their daughters, flocked to Herman-Giddens’s slide shows, gasping as she flashed images of possible culprits: obesity, processed foods, plastics.

Meanwhile, doctors wrote letters to journals criticizing the sample in Herman-Giddens’s study. (She collected data from girls at physicians’ offices, leaving her open to the accusation that it wasn’t random.) Was the age of puberty really dropping? Parents said yes. Leading pediatric endocrinologists said no. The stalemate lasted a dozen years. Then in August 2010, the conflict seemed to resolve. Well-respected researchers at three big institutions — Cincinnati Children’s Hospital, Kaiser Permanente of Northern California and Mount Sinai School of Medicine in New York — published another study in Pediatrics, finding that by age 7, 10 percent of white girls, 23 percent of black girls, 15 percent of Hispanic girls and 2 percent of Asian girls had started developing breasts.

Now most researchers seem to agree on one thing: Breast budding in girls is starting earlier. The debate has shifted to what this means. Puberty, in girls, involves three events: the growth of breasts, the growth of pubic hair and a first period. Typically the changes unfold in that order, and the proc­ess takes about two years. But the data show a confounding pattern. While studies have shown that the average age of breast budding has fallen significantly since the 1970s, the average age of first period, or menarche, has remained fairly constant, dropping to only 12.5 from 12.8 years. Why would puberty be starting earlier yet ending more or less at the same time?

To endocrinologists, girls who go through puberty early fall into two camps: girls with diagnosable disorders like central precocious puberty, and girls who simply develop on the early side of the normal curve. But the line between the groups is blurring. “There used to be a discrete gap between normal and abnormal, and there isn’t anymore,” Louise Green­span, a pediatric endocrinologist and co-author of the August 2010 Pediatrics paper, told me one morning in her office at Kaiser Permanente in San Francisco. Among the few tools available to help distinguish between so-called “normal” and “precocious” puberty are bone-age X-rays. To illustrate how they work, Greenspan pulled out a beautiful old book, Greulich and Pyle’s “Radiographic Atlas of Skeletal Development of the Hand and Wrist,” a standard text for pediatric endocrinologists. Each page showed an X-ray of a hand illustrating “bone age.” The smallest hand was from a newborn baby, the oldest from an adult female. “When a baby is born, there’s all this cartilage,” Greenspan said, pointing to large black gaps surrounding an array of delicate white bones. As the body grows, the pattern of black and white changes. The white bones lengthen, and the black interstices between them, some of which is cartilage, shrink. This process stops at the end of puberty, when the growth plates fuse.

One main risk for girls with true precocious puberty is advanced bone age. Puberty includes a final growth spurt, after which girls mostly stop growing. If that growth spurt starts too early in life, it ends at an early age too, meaning a child will have fewer growing years total. A girl who has her first period at age 10 will stop growing younger and end up shorter than a genetically identical girl who gets her first period at age 13.

That morning one of Greenspan’s patients was a 6½-year-old girl with a bone age of 9. She was the tallest girl in her class at school. She started growing pubic hair at age 4. No one thought her growth curve was normal, not even her doctors. (Eight used to be the age cutoff for normal pubic-hair growth in girls; now it’s as early as 7.) For this girl, Greenspan prescribed a once-a-month shot of the hormone Leuprolide, to halt puberty’s progress. The girl hated the shot. Yet nobody second-guessed the treatment plan. The mismatch between her sexual maturation and her age — and the discomfort that created, for everybody — was just too great.

By contrast, Ainsley was older, and her puberty was progressing more slowly, meaning she wasn’t at much of an increased risk for short stature or breast cancer. (Early periods are associated with breast cancer, though researchers don’t know if the risk stems from greater lifetime exposure to estrogen or a higher lifetime number of menstrual cycles, or perhaps something else, like the age at which a girl has her growth spurt.) In cases of girls Ainsley’s age, Greenspan has been asked by parents to prescribe Leuprolide. But Greenspan says this is a bad idea, because Leuprolide’s possible side effects — including an increased risk of osteoporosis — outweigh the benefits for girls that age. “If you have a normal girl, a girl who’s 8 or 9, there’s a big ethical issue of giving them medicine. Giving them medicine says, ‘Something is wrong with your body,’ as opposed to, ‘This is your body, and let’s all find a way to accept it.’ ”

“I would have a long conversation with her family, show them all the data,” Greenspan continues. Once she has gone through what she calls “the proc­ess of normalizing” — a process intended to replace anxiety with statistics — she has rarely had a family continue to insist on puberty-arresting drugs. Indeed, most parents learn to cope with the changes and help their daughters adjust too. One mother described for me buying a drawer full of football shirts, at her third-grade daughter’s request, to hide her maturing body. Another reminded her daughter that it’s O.K. to act her age. “It’s like when you have a really big toddler and people expect the kid to talk in full sentences. People look at my daughter and say, ‘Look at those cheekbones!’ We have to remind her: ‘You may look 12, but you’re 9. It’s O.K. to lose your cool and stomp your feet.’ ”

“We still have a lot to learn about how early puberty affects girls psychologically,” says Paul Kaplowitz, chief of endocrinology at Children’s National Medical Center. “We do know that some girls who start maturing by age 8 progress rapidly and have their first period before age 10, and many parents prefer that we use medications to slow things down. However, many girls do fine if they are simply monitored and their parents are reassured that they will get through it without major problems.”

In some ways early puberty is most straightforward for families like those of the kindergartner on Leuprolide. She has a diagnosis, a treatment plan. In Greenspan’s office, I asked the girl’s father at what age he might choose to take his child off the drugs and let her puberty proceed. He laughed. Then he spoke for most parents when he said, “Would it be bad to say 22?”

So why are so many girls with no medical disorder growing breasts early? Doctors don’t know exactly why, but they have identified several contributing factors.

Girls who are overweight are more likely to enter puberty early than thinner girls, and the ties between obesity and puberty start at a very young age. As Emily Walvoord of the Indiana University School of Medicine points out in her paper “The Timing of Puberty: Is It Changing? Does It Matter?” body-mass index and pubertal timing are associated at age 5, age 3, even age 9 months. This fact has shifted pediatric endocrinologists away from what used to be known as the critical-weight theory of puberty — the idea that once a girl’s body reaches a certain mass, puberty inevitably starts — to a critical-fat theory of puberty. Researchers now believe that fat tissue, not poundage, sets off a feedback loop that can cause a body to mature. As Robert Lustig, a professor of clinical pediatrics at the University of California, San Francisco’s Benioff Children’s Hospital, explains, fatter girls have higher levels of the hormone leptin, which can lead to early puberty, which leads to higher estrogen levels, which leads to greater insulin resistance, causing girls to have yet more fat tissue, more leptin and more estrogen, the cycle feeding on itself, until their bodies physically mature.

In addition, animal studies show that the exposure to some environmental chemicals can cause bodies to mature early. Of particular concern are endocrine-disrupters, like “xeno-estrogens” or estrogen mimics. These compounds behave like steroid hormones and can alter puberty timing. For obvious ethical reasons, scientists cannot perform controlled studies proving the direct impact of these chemicals on children, so researchers instead look for so-called “natural experiments,” one of which occurred in 1973 in Michigan, when cattle were accidentally fed grain contaminated with an estrogen-mimicking chemical, the flame retardant PBB. The daughters born to the pregnant women who ate the PBB-laced meat and drank the PBB-laced milk started menstruating significantly earlier than their peers.

One concern, among parents and researchers, is the effect of simultaneous exposures to many estrogen-mimics, including the compound BPA, which is ubiquitous. Ninety-three percent of Americans have traces of BPA in their bodies. BPA was first made in 1891 and used as a synthetic estrogen in the 1930s. In the 1950s commercial manufacturers started putting BPA in hard plastics. Since then BPA has been found in many common products, including dental sealants and cash-register receipts. More than a million pounds of the substance are released into the environment each year.

Family stress can disrupt puberty timing as well. Girls who from an early age grow up in homes without their biological fathers are twice as likely to go into puberty younger as girls who grow up with both parents. Some studies show that the presence of a stepfather in the house also correlates with early puberty. Evidence links maternal depression with developing early. Children adopted from poorer countries who have experienced significant early-childhood stress are also at greater risk for early puberty once they’re ensconced in Western families.

Bruce Ellis, a professor of Family Studies and Human Development at the University of Arizona, discovered along with his colleagues a pattern of early puberty in girls whose parents divorced when those girls were between 3 and 8 years old and whose fathers were considered socially deviant (meaning they abused drugs or alcohol, were violent, attempted suicide or did prison time). In another study, published in 2011, Ellis and his colleagues showed that first graders who are most reactive to stress — kids whose pulse, respiratory rate and cortisol levels fluctuate most in response to environmental challenges — entered puberty earliest when raised in difficult homes. Evolutionary psychology offers a theory: A stressful childhood inclines a body toward early reproduction; if life is hard, best to mature young. But such theories are tough to prove.

Social problems don’t just increase the risk for early puberty; early puberty increases the risk for social problems as well. We know that girls who develop ahead of their peers tend to have lower self-esteem, more depression and more eating disorders. They start drinking and lose their virginity sooner. They have more sexual partners and more sexually transmitted diseases. “You can almost predict it” — that early maturing teenagers will take part in more high-risk behaviors, says Tonya Chaffee, associate clinical professor of pediatrics at University of California, San Francisco, who oversees the Teen and Young Adult Health Center at San Francisco General Hospital. Half of the patients in her clinic are or have been in the foster system. She sees in the outlines of their early-developing bodies the stresses of their lives — single parent or no parent, little or no money, too much exposure to violence.

Some of this may stem from the same social stresses that contribute to early puberty in the first place, and some of it may stem from other factors, including the common nightmare of adolescence: being different. As Julia Graber, associate chairwoman of psychology at the University of Florida, has shown, all “off-time” developers — early as well as late — have more depression during puberty than typically-developing girls. But for the late bloomers, the negative effect wears off once puberty ends. For early bloomers, the effect persists, causing higher levels of depression and anxiety through at least age 30, perhaps all through life. “Some early-maturing girls have very serious problems,” Graber told me. “More than I expected when I started looking for clinical significance. I was surprised that it was so severe.”

Researchers know there’s a relationship between pubertal timing and depression, but they don’t know exactly how that relationship works. One theory is that going through puberty early, relative to other kinds of cognitive development, causes changes in the brain that make it more susceptible to depression. As Elizabeth Sowell, director of the Developmental Cognitive Neuroimaging Laboratory at Children’s Hospital Los Angeles, points out, girls in general tend to go through puberty earlier than boys, and starting around puberty, girls, as a group, also experience more anxiety and depression than boys do. Graber offers a broader hypothesis, perhaps the best understanding of the puberty-depression connection we have for now. “It may be that early maturers do not have as much time as other girls to accomplish the developmental tasks of childhood. They face new challenges while everybody else is still dealing with the usual development of childhood. This might be causing them to make less successful transitions into adolescence and beyond.”

Over the past year, I talked to mothers who tried to forestall their daughters’ puberty in many different ways. Some trained with them for 5K runs (exercise is one of the few interventions known to help prevent early puberty); others trimmed milk and meat containing hormones from their daughters’ diets; some purged from their homes plastics, pesticides and soy. Yet sooner rather than later, most threw up their hands. “I’m empathetic with parents in despair and wanting a sense of agency,” says Sandra Steingraber, an ecologist and the author of “Raising Elijah: Protecting Our Children in an Age of Environmental Crisis.” “But this idea that we, as parents, should be scrutinizing labels and vetting birthday party goody bags — the idea that all of us in our homes should be acting as our own Environmental Protection Agencies and Departments of Interior — is just nuts. Even if we could read every label and scrutinize every product, our kids are in schools and running in and out of other people’s homes where there are brominated flame retardants on the furniture and pesticides used in the backyard.”

Adding to the anxiety is the fact that we know so little about how early puberty works. A few researchers, including Robert Lustig, of Benioff Children’s Hospital, are beginning to wonder if many of those girls with early breast growth are in puberty at all. Lustig is a man prone to big, inflammatory ideas. (He believes that sugar is a poison, as he has argued in this magazine.) To make the case that some girls with early breast growth may not be in puberty, he starts with basic science. True puberty starts in the brain, he explains, with the production of gonadotropin-releasing hormone, or GnRH. “There is no puberty without GnRH,” Lustig told me. GnRH is like the ball that rolls down the ramp that knocks over the book that flips the stereo switch. Specifically, GnRH trips the pituitary, which signals the ovaries. The ovaries then produce estrogen, and the estrogen causes the breasts to grow. But as Lustig points out, the estrogen that is causing that growth in young girls may have a different origin. It may come from the girls’ fat tissue (postmenopausal women produce estrogen in their fat tissue) or from an environmental source. “And if that estrogen didn’t start with GnRH, it’s not puberty, end of story,” Lustig says. “Breast development doesn’t automatically mean early puberty. It might, but it doesn’t have to.” Don’t even get him started on the relationship between pubic-hair growth and puberty. “Any paper linking pubic hair with early puberty is garbage. Gar-bage. Pubic hair just means androgens, or male hormones. The first sign of puberty in girls is estrogen. Androgen is not even on the menu.”

Frank Biro, lead author of the August 2010 Pediatrics paper and director of adolescent medicine at Cincinnati Children’s Hospital, began having similar suspicions last spring after he flew to Denmark to give a lecture. Following his talk, Biro looked over the published data on puberty of his colleague Anders Juul. In Juul’s study, some of the girls with early breast development had unexpectedly low levels of estradiol, the predominant form of estrogen in women’s bodies from the onset of puberty through menopause. Biro had seen a pattern like this in his data, suggesting to him that the early breast growth might be coming from nonovarian estrogens. That is to say, the headwaters for the pubertal changes might not be in the girls’ brains. He is now running models on his own data to see if he can determine where the nonovarian estrogens are coming from.

The possibility that these early “normal” girls are reacting to estrogens that are not coming from their ovaries is compelling. Part of the comfort is that a girl who is not yet in puberty may not have developed an adolescent brain. This means she would not yet feel the acute tug of her own sexual urges. She would not seek thrills and risk. Still, the idea that there are enough toxins or fat cells in a child’s body to cause breast development is hardly consoling. Besides, some of the psychosocial problems of early puberty derive from what’s happening inside a girl’s body; others, from how people react to her. “If a girl is 10 and she looks 15, it doesn’t make any difference if her pituitary is turned on or if something else caused her breast growth,” Biro says. “She looks like a middle adolescent. People are going to treat her that way. Maybe she’s not interested in reciprocal sex, but she might be pressured into sex nonetheless, and her social skills will be those of a 10-year-old.”

So what are families of early bloomers to do? Doctors urge parents to focus on their daughters’ emotional and physical health rather than on stopping or slowing development. In this way, the concept of a new normal is not just a brushoff but an encouragement to support a girl who is vulnerable.

“I know they can’t change the fact that their daughter started developing early, but they can change what happens downstream,” Louise Greenspan, the pediatric endocrinologist at Kaiser Permanente, told me. Parents can keep their daughters active and at healthy body weights. They can treat them the age they are, not the age they look. They can defend against a culture that sells push-up bikinis for 7-year-olds and otherwise sexualizes young girls. “Most of the psychological issues associated with early puberty are related to risk-taking behaviors,” Greenspan continued, and parents can mitigate those. “I know it sounds corny and old-fashioned, but if you’re in a supportive family environment, where you are eating family meals and reading books together, you actually do have control.” Early breast growth may be just that — early breast growth: disconcerting, poorly understood, but not a guarantee of our worst fears. “You don’t go directly from the first signs of early puberty to anorexia, depression, drinking and early sexual debut.”

In Fort Collins, Tracee, Ainsley’s mother, tried to stay focused on the positive. At one point during my visit, she disappeared into her basement, the headquarters for her company, T.G.R. Body, and returned with a pink hat box filled with chemical-free samples of Peppermint Pimple Popper and Bad Hair Day Miracle Powder. “I just want to be part of the solution,” Tracee said, rubbing a sample of silver hair-streaking gel on my wrist. “I’m so tired of running away. I need to have something Ainsley is moving toward.”

Mothers who have been through it urge candor. “Be honest with her, and by honest I mean brutally honest” — about what’s going to happen to her body — “while still being kind ,” says the mother of a girl who recently turned 10 but who first showed signs of developing what she calls “a shape” at age 3. “You don’t want your daughter experiencing something for which she’s unprepared.”

Patience and perspective may be the greatest palliatives. “The thing with puberty is that everybody is going to go through it at some point,” another mother told me. Three years ago this woman was installing small trash cans in her third-grade girl’s school bathroom stalls so that her daughter could discreetly throw away menstrual pads. But now that daughter is 12, in the sixth grade; her body seems less strange. “I feel so much better, and so does she. By another two or three years down the road, all the other girls will have caught up.”

Elizabeth Weil is a contributing writer for the magazine and the author of a new memoir about marriage, “No Cheating, No Dying.”

Editor: Ilena Silverman

NYT

Twitter Updates

NetwokedBlogs

Search This Blog

Total Pageviews