The Quirky World of Competitive Snow Carving Comes to California



The weekend at Northstar ski resort in Truckee, California, is beautiful, sunny, and in the 30s. For eight teams of snow carvers from around the world, though, it’s terrible — the melty snow is sloppy, hard to carve, and even dangerous.

Teams of three from Finland, Japan, Germany, Canada, and the U.S. were selected from more than 40 applicants for the inaugural Carve Tahoe, a five-day competition to hew works of art from 14-foot-high, 20-ton blocks of snow. But despite the bad snow, the teams rely on decades of experience, handcrafted tools, and creative techniques to fashion their massive sculptures. The team members are sculptors and artists and designers, but also doctors and lawyers. Though they spend weeks each year carving, nobody makes a living doing it.


“Everyone seems to have their own method of doing things,” says Team Wisconsin’s Mark Hargarten. “It’s amazing how different they are.”


The Wisconsin team uses a grid system for their carving — a Native American wearing an eagle costume, its feathers turning to flames, called “Dance of the Firebird.” The polyurethane model they built is scaled so 1/2 inch equals one foot on the finished snow sculpture. They cut a copy of the model in four, and covered each section with clay, sectioned in 1/2 inch increments. They etch corresponding lines in the snow, one foot to a side, and they peel off one piece of clay, carve the part of the sculpture they can see, and move on to the next.


“You never get lost using the method,” says Dan Ingebrigtson, a professional sculptor from Milwaukee. “Three or four guys can work from different angles, and meet in the middle.”


Wisconsin’s got several other strategies behind their carving as well. From the south, it looks like they haven’t even started; they left the southern side of the block intact to protect the rest of it from the sun, and the wall has been decimated by the heat. More than 20 percent of its thickness has melted by Sunday night, three days in. After the sun goes down, the team is hollowing out the interior of the structure, so it will freeze faster overnight.


Other teams are relying on nighttime freezing as well. A team partly from the U.S. and partly from Canada carves spires from blocks they removed from the sculpture, and plans to attach them to the top of their sculpture, “The Stand,” which incorporates four interwoven trees. They’ll use melty snow pulled from the middle of the block right when the sun goes down to cement the tops onto the trees, says team member Bob Fulks from the top of a stepladder as he cuts away at the sculpture with an ice chisel.


Fulks’ team is leaving Tahoe after the competition to go straight to Whitehorse, in the Yukon, for another competition, where he anticipates no problems with warm weather.


“It’s a good gig, you can travel all over the world doing it,” he says. “You go around and see the same people.”


Many of the carvers know each other from previous competitions.


“We’ve sculpted with almost everybody here before,” says Team Idaho-Dunham’s Mariah Dunham, who is working on “Sweet House (of Madness)” with her mother, Barb. The creation is a beehive, with the south side as the exterior, and the north side (intentionally placed out of the sun) as a representation of the comb, including hexagonal holds that perforate all the way to the hollow interior.


Though Carve Tahoe is new, snow carving is not. Many of the sculptors have been at it for more than 20 years, traveling around the world and meeting and competing against many of the same people — though each competition demands unique new designs from all the sculptors. Kathryn Keown discovered snow carving while Googling something completely different, and decided she wanted to host an international event.


“First we fell in love with the sculptures, then we fell in love with the sculptors,” says Keown, who founded the competition with Hub Strategy, the ad agency where she works.


Keown contacted several ski areas before Northstar, but the resort was on board right away; its owner, Vail Resorts also owns Breckenridge, where one of the biggest and most prestigious snow carving competitions is held.


But Keown wanted to commit to the design of the competition, not just the sculptures. Applicants submitted their designs last summer, and Keown enlisted Lawrence Noble, chair of the School of Fine Art at the Academy of Art University to help choose modern, complex, realist designs. She wanted no artsy, kitschy snowmen.


Then she chose a design-friendly logo and judges. In addition to Noble, the panel of judges features a sushi chef from Northstar, two interior designers, a photographer from nearby Squaw Valley, and Bryan Hyneck, vice president of design at Speck, which makes cases for mobile devices and was one of the event’s sponsors.


“The level of complexity and sophistication in this type of sculpture is just amazing,” says Hyneck, who has judged industrial and graphic design competitions, but never snow carving. “It’s amazing how organic some of the shapes can be.”


As a judge, Hyneck says he’ll focus on the craft and the execution of the sculptures, and how the sculptors use particular techniques to take advantage of the snow’s properties. But he adds that subject matter, point of view, message, and relationship to a theme are all important points as well.


“Anybody that is really going to push the limits of the capabilities of the media is going to get a lot of my attention,” he says.


For some, like the Germans, that means suspending massive structures made completely of snow. Their sculpture, titled “Four Elements”, features four large spires encircled by a tilted disc. Despite a trickle of melted snow dripping off the bottom edge, one — or even two — of the German carvers frequently stand atop the sculpture, using saws or chisels to shape the towers.


Sunday evening, after the sun has gone down and the temperature dropped, Josh Knaggs, bearded, with a cigarette in his mouth, is sitting in the curve made by the largest bear from the Team Idaho-Bonner’s Ferry sculpture, “Endangered Bears.” Wearing a blue event-issued jacket, he’s brushing out the hollow loop made by mama and papa bear.


Three days later, the judges award Knaggs and his team third prize, with Japan’s modern work, “Heart to Heart” coming in second and Germany’s gravity-defying “Four Elements” taking first. The teams disperse, and after a few more sunny days, Northstar tears down the structures before they get too soft and fall — all except the German piece, which can’t bear its own weight and collapses after judging is complete. But the ephemeral nature of the snow is part of what attracts the competitors.


“It’s for the moment, and it’s a beauty all in itself, creating something that’s gonna be disappearing, you know, it’s okay that it disappears,” says Team Truckee’s Ira Kessler. “We are making it for the moment.”


All Photos: Bryan Thayer/Speck


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Opera world stages its own awards as faces budget crunch






LONDON (Reuters) – The world of opera, faced with budget cuts and wanting to raise appreciation of opera, has launched its own annual international awards, unveiling a shortlist of finalists in 23 categories.


The Operas, which will be presented at a ceremony in London on April 22, are the brainchild of Opera Magazine and British businessman Harry Hyman.






Opera Magazine editor John Allison said he hoped the awards would bring recognition to opera at a time when many opera houses were struggling to make ends meet due to a decline in private sponsorships and cuts in state subsidies.


English National Opera, one of London’s two principal opera companies, last month announced a loss for 2012 with audience figures down 9 percent and a drop in its public subsidy, while Paris Opera chief Nicolas Joel has publicly decried budget cuts and said he did not intend to renew his contract in 2015.


“Opera houses all over the world are in a lot of difficulty at the moment as everything is being cut and everyone is feeling the pinch. Some smaller houses in the United States have closed,” Allison told Reuters.


“Opera houses work very hard and artists put their life and soul into their work but there are a lot of good performances that come and go and are not recognized. Hopefully these awards will raise opera in everyone’s conscience.”


Allison said the awards also aimed to boost support for new and emerging artists who struggle to make a living from their profession and receive little public recognition.


“Everyone has awards – films, books, music – but there just has not been a set of international awards for opera. We want to change that,” said Allison.


The International Opera Awards, to be known as The Operas, involve 23 categories that recognize “the achievements of all the performers, producers and teams that work in Opera”.


Awards will be given to best female singer, male singer, conductor, opera company, and chorus, and there is also a life-time achievement award and a readers’ award.


Prizes for young singers will come with bursaries attached.


Finalists for the male singer are tenors Aleksandrs Antonenko, Piotr Beczala, Joseph Calleja, Jonas Kaufmann, bass-baritone Luca Pisaroni, and baritone Bryn Terfel.


Female singers in the running for the award are Sarah Connolly, Joyce DiDonato, Evelyn Herlitzius, Catherine Naglestad, Nina Stemme, and Beatrice Uria-Monzon.


The conductors shortlisted are Britons Richard Farnes and Antonio Pappano, Germany’s Ingo Metzmacher and Christian Thielemann, and Italian Nicola Luisotti.


The opera companies running for the prize are Oper Frankfurt, Opera National de Lyon, Staatsoper Stuttgart, Stanislavsky Music Theatre Moscow and Theater an der Wien.


One category unlikely to be seen at the Grammys is accessibility with the Metropolitan Opera in New York, London-based Streetwise Opera, Teatro Sociale in Como, Italy, and Welsh National Opera all vying for that prize.


Allison said more than 1,500 nominations were received from 41 countries with the judging panel made up 10 opera experts ranging from critics and opera house chiefs to singers.


(Reporting by Belinda Goldsmith, editing by Paul Casiato)


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Livestrong Tattoos as Reminder of Personal Connections, Not Tarnished Brand





As Jax Mariash went under the tattoo needle to have “Livestrong” emblazoned on her wrist in bold black letters, she did not think about Lance Armstrong or doping allegations, but rather the 10 people affected by cancer she wanted to commemorate in ink. It was Jan. 22, 2010, exactly a year since the disease had taken the life of her stepfather. After years of wearing yellow Livestrong wristbands, she wanted something permanent.




A lifelong runner, Mariash got the tattoo to mark her 10-10-10 goal to run the Chicago Marathon on Oct. 10, 2010, and fund-raising efforts for Livestrong. Less than three years later, antidoping officials laid out their case against Armstrong — a lengthy account of his practice of doping and bullying. He did not contest the charges and was barred for life from competing in Olympic sports.


“It’s heartbreaking,” Mariash, of Wilson, Wyo., said of the antidoping officials’ report, released in October, and Armstrong’s subsequent confession to Oprah Winfrey. “When I look at the tattoo now, I just think of living strong, and it’s more connected to the cancer fight and optimal health than Lance.”


Mariash is among those dealing with the fallout from Armstrong’s descent. She is not alone in having Livestrong permanently emblazoned on her skin.


Now the tattoos are a complicated, internationally recognized symbol of both an epic crusade against cancer and a cyclist who stood defiant in the face of accusations for years but ultimately admitted to lying.


The Internet abounds with epidermal reminders of the power of the Armstrong and Livestrong brands: the iconic yellow bracelet permanently wrapped around a wrist; block letters stretching along a rib cage; a heart on a foot bearing the word Livestrong; a mural on a back depicting Armstrong with the years of his now-stripped seven Tour de France victories and the phrase “ride with pride.”


While history has provided numerous examples of ill-fated tattoos to commemorate lovers, sports teams, gang membership and bands that break up, the Livestrong image is a complex one, said Michael Atkinson, a sociologist at the University of Toronto who has studied tattoos.


“People often regret the pop culture tattoos, the mass commodified tattoos,” said Atkinson, who has a Guns N’ Roses tattoo as a marker of his younger days. “A lot of people can’t divorce the movement from Lance Armstrong, and the Livestrong movement is a social movement. It’s very real and visceral and embodied in narrative survivorship. But we’re still not at a place where we look at a tattoo on the body and say that it’s a meaningful thing to someone.”


Geoff Livingston, a 40-year-old marketing professional in Washington, D.C., said that since Armstrong’s confession to Winfrey, he has received taunts on Twitter and inquiries at the gym regarding the yellow Livestrong armband tattoo that curls around his right bicep.


“People see it and go, ‘Wow,’ ” he said, “But I’m not going to get rid of it, and I’m not going to stop wearing short sleeves because of it. It’s about my family, not Lance Armstrong.”


Livingston got the tattoo in 2010 to commemorate his brother-in-law, who was told he had cancer and embarked on a fund-raising campaign for the charity. If he could raise $5,000, he agreed to get a tattoo. Within four days, the goal was exceeded, and Livingston went to a tattoo parlor to get his seventh tattoo.


“It’s actually grown in emotional significance for me,” Livingston said of the tattoo. “It brought me closer to my sister. It was a big statement of support.”


For Eddie Bonds, co-owner of Rabbit Bicycle in Hill City, S.D., getting a Livestrong tattoo was also a reflection of the growth of the sport of cycling. His wife, Joey, operates a tattoo parlor in front of their store, and in 2006 she designed a yellow Livestrong band that wraps around his right calf, topped off with a series of small cyclists.


“He kept breaking the Livestrong bands,” Joey Bonds said. “So it made more sense to tattoo it on him.”


“It’s about the cancer, not Lance,” Eddie Bonds said.


That was also the case for Jeremy Nienhouse, a 37-year old in Denver, Colo., who used a Livestrong tattoo to commemorate his own triumph over testicular cancer.


Given the diagnosis in 2004, Nienhouse had three rounds of chemotherapy, which ended on March 15, 2005, the date he had tattooed on his left arm the day after his five-year anniversary of being cancer free in 2010. It reads: “3-15-05” and “LIVESTRONG” on the image of a yellow band.


Nienhouse said he had heard about Livestrong and Armstrong’s own battle with the cancer around the time he learned he had cancer, which alerted him to the fact that even though he was young and healthy, he, too, could have cancer.


“On a personal level,” Nienhouse said, “he sounds like kind of a jerk. But if he hadn’t been in the public eye, I don’t know if I would have been diagnosed when I had been.”


Nienhouse said he had no plans to have the tattoo removed.


As for Mariash, she said she read every page of the antidoping officials’ report. She soon donated her Livestrong shirts, shorts and running gear. She watched Armstrong’s confession to Winfrey and wondered if his apology was an effort to reduce his ban from the sport or a genuine appeal to those who showed their support to him and now wear a visible sign of it.


“People called me ‘Miss Livestrong,’ ” Mariash said. “It was part of my identity.”


She also said she did not plan to have her tattoo removed.


“I wanted to show it’s forever,” she said. “Cancer isn’t something that just goes away from people. I wanted to show this is permanent and keep people remembering the fight.”


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Common Sense: High Taxes Are Not a Prime Reason for Relocation, Studies Say


Pool photo by Mikhail Klimentyev


Gerard Depardieu with Vladimir Putin in January. Russia granted Mr. Depardieu a passport after his spat with France over taxes.







Last month, Vladimir V. Putin hugged his newly minted fellow Russian citizen, the actor Gerard Depardieu, posing for cameras at the Black Sea port of Sochi. “I adore your country,” Mr. Depardieu gushed — especially its 13 percent flat tax on personal income.




Sochi may not be St. Tropez, but it does have winter temperatures in the 60s and even palm trees. Mr. Putin’s deputy prime minister confidently predicted a “mass migration of wealthy Europeans to Russia.”


Here in the United States, the three-time Masters champion Phil Mickelson recently walked off the 18th hole at Humana Challenge and said he might move from California because the state increased its top income tax rate to 13.3 percent from 10.3 percent.


“Hey Phil,” Gov. Rick Perry of Texas wrote in a Twitter message, “Texas is home to liberty and low taxes ... we would love to have you as well!!” Tiger Woods later said that he had left California for Florida for just that reason years ago. Mr. Mickelson can “vote with his Gulfstream,” a Wall Street Journal editorial noted, and warned California to “expect a continued migration.”


It’s an article of faith among low-tax advocates that income tax increases aimed at the rich simply drive them away. As Stuart Varney put it on Fox News: “Look at what happened in Britain. They raised the top tax rate to 50 percent, and two-thirds of the millionaires disappeared in the next tax year. Same things are happening in France. People are leaving where the top tax rate is 75 percent. Same thing happened in Maryland a few years ago. New millionaire’s tax, the millionaires disappeared. You’ve got exactly the same thing in California.”


That, at least, is what low-tax advocates want us to think, and on its face, it seems to make sense. But it’s not the case. It turns out that a large majority of people move for far more compelling reasons, like jobs, the cost of housing, family ties or a warmer climate. At least three recent academic studies have demonstrated that the number of people who move for tax reasons is negligible, even among the wealthy.


Cristobal Young, an assistant professor of sociology at Stanford, studied the effects of recent tax increases in New Jersey and California.


“It’s very clear that, over all, modest changes in top tax rates do not affect millionaire migration,” he told me this week. “Neither tax increases nor tax cuts on the rich have affected their migration rates.”


The notion of tax flight “is almost entirely bogus — it’s a myth,” said Jon Shure, director of state fiscal studies at the Center on Budget and Policy Priorities, a nonprofit research group in Washington. “The anecdotal coverage makes it seem like people are leaving in droves because of high taxes. They’re not. There are a lot of low-tax states, and you don’t see millionaires flocking there.”


Despite the allure of low taxes, Mr. Depardieu hasn’t been seen in Russia since picking up his passport and seems to be hedging his bets by maintaining a residence in Belgium. Meanwhile, Russian billionaires are snapping up trophy properties in high-tax London, New York and Beverly Hills, Calif.


“I don’t hear about many billionaires moving to Moscow,” said Robert Tannenwald, a lecturer in economic policy at Brandeis University and former Federal Reserve economist. Along with Nicholas Johnson, he and Mr. Shure are co-authors of “Tax Flight Is a Myth,” a 2011 research paper.


Of course, some people do move for tax reasons, especially wealthy retirees, athletes and other celebrities without strong ties to high-tax locations, like jobs and families. In renouncing his French citizenship, Mr. Depardieu follows other French celebrities, the chef Alain Ducasse, the singer Johnny Hallyday and Yannick Noah, a former tennis star. Several Paris hedge fund managers have decamped to London and the fashion mogul Bernard Arnault applied for Belgian citizenship, though not, he has said, for tax reasons.


Stars like Mr. Depardieu and Mr. Mickelson certainly have incentives to move. Mr. Depardieu complained that he paid 85 percent of his income in taxes in France last year and has paid 145 million euros over 45 years. France has a top rate of 41 percent as well as a wealth tax, and the Socialist president, François Hollande, is trying to impose a temporary surcharge of 75 percent on incomes over 1 million euros. Mr. Mickelson earned more than $60 million last year, Sports Illustrated estimates, which means the three-percentage-point California tax increase could add up to an additional $1.8 million in tax.


This article has been revised to reflect the following correction:

Correction: February 15, 2013

An earlier version of this column misstated Mr. Depardieu’s citizenship. He has applied for residency in Belgium; he is not a citizen of that nation. The earlier version also misidentified the golf tournament at which the golfer Phil Mickelson said he might move from California to escape its taxes. It was the Humana Challenge, not Pebble Beach.



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Former Bell official says he voted for pay raise out of fear









One of the former Bell city leaders accused of plundering the town's treasury by taking oversized salaries testified Thursday that the fat paychecks and other extraordinary benefits that came with the job were all but forced on him.


George Cole, a former steelworker, returned to the witness stand for a second day and testified that he voted for a 12% annual pay raise for a City Council board in 2008 only because he feared retribution from then-City Manager Robert Rizzo.


"He had shown himself to be very vindictive if you crossed him at that time," Cole said. "I was worried that if I didn't vote for this, if I voted against it, he would do whatever he could to destroy the work that was important to me and the community. I knew that was his character."





Cole said it was the most difficult decision he ever made while on the council but was in the best interest of Bell — a city, he said, where he had devoted decades to advocating for new schools and programs for at-risk youths and senior citizens.


Cole, along with Luis Artiga, Victor Bello, Oscar Hernandez, Teresa Jacobo and George Mirabal, is accused of drawing an inflated salary from boards and authorities that rarely met and did little work.


The pay increases for the authorities were placed on the consent calendar — a place for routine and non-controversial items that are voted on without discussion. Cole defended the practice and said the agendas, minutes and staff reports were always available to the public at City Hall and at the library.


"I never tried to hide what we were doing," Cole said.


He also testified that the minutes did not reflect work done for those authorities.


Cole justified his vote for previous City Council pay raises to allow for a more diverse pool of council candidates who could use the money. And when he voted for a council salary increase in 2005, Cole noted that Bell was in a "very strong financial position."


The 63-year-old also told jurors that when he discovered $15,500 had been deposited into a 401(k)-style account for him, he complained. Cole said Rizzo refused to remove the money.


Initially, Cole said, Rizzo was a first-rate city administrator, making improvements such as repairing and keeping streets clean and erecting a protective fence around the city's largest park.


"From the time he started, he was able to accomplish things other managers previous to him said couldn't be done or were unable to do," Cole said.


Cole said the two would sometimes meet for breakfast to discuss city matters. "It was business," he said. "It wasn't two chums getting together."


But when Cole decided to give up his salary during his last year in office, he said it fractured his relationship with Rizzo. When he learned about Rizzo's near-$800,000 salary from a story published in The Times in 2010, he said he felt sick.


"I just felt like the dumbest person in the world that this guy had just pulled one of the biggest cons I've ever seen on, not just me, but on the city of Bell," Cole testified.


Rizzo faces 69 felony corruption charges. He and his former assistant, Angela Spaccia, are expected to go on trial later this year.


Cole's top annual salary was $67,000, his attorney said. At the time, he was earning nearly $95,000 a year as chief executive of the Steelworkers Old Timers Foundation.


In 2004, the city paid the state pension system $36,648 to buy Cole an additional five years of service time. Cole was one of 11 Bell administrators for whom the city bought service time.


CalPERS — the state's largest public pension program — has disallowed the service time the city bought, saying the buy-ins were not council-approved and that a municipality cannot pay for them.


Cole also was among the 40 or so Bell employees who were scheduled to receive additional payments through Bell's own supplemental retirement plan, established in 2003. In combination with the CalPERS pension, the payout was among the best retirement plans for non-safety employees in the state. The council never approved the plan.


jeff.gottlieb@latimes.com


corina.knoll@latimes.com





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AMC Aims to Repeat <em>Walking Dead</em> Success With New <em>Terror</em> Series











And the first cable network looking to capitalize on the massive mainstream success of The Walking Dead TV show is … Walking Dead network AMC. After proving that modern horror can draw audiences to rival — and, in some cases, beat — the big broadcast networks with the adaptation of Robert Kirkman and Charlie Adlard’s long-running zombie comic, the network is developing a second horror drama based on Dan Simmons’ aptly named 2007 novel The Terror.


The Terror offers a fictionalized version of the real-life “lost expedition” of British Royal Navy officer Captain Sir John Franklin in 1845, in which two vessels, the HMS Erebus and the HMS Terror, became trapped in ice in the Canadian Arctic, leading to the eventual deaths of both ships’ crews. While the true story of what happened to the expedition is both mysterious and grisly, Simmons’ take on it is far more ready-for-television, featuring a mythological beast hunting the crews and continually fracturing alliances and relationships between the human survivors.


Much as it did with The Walking Dead, which was originally the product of producer Gail Anne Hurd (Alien, Terminator) and writer/director Frank Darabont (The Shawshank Redemption),  AMC is relying on well-regarded genre veterans to usher the show into reality. Blade Runner and Prometheus director Ridley Scott will be executive producer for the series, while his production company, Scott Free, pairs with Television 360 (Game of Thrones) to bring the show to screen. A pilot script is currently being written by David Kajganich, a screenwriter whose previous credits include 2007′s Invasion of the Body Snatchers remake, The Invasion.


Considering the record-breaking success The Walking Dead has had, the real surprise isn’t that AMC wants to try and repeat its successful formula with a new series; it’s that other cable networks aren’t doing exactly the same thing already.






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Work starts on Seaside Heights, NJ, boardwalk






SEASIDE HEIGHTS, N.J. (AP) — The sounds shaking the ground in Seaside Heights aren’t from nightclubs.


The town featured in the MTV reality showJersey Shore” has started rebuilding the boardwalk that was destroyed by Superstorm Sandy.






Heavy equipment began drilling holes in the sand and pounding pilings into the ground Friday. It’s the first phase of a project that could ultimately cost $ 6 million to $ 7 million.


Mayor Bill Akers says the mile-long walkway should be done by May 10, but amenities like railings, lighting and ramps will come after that.


Many residents turned out to see the start of the work. They expressed hope that the place where they vacationed as children and came to settle down will recapture what made it so special to them.


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Doctor and Patient: Afraid to Speak Up to Medical Power

The slender, weather-beaten, elderly Polish immigrant had been diagnosed with lung cancer nearly a year earlier and was receiving chemotherapy as part of a clinical trial. I was a surgical consultant, called in to help control the fluid that kept accumulating in his lungs.

During one visit, he motioned for me to come closer. His voice was hoarse from a tumor that spread, and the constant hissing from his humidified oxygen mask meant I had to press my face nearly against his to understand his words.

“This is getting harder, doctor,” he rasped. “I’m not sure I’m up to anymore chemo.”

I was not the only doctor that he confided to. But what I quickly learned was that none of us was eager to broach the topic of stopping treatment with his primary cancer doctor.

That doctor was a rising superstar in the world of oncology, a brilliant physician-researcher who had helped discover treatments for other cancers and who had been recruited to lead our hospital’s then lackluster cancer center. Within a few months of the doctor’s arrival, the once sleepy department began offering a dazzling array of experimental drugs. Calls came in from outside doctors eager to send their patients in for treatment, and every patient who was seen was promptly enrolled in one of more than a dozen well-documented treatment protocols.

But now, no doctors felt comfortable suggesting anything but the most cutting-edge, aggressive treatments.

Even the No. 2 doctor in the cancer center, Robin to the chief’s cancer-battling Batman, was momentarily taken aback when I suggested we reconsider the patient’s chemotherapy plan. “I don’t want to tell him,” he said, eyes widening. He reeled off his chief’s vast accomplishments. “I mean, who am I to tell him what to do?”

We stood for a moment in silence before he pointed his index finger at me. “You tell him,” he said with a smile. “You tell him to consider stopping treatment.”

Memories of this conversation came flooding back last week when I read an essay on the problems posed by hierarchies within the medical profession.

For several decades, medical educators and sociologists have documented the existence of hierarchies and an intense awareness of rank among doctors. The bulk of studies have focused on medical education, a process often likened to military and religious training, with elder patriarchs imposing the hair shirt of shame on acolytes unable to incorporate a profession’s accepted values and behaviors. Aspiring doctors quickly learn whose opinions, experiences and voices count, and it is rarely their own. Ask a group of interns who’ve been on the wards for but a week, and they will quickly raise their hands up to the level of their heads to indicate their teachers’ status and importance, then lower them toward their feet to demonstrate their own.

It turns out that this keen awareness of ranking is not limited to students and interns. Other research has shown that fully trained physicians are acutely aware of a tacit professional hierarchy based on specialties, like primary care versus neurosurgery, or even on diseases different specialists might treat, like hemorrhoids and constipation versus heart attacks and certain cancers.

But while such professional preoccupation with privilege can make for interesting sociological fodder, the real issue, warns the author of a courageous essay published recently in The New England Journal of Medicine, is that such an overly developed sense of hierarchy comes at an unacceptable price: good patient care.

Dr. Ranjana Srivastava, a medical oncologist at the Monash Medical Centre in Melbourne, Australia, recalls a patient she helped to care for who died after an operation. Before the surgery, Dr. Srivastava had been hesitant to voice her concerns, assuming that the patient’s surgeon must be “unequivocally right, unassailable, or simply not worth antagonizing.” When she confesses her earlier uncertainty to the surgeon after the patient’s death, Dr. Srivastava learns that the surgeon had been just as loath to question her expertise and had assumed that her silence before the surgery meant she agreed with his plan to operate.

“Each of us was trying our best to help a patient, but we were also respecting the boundaries and hierarchy imposed by our professional culture,” Dr. Srivastava said. “The tragedy was that the patient died, when speaking up would have made all the difference.”

Compounding the problem is an increasing sense of self-doubt among many doctors. With rapid advances in treatment, there is often no single correct “answer” for a patient’s problem, and doctors, struggling to stay up-to-date in their own particular specialty niches, are more tentative about making suggestions that cross over to other doctors’ “turf.” Even as some clinicians attempt to compensate by organizing multidisciplinary meetings, inviting doctors from all specialties to discuss a patient’s therapeutic options, “there will inevitably be a hierarchy at those meetings of who is speaking,” Dr. Srivastava noted. “And it won’t always be the ones who know the most about the patient who will be taking the lead.”

It is the potentially disastrous repercussions for patients that make this overly developed awareness of rank and boundaries a critical issue in medicine. Recent efforts to raise safety standards and improve patient care have shown that teams are a critical ingredient for success. But simply organizing multidisciplinary lineups of clinicians isn’t enough. What is required are teams that recognize the importance of all voices and encourage active and open debate.

Since their patient’s death, Dr. Srivastava and the surgeon have worked together to discuss patient cases, articulate questions and describe their own uncertainties to each other and in patients’ notes. “We have tried to remain cognizant of the fact that we are susceptible to thinking about hierarchy,” Dr. Srivastava said. “We have tried to remember that sometimes, despite our best intentions, we do not speak up for our patients because we are fearful of the consequences.”

That was certainly true for my lung cancer patient. Like all the other doctors involved in his care, I hesitated to talk to the chief medical oncologist. I questioned my own credentials, my lack of expertise in this particular area of oncology and even my own clinical judgment. When the patient appeared to fare better, requiring less oxygen and joking and laughing more than I had ever seen in the past, I took his improvement to be yet another sign that my attempt to talk about holding back chemotherapy was surely some surgical folly.

But a couple of days later, the humidified oxygen mask came back on. And not long after that, the patient again asked for me to come close.

This time he said: “I’m tired. I want to stop the chemo.”

Just before he died, a little over a week later, he was off all treatment except for what might make him comfortable. He thanked me and the other doctors for our care, but really, we should have thanked him and apologized. Because he had pushed us out of our comfortable, well-delineated professional zones. He had prodded us to talk to one another. And he showed us how to work as a team in order to do, at last, what we should have done weeks earlier.

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DealBook: Confidence on Upswing, Mergers Make Comeback

The mega-merger is back.

For the corporate takeover business, the last half-decade was a fallow period. Wall Street deal makers and chief executives, brought low by the global financial crisis, lacked the confidence to strike the audacious multibillion-dollar acquisitions that had defined previous market booms.

Cycles, however, turn, and in the opening weeks of 2013, merger activity has suddenly roared back to life. On Thursday, Berkshire Hathaway, the conglomerate run by Warren E. Buffett, said it had teamed up with Brazilian investors to buy the ketchup maker H. J. Heinz for about $23 billion. And American Airlines and US Airways agreed to merge in a deal valued at $11 billion.

Those transactions come a week after a planned $24 billion buyout of the computer company Dell by its founder, Michael S. Dell, and private equity backers. And Liberty Global, the company controlled by the billionaire media magnate John C. Malone, struck a $16 billion deal to buy the British cable business Virgin Media.

“Since the crisis, one by one, the stars came into alignment, and it was only a matter of time before you had a week like we just had,” said James B. Lee Jr., the vice chairman of JPMorgan Chase.

Still, bankers and lawyers remain circumspect, warning that it is still too early to declare a mergers-and-acquisitions boom like those during the junk bond craze of 1989, the dot-com bubble of 1999 and the leveraged buyout bonanza of 2007. They also say that it is important to pay heed to the excesses that developed during these moments of merger mania, which all ended badly.

A confluence of factors has driven the recent deals. Most visibly, the stock market has been on a tear, with the Standard & Poor’s 500-stock index this week briefly hitting its highest levels since November 2007. Higher share prices have buoyed the confidence of chief executives, who now, instead of retrenching, are looking for ways to expand their businesses.

A number of clouds that hovered over the markets last year have also been removed, eliminating the uncertainty that hampered deal making. Mergers and acquisitions activity in 2012 remained tepid as companies took a wait-and-see approach over the outcome of the presidential election and negotiations over the fiscal cliff. The problems in Europe, which began in earnest in 2011, shut down a lot of potential transactions, but the region has since stabilized.

“When we talk to our corporate clients as well as the bankers, we keep hearing them talk about increased confidence,” said John A. Bick, a partner at the law firm Davis Polk & Wardwell, who advised Heinz on its acquisition by Mr. Buffett and his partners.

Mr. Bick said that mega-mergers had a psychological component, meaning that once transactions start happening, chief executives do not want to be left behind. “In the same way that success breeds success, deals breed more deals,” he said.

A central reason for the return of big transactions is the mountain of cash on corporate balance sheets. After the financial crisis, companies hunkered down, laying off employees and cutting costs. As a result, they generated savings. Today, corporations in the S.& P. 500 are sitting on more than $1 trillion in cash. With interest rates near zero, that money is earning very little in bank accounts, so executives are looking to put it to work by acquiring businesses.

The private equity deal-making machine is also revving up again. The world’s largest buyout firms have hundreds of billions of dollars of “dry powder” — money allotted to deals in Wall Street parlance — and they are on the hunt. The proposed leveraged buyout of Dell, led by Mr. Dell and the investment firm Silver Lake Partners, was the largest private equity transaction since July 2007, when the Blackstone Group acquired the hotel chain Hilton Worldwide for $26 billion just as the credit markets were seizing up.

But perhaps the single biggest factor driving the return of corporate takeovers is the banking system’s renewed health. Corporations often rely on bank loans for financing acquisitions, and the ability of private equity firms to strike multibillion-dollar transactions depends on the willingness of banks to lend them money.

For years, banks, saddled by the toxic mortgage assets weighing on their balance sheets, turned off the lending spigot. But with the housing crisis in the rearview mirror and economic conditions slowly improving, banks are again lining up to provide corporate loans at record-low interest rates to finance acquisitions.

The banks, of course, are major beneficiaries of megadeals, earning big fees from both advising on the transactions and lending money to finance them. Mergers and acquisitions in the United States total $158.7 billion so far this year, according to Thomson Reuters data, more than double the amount in the same period last year. JPMorgan, for example, has benefited from the surge, advising on four big deals in recent weeks, including the Dell bid and Comcast’s $16.7 billion offer for the rest of NBCUniversal that it did not already own.

Mr. Buffett, in a television interview last month, declared that the banks had repaired their businesses and no longer posed a threat to the economy. “The capital ratios are huge, the excesses on the asset aside have been largely cleared out,” said Mr. Buffett, whose acquisition of Heinz will be his second-largest acquisition, behind his $35.9 billion purchase of a majority stake in the railroad company Burlington Northern Santa Fe in 2009.

While Wall Street has an air of giddiness over the year’s start, most deal makers temper their comments about the current environment with warnings about undisciplined behavior like overpaying for deals and borrowing too much to pay for them.

Though private equity firms were battered by the financial crisis, they made it through the downturn on relatively solid ground. Many of their megadeals, like Hilton, looked destined for bankruptcy after the markets collapsed, but they have since recovered. The deals have benefited from an improving economy, as well as robust lending markets that allowed companies to push back the large amounts of debt that were to have come due in the next few years.

But there are still plenty of cautionary tales about the consequences of overpriced, overleveraged takeovers. Consider Energy Future Holdings, the biggest private equity deal in history. Struck at the peak of the merger boom in October 2007, the company has suffered from low natural gas prices and too much debt, and could be forced to restructure this year. Its owners, a group led by Kohlberg Kravis Roberts and TPG, are likely to lose billions.

Even Mr. Buffett made a mistake on Energy Future Holdings, having invested $2 billion in the company’s bonds. He admitted to shareholders last year that the investment was a blunder and would most likely be wiped out.

“In tennis parlance,” Mr. Buffett wrote, “this was a major unforced error.”

Michael J. de la Merced contributed reporting.

A version of this article appeared in print on 02/15/2013, on page A1 of the NewYork edition with the headline: Confidence on Upswing, Mergers Make Comeback.
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Oscar Pistorius arrested in slaying of model Reeva Steenkamp




















Paralympian Oscar Pistorius charged with murder
































































South African police Thursday arrested double amputee Olympic runner Oscar Pistorius and said he would be charged with murder after his girlfriend, Reeva Steenkamp, was shot and killed at his home earlier in the morning.


Police spokesperson Brigadier Denise Beukes said that Pistorius was at his home after the death of the victim and that "there is no other suspect involved."


"There are witnesses and they have been interviewed this morning. We are talking about neighbors and people that heard things earlier in the evening and when the shooting took place," Beukes said.








Pistorius' court hearing was originally scheduled for Thursday afternoon but has been postponed until Friday to give forensic investigators time to carry out their work.


The athlete's father, Henke Pistorius, told South Africa's SABC radio news that he didn't know the facts. "If anyone makes a statement, it will have to be Oscar. He's sad at the moment."


Media in South Africa are reporting that Steenkamp was surprising Pistorius for Valentine's Day when he mistook her for a burglar and shot her. Steenkamp was shot in the arm and head and a 9-mm pistol was recovered at the scene.


"We have also taken cognizance of the media reports during the morning of an alleged break-in or that the young lady was mistaken to be a burglar," Beukes said. "Obviously our forensic investigation is still ongoing and we're not sure where this report came from.... Our detectives have been on the scene, our forensic investigators have been on the scene and the investigation is ongoing."

South African police said that there had been "previous incidents" of a domestic nature reported at Pistorius' home.

Pistorius, 26, was born without the fibula bone in both legs. He was known as the "Blade Runner" for his use of carbon fiber prosthetic blades. He was the first double amputee to run in the Olympics and reached the 400 meter semifinals in London 2012.


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