Mind Faded, Darrell Royal’s Wisdom and Humor Intact Till End

Three days before his death last week at 88, Darrell Royal told his wife, Edith: “We need to go back to Hollis” — in Oklahoma. “Uncle Otis died.”

“Oh, Darrell,” she said, “Uncle Otis didn’t die.”

Royal, a former University of Texas football coach, chuckled and said, “Well, Uncle Otis will be glad to hear that.”

The Royal humor never faded, even as he sank deeper into Alzheimer’s disease. The last three years, I came to understand this as well as anyone. We had known each other for more than 40 years. In the 1970s, Royal was a virile, driven, demanding man with a chip on his shoulder bigger than Bevo, the Longhorns mascot. He rarely raised his voice to players. “But we were scared to death of him,” the former quarterback Bill Bradley said.

Royal won 3 national championships and 167 games before retiring at 52. He was a giant in college football, having stood shoulder to shoulder with the Alabama coach Bear Bryant. Royal’s Longhorns defeated one of Bryant’s greatest teams, with Joe Namath at quarterback, in the 1965 Orange Bowl. Royal went 3-0-1 in games against Bryant.

Royal and I were reunited in the spring of 2010. I barely recognized him. The swagger was gone. His mind had faded. Often he stared aimlessly across the room. I scheduled an interview with him for my book “Courage Beyond the Game: The Freddie Steinmark Story.” Still, I worried that his withering mind could no longer conjure up images of Steinmark, the undersize safety who started 21 straight winning games for the Longhorns in the late 1960s. Steinmark later developed bone cancer that robbed him of his left leg.

When I met with Royal and his wife, I quickly learned that his long-term memory was as clear as a church bell. For two hours, Royal took me back to Steinmark’s recruiting trip to Austin in 1967, through the Big Shootout against Arkansas in 1969, to the moment President Richard M. Nixon handed him the national championship trophy in the cramped locker room in Fayetteville. He recalled the day at M. D. Anderson Hospital in Houston the next week when doctors informed Steinmark that his leg would be amputated if a biopsy revealed cancer. Royal never forgot the determined expression on Steinmark’s face, nor the bravery in his heart.

The next morning, Royal paced the crowded waiting room floor and said: “This just can’t be happening to a good kid like Freddie Steinmark. This just can’t be happening.”

With the love of his coach, Steinmark rose to meet the misfortune. Nineteen days after the amputation, he stood with crutches on the sideline at the Cotton Bowl for the Notre Dame game. After the Longhorns defeated the Fighting Irish, Royal tearfully presented the game ball to Steinmark.

Four decades later, while researching the Steinmark book, I became close to Royal again. As I was leaving his condominium the day of the interview, I said, “Coach, do you still remember me?” He smiled and said, “Now, Jim Dent, how could I ever forget you?” My sense of self-importance lasted about three seconds. Royal chuckled. He pointed across the room to the message board next to the front door that read, “Jim Dent appt. at 10 a.m.”

Edith and his assistant, Colleen Kieke, read parts of my book to him. One day, Royal told me, “It’s really a great book.” But I can’t be certain how much he knew of the story.

Like others, I was troubled to see Royal’s memory loss. He didn’t speak for long stretches. He smiled and posed for photographs. He seemed the happiest around his former players. He would call his longtime friend Tom Campbell, an all-Southwest Conference defensive back from the 1960s, and say, “What are you up to?” That always meant, “Let’s go drink a beer.”

As her husband’s memory wore thin, Edith did not hide him. Instead, she organized his 85th birthday party and invited all of his former players. Quarterback James Street, who engineered the famous 15-14 comeback against Arkansas in 1969, sat by Royal’s side and helped him remember faces and names. The players hugged their coach, then turned away to hide the tears.

In the spring of 2010, I was invited to the annual Mexican lunch for Royal attended by about 75 of his former players. A handful of them were designated to stand up and tell Royal what he meant to them. Royal smiled through each speech as his eyes twinkled. I was mesmerized by a story the former defensive tackle Jerrel Bolton told. He recalled that Royal had supported him after the murder of his wife some 30 year earlier.

“Coach, you told me it was like a big cut on my arm, that the scab would heal, but that the wound would always come back,” Bolton said. “It always did.”

Royal seemed to drink it all in. But everyone knew his mind would soon dim.

The last time I saw him was June 20 at the County Line, a barbecue restaurant next to Bull Creek in Austin. Because Royal hated wheelchairs and walkers, the former Longhorn Mike Campbell, Tom’s twin, and I helped him down the stairs by wrapping our arms around his waist and gripping the back of his belt. I ordered his lunch, fed him his sandwich and cleaned his face with a napkin. He looked at me and said, “Was I a college player in the 1960s?”

“No, Coach,” I said. “But you were a great player for the Oklahoma Sooners in the late 1940s. You quarterbacked Oklahoma to an 11-0 record and the Sooners’ first national championship in 1949.”

He smiled and said, “Well, I’ll be doggone.”

After lunch, Mike Campbell and I carried him up the stairs. We sat him on a bench outside as Tom Campbell fetched the car. In that moment, the lunch crowd began to spill out of the restaurant. About 20 customers recognized Royal. They took his photograph with camera phones. Royal smiled and welcomed the hugs.

“He didn’t remember a thing about it,” Tom Campbell said later. “But it did his heart a whole lot of good.”

Jim Dent is the author of “The Junction Boys” and eight other books.

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Mind Faded, Darrell Royal’s Wisdom and Humor Intact Till End

Three days before his death last week at 88, Darrell Royal told his wife, Edith: “We need to go back to Hollis” — in Oklahoma. “Uncle Otis died.”

“Oh, Darrell,” she said, “Uncle Otis didn’t die.”

Royal, a former University of Texas football coach, chuckled and said, “Well, Uncle Otis will be glad to hear that.”

The Royal humor never faded, even as he sank deeper into Alzheimer’s disease. The last three years, I came to understand this as well as anyone. We had known each other for more than 40 years. In the 1970s, Royal was a virile, driven, demanding man with a chip on his shoulder bigger than Bevo, the Longhorns mascot. He rarely raised his voice to players. “But we were scared to death of him,” the former quarterback Bill Bradley said.

Royal won 3 national championships and 167 games before retiring at 52. He was a giant in college football, having stood shoulder to shoulder with the Alabama coach Bear Bryant. Royal’s Longhorns defeated one of Bryant’s greatest teams, with Joe Namath at quarterback, in the 1965 Orange Bowl. Royal went 3-0-1 in games against Bryant.

Royal and I were reunited in the spring of 2010. I barely recognized him. The swagger was gone. His mind had faded. Often he stared aimlessly across the room. I scheduled an interview with him for my book “Courage Beyond the Game: The Freddie Steinmark Story.” Still, I worried that his withering mind could no longer conjure up images of Steinmark, the undersize safety who started 21 straight winning games for the Longhorns in the late 1960s. Steinmark later developed bone cancer that robbed him of his left leg.

When I met with Royal and his wife, I quickly learned that his long-term memory was as clear as a church bell. For two hours, Royal took me back to Steinmark’s recruiting trip to Austin in 1967, through the Big Shootout against Arkansas in 1969, to the moment President Richard M. Nixon handed him the national championship trophy in the cramped locker room in Fayetteville. He recalled the day at M. D. Anderson Hospital in Houston the next week when doctors informed Steinmark that his leg would be amputated if a biopsy revealed cancer. Royal never forgot the determined expression on Steinmark’s face, nor the bravery in his heart.

The next morning, Royal paced the crowded waiting room floor and said: “This just can’t be happening to a good kid like Freddie Steinmark. This just can’t be happening.”

With the love of his coach, Steinmark rose to meet the misfortune. Nineteen days after the amputation, he stood with crutches on the sideline at the Cotton Bowl for the Notre Dame game. After the Longhorns defeated the Fighting Irish, Royal tearfully presented the game ball to Steinmark.

Four decades later, while researching the Steinmark book, I became close to Royal again. As I was leaving his condominium the day of the interview, I said, “Coach, do you still remember me?” He smiled and said, “Now, Jim Dent, how could I ever forget you?” My sense of self-importance lasted about three seconds. Royal chuckled. He pointed across the room to the message board next to the front door that read, “Jim Dent appt. at 10 a.m.”

Edith and his assistant, Colleen Kieke, read parts of my book to him. One day, Royal told me, “It’s really a great book.” But I can’t be certain how much he knew of the story.

Like others, I was troubled to see Royal’s memory loss. He didn’t speak for long stretches. He smiled and posed for photographs. He seemed the happiest around his former players. He would call his longtime friend Tom Campbell, an all-Southwest Conference defensive back from the 1960s, and say, “What are you up to?” That always meant, “Let’s go drink a beer.”

As her husband’s memory wore thin, Edith did not hide him. Instead, she organized his 85th birthday party and invited all of his former players. Quarterback James Street, who engineered the famous 15-14 comeback against Arkansas in 1969, sat by Royal’s side and helped him remember faces and names. The players hugged their coach, then turned away to hide the tears.

In the spring of 2010, I was invited to the annual Mexican lunch for Royal attended by about 75 of his former players. A handful of them were designated to stand up and tell Royal what he meant to them. Royal smiled through each speech as his eyes twinkled. I was mesmerized by a story the former defensive tackle Jerrel Bolton told. He recalled that Royal had supported him after the murder of his wife some 30 year earlier.

“Coach, you told me it was like a big cut on my arm, that the scab would heal, but that the wound would always come back,” Bolton said. “It always did.”

Royal seemed to drink it all in. But everyone knew his mind would soon dim.

The last time I saw him was June 20 at the County Line, a barbecue restaurant next to Bull Creek in Austin. Because Royal hated wheelchairs and walkers, the former Longhorn Mike Campbell, Tom’s twin, and I helped him down the stairs by wrapping our arms around his waist and gripping the back of his belt. I ordered his lunch, fed him his sandwich and cleaned his face with a napkin. He looked at me and said, “Was I a college player in the 1960s?”

“No, Coach,” I said. “But you were a great player for the Oklahoma Sooners in the late 1940s. You quarterbacked Oklahoma to an 11-0 record and the Sooners’ first national championship in 1949.”

He smiled and said, “Well, I’ll be doggone.”

After lunch, Mike Campbell and I carried him up the stairs. We sat him on a bench outside as Tom Campbell fetched the car. In that moment, the lunch crowd began to spill out of the restaurant. About 20 customers recognized Royal. They took his photograph with camera phones. Royal smiled and welcomed the hugs.

“He didn’t remember a thing about it,” Tom Campbell said later. “But it did his heart a whole lot of good.”

Jim Dent is the author of “The Junction Boys” and eight other books.

Read More..

Chinese Official Reaffirms ‘Rebalancing’ of Economy

BEIJING — A senior Chinese official reaffirmed on Saturday a national goal of shifting China’s economy away from its dependence on investment and exports and toward a more sustainable emphasis on consumption spending.

In doing so, the official, Zhang Ping, the chairman of the National Development and Reform Commission, glossed over recent data that suggested the reverse might be happening.

Mr. Zhang, whose agency oversees economic planning and coordinates the country’s economic ministries, said in a news conference held in conjunction with the 18th Party Congress that the Chinese economy was growing again, crediting government policies aimed at moving China away from its reliance on capturing an ever greater share of overseas markets for its exports. He also claimed success in easing the economy’s dependence on enormous investment, which has become less efficient and less productive as many industries struggle with overcapacity.

“Starting from August, the turn toward a slower economy has been effectively curbed,” Mr. Zhang said. “From the October economic data, we can see that the trend toward a rebalancing of the Chinese economy is all the more obvious.”

But independent economists question whether any such conclusion is justified. China’s General Administration of Customs announced on Saturday morning that the country’s trade surplus in October had soared to $32 billion, the highest level in nearly four years. Exports surged 11.6 percent from a year earlier, while imports rose 2.4 percent.

Chinese officials are acutely conscious of the frictions that their trade surpluses create with importer nations like the United States, and have argued for many years that the surpluses are temporary and should not be an issue because they might soon disappear. President Obama and Mitt Romney, the Republican nominee, vied during the presidential election campaign over who could be tougher in trade and currency disputes with China over the next four years.

Commerce Minister Chen Deming tried again on Saturday to allay foreign concerns about rising Chinese exports, describing the surge as unlikely to last. He said exports would probably not remain strong because of economic troubles in overseas markets and because of what Mr. Chen described as an international rise in protectionism.

“The trade situation will be relatively grim in the next few months,” he said, “and there will be many difficulties next year.”

Investment has also surged rapidly this autumn, government statistics released on Friday showed, as state-owned banks have lent heavily to state-owned enterprises.

A series of news conferences on economic policy — a third was held on Saturday evening on efforts to encourage industrial innovation — came as the 2,268 delegates to the Party Congress attended closed-door meetings on the third day of the gathering, which is held every five years. The Congress is scheduled to choose a new Central Committee of the Chinese Communist Party this coming week, and that committee will approve a list of leaders who are expected to run the country for the next decade.

Mr. Zhang said in his news conference that the economy was becoming less reliant on exports and investment spending. He omitted October in citing data from 2012’s first nine months that he described as showing that consumption had been playing a bigger role than investment in economic growth. He also said exports had been a drag on growth.

But investment, which had slumped early this year as the government limited bank lending and restricted real estate sales to pop a housing bubble, has been bouncing back as the restrictions have been eased. Exports were also very weak early this year because of Europe’s difficulties, but are strengthening as American demand rebounds.

Wang Tao, a China economist at UBS in Hong Kong, said short-term changes in various sectors of the economy made it hard to draw any reliable conclusions about whether policy makers had been able to shift the foundations of the Chinese economy onto a firmer and more sustainable footing.

But she expressed skepticism that any fundamental shift had taken place so far, saying: “These are cyclical moves. Rebalancing happens very slowly.”

At the news conference on innovation, corporate executives expressed concern about China’s ability to create its own inventions. But Liang Wengen, the president of Sany Heavy Industry, a big construction equipment manufacturer, answered a last question on American investment policies.

Mr. Liang is widely viewed as a well-connected industrialist with the best chance of becoming the first business tycoon to join the Central Committee, possibly this coming week. He bitterly criticized the Obama administration on Saturday evening for its decision not to allow an American company owned by Sany executives to install Sany-made wind turbines in or near restricted airspace next to a United States Navy site where drones are developed.

Mr. Liang promised a long legal battle against the decision, saying: “We will fight to the end. We hope we will achieve final victory, because we believe in the justice of U.S. law, the courage of the American people and the justice of the world.”

Patrick Zuo contributed research.

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Bits Blog: On Twitter, Steve Jobs Is Immortal

Steve Jobs is gone, but on Twitter his @name lives on. And on.

The chief executive of Apple, who died in 2011, is memorialized on Twitter by about a thousand fans, parodists, traffic seekers, unrepentant haters and crypto-historians, among others. The accounts use his name as either as a title or, with many variations, as an address.

The copycats include @FakeSteveJobs, @FauxSteve and @SteveJobsFalso, a collection of admitted imposters who are following in the footsteps of a parody Web site that was active from 2006 to 2011. Other versions include @RememberSteve, @PulseonJobs and @RealSteveJobs. There are a couple of @BlackSteveJobs, plus Twitter accounts by various articles of clothing and body parts.

Several of the accounts are operated by start-ups hoping to generate attention for themselves. Their tweets contain links to corporate Web pages. Some of the accounts are in languages like Arabic, Thai or Japanese. Many others use Mr. Jobs’s name for the account but have a different address.

Searching the name “Steve Jobs” on Twitter yields about 1,080 accounts, some of which are unrelated to the Apple co-founder; there are people on Twitter who are really named Steve Jobs.

Twitter does not keep score of how many of its 140 million accounts are fakes, but it generally supports the idea of parody accounts. “It’s very helpful for political dissidents, who can’t write under their own name,” said Rachael Horwitz, a company spokeswoman. She also noted that Dick Costolo, Twitter’s chief executive, has a parody account. Jack Dorsey, the chairman of the company’s board, is likewise roasted.

Possibly for his close identification with technology, Mr. Jobs does appear to be the most popular identity on Twitter to leverage. President Obama has about 600 versions of his name, either through the “@” address, or in the name of the account. Given much of the venom of the recent election, several of these accounts are remarkably ugly, certainly worse than the treatment afforded Mr. Jobs. Michelle Obama, who like the president has an official and verified Twitter account, has about 500 copycats.

Bill Gates, Mr. Jobs’s longtime nemesis and eventual frenemey, does better than the president and first lady, with about 840 imitators and parodists. There is also a Klingon version of him, which to date Mr. Jobs’s name does not appear to share. There also appear to be a lot more people on Twitter who are simply named “Bill Gates,” a characteristic that must fill their lives with a lot of predictable humor.

Justin Beiber gets a mere 240 people hoping for a bit of his lustre. John Lennon, Mr. Jobs’ idol, has fewer than 100.

Twitter will take down parody accounts, but usually when it is not clear that they are parodies. That is not a problem in the case of most public figures. “It’s a form of speech,” Ms. Horwitz said. On the Internet, everyone needs a thicker skin. The situation does come up enough that the company has published formal policies on acceptable parody and fan accounts , along with impersonation.

There are parody accounts for Oracle’s chief executive, Larry Ellison; for Larry Page, the chief executive and co-founder of Google; and for Mark Zuckerberg, the chief of Facebook. With so many parody accounts around, some technology chief executives may worry if they are not being parodied.

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The New Old Age Blog: The Emotional Aftermath of Hurricane Sandy

Let’s talk about the emotional aftermath of the storm that left tens of thousands of older people on the East Coast without power, bunkered down in their homes, chilled to the bone and out of touch with the outside world.

Let’s name the feelings they may have experienced. Fear. Despair. Hopelessness. Anxiety. Panic.

Linda Leest and her staff at Services Now for Adult Persons in Queens heard this in the voices of the older people they had been calling every day, people who were homebound and at risk because of medical conditions that compromise their physical functioning.

“They’re afraid of being alone,” she said in a telephone interview a few days after the storm. “They’re worried that if anything happens to them, no one is going to know. They feel that they’ve lost their connection with the world.”

What do we know about how older adults fare, emotionally, in a disaster like that devastating storm, which destroyed homes and businesses and isolated older adults in darkened apartment buildings, walk-ups and houses?

Most do well — emotional resilience is an underappreciated characteristic of older age — but those who are dependent on others, with pre-existing physical and mental disabilities, are especially vulnerable.

Most will recover from the disorienting sense that their world has been turned upside down within a few weeks or months. But some will be thrown into a tailspin and will require professional help. The sooner that help is received, the more likely it is to prevent a significant deterioration in their health.

The best overview comes from a November 2008 position paper from the American Association for Geriatric Psychiatry that reviewed the effects of Hurricane Katrina and other disasters. After Katrina, “the elderly had the highest mortality rates, health decline and suicide rates of any subgroup,” that document notes. “High rates of psychosomatic problems were seen, with worsening health problems and increased mortality and disability.”

This is an important point: Emotional trauma in older adults often is hard to detect, and looks different from what occurs in younger people. Instead of acknowledging anxiety or depression, for instance, older people may complain of having a headache, a bad stomachache or some other physical ailment.

“This age group doesn’t generally feel comfortable talking about their feelings; likely, they’ll mask those emotions or minimize what they’re experiencing,” said Dr. Mark Nathanson, a geriatric psychiatrist at Columbia University Medical Center.

Signs that caregivers should watch out for include greater-than-usual confusion in an older relative, a decline in overall functioning and a disregard for “self care such as bathing, eating, dressing properly and taking medication,” Dr. Nathanson said.

As an example, he mentioned an older man who had “been sitting in a cold house for days and decided to stop taking his water pill because he felt it was just too much trouble.” Being distraught or distracted and forgetting or neglecting to take pills for chronic conditions like diabetes or heart disease can have immediate harmful effects.

Especially at risk of emotional disturbances are older adults who are frail and advanced in age, those who have cognitive impairments like Alzheimer’s disease, those with serious mental illnesses like schizophrenia or major depression, and those with chronic medical conditions or otherwise in poor physical health, according to the geriatric psychiatry association’s position paper.

A common thread in all of the above is the depletion of physical and emotional reserves, which impairs an older person’s ability to adapt to adverse circumstances.

“In geriatrics, we have this idea of the ‘geriatric cascade’ that refers to how a seemingly minor thing can set in motion a functional, cognitive and psychological downward spiral” in vulnerable older adults, said Dr. Mark Lachs, chief of the division of geriatrics at Weill Cornell Medical College. “Well, the storm was a major thing — a very large disequilibrating event — and its impact is an enormous concern.”

Of special concern are older people who may be in the early stages of Alzheimer’s disease or other types of dementia who are living alone. For this group, the maintenance of ordinary routines and the sense of a dependable structure in their lives is particularly important, and “a situation like Sandy, which causes so much disruption, can be a tipping point,” Dr. Lachs said.

Also of concern are older people who may have experienced trauma in the past, and who may suffer a reignition of post-traumatic stress symptoms because of the disaster.

Most painful of all, for many older adults, is the sense of profound isolation that can descend on those without working phones, electricity or relatives who can come by to help.

“That isolation, I can’t tell you how disorienting that can be,” said Bobbie Sackman, director of public policy for the Council of Senior Centers and Services of New York City. “They’re scared, but they won’t tell you because they’re too proud and ashamed to ask for help.”

The best remedy, in the short run, is the human touch.

“Now is the time for people to reach out to their neighbors in high-rises or in areas where seniors are clustered, to knock on doors and ask people how they are doing,” said Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in the Bronx.

Don’t make it a one-time thing; let the older person know you’ll call or come by again, and set up a specific time so “there’s something for them to look forward to,” Dr. Kennedy said. So-called naturally occurring retirement communities with large concentrations of older people should be organizing from within to contact residents who may not be connected with social services and find out how they’re doing, he recommended.

In conversations with older adults, offer reassurance and ask open-ended questions like “Are you low on pills?” or “Can I run out and get you something?” rather than trying to get them to open up, experts recommended. Focusing on problem-solving can make people feel that their lives are being put back in order and provide comfort.

Although short-term psychotherapy has positive outcomes for older adults who’ve undergone a disaster, it’s often hard to convince a senior to seek out mental health services because of the perceived stigma associated with psychological conditions. Don’t let that deter you: Keep trying to connect them with services that can be of help.

Be mindful of worrisome signs like unusual listlessness, apathy, unresponsiveness, agitation or confusion. These may signal that an older adult has developed delirium, which can be extremely dangerous if not addressed quickly, Dr. Nathanson said. If you suspect that’s the case, call 911 or make sure you take the person to the nearest hospital emergency room.

This is a safe place to talk about all kinds of issues affecting older adults. Would you be willing to share what kinds of mental health issues you or family members are dealing with since the storm so readers can learn from one another?

Read More..

The New Old Age Blog: The Emotional Aftermath of Hurricane Sandy

Let’s talk about the emotional aftermath of the storm that left tens of thousands of older people on the East Coast without power, bunkered down in their homes, chilled to the bone and out of touch with the outside world.

Let’s name the feelings they may have experienced. Fear. Despair. Hopelessness. Anxiety. Panic.

Linda Leest and her staff at Services Now for Adult Persons in Queens heard this in the voices of the older people they had been calling every day, people who were homebound and at risk because of medical conditions that compromise their physical functioning.

“They’re afraid of being alone,” she said in a telephone interview a few days after the storm. “They’re worried that if anything happens to them, no one is going to know. They feel that they’ve lost their connection with the world.”

What do we know about how older adults fare, emotionally, in a disaster like that devastating storm, which destroyed homes and businesses and isolated older adults in darkened apartment buildings, walk-ups and houses?

Most do well — emotional resilience is an underappreciated characteristic of older age — but those who are dependent on others, with pre-existing physical and mental disabilities, are especially vulnerable.

Most will recover from the disorienting sense that their world has been turned upside down within a few weeks or months. But some will be thrown into a tailspin and will require professional help. The sooner that help is received, the more likely it is to prevent a significant deterioration in their health.

The best overview comes from a November 2008 position paper from the American Association for Geriatric Psychiatry that reviewed the effects of Hurricane Katrina and other disasters. After Katrina, “the elderly had the highest mortality rates, health decline and suicide rates of any subgroup,” that document notes. “High rates of psychosomatic problems were seen, with worsening health problems and increased mortality and disability.”

This is an important point: Emotional trauma in older adults often is hard to detect, and looks different from what occurs in younger people. Instead of acknowledging anxiety or depression, for instance, older people may complain of having a headache, a bad stomachache or some other physical ailment.

“This age group doesn’t generally feel comfortable talking about their feelings; likely, they’ll mask those emotions or minimize what they’re experiencing,” said Dr. Mark Nathanson, a geriatric psychiatrist at Columbia University Medical Center.

Signs that caregivers should watch out for include greater-than-usual confusion in an older relative, a decline in overall functioning and a disregard for “self care such as bathing, eating, dressing properly and taking medication,” Dr. Nathanson said.

As an example, he mentioned an older man who had “been sitting in a cold house for days and decided to stop taking his water pill because he felt it was just too much trouble.” Being distraught or distracted and forgetting or neglecting to take pills for chronic conditions like diabetes or heart disease can have immediate harmful effects.

Especially at risk of emotional disturbances are older adults who are frail and advanced in age, those who have cognitive impairments like Alzheimer’s disease, those with serious mental illnesses like schizophrenia or major depression, and those with chronic medical conditions or otherwise in poor physical health, according to the geriatric psychiatry association’s position paper.

A common thread in all of the above is the depletion of physical and emotional reserves, which impairs an older person’s ability to adapt to adverse circumstances.

“In geriatrics, we have this idea of the ‘geriatric cascade’ that refers to how a seemingly minor thing can set in motion a functional, cognitive and psychological downward spiral” in vulnerable older adults, said Dr. Mark Lachs, chief of the division of geriatrics at Weill Cornell Medical College. “Well, the storm was a major thing — a very large disequilibrating event — and its impact is an enormous concern.”

Of special concern are older people who may be in the early stages of Alzheimer’s disease or other types of dementia who are living alone. For this group, the maintenance of ordinary routines and the sense of a dependable structure in their lives is particularly important, and “a situation like Sandy, which causes so much disruption, can be a tipping point,” Dr. Lachs said.

Also of concern are older people who may have experienced trauma in the past, and who may suffer a reignition of post-traumatic stress symptoms because of the disaster.

Most painful of all, for many older adults, is the sense of profound isolation that can descend on those without working phones, electricity or relatives who can come by to help.

“That isolation, I can’t tell you how disorienting that can be,” said Bobbie Sackman, director of public policy for the Council of Senior Centers and Services of New York City. “They’re scared, but they won’t tell you because they’re too proud and ashamed to ask for help.”

The best remedy, in the short run, is the human touch.

“Now is the time for people to reach out to their neighbors in high-rises or in areas where seniors are clustered, to knock on doors and ask people how they are doing,” said Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in the Bronx.

Don’t make it a one-time thing; let the older person know you’ll call or come by again, and set up a specific time so “there’s something for them to look forward to,” Dr. Kennedy said. So-called naturally occurring retirement communities with large concentrations of older people should be organizing from within to contact residents who may not be connected with social services and find out how they’re doing, he recommended.

In conversations with older adults, offer reassurance and ask open-ended questions like “Are you low on pills?” or “Can I run out and get you something?” rather than trying to get them to open up, experts recommended. Focusing on problem-solving can make people feel that their lives are being put back in order and provide comfort.

Although short-term psychotherapy has positive outcomes for older adults who’ve undergone a disaster, it’s often hard to convince a senior to seek out mental health services because of the perceived stigma associated with psychological conditions. Don’t let that deter you: Keep trying to connect them with services that can be of help.

Be mindful of worrisome signs like unusual listlessness, apathy, unresponsiveness, agitation or confusion. These may signal that an older adult has developed delirium, which can be extremely dangerous if not addressed quickly, Dr. Nathanson said. If you suspect that’s the case, call 911 or make sure you take the person to the nearest hospital emergency room.

This is a safe place to talk about all kinds of issues affecting older adults. Would you be willing to share what kinds of mental health issues you or family members are dealing with since the storm so readers can learn from one another?

Read More..

DealBook: In Unusual Move, the Delaware Supreme Court Rebukes a Judge

As the chief judge of the Delaware Court of Chancery — the country’s most influential court overseeing business cases — Leo E. Strine Jr. has been called an activist. He has also been called an iconoclast, a genius and a humorist.

But this week, Delaware’s highest court called him out of bounds.

The Delaware Supreme Court issued a stinging rebuke of Judge Strine on Wednesday, criticizing him for what it said was an improper digression in an opinion. Judge Strine’s decision related to a contractual dispute but went off on an 11-page tangent about an obscure issue related to limited liability companies.

“The court’s excursus on this issue strayed beyond the proper purview and function of a judicial opinion,” the Supreme Court wrote, adding, “We remind Delaware judges that the obligation to write judicial opinions on the issues presented is not a license to use those opinions as a platform from which to propagate their individual world views on issues not presented.”

Famous among lawyers for his colorful opinions and courtroom meanderings — which are frequently laced with cultural references, both high and low — Judge Strine has supporters and detractors in the securities class-action bar. The Delaware Court of Chancery exerts a powerful influence on United States business because many large companies are incorporated in Delaware and litigate cases there.

Several lawyers, none of whom would be quoted by name because they all practice before him, said it was only a matter of time before someone sought to rein him in. “I’m only surprised it took this long,” said a corporate litigator from New York who has argued cases in Judge Strine’s courtroom.

The Supreme Court advised Judge Strine that if he wished to “ruminate on what the proper direction of Delaware law should be, there are appropriate platforms, such as law review articles, the classroom, continuing legal education presentations and keynote speeches.”

Stephen Gillers, a professor of legal and judicial ethics at New York University School of Law, said that the court’s admonition was highly unusual.

“You rarely see this type of ruling because judges understand that a judicial opinion has a distinct and narrow function and is not supposed to be a platform for your public agenda or your broader views on the law,” he said.

Reached by e-mail, Judge Strine, whose official title is chancellor of the Delaware Court of Chancery, declined to comment.

The ruling came during a week when Judge Strine’s unique judicial stylings were on prominent display. During a hearing in a lawsuit between the fashion designer Tory Burch and her former husband, Christopher Burch, he described the dispute as a “drunken WASP fest.” At the center of the case is whether Mr. Burch, in starting his own retail stores, C. Wonder, borrowed too heavily from Ms. Burch’s successful chain.

During the hearing, Judge Strine addressed scheduling issues in the case, and said, “I didn’t see any reason to burden anyone’s Hanukkah, New Year’s, Christmas, Kwanzaa, Festivus with this preppy clothing dispute.”

He went on to consider why he gets assigned all the preppy clothing cases, noting that he had recently heard a dispute involving J. Crew. That led to a critique of a certain line of rain boots.

“What’s a duck shoe?” he asked. “You see all these freaks wearing this really ugly — I like L. L. Bean, but those duck shoes are ugly. I mean, there’s no way around it.”

He then said he was puzzled by his son’s recent purchase of a pair of Topsiders. “I’m like, what is this?” Judge Strine asked. “I mean, you know, how do you actually want to wear these things?”

As the hearing continued, Judge Strine suggested that there might be nothing unique about the clothing lines of Mr. Burch and Ms. Burch, who divorced in 2007. He stumped one of the lawyers in the case by quizzing him on Ralph Lauren’s original surname, which is Lifschitz.

After his lengthy sidebar on preppy attire, Judge Strine said he was deep in “an autumnal Cheever phase,” referring to the novelist and short story writer. He then encouraged the lawyers to read Cheever’s works, go see the Broadway revival of “Who’s Afraid of Virginia Woolf?” and watch “Mad Men.”

“We’ll be all geared up and in the mood for this sort of drunken WASP fest,” Judge Strine said, and then proceeded to ask about the litigants’ religion. “Are the Burches WASPs?” he asked.

Robert Isen, the chief legal officer at Tory Burch, hesitated before responding, “Tory Burch is Jewish and Chris is not Jewish.”

The answer did not entirely satisfy Judge Strine. “But not Jewish doesn’t make you a WASP, because it could make you an equally excluded faith like Catholic, right?” he asked. “I mean, that’s not a WASP. You know, a WASP is a WASP.”

Mr. Gillers of N.Y.U. Law said that discussing religion in such a manner was conduct unbecoming of a judge. Even if it is done lightheartedly, he said, it could compromise the public’s confidence in the impartiality and integrity of the judiciary.

“Asking about religion, in my mind, is way off base,” Mr. Gillers said. “It’s certainly not legally relevant, and a judge certainly wouldn’t do that with race or sexual orientation.”

Judge Strine began his career in the early 1990s as a lawyer in the Wilmington, Del., office of the law firm Skadden, Arps, Slate, Meagher & Flom. He then joined the staff of the Delaware governor Thomas R. Carper, who is now a senator. Judge Strine, who is 48, was named to the Court of Chancery at 34. Many of his opinions are considered among the most influential rulings in corporate law.

A lawyer based in Wilmington, Del., who described himself as a supporter of Judge Strine, said that behind this week’s Supreme Court ruling was a simmering tension between Myron Steele, the chief justice of the Delaware Supreme Court, and Judge Strine. That conflict appears to have its roots in a disagreement over an arcane subject: the default fiduciary duties of a limited liability company.

This lawyer said that he found Judge Strine’s rapier wit and off-topic asides to be a breath of fresh air in a judiciary that too often can be painfully dull.

“He’s a brilliant dude,” he said. “It’s just Leo being Leo.”

A version of this article appeared in print on 11/10/2012, on page B1 of the NewYork edition with the headline: In Unusual Move, the Delaware Supreme Court Rebukes a Judge.

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Citing Affair, Petraeus Resigns as C.I.A. Director

The sudden development came just days after President Obama won re-election to a second term. Mr. Petraeus, a highly decorated general who had led the wars in Iraq and Afghanistan, had been expected to remain in the president’s administration.

Instead, Mr. Petraeus said in the statement that the president accepted his resignation on Friday after he had informed him of his indiscretion a day earlier.

“After being married for over 37 years, I showed extremely poor judgment by engaging in an extramarital affair,” Mr. Petraeus wrote. “Such behavior is unacceptable, both as a husband and as the leader of an organization such as ours. This afternoon, the president graciously accepted my resignation.”

Mr. Obama released a statement praising Mr. Petraeus for his “extraordinary service” to the country and saying that Michael J. Morell, the deputy director of the C.I.A., would take over once again as acting director. He served in that position briefly after Leon E. Panetta left the agency last year.

“By any measure, through his lifetime of service, David Petraeus has made our country safer and stronger,” the president said. Without directly addressing the affair, Mr. Obama added: “Going forward, my thoughts and prayers are with Dave and Holly Petraeus, who has done so much to help military families through her own work. I wish them the very best at this difficult time.” Ms. Petraeus is the assistant director of the Office of Servicemember Affairs at the Consumer Financial Protection Bureau.

The development came as a shock to the national security establishment. In a statement, James R. Clapper, the director of national intelligence, called the decision “a loss” to the country.

“Dave’s decision to step down represents the loss of one of our nation’s most respected public servants.” Mr. Clapper wrote. “From his long, illustrious Army career to his leadership at the helm of C.I.A., Dave has redefined what it means to serve and sacrifice for one’s country.”

By acknowleding an extramarital affair, Mr. Petraeus, 60, was confronting a sensitive issue for a spy chief. Intelligence agencies are often concerned about the possibility that agents who engage in such behavior could be blackmailed for information.

In his statement, Mr. Petraeus did not provide any details about his behavior, saying that he asked the president to be allowed “for personal reasons” to resign.

Mr. Petraeus praised his colleagues at the C.I.A.’s headquarters in Langley, Va., calling them “truly exceptional in every regard” and thanking them for their service to the country. He made it clear that his departure was not how he had envisioned ending a storied career in the military and in intelligence.

“Teddy Roosevelt once observed that life’s greatest gift is the opportunity to work hard at work worth doing,” he said. “I will always treasure my opportunity to have done that with you, and I will always regret the circumstances that brought that work with you to an end.”

Over the last several years, Mr. Petraeus had become one of the most recognizable military officials, serving as the public face of the war effort in Congress and on television.

Under President George W. Bush, Mr. Petraeus was credited for helping to develop and put in place the “surge” in troops in Iraq that helped wind down the war in that country. Mr. Petraeus was moved to Afghanistan in 2010 after Mr. Obama fired General Stanley H. McChrystal over comments he made to a magazine reporter.

In Afghanistan, Mr. Petraeus led the push for a similar increase in troops ordered by Mr. Obama, but he was unable to replicate the success he had in the Iraq conflict.

Last year, Mr. Obama persuaded Mr. Petraeus to leave the Army after 37 years to lead the C.I.A., succeeding Mr. Panetta, who moved to the Defense Department.

This article has been revised to reflect the following correction:

Correction: November 9, 2012

An earlier version of this article incorrectly stated that David H. Petraeus was expected to remain in President Obama’s cabinet. The C.I.A. director is not a cabinet member in the Obama administration.

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Bits Blog: Google Is Blocked in China as Party Congress Begins

All Google services, including its search engine, Gmail and Maps, were inaccessible in China on Friday night and into Saturday, the company confirmed. The block comes as the 18th Communist Party Congress, the once-in-a-decade meeting to appoint new government leadership, gets under way.

Traffic to Google sites fell off Friday evening in China, according to Google’s Transparency Report, which provides information about traffic worldwide.

The company said it was not having any technical problems, but did not say whether it believed its sites had been blocked by the government or were the victims of hacking.

“We’ve checked and there’s nothing wrong on our end,” said Christine Chen, a Google spokeswoman.

Despite great fanfare, China’s Party Congress takes place under wraps. Reporters are not allowed in, and in the days preceding the event, the government has imposed restrictions ranging from replacing books in bookstores to banning balloons because they could carry messages of protest.

Internet speeds have also slowed, while Chinese citizens have been satirizing the meeting online.

The block on Google sites appears to be the latest in a long pattern of increasingly sophisticated Internet censorship by the Chinese government. It comes two weeks after China blocked Web access to The New York Times, following an article about its prime minister’s family wealth.

Google has had a particularly strained relationship with China. In 2010, the company said it had been the victim of serious hacking attacks coming from China. In response, it removed its Chinese language search engine from China and began redirecting traffic to the Hong Kong version of the search engine.

YouTube, Google’s video site, has been blocked in China since 2009. And Gmail has been partially blocked at various times, beginning around the time of the Arab Spring.

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Well: Can Foods Affect Colon Cancer Survival?

A new study suggests that what you eat may affect your chances of surviving colon cancer.

The research is among the first to look at the impact that specific nutrients have on the likelihood of disease recurrence in people with colon cancer, one of the leading causes of cancer death in the United States. It found that people treated for Stage 3 disease, in which tumor cells have spread to lymph nodes, had greatly increased chances of dying of it or experiencing a recurrence if their diets were heavy in carbohydrate-rich foods that cause spikes in blood sugar and insulin.

The patients who consumed the most carbohydrates and foods with high glycemic loads — a measure of the extent to which a serving of food will raise blood sugar — had an 80 percent greater chance of dying or having a recurrence during the roughly seven-year study period than those who had the lowest levels. Stage 3 colon cancer patients typically have a five-year survival rate of about 50 to 65 percent.

The study, however, was observational, meaning it could only highlight an association between carbohydrates and cancer outcomes without proving direct cause and effect. The researchers also obtained some of their data from food questionnaires that required patients to recall details about their diets, a method that can be unreliable.

Still, the researchers, who published their findings in The Journal of the National Cancer Institute, believe insulin may play a critical role in colon cancer recurrence. Chronically high insulin levels have been linked to cancer recurrence and mortality in previous research, and people with a history of Type 2 diabetes or elevated plasma C-peptide, a marker of long-term insulin production, have also been found to have an increased risk of colon cancer. One hypothesis is that insulin may fuel the growth of cancer cells and prevent cell death, or apoptosis, in cancer cells that have spread.

“It’s not simply that all carbs are bad or that you should avoid all sugar,” said Dr. Jeffrey A. Meyerhardt, the lead author of the study and an associate professor of medicine at the Dana-Farber Cancer Institute in Boston. It’s not as simple as ‘sugar causes cancer to grow.’”

He added: “Different carbs and sugar lead to different responses in your body. I think people should focus on a well-balanced diet” and substitute foods associated with lower glycemic loads or carbs for foods that have higher levels.

Earlier research published by Dr. Meyerhardt’s group showed that Stage 3 colon cancer patients who most closely followed a Western-style diet — with high intakes of meat, fat, refined grains and sugary desserts — had a threefold increase in recurrence and death from the disease compared with those who most strongly deviated from Western patterns of eating.

For this study, Dr. Meyerhardt and his team wanted to see to what extent carbohydrate intake could influence the progression of the disease, so they followed about 1,000 Stage 3 colon cancer patients taking part in a clinical trial sponsored by the National Cancer Institute. The patients, who had all had surgery and chemotherapy as part of their treatments, provided information on their diets and lifestyle habits. But the researchers went beyond just carbohydrate and sugar intake, taking into account glycemic measures.

The glycemic index, an increasingly popular nutritional measure, looks at the rate at which carbohydrate-containing foods raise a person’s fasting level of blood sugar and subsequent need for insulin. Sugary drinks, white bread and other highly processed carbohydrates rank higher on the index, while those that are digested more slowly, like brown rice, many vegetables, unrefined grains and legumes, have a lower index value.

Another barometer, however, is the glycemic load, which refers to the blood sugar effect of a standard serving of a food. A glycemic load of 10 or less for a food is generally considered low, while 20 or more is high. The latest study showed that glycemic load and total carbohydrate intake were the best predictors of cancer recurrence and mortality, and the link was strongest in people who were overweight or obese.

Dr. Meyerhardt said the findings suggest that colon cancer patients would be wise to keep glycemic load in mind while making food decisions, looking for ways to work into their diets foods that rank lower on the scale.

“So if you think about beverages, most juices and certainly sodas have a higher glycemic load than flavored waters and tomato juice and things like that,” he said. “Fruits like a date or raisins have very high glycemic loads, whereas fresh fruits like an apple, orange or cantaloupe all have sugar but have a very low glycemic load. Substitute brown rice for white, whole grains instead of white bread, and instead of having a starchy potato as your side dish, substitute beans and vegetables.”

One expert who was not involved in the research, Somdat Mahabir, a nutritional epidemiologist with the National Cancer Institute’s division of cancer control and population sciences, said the findings from the latest study must be borne out in further research. But in the meantime, making dietary changes that reduce glycemic load is a reasonable recommendation for colon cancer patients, he said, since it can only be helpful, not harmful.

“The results of the current study need to be confirmed, but the current indications are that diet is important to colon cancer survival,” Dr. Mahabir said.

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