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For half a century until 1970, America's incarceration rate held steady and was in line with the norm for other advanced countries. Beginning in the early 1970s, our incarceration rate soared fivefold, peaking about a decade ago before dropping somewhat. The United States had fewer than 200,000 people in federal or state prison in 1970; now it has 1.4 million, not even counting those in local jails. Democrats and Republicans alike embraced tougher prison sentences, although Republican politicians often appeared particularly enthusiastic. Among the intellectual authors of this policy was Attorney General William Barr in his previous stint in that office, under the first President George Bush; at that time, Barr issued a report entitled "The Case for More Incarceration." The upshot is that one in seven Americans in prison today is serving a life sentence, nearly half of them people of color. Total spending on them while incarcerated is about $1 million per person.

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The United States now accounts for almost one-quarter of the world's incarcerated people. Its national incarceration rate is six times that of Canada or France, twelve times that of Sweden. In the United States, 70 percent of criminal sanctions involve incarceration; in Germany, it's 6 percent. In Germany, the sanction is more likely to be a fine, community service or obligatory job training. There is an emphasis on supervised work that helps the criminal compensate the victim.

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Policing in America is harsher than in other democracies. In Grand Rapids, Michigan, police officers pointed a gun at and handcuffed a shrieking eleven-year-old girl who wasn't suspected of any offense but happened to be at a home being searched. Video of that encounter left even the police chief shaken. "You listen to the eleven-year-old's response, it makes my stomach turn," said the chief, David Rahinsky. "It makes me physically nauseous." At about the same time in Eustis, Florida, police arrested a ninety-three-year-old woman accused of trespassing because the old age home in which she had been living for six years said she was behind in rent.

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American incarceration often involves private for-profit prisons, an idea other countries find unthinkable because it gives corporations substantial control over individuals. Texas was the first state to introduce for-profit prisons, in 1985, and now about half the states have them.

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At the federal level, a scathing Justice Department report found that private prisons had glaring security lapses, and President Obama began phasing out their use at the federal level. President Trump reversed that and expanded the use of for-profit prisons to house people in immigration custody.

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For-profit prisons save money by cutting costs, even if it means reduced security that endangers both inmates and corrections officers. A Mississippi private prison had an assault rate at least double that of similar public facilities, while in Florida a juvenile detention center was accused of physical and sexual abuse, including forcing youths to fight one another like gladiators. "It's the Lord of the Flies," one investigator said. In Michigan, a private contractor was accused of serving inmates rotten food with rat-bite marks on cakes camouflaged by frosting. Just as alarming, private prisons lobby for harsher sentences to increase their occupancy rates and improve their profitability. The two largest for-profit prison companies have devoted $25 million to lobbying.

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In Pennsylvania, the corruption was explicit: the owner of private juvenile detention centers paid hundreds of thousands of dollars in bribes to two judges who then found youths guilty and sentenced them to his centers. This "kids for cash" arrangement led to children being unjustly detained, including one boy, Edward Kenzakoski, who had no previous record but was held for months for supposedly possessing drug paraphernalia. That started Edward on a downward slide, and he later committed suicide.

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"Do you remember my son?" Edward's mom, Sandy Fonzo, screamed at one of the judges, Mark Ciavarella, who had put her son in detention, after the judge was convicted. "He's gone. He shot himself in the heart, you scumbag."

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America should remember Dostoyevsky's observation: "The degree of civilization in a society can be judged by entering its prisons." The United States needs not just more humane prisons and shorter sentences, but also, as we've made clear, more interventions to help at-risk children before they end up facing judges. If social workers had reached Ian Manuel when he was a young boy, and if there had been some afterschool program for him other than the streets, he might not have found himself pulling a gun on Debbie Baigrie. We know that when children are randomly assigned to home visitation programs like Nurse-Family Partnership or to good preschool initiatives, they are less likely to have trouble with the law years later. Likewise, school programs like Citizen Schools, Becoming a Man or Communities in Schools, and gang outreach initiatives like Cure Violence, seem to reduce crime rates. Yet these programs are starved of funds: home visitation reaches less than 2 percent of the households that would benefit from it.

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Also inspiring are some of the efforts to help prisoners readjust to society, programs like Women in Recovery, which was successful in turning Rebecca Hale's life around. Recidivism rates are high partly because we don't do enough to support people as they emerge from prison. There are already some signs of a shift, though. We see agreement among many on both left and right that mass incarceration has gone too far, and red states such as Texas have been leaders in reducing the number of prisoners. Overall incarceration rates in America have finally started coming down, and politicians and experts alike are talking about reforming the bail system-which has fueled the sharp rise of people in jails around the country and imposed enormous burdens on the poor. After Harvey Weinstein was arrested for sexual assault following accusations by more than eighty women, he was freed on bail. In contrast, a young adult caught smoking marijuana may be unable to afford bail and thus be stuck indefinitely in jail, losing his job and, unable to make payments, perhaps his home and car as well.

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There's belatedly a broader rethinking under way of the harshness of the "justice" system. Leann Bertsch, the head of the North Dakota prison system, visited a prison in Norway and was startled by how humane it was. The mission of prisons in Norway is to prepare inmates for reintegration into society, so facilities are well-kept and inmates are usually housed in prisons near family, for officials discovered that frequent family visits reduce the likelihood of recidivism. The maximum sentence for most crimes is twenty-one years. After the prison visit, Bertsch retreated to her Radisson Hotel room and wept at the misery she oversaw in America's penal system. "We're hurting people," she realized. Bertsch, who is also past president of the Association of State Correctional Administrators, told Mother Jones. "I had always thought that we run a good system. We're decent. We don't abuse people. We run safe facilities with good programs." But after seeing Norway's prisons, she wondered, "How did we think it was okay to put human beings in cagelike settings?"

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Conservative Republicans like Governor Phil Bryant of Mississippi have introduced reforms that shorten sentences, and Bryant told us that the political climate has changed so that voters like this stance and appreciate the money saved. Mark Holden, a senior vice president of Koch Industries, agrees with us on almost nothing but told us that he believes the justice system is such a mess that "it needs to be blown up" - here he smiled - "in a nonviolent way."

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Nicholas Kristoff "Tightrope: Americans Reaching for Hope" (2020)

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In their book, The Stigma of Genius, the biographers Joe L. Kincheloe, Shirley R. Steinberg, and Deborah J. Tippins puzzled over the dichotomy between Einstein's public charm and charisma and his private life as a loner. He was an aloof observer of people and a solitary child. In The Private Lives of Albert Einstein, Roger Highfield and Paul Garter wrote, "Einstein described his dedication to science as an attempt to escape the merely personal by fixing his gaze on the objective universe. The desire to locate a reality free of human uncertainties was fundamental to his most important work" (referring to the theory of relativity). I can relate to this. On weekends I write and draw by myself, and during the week I give talks and act very social. Yet there is something missing in my social life. I can act social, but it is like being in a play. Several parents have told me that their autistic child has done a great job in the school play, acting like somebody else. As soon as the play is over, he or she reverts to being solitary

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Like Einstein, I am motivated by the search for intellectual truth. For me, searching for the meaning of life has always been an intellectual activity driven by anxiety and fear. Deep emotional relationships are secondary. I am happiest when I see tangible results, such as giving a mother information on the latest educational programs that will enable her autistic child to achieve in school. I value positive, measurable results more than emotion. My concept of what constitutes a good person is based on what I do rather than what I feel.

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Einstein had many traits of an adult with mild autism, or Asperger's syndrome. Kincheloe and his colleagues reported that Einstein's lectures were scattered and sometimes incomprehensible. Students would often be confused because they could not see associations between some of the specific examples he gave and general principles. The association was obvious to Einstein's visual mind but not to his verbal-thinking students. Students reported that Einstein would lose his train of though: while writing a theorem on the blackboard. A few minutes later he would emerge from a trance and write a new hypothesis. The tendency for scattered thought is due to associative thinking.

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Einstein also did poorly in school until he was sent to one that allowed him to use his visualization skills. He told his psychologist friend Max Wertheimer, "Thoughts did not come in any verbal formulation. I rarely think in words at all, thought comes, and I try to express it in words afterwards." When he developed the theory of relativity, he imagined himself on a beam of light. His visual images were vaguer than mine, and he could decode them into mathematical formulas. My visual images are extremely vivid, but I am unable to make the connection with mathematical symbols. Einstein's calculation abilities were not phenomenal. He often made mistakes and was slow, but his genius lay in being able to connect visual and mathematical thinking.

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Einstein's dress and hair were typical of an adult with autistic tendencies, most of whom have little regard for social niceties and rank. When he worked at the Swiss patent office, he sometimes wore green slippers with flowers on them. He refused to wear suits and ties in the days when professors dressed for teaching. I wouldn't be surprised if his dislike for dress clothes was sensory. The clothes he preferred were all soft, comfortable clothes such as sweatshirts and leather jackets. Nor did Einstein's hair meet the norm for men's hair fashions. Long, wild hair that was not cut was definitely not the style. He just did not care.

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It has been suggested by Oliver Sacks that the philosopher Ludwig Wittgenstein was probably a high-functioning person with autism. He did not talk until he was four years old, and he was considered a dullard with no talent. It is likely that his family history included depression, because both of his brothers committed suicide. He had great mechanical ability, and at age ten he constructed a sewing machine. Young Wittgenstein was a poor student, and he never wore a tie or hat. He used formal pedantic language and used the polite form of "sie" in German to address his fellow students, which alienated them and caused them to tease him. Overly formal speech is common in high-functioning autistics.

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Vincent van Gogh's artwork reveals great emotion and brilliance, but as a child and a young man he had some autistic traits. Like Einstein and Wittgenstein, van Gogh showed no outstanding abilities. Biographers describe him as an aloof, odd child. He threw many tantrums and liked to go in the fields alone. He did not discover his artistic talents until he was twenty-seven years old. Prior to establishing a career in art, he had many of the characteristics of an adult with Asperger's syndrome. He was ill groomed and blunt. In his book Great Abnormals, Vernon W Grant describes his voice and mannerisms, which also resemble those of an adult with autistic tendencies: "He talked with tension and a nervous rasp in his voice. He talked with complete self-absorption and little thought for the comfort or interest in his listeners." Van Gogh wanted to have a meaningful existence, and this was one of his motivations for studying art. His early paintings were of working people, to whom he related. According to Grant, van Gogh was forever a child and had a very limited ability to respond to the needs and feelings of others. He could love mankind in the abstract, but when forced to deal with a real person, he was "too self-enclosed to be tolerant."

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Van Gogh's art became bright and brilliant after he was admitted to an asylum. The onset of epilepsy may explain his switch from dull to extremely bright colors. Seizures changed his perception. The swirls in the sky in his painting Starry Night are similar to the sensory distortions that some people with autism have. Autistics with severe sensory processing problems see the edges of objects vibrate and get jumbled sensory input. These are not hallucinations but perceptual distortions.

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Bill Gates, the head of Microsoft and the inventor of Windows, is another person who has some autistic traits. Time magazine was the first to make the connection, comparing Oliver Sacks's New Yorker article about me with John Seabrook's article on Gates in the same magazine. Some of the traits that were similar were repetitive rocking and poor social skills. Gates rocks during business meetings and on airplanes; autistic children and adults rock when they are nervous. Other autistic traits he exhibits are lack of eye contact and poor social skills. Seabrook wrote, "Social niceties are not what Bill Gates is about. Good spelling is not what Bill Gates is about." As a child, Gates had remarkable savant skills. He could recite long passages from the Bible without making a single mistake. His voice lacks tone, and he looks young and boyish for his age. Clothes and hygiene are low on his list of important things.

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Temple Grandin "Thinking in Pictures" (1996)

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A farmer living in northern Japan, Kubo agreed to see me in a friend's office in the town center. He seemed friendly, with a frequent grin that displayed a mouthful of silver. His graying crewcut topped a round face with a week's worth of gray stubble rising from a lined, sun-darkened jaw. Muscular and powerful, with callused and weather-beaten hands, he was well scrubbed and tidied up, decked out in his best pair of gray slacks. His wife, a thin, frail, graying woman, had brought rice rolls for us to eat as we talked. The two of them seemed like perfect grandparents, the model of a sweet old Japanese couple, except that Kubo was the most evil person I've ever met.

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His wife doesn't know his secret, nor does anyone else in his family.

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Kubo swore an oath in 1945, at the end of the war, not to tell anyone what he saw and not to have any contact with his former army buddies, and he pretty much kept the promise over the decades. Ironically, he confided in me only because he wanted to convince me that Japan's army had not been as brutal as foreigners thought. He waited until his wife had left the room, and then he began his story.

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"I joined the army when I was twelve years old, in 1937," he said. "I didn't question the war at all. Everything was done for emperor and country. I thought that the emperor was a living god." Kubo was sent to China to join Unit 731, and the officers gave Kubo a bit of medical training so that he could help with the experiments. These experiments were conducted on Chinese prisoners, mostly Communists, who were called maruta, or "logs." One of the first experiments that Kubo saw involved an outdoor test of the effectiveness of a lethal gas. It was conducted on an open plain, in the grain fields that seem to stretch forever in northeastern China, and the victims and the experimenters drove together to the site in trucks.

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"The maruta were chained and tied with ropes to wooden stakes," Kubo recalled. "Some were in a crucifixion position, and others had their hands tied behind their backs. I wasn't told anything about them, but they were all men, and they seemed all young or in middle age and in good health. That was best for medical testing. Then we brought out a machine that was supposed to spew out poison gas, and we measured the distance from the machine to the prisoners, so that we could figure out how far away the gas would be effective. Our goal was to make fighting more efficient.

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"We ran back and watched as the machine began to produce the poison gas. But before anything happened, the wind suddenly changed - it sent the gas blowing in our direction. So we had to run for our lives, and I never did see what happened to those prisoners."

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Kubo spent much of his time trying to contaminate Chinese cities with bubonic plague, and he also tried to infect rivers and wells with bacteriological agents to poison anybody in the area. At one point, he paused and frowned as he noticed that I seemed to be paying a good deal of attention to what he regarded as the peccadilloes of war. "When we threw germs into rivers and wells, they contaminated our water as well," Kubo said. "And what we did in Unit 731 was mostly academic study. I didn't see any torture or anything."

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What kind of academic study?

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"Well, we would infect maruta with the plague to see how long it would take them to die, to see how it would affect them. We wanted to understand better how we could use the plague germs against our enemies. Sometimes we would dissect the maruta after they had been infected, to study how the plague spread in their internal organs. Once the doctors let me take the first cut."

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Kubo recalled that the maruta he cut was a Communist prisoner, thirty-four years old, who had been infected with the plague. The prisoner was brought in and tied naked to the operating table, facing up, and Kubo and the other Japanese approached him wearing gowns and face masks so that they would not get the disease. The prisoner was not anesthetized, and he looked silently at Kubo as preparations began for the first incision.

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"It was the easiest part of the surgery, which is why they let me do it," Kubo said. "The fellow knew that it was over for him, and so he hadn't struggled when they led him into the room and tied him down. But when I picked up the scalpel, that's when he began screaming. I cut him open from the chest to the stomach, and he screamed terribly, and his face was all twisted in agony. He made this unimaginable sound, he was screaming so horribly. But then he finally stopped. He was unconscious."

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Kubo paused and shook his head genially.

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"This was all in a day's work for the surgeons," he added. "But it really left an impression on me, because it was my first time."

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The atrocities that the Japanese army committed during World War II are well known, so what struck me was not so much Kubo's brutality back then as his lack of remorse today. Our conversation was at cross-purposes, because he had agreed to speak in the belief that a conversation would make me realize that Unit 731 had not been so awful after all. We became increasingly frustrated with each other.

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"Do you think that vivisection was wrong?" I asked. "Do you feel that what you did was immoral?"

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"People do experiments on live bodies all the time," Kubo replied, looking injured. "Like heart transplants and other surgery, even though sometimes those experiments fail. And those doctors are paid so much money!"

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"But transplants are meant to save lives, not destroy them. And those doctors use anesthesia."

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"We couldn't use anesthesia. Vivisection should be done under normal circumstances. If we'd used anesthesia, that might have affected the body organs and blood vessels that we were examining. So we couldn't have used an anesthetic."

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"So you don't think you did anything wrong?"

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Kubo shrugged impatiently, exasperated by my questioning. "People say that Unit 731 was brutal, and I can't say that they are wrong. But all this came to the surface only because we lost the war. If we had won, this would have been kept secret. And I think Unit 731 did some good things, because what we did in Unit 731 was mostly academic stuff. If we had won the war, all this would have been justified."

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"But what about experiments on children? I read about a thirty-year-old Russian woman and her child. Unit 731 put them in a gas chamber with glass windows, and the soldiers clustered around to watch as the gas choked her, as she tried to save her child by lying on top of him. Is that justifiable?"

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"Of course there were experiments on kids. But probably their fathers were spies."

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I paused. His geniality had a harder edge now, and we were glaring indignantly at each other.

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"Do you think this could ever happen again?" I asked.

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"Yes, there's a chance this could happen again. Because in a war, you have to win."

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I realized that Kubo is representative of Japan's dark side, its refusal to show contrition, its inability to face the past. But he is unusual not only in his wartime behavior but also in his obduracy. Polls show that Japanese believe two-to-one that their government has not done enough to apologize for the war or help the victims. Kubo and hard-liners like him linger, but they are slowly yielding ground and Japan is coming around.

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Nicholas Kristof & Sheryl WuDunn "China Wakes" (1994)

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The Public Be Damned

(Vanderbilt)

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This took place in a little country pub, a tiny little pub, in which the beer was pumped up from the cellar by a very old servant of the pub.? And unfortunately this old servant of the pub wasn't quite as spry as he used to be.? He had something wrong with his legs due to being in this damp cellar, a disease known as cellar-knees, actually.

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One day, the beer pipe that led up into the public bar went wrong, and suddenly beer started spouting out from this pipe all over the public bar and in no time at all it was up to the bar maid's . . . well about nine or ten inches high.?

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The people all fled out and they didn't what do to stop this beer coming and the old gentleman redeemed himself at last by getting all the beer crates, placing them all so that no more beer could flow up and called up the ladder, "It's all right, governor, the pub lick be damned."

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Denis Norden 570212b

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Ask Well

I have high cholesterol, but when I tried statins, I didn't like the side effects. What are non-pharmaceutical ways to lower my cholesterol?

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People with high cholesterol often fall into two groups: those whose levels are so high that they need cholesterol-lowering medications like statins to reduce their risk for heart disease; and those whose levels are elevated, but not so high that they require medication, said Dr. Felipe Lobelo, a life-style medicine researcher at Emory University in Atlanta.

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If people in the latter group have an otherwise low risk for heart disease, life-style changes should be their first step in trying to improve their health, according to the American Heart Association.

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Your cholesterol levels refer to a measure of two types of particles in your blood: low-density lipoprotein (sometimes called "bad," or LDL) cholesterol and high-density lipoprotein (often referred to as "good," or HDL) cholesterol. When there's too much LDL cholesterol in your blood, it can gum up your blood vessels, making it harder for your heart to pump blood through them.

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For adults ages 20 or older, it's generally considered healthy for blood LDL cholesterol levels to be under 100 milligrams per deciliter. If your levels rise to 189 milligrams per deciliter but your risk for heart disease is otherwise low, the A.H.A. says, it may be worth trying lifestyle changes to bring your cholesterol down before you rely on prescription medication.

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Levels above 190 milligrams per deciliter typically lead to a statin prescription.

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Certain lifestyle tweaks such as getting sufficient sleep, reducing tobacco use and managing stress can help improve cholesterol levels. But two lifestyle choices in particular can yield much greater benefits, said Dr. Frank B. Hu, a professor of nutrition and epidemiology at the Harvard Chan School of Public Health.

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EXERCISE When we exercise, HDL cholesterol is released into the bloodstream, where it sweeps up fatty plaque deposits in the blood vessels and transports them to the liver for disposal.

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The A.H.A. recommends that all adults get at least 150 minutes of moderate exercise, or 75 minutes of vigorous exercise, per week, Dr. Lobelo said. ?That can include walking, swimming, lifting weights, dancing or whatever else you enjoy and can do without injury, he added.

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The key, he said, is to ensure that your heart rate is elevated enough. If you're struggling to talk while you're exercising, Dr. Lobelo said, you know you're working hard enough.

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Regular exercise can help lower your cholesterol, particularly if you didn't exercise before, Dr. Lobelo said. He added that it may take longer for some people to improve their cholesterol levels through exercise than others. So if it's not coming down immediately, don't get discouraged.

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DIET Research suggests that a plant-forward diet called the portfolio diet - which includes soy products like tofu and other plant-based proteins like beans, lentils and chickpeas; viscous-fiber-containing foods like oats, barley, psyllium husk, berries. apples and citrus fruits; nuts and seeds: avocado; and healthy plant-based oils like canola and olive - can help lower cholesterol, said Andrea Glenn, a nutrition researcher at New York University.

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In a review of seven clinical trials that included about 440 participants who had high cholesterol levels but who didn't require medication, researchers found that the portfolio diet helped reduce their LDL cholesterol by up to 30 percent. That's about as effective as the older versions of statin drugs that were widely used in the '90s, Dr. Glenn said.

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Dr. Glenn and her colleagues followed about 210,000 U.S. adults for about 30 years in a study published in 2023. They found that those who closely followed this diet had a 14 percent lower risk of cardiovascular disease than those who ate less of these foods, Dr. Glenn said.

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The portfolio diet works because it combines various kinds of foods and nutrients that help lower cholesterol in different ways, she said.

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Plant proteins like beans, chickpeas and soy products, for instance, can inhibit the production of apolipoprotein B, which normally helps your body take up cholesterol from foods. Viscous fiber traps or binds cholesterol in the intestines, making it harder to absorb. And nuts are good sources of unsaturated fatty acids, plant sterols and fiber, which can all lower LDL cholesterol levels.

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Even adding or replacing a few foods - like adding nuts to your morning granola or swapping red meat with chickpeas or tofu - can help improve your cholesterol, Dr. Glenn said.

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"There's certainly no magic bullet," Dr. Hu said. But diet, exercise and other healthy habits can go a long way in helping to lower cholesterol. "We have to think about it from a holistic point of view."

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Jyoti Madhusoodanan

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An Australian woman won the first-ever world's ugliest lawn competition. Kathleen Murray's yard of sparse yellow grass, shriveled plants and bandicoot-dug divots is now the land of legend. The contest was created two years ago in Gotland, Sweden, to encourage locals to conserve water during a disastrous drought. This year, the competition went global, with entries from the U.K., Germany, France and the U.S., so it could be a good excuse to stop mowing the lawn

Not only are the busboys, laborers, and other black railroad workers as much the real McCoy as Pullman porters, their numbers include the original real McCoy. Elijah McCoy was trained as an engineer, but, because he was a Negro, one of the few jobs he could land on the railroad in the mid-1800s was as a fireman shoveling coal and oiling the engine. He quickly realized the inefficiencies of using a tiny oil can like his and having to stop the engine to lubricate it. So he devised, then patented, a system that provided continuous oiling of the gears on trains as well as ships. While his invention worked brilliantly, its many imitators did not; hence would-be purchasers insisted on knowing whether they had the "real McCoy."

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Larry Tye "Rising from the Rails" (2004)

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In doing our research and reporting for this book, we came to see that life's journey for affluent, well-educated American families is like a stroll along a wide, smooth path, forgiving of missteps. But increasingly, for those from lower on the socioeconomic spectrum, life resembles a tightrope walk. Some make it across, but for so many, one stumble and that's it. What's more, a tumble from the tightrope frequently destroys not only that individual but the entire family, including children and, through them, grandchildren. The casualties are everywhere in America, if we only care to notice.

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Some 68,000 Americans now die annually from drug overdoses, another 88,000 from alcohol abuse and 47,000 from suicide. More Americans die from these causes every two weeks than died during eighteen years of war in Afghanistan and Iraq. Yet much of affluent America has shrugged, with elites paying little attention to the disintegration of communities across the country - or, worse, blaming the victims. In fact, plenty of blame could go elsewhere: Politicians, journalists, religious leaders and business executives were too often derelict as communities cratered and tens of millions of people endured the pain. The United States still doesn't have a coherent plan to address the challenges.

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Nicholas Kristoff "Tightrope: Americans Reaching for Hope" (2020)

Genius Is an Abnormality

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It is likely that genius is an abnormality. If the genes that cause autism and other disorders such as manic-depression were eliminated, the world might be left to boring conformists with few creative ideas. The interacting cluster of genes that cause autism, manic-depression, and schizophrenia probably has a beneficial effect in small doses. In her book Touched with Fire, Dr. Kay Redfield Jamison reviewed studies that showed a link between manic-depression and creativity. Manic-depressives experience a continuum of emotions, from moody to full-blown mania and deep, dark depression. When writers experience a mild form of the condition, they often produce some of their best work. When the disorder becomes full-blown, they are no longer able to function. There is a tendency for the mood swings to worsen with age, and this may explain why famous writers such as Ernest Hemingway committed suicide relatively late in life. Studies have shown that artists, poets, and creative writers have higher rates of manic-depression or depressive disorder than the general population.

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A study done at the University of Iowa by N C. Andreason showed that 80 percent of creative writers have had mood disorders at some time during their life. A high percentage of artists, poets, and writers have to be medicated to control their condition. Thirty-eight percent of writers and artists have had to take medication, and 50 percent of poets have had to receive treatment. The University of Iowa study also showed that parents and siblings of writers have a high rate of mood disorders.

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Dean Simonton, at the University of California at Davis, has studied the factors that make a person a great politician, such as leadership, charisma, and boundless energy or drive. People with these qualities often have had problems with depression and alcohol abuse. Simonton concludes that "in order to be creative, it seems you have to be slightly crazy"

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A study of mathematical giftedness further reinforces the idea of abnormality and genius. A paper by Camilla Persson Benbour, at Iowa State University, provides strong evidence that mathematical genius and giftedness are highly correlated with physical abnormalities. Three things that occur more frequently in people with high mathematical ability than in the population at large are left-handedness, allergies, and nearsightedness. Both learning disability in mathematics and math talent are associated with left-handedness. Young children who show very high ability in verbal reasoning and mathematics are twice as likely to have allergies as the rest of the population. Students with extremely high ability are also more likely to be nearsighted. The old stereotype of a little genius with thick glasses may be true.

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Obviously, not all geniuses are abnormal, but the genes that produce normal people with certain talents are likely to be the same genes that produce the abnormalities found at the extreme end of the same continuum. Back in the 1940s researchers recognized that elimination of the genes that cause manic depression would have a terrible cost. Researchers at McLean Hospital near Boston concluded,

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If we could extinguish the sufferers from manic-depressive psychosis from the world, we would at the same time deprive ourselves of an immeasurable amount of the accomplished and good, of color and warmth, of spirit and freshness. Finally, only dried-up bureaucrats and schizophrenics would be left. Here I must say that I would rather accept into the bargain the diseased manic-depressives than give up the healthy individuals of the same heredity cycle.

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Twenty years earlier, John W. Robertson wrote in his book Edgar A. Poe, A Psychopathic Study,

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Eradicate the nervous diathesis, suppress the hot blood that results from the over-close mating of neurotics, or from that unstable nervous organization due to alcoholic inheritance, or even from insanity and the various forms of parental degeneracy, and we would have a race of stoics - men without imagination, individuals incapable of enthusiasms, brains without personality, souls without genius.

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As I have said, it has only been recently that I realized the magnitude of the difference between me and most other people. During the past three years I have become fully aware that my visualization skills exceed those of most other people. I would never want to become so normal that I would lose these skills. Similarly, being childlike may have helped me to be creative. In his book Creating Minds, Howard Gardner outlined the creative lives of seven great twentieth-century thinkers, including Einstein, Picasso, and T S. Eliot. One common denominator was a childlike quality. Gardner describes Einstein as returning to the conceptual world of a child, and says that he was not hampered by the conventional paradigms of physics. It is interesting that autism is caused by brain immaturity In many ways I have remained a child. Even today I do not feel like a grownup in the realm of interpersonal relationships.

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Some scientists are strictly analytical thinkers. The physicist Richard Feynman denied the validity of poetry and art. In hi biography of Feynman, Genius, James Gleick wrote, "He would not concede that poetry or painting or religion could reach a different kind of truth." Of course, many scientists do value poetry and share traits from both the creative and scientific end of the continuum, just as some scientists, artists, and highly analytical philosophers have some autistic traits. Albert Einstein, Ludwig Wittgenstein, and Vincent van Gogh all exhibited developmental abnormalities during early childhood. By definition, autism is an early-onset disorder, and problems such as delayed speech and odd behavior must show up at an early age for a person to be labeled as having autistic traits.

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As a child, Einstein had many of these traits. He did no' learn to speak until he was three. In a letter to a mother of an autistic child, he admitted to not being able to learn to speak until late and that his parents had been worried about it. Bernard Patten reports in the Journal of Learning Disabilities that Einstein silently repeated words to himself until age seven and did not freely associate with his peers. Whereas some prodigies develop at an early age, Einstein did not exhibit any great genius as a young child. Some people thought he was a dullard. He was a bad speller and did poorly in foreign languages. Like many autistic-type children, he was very good at jigsaw puzzles and spent hours building houses from playing cards. He had a single-mindedness of purpose and a poor memory for things that did not interest him, especially things of a personal nature. In Einstein: The Life and Times, the biographer Ronald W Clark wrote that Einstein's backwardness may have helped guide him in his field. Einstein himself said, "I sometimes ask myself, how did it come that I was the one to develop the theory of relativity? The reason, I think, is that a normal adult never stops to think about problems of space and time." He had tremendous ability to concentrate and could work for hours or days on the same problem.

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In Einstein Lived Here, Abraham Pais wrote, "To be creative in establishing lasting deep human relations demands efforts that Einstein was simply never willing to make." Like me, he was more attached to ideas and work. I don't know what a deep relationship is. His deep passion was for science. Science was his life. One of his graduate students said, "I have never mown anybody who enjoyed science so sensuously as Einstein." According to Howard Gardner, Einstein was interested in the relationships between objects far more than in relationships between people.

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Temple Grandin "Thinking in Pictures" (1996)

Two pioneering scholars, Betty Hart and Todd R. Risley, spent more than two years observing forty-two families. Hart and Risley taped the parents' interactions with young children, transcribed the tapes, and then counted the words. They found that the age at which babies began to speak didn't correlate to family income, but the number of words they heard depended hugely on socioeconomic status, A child on welfare heard about 3 million words spoken a year, a working-class child about 6 million words a year, and a child of professionals about 11 million words annually.

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By the age of four, a child of professionals would have heard 32 million more words than a child on welfare. This "thirty-million-word gap" appears to have a huge impact in the child's development. "With few exceptions, the more parents talked to their children, the faster the children's vocabularies were growing and the higher the children's IQ test scores at age three and later," Hart and Risley wrote. They continued to follow the children until they were nine years old and found that the number of words young children heard seemed to have a substantial impact on their brain development, IQ, and school performance. Later research has confirmed their findings, as well as their conclusion that by school age poor children are often so far behind that it is difficult for them to catch up. Moreover, many of the words low-income children heard were stem ones of scolding, while professional parents praised their children at every opportunity. Children on welfare heard two words of discouragement for every encouraging one, while children of professionals received six encouraging words for every discouraging one.

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As David Olds and many other researchers have found, it's not that poor families are averse to talking to their babies or to praising them. Nobody aspires to be a bad mom or dad. By and large, parents of every background love their kids, want them to succeed, and are happy to help them thrive. The problem is that struggling single moms living in poverty are stressed and busy, don't realize that talking to a baby is critical, and often are accustomed to a parenting style that is authoritarian. Some mothers think that putting a child in front of a television set is a substitute for conversation. Hart and Risley discovered in their data that what mattered was an actual human being speaking to a child: television had no impact on vocabulary and cognitive development. I-LABS, a Seattle brain laboratory, examined babies' brains in a $4 million magneto encephalography scanning room - the only one in the world set up for infants - and found the same thing. When a baby listens to a real person, it treats this as a social interaction and processes the information. When the baby is in front of a television screen, the child's brain treats the words as random noise.

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We've already discussed some of the earliest interventions that improve long-term outcomes and help chip away at the cycle of poverty. Research also points to effective ways to help children continue through pre-kindergarten to build literacy and verbal skills. Children who are readers help themselves, and nothing gets kids more ready for school than giving them the joy of reading. Oklahoma, Georgia, West Virginia, and other states have shown what works in creating broader opportunity through early childhood programs. Some of those programs offer ways that each of us can playa role in advancing these goals.

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Nicholas Kristof & Sheryl WuDunn "A Path Appears" (2014)

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Ask Well

Everyone says that the DEET in bug spray is awful, but my own research seems to suggest that it's well tested and safe. Am I giving myself a little bit of cancer every time I use it?

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A DEET-containing bug spray might smell unpleasant, but when used correctly, DEET's offensive odor might be its most harmful effect, said Dr. Joseph Kennedy, a physician and medical toxicologist at the University of Vermont Medical Center.

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Still, there's widespread concern that DEET might be toxic or cause cancer, he said.

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Here is why people think DEET is bad for human health, and what we know about its safety.

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Contrary to what many people may think, DEET is not an insecticide, Dr. Kennedy said. It doesn't kill mosquitoes and is not poisonous to them. Instead, it deters them, likely with its noxious smell.

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"The whole point of smelling unpleasant is you're not the only one that thinks that," Dr. Kennedy said. "Insects do, too," he said. That includes other bugs like ticks, fleas and biting flies.

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Another theory about how DEET works is that it masks certain human emissions, like carbon dioxide, which insects are normally attracted to, Dr. Kennedy said.

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Millions of people in the United States use DEET-containing products every year, according to the Environmental Protection Agency. Yet between 2007 and 2012, there were only about 2,800 reported health incidents involving the chemical, the agency said in its most recent review.

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DEET has been used for about 80 years. If it was toxic or caused cancer, "it would have showed up a long time ago," said Jeffrey Bloomquist, an insect toxicologist at the University of Florida.

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Most incidents the E.P.A. noted were minor, involving skin, eye or respiratory irritation like rashes, watery eyes or wheezing.

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DEET-containing products are safe when applied only to exposed skin and not sprayed directly onto the face or broken skin, Dr. Bloomquist said.

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And don't use more than is needed, Dr. Bloomquist said, especially with children. He recommended that young children or infants use products with lower concentrations of DEET (a 24 percent solution should be adequate). And he suggested spraying it onto their clothing.

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If used improperly, such as if someone swallows it or applies too much, DEET can cause severe health effects like seizures, low blood pressure, uncoordinated movements or death, Dr. Kennedy said. But those cases are rare - seizures, for example, occur only once in every 100 million uses, according to the E P.A.

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Little quality research on the relationship between DEET and cancer has been conducted in humans, Dr. Bloomquist said. The Centers for Disease Control and Prevention has reported that long-term exposure is not associated with an increase in tumors in rodents, rats or dogs.

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DEET also hasn't been shown to cause harm to pregnant women or their fetuses.

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In the 1980s and 1990s, a few isolated reports of seizures and deaths linked to DEET sparked concern. However, those people hadn't used DEET as directed.

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Between 1960 and.2020, researchers have reported nine deaths related to DEET poisoning. Of those, four had intentionally swallowed the chemical - and among them, son had also ingested other substances, like alcohol or antidepressants, which could have played a role in their deaths. The other cases included two young children and a baby whose parents had applied DEET every night for weeks or months, and two adults who had applied more DEET than necessary. It's unclear if the DEET or something else - such as an underlying health condition - played a role.

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One major benefit of DEET is its ability to protect against insects that may transmit potentially deadly illnesses like dengue, West Nile or Lyme disease.

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There are risks and benefits when using any chemical, Dr. Kennedy said. But the toxic side effects of DEET are far less common than what can occur with insect-borne illnesses, such as an irregular heartbeat caused by Lyme disease or severe anemia with tick-borne babesiosis, he said. "These truly life-altering diseases can be prevented with just some basic precaution and application of a repellent."

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Isobel Whitcomb

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Imagine you're at a nice restaurant trying to enjoy your meal, and some kids at the next table are raising a ruckus, and you don't know whether to leave or complain. A restaurant in North Georgia has a third option, fining the parents 50 bucks. It's right there on the menu of the Toccoa Riverside restaurant in Blue Ridge, adult surcharge for adults unable to parent. Some online reviewers are not happy, saying they'll never be back, but other reviewers said, you know, the food was worth it

At their peak, Pullman sleepers accommodated 100,000 people a night, which was more than all the nation's top-notch hotels combined. That meant stocking 4,195,873 towels, 466,362 blankets, and 145,315 jackets for porters. All of which made Conrad Hilton look like a country innkeeper and made the Pullman sleeper, in the words of its most lyrical chroniclers, "an American institution comparable to baseball and Congress." George had achieved his dream: he was, as his company boasted in its ads, the World's Greatest Housekeeper. And it was not just America that reveled in his accomplishments: in twenty languages, Pullman defined luxury, comfort, and safety in travel.

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Larry Tye "Rising from the Rails" (2004)

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In Oklahoma, criminal defendants can be assessed sixty-six different kinds of fees, ranging from a "courthouse security fee" to a "sheriff's fee for pursuing fugitive from justice." There's even a fee for an indigent person applying for a public defender, even though the indigent by definition can't pay; once they confirm their indigence by failing to pay, they are arrested. The sums accumulate to staggering levels. Cynthia Odom, an office worker in Tulsa, told us that she owes $170,000 and is constantly at risk of being carted off to jail, away from her two children. Even the Tulsa district attorney, Stephen Kunzweiler, told us, "It's a dysfunctional system."

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That's not simply Oklahoma. In New York City, detainees were regularly held for failure to pay a one-dollar bail. Typically, this happened when someone was arrested on multiple charges, with $500 bail on the primary charge and one-dollar bail on the secondary charge. But then the main charge was dropped, and the person remained stuck in jail because the computer showed a remaining one-dollar debt. Even if the inmates had healthy bank accounts, they couldn't access them to pay any sum, and sometimes they had no one to ask for help; the obstacle wasn't the money but finding a friend or relative with the time and English-language ability to confront the system and pay the bail. One mother missed her child's funeral because she was jailed on one-dollar bail. Some inmates were held for days, weeks or occasionally months for failure to pay the same amount. Finally, a group of New York University students came up with a solution: they formed the Dollar Bail Brigade, a collection of volunteers who would periodically go to jail and bailout inmates for one dollar. Even for elite university students, the bureaucratic challenges can be staggering: it took one volunteer twenty-four hours and three jail visits to pay an inmate's single dollar of bail.

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It's puzzling that many politicians fear that poor people are trying to milk the system, while they don't seem to fear rich people doing the same with far more dollars at stake. The latest fashion for smacking the downtrodden among some lawmakers: work requirements to receive benefits such as Medicaid. In theory, requiring certain people to work in return for benefits could be a useful way to nudge the long-term unemployed back into the labor force. But in practice these requirements are often just an excuse to cut off benefits. Arkansas in 2018 became the first state to impose work requirements for Medicaid. It also required participants to log their work hours online with an email address and a code sent by mail, and proceed through several successive web pages. Unfortunately, Arkansas ranks forty-eighth among states in internet access, and many Medicaid recipients have no email or internet. Even months later, in early 2019, Arkansas's Medicaid website had no clear explanation of the new work requirements or how to reapply or input work hours. Of the first group subjected to the requirement, 72 percent could not comply. So families lost health insurance, and then some people were unable to get medication and, their sicknesses flaring, lost jobs. This is a reminder that work requirements are often a camouflaged and mean-spirited move to kick people out of the safety net. Meanwhile, from 2007 to 2016, the state granted subsidies of $156 million to corporations, including HP and Caterpillar, under an "economic development" program that researchers found had almost no correlation to increased employment.

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Some local leaders are refusing to expand social programs even when voters demand it. After residents in Utah and Idaho voted to expand Medicaid in November 2018, the Republican legislatures tried to roll back those votes. The ethos of the country changed in this half century. Many Americans came to celebrate wealth as a prime metric of success and became more judgmental of those who lost jobs, went bankrupt, used drugs or otherwise stumbled; the acme of this changing ethos was the election in 2016 of a billionaire president who was best known for ostentatious living and for his reality TV refrain: "You're fired!"

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Nicholas Kristoff "Tightrope: Americans Reaching for Hope" (2020)

Four Cornerstones of Social Awareness

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Achieving social success is dependent upon certain core attributes of the person with ASD. In our book, Unwritten Rules of Social Relationships, my co-author Sean Barron and I introduce four aspects of thinking and functioning we think contribute the most to successful social awareness and social interactions. These Four Cornerstones of Social Awareness are:

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Perspective-taking: the ability to put ourselves in another person's shoes - to understand that people can have similar or different viewpoints, emotions, and responses from our own. At an even more basic level is acknowledging that people exist and that they are sources of information to help us make sense of the world.

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Flexible thinking: the ability to accept change and be responsive to changing conditions and the environment; the mental ability to notice and process alternatives in both thought and actions; the ability to compare, contrast, evaluate.

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Positive self-esteem: a "can-do" attitude that develops through experiencing prior success and forms the basis for risk-taking in the child or adult. Self-esteem is built upon repeated achievements that start small and are concrete and become less tangible and more complex.

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Motivation: a sustained interest in exploring the world and working towards internal and external goals, despite setbacks and delays.

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Often, motivation needs to be encouraged in kids with ASD, especially within the social arena. Let the child feel the benefits of motivation first through using the child's favorite topics or special interests, and then slowly broadening out into other activities. If the child loves trains, teach reading, math, and wnting with train-centered books, examples, and activities. Play train-themed games to motivate social interaction.

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Based on the social understanding Sean and I have achieved in our lives, we emphatically agree that perspective-taking, being able to look beyond oneself and into the mind of another person, is THE SINGLE MOST IMPORTANT ASPECT OF FUNCTIONING THAT DETERMINES THE LEVEL OF SOCIAL SUCCESS to be achieved by a child or adult with ASD. Through it we learn that what we do affects others - in positive and negative ways. It's the link that allows us to feel connected to others. It gives us the ability to consider our own thoughts in relation to information we process about a social situation, and then develop a response that contributes to, rather than detracts from, the social experience.

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In our book, Sean describes how "talk therapy," as he called it, helped him develop better social thinking skills and appreciate the varied perspectives of other people in his life. During his middle and high school years, he and his parents would sit for hours, sometimes until 1:00 or 2:00 a.m., discussing the most basic concepts of how relationships worked. For instance, Sean explains that even in his late teens, he still didn't understand why it wasn't okay to "absorb" people who took a genuine interest in him and showed they cared about him - that is, why it wasn't acceptable to spend all the time he wanted with someone who was much older and had family and other personal obligations. He couldn't understand why they wouldn't make him the centerpiece of their lives, as did his parents.

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For me, social thinking skills largely developed over time and through repeated experiences. The more social data I put on my mental hard drive, the better able I was to see the connections between my own thoughts and actions and those of others. For me, these social equations were born from my logical mind: "If I do X, then the majority of people will respond with Y." As I acquired more and more data through direct experience, I formed categories and subcategories and even more refined subcategories m my social thinking. That's why it's so important for parents to engage children in all sorts of different activities and experiences. Without that direct learning - and lots of it - children don't have the information they need to make these social connections in their thinking.

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Perspective-taking works hand-in-hand with flexible thinking; it provides opportunities for experiencing success in social interactions, which in turn fosters positive self-esteem. It can also act as a source of internal motivation, especially as children grow into adults and the type and quality of social interaction expands.

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Social THINKING skills must be directly taught to children and adults with ASD. Parents, teachers, and service providers are slowly starting to realize the importance of incorporating such lessons into the child's overall education plan. Doing so opens doors of social understanding in all arenas of life.

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Temple Grandin "The Way I See It: A Personal Look at Autism & Asperger's" (2011)

Rashida Yaye, a girl in the West African country of Niger, was born with one of the most common birth defects in the world: clubfoot. About one baby in a thousand is born with this deformity, with one or both feet pointing in the wrong direction. In fact, Nick's mother, Jane Kristof, was born with a clubfoot. But in the United States or Europe, a doctor places the baby's foot in a series of corrective casts for about a month, and - presto! - the foot is healed. Because there is such effective treatment and no lasting disfigurement, we in the West almost never see clubfoot and are therefore unaware of how common it is. We didn't even know until we were writing this book that Jane Kristof had had a clubfoot. We never would have guessed it because she is an exceptionally vigorous walker even in her eighties.

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That's common in the West. Kristi Yamaguchi, the Olympic goldmedal-winning figure skater who symbolized grace and beauty, was also born with a clubfoot. So was Mia Hamm, who scored more international soccer goals than any other player in the history of the sport. Ditto for Charles Woodson, who won the Heisman Trophy as the best collegiate football player in America and, as a member of the Green Bay Packers, shared in the Super Bowl XLV victory. Indeed, there are so many professional athletes in America who started out with this condition that the San Francisco Giants claims to be the team with the most athletes born with clubfoot!

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When Shoshana Kline, in Venice, California, received a mailing about clubfoot from an American aid group called FirstStep, she was intrigued. Her mailbox was filled with appeals to address other needs in the world, but the photos on the leaflet caught her eye, because Kline herself had been born with a severe clubfoot. It was family lore that her first pediatrician had told her parents that she would never be able to walk. "My parents really freaked out," Kline says. Although she has no memories of those early days, "there are 20,000 pictures of me like that - all my baby pictures have me with these disgusting casts on my feet!"

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Those casts solved Kline's clubfoot, and in high school and college she excelled at sports. "Not only do I have normal legs, but I was a skilled athlete," she says. "The idea that there are people in other countries who don't get it treated and corrected, that really means something to me." The letter from FirstStep was written by Brian Mullaney, the former head of an aid group called Smile Train whose work fighting cleft palates Kline had heard of and respected, so she sent in a check for $250.

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"This is something that affected my life, that I care about and that I want to contribute to," she explained to us. FirstStep forwarded the money to CURE, a Pennsylvania charity that in 2010 had opened a hospital in Niamey, the capital of Niger, to repair clubfoot. Niger is one of the world's poorest countries, and most children born with clubfoot there never get help. "If you go out on the streets, you will see many children with clubfoot who are begging," Moutari Malam Saddi, a hospital administrator, told us when we visited the hospital in Niamey. "They never go to school, they just become a kind of curse on the family, and little by little they accept their status. They think they are useless and have to beg."

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That seemed likely to be the fate of Rashida, for she was born with clubfoot on both feet (which is not unusual) in the remote farming village of Torodi, in the far west of Niger near the border with Burkina Faso. Torodi is a collection of thatched-roof mud huts, a few welts, a mud-walled mosque, and surrounding fields of millet. Not many farmers there are literate, and none of them have electricity or plumbing. Over the years, other children in Torodi have been born with clubfoot, and none ever received medical help. Rashida, especially as a girl in a country with a strong preference for sons, seemed destined to become one more disabled person - unable to walk, work, or go to school.

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"I thought it was impossible for my daughter to be healed," her father, Yaye Hamma, a farmer and tea seller, told us. Initially he accepted Rashida's condition as fate. But Yaye has only three children, fewer than most villagers, and he grew particularly fond of Rashida's bubbly and affectionate nature. His heart broke as he imagined her being mocked or forced to become a beggar. So he took her to a local doctor, who could do nothing himself to help but did mention he had heard that in Niamey a new foreign hospital had just opened that could treat clubfoot. It was a long shot, but Yaye was determined to find this hospital and get help for Rashida, now two years old. He asked friends for help with transportation money, but they scoffed.

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"People told me that I was wasting my money" Yaye said. "Nobody helped." But he loved Rashida too much to give up, so he left his other children behind in the village with his wife and boarded a bus to Niamey. After walking about the city for miles and making endless inquiries, he found the CURE hospital. When he walked in, he saw dozens of children just like Rashida; others were already mostly cured. Yaye began to dare to hope.

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The $250 cost of the repair would have been prohibitive for the family, but Shoshana Kline's donation covered all the expenses. Doctors placed Rashida's feet in a plaster cast that straightened them just a bit. After a couple of weeks, another cast straightened her feet further. After six of these successive foot casts were employed over seven weeks, Rashida was brought in for a simple procedure called a tendonotomy, in which an incision is made under local anesthetic to release the Achilles tendon so that the foot will open up more. Dr. Chris Carter, a Canadian orthopedic surgeon who has spent much of his career as a missionary doctor in Africa, performed the brief procedure on each of Rashida's feet as his wife, Danielle, a surgical nurse, held Rashida's hand to comfort her. In twenty minutes, Rashida's legs were swathed in two final casts, which would be removed in a few days-and then her treatment would be over. Soon she was sitting in her dad's lap in the hospital courtyard as the sun set over Niamey. Both were beaming contentedly.

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"I believe that she will heal completely," Yaye said. "I love my daughter very, very much, and that is why I am here."

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So that's how a California woman, by donating $250, underwrote the transformation of a life halfway around the world. In Torodi, Rashida was soon walking and running normally and going to school, the first child in the area to be cured of clubfoot. She is the pathbreaker, and other parents and children will follow. Villagers previously doomed will grow up to become teachers, nurses, village leaders. Kline's donation will ripple through the community. To us, it is positively inspiring that $250 can accomplish so much. That's not a sacrifice but an opportunity.

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Nicholas Kristof & Sheryl WuDunn "A Path Appears" (2014)

Hitch Your Wagon to A Star

(Emerson)

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There is a very famous director of exciting thrillers, who does most of his work in Hollywood, called Alfred Hitchcock.

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Now Alfred Hitchcock is a very fat man and he also is slightly eccentric in a very amusing way.

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Alfred Hitchcock, being a fat man, used to have a little idiosyncrasy, which isn't known to many people. I happened to know about it, so I can tell you this.

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But when one of the minor players on the set, when they were due to go on, instead of beckoning them over with a finger he used to do a sort of wiggle-waggle at them, being a very fat man he could do that, a sort of woggle-waggle.

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And one day he wanted the bit player to go on the set.? What he didn't realize was it wasn't the bit player at all, it was Cary Grant, who was the star of the film.

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So he got up and said, "Come on let's get going on the film," and did this little waggle to what he thought was the bit player.

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And the Assistant Director said, "Hitch! You're wagging to a star."

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Frank Muir 570205a

Ask Well

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I had a C-section about a year ago; my scar sometimes hurts, itches and even smells. What's going on?

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If you've had a cesarean section, you may have expected your wound to be healed and relatively pain free after a few months. But an estimated 7 to 18 percent of people develop chronic scar pain after a C-section, and numbness, itching and odor can be common, too - sometimes for months or even years after the surgery.

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About 30 percent of births are via C-section, said Katie Kelly, a pelvic floor physical therapist in New Brunswick. That's "a lot of women who could potentially have issues," she said.

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During the six to eight weeks after a C-section, it's common to experience pain, soreness and itching around the incision site, said Ashley Rawlins, a physical therapist in Dallas who specializes in pelvic and obstetric health. "Our body is warning us, 'Hey, be careful," Dr. Rawlins said, so that we move cautiously and don't disrupt the healing process.

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Itching can arise, too, because the body produces itch-inducing chemicals called histamines, Dr. Rawlins said, which increase blood flow to the wound and facilitate healing. Some people can also have allergic reactions to the disinfectants or adhesives used during surgery, said Dr. Angela Lamb, a dermatologist at Mount Sinai Dermatology in New York City, so if the itching is intense or your skin is red and blistery, consult your doctor.

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If your incision smells bad during the first six to eight weeks after surgery, it's possible that you have an infection, Dr. Lamb said. This could either be a bacterial infection of the wound itself, or a yeast infection of the tissue surrounding it, she added. Call your doctor to make sure everything is healing properly, she recommended.

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To reduce the chance of an infection, keep the area around the incision clean and dry, Dr. Rawlins suggested. A few times a day, dab the area with a clean, dry cloth to remove any moisture.

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Even beyond the first six to eight weeks, though, certain symptoms can persist. Sometimes, the scar tissue is so tight that it pulls on the surrounding skin or muscle, leading to discomfort, Ms. Kelly said. If this happens, a physical therapist can help you relax and stretch the tissue, Dr. Rawlins said. You can also try massaging the scar yourself, she added, by gently pressing on it, massaging the area in a circular motion or gently rolling the scar between your fingers.

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A brush from your underwear or pressure from your pants seam can also be a "significant source of pain and itch," Dr. Rawlins said. She recommended that people with sensitive scars wear softer fabrics, seamless underwear or high-waisted clothing.

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It's also possible for the muscles near your midsection, like the abdominal or inner thigh muscles, to feel sore for a while, Ms. Kelly said. People tend to lean forward during C-section recovery so as not to pull on the incision, but over time, this can cause tight, sore muscles around the hip flexors, stomach and even the chest. Once your incision has healed, try sitting with a straighter posture, Dr. Rawlins recommended, and do gentle abdominal and thigh stretches.

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Certain nerves can also get severed during surgery, leading first to numbness, and then to aches and pains when the nerves start to regenerate, Dr. Rawlins said. Sometimes, scar tissue can entrap nerves as it forms, causing a burning sensation in the lower abdomen and groin, Ms. Kelly added. Nerve pain usually subsides over time, but if it persists, see a physician.

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Scars can also keep growing beyond the original incision site and turn into keloid scars, which are thick and raised. These can cause pain and itching, too, Dr. Lamb said, and may be treated with steroid injections or silicone creams or tapes.

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Infections are also possible, even months or years after the scar has healed. One common infection is called intertrigo, which develops when skin rubs together and moisture builds in the crease around the scar, allowing yeast or other microbes to proliferate. Intertrigo is typically treated with topical or oral anti-fungal medications or antibiotics.

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If you're having a tough C-section recovery, call your doctor, experts say.

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Women may feel hesitant seeking help, but "it's not something that someone has to suffer in silence with," Dr. Rawlins said.

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Melinda Wenner Moyer

Imagine losing a diamond ring worth more than $800,000. That's what happened to a woman in Paris. The woman was staying at the famed Ritz Hotel and left her ring on the nightstand in her room. When she returned from a morning out, the ring was gone. Authorities were alerted, but after a search by hotel and security staff, the ring was found in a vacuum cleaner bag. Finders keepers clearly didn't apply in this case.

The customs officer was another government agent the porter was supposed to stand in for. That meant rooting out gambling and, during Prohibition, purging Pullman compartments of alcohol. It also meant enforcing peculiar laws particular to the states. In Maryland it was illegal to throw anything from a moving train. Iowa outlawed the sleight-of-hand game three-card monte, while spitting on the train was a crime in Mississippi, Oklahoma, Pennsylvania, Texas, Virginia, Kansas, Louisiana, South Carolina, and Wisconsin. Wisconsin had a separate statute that made it unlawful to sweep a car unless the floor had been watered to prevent dust lucking up. A third Wisconsin law, eventually overturned by that state's highest court, gave extra stretching space to Pullman passengers as large as its legislative author by ordering porters to close upper berths if no one was sleeping there. The Pullman Company vehemently protested, afraid that would foil its strategy of opening vacant uppers so passengers would be sufficiently pinched for space that they would buy the upper berth just to close it.

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Larry Tye "Rising from the Rails" (2004)

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