Well: Think Like a Doctor: A Confused and Terrified Patient

The Challenge: Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.

The Presenting Problem:

A 55-year-old man who is recovering from a devastating injury in a rehabilitation facility suddenly becomes confused, frightened and paranoid.

The Patient’s Story:

The patient, who was recovering from a terrible injury and was too weak to walk, had been found on the floor of his room at the extended care facility, raving that there were people out to get him. He was taken to the emergency room at the Waterbury Hospital in Connecticut, where he was diagnosed with a urinary tract infection and admitted to the hospital for treatment. Doctors thought his delirium was caused by the infection, but after 24 hours, despite receiving the appropriate antibiotics, the patient remained disoriented and frightened.

A Sister’s Visit:

The man’s sister came to visit him on his second day in the hospital. As she walked into the room she was immediately struck by her brother’s distress.

“Get me out of here!” the man shouted from his hospital bed. “They are coming to get me. I gotta get out of here!”

His blue eyes darted from side to side as if searching for his would-be attackers. His arms and legs shook with fear. He looked terrified.

For the past few months, the man had been in and out of the hospital, but he had been getting better — at least he had been improving the last time his sister saw him, the week before. She hurried into the bustling hallway and found a nurse. “What the hell is going on with my brother?” she demanded.

A Long Series of Illnesses:

Three months earlier, the patient had been admitted to that same hospital with delirium tremens. After years of alcohol abuse, he had suddenly stopped drinking a couple of days before, and his body was wracked by the sudden loss of the chemical he had become addicted to. He’d spent an entire week in the hospital but finally recovered. He was sent home, but he didn’t stay there for long.

The following week, when his sister hadn’t heard from him for a couple of days, she forced her way into his home. There she found him, unconscious, in the basement, at the bottom of his staircase. He had fallen, and it looked as if he may have been there for two, possibly three, days. He was close to death. Indeed, in the ambulance on the way to the hospital, his heart had stopped. Rapid action by the E.M.T.’s brought his heart back to life, and he made it to the hospital.

There the extent of the damage became clear. The man’s kidneys had stopped working, and his body chemistry was completely out of whack. He had a severe concussion. And he’d had a heart attack.

He remained in the intensive care unit for nearly three weeks, and in the hospital another two weeks. Even after these weeks of care and recovery, the toll of his injury was terrible. His kidneys were not working, so he required dialysis three times a week. He had needed a machine to help him breathe for so long that he now had to get oxygen through a hole that had been cut into his throat. His arms and legs were so weak that he could not even lift them, and because he was unable even to swallow, he had to be fed through a tube that went directly into his stomach.

Finally, after five weeks in the hospital, he was well enough to be moved to a short-term rehabilitation hospital to complete the long road to recovery. But he was still far from healthy. The laughing, swaggering, Harley-riding man his sister had known until that terrible fall seemed a distant memory, though she saw that he was slowly getting better. He had even started to smile and make jokes. He was confident, he had told her, that with a lot of hard work he could get back to normal. So was she; she knew he was tough.

Back to the Hospital:

The patient had been at the rehab facility for just over two weeks when the staff noticed a sudden change in him. He had stopped smiling and was no longer making jokes. Instead, he talked about people that no one else could see. And he was worried that they wanted to harm him. When he remained confused for a second day, they sent him to the emergency room.

You can see the records from that E.R. visit here.

The man told the E.R. doctor that he knew he was having hallucinations. He thought they had started when he had begun taking a pill to help him sleep a couple of days earlier. It seemed a reasonable explanation, since the medication was known to cause delirium in some people. The hospital psychiatrist took him off that medication and sent him back to rehab that evening with a different sleeping pill.

Back to the Hospital, Again:

Two days later, the patient was back in the emergency room. He was still seeing things that weren’t there, but now he was quite confused as well. He knew his name but couldn’t remember what day or month it was, or even what year. And he had no idea where he was, or where he had just come from.

When the medical team saw the patient after he had been admitted, he was unable to provide any useful medical history. His medical records outlined his earlier hospitalizations, and records from the nursing home filled in additional details. The patient had a history of high blood pressure, depression and alcoholism. He was on a long list of medications. And he had been confused for the past several days.

On examination, he had no fever, although a couple of hours earlier his temperature had been 100.0 degrees. His heart was racing, and his blood pressure was sky high. His arms and legs were weak and swollen. His legs were shaking, and his reflexes were very brisk. Indeed, when his ankle was flexed suddenly, it continued to jerk back and forth on its own three or four times before stopping, a phenomenon known as clonus.

His labs were unchanged from the previous visit except for his urine, which showed signs of a serious infection. A CT scan of the brain was unremarkable, as was a chest X-ray. He was started on an intravenous antibiotic to treat the infection. The thinking was that perhaps the infection was causing the patient’s confusion.

You can see the notes from that second hospital visit here.

His sister had come to visit him the next day, when he was as confused as he had ever been. He was now trembling all over and looked scared to death, terrified. He was certain he was being pursued.

That is when she confronted the nurse, demanding to know what was going on with her brother. The nurse didn’t know. No one did. His urinary tract infection was being treated with antibiotics, but he continued to have a rapid heart rate and elevated blood pressure, along with terrifying hallucinations.

Solving the Mystery:

Can you figure out why this man was so confused and tremulous? I have provided you with all the data available to the doctor who made the diagnosis. The case is not easy — that is why it is here. I’ll post the answer on Friday.

---

Rules and Regulations: Post your questions and diagnosis in the comments section below.. The correct answer will appear Friday on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

Read More..

DealBook: E-Mails Show Flaws in JPMorgan's Mortgage Securities

When an outside analysis uncovered serious flaws with thousands of home loans, JPMorgan Chase executives found an easy fix.

Rather than disclosing the full extent of problems like fraudulent home appraisals and overextended borrowers, the bank adjusted the critical reviews, according to documents filed early Tuesday in federal court in Manhattan. As a result, the mortgages, which JPMorgan bundled into complex securities, appeared healthier, making the deals more appealing to investors.

The trove of internal e-mails and employee interviews, filed as part of a lawsuit by one of the investors in the securities, offers a fresh glimpse into Wall Street’s mortgage machine, which churned out billions of dollars of securities that later imploded. The documents reveal that JPMorgan, as well as two firms the bank acquired during the credit crisis, Washington Mutual and Bear Stearns, flouted quality controls and ignored problems, sometimes hiding them entirely, in a quest for profit.

The lawsuit, which was filed by Dexia, a Belgian-French bank, is being closely watched on Wall Street. After suffering significant losses, Dexia sued JPMorgan and its affiliates in 2012, claiming it had been duped into buying $1.6 billion of troubled mortgage-backed securities. The latest documents could provide a window into a $200 billion case that looms over the entire industry. In that lawsuit, the Federal Housing Finance Agency, which oversees Fannie Mae and Freddie Mac, has accused 17 banks of selling dubious mortgage securities to the two housing giants. At least 20 of the securities are also highlighted in the Dexia case, according to an analysis of court records.

In court filings, JPMorgan has strongly denied wrongdoing and is contesting both cases in federal court. The bank declined to comment.

Dexia’s lawsuit is part of a broad assault on Wall Street for its role in the 2008 financial crisis, as prosecutors, regulators and private investors take aim at mortgage-related securities. New York’s attorney general, Eric T. Schneiderman, sued JPMorgan last year over investments created by Bear Stearns between 2005 and 2007.

Jamie Dimon, JPMorgan’s chief executive, has criticized prosecutors for attacking JPMorgan because of what Bear Stearns did. Speaking at the Council on Foreign Relations in October, Mr. Dimon said the bank did the federal government “a favor” by rescuing the flailing firm in 2008.

The legal onslaught has been costly. In November, JPMorgan, the nation’s largest bank, agreed to pay $296.9 million to settle claims by the Securities and Exchange Commission that Bear Stearns had misled mortgage investors by hiding some delinquent loans. JPMorgan did not admit or deny wrongdoing.

“The true price tag for the ongoing costs of the litigation is terrifying,” said Christopher Whalen, a senior managing director at Tangent Capital Partners.

The Dexia lawsuit centers on complex securities created by JPMorgan, Bear Stearns and Washington Mutual during the housing boom. As profits soared, the Wall Street firms scrambled to pump out more investments, even as questions emerged about their quality.

With a seemingly insatiable appetite, JPMorgan scooped up mortgages from lenders with troubled records, according to the court documents. In an internal “due diligence scorecard,” JPMorgan ranked large mortgage originators, assigning Washington Mutual and American Home Mortgage the lowest grade of “poor” for their documentation, the court filings show.

The loans were quickly sold to investors. Describing the investment assembly line, an executive at Bear Stearns told employees “we are a moving company not a storage company,” according to the court documents.

As they raced to produce mortgage-backed securities, Washington Mutual and Bear Stearns also scaled back their quality controls, the documents indicate.

In an initiative called Project Scarlett, Washington Mutual slashed its due diligence staff by 25 percent as part of an effort to bolster profit. Such steps “tore the heart out” of quality controls, according to a November 2007 e-mail from a Washington Mutual executive. Executives who pushed back endured “harassment” when they tried to “keep our discipline and controls in place,” the e-mail said.

Even when flaws were flagged, JPMorgan and the other firms sometimes overlooked the warnings.

JPMorgan routinely hired Clayton Holdings and other third-party firms to examine home loans before they were packed into investments. Combing through the mortgages, the firms searched for problems like borrowers who had vastly overstated their incomes or appraisals that inflated property values.

According to the court documents, an analysis for JPMorgan in September 2006 found that “nearly half of the sample pool” — or 214 loans — were “defective,” meaning they did not meet the underwriting standards. The borrowers’ incomes, the firms found, were dangerously low relative to the size of their mortgages. Another troubling report in 2006 discovered that thousands of borrowers had already fallen behind on their payments.

But JPMorgan at times dismissed the critical assessments or altered them, the documents show. Certain JPMorgan employees, including the bankers who assembled the mortgages and the due diligence managers, had the power to ignore or veto bad reviews.

In some instances, JPMorgan executives reduced the number of loans considered delinquent, the documents show. In others, the executives altered the assessments so that a smaller number of loans were considered “defective.”

In a 2007 e-mail, titled “Banking overrides,” a JPMorgan due diligence manager asks a banker: “How do you want to handle these loans?” At times, they whitewashed the findings, the documents indicate. In 2006, for example, a review of mortgages found that at least 1,154 loans were more than 30 days delinquent. The offering documents sent to investors showed only 25 loans as delinquent.

A person familiar with the bank’s portfolios said JPMorgan had reviewed the loans separately and determined that the number of delinquent loans was far less than the outside analysis had found.

At Bear Stearns and Washington Mutual, employees also had the power to sanitize bad assessments. Employees at Bear Stearns were told that they were responsible for “purging all of the older reports” that showed flaws, “leaving only the final reports,” according to the court documents.

Such actions were designed to bolster profit. In a deposition, a Washington Mutual employee said revealing loan defects would undermine the lucrative business, and that the bank would suffer “a couple-point hit in price.”

Ratings agencies also did not necessarily get a complete picture of the investments, according to the court filings. An assessment of the loans in one security revealed that 24 percent of the sample was “materially defective,” the filings show. After exercising override power, a JPMorgan employee sent a report in May 2006 to a ratings agency that showed only 5.3 percent of the mortgages were defective.

Such investments eventually collapsed, spreading losses across the financial system.

Dexia, which has been bailed out twice since the financial crisis, lost $774 million on mortgage-backed securities, according to court records.

Mr. Schneiderman, the New York attorney general, said that overall losses from flawed mortgage-backed securities from 2005 and 2007 were $22.5 billion.

In a statement shortly after he sued JPMorgan Chase, Mr. Schneiderman said the lawsuit was a template “for future actions against issuers of residential mortgage-backed securities that defrauded investors and cost millions of Americans their homes.”

Read More..

Tunisian opposition leader Chokri Belaid shot dead outside home

The Unified Democratic Nationalist Party says Chokri Belaid was shot as he left his house in the capital Tunis. Witnesses say he was taken to a nearby clinic and died. (Hassene Dridi / Associated Press / December 29, 2010)

By Jeffrey Fleishman

February 6, 2013, 3:41 a.m.

CAIRO -- A leading opponent of Tunisia's Islamist-led government was assassinated in front of his home Wednesday, raising fears of sharpening political turmoil in the country that ignited the Arab Spring movement but remains starkly divided between liberals and Islamists.

Chokri Belaid, head of the Unified Democratic Nationalist Party, was shot on his way to work in the capital, Tunis, according to authorities. No one claimed immediate responsibility for the attack, but it comes as Tunisia faces a troubled economy and a restive transition to democracy after decades of dictatorship.  

"This is a criminal act, and act of terrorism not only against Belaid but against the whole of Tunisia," Prime Minister Hamadi Jebali told a radio station. Shortly after the killing, hundreds of protesters gathered outside the Interior Ministry.

An outspoken liberal with a bushy mustache, Belaid often criticized Nahda, the dominant moderate Islamist party for failing to unite the country's political factions. He had accused Ennahda of not clamping down on increasingly violent ultraconservative Salafis from attacking movie houses, art galleries and institutions they deem as against Islam.

Belaid's family told Tunisian media that he had received repeated death threats.

"Chokri Belaid was killed today by four bullets to the head and chest ... doctors told us that he has died. This is a sad day for Tunisia," Ziad Lakhader, a leader of the Popular Front, was quoted as saying to Reuters.

Tunisian President President Moncef Marzouki who was traveling in France said he would cancel a planned trip to Cairo on Thursday and return home.

ALSO:

Bulgarian probe links Hezbollah to Israeli tourist bus attack

Bangladesh war crimes court jails Islamic party leader for life

Ahmadinejad ally linked to human rights abuses arrested in Iran

jeffrey.fleishman@latimes.com

Read More..

Karen Russell's <em>Vampires in the Lemon Grove</em> Is a Darkly Surreal Treat

Karen Russell is one of America’s most lauded young writers. Her first novel, Swamplandia!, was a Pulitzer Prize finalist and has been optioned by HBO. Her fiction combines a literary sensibility with a generous helping of the weird and surreal, which has made her popular with both literary magazines and fantasy and science fiction fans. This cross-genre approach is one that she sees in the work of many of her favorite authors, such as Kelly Link.

“You’re going to sacrifice a mimetic representational realism to tell another kind of truth,” says Russell in this week’s episode of the Geek’s Guide to the Galaxy podcast. “It’s like an optical trick to let you see something … that you might not be aware of if you were reading about the same plot set in a mall in New Jersey.”

Her first collection, St. Lucy’s Home for Girls Raised by Wolves, dealt largely with adolescents coming of age in a whimsical version of Russell’s native south Florida. Her second collection, Vampires in the Lemon Grove, ventures farther afield, with one story set in an Italian resort town and another set during the Meiji Restoration in Japan. The tone of the second book is darker, with several of the tales veering into outright horror, but stories about Antarctic tailgaters or U.S. presidents reincarnated as farm animals continue to revel in a joyful absurdism.

“Sometimes I wish you could just write the parody of whatever you’re writing,” says Russell. “It would probably be better in some ways.”

Listen to our complete interview with Karen Russell in Episode 79 of Geek’s Guide to the Galaxy (above), in which she recalls her early days as a secret nerd, confesses to feeling like the Bernie Madoff of fiction, and reveals that she’s highly ticklish. Then stick around after the interview as guest geek Lynne M. Thomas joins hosts John Joseph Adams and David Barr Kirtley for a panel discussion on the weirdest stories ever.

Karen Russell on being a secret nerd:

“I was the kind of nerd that wasn’t even courageous. I couldn’t even courageously claim my identity as a nerd … I remember I loved this Stephen R. Donaldson book called The Mirror of Her Dreams. It’s a two-book series, and it’s about this woman who … uses mirrors to see other worlds, and then she can enter those other worlds, which is basically a lot like writing, so I had this very concrete way to think about art as creation … But I remember being so embarrassed — hot-in-the-face embarrassed — when somebody saw that I was reading that … In Miami there seemed to be a stigma just if you were reading generally — that was suspicious enough — but certain of those covers aren’t doing you any favors. You know, there’s a woman in front of a dragon on the cover of your book. I think that had certain connotations, at least in my Miami high school, that I was eager to avoid.”

Karen Russell on her short story “Reeling for the Empire”:

“There’s an argument that the birth of feminist consciousness in Japan begins at this moment, because these women bind together to revolt against these conditions. There are these factory protests — completely female factory protests — because these places were riddled with tuberculosis and they basically held the women hostage. They were essentially slaves, and they worked ten-hour days in many cases … It’s a real horror story, and I think that to do that conversion and make it about this monstrous metamorphosis, where these women become these hybridized animal/machines, I think that was a way for me to think through what that must have been like when production gets mechanized, and suddenly time ceases to function the way it did before, and the factory work day is in place, and these women’s bodies became cogs in the larger machine.”

Lynne M. Thomas on pushing the envelope:

“There’s a story that I bought from Rachel Swirsky that hasn’t come out yet where I’m basically going to have to put a trigger warning on it for every possible kind of trigger there is — a trigger warning is for stories with things like domestic violence or sexual assault where people who have been subject to those crimes in real life might have a PTSD sort of reaction. And with Rachel, I was having this conversation where I was saying I’ve never seen these three types of stories done successfully in a way that didn’t completely upset me in the wrong ways, and she was like, ‘Challenge accepted!’ And she wrote this story that … I can’t even … I read it and I was like, ‘This is the most amazing, disturbing thing that I have ever read,’ and I bought in on the spot. I couldn’t believe that she’d managed to take a whole bunch of things that are so collectively awful and turn them into art. It’s called ‘Abomination Rises on Filthy Wings.’ Yeah, it’s not messing around.”

John Joseph Adams on the editor’s responsibility:

“As an editor, it kind of feels like a betrayal of your readers a little bit if you publish something that you don’t fully understand yourself, because when you present it to them, they want to believe that it’s going to make some sense, if they’re a good enough reader, and as an editor I don’t feel that I can be like, ‘Well, I think I understand it, but not really, so let’s leave it out there for the readers.’ And so the M. Rickert story is really the only time I’ve ever made an exception to that rule, and only because I’m certain that it’s brilliant, and the whole point of it is to make you feel that sense of strangeness, and it definitely succeeds in that.”

Read More..

Chris Pratt nabs lead in “Guardians of the Galaxy”

LOS ANGELES (TheWrap.com) – Chris Pratt has scored one of the lead roles in Marvel Studios‘ “Guardians of the Galaxy.”

The “Parks & Recreation” actor will play Star-Lord, the leader of a group of intergalactic heroes, an individual with knowledge of the deal told TheWrap. Marvel and parent company Disney hope that “Guardians” can be a comic book franchise to rival the $ 1.5 billion grossing “The Avengers.”

James Gunn (“Slither”) is directing the film, which is scheduled to be released on August 1, 2014. In addition to heading the team, Star-Lord is a master strategist who wears a suit that give him superhuman strength. Together with a team that includes a raccoon, who is an expert marksman, and an oversized bramble who controls trees, the Guardians teleport around the cosmos preventing disasters.

The role might have seemed a stretch for Pratt, who was best known for his work on as a doughy shoeshine stand operator on NBC’s “Parks & Recreation,” but the actor has made a point of showing off his dramatic skills in films like “Moneyball” (2011).

He also showed he has the ability to bulk up, transforming himself physically to play a Navy SEAL in “Zero Dark Thirty” last year. While making the promotional rounds for the film, Pratt shared a photo of himself in underwear that highlighted his newly toned body and, in retrospect, could have served as an audition shot for the team at Marvel.

Pratt is represented by CAA.

Deadline first reported news of his casting.

Movies News Headlines – Yahoo! News

Title Post: Chris Pratt nabs lead in “Guardians of the Galaxy”
Url Post: http://www.news.fluser.com/chris-pratt-nabs-lead-in-guardians-of-the-galaxy/
Link To Post : Chris Pratt nabs lead in “Guardians of the Galaxy”
Rating:
100%

based on 99998 ratings.
5 user reviews.
Author: Fluser SeoLink
Thanks for visiting the blog, If any criticism and suggestions please leave a comment

Read More..

Ipswich Journal: Paul Mason Is One-Third the Man He Used to Be

Paul Nixon Photography

Paul Mason in 2012, two years after gastric bypass surgery stripped him of the unofficial title of “the world’s fattest man.”

IPSWICH, England — Who knows what the worst moment was for Paul Mason — there were so many awful milestones, as he grew fatter and fatter — but a good bet might be when he became too vast to leave his room. To get him to the hospital for a hernia operation, the local fire department had to knock down a wall and extricate him with a forklift.

That was nearly a decade ago, when Mr. Mason weighed about 980 pounds, and the spectacle made him the object of fascinated horror, a freak-show exhibit. The British news media, which likes a superlative, appointed him “the world’s fattest man.”

Now the narrative has shifted to one of redemption and second chances. Since a gastric bypass operation in 2010, Mr. Mason, 52 years old and 6-foot-4, has lost nearly two-thirds of his body weight, putting him at about 336 pounds — still obese, but within the realm of plausibility. He is talking about starting a jewelry business.

“My meals are a lot different now than they used to be,” Mr. Mason said during a recent interview in his one-story apartment in a cheerful public housing complex here. For one thing, he no longer eats around the clock. “Food is a necessity, but now I don’t let it control my life anymore,” he said.

But the road to a new life is uphill and paved with sharp objects. When he answered the door, Mr. Mason did not walk; he glided in an electric wheelchair.

And though Mr. Mason looks perfectly normal from the chest up, horrible vestiges of his past stick to him, literally, in the form of a huge mass of loose skin choking him like a straitjacket. Folds and folds of it encircle his torso and sit on his lap, like an unwanted package someone has set there; more folds encase his legs. All told, he reckons, the excess weighs more than 100 pounds.

As he waits to see if anyone will agree to perform the complex operation to remove the skin, Mr. Mason has plenty of time to ponder how he got to where he is. He was born in Ipswich and had a childhood marked by two things, he says: the verbal and physical abuse of his father, a military policeman turned security guard; and three years of sexual abuse, starting when he was 6, by a relative in her 20s who lived in the house and shared his bed. He told no one until decades later.

After he left school, Mr. Mason took a job as a postal worker and became engaged to a woman more than 20 years older than him. “I thought it would be for life, but she just turned around one day and said, ‘No, I don’t want to see you anymore — goodbye,’ ” he said.

His father died, and he returned home to care for his arthritic mother, who was in a wheelchair. “I still had all these things going around in my head from my childhood,” he said. “Food replaced the love I didn’t get from my parents.” When he left the Royal Mail in 1986, he said, he weighed 364 pounds.

Then things spun out of control. Mr. Mason tried to eat himself into oblivion. He spent every available penny of his and his mother’s social security checks on food. He stopped paying the mortgage. The bank repossessed their house, and the council found them a smaller place to live. All the while, he ate the way a locust eats — indiscriminately, voraciously, ingesting perhaps 20,000 calories a day. First he could no longer manage the stairs; then he could no longer get out of his room. He stayed in bed, on and off, for most of the last decade.

Social service workers did everything for him, including changing his incontinence pads. A network of local convenience stores and fast-food restaurants kept the food coming nonstop — burgers, french fries, fish and chips, even about $22 worth of chocolate bars a day.

“They didn’t deliver bags of crisps,” he said of potato chips. “They delivered cartons.”

His life became a cycle: eat, doze, eat, eat, eat. “You didn’t sleep a normal sleep,” he said. “You’d be awake most of the night eating and snacking. You totally forgot about everything else. You lose all your dignity, all your self-respect. It all goes, and all you focus on is getting your next fix.”

He added, “It was quite a lonely time, really.”

He got infections a lot and was transported to the hospital — first in a laundry van, then on the back of a truck and finally on the forklift. For 18 months after a hernia operation in 2003, he lived in the hospital and in an old people’s home — where he was not allowed to leave his room — while the local government found him a house that could accommodate all the special equipment he needed.

This article has been revised to reflect the following correction:

Correction: February 6, 2013

The headline on an earlier version of this article misstated Paul Mason’s current weight relative to what he weighed nearly a decade ago. He is now about one-third, not two-thirds, the weight he was then.

Read More..

Deal Professor: Corporate Forces Endangered the Twinkie, but May Save It

Snack cake aficionados rejoice, the Twinkie will live.

Its demise nearly came at the hands of corporate America’s machinations. Its survival, however, depends on some of those same machinations. In the end, it was the extreme outcome of a liquidation in bankruptcy that made the 83-year-old brand salvageable.

The history of the cream-filled snack illustrates a number of the forces that have driven American capitalism over the last hundred years. Its first owner, Continental Baking Company, bought companies left and right in the 1920s, including the Taggart Baking Company, maker of Wonder bread, in 1925.

But the Twinkie was an in-house invention. It was created in 1930 by an executive working at Continental Baking who was looking for a product to sell after strawberry season ended, when the factory line for cream-filled strawberry shortcake sat empty. The yellowish, cream-filled Twinkie was a hit and the company quickly expanded.

Continental Baking continued its acquisition spree and by 1968 it was a motley assortment of baking brands that fed on America’s tastes for sweet and easy food. It was then acquired by Harold Geneen‘s ITT, a conglomerate that sold not only Twinkies but also munitions. There, the brand sat for 16 years until Continental Baking was sold in 1984 for $475 million to Ralston Purina.

By then the baking business had entered a slow growth phase as inflation in baked goods, which had allowed the company continually to raise prices, subsided. Ralston Purina was unable to produce growth in the brands and ended up selling the bakery for about $400 million in 1995 to Interstate Bakeries.

Interstate Bakeries became the largest bakery in the country, but the sentiment around the deal was aptly expressed by a food industry analyst, who said at the time that Ralston Purina’s sale “basically allows them to get rid of a dog.”

Interstate Bakeries was itself a mongrel of many brands put together by serial acquisitions. Unfortunately, Interstate turned out to be better at acquiring companies than managing them. The brands had been passed around often and in the traveling it appears management never could get a more coherent vision for the company other than acquiring yet more unhealthy brands and leaving them to languish.

Then, at the turn of the millennium, the company was hit by a double blow: a taste for health and less carbohydrates among consumers and a botched attempt to put an additive in its breads to give them longer shelf life. You can tell that something is wrong with a food company when its strategy to save itself is to make its food last weeks longer.

It was also not the time to lack vision. The company’s historically high labor and food costs could no longer be covered up by rising prices. Consumers demanded ever cheaper snack food prices.

The company entered bankruptcy in 2004. More than four years later, it emerged, now owned by Ripplewood, which put up $130 million to acquire it. It was then that the company rebranded itself as Hostess Brands.

Despite the company’s cost reductions, and its lowering the employee head count by about 10,000, that was still not enough. The company had more than $800 million in debt coming out of bankruptcy, which was actually over $150 million more than it started with. Not to mention that it had spent $170 million on advisers during bankruptcy.

Indeed, people close to Hostess also say that Ripplewood’s plan was yet another merger: to sell the company to the Sara Lee Corporation. But when Sara Lee sold its bakery operations to Grupo Bimbo, there was no Plan B.

The company filed for bankruptcy again in 2012. It lost $341 million in the previous fiscal year, according to Standard & Poor’s Capital IQ. And management, which had gone through six chief executives in a decade, had been unable to execute a turnaround plan.

When the Bakery, Confectionery, Tobacco Workers and Grain Millers International Union drew a line in the sand in November and said it would rather risk liquidation, it was over.

It was a principled position that the brands would do better with a fresh start and new management. Hostess filed a plan to liquidate the company and fire almost all its 18,000 employees.

The news spread that the Twinkie had finally met its match, along with Wonder bread, the Devil Dog and all the other products. It was then that the mechanisms of corporate America were put in motion to revive Hostess.

Hostess’s investment banks went to work and lined up potential bidders. In fact, they didn’t have to do much, as the announcement of the company’s liquidation and the publicity that followed brought in more than 80 bidders in a few days. It also led to a quick run on Twinkies and other Hostess brands.

The interest came as a surprise to Hostess. Its executives — fearing that liquidation would destroy everything — had worked hard with the Teamsters union for a plan to save the company, only to be frustrated by the bakers union at the last minute. But liquidation has proved to be the Twinkie’s savior.

Instead of trying to work out a compromise by reorganizing in bankruptcy, the company used the bankruptcy process to escape all its past burdensome debts. Freed of 394 union contracts, more than $2 billion in pension liabilities and any need to retain factories, the value of the Twinkie was reduced solely to what people were willing to pay for the brand. News of the Twinkies demise was the best thing that ever could have happened to the company.

Two private equity firms, C. Dean Metropoulos & Company and Apollo Global Management, have agreed to pay $410 million to buy the Hostess business, including Twinkies. And Flowers Foods has agreed to buy Wonder and Hostess’s other bread businesses for $360 million. Even Drake’s will survive; McKee Foods has agreed to pay $27.5 million for the business.

These are so-called stalking horse bids. In bankruptcy there is an open auction of the liquidated business, which in this case is expected to occur in bankruptcy court in February and March, when others will bid.

All told, it appears that the sale of Hostess may reap over a billion dollars, almost twice what the creditors initially expected if it had not been liquidated. In other words, the liquidation of Hostess has made the company worth more.

There’s a lesson here. While corporate machinations and passing along brands can damage them, the clean bill of liquidation allowed corporate America to re-evaluate the Twinkie.

Sure, there will be future battles as Hostess’s old unions struggle to have their employees rehired and new management tries to restart the company. And nothing can heal the wounds of the employees who have lost savings and pensions as well as jobs.

But the brands will now come under better management and, we can hope, more capable owners who can turn to reviving these businesses. In other words, while extreme finance was the cause of Hostess’s demise, it may very well now be the Twinkie’s savior.

---

Read More..

GOP lawmakers want probe of Cal Fire over off-budget account

State Republican legislators want federal prosecutors to investigate the California Department of Forestry and Fire Protection for putting $3.6 million from legal settlements into an off-budget account.

"This subterfuge money has been spent on a wide array of questionable expenditures that has nothing to do with reimbursing the state for firefighting costs," the legislators wrote in a Friday letter to Gov. Jerry Brown, asking him to request an investigation by the U.S. attorney.

The letter follows a story in The Times that found that from 2005 to 2012, Cal Fire, as the department is commonly known, placed funds with the California District Attorneys Assn. to use for training and equipment. Cal Fire regulations say the money is supposed to be sent to the state general fund.

The legislators said the state attorney general had authorized sending the money to the California District Attorneys Assn. Brown served as attorney general from 2007 to 2011.

Lynda Gledhill, a spokeswoman for the current attorney general, denied that claim.

"The California Department of Justice did not endorse placement of settlement money into an account outside of the budget process," Gledhill said. "Atty. Gen. [Kamala] Harris has directed her office to examine the state's settlement practices to ensure all settlements are not only lawful, but fully transparent to the public."

The state Department of Finance has begun an audit of the fund, which is expected to take about two months, spokesman H.D. Palmer said.

In addition, a joint Assembly and state Senate committee announced last week that it will conduct a hearing to determine the extent California agencies are using off-budget accounts to hold money outside the state system.

The GOP letter was signed by 25 members of the Senate and Assembly. They also are using the issue to call for an end to a law the Legislature passed last year requiring rural homeowners who rely on state firefighters to pay $150 a year for fire prevention services.

"It is clear that the state has not been judicious in its use of taxpayer dollars," the lawmakers' letter said. "The state must stop these outrageous duplicitous tactics."

Senate Republican leader Robert Huff of Diamond Bar and Assembly GOP leader Connie Conway of Tulare sent a letter last week asking the attorney general to refer the matter to the U.S. attorney. A spokeswoman for the U.S. attorney in Sacramento said no information about the fund had been brought to her office.

Janet Upton, a Cal Fire spokeswoman, said the agency would welcome an investigation.

"We stand by the intent of this fund and have many examples of good things it's done that benefit the taxpayers of this state," she said.

Cal Fire's own audit, released in 2009, raised questions about whether the fund was allowed. But many of the critical comments were dropped from the audit's final version.

The scrutiny follows similar revelations that the state Department of Parks and Recreation hid $20 million as budget cuts were forcing the closure of parks. Although the Department of Finance looked for other secret funds, it did not find Cal Fire's account with the prosecutors' association.

jeff.gottlieb@latimes.com

Read More..

Exploding the Phone: The Untold Story of the Teenagers and Outlaws Who Hacked Ma Bell

An excerpt from Exploding the Phone

by Phil Lapsley

“

Locke spent the next twenty-four hours in what felt like a scene from a 1940s detective movie: a barren room with nothing more than a wooden table, a chair for him, two chairs for his interrogators, and a bare lightbulb dangling from the ceiling. Sitting across from him, the FBI agent and the telephone security man worked hard to get him to confess to using the blue box.

Before smartphones and iPads, before the internet or the personal computer, a misfit group of technophiles, blind teenagers, hippies, and outlaws figured out how to hack the world’s largest machine: the telephone system. The following is an excerpt from the new book Exploding the Phone written by Philip D. Lapsley and published by Grove/Atlantic, which tells the story of the “phone phreaks.”

There it was again.

Jake Locke set down his cup and looked more closely at the classified ad. It was early afternoon on a clear spring day in Cambridge in 1967. Locke, an undergrad at Harvard University, had just gotten out of bed. A transplant from southern California, he didn’t quite fit in with Harvard’s button-down culture — another student had told him he looked like a “nerdy California surfer,” what with his black-framed eyeglasses, blond hair, blue eyes, and tall, slim build. Now in the midst of his sophomore slump, Locke found himself spending a lot of time sleeping late, cutting classes, and reading the newspaper to find interesting things to do. Pretty much anything seemed better than going to classes, in fact. (“John Locke” is a pseudonym).

It was a slow news day. The Crimson, Harvard’s student newspaper, didn’t have much in the way of interesting articles, so Locke once again found himself reading the classified ads over breakfast. He had become something of a connoisseur of these little bits of poetry — people selling cars, looking for roommates, even the occasional kooky personal ad probably intended as a joke between lovers—all expressed in a dozen or so words.

But this ad was different. It had been running for a while and it had started to bug him.

WANTED HARVARD MIT Fine Arts no. 13 notebook. (121 pages) & 40 page reply K.K. & C.R. plus 2,800; battery; m.f. El presidente no esta aqui asora, que lastima. B. David Box 11595 St. Louis, MO 63105.

Locke had seen similar classified ads from students who had lost their notes for one class or another and were panicking as exams rolled around. They often were placed in the Crimson in the hopes that some kind soul had found their notes and would return them. Fine Arts 13 was the introductory art appreciation class at Harvard, so that fit.

But nothing else about the ad made any sense. Fine Arts 13 wasn’t offered at MIT. And what was all the gibberish afterward? 2,800? Battery? M.f., K.K., C.R.? What was with the Spanish? And why was somebody in St. Louis, Missouri, running an ad in Cambridge, Massachusetts, looking for a notebook for a class at Harvard? Locke had watched the ad run every day for the past few weeks. Whoever they were, and whatever it was, they clearly wanted this notebook. Why were they so persistent?

One way to find out.

Locke looked around for a piece of paper and a pen. He wrote: “Dear B. David: I have your notebook. Let’s talk. Sincerely, Jake.”

He dropped the letter in the mail on his way into Harvard Square to find something interesting to do.

An envelope with a St. Louis, Missouri, postmark showed up in Locke’s mailbox a week later. Locke opened the envelope and read the single sheet of paper. Or rather, he tried to read it. It wasn’t in English. It seemed to be written in some sort of alien hieroglyphics. It was brief, only a paragraph or so long. The characters looked familiar somehow but not enough that he could decipher them.

Locke showed the letter to everyone he saw that day but nobody could read it. Later that evening, as Locke sat at the kitchen table in his dorm room and stared at the letter, trying to puzzle it out, one of his roommates came home. Shocked that Locke might actually be doing something that looked like homework, his roommate asked what he was working on. Locke passed the letter across the table and told him about it.

His roommate took one look and said, “It looks like Russian.”

Locke said, “That’s what I thought. But the characters don’t seem right.”

“Yeah. They’re not. In fact …” His roommate’s voice trailed off for a moment. “In fact, they’re mirror writing.”

“What?”

“You know, mirror writing. The letters are written backwards. See?”

Locke looked. Sure enough: backwards.

Locke and his roommate went to the mirror and transcribed the reversed lettering. It was Cyrillic — Russian letters. Fortunately, Locke’s roommate was taking a Russian class. They sat back down at the table and translated the letter.

“Dear Jake,” the letter read. “Thank you very much for your reply. However, I seriously doubt that you have what I need. I would strongly advise you to keep to yourself and not interfere. This is serious business and you could get into trouble.” Signed, B. David.

Locke sat back. Someone had put a cryptic ad in the newspaper. He’d responded. They sent him a letter. In mirror writing. In Russian. In 1967. During the cold war.

Spy ring.

It just didn’t get much cooler than this, Locke figured. Intriguing. Terrifying, even. And far, far better than going to class.

Pages: 1 2 3 4 5 6 View All

Read More..

The New Old Age Blog: In Blended Families, Responsibility Blurs

Every year, Fran McDowell waited for the summer week when she would sing in a choral festival in the North Carolina mountains, then spend a few days in a lakeside cabin with close women friends.

That getaway grew more complicated to arrange — but perhaps more necessary — after her husband, Herb Beadle, was diagnosed with Alzheimer’s disease. They had a “gloriously happy” marriage — her first, his second — for 11 years, and she was more than willing to care for him in sickness as in health. But he could no longer manage alone in their Atlanta home.

For a few years, other family members pitched in to allow Ms. McDowell her cherished vacation. Eventually, though, she had to ask her husband’s daughter, a medical professional in another state, to take him into her home for a week.

She said no, then yes. Then, the day before Ms. McDowell was to drive him there, her stepdaughter again refused, leaving no time for alternate arrangements. If this had been her biological child, “I would have said, ‘Come on, don’t do this to me,’” Ms. McDowell said. Instead, reluctant to make waves, she canceled her trip.

“I think confrontation is riskier for stepparents,” she told me. “I was the compliant one who would bite my tongue rather than say what I thought.”

Ms. McDowell never told her stepdaughter, or anyone in the family, how angry and disappointed she was, or how difficult it was becoming to care for their father, who died three years ago at 86. She told the members of her dementia caregivers support group instead.

It was that group’s leader, Moira Keller, who e-mailed me to suggest this topic. A clinical social worker with the Sixty Plus program at Piedmont Atlanta Hospital, she wrote that “one of the biggest challenges I have is blended families in later life.”

Though I’ve written about the way the 1970s’ spike in divorces could complicate caregiving for adult children — more households to sustain, more siblings to either help or hinder — I hadn’t considered the impact on the older people themselves.

But Ms. Keller seems to be onto something. “The generation most likely to have stepchildren” — the boomers — “don’t need much care yet,” said Merril Silverstein, a Syracuse University sociologist co-editing a coming issue of the Journal of Marriage and the Family on stepfamilies in later life. “The crunch will come in 10 or 20 years.”

Initially, many adult children whose divorced or widowed parents remarry seem delighted, Ms. Keller said when we spoke. “They’re thrilled that Mom or Dad isn’t alone,” she said. “It’s a wonderful thing — until somebody gets sick.”

Then, she has found, “it gets really blurry. Who’s going to do what?” Grown children don’t have much history with these new spouses; they often feel less responsibility to intervene or help out, and stepparents may be unwilling to ask. Perhaps it’s unclear whether children or new spouses have decision-making authority.

“Older couples in this situation fall through the cracks,” Ms. Keller said.

Research shows that the ties which lead adult children to become caregivers — depending on how much contact they have with parents, how nearby they live, how obligated they feel — are weaker in stepchildren, Dr. Silverstein said. Money sometimes enters the equation too, Ms. Keller added, if biological children resent a parent’s spending their presumed inheritance on care for an ailing stepparent.

Adela Betsill, another of Ms. Keller’s support group members, married her longtime partner five years ago — her second marriage, his third. She has since given up her interior design business to care for Robert who, at 72, has also developed Alzheimer’s disease. His two children have had little involvement — perhaps because she’s just 49 and presumed able to handle everything.

Thus, though Robert’s son works from an office in their home, if Ms. Betsill needed to go out and asked him to remind his father to eat lunch, “he might, or he might not,” she said. “I don’t think he realizes it’s a burden.” So she has not asked.

Would it be different if she were his biological mother and he saw her wearing out under the strain? She thinks so, but it’s hard to know. After all, biological families also experience plenty of conflict and avoidance as elders age.

Still, that sense of reciprocity we often hear from caregivers — she took care of me when I was young, so I need to help out now that she’s old — doesn’t apply in late-life stepfamilies. Ms. Betsill didn’t raise this man, or his half sister.

Older couples who marry or remarry often discuss their finances, Ms. Keller has found. (An elder attorney, Craig Reaves, discussed the legal consequences here.) But illness and dependence may prove even more difficult subjects to broach.

“If I could yell one thing from a mountaintop,” Ms. Keller said, “it’s to talk about this stuff, too. Who’s going to take care of you if you become sick? Talk about that while you’re still healthy.”

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..