Her knee shredded, Lindsey Vonn done for season

SCHLADMING, Austria (AP) — All it took was a moment. Lindsey Vonn landed hard and tumbled face first with a piercing shriek.

Just like that, the star American skier was on the ground with two torn ligaments in her right knee and a broken bone in her lower leg.

The cascading fall down the slope during the super-G at the world championships Tuesday knocked out the four-time World Cup champion for the rest of the season, the latest and most serious in a string of injuries for Vonn at skiing's biggest events.

The U.S. team said in a statement it expects her back for the next World Cup season and the 2014 Sochi Olympics, which start a year from this week.

The harrowing accident came after Vonn was lifted into the air off a jump in the opening race at the championships. As she hit the ground, her right leg gave way and she spun down face first, throwing an arm out to protect herself. She ended up on her back as she smashed through a gate.

On the television feed, Vonn was clearly heard screaming an expletive as she landed, then a despairing "Yes, yes," when someone asked, "Are you hurt?"

Race leader and eventual champion Tina Maze watched with her mouth agape. The concern also was obvious on the face of Vonn's sister, Laura Kildow, who has been traveling with her full time this season.

For 12 minutes, Vonn lay on the snow getting medical treatment before being airlifted by helicopter to a hospital in Schladming.

Vonn tore her anterior cruciate ligament and medial collateral ligament in her right knee, U.S. ski team medical director Kyle Wilkens said in a statement. The broken bone was described as a "lateral tibial plateau fracture."

Christian Kaulfersch, the assistant medical director at the worlds, said Vonn left the Schladming hospital on Tuesday afternoon and will have surgery in another hospital. "She first wanted to go back to the team hotel to mentally deal with all what has happened," Kaulfersch said.

Vonn's father, Alan Kildow, spoke with her by phone and said that she's, "mad at the way things turned out." His daughter told him that she landed in a clump of sugar snow, or ice crystals, that caused her to fall forward, he said.

"She's a tough character. A very determined and tough character," Kildow told The Associated Press in a phone interview. "She will be back."

Kildow said that surgery could take place as soon as this weekend, likely at the Steadman Clinic, in Vail, Colo. Recovery time varies, according to Dr. Tom Hackett, an orthopedic surgeon at the clinic and the team physician for the U.S. snowboard squad.

But Vonn could be looking at six-to-eight months before she's back on skis.

"It's not like at six months you say, 'OK, you can get back on a super-G course," Hackett said. "There's a progression to getting back on skis, getting back to taking some easy runs, getting back to some gates, and working your way back to some steeper terrain. There's a whole return to snow progression that we've developed over many years."

Time enough to get back for Sochi?

"I think so," Hackett said. "I would be very optimistic she could come back strong. She's a fierce competitor. She's a fighter and chances are that she will — I would think — essentially take all of that athletic energy and put it into her rehabilitation. There's a really good chance she could come back as strong as ever."

Comebacks are nothing new for Vonn, who has also been afflicted by injuries at her last six major championships — from a thumb she sliced on a champagne bottle at the 2009 worlds in Val d'Isere, France, to a bruised shin that she cured with Austrian cheese at the Vancouver Olympics.

This one, however, could prove the biggest test yet for the 28-year-old who won the downhill at the 2010 Vancouver Olympics.

Vonn took a month off this season after being hospitalized for an intestinal illness in November, and had just regained her form with two wins last month.

That was evident at the start of her Tuesday's run. She led Maze by 0.04 seconds at the first checkpoint and was just 0.12 back at the second interval and seemingly on her way to a medal, if not victory.

Exactly what went wrong was debated by competitors and officials at the championships.

The start of the race was delayed by 3½ hours because of fog hanging over the course and it began in waning light at 2:30 p.m local time. Even before Vonn's crash, a course worker fell and also had to be airlifted. He was reported to have broken his nose.

All the delays made for what skiers call flat light — overcast and dreary conditions — when Vonn raced.

"Lindsey did a great job on top and Lindsey has won a lot of races in flat light so the flat light was definitely not a problem," U.S. Alpine director Patrick Riml told the AP.

"We are upset obviously with what happened but if you don't know the facts and why they decided to start and what the weather forecast was it's hard to say without any reasoning," Riml said. "And they probably had a reason, otherwise they wouldn't have started."

Atle Skaardal, women's race director for the International Ski Federation, defended the decision to go ahead with the event.

"I can confirm that the visibility was great, there were no problems, and the course was also in good shape," he said. "I don't see that any outside factors played a role in this accident. ... The other factors were like they were supposed to be for ski racing."

Vonn's list of injuries at major championships is long.

Two years ago, she pulled out midway through the last worlds in Garmisch-Partenkirchen, Germany, because of a mild concussion. At the 2010 Vancouver Olympics, Vonn skied despite a severely bruised shin to win the downhill and take bronze in the super-G.

At the 2009 worlds in Val d'Isere, she sliced her thumb on a champagne bottle after sweeping gold in the downhill and super-G, forcing her out of the giant slalom. At the 2007 worlds in Are, Sweden, Vonn injured her knee in training and missed her final two events.

And at the 2006 Turin Olympics, she had a horrific crash in downhill training and went directly from her hospital room to the mountain to compete in four of her five events.

The conditions Tuesday varied from racer to racer, and as the light began to fade even more, organizers stopped the race after only 36 of the 59 skiers had come down.

Maze skied immediately before Vonn.

"I saw it was a very high jump, so I knew I had to take the right line to make the next gate," she said. "World championship races often have special conditions and the mistakes from the girls were not because of the slope."

The two racers who started immediately after Vonn, former overall winner Maria Hoefl-Riesch of Germany and local favorite Anna Fenninger of Austria, each skied off course. In all, six women who started the course failed to finish. Still, Skaardal said he never thought about stopping the race.

"It's not a very difficult course but in some parts you couldn't see anything," said Fabienne Suter of Switzerland, who finished fifth.

Vonn's teammate Julia Mancuso also thrived in the difficult conditions and won the bronze medal.

"It's the same for everybody," U.S. speed coach Chip White said. "Everyone had to wait for a long time and that's always difficult. And the holds were every 15 minutes so it really doesn't give you a chance to go and do something else. You're always kind of on edge at the ready. It's a difficult situation but everybody had the same difficult situation."

Not long after Vonn was injured, NBC hosted a news conference in New York to discuss its coverage of the Sochi Games. A poster of a smiling Vonn hung in the room next to one of snowboarder Shaun White, evidence of the network's unsurprising expectations that she would be one of the biggest stars in Sochi.

The network's executives chose to put a positive spin on the injury.

"We expect her to be the comeback Olympian of the year," NBC Sports Group Chairman Mark Lazarus said.

___

Associated Press writer Eric Willemsen in Schladming and AP Sports Writers Pat Graham and Rachel Cohen contributed to this report.

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Well: Warning Too Late for Some Babies

Six weeks after Jack Mahoney was born prematurely on Feb. 3, 2011, the neonatal staff at WakeMed Hospital in Raleigh, N.C., noticed that his heart rate slowed slightly when he ate. They figured he was having difficulty feeding, and they added a thickener to help.

When Jack was discharged, his parents were given the thickener, SimplyThick, to mix into his formula. Two weeks later, Jack was back in the hospital, with a swollen belly and in inconsolable pain. By then, most of his small intestine had stopped working. He died soon after, at 66 days old.

A month later, the Food and Drug Administration issued a caution that SimplyThick should not be fed to premature infants because it may cause necrotizing enterocolitis, or NEC, a life-threatening condition that damages intestinal tissue.

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Catherine Saint Louis speaks about using SimplyThick in premature infants.

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Experts do not know how the product may be linked to the condition, but Jack is not the only child to die after receiving SimplyThick. An F.D.A. investigation of 84 cases, published in The Journal of Pediatrics in 2012, found a “distinct illness pattern” in 22 instances that suggested a possible link between SimplyThick and NEC. Seven deaths were cited; 14 infants required surgery.

Last September, after more adverse events were reported, the F.D.A. warned that the thickener should not be given to any infants. But the fact that SimplyThick was widely used at all in neonatal intensive care units has spawned a spate of lawsuits and raised questions about regulatory oversight of food additives for infants.

SimplyThick is made from xanthan gum, a widely-used food additive on the F.D.A.’s list of substances “generally recognized as safe.” SimplyThick is classified as a food and the F.D.A. did not assess it for safety.

John Holahan, president of SimplyThick, which is based in St. Louis, acknowledged that the company marketed the product to speech language pathologists who in turn recommended it to infants. The patent touted its effectiveness in breast milk.

However, Mr. Holahan said, “There was no need to conduct studies, as the use of thickeners overall was already well established. In addition, the safety of xanthan gum was already well established.”

Since 2001, SimplyThick has been widely used by adults with swallowing difficulties. A liquid thickened to about the consistency of honey allows the drinker more time to close his airway and prevent aspiration.

Doctors in newborn intensive care units often ask non-physician colleagues like speech pathologists to determine whether an infant has a swallowing problem. And those auxiliary feeding specialists often recommended SimplyThick for neonates with swallowing troubles or acid reflux.

The thickener became popular because it was easy to mix, could be used with breast milk, and maintained its consistency, unlike alternatives like rice cereal.

“It was word of mouth, then neonatologists got used to using it. It became adopted,” said Dr. Steven Abrams, a neonatologist at Texas Children’s Hospital in Houston. “At any given time, several babies in our nursery — and in any neonatal unit — would be on it.”

But in early 2011, Dr. Benson Silverman, the director of the F.D.A.’s infant formula section, was alerted to an online forum where doctors had reported 15 cases of NEC among infants given SimplyThick. The agency issued its first warning about its use in babies that May. “We can only do something with the information we are provided with,” he said. “If information is not provided, how would we know?”

Most infants who took SimplyThick did not fall ill, and NEC is not uncommon in premature infants. But most who develop NEC do so while still in the hospital. Some premature infants given SimplyThick developed NEC later than usual, a few after they went home, a pattern the F.D.A. found unusually worrisome.

Even now it is not known how the thickener might have contributed to the infant deaths. One possibility is that xanthan gum itself is not suitable for the fragile digestive systems of newborns. The intestines of premature babies are “much more likely to have bacterial overgrowth” than adults’, said Dr. Jeffrey Pietz, the chief of newborn medicine at Children’s Hospital Central California in Madera.

“You try not to put anything in a baby’s intestine that’s not natural.” If you do, he added, “you’ve got to have a good reason.”

A second possibility is that batches of the thickener were contaminated with harmful bacteria. In late May 2011, the F.D.A. inspected the plants that make SimplyThick and found violations at one in Stone Mountain, Ga., including a failure to “thermally process” the product to destroy bacteria of a “public health significance.”

The company, Thermo Pac, voluntarily withdrew certain batches. But it appears some children may have ingested potentially contaminated batches.

The parents of Jaden Santos, a preemie who died of NEC while on SimplyThick, still have unused packets of recalled lots, according to their lawyer, Joe Taraska.

The authors of the F.D.A. report theorized that the infants’ intestinal membranes could have been damaged by bacteria breaking down the xanthan gum into too many toxic byproducts.

Dr. Qing Yang, a neonatologist at Wake Forest University, is a co-author of a case series in the Journal of Perinatology about three premature infants who took SimplyThick, developed NEC and were treated. The paper speculates that NEC was “most likely caused by the stimulation of the immature gut by xanthan gum.”

Dr. Yang said she only belatedly realized “there’s a lack of data” on xanthan gum’s use in preemies. “The lesson I learned is not to be totally dependent on the speech pathologist.”

Julie Mueller’s daughter Addison was born full-term and given SimplyThick after a swallow test showed she was at risk of choking. It was recommended by a speech pathologist at the hospital.

Less than a month later, Addison was dead with multiple holes in her small intestine. “It was a nightmare,” said Ms. Mueller, who has filed a lawsuit against SimplyThick. “I was astounded how a hospital and manufacturer was gearing this toward newborns when they never had to prove it would be safe for them. Basically we just did a research trial for the manufacturer.”

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Nanoparticles in Food Raise Concern by Advocacy Group

Nanomaterials, substances broken down by technology into molecule-size particles, are starting to enter the food chain through well-known food products and their packaging, but there is little acknowledgment by the companies using them, according to a new report from a nonprofit group that works to enhance corporate accountability.

Some companies may not even know whether nanomaterials are present in their products, the corporate accountability group As You Sow said.

Only 26 out of 2,500 companies, including PepsiCo, Whole Foods and the corporate parent of Pizza Hut and Taco Bell, responded to a survey from As You Sow about their use of nanomaterials.

“Only 14 said they don’t use nanomaterials, and of those only two had any policies on the use of nanomaterials,” said Andy Behar, chief executive of As You Sow. Various food companies have said they are interested in nanotechnology, which can help make products creamier without additional fat, intensify and improve flavors and brighten colors.

Their small size allows nanoparticles to go places in the body where larger particles cannot and enter cells. They have been found in the blood stream after ingestion and inhalation, and while research on their health effects is limited, studies have shown them to have deleterious effects on mice and cells.

“We’re not taking a no nano position,” Mr. Behar said. “We’re saying just show it’s safe before you put these things into food or food packaging.”

He noted that the European Union requires labeling of foods containing nanomaterials and that the European Food Safety Authority has published guidance for assessing nanomaterials in food and animal feed.

Last April, the Food and Drug Administration issued an unusually emphatic statement on nanomaterials, saying it did not have enough data to determine the safety of nanomaterials in food.

The Environmental Protection Agency is evaluating various nanoparticles used in consumer products, like sunscreens.

As You Sow tested 10 varieties of powdered doughnuts for the presence of nanoparticles. With the help of an independent lab, it found that Hostess Donettes and Dunkin’ Donuts Powdered Cake Donuts tested positive for the presence of titanium dioxide materials of less than 10 nanometers. Titanium dioxide is used to brighten white substances. The nano variety is under investigation by the E.P.A.

Michelle King, a spokeswoman for Dunkin’ Donuts, said the company was working with its supplier to validate As You Sow’s findings. Hostess Brands went out of business during the test and closed its factories.

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Europol Investigation Shows Fixing Is Suspected in 680 Soccer Matches

Robin Van Lonkhuijsen/Agence France-Presse — Getty Images

Rob Wainwright, the director of Europol, at a press conference in The Hague on Monday.

Soccer is known throughout much of the world as the beautiful game. But the sport’s ugliest side — the scourge of match-fixing — will not soon go away.

With the 2014 World Cup in Brazil drawing closer, a European police intelligence agency said Monday that its 19-month investigation, code-named Operation Veto, revealed widespread occurrences of match-fixing in recent years, with 680 games globally deemed suspicious. The list of match types is staggering: some 150 international matches, mostly in Africa, Asia and Latin America; roughly 380 games in Europe, covering World Cup and European championship qualifiers as well as two Champions League games; and games that run the gamut from lower-division semiprofessional matches to contests in top domestic leagues.

But officials at the news conference at The Hague repeatedly sidestepped questions from reporters on how many of the actual 680 matches cited had been previously reported, and, in some instances, previously prosecuted, and how many of them represented new information.

Nor would the officials identify any of the teams and individuals newly linked to match-fixing, citing the need to guard the confidentiality of police procedures.

Still, one new tantalizing detail did emerge: the revelation that one of the suspicious matches uncovered was a game in the Champions League — the most prestigious annual soccer tournament in the world — and that it was played in England in the last three or four years.

Even as the news conference continued, fans immediately took to social media to speculate on the match in question and, indeed, on which English team might have been involved. Manchester United, Manchester City, Arsenal, Chelsea, Liverpool and Tottenham are the only English teams that have participated in the Champions League during the time frame cited by officials. All six are iconic teams in England’s Premier League, which is by far the world’s most popular soccer league and has an unparalleled global following.

And while the absence of details left it unclear as to whether investigators believed an English team was culpable in fixing a Champions League game, or whether it was an opposing team from another country that had come to England for the match, the fact that match-fixing was now being linked to the country that represents the biggest international stage in soccer left many in the sport apprehensive.

“It would be naïve and complacent of those in the U.K. to think such a criminal conspiracy does not involve the English game and all the football in Europe,” Rob Wainwright, the director of the police intelligence agency, known as Europol, told reporters.

Most of the investigation’s focus, however, was elsewhere. Europol described a wide-ranging network of fixing that struck at the sport’s core. Nearly $11 million in profits and nearly $3 million in bribes were discovered during the investigation, which uncovered “match-fixing activity on a scale we have not seen before,” Wainwright said.

“This is a sad day for European football,” he added.

Fixers typically seek to dictate a game’s result by corrupting the players or the on-field officials, and the Europol officials said Monday that roughly 425 people were under suspicion because of the investigation, with 50 people having been arrested. The scope of the investigation covered games from roughly 2008 to 2011.

An organized crime syndicate based in Asia is believed to be the driving force behind the fixing activity, which stretches across at least 15 countries, Europol officials said. Individual bribes were, in some instances, higher than $136,000, and fixers would place bets on the tainted matches through bookmakers in Asia.

Various matches in Africa, Asia and South and Central America were identified as suspicious, and Declan Hill, a Canadian journalist and the author of “The Fix: Soccer and Organized Crime,” said his reporting on the subject — which was included in Europol’s investigation — had not previously indicated such widespread fixing among national teams.

David Jolly contributed reporting from The Hague.

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Facebook After Death: Who Owns Your Pages When You Die?

Most people can’t live without Facebook — but what happens to your Facebook page when you are no longer living? New Hampshire and other states are trying to figure that out.

State Rep. Peter Sullivan has introduced legislation to allow the executor of an estate control over the social networking pages of the dead. Last week, the New Hampshire House of Representatives voted 222-128 to give Sullivan more time to write an amendment that begins a study of the issue.

The bill proposed by Sullivan, a Democrat from Manchester, would allow control of someone’s Facebook, Twitter, and other accounts such as Gmail to be passed to the executor of their estate after death.

According to Sullivan, passage of his bill would bridge a gap in policies of social media sites regarding posthumous users. He said his bill would protect residents who have suffered loss.

“This would give the families a sense of closure, a sense of peace. It would help prevent this form of bullying that continues even after someone dies and nobody is really harmed by it.”

In an interview with WMUR, Sullivan tells the story of a young Canadian girl who committed suicide because of bullying. After she died the taunting continued on her Facebook page.

Read More About Teens Bullied On Facebook

“The family wasn’t able to do anything; they didn’t have access to her account.” Sullivan said. “They couldn’t go in and delete those comments, and they couldn’t take the page down completely.”

Five other states, including Oklahoma, Idaho, Rhode Island, Indiana and Connecticut, have established legislation regulating one’s digital presence after death. Rhode Island and Connecticut were first, but their bills were limited in scope to email accounts, excluding social networking sites.

According to opponents of Sullivan’s bill, contracts and provisions between the social media user and the site already lay out what happens to the page once the user passes. Opponents say Sullivan’s bill is unenforceable and incomplete. Some also say the issue would be better suited for federal law.

Ryan Kiesel, then a state legislator from Oklahoma, sponsored a similar bill in 2010 called the Digital Property Management After Death law. Though he supports states’ efforts to bring light to this issue, saying that it is a good way to get the conversation started, he also believes that this is a case that should eventually taken up by the federal government.

“Facebook and other online providers have changed their privacy policies to keep up with the times, but we still see a lot of flux within different sites like Facebook , Flickr, or Google, for example.” Keisel told ABC News. “The federal government should pass uniform laws to govern all digital assets because it is quite difficult for an estate to have to navigate endless numbers of digital policies postmortem.”

Kiesel, who now works as a civil rights activist, compared one’s digital legacy to the distribution of someone’s tangible assets after death.

Get more pure politics at ABCNews.com/Politics

“In Oklahoma, if you are administrator of the estate of a deceased person’s house and you find a box under their bed, you are well within your right to see what’s inside that box and if property is worth distributing, you should distribute it accordingly.” Kiesel told ABC News that the same idea goes for digital legacy.

Today marks the ninth Anniversary of the launch of Facebook, which currently has over 1 billion active users. That number, which has grown from just a million users in 2004, suggests there must be an enormous number of Facebook pages that must currently be occupied by deceased people.

Facebook has not completely ignored the growing number of deceased users. The site has created a function allowing Facebook pages to become memorials after they have died.

“Please use this form to request the memorialization of a deceased person’s account,” the site reads. “We extend our condolences and appreciate your patience and understanding throughout this process.”

Memorialization of a Facebook page, however, can only be done via online request. And the terms of service for Facebook’s say that it will not issue login and password information to family members of the deceased. The requestor must contact Facebook and request that the profile is taken down or memorialized.

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Cause of Super Bowl power outage remains unclear

NEW ORLEANS (AP) — Who turned out the lights?

The day after the 34-minute blackout at the Super Bowl, the exact cause — and who's to blame — were unclear, though a couple of potential culprits had been ruled out.

It wasn't Beyonce's electrifying halftime performance, according to Doug Thornton, manager of the state-owned Superdome, since the singer had her own generator. And it apparently wasn't a case of too much demand for power. Meters showed the 76,000-seat stadium was drawing no more electricity than it does during a typical New Orleans Saints game, Thornton said.

The lights-out game Sunday proved an embarrassment for the Big Easy just when it was hoping to show the rest of the world how far it has come since Hurricane Katrina in 2005. But many fans and residents were forgiving, and officials expressed confidence that the episode wouldn't hurt the city's hopes of hosting the championship again.

To New Orleans' great relief, NFL Commissioner Roger Goodell said the city did a "terrific" job hosting its first pro football championship in the post-Katrina era, and added: "I fully expect that we will be back here for Super Bowls."

Fans watching from their living rooms weren't deterred, either. An estimated 108.4 million people saw the Baltimore Ravens beat the San Francisco 49ers 34-31, making it the third most-viewed program in television history. Both the 2010 and 2011 games hit the 111 million mark.

The problem that caused the outage was believed to have happened around the spot where a line that feeds current from the local power company, Entergy New Orleans, connects with the Superdome's electrical system, officials said. But whether the fault lay with the utility or with the Superdome was not clear.

Determining the cause will probably take days, according to Dennis Dawsey, a vice president for distribution and transmission for Entergy. He said the makers of some of the switching gear have been brought in to help figure out what happened.

An attorney for the state board that oversees the Superdome said the blackout did not appear to be related to the replacement in December of electrical equipment connecting the stadium to Entergy. Officials with the utility and the Superdome noted that an NFL game, the Sugar Bowl and another bowl game were played there in recent weeks with no apparent problems.

The blackout came after a nearly flawless week of activity for football fans in New Orleans leading up to the big game.

"I hope that's not what they'll remember about this Super Bowl," French Quarter artist Gloria Wallis said. "I hope that what they'll remember is they had a great time here and that they were welcomed here."

Ravens fan Antonio Prezioso, a Baltimore native who went to the game with his 11-year-old son, said the outage just extended the experience.

"The more time we could spend at the game was a good thing, as long as it ended the way it did," he said, laughing.

The city last hosted the Super Bowl in 2002, and officials were hoping this would serve as the ultimate showcase for the city's recovery. The storm tore holes in the roof of the Superdome and caused water damage to its electrical systems, and more than $330 million was spent repairing and upgrading the stadium.

Sunday's Super Bowl was New Orleans' 10th as host, and officials plan to make a bid for an 11th in 2018.

Mayor Mitch Landrieu told WWL-AM on Monday that the outage won't hurt the city's chances, and he joked that the game got better after the blackout: "People were leaving and the game was getting boring, so we had to do a little something to spice it up."

Jarvis DeBerry, a columnist for nola.com and The Times-Picayune, wrote that the power outage gave the media "an opportunity to laugh at the apparent ineptitude or suggest that the ghosts of Hurricane Katrina were haunting the Superdome."

"That's not the kind of attention the city was looking for, obviously," he wrote, "but it's certainly too soon to say if people will remember the power shortage over San Francisco's furious comeback attempt against Baltimore or if this will harm the city's future opportunities to host the Super Bowl."

Bjorn Hanson, dean of New York University's Center for Hospitality and Sports Management, said the episode shouldn't hurt the city's reputation as a big convention destination. "I think people view it for what it was: an unusual event with a near-record power draw," he said. "It was the equivalent of a circuit breaker flipping."

The American Association of Neurological Surgeons will meet in New Orleans from April 27 to May 1. Patty Anderson, director of meetings for the group, said of the blackout: "I never even gave it a second thought. To me, the city is bigger, stronger and more vibrant than it's ever been."

___

Associated Press writers Beth Harpaz, Brett Martel, Stacey Plaisance and Barry Wilner contributed to this report.

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Well: Expressing the Inexpressible

When Kyle Potvin learned she had breast cancer at the age of 41, she tracked the details of her illness and treatment in a journal. But when it came to grappling with issues of mortality, fear and hope, she found that her best outlet was poetry.

How I feared chemo, afraid
It would change me.
It did.
Something dissolved inside me.
Tears began a slow drip;
I cried at the news story
Of a lost boy found in the woods …
At the surprising beauty
Of a bright leaf falling
Like the last strand of hair from my head

Ms. Potvin, now 47 and living in Derry, N.H., recently published “Sound Travels on Water” (Finishing Line Press), a collection of poems about her experience with cancer. And she has organized the Prickly Pear Poetry Project, a series of workshops for cancer patients.

“The creative process can be really healing,” Ms. Potvin said in an interview. “Loss, mortality and even hopefulness were on my mind, and I found that through writing poetry I was able to express some of those concepts in a way that helped me process what I was thinking.”

In April, the National Association for Poetry Therapy, whose members include both medical doctors and therapists, is to hold a conference in Chicago with sessions on using poetry to manage pain and to help adolescents cope with bullying. And this spring, Tasora Books will publish “The Cancer Poetry Project 2,” an anthology of poems written by patients and their loved ones.

Dr. Rafael Campo, an associate professor of medicine at Harvard, says he uses poetry in his practice, offering therapy groups and including poems with the medical forms and educational materials he gives his patients.

“It’s always striking to me how they want to talk about the poems the next time we meet and not the other stuff I give them,” he said. “It’s such a visceral mode of expression. When our bodies betray us in such a profound way, it can be all the more powerful for patients to really use the rhythms of poetry to make sense of what is happening in their bodies.”

On return visits, Dr. Campo’s patients often begin by discussing a poem he gave them — for example, “At the Cancer Clinic,” by Ted Kooser, from his collection “Delights & Shadows” (Copper Canyon Press, 2004), about a nurse holding the door for a slow-moving patient.

How patient she is in the crisp white sails
of her clothes. The sick woman
peers from under her funny knit cap
to watch each foot swing scuffing forward
and take its turn under her weight.
There is no restlessness or impatience
or anger anywhere in sight. Grace
fills the clean mold of this moment
and all the shuffling magazines grow still.

In Ms. Potvin’s case, poems related to her illness were often spurred by mundane moments, like seeing a neighbor out for a nightly walk. Here is “Tumor”:

My neighbor walks
For miles each night.
A mantra drives her, I imagine
As my boys’ chant did
The summer of my own illness:
“Push, Mommy, push.”
Urging me to wind my sore feet
Winch-like on a rented bike
To inch us home.
I couldn’t stop;
Couldn’t leave us
Miles from the end.

Karin Miller, 48, of Minneapolis, turned to poetry 15 years ago when her husband developed testicular cancer at the same time she was pregnant with their first child.

Her husband has since recovered, and Ms. Miller has reviewed thousands of poems by cancer patients and their loved ones to create the “Cancer Poetry Project” anthologies. One poem is “Hymn to a Lost Breast,” by Bonnie Maurer.

Oh let it fly
let it fling
let it flip like a pancake in the air
let it sing: what is the song
of one breast flapping?

Another is “Barn Wish” by Kim Knedler Hewett.

I sit where you can’t see me
Listening to the rustle of papers and pills in the other room,
Wondering if you can hear them.
Let’s go back to the barn, I whisper.
Let’s turn on the TV and watch the Bengals lose.
Let’s eat Bill’s Doughnuts and drink Pepsi.
Anything but this.

Ms. Miller has asked many of her poets to explain why they find poetry healing. “They say it’s the thing that lets them get to the core of how they are feeling,” she said. “It’s the simplicity of poetry, the bare bones of it, that helps them deal with their fears.”

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Have you written a poem about cancer? Please share them with us in the comments section below.

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DealBook: Dell Nears a Buyout Deal of More Than $23 Billion

Dell Inc. neared an agreement on Monday to sell itself to a group led by its founder and the investment firm Silver Lake for more than $23 billion, people briefed on the matter said, in what would be the biggest buyout since the financial crisis.

If completed, a takeover would be the most radical attempt yet by Michael S. Dell to revive the company that bears his name. Such is the size of the potential deal that Mr.
Dell has called upon Microsoft, one of his most important business partners, to shore up the proposal with additional financial muscle. The question will now turn to whether taking the personal computer maker private will accomplish what years of previous turnaround efforts have not.

The final details were being hammered out on Monday evening, and a deal could be announced as soon as Tuesday. Still, last-minute snags could cause the negotiations to collapse, the people briefed on the matter cautioned.

The consortium is expected to pay between $13.50 and $13.75 a share, these people said. Mr. Dell is expected to contribute his nearly 16 percent stake to the deal, worth about $3.8 billion under the current set of terms. He is also expected to contribute hundreds of millions of dollars in fresh capital from his own fortune.

Silver Lake would likely contribute roughly $1 billion, these people added. Microsoft is expected to put in about $2 billion, though that would likely come in the form of preferred shares or debt.

Dell is also expected to bring home some of the cash that is currently held in offshore accounts to help with the financing.

A spokesman for Dell declined to comment.

For decades, Dell benefited from its status as a pioneer in the market for personal computers. Founded in 1984 in a dormitory room at the University of Texas, the company grew into one of the biggest computer makers in the world, built on the simple premise that customers would flock to customize their machines.

By the late 1990s, its fast-rising stock created a company worth $100 billion and minted a class of “Dellionaires” whose holdings made for big fortunes, at least on paper. Mr. Dell himself amassed a fortune worth an estimated $16 billion and formed a quietly powerful investment firm to manage those riches.

But since then, growing competition has sapped Dell’s strength. Rivals like Lenovo and Samsung have made the PC-making business less profitable. Last month, the market research firm Gartner reported that Dell sold 37.6 million PCs worldwide in 2012, a 12.3 percent drop from the previous year’s shipments. Perhaps more significant is the emergence of the smartphone and the tablet, two classes of devices that have eaten away at sales of traditional computers.

Mr. Dell has sought to move the company into the more lucrative and stable business of providing corporations with software services, spending billions of dollars on acquisitions to lead that transformation. The aim is to refashion Dell into something more like I.B.M. or Oracle. Even so, manufacturing PCs still makes up half of the company’s business.

The company’s stock had fallen in 59 percent in the 10 years ended Jan. 13, the last business day before word of the buyout talks emerged. That has actually made Dell more tempting as a takeover target for its founder and Silver Lake, which see it as undervalued.

A Dell deal would be a watershed moment for the leveraged buyout industry: It would be the largest takeover since the Blackstone Group paid $25 billion for Hilton Hotels in the summer of 2007. No leveraged buyout since the financial crisis has surpassed the $7.2 billion that Kohlberg Kravis Roberts and others paid for the Samson Investment company, an oil and gas driller, in the fall of 2011.

Private equity executives have hungered for the chance to strike a deal worth more than $10 billion, an accomplishment believed difficult because of the sheer size of financing required. Dell will take on more than $15 billion in debt, an enormous amount arranged by no fewer than four banks.

Leading the charge for Dell is Silver Lake, known as one of the biggest investors in technology companies.

But the debt markets have been soaring over the past two years, as the cost of junk bonds has stayed low. Persistent low interest rates has prompted debt buyers to seek investments that carry higher yields

Dell was unusually well-placed to make a deal with private equity. The company carries $4.9 billion in long-term debt, which some analysts have regarded as a manageable amount. And its management has signaled a willingness to bring back at least some of the company’s cash horde that is held overseas, despite potentially ringing up a hefty tax bill.

And then there is the matter of Mr. Dell’s stake. Advisers to Dell have taken pains to structure the transaction to avoid the potential conflicts of interest involved in a chief executive taking his company private, the people briefed on the matter said.

A special committee of Dell’s board has hired an independent investment bank, Evercore Partners, as an adviser who will seek out alternative takeover bids.
It is unclear whether the company’s biggest investors will accept a deal at the levels that the buyer consortium is advocating. Shares of Dell fell 2.6 percent, to $13.27, on Monday after reports of the proposed price range emerged.

Still, an analyst with Sanford C. Bernstein, A. M. Sacconaghi, wrote in a research note last month that he believed Mr. Dell was likely to succeed in at least taking the company private.

“Net net, we believe that if a deal goes to a shareholder vote it will likely be approved,” he wrote — cautioning that victory is dependent on activist investors not clamoring for a significantly higher price.

But going private may not solve all of the company’s problems. Mr. Sacconaghi said that a leveraged buyout makes sense so long as Dell is able to stanch bleeding in its PC business and bring back some of its overseas cash over time.

The bigger question is whether Mr. Dell will undertake more drastic changes at the company once it is away from the glare of the public markets. Analysts at Barclays wrote last month that shedding unattractive businesses, like its consumer PC arm, would make a take-private more attractive.

Absent big moves, the strain of the additional debt could starve Dell of the cash it needs to tackle additional acquisitions to complete its transformation into an enterprise software company.

Biggest Private Equity-Backed Leveraged Buyouts

DEAL, IN BILLIONS	TARGET	BUYER	ANNOUNCED
Source: Thomson Reuters *At time of deal, including assumption of debt, not adjusted for inflation.
$44.3	TXU	Morgan Stanley, Citigroup, Lehman Brothers Holdings, Kohlberg Kravis Roberts, Texas Pacific Group and Goldman Sachs	February 2007
37.7	Equity Office Properties Trust	Blackstone Group	November 2006
32.1	HCA	Bain Capital, Kohlberg Kravis Roberts and Merrill Lynch Global Private	July 2006
30.2	RJR Nabisco	Kohlberg Kravis Roberts	October 1988
30.1	BAA	Grupo Ferrovial SA, Caisse de Depot et Placement and GIC Special Invest	March 2006
27.6	Harrah’s Entertainment	Texas Pacific Group and Apollo Management	October 2006
27.4	Kinder Morgan	GS Capital Partners, The Carlyle Group and Riverstone Holdings	May 2006
27.2	Alltel	TPG Capital and GS Capital Partners	May 2007
27.0	First Data	Kohlberg Kravis Roberts	April 2007
26.7	Hilton Hotels	Blackstone Group	July 2007

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Broad Powers Seen for Obama in Cyberstrikes

WASHINGTON — A secret legal review on the use of America’s growing arsenal of cyberweapons has concluded that President Obama has the broad power to order a pre-emptive strike if the United States detects credible evidence of a major digital attack looming from abroad, according to officials involved in the review. 

That decision is among several reached in recent months as the administration moves, in the next few weeks, to approve the nation’s first rules for how the military can defend, or retaliate, against a major cyberattack. New policies will also govern how the intelligence agencies can carry out searches of faraway computer networks for signs of potential attacks on the United States and, if the president approves, attack adversaries by injecting them with destructive code — even if there is no declared war.

The rules will be highly classified, just as those governing drone strikes have been closely held. John O. Brennan, Mr. Obama’s chief counterterrorism adviser and his nominee to run the Central Intelligence Agency, played a central role in developing the administration’s policies regarding both drones and cyberwarfare, the two newest and most politically sensitive weapons in the American arsenal.  

Cyberweaponry is the newest and perhaps most complex arms race under way. The Pentagon has created a new Cyber Command, and computer network warfare is one of the few parts of the military budget that is expected to grow. Officials said that the new cyberpolicies had been guided by a decade of evolution in counterterrorism policy, particularly on the division of authority between the military and the intelligence agencies in deploying cyberweapons. Officials spoke on condition of anonymity because they were not authorized to talk on the record.

Under current rules, the military can openly carry out counterterrorism missions in nations where the United States operates under the rules of war, like Afghanistan. But the intelligence agencies have the authority to carry out clandestine drone strikes and commando raids in places like Pakistan and Yemen, which are not declared war zones. The results have provoked wide protests.

Mr. Obama is known to have approved the use of cyberweapons only once, early in his presidency, when he ordered an escalating series of cyberattacks against Iran’s nuclear enrichment facilities. The operation was code-named Olympic Games, and while it began inside the Pentagon under President George W. Bush, it was quickly taken over by the National Security Agency, the largest of the intelligence agencies, under the president’s authority to conduct covert action.

As the process of defining the rules of engagement began more than a year ago, one senior administration official emphasized that the United States had restrained its use of cyberweapons. “There are levels of cyberwarfare that are far more aggressive than anything that has been used or recommended to be done,” the official said. 

The attacks on Iran illustrated that a nation’s infrastructure can be destroyed without bombing it or sending in saboteurs.

While many potential targets are military, a country’s power grids, financial systems and communications networks can also be crippled. Even more complex, nonstate actors, like terrorists or criminal groups, can mount attacks, and it is often difficult to tell who is responsible. Some critics have said the cyberthreat is being exaggerated by contractors and consultants who see billions in potential earnings.

One senior American official said that officials quickly determined that the cyberweapons were so powerful that — like nuclear weapons — they should be unleashed only on the direct orders of the commander in chief. 

A possible exception would be in cases of narrowly targeted tactical strikes by the military, like turning off an air defense system during a conventional strike against an adversary.

“There are very, very few instances in cyberoperations in which the decision will be made at a level below the president,” the official said. That means the administration has ruled out the use of “automatic” retaliation if a cyberattack on America’s infrastructure is detected, even if the virus is traveling at network speeds.

 While the rules have been in development for more than two years, they are coming out at a time of greatly increased cyberattacks on American companies and critical infrastructure. The Department of Homeland Security recently announced that an American power station, which it did not name, was crippled for weeks by cyberattacks. The New York Times reported last week that it had been struck, for more than four months, by a cyberattack emanating from China. The Wall Street Journal and The Washington Post have reported similar attacks on their systems.

 “While this is all described in neutral terms — what are we going to do about cyberattacks — the underlying question is, ‘What are we going to do about China?’ ” said Richard Falkenrath, a senior fellow at the Council on Foreign Relations. “There’s a lot of signaling going on between the two countries on this subject.”

International law allows any nation to defend itself from threats, and the United States has applied that concept to conduct pre-emptive attacks.

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Take-Two delays launch of Grand Theft Auto V video game

(Reuters) – Take-Two Interactive Software Inc said on Thursday it has pushed back the launch of the latest game from its hit “Grand Theft Auto” franchise to September 17 from its previously announced release window of spring 2013.

Shares of Take-Two were down six percent at $ 12.31 in early afternoon trading on the Nasdaq.

The delay was to allow Take-Two’s Rockstar Games studio, which develops “Grand Theft Auto” games, additional development time, the video game company said.

“Grand Theft Auto V” will be released worldwide for Microsoft Corp‘s Xbox and Sony Corp‘s PlayStation3 game consoles on September 17, the company said.

The action-adventure game lets players complete criminal missions in urban settings. The franchise’s last title “Grand Theft Auto IV” has sold over 25 million units since its release in 2008.

Grand Theft Auto V is set in a fictional city inspired by present-day Southern California.

The delayed launch pushes earnings from Grand Theft Auto V sales from June to September, Sterne Agee analyst Arvind Bhatia said. The new title of the massively popular franchise has the potential to rake in close to $ 1 billion in retail sales and sell 15 to 20 million units, according to Bhatia.

“It adds to their development cost and it’s launching closer to what we think is going to be a period where new consoles will be coming out and there will be more competition from other titles,” Bhatia said.

The video game industry has been struggling to cope with flagging sales over the last year. Analysts say consumers are holding back from buying hardware and software as they wait for rumored next-generation versions of Sony Corp’s PlayStation and Microsoft Corp’s Xbox, expected later this year.

The delay could mean Take-Two is possibly creating a “cross-generation” title that could work on current and next-generation consoles, said analyst Mike Hickey of National Alliance Capital Markets.

“Remember, Xbox signed an exclusive deal with Rockstar at the beginning of the prior cycle for episodic content, and Sony provided exclusive resources for the completion of Grand Theft Auto IV,” Hickey said.

(Reporting by Malathi Nayak in San Francisco; Editing by Leslie Adler and Alden Bentley)

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