G-20 seeks to allay fear of currency war









WASHINGTON — Top finance officials of the world's 20 largest economies sought Saturday to allay fear of a currency war, pledging not to target exchange rates to gain a competitive advantage in trade.


But the joint statement, issued at the end of a meeting in Moscow of the so-called Group of 20, or G-20, did not single out any country, essentially giving a pass to Japan to keep pursuing its economic policies despite a significant slide in the value of the yen since November.


Japan's new government under Prime Minister Shinzo Abe, who will meet with President Obama this week in Washington, had been talking down the yen and has pressed its central bank for more expansive monetary stimulus to break out of its deflationary trap and boost the nation's stagnant economy. A cheaper currency helps a country's exporters sell their goods to foreign markets.





Some analysts said they now expect the yen to dip further, a prospect that could stoke contention over exchange rates and present complications for the United States in its long-running efforts to influence China to make more rapid adjustments in its currency.


"The U.S. could tolerate the yen depreciation, but clearly this is a potential problem in so far as China could interpret it as a possible green light to make its currency weaker," said Domenico Lombardi, a senior scholar at the Brookings Institution in Washington.


American officials were careful not to fault Japan, an important ally in Asia. What's more, the Federal Reserve also has taken extraordinary measures to stimulate its domestic economy, for which the U.S. has come under similar accusations from some G-20 nations that it was aiming to cheapen the dollar to boost exports.


Federal Reserve Chairman Ben S. Bernanke, in remarks Friday at a G-20 session with finance ministers and central bankers, said the United States was simply "using domestic policy tools to advance domestic objectives."


The Fed has been aggressively buying Treasury bonds with the aim of pushing down long-term interest rates to stimulate investment and reduce the unemployment rate, but that has contributed to a weakening of the dollar.


Many economists believe that currency manipulation occurs when a government intervenes, for example, by buying up dollars, specifically to devalue its currency. This, they say, is different from what may be an unintended byproduct of large-scale monetary stimulus to support one's domestic economy.


Intended or not, other analysts said the distinction was not so clear when the result was the same.


Aiming to make that more clear, the G-20 statement said monetary policies should be directed at price stability and domestic growth. "We will refrain from competitive devaluation," it said.


The statement said the G-20 would "monitor and minimize the negative spillovers on other countries of policies implemented for domestic purposes," but it did not set any benchmarks or enforcement mechanism.


A weaker Japanese yen isn't likely to have a major effect on the U.S. economy, and certainly not any time soon. American officials are far more interested in the politically sensitive issue of the Chinese currency. Although the Chinese yuan has risen significantly against the dollar in recent years, many in the U.S. still consider it undervalued and harmful to American exporters.


Besides currency fluctuations, G-20 finance officials also took up budget austerity. The Eurozone's debt crisis and deepening recession have prompted some in Europe to rethink the idea of setting tough budget deficit targets.


The Obama administration, fighting at home to avert stringent fiscal cuts that it believes could hurt the nation's economic recovery, has long pressed the G-20 to put more emphasis on pro-growth policies and less on austerity. But Germany and some others have insisted on fiscal consolidation and debt reduction as key pathways to recovery.


A debt-cutting agreement forged at the G-20 in Toronto in 2010 will expire this year, and officials at the Moscow meeting made no announcement on the issue.


Reflecting a reduced sense of urgency as the Eurozone's troubles have eased somewhat and the global outlook has moderately improved, the joint statement noted that risks to the world economy had receded.


Still, it said, growth remains too weak and unemployment too high:


"A sustained effort is required to continue building a stronger economic and monetary union in the euro area and to resolve uncertainties related to the fiscal situation in the United States and Japan, as well as to boost domestic sources of growth in surplus economies."


The G-20 represents the largest industrialized and developing nations, with about 90% of the world's economic output. It was designated in 2009 as the primary international forum for world leaders to address global financial issues and coordinate economic policies.


The finance ministers' gathering, which ended Saturday, was the first with Russia's President Vladimir Putin as this year's chairman of the G-20. Additional sessions are scheduled in the spring and summer before Obama and other heads of G-20 economies meet in September in St. Petersburg, Russia.


don.lee@latimes.com





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'Blade Runner' Oscar Pistorius weeps as he faces murder charge









JOHANNESBURG, South Africa -- Olympic sprinter Oscar Pistorius, the double-amputee revered in South Africa for overcoming his disability to compete in the London Games last year, wept in court Friday as he faced a murder charge in connection with the fatal shooting of his girlfriend.

During the proceedings in Pretoria, Gerrie Nel, one of the National Prosecuting Authority’s most senior advocates, said he would argue the killing of model and law graduate Reeva Steenkamp was premeditated murder, the most serious category of offense under South African law.


Nel is known for prosecuting high-profile cases, including winning the conviction of former police chief and Interpol boss Jackie Selebi on corruption charges.


Pistorius, nicknamed the "Blade Runner" because of the carbon-fiber prosthetic legs he uses to compete, did not enter a formal plea and was remanded into custody at Brooklyn police station in Pretoria until Tuesday, when his bail application is to be heard.








Under South African law, a suspect charged with such a high-level offense would have to prove exceptional circumstances to be granted bail.


In a packed courtroom, members of Pistorius' family struggled to pass through a media scrum and to find seats. The hearing coincided with "Black Friday," a day when people were being urged to wear black to protest rapes and violence against women.


[Updated, 8:35 a.m. Feb. 15: The family and Pistorius' management company later issued a statement denying that the athlete had murdered his girlfriend, saying: "The alleged murder is disputed in the strongest possible terms."


Some details of Pistorius' argument and the state's case are expected Tuesday.]

The famed athlete's court appearance came as South African media reported that he shot Steenkamp, his girlfriend of several months, four times through a bathroom door.


Under South African law, a person who fatally shoots an intruder has to prove he or she had a reasonable fear that the intruder posed a real threat to his or her life.

South Africa has one of the highest rates of gun homicides in the world, with killings of women by intimate partners the leading cause of female homicide in the country. About 57% of female homicide victims were killed by their partners in 2009, according to a report last year by the Medical Research Council.


One-third of female homicides were committed by partners with a history of prior violence against their partners, according to the report.

Friends of Steenkamp and Pistorius mourned the incident on social media.

"Drained, confused, I just can't wrap my head around things," one of Pistorius’ close friends, Alex Pilakoutas, posted on Twitter.


Darren Fresco, who described himself as one of Steenkamp’s best friends said he was hoping to wake from a nightmare and hear her infectious laughter again.

"We were just goofing off the other day talking to each other in only the way that we could to each other. My heart is on the verge of exploding with the pain of such a sudden loss of one of my best friends," Fresco, who said he was one of the last people to exchange tweets with Steenkamp, posted on Facebook.

ALSO:

Oscar Pistorius remains in jail facing murder charge

Mexico finds fire-god figure at top of Pyramid of the Sun

Iranian general reportedly assassinated while traveling from Syria


robyn.dixon@latimes.com





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Judge sets May trial date for Kardashian divorce


LOS ANGELES (AP) — Kim Kardashian has a due date for her baby and now a trial date for her divorce from NBA player Kris Humphries.


A judge on Friday set a May 6 trial for the reality TV star who wants to end her marriage before July, when her child with Kanye West is due.


Kardashian filed for divorce on Oct. 31, 2011, after she and Humphries had been married just 72 days. Their lavish, star-studded nuptials were recorded and broadcast by E! Entertainment Television.


The trial is expected to last three to five days and could reveal details about Kardashian's reality show empire, which includes "Keeping Up With the Kardashians" and several spinoffs.


Two judges determined Friday that Humphries' lawyers had adequate time to prepare for the trial.


Humphries wants the marriage annulled based on his claim that Kardashian only married him for the sake of her show.


She denies that allegation and says the case should be resolved through what would be her second divorce.


Humphries' attorney Marshall Waller asked for a delay until basketball season is over.


But Superior Court Judge Scott Gordon refused, saying firefighters, police officers, truck drivers and others have to miss work for trials, and Humphries must do the same if necessary.


Waller filed paperwork Thursday to withdraw from the case but didn't mention that development in court and refused to answer any questions about the document on Friday.


Waller said he was still hoping to obtain and review 13,000 hours of footage from Kardashian's reality shows to try to prove the fraud claim but noted he does not yet have an agreement to receive the footage.


Kardashian's lawyer said her client was ready for trial.


"Let's get this case dispensed with," attorney Laura Wasser said.


Humphries has provided a deposition in the case, as have West and Kardashian family matriarch Kris Jenner.


___


Anthony McCartney can be reached at http://twitter.com/mccartneyAP


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Fat Dad: Baking for Love

Fat Dad

Dawn Lerman writes about growing up with a fat dad.

My grandmother Beauty always told me that the way to a man’s heart was through his stomach, and by the look of pure delight on my dad’s face when he ate a piece of warm, homemade chocolate cake, or bit into a just-baked crispy cookie, I grew to believe this was true. I had no doubt that when the time came, and I liked a boy, that a batch of my gooey, rich, chocolatey brownies would cast him under a magic spell, and we would live happily ever.

But when Hank Thomas walked into Miss Seawall’s ninth grade algebra class on a rainy, September day and smiled at me with his amazing grin, long brown hair, big green eyes and Jimi Hendrix T-shirt, I was completely unprepared for the avalanche of emotions that invaded every fiber of my being. Shivers, a pounding heart, and heat overcame me when he asked if I knew the value of 1,000 to the 25th power. The only answer I could think of, as I fumbled over my words, was “love me, love me,” but I managed to blurt out “1E+75.” I wanted to come across as smart and aloof, but every time he looked at me, I started stuttering and sweating as my face turned bright red. No one had ever looked at me like that: as if he knew me, as if he knew how lost I was and how badly I needed to be loved.

Hank, who was a year older than me, was very popular and accomplished. Unlike other boys who were popular for their looks or athletic skills, Hank was smart and talented. He played piano and guitar, and composed the most beautiful classical and rock concertos that left both teachers and students in awe.

Unlike Hank, I had not quite come into my own yet. I was shy, had raggedy messy hair that I tied back into braids, and my clothes were far from stylish. My mother and sister had been on the road touring for the past year with the Broadway show “Annie.” My sister had been cast as a principal orphan, and I stayed home with my dad to attend high school. My dad was always busy with work and martini dinners that lasted late into the night. I spent most of my evenings at home alone baking and making care packages for my sister instead of coercing my parents to buy me the latest selection of Gloria Vanderbilt jeans — the rich colored bluejeans with the swan stitched on the back pocket that you had to lie on your bed to zip up. It was the icon of cool for the popular and pretty girls. I was neither, but Hank picked me to be his math partner anyway.

With every equation we solved, my love for Hank became more desperate. After several months of exchanging smiles, I decided to make Hank a batch of my chocolate brownies for Valentine’s Day — the brownies that my dad said were like his own personal nirvana. My dad named them “closet” brownies, because when I was a little girl and used to make them for the family, he said that as soon as he smelled them coming out of the oven, he could imagine dashing away with them into the closet and devouring the whole batch.

After debating for hours if I should make the brownies with walnuts or chips, or fill the centers with peanut butter or caramel, I got to work. I had made brownies hundreds of times before, but this time felt different. With each ingredient I carefully stirred into the bowl, my heart began beating harder. I felt like I was going to burst from excitement. Surely, after Hank tasted these, he would love me as much as I loved him. I was not just making him brownies. I was showing him who I was, and what mattered to me. After the brownies cooled, I sprinkled them with a touch of powdered sugar and wrapped them with foil and red tissue paper. The next day I placed them in Hank’s locker, with a note saying, “Call me.”

After seven excruciating days with no call, some smiles and the usual small talk in math class, I conjured up the nerve to ask Hank if he liked my brownies.

“The brownies were from you?” he asked. “They were delicious.”

Then Hank invited me to a party at his house the following weekend. Without hesitation, I responded that I would love to come. I pleaded with my friend Sarah to accompany me.

As the day grew closer, I made my grandmother Beauty’s homemade fudge — the chocolate fudge she made for Papa the night before he proposed to her. Stirring the milk, butter and sugar together eased my nerves. I had never been to a high school party before, and I didn’t know what to expect. Sarah advised me to ditch the braids as she styled my hair, used a violet eyeliner and lent me her favorite V-neck sweater and a pair of her best Gloria Vanderbilt jeans.

When we walked in the door, fudge in hand, Hank was nowhere to be found. Thinking I had made a mistake for coming and getting ready to leave, I felt a hand on my back. It was Hank’s. He hugged me and told me he was glad I finally arrived. When Hank put his arm around me, nothing else existed. With a little help from Cupid or the magic of Beauty’s recipes, I found love.


Fat Dad’s ‘Closet’ Brownies

These brownies are more like fudge than cake and contain a fraction of the flour found in traditional brownie recipes. My father called them “closet” brownies, because when he smelled them coming out of the oven he could imagine hiding in the closet to eat the whole batch. I baked them in the ninth grade for a boy that I had a crush on, and they were more effective than Cupid’s arrow at winning his heart.

6 tablespoons unsalted butter, plus extra for greasing the pan
8 ounces bittersweet chocolate, chopped, or semisweet chocolate chips
3/4 cup brown sugar
2 eggs at room temperature, beaten
1 teaspoon vanilla extract
1/4 cup flour
1/2 cup chopped walnuts (optional)
Fresh berries or powdered sugar for garnish (optional)

1. Preheat oven to 350 degrees.

2. Grease an 8-inch square baking dish.

3. In a double boiler, melt chocolate. Then add butter, melt and stir to blend. Remove from heat and pour into a mixing bowl. Stir in sugar, eggs and vanilla and mix well.

4. Add flour. Mix well until very smooth. Add chopped walnuts if desired. Pour batter into greased baking pan.

5. Bake for 35 minutes, or until set and barely firm in the middle. Allow to cool on a rack before removing from pan. Optional: garnish with powdered sugar, or berries, or both.

Yield: 16 brownies


Dawn Lerman is a New York-based health and nutrition consultant and founder of Magnificent Mommies, which provides school lectures, cooking classes and workshops. Her series on growing up with a fat father appears occasionally on Well.

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Pen collectors going strong even as handwriting dwindles









The discussion over minute details at a Manhattan Beach hotel ballroom seemed endless: Is the ink chamber filled with a pump, a button or an eyedropper? Was the pen exposed to heat or humidity, which darkens its color and decreases its value?


For the 25th year, the Los Angeles International Pen Show convened Thursday, with about 1,200 exhibitors and collectors expected to gather at the local Marriott hotel.


On Sunday, the last day, the show opens to the public for $7 at the door. The pens, though, cost significantly more, starting a little below $100 and breaking seven figures on the high end.





At those prices, it's easy to see the focus on details. But show organizer Chris Odgers, whose day job is as a vice president licensing content for Warner Bros. Pictures, noted that pen culture is about more than the minute details.


"People that do this are about preserving and telling some history," Odgers said.


Pen lovers honor craftsmanship and a personal touch, even as communication moves to keyboards and touch screens, he said. They keep journals and write letters. Many emphasize penmanship and mourn the loss of cursive writing education in schools.


Nationwide, the focus on penmanship has fallen. Annual shipments in the pen and mechanical pencil industry fell 36% from 2002 to 2007, according to U.S. census data.


However, the collecting culture has thrived, thanks to a group of doctors, lawyers, artists and architects who still like the way a nib, or fountain pen tip, makes their handwriting look.


By day, lawyer Cliff Harrington represents large media companies before the Federal Communications Commission in the nation's capital.


But every so often he dons a drab button-down and plants himself behind a folding table at the dozen pen shows he attends each year.


"I've been coming here for 20 years," Harrington said. "The pens are always very interesting here."


For some, pens are also good business. Fred Krinke's Monrovia store, the Fountain Pen Shop, has been in the family since his grandfather opened it in downtown Los Angeles 91 years ago.


Krinke, who has attended the show every year since it began, helps promote the event because the conventions are an important way to create new collectors and keep his business strong, especially as interest in handwriting declines.


"The more people that come, the better it is for us," Krinke said.


Some collectors obsess over pens from a certain company or time period. Others crave custom-made caps and inkwells. And some simply covet pens that are, say, blue.


Rita Lott, 49, of Dakota Dunes, S.D., inadvertently launched her husband's pen collection when she bought him a fountain pen as a wedding gift 20 years ago. Robert Lott, also 49, now owns about 500 pens. On Thursday he added two more: two 14-carat gold Waterman Taper Cap fountain pens, together valued at more than $20,000.


"Was I looking for them? No," said Robert, a retired Army lieutenant colonel. "But when a pen like that surfaces, you just have to step up and do it because you love it."


Although her husband has amassed "a sickening amount" of pens, Rita said, she appreciates that going to the conventions gives her the opportunity to travel.


"We've met a lot of friends, and it's something we've been able to share," she said as her husband peered through bulky jeweler's goggles to check a pen for cracks and blemishes.


A few tables down, Bob Novak, 61, of New York spread out his wares and eyed the competition. He's part of a cadre of dealers who crisscross the country attending pen shows, buying pens the way investors buy stocks.





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









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


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


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





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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


jeff.gottlieb@latimes.com


corina.knoll@latimes.com





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Ryan O'Neal wins appeals ruling in defamation case


LOS ANGELES (AP) — Ryan O'Neal may have enough evidence to show that he was defamed by a man who claimed the actor stole a valuable portrait of the late Farrah Fawcett, an appeals court ruled Thursday.


A divided panel of the 2nd District Court of Appeal ruled that O'Neal's case against Craig Nevius, a former Fawcett associate, should be allowed to proceed and that the actor may be able to win some damages. One justice disagreed and wrote that the case should be dismissed.


O'Neal sued in July 2011, claiming he was defamed by Nevius' comments that the actor had stolen a Fawcett portrait created by Andy Warhol. The painting is the subject of a separate lawsuit between O'Neal and the University of Texas, which claims Fawcett left the artwork to the school after her 2009 death.


Nevius' attorney, Lincoln Bandlow, said he would appeal the ruling to the California Supreme Court. He had appealed a lower court's ruling allowing the case to go forward.


O'Neal's attorney Todd Eagan wrote in a statement that he and O'Neal were pleased with the ruling. "We look forward to a complete victory against Mr. Nevius at trial," he wrote.


O'Neal's suit seeks more than $1 million in damages. He claimed in the case that Warhol gave him the portrait and he intends to bequeath it to his only son from his longtime relationship with Fawcett, Redmond O'Neal.


Nevius' comments that O'Neal stole the artwork were made in interviews with Star magazine and "Good Morning America," and he cooperated with UT investigators searching for the portrait.


Although Nevius initially denied he accused O'Neal of stealing the painting, he acknowledged in a later court filing that he made the claim to university investigators.


"The inferences reasonably drawn from the evidence here would support a jury's finding that Nevius harbored strong ill-feelings toward O'Neal," the justices siding with O'Neal wrote. The dissent argues that Nevius' comments were constitutionally protected speech and the case should have been dismissed.


O'Neal's fight with UT over the portrait returns to court Feb. 27.


The actor and Nevius have battled in court for years.


Nevius collaborated on a documentary of Fawcett's fight with cancer but sued the actor claiming he interfered in the project and removed him from it shortly before Fawcett's death. The case was dismissed before trial.


___


Anthony McCartney can be reached at http://twitter.com/mccartneyAP .


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Doctor and Patient: Afraid to Speak Up to Medical Power

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Carl Icahn buys nearly 13% stake in Herbalife as battle heats up









NEW YORK — It's no longer just a war of words.


Corporate raider Carl Icahn has thrown $214 million behind Herbalife Ltd., the Los Angeles-based maker of health foods and nutritional supplements accused of being a pyramid scheme by Icahn's foe, fellow Wall Street tycoon Bill Ackman.


Documents filed with the Securities and Exchange Commission on Thursday reveal that Icahn purchased more than 14 million shares and options in Herbalife, a nearly 13% stake that would make him the company's second-largest investor. Icahn said he would pursue talks with executives about possibly recapitalizing the company or even taking it private.





Icahn and Ackman have been engaged in a rare public battle for the last month, hurling insults at each other about past dealings and their respective positions in Herbalife. The two foes have bad blood stemming from a business dispute.


Ackman launched his assault on the company Dec. 20 by unveiling a $1-billion short position, or bet, against Herbalife. That same day, Icahn began snapping up the company's stock, according to the SEC filing.


"It's pretty obvious Icahn really wants to turn the screws on Ackman," said Chris Stuart, chief executive of Shortzilla, a Boston-area research firm. "He's put his money where his mouth is, for sure."


Investors saw Icahn's disclosure as reassuring that Herbalife was not going to collapse, as Ackman has predicted. Its shares surged more than 24% in after-hours trading after closing up $1.87, or 5.1%, at $38.27 on Thursday.


"I think he is definitely trying to hammer his good buddy Ackman, but he could also make a lot of money in this," said Timothy Ramey, an analyst with D.A. Davidson & Co. "It's an undervalued stock."


Ackman, who heads the hedge fund Pershing Square Capital Management, says that Herbalife defrauds its low-income distributors. His wager against the company pays off if its stock falls.


Herbalife hit back by saying the hedge fund manager was misinformed about the company and made an irresponsible bet with his investors' money. The company pointed to its 32 years in business as evidence that it is not a pyramid scheme.


Icahn sees Herbalife as undervalued and believes that the company has a "legitimate business model, with favorable long-term opportunities for growth," the filing says.


This is just the latest chapter in a long history of Icahn trying to exert influence on companies and their boards of directors in hopes of either motivating a merger or having his stake bought out at a premium.


In the 1980s, he famously took over airline TWA and immediately liquidated most of its assets. Since then, he's taken big stakes or controlling positions in companies including RJR Nabisco, Viacom, Marvel Comics, Blockbuster and Netflix.


Neither Icahn nor Ackman responded to requests for comment. Herbalife also declined to comment.


The battle over Herbalife is becoming a Wall Street spectacle, with money managers supporting either team Ackman or team Icahn.


Robert L. Chapman Jr., managing member of Chapman Capital in Manhattan Beach, who said he has invested in Herbalife, wrote in an email: "Carl Icahn just delivered Bill Ackman a Valentine he'll never forget."


andrew.tangel@latimes.com,


stuart.pfeifer@latimes.com





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Federal appeals court weighs overturning Barry Bonds' conviction









SAN FRANCISCO —A federal appeals court wrestled Wednesday with whether to overturn slugger Barry Bonds' felony conviction for obstruction of justice.


The three-judge panel of the U.S. 9th Circuit Court of Appeals weighed whether Bonds broke the law by being evasive in a 52-word answer he gave a federal grand jury in 2003. The grand jury was investigating illegal distribution of performance-enhancing drugs.


Bonds was asked in the grand jury session whether his personal trainer had ever given him a substance that required a syringe to inject. In his response, Bonds rambled on about his childhood and his friendship with the trainer before finally telling the grand jury that he had not received an injectable substance.





The grand jury eventually indicted Bonds, and he was tried in 2011 on three counts of perjury and one count of obstruction. The trial jury convicted him of obstruction of justice, based on that meandering answer, but it deadlocked on the perjury charges.


How the three-judge panel was leaning after Wednesday's hearing was nearly as difficult to parse as Bonds' answer. Judge Michael Daly Hawkins appeared troubled by the fact that Bonds eventually answered the grand jury query: "Can a grand jury witness obstruct justice by giving a series of evasive answers and then giving a direct answer that is not evasive?" Hawkins asked.


Assistant U.S. Atty. Merry Jean Chan, however, said Bond's rambling response was intended to deceive. She argued that the obstruction conviction was not limited to those 52 words but reflected evasion throughout Bonds' testimony.


Hawkins then questioned why prosecutors, if they thought Bonds was being evasive, did not go before a judge to ask that Bonds be ordered to answer the grand jury's questions.


Dennis Riordan, an attorney for Bonds, told the court that the grand jury was not troubled by the 52-word passage that led to the trial jury's conviction years later.


"There is one thing we know for sure," Riordan said. "This grand jury did not consider those 52 words were criminal activity.... That is a dagger in the heart of this conviction."


Chan countered that Bonds' testimony was "littered with multiple examples" of misleading testimony.


Bonds' conviction came at the end of a 12-day trial. He was sentenced to two years probation, 250 hours of community service, a $4,000 fine and a month of monitored home confinement, all of which have been put on hold pending his appeal.


The 9th Circuit panel, which included Judges Mary Schroeder and Mary Murguia, did not indicate when it might rule.


maura.dolan@latimes.com





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