Tuesday, September 14, 2010

Suicide Reveals Signs of a Disease Seen in N.F.L.

September 13, 2010
Suicide Reveals Signs of a Disease Seen in N.F.L.
By ALAN SCHWARZ
ALLENTOWN, Pa. — A brain autopsy of a University of Pennsylvania football player who killed himself in April has revealed the same trauma-induced disease found in more than 20 deceased National Football League players, raising questions of how young football players may be at risk for the disease.

Owen Thomas, a popular 6-foot-2, 240-pound junior lineman for Penn with no previous history of depression, hanged himself in his off-campus apartment after what friends and family have described as a sudden and uncharacteristic emotional collapse. Doctors at Boston University subsequently received permission from the family to examine Thomas’s brain tissue and discovered early stages of chronic traumatic encephalopathy, a disease linked to depression and impulse control primarily among N.F.L. players, two of whom also committed suicide in the last 10 years.

Doctors in the Boston University group and outside it cautioned that Thomas’s suicide should not be attributed solely or even primarily to the damage in his brain, given the prevalence of suicide among college students in general. But they said that a 21-year-old’s having developed the disease so early raised the possibility that it played a role in his death, and provided arresting new evidence that the brain damage found in N.F.L. veterans can afflict younger players.

Thomas never had a diagnosis of a concussion on or off the football field or even complained of a headache, his parents said, although they acknowledged he was the kind of player who might have ignored the symptoms to stay on the field. Because of this, several doctors said, his C.T.E. — whose only known cause is repetitive brain trauma — must have developed from concussions he dismissed or from the thousands of subconcussive collisions he withstood in his dozen years of football, most of them while his brain was developing.

The idea that C.T.E. can stem from hits below the level of concussion — which are endemic to football and all but impossible for doctors to see or manage — is relatively new. Ever since C.T.E. in professional football players began making national headlines in early 2007, it has generally been ascribed to mistreated or at least cumulative concussions, for which awareness and education can be an antidote.

The diagnosis in Thomas’s case was independently confirmed by Dr. Daniel Perl, a professor of pathology at Uniformed Services University of the Health Sciences, the medical school for the United States military.

“It’s not unreasonable that aspects of his behavior were related to the underlying brain disease that was detected,” said Dr. Perl, adding that he was speaking as an experienced neuropathologist and not on behalf of his organization. “This is real.”

He added, “This is a call for a broader range of research into this problem that extends beyond the heavy duty N.F.L. level of athletics.”

Thomas is the youngest and first amateur football player to be found with clear C.T.E., which is linked with cognitive impairment, depression and ultimately dementia. One 18-year-old former high school player who died two years ago, and whose name has been withheld by the Boston University researchers at his family’s request, had only incipient traces of the disease.

Thomas’s parents, the Rev. Tom Thomas and the Rev. Kathy Brearley, requested that their son’s case be made public to educate other families about the possible and perhaps addressable risks of football at all levels. About 1.4 million children ages 14 to 18 play high school football every fall, and about three million others play in youth leagues at younger ages.

Thomas’s parents emphasized that they did not hold responsible the University of Pennsylvania specifically or their son’s youth and high school programs in South Whitehall Township, which is outside Allentown. They also said they were not considering legal action.

“This is an issue beneath the N.F.L. level,” Mr. Thomas said. “I want people to take this seriously.”

Sitting with her husband on the porch that overlooks the yard where Owen once played, Ms. Brearley added, “We have to think of different options that can take a hearty, meaty, great contact sport but minimize the risk to young people.”

Owen Thomas was the second Penn player to commit suicide in five years; running back Kyle Ambrogi killed himself in 2005. The university will honor Thomas at a ceremony before Penn’s opening home game against Lafayette on Saturday. He had been elected one of the team’s captains before he died.

“Obviously this is a contact sport — could this happen? Absolutely,” said Penn Coach Al Bagnoli, noting how Penn trainers never clear a player with a concussion to return until he withstands appropriate medical scrutiny. “Do people take as many precautions as we can? Absolutely.”

Before Thomas, 21, the youngest player who previously received a diagnosis of C.T.E. was Chris Henry, 26, a Cincinnati Bengals receiver who died in December during a domestic dispute in which he appeared to jump from the back of a moving pickup truck. The only previous non-N.F.L. player with a clear case of C.T.E. was Mike Borich, a former Western Illinois receiver who died in February 2009 after a drug overdose at 42.

The Thomas case will almost certainly prove more arresting to those assessing the long-term risks of football at all levels, as he had developed the disease before leaving college and, for reasons that remain unknown, developed severe depression and killed himself.

“It’s pretty hard to make a jump with one case,” said Dr. James Moriarity, the University of Notre Dame’s head physician, who oversees the athletic department’s medical care. “But if it’s true that that happened, it would kill the sport,” he said, referring to an amateur player getting C.T.E. “As a parent, it’s going to be hard to justify kids going out and doing that.”

Owen Thomas was a third generation college football player. His grandfather Frank Thomas played for Millersville (Pa.) University in the 1930s, and his father played four years at the University of Virginia in the late 1960s.

Owen started playing at age 9 and relished football’s physicality.

“He loved to hit people,” his mother said. “He loved to go into practice and hit really hard. He loved to intimidate. It’s kind of sad. We all love football. We all love watching. We all love these great hits.”

Thomas played three seasons at Parkland High School, talented enough at linebacker and tight end to often play every down of every game — even blocking on punts and kickoffs, one of his favorite responsibilities. He was bright enough to be admitted to Penn’s Wharton School of Business, one of the best undergraduate business programs in the country. He played freshman football and then started the last two seasons on the varsity, earning second-team all-Ivy League honors in 2009 and helping lead the Quakers to the Ivy title.

Dr. Robert Stern, a director of the Boston University group, said the identification of factors like genetics would probably someday explain why some people develop C.T.E. while most do not. Thomas’s case, he said, proves that the disease can begin, and perhaps influence behavior, among football players below the N.F.L. level.

“We don’t know if it’s a specific age, we don’t know if it’s a cumulative number of years of exposure to head trauma, we don’t know what combination of hits to the head set this disease in motion,” Dr. Stern said. “These are critical issues that need to be answered in order to help guide any dramatic policy changes and individual decisions down the road.”

Dr. Stern and other experts in the field emphasized that C.T.E. could not be blamed solely for a person’s suicide. But some of the clues left from Thomas’s case, they said, suggested that the damage in his brain might have exacerbated his sudden depression and compromised his ability to think clearly about his actions.

Thomas left no note and still had his cellphone in his pocket — which his mother said indicated that he was acting on impulse, not forethought.

Dr. Perl said that although links were easy to make in hindsight, lack of impulse control is a consistent manifestation of how executive function can be compromised by C.T.E.’s neurofibrillary tangles and tau protein formations in the frontal lobe of the cerebral cortex. Dr. Perl added that C.T.E. typically impaired a person’s short-term memory — which in a college student approaching exams would be harrowing — but that the relatively mild C.T.E. in Thomas’s hippocampus did not suggest severe memory problems, though that was possible.

Ms. Brearley said she would never know the root of her son’s actions, but the C.T.E. diagnosis gave her solace, if not a solution.

“It gives me some peace in my heart to think this is a missing piece of a jigsaw puzzle,” she said.

Thomas’s parents said they wanted to share his story to warn other families of young football players that C.T.E. and all of its still-unknown ramifications were no longer confined to the N.F.L. In this respect, Owen Thomas will probably become amateur football’s counterpart to Andre Waters, the former hard-hitting Philadelphia Eagle whose suicide in 2006 catalyzed much of the awareness of head injuries in the N.F.L.

Mr. Thomas said he recalled the day he read about Waters’s brain damage in a newspaper. He also remembered what he had thought ever since: “Thank goodness that’s only the N.F.L. — it can’t happen to Owen.”

23/04 Bishop, 73, in Belgium Steps Down Over Abuse

April 23, 2010
Bishop, 73, in Belgium Steps Down Over Abuse
By ELISABETTA POVOLEDO
ROME — The longest-serving bishop in Belgium resigned Friday after admitting to sexually abusing “a boy in my close entourage” many years ago, becoming the latest cleric to quit in a spreading abuse scandal.

The development added to a corrosive catalog of disclosures that has damaged the credibility of the Roman Catholic Church and shaken the trust of many believers in their spiritual leaders.

In a statement issued by the Vatican on Friday, Roger Vangheluwe, 73, the bishop of Bruges since 1985, said that the abuse had occurred “when I was still a simple priest and for a while when I began as a bishop.”

“This has marked the victim forever,” he said.

The bishop said that he had asked the victim and his family several times to forgive him, but that the wound had not healed, “neither in me nor the victim.” A recent media storm merely deepened the trauma, he said. “I am profoundly sorry,” he said.

This week, in a rare public comment directly addressing the issue of abuse, Pope Benedict XVI promised that the church would take action to deal with the crisis.

Bishop Vangheluwe is the first Belgian bishop to step down since the abuse scandal began to erupt in recent months in several European countries. Bishops elsewhere have resigned, though. On Thursday the church authorities in Germany said that Bishop Walter Mixa, one of the country’s most prominent and outspoken conservative clerics, had tendered his resignation after being accused of beating children decades ago.

On the same day, the Vatican said the pope had accepted the resignation of Bishop James Moriarty of Kildare and Leighlin, Ireland. Bishop Moriarty had been cited in an Irish government report on the mishandling and concealment of cases of priestly abuse.

Most bishops who have quit have done so because they were accused of covering up accusations against priests under their authority. While not as common, several bishops before Bishop Vangheluwe have been personally accused of abuse.

Several American bishops have stepped down in the wake of allegations of sexual abuse or assault. So have a Norwegian bishop, Georg Mueller, who resigned last May, and an Austrian cardinal, Hans Hermann Groer, who resigned in 1998.

Bishop Vangheluwe’s statement was also read to reporters at a news conference in Brussels by Archbishop André-Joseph Léonard, who called Bishop Vangheluwe a “generous and dynamic bishop,” but said that his transgression would shock many.

“We are aware of the crisis of confidence his resignation will set in motion,” Archbishop Léonard said. But he stressed that the Catholic Church in Belgium was determined to “turn over a leaf from a not-very-distant past when such matters would pass in silence or be concealed.”

The resignation came 10 years after the church in Belgium set up a commission to look into complaints of abuse that frequently seemed at loggerheads with the church leadership.

Archbishop Léonard acknowledged in an Easter homily this year that as the Vatican leadership confronted persistent accusations of abuse, “the reputation of church leaders was given a higher priority than that of abused children,” The Associated Press reported.


Alan Cowell contributed reporting from Paris.


This article has been revised to reflect the following correction:

Correction: April 23, 2010


An earlier version of this article misstated the year in which Roger Vangheluwe became bishop of Bruges. He became bishop in 1985, not 1984.

Victims Angry as Belgium Responds to Church Abuse

September 13, 2010
Victims Angry as Belgium Responds to Church Abuse
By STEPHEN CASTLE
BRUSSELS — The leader of the Roman Catholic Church in Belgium on Monday acknowledged the scale of the scandal that had engulfed the country over sexual abuse by priests and promised to do more for the victims, but he offered few short-term solutions and said little of substance about further pursuing the abusers.

The church leader, Archbishop André-Joseph Léonard, said at a news conference that suffering had caused a “shiver” to run through the church, but that it was too soon for a detailed response to the crisis. The extent of the abuse was revealed in a report published Friday.

The lack of more comprehensive steps was greeted with anger by representatives of victims, with one lawyer calling the church’s response “scandalous.”

The one concrete announcement from the archbishop was that the church in Belgium would set up a new center for victims to focus on “recognition, reconciliation and healing,” which is likely to open at the end of the year.

That effort follows the release of the 200-page report on Friday, compiled by an internal commission set up by the church, which included harrowing testimony from victims and said that one had been abused from the age of 2. Thirteen people are thought to have committed suicide as a result of abuse, the report said.

The internal commission, led by Peter Adriaenssens, a prominent psychiatrist, decided to wrap up its work after the police carried out a series of high-profile raids on church property in June. In one raid, the police searched the church offices in Mechelen, disturbing the tomb of a cardinal in an unsuccessful hunt for proof of a cover-up. Belgium’s Court of Appeal has since ruled that documents seized in such raids should not be admissible in any trial.

By holding Monday’s news conference, the church appeared to be acknowledging the task it faces in re-establishing trust among a Belgian population shocked by revelations that abuse stretches back decades.

Belgium is the country in which the secular authorities have stepped most forcefully into the Roman Catholic Church’s abuse scandal.

Though there was no direct apology to the victims on Monday, the archbishop expressed anger and alarm over the scandal and promised to engage with the victims as much as possible.

“We must listen to their questions to re-establish their dignity and help them to heal the suffering they have endured,” Archbishop Léonard said.

But there was no clear proposal for pursuing the abusers or for compensating their victims, resulting in disappointment for some of the groups representing those affected. Most of the wrongdoing took place more than 10 years ago, past the statute of limitations for legal prosecution.

“I have had some reaction from my clients — 35 victims — all of them were very, very angry with this scandalous reaction,” said Walter Van Steenbrugge, a lawyer representing some of the abuse victims. “We were thinking they were ready to pay the costs of all the therapy the victims needed in all these years.”

Instead, the response was “very, very disappointing,” Mr. Van Steenbrugge said, adding that his clients would pursue civil cases against the church.

Lieve Halsberghe, who represents a victims’ group called Human Rights in the Church, said: “They are reading from a script. They are promising that they are going to do things, but we don’t see anything concrete.”

She continued: “We want the guilty to be punished, and we want the story dug out so every victim has justice. There are perpetrators out there who have not confessed and not admitted that they have done wrong. They are psychologically terrorizing their victims.”

The group wants any new structure aimed at helping victims to be independent of the church. Some abuse victims will want compensation, Ms. Halsberghe said, while others will not.

Mr. Van Steenbrugge and Ms. Halsberghe criticized the archbishop’s call for a dialogue with the legal authorities as well as with victims. This, they suggested, could threaten the independence of the judicial process.

The scandal became public when the former bishop of Bruges, Roger Vangheluwe, resigned in April after admitting that he had abused a boy later revealed to be his nephew. Former Bishop Vangheluwe said Saturday that he would leave the Trappist monastery where he had been living and go into hiding.

Protected from prosecution by the statute of limitations, the former bishop has faced increasing calls to give up his status as a priest. Archbishop Léonard said it was for the Vatican to decide on any punishment.

The Rev. Federico Lombardi, the Vatican spokesman, said the pope had already accepted former Bishop Vangheluwe’s resignation, and since the bishop had already left the diocese and the ministry, he was “no longer involved” in the local church. “He has retired to prayer and penitence,” Father Lombardi said.

Father Lombardi said that as far as he knew, no official request had been made to the Vatican to defrock Bishop Vangheluwe.


Elisabetta Povoledo contributed reporting from Rome.

Rape: Rights Group Calls Test to Determine Sexual Activity a ‘Second Assault’ in India

September 13, 2010
Rape: Rights Group Calls Test to Determine Sexual Activity a ‘Second Assault’ in India
By DONALD G. McNEIL Jr.
An international human rights group urged India last week to ban a “degrading and unscientific” test commonly performed on rape victims to see if they have previous sexual experience.

In the test, a doctor inserts fingers into the victim during the forensic examination to test for “vaginal laxity” and is expected to deliver a medical opinion as to whether she appears to be “habituated to sexual intercourse.” The group, Human Rights Watch, argued that the test constituted a second assault on a traumatized woman.

The test is required by courts in some Indian states — including those of Delhi and Mumbai, the national and financial capitals — and, according to local reports, is in the forensic examination still endorsed by the Indian Medical Association.

In most democracies, whether or not a woman has ever had sex before is considered irrelevant in deciding whether she consented to the act under consideration. In 2003, India’s Supreme Court ruled that victims could not be cross-examined on their general moral character, Human Rights Watch said. But it has not ensured that its decision is enforced, and references to those who allege rape as “dissolute” or “of doubtful character” still appear in court rulings.

World Health Organization guidelines calls for victims of sexual violence to get health care at the same time as the forensic examination and from the same person, and for minimally invasive examinations.

Delicious Ways to Love Downtown Los Angeles

September 8, 2010
Delicious Ways to Love Downtown Los Angeles
By JENNIFER STEINHAUER
Monica Almeida/The New York Times
When Joshua Smith, the chef at Church & State, gets involved with potatoes or pigs, he scores. The two-year-old restaurant can attract a raucous dinner crowd. More Photos »


DOWNTOWN Los Angeles has been “reviving” for the better part of 20 years.

The seed may have been planted in 1988, with the naming of Frank Gehry as the architect for Walt Disney Concert Hall — a civic commitment to return downtown to its early 20th-century glory days, when it was a hubbub of activity rather than a place to flee come sunset. Revitalization continued in the 1990s, with rezoning laws that allowed for the transformation of old warehouses into sleek lofts.

In recent years, the openings of the Grammy Museum and a Ritz-Carlton, as well as the philanthropist Eli Broad’s unwavering focus on Grand Avenue as a cultural destination, have hastened the otherwise glacial pace of downtown redux.

There have been barriers: a large and intransient homelessness problem, the recent credit crisis that left some developers in the lurch, and the physical nature of downtown, enveloped in a sea of freeways that make it feel cut off from large swaths of the rest of this city. Yet downtown Los Angeles is now genuinely a place where people want to live and travel to for art fairs, music festivals, basketball games and more.

But, until recently, not to eat.

Yes, there is Little Tokyo, where I have sat in silent awe of the fish at Sushi Gen, and the occasional historic spot, like Philippe the Original, which makes claims on inventing the French dip. But true destination restaurants have been few.

That, too, is changing, with smart new bistros emphasizing creativity and local produce; hidden bars; and cheap-but-chic fare springing up from points east and west. An increasing number of intrepid diners are venturing a few miles east on the 10 Freeway toward the contemporary response to years of suburbanization and sprawl that led to downtown’s descent years ago. And they will now be well fed.

Lazy Ox Canteen

Huh? That was my first reaction as I slid my quarters into the parking meter a block away from this gastro-pub, its sign barely distinguishable. Sitting on the edge of Little Tokyo, the restaurant occupies a stretch of South San Pedro Street that feels slightly deserted, like a toy factory at night. But once I slipped into my seat at the handsome wooden bar (which is where I suggest you plant yourself) and ordered up one of the many great rosés on offer by the glass, a warm, fun feeling began to flow.

The staff here is extremely knowledgeable about the finer points of each goody coming from the kitchen of the chef, Josef Centeno, which is impressive, considering how numerous and eclectic they are. My dining companion and I started with breakfast in a shell — a coddled egg bathed in maple syrup, crème fraîche, Cream of Wheat and tiny bits of pancetta — a dish the bartender assured us took the skill set of a mason to assemble.

Next up was braised beef tongue ravioli with toasted pine nuts, dried chilies and spiced lebni, a kind of tangy yogurt — almost unbearably seductive. Ditto ricotta fritters with saffron honey. My guest, who claimed to dislike anchovies, was won over by the ones marinated with piquillo peppers, and proclaimed them “like an oyster” — which is sort of like comparing Lindsay Lohan with Audrey Hepburn, but I saw where he was going. We finished the evening, staring hazily at the crowd — youngish, appropriately hairy of the face — and polishing off a blue- and blackberry crumble.

Lazy Ox Canteen, 241 South San Pedro Street; (213) 626-5299; lazyoxcanteen.com. $70. (All prices are for an average meal for two, without drinks or tip.)

WP24 at the Ritz-Carlton

Wolfgang Puck is to modern dining in Los Angeles what the bikini is to its beaches — you can’t have one without the other. Spago in Beverly Hills remains a premier lunch spot, and without Mr. Puck, the city may never have known the joys of goat cheese. At his latest venture, on the 24th floor of the Ritz-Carlton hotel, Mr. Puck is making use of his occasional proclivity for Asian fusion with a high-end take on Hong Kong dining.

“I expected to make the best modern Chinese restaurant,” he said in an e-mail, “with great food, a great wine list and great service.”

At WP24, you first enter the bar, where couples sit whispering to each other over elderflower cocktails, and dudes in T-shirts tap away on MacBooks while downing dumplings, high above the neon and illuminated freeways. The bar scene fades away as you pass through padded doors into the formal dining room, in muted shades, and settle into a leather chair for dinner, still taking in the panoramic view of Los Angeles, which is an unusual restaurant vista here. At a large table in the center of the room, servers carve up Peking duck and other dishes.

Start with a refreshing umami cocktail (plum, cucumber and gin). Skip the shrimp dumplings and go for a tasting of dim sum, then move to sea bass in a salt crust and maybe a hot pot of slow-cooked beef cheeks, decadent and deeply flavorful. The pistachio cherry fondant was good, but I returned with my husband on another night just for the marjolasian, essentially a high-end Twix bar, because I couldn’t get it out of my mind.

WP24 at the Ritz-Carlton, 900 West Olympic Boulevard; (213) 743-8824; wolfgangpuck.com. $140.

Church & State

Since it opened almost two years ago, food enthusiasts have been quite gaga over this bistro, set among a cluster of sketchy industrial blocks. And, indeed, there is much to like. Start at the lively and evocative bar and the restaurant’s extensive and exciting wine list, which includes roughly two dozen pours by the glass. Cocktails are equally numerous and judiciously balanced, like the sublime basil avec concombre, a gin-based concoction.

Back in the kitchen, when the chef, Joshua Smith, gets involved with potatoes or pigs, he scores. The salade d’harengs is a lovely combination of smoked herring and fingerling potatoes, and the best thing about the veal skirt steak stroganoff is the accompanying roasted potatoes. Pigs’ ears are another fun option. Avoid the ratatouille; in general it’s best to hew to menu items that seem vaguely Scandinavian over the traditional French choices.

The dining room could use some work: At night, the din would deafen all but denizens of glam-rock reunion tours. One night a friend and I found the service almost a parody of faux French snootiness (the waiter never even offered us a drink). Go anyway. But try lunch if you can, when the room is quieter (though still filled with diners) and bathed in beautiful Los Angeles afternoon light. Have a pan-seared skate wing and a glass of riesling, and let your mind wander to the neighborhood’s industrial past.

Church & State, 1850 Industrial Street; (213) 405-1434; churchandstatebistro.com. $60.

Rivera

Sleek and modern, with low, comfy chairs and bullfighting images on monitors, Rivera bills itself as contemporary Latin cuisine, near the Staples Center in the heart of downtown. Tequila is the tipple of choice here — the menu boasts rare and interesting selections, as well as a very affordable list of Spanish and Portuguese wines. Cocktails are also tasty — you will order a “Blood sugar sex magic” (an homage to the band the Red Hot Chili Peppers, teaming red peppers with rye and basil) because — well, do I really need to explain?

The tortillas with rose petals were a savory highlight, as was the house specialty, paper thin jamón Ibérico — the foie gras of hams — served on toast. An appetizer of quail bathed in a paprika sauce is bright and delicious, served on a plate bearing an image of a skull — a cheeky touch. This is Los Angeles, so there must be Jidori chicken, from a local purveyor of super fresh birds, cooked here with a Spanish peanut salsa.

Skip dessert, with one exception: Remember, in the movie “Wag the Dog,” when William H. Macy said, “There’s no difference between good flan and bad flan”? He clearly hadn’t tried Rivera’s.

Restaurants in Los Angeles generally reflect their neighborhoods, but this place attracts a mixed crowd of people headed for LA Live, the entertainment complex downtown: women in skirts that are shorter than their mothers would like, and, on the night we were there, a table of makeup artists — one sporting a bee hive — celebrating around a very large, bar-like table. Sit at the bar, stick to snacks and cocktails, and take in the scene.

Rivera, 1050 South Flower Street, No. 102; (213) 749-1460; riverarestaurant.com. $80.

Starry Kitchen

Everyone loves a restaurant back story, and Starry Kitchen’s isn’t bad. Nguyen and Thi Tran were running an underground restaurant in North Hollywood, sending out invitations on the down low to guests who would partake in their varied Asian dishes, paying at a card table set up with a cash box. Now, the married couple have gone legit in a big way, operating out of a food court in the center of a complex of office buildings downtown, happily near the Museum of Contemporary Art.

Mr. Tran works the front of their little space, alerting visitors in a profanity-laced speech the second they enter that the menu changes all the time — save for the lemon grass chicken with ginger, which he claims is only for the frightened and the weak. (Actually it’s quite good, especially when paired with scallion-laced rice.) You pick a protein, a vegetable and a side dish, and a presentation (wrap, bowl, etc.), and it all comes out in a jiffy. The Japanese sesame fried chicken was a good choice, too, but who knows if it will be on the menu when you go. That, of course, is part of the fun.

Starry Kitchen, 350 South Grand Avenue; (213) 617-3474; starrykitchen.com. $18.