Google's Android software in 3 out of 4 smartphones

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Gays in Pakistan Move Cautiously to Gain Acceptance

Max Becherer for the International Herald Tribune

HIDING IN PLAIN SIGHT Ali, a gay man who lives in Lahore, is in a support group for lesbian, gay, bisexual and transgender Pakistanis. “The gay scene here is very hush-hush,” he says.

LAHORE, Pakistan — The group meets irregularly in a simple building among a row of shops here that close in the evening. Drapes cover the windows. Sometimes members watch movies or read poetry. Occasionally, they give a party, dance and drink and let off steam.

The group is invitation only, by word of mouth. Members communicate through an e-mail list and are careful not to jeopardize the location of their meetings. One room is reserved for “crisis situations,” when someone may need a place to hide, most often from her own family. This is their safe space — a support group for lesbian, gay, bisexual and transgender Pakistanis.

“The gay scene here is very hush-hush,” said Ali, a member who did not want his full name used. “I wish it was a bit more open, but you make do with what you have.”

That is slowly changing as a relative handful of younger gays and lesbians, many educated in the West, seek to foster more acceptance of their sexuality and to carve out an identity, even in a climate of religious conservatism.

Homosexual acts remain illegal in Pakistan, based on laws constructed by the British during colonial rule. No civil rights legislation exists to protect gays and lesbians from discrimination.

But the reality is far more complex, more akin to “don’t ask, don’t tell” than a state-sponsored witch hunt. For a long time, the state’s willful blindness has provided space enough for gays and lesbians. They socialize, organize, date and even live together as couples, though discreetly.

One journalist, in his early 40s, has been living as a gay man in Pakistan for almost two decades. “It’s very easy being gay here, to be honest,” he said, though he and several others interviewed did not want their names used for fear of the social and legal repercussions. “You can live without being hassled about it,” he said, “as long as you are not wearing a pink tutu and running down the street carrying a rainbow flag.”

The reason is that while the notion of homosexuality may be taboo, homosocial, and even homosexual, behavior is common enough. Pakistani society is sharply segregated on gender lines, with taboos about extramarital sex that make it almost harder to conduct a secret heterosexual romance than a homosexual one. Displays of affection between men in public, like hugging and holding hands, are common. “A guy can be with a guy anytime, anywhere, and no one will raise an eyebrow,” the journalist said.

For many in his and previous generations, he said, same-sex attraction was not necessarily an issue because it did not involve questions of identity. Many Pakistani men who have sex with men do not think of themselves as gay. Some do it regularly, when they need a break from their wives, they say, and some for money.

But all the examples of homosexual relations — in Sufi poetry, Urdu literature or discreet sexual conduct — occur within the private sphere, said Hina Jilani, a human rights lawyer and activist for women’s and minority rights. Homoeroticism can be expressed but not named.

“The biggest hurdle,” Ms. Jilani said, “is finding the proper context in which to bring this issue out into the open.”

That is what the gay and lesbian support group in Lahore is slowly seeking to do, even if it still meets in what amounts to near secrecy.

The driving force behind the group comes from two women, ages 30 and 33. They are keenly aware of the oddity that two women, partners no less, have become architects of the modern gay scene in Lahore; if gay and bisexual men barely register in the collective societal consciousness of Pakistan, their female counterparts are even less visible.

“The organizing came from my personal experience of extreme isolation, the sense of being alone and different,” the 30-year-old said.

She decided that she needed to find others like her in Pakistan. Eight people, mostly the couple’s friends, attended the first meeting in January 2009.

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Dominican police arrest 3 in killing of ex-Yankee

SANTO DOMINGO, Dominican Republic (AP) — Police in the Dominican Republic said Saturday that they have arrested three men suspected in the killing of former major league pitcher Pascual Perez during an attempted home robbery. Another two suspects remain at large.

Maximo Baez, the police department's criminal investigations director, said one of the arrested men personally knew Perez and confessed that he and four others had planned to steal the $2,400 monthly pension he received for his 11-season career in the Major Leagues.

The 55-year-old's ex-wife found his body on Thursday at the home where he lived alone in San Gregorio de Nigua, a town west of the capital of Santo Domingo. Police said he had severe head wounds caused by being hit repeatedly with a hammer.

Authorities said they expected to file charges against the suspects later Saturday.

Police identified another one of those arrested as a low-level drug dealer. A third suspect was arrested Saturday after police said he sold one of Perez's cell phones for $6.25.

Police said they have also identified the two fugitives.

During his time in professional baseball, Perez had a rocky career including two suspensions for drug use.

The right-hander was first signed by the Pittsburgh Pirates in January 1976 as an amateur free agent, according to Baseball-Reference.com, an online sports information site. He then pitched for the Atlanta Braves from 1982-85. He was 15-8 in 1983 and 14-8 in 1984.

Perez last played in the majors for the New York Yankees in 1991, compiling a lifetime record of 67-68 with the Braves, Pirates, Expos and Yankees.

In March 1992, he was suspended after failing a drug test the day he arrived for spring training with the Yankees. He was entering the final season of a three-year, $5.7 million contract, but never returned to major league baseball.

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Second Illness Infects Meningitis Sufferers

Just when they might have thought they were in the clear, people recovering from meningitis in an outbreak caused by a contaminated steroid drug have been struck by a second illness.

The new problem, called an epidural abscess, is an infection near the spine at the site where the drug — contaminated by a fungus — was injected to treat back or neck pain. The abscesses are a localized infection, different from meningitis, which affects the membranes covering the brain and spinal cord. But in some cases, an untreated abscess can cause meningitis. The abscesses have formed even while patients were taking powerful antifungal medicines, putting them back in the hospital for more treatment, often with surgery.

The problem has just begun to emerge, so far mostly in Michigan, which has had more people sickened by the drug — 112 out of 404 nationwide — than any other state.

“We’re hearing about it in Michigan and other locations as well,” said Dr. Tom M. Chiller, the deputy chief of the mycotic diseases branch of the Centers for Disease Control and Prevention. “We don’t have a good handle on how many people are coming back.”

He added, “We are just learning about this and trying to assess how best to manage these patients. They’re very complicated.”

In the last few days, about a third of the 53 patients treated for meningitis at St. Joseph Mercy Hospital in Ann Arbor, Mich., have returned with abscesses, said Dr. Lakshmi K. Halasyamani, the chief medical officer.

“This is a significant shift in the presentation of this fungal infection, and quite concerning,” she said. “An epidural abscess is very serious. It’s not something we expected.”

She and other experts said they were especially puzzled that the infections could occur even though patients were taking drugs that, at least in tests, appeared to work against the fungus causing the infection, a type of black mold called Exserohilum.

The main symptom is severe pain near the injection site. But the abscesses are internal, with no visible signs on the skin, so it takes an M.R.I. scan to make the diagnosis. Some patients have more than one abscess. In some cases, the infection can be drained or cleaned out by a neurosurgeon.

But sometimes fungal strands and abnormal tissue are wrapped around nerves and cannot be surgically removed, said Dr. Carol A. Kauffman, an expert on fungal diseases at the University of Michigan. In such cases, all doctors can do is give a combination of antifungal drugs and hope for the best. They have very little experience with this type of infection.

Some patients have had epidural abscesses without meningitis; St. Joseph Mercy Hospital has had 34 such cases.

A spokesman for the health department in Tennessee, which has had 78 meningitis cases, said that a few cases of epidural abscess had also occurred there, and that the state was trying to assess the extent of the problem.

Dr. Chiller said doctors were also reporting that some patients exposed to the tainted drug had arachnoiditis, a nerve inflammation near the spine that can cause intense pain, bladder problems and numbness.

“Unfortunately, we know from the rare cases of fungal meningitis that occur, that you can have complicated courses for this disease, and it requires prolonged therapy and can have some devastating consequences,” he said.

The meningitis outbreak, first recognized in late September, is one of the worst public health disasters ever caused by a contaminated drug. So far, 29 people have died, often from strokes caused by the infection. The case count is continuing to rise. The drug was a steroid, methylprednisolone acetate, made by the New England Compounding Center in Framingham, Mass. Three contaminated lots of the drug, more than 17,000 vials, were shipped around the country, and about 14,000 people were injected with the drug, mostly for neck and back pain. But some received injections for arthritic joints and have developed joint infections.

Inspections of the compounding center have revealed extensive contamination. It has been shut down, as has another Massachusetts company, Ameridose, with some of the same owners. Both companies have had their products recalled.

Compounding pharmacies, which mix their own drugs, have had little regulation from either states or the federal government, and several others have been shut down recently after inspections found sanitation problems.

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In Election-Night Party Planning, Flexibility Is a Must

Isaac Brekken for The New York Times

Frank Roskowski, director of technical services at the Aria Resort in Las Vegas, says it's difficult to determine the contours of an election-night party.

Isaac Brekken for The New York Times

A sign points to an early-voting site in Las Vegas, a city well suited to election parties because many of its ballrooms can expand or contract to accommodate victory or loss.

WHEN empty, the Bristlecone ballroom at the Aria Resort and Casino here is 57,000 square feet of beige carpeting and fluorescent lights. But two years ago, it was briefly the overstuffed epicenter of American politics.

This is where Senator Harry Reid, the Nevada Democrat and majority leader, held his election-night party after prevailing in a race that many had predicted he would lose. To Democrats, this was a site for triumph and relief; for Republicans, it was one for disappointment and loss.

For Frank Roskowski, it was something else entirely. “It was carnage. It was goofy,” he said, grinning as he surveyed the room last week.

Mr. Roskowski, whom everyone calls Mustache Frank, is Aria’s director of technical services, and he is reminiscing about the chaos and bustle of Nov. 2, 2010. Democrats lost a bunch of races across the country, not to mention control of the House of Representatives, and in the days before the votes were tallied it looked possible that Mr. Reid would be a casualty. Twenty-two television crews were jockeying for position in the Bristlecone, starting at 4 a.m.

“The TV trucks all were fighting because the thing is, they have to run cable to a connection point,” Mr. Roskowski recalls. “So the guy in the truck, if he gets here early, he only has to run 100 feet. If he’s late, he’s got to run 500. At 3 in the morning, they’re out there, I’m out there, my guys are out there and these TV guys are like: ‘Hey, you want doughnuts? You want beer? 50 bucks?’ I’m like: ‘Whoa. Here’s what was sent to me. You’re here, you’re here, you’re here.”

As a feat of event planning, there is nothing quite like an election-night party. At most festivities that call for banquet halls and cocktails, there is little doubt about the basic contours of the main event. If it’s a wedding, two people are married and the union is celebrated. Organize a conference, and a crowd will mingle and drink. But an election-night party could be an evening of triumph or fiasco, a celebration or a wake. It’s like a trip to the hospital that might culminate with a fatal diagnosis or a healthy baby.

Both tragedy and triumph must be accommodated. It’s fine for politicians to say, “When I’m elected” or “When I’m re-elected,” but the election-night party planner toils in the realm of the possible, not the fondly wished for. If you anticipate an enormous, victory-hailing crowd and you lose, you are looking at not just a defeated candidate but also a tableau that accentuates all the empty space where supporters were supposed to revel. So, what to do? Order a few thousand balloons but don’t fill them until the polls close? Hide the confetti until the victory is certified?

What is far more essential, it turns out, is a room that can be shrunk or enlarged, quickly. Which is why Las Vegas is arguably the greatest election-night city in the country. Expandable banquet rooms are a specialty here, and turning a space that fits 100 into a space that fits 2,000 — and vice versa — is a feat that can be pulled off in places like the Bristlecone ballroom in a matter of minutes. The trick is air walls, huge movable slabs that slide back and forth like pocket doors.

Ultimately, on election night in 2010 here, the space in front of all the television cameras fit a mere 150 people. That was a tiny fraction of the entire room, and it left a tundra of emptiness out of view of all those cameras. But priority No. 1 was making the room look packed.

“When you tuned in at home,” Mr. Roskowski says, “it looked body-to-body tight.”

THE worlds of electioneering and catering will again intersect on Tuesday, as candidates await the public’s verdicts in settings of their choosing. For catering, it is often an evening of modest profit — a typical event with a couple of hundred people will cost $50,000, depending on the quality and quantity of food and drink. For the campaigns, devising these get-togethers can seem both fraught and irrelevant at the same time. Yes, all the stagecraft and planning matter. But what is the point of worrying about the finish line when the race is in the last sprint? Many campaigns contacted for this article would not discuss their plans, or they kept the discussion to a bare minimum.

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Microsoft vs Google trial raises concerns over secrecy

SAN FRANCISCO (Reuters) - Two weeks before a high-stakes trial pitting Google's Motorola Mobility unit against Microsoft, Google made what has become a common request for a technology company fighting for billions of dollars: A public court proceeding, conducted largely in secret.

Google and Microsoft, like rivals embroiled in smartphone patent wars, are eager to keep sensitive business information under wraps - in this case, the royalty deals they cut with other companies on patented technology. Microsoft asked for similar protections in a court filing late on Thursday.

Such royalty rates, though, are the central issue in this trial, which begins November 13 in Seattle.

U.S. District Judge James Robart has granted requests to block many pre-trial legal briefs from public view. Though he warned he may get tougher on the issue, the nature of the case raises the possibility that even his final decision might include redacted, or blacked-out, sections.

Legal experts are increasingly troubled by the level of secrecy that has become commonplace in intellectual property cases where overburdened judges often pay scant attention to the issue.

Widespread sealing of documents infringes on the basic American legal principle that court should be public, says law professor, Dennis Crouch, and encourages companies to use a costly, tax-payer funded resource to resolve their disputes.

"There are plenty of cases that have settled because one party didn't want their information public," said Crouch, an intellectual property professor at University of Missouri School of Law.

Tech companies counter that they should not be forced to reveal private business information as the price for having their day in court.

The law does permit confidential information to be kept from public view in some circumstances, though companies must show the disclosure would be harmful.

Google argues that revelations about licensing negotiations would give competitors "additional leverage and bargaining power and would lead to an unfair advantage."

Robart has not yet ruled on Google and Microsoft's requests, which, in the case of Google includes not only keeping documents under seal, but also clearing the courtroom during crucial testimony.

It is also unclear whether Robart will redact any discussion of royalty rates in his final opinion. The judge, who will decide this part of the case without a jury, did not respond to requests for comment.

NOT PAYING ATTENTION

Apple Inc and Microsoft Corp have been litigating in courts around the world against Google Inc and partners like Samsung Electronics Co Ltd, which use the Android operating system on their mobile devices.

Apple contends that Android is basically a copy of its iOS smartphone software, and Microsoft holds patents that it contends cover a number of Android features.

Google bought Motorola for $12.5 billion, partly to use its large portfolio of communications patents as a bargaining chip against its competitors.

Robart will decide how big a royalty Motorola deserves from Microsoft for a license on some Motorola wireless and video patents.

Apple, for its part, is set to square off against Motorola on Monday in Madison, Wisconsin, in a case that involves many of the same issues.

In Wisconsin, Apple and Motorola have filed most court documents entirely under seal. U.S. District Judge Barbara Crabb did not require them to seek advance permission to file them secretly, nor did she mandate that the companies make redacted copies available for the public.

Judges have broad discretion in granting requests to seal documents. The legal standard for such requests can be high, but in cases where both sides want the proceedings to be secret, judges have little incentive to thoroughly review secrecy requests.

In Apple's Northern California litigation against Samsung, both parties also sought to keep many documents under seal. After Reuters challenged those secrecy requests, on grounds it wanted to report financial details, U.S. District Judge Lucy Koh ordered both companies to disclose a range of information they considered secret - including profit margins on individual products - but not licensing deals. Apple and Samsung are appealing the disclosure order.

In response to questions from Reuters last week, Judge Crabb in Wisconsin, who will also decide the case without a jury, acknowledged she had not been paying attention to how many documents were being filed under seal. Federal judges in Madison will now require that parties file redacted briefs, she said, though as of Wednesday, Apple and Motorola were still filing key briefs entirely under seal.

"Just because there is a seed or kernel of confidential information doesn't mean an entire 25-page brief should be sealed," said Bernard Chao, an intellectual property professor at University of Denver Sturm College of Law.

Crabb promised that the upcoming trial would be open.

"Whatever opinion I make is not going to be redacted," she told Reuters in an interview.

CHECKING THE COMPS

Microsoft sued Motorola two years ago, saying Motorola had promised to license its so-called "standards essential" patents at a fair rate, in exchange for the technology being adopted as a norm industrywide. But by demanding roughly $4 billion a year in revenue, Microsoft says Motorola broke its promise.

Robart will sort out what a reasonable royalty for those standards patents should be, partly by reviewing deals Motorola struck with other companies such as IBM and Research in Motion - much like an appraiser checking comparable properties to figure out whether a home is priced right.

In this case, though, the public may not be able to understand exactly what figures Robart is comparing. Representatives for Microsoft and Google declined to comment.

In its brief, Microsoft said licensing terms could be sealed without the need to clear the courtroom.

"Permitting redaction of this information will minimize the harm to Microsoft and third parties while also giving due consideration to the public policies favoring disclosure," the company argued.

IBM and RIM have also asked Robart to keep licensing information secret.

Chao doesn't think Robart will ultimately redact his own ruling, even though it may include discussion of the specific royalty rates. "I can't imagine that," he said.

Most judges cite lack of resources and overflowing dockets as the reason why they don't scrutinize secrecy requests more closely, especially when both parties support them.

In Wisconsin, Crabb said that even though she will now require litigants to ask permission to file secret documents, it is highly unlikely that she will actually read those arguments - unless someone else flags a problem.

"We're paddling madly to stay afloat," Crabb said.

The Wisconsin case in U.S. District Court, Western District of Wisconsin is Apple Inc. vs. Motorola Mobility Inc., 11-cv-178. The Seattle case in U.S. District Court, Western District of Washington is Microsoft Corp. vs. Motorola Inc., 10-cv-1823.

(Reporting by Dan Levine in San Francisco; Additional reporting by Bill Rigby in Seattle.; Editing by Jonathan Weber, Andrew Hay and Bernadette Baum)

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Guinea-Bissau, After Coup, Is Drug-Trafficking Haven

Agence France-Presse — Getty Images

Guinea-Bissau soldiers patrolled a street in the capital, Bissau, on Oct. 21 after dissident soldiers raided an army barracks in an apparent attempt to topple the military junta.

BISSAU, Guinea-Bissau — When the army ousted the president here just months before his term was to expire, a thirst for power by the officer corps did not fully explain the offensive. But a sizable increase in drug trafficking in this troubled country since the military took over has raised suspicions that the president’s sudden removal was what amounted to a cocaine coup.

The military brass here has long been associated with drug trafficking, but the coup last spring means soldiers now control the drug racket and the country itself, turning Guinea-Bissau in the eyes of some international counternarcotics experts into a nation where illegal drugs are sanctioned at the top.

“They are probably the worst narco-state that’s out there on the continent,” said a senior Drug Enforcement Administration official in Washington, who spoke on the condition of anonymity so as not to jeopardize his work in the region. “They are a major problem.”

Since the April 12 coup, more small twin-engine planes than ever are making the 1,600-mile Atlantic crossing from Latin America to the edge of Africa’s western bulge, landing in Guinea-Bissau’s fields, uninhabited islands and remote estuaries. There they unload their cargos of cocaine for transshipment north, experts say.

The fact that the army has put in place a figurehead government and that military officers continue to call the shots behind the scenes only intensifies the problem.

The political instability continued as soldiers attacked an army barracks on Oct. 21, apparently in an attempt to topple the government. A dissident army captain was arrested on an offshore island on Oct. 27 and accused of being the organizer of the countercoup attempt. Two critics of the government were also assaulted and then left outside the capital.

From April to July there were at least 20 landings in Guinea-Bissau of small planes that United Nations officials suspected were drug flights — traffic that could represent more than half the estimated annual cocaine volume for the region. The planes need to carry a one-and-a-half-ton cargo to make the trans-Atlantic trip viable, officials say. Europe, already the destination for about 50 tons of cocaine annually from West Africa, United Nations officials say, could be in for a far greater flood.

Was the military coup itself a diversion for drug trafficking? Some experts point to signs that as the armed forces were seizing the presidency, taking over radio stations and arresting government officials, there was a flurry of drug activity on one of the islands of the Bijagós Archipelago, what amounted to a three-day offloading of suspicious sacks.

That surreptitious activity appears to have been simply a prelude.

“There has clearly been an increase in Guinea-Bissau in the last several months,” said Pierre Lapaque, head of the regional United Nations Office on Drugs and Crime for West and Central Africa. “We are seeing more and more drugs regularly arriving in this country.”

Mr. Lapaque called the trafficking in Guinea-Bissau “a major worry” and an “open sore,” and, like others, suggested that it was no coincidence that trafficking had spiked since the coup.

Joaquin Gonzalez-Ducay, the European Union ambassador in Bissau, said: “As a country it is controlled by those who formed the coup d’état. They can do what they want to do. Now they have free rein.”

The senior D.E.A. official said, “People at the highest levels of the military are involved in the facilitation” of trafficking, and added: “In other African countries government officials are part of the problem. In Guinea-Bissau, it is the government itself that is the problem.”

United Nations officials agree. “The coup was perpetrated by people totally embedded in the drugs business,” said one official, who spoke on the condition of anonymity because of the delicacy of the political environment here.

The country’s former prosecutor general, Octávio Inocêncio Alves, said, “A lot of the traffickers have direct relationships with the military.”

The civilian government and the military leadership that sits watchfully in its headquarters in an old Portuguese fort at the other end of town reject the United Nations drug accusations.

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Bloomberg: N Marathon will go on, despite outcry

NEW YORK (AP) — With people in storm-ravaged areas still shivering without electricity and the death toll in New York City alone at 39, many New Yorkers were repelled by the prospect of police officers being assigned to protect a marathon.

They recoiled at the thought of storm victims being evicted from hotels to make room for people coming into town for the race. And they resented the sight of big generators humming along at the finish-line tents in Central Park.

Mayor Michael Bloomberg said he hoped to lift spirits and unite the stricken city when he decided to press ahead with this weekend's New York City Marathon. Instead, the move became a source of division Friday, with some New Yorkers — even some runners — saying this is not the time for a road race.

They complained that holding the event just six days after Superstorm Sandy would be insensitive and tie up precious resources when many people are still suffering.

Joan Wacks, whose Staten Island waterfront condo was swamped with 4 feet of water, predicted authorities will still be recovering bodies when the estimated 40,000 runners from around the world hit the streets for the 26.2-mile race Sunday, and she called the mayor "tone deaf."

"He is clueless without a paddle to the reality of what everyone else is dealing with," she said. "If there are any resources being put toward the marathon, that's wrong. I'm sorry, that's wrong."

At a news conference, Bloomberg defended his decision as a way to raise money for the city's recovery and boost morale after Sandy flooded neighborhoods and knocked out power to hundreds of thousands homes and businesses.

Bloomberg said New York "has to show that we are here and we are going to recover" and "give people something to cheer about in what's been a very dismal week for a lot of people."

"You have to keep going and doing things," he said, "and you can grieve, you can cry and you can laugh all at the same time. That's what human beings are good at."

Noting that street lights should be back on in Manhattan by midnight Friday and parts of the transit system are up and running again, he gave assurances that the race would not take away police officers and other resources needed in the recovery.

He also pointed out that his predecessor, Rudolph Giuliani, went ahead with the marathon two months after the 9/11 terrorist attacks, and "it pulled people together."

One of the world's pre-eminent road races, the marathon generates an estimated $340 million for the city. This time, the marathon's sponsors and organizers have dubbed it the "Race to Recover" and intend to use the event to raise money for the city to deal with the crisis. New York Road Runners, the race organizer, will donate $1 million and said sponsors have pledged more than $1.5 million.

"It's hard in these moments to know what's best to do," NYRR president Mary Wittenberg said. "The city believes this is best to do right now."

The course runs from the Verrazano-Narrows Bridge on hard-hit Staten Island to Central Park, sending runners through all five boroughs. The course will not be changed, since there was little damage along the route.

Police Commissioner Raymond Kelly said police officers will not be taken off storm-recovery duty to work the marathon. He said the estimated 2,000 officers on the marathon route come in on their days off, on overtime, while those on storm duty work extended shifts on their regular work days.

"People who are engaged in recovery work and security work, those numbers will remain essentially the same," he said.

Michael Sofronas of Manhattan used to run the marathon and has been a race volunteer for four years, serving as an interpreter for foreign runners. But he said he won't volunteer this year.

"I'm also really very aghast at the fact that we've just gone through the Sandy hurricane and I believe that the people should not be diverted to the marathon. They should focus on the people in need," he said. "It's all about money, money from everybody. The sponsors, the runners."

A Swede who arrived in New York this week to run in the marathon sided with the mayor.

"It doesn't feel good, coming to New York," Maria Eriksson said. "But the marathon has been planned for such a long time. And besides, it brings so much money to the city. That should help. What help would it be to cancel?"

Other runners were torn.

Olivia Waldman, who lives on the Upper East Side, said: "I want to be a part of this marathon and I also want to be a part of the hurricane relief. I'm trying to help where I can, and the marathon is going on, so we have to help in making that go forward."

But John Esposito, a Staten Islander helping his elderly parents clean out their flooded home, said: "They brought giant generators to power the marathon tents while we've got thousands of people without power. ... How about putting one of these generators here? Have some compassion."

Adam Shanker of Short Hills, N.J., said he moved his family from his dark and cold house to a Manhattan hotel, only to learn they were being kicked out Friday to make room for someone with reservations for the marathon.

"I hate Mayor Bloomberg," he said. "It is absolutely retarded to have a marathon starting, especially in Staten Island, where people just lost everything in the world. And they're going to have these people run through our streets like celebrating some kind of run, which I think is great, but not now. ... And now people who can't even get rooms are getting kicked out of the only rooms they have because these people have rooms. And, you know, what is he thinking?"

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Well: Think Like a Doctor: A Terrible Leg Wound Solved

On Thursday, we challenged Well readers to solve a case of a woman with painful, pus-filled leg wounds that did not respond to antibiotics. More than 400 people wrote in, and a whopping 85 came up with the right answer. The first person to figure out the diagnosis was Heather Chambers, a third-year medical student at Dalhousie Medical School in Halifax, Nova Scotia.

The correct diagnosis is…

Pyoderma gangrenosum.

In an e-mail, Ms. Chambers wrote, “Having just begun the clinical portion of my training, I’ve certainly never seen pyoderma gangrenosum, and, being quite rare, it’s likely I will never see it over the course of my career. However, I recall learning about it as part of our preclinical dermatology curriculum last spring, and it was the first condition that came to mind that could account for a deep and seemingly infected ulcer that wouldn’t respond to a powerful broad spectrum antibiotic like vancomycin.”

The Diagnosis

Pyoderma gangrenosum is a rare and somewhat mysterious skin condition that arises when the immune system mistakenly turns on itself, destroying its own tissue as if it were some foreign invader. It is not at all clear why this happens, but the condition is most commonly seen in those with certain inflammatory diseases, including ulcerative colitis, Crohn’s disease and infectious hepatitis, as well as certain blood cancers, like leukemia, and some types of arthritis.

It’s a tricky disease to diagnose, and yet if a doctor does not diagnose it, the chance of a patient’s receiving the right treatment is small. Affected tissues look infected — the involved skin is red and hot and covered with pus — and yet there are no organisms involved in the disease. Antibiotics are useless in this setting — and yet, because it looks so much like an infection, doctors try one antibiotic after another in search of the right one.

The terrible ulcers caused by pyoderma gangrenosum often have dark, dead-looking skin at their edges, leading doctors to think that surgery is needed to clear away the dying tissue and give new tissue a chance to grow. Yet surgery makes the lesions worse by unleashing a new round of tissue destruction. The only way to treat the condition is to suppress the immune system — the very opposite of how a patient with an infection should be treated.

Pyoderma gangrenosum most commonly arises in middle-aged people, slightly more often in women than in men. Although it can be treated, the outbreaks often leave scars and can recur.

How the Diagnosis Was Made

When Dr. Nadine Stanojevic, the resident on duty, saw that the patient was not improving after receiving vancomycin for more than 48 hours, she grew increasingly worried. Staphylococcus aureus is the classic pus-forming infection, but there are other bacteria that can do this as well and that wouldn’t necessarily respond to the drug. Should she change the patient to a different antibiotic?

She decided to let the cultures guide her. A virulent infection like the one this woman had would certainly grow well in the nutrient-filled cultures of the microbiology lab.

But it didn’t. There were no organisms at all in the pus-filled goo she’d removed from the patient’s wound, the lab reported. Nothing was seen under the microscope, and nothing was growing in the petri dishes.

So maybe this was not an infection, Dr. Stanojevic thought. When the young doctor had first seen the wounds on the patient’s leg, it reminded her of an earlier case she had seen and written up for a medical conference: It involved a man with rheumatoid arthritis who had the same kind of pus-layered ulcers. He had been given antibiotics for weeks, which didn’t help, and was finally given a diagnosis of pyoderma gangrenosum, caused by the rheumatoid arthritis.

This woman also had arthritis, possibly rheumatoid arthritis. Could she also have pyoderma gangrenosum?

When the blood tests came back showing that the patient didn’t have rheumatoid arthritis, it seemed unlikely. But after no bacteria were found and the patient wasn’t getting better, it was time to reconsider. Dr. Stanojevic looked up images of pyoderma gangrenosum on her computer. This patient had the same kind of huge, discolored, pus-filled lesions she saw on the screen.

A quick search through the medical literature revealed that pyoderma gangrenosum can also be caused by infection, and this patient had hepatitis C. She suggested the diagnosis to the attending physician on the team, a young doctor named Jeremy Schwartz, telling him about the other patient she’d seen.

“She had written this case report of pyoderma gangrenosum,” Dr. Schwartz told me later. “I had never seen a case. So I felt like she was more of an authority on this than I was.”

Lifelong Learning

In medicine we recognize that although we all have the same core education, each of us also has areas of expertise based on experience. In studies done decades ago, it was shown that the doctor most likely to make a diagnosis is the one who has seen the condition before. That remains true.

Dr. Schwartz and Dr. Stanojevic decided to stop the antibiotics, which clearly weren’t helping, and get a second opinion from a dermatologist. The specialist agreed that pyoderma gangrenosum was the most likely diagnosis. And because there is no definitive test for the disease, he suggested they get a biopsy from the wound and send it to the microbiology lab to look for any signs of infection and to pathology to look for evidence of pyoderma gangrenosum. Within 48 hours they had a probable diagnosis of pyoderma gangrenosum.

Once the diagnosis was made, the patient was started on steroids. The response was immediate. By the next day her legs were dramatically better. There was no pus, no redness, almost no swelling. And since there was a good chance that the pyoderma gangrenosum was caused by the hepatitis C, she was referred to a hepatitis specialist. Curing that would prevent further episodes of these painful, ugly ulcers.

Dr. Schwartz found the whole process of making this diagnosis exciting. Medicine requires a love of lifelong learning, mostly through experience. “Pyoderma gangrenosum is one of these things with long Latin names that you read about, but you don’t really know it until you see it,” he said. “But once you’ve seen it, you’ll never miss it again.”

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Common Sense: Comparing the Tax Bite Under Obama and Romney

What federal tax rate would you pay if Mitt Romney were elected president? And what would it be if Barack Obama were re-elected, assuming Congress goes along with the candidates’ proposals?

Win Mcnamee/Getty Images

President Obama and Mitt Romney during their debate in Boca Raton, Fla., last month. Tax reform and the related issue of economic growth have been major themes in the presidential campaign.

Would you pay more or less in tax? And how would that stack up against the richest Americans like Warren Buffett, who’s currently paying a lower rate than his secretary?

Considering how central these issues have been to the campaign, it’s curious how hard it is to come up with answers, perhaps because both candidates want voters to believe that someone’s else’s taxes may have to rise, but not theirs. Whether Mr. Romney’s math adds up and whether taxing the rich would make a dent in the deficit might make an interesting public policy debate, but those issues further obscure the most basic question, which is what effect the proposals will have on each of us.

I’m not saying voters should simply vote their pocketbooks. But I would at least like to know how much I’m being asked to pay and what I might expect in return. This has been especially true since I discovered this year that I paid a rate in federal income tax that’s nearly twice as high as Mr. Romney’s. As I said then, I’m not faulting Mr. Romney for taking advantage of the existing tax code, but that disparity continues to rankle.

Tax reform and the related issue of economic growth have been major themes in the campaign that will end on Tuesday. The economy has taken center stage, and both candidates have been making much of tax platforms that aim to spur growth and job creation while promoting fairness. Mr. Romney has been the more ambitious, calling for sweeping tax reform that would lower rates while broadening the base by limiting unspecified deductions and loopholes. “Tax policy shapes almost everything individuals and enterprises do as they participate in the economy,” he says on his “Mitt Romney for President” Web site.

President Obama has called for a return to the top rates that prevailed in the Clinton administration and higher rates on capital gains and dividends. “We can’t get this done unless we also ask the wealthiest households to pay higher taxes on their incomes above $250,000 — pay the same rate we had when Bill Clinton was president,” Mr. Obama said last month while campaigning in New Hampshire. “We created 23 million new jobs, and we went from a deficit to surplus. That’s how you do it.”

So what would the impact of their tax proposals be? After consulting several tax experts, I did the calculations both on my own returns for 2009 and 2011 as well as for the wealthiest 400 taxpayers.

For the Romney plan, I took the proposals from his Web site that apply to taxpayers with adjusted gross incomes over $200,000: a 20 percent cut in the top rate (to 28 percent from 35 percent); dividends and capital gains taxed at the existing preferential rate of 15 percent; and the abolition of the alternative minimum tax. Mr. Romney hasn’t said what itemized deductions he would abolish or limit, but he has said he might cap or eliminate those deductions for high-income taxpayers.

Mr. Romney has mentioned a cap on deductions of $17,000, and has also said: “One way, for instance, would be to have a single number. Make up a number, $25,000, $50,000. Anybody can have deductions up to that amount And then that number disappears for high-income people,” meaning high-income people would be allowed no itemized deductions.

So in the spirit of Mr. Romney’s comments, I eliminated all itemized deductions. I retained the self-employed health insurance deduction and the deduction for contributions to a qualifying retirement plan. So far as I can tell, Mr. Romney hasn’t proposed abolishing those.

I took Mr. Obama’s tax proposals from his proposed budget and subsequent campaign statements, in which he has called for a return to Clinton era rates of 36 percent (for single taxpayers in roughly the $200,000 to $400,000 bracket) and 39.6 percent for those earning over $400,000 for both ordinary and dividend income and a 20 percent rate on capital gains. While Mr. Obama has talked about repealing the A.M.T., he hasn’t actually proposed doing so and has only suggested indexing it to inflation, so I retained the A.M.T. in the Obama calculations.

I assumed the Obama proposals would raise my rate and the Romney plan would lower it. But the Romney plan actually increased my rate to 25.5 percent from 22.2 percent in 2011, and to 27.6 percent from 26.7 percent in 2009. The Obama plan raised it even more substantially, to 30.6 percent in 2011 and 29.3 percent in 2009.

Including the minimum tax in the Obama plan had a significant impact. If Mr. Obama abolished it, my rate under his plan fell to 29.7 percent in 2011 and to 26.7 percent in 2009 — lower than the Romney plan, in fact, in 2009. If Mr. Romney allowed me the $17,000 in itemized deductions he has mentioned, it would have only a negligible impact, lowering my rates 0.5 percent.

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