Email hacker reveals Bush family photos, addresses

(Reuters) – The Secret Service is investigating the hacking of email accounts belonging to members of the Bush family that divulged correspondence, addresses, phone numbers and a picture of a self-portrait painted by former President George W. Bush standing in a shower.

A report on the Smoking Gun website, said the pilfered emails provided a rare glimpse into the private lives of one of America’s most powerful political dynasties. The Bushes are only the second family in U.S. history to send a father and son to the White House.

The website said a hacker known as Guccifer raided the email accounts and posted the photos online. The pictures include an image of former President George H.W. Bush, who was released from a Houston hospital last month after seven weeks of treatment for bronchitis and related ailments, in a hospital bed.

Another photo showed the elder Bush, 88, posing outside a home with Bill Clinton, who was president between the two Bushes.

The intercepted photos also featured a portrait painted by George W. Bush of himself showering. It shows a gray-headed man, nude from the waist up, regarding the viewer with Bush-like features from the reflection in a shaving mirror. Another painting in the same style shows a pair of legs in a bathtub.

“I really like the paintings of George W. Bush,” New York magazine art critic Jerry Saltz wrote Friday.

Saltz, who normally reserves his criticism for the likes of French painter Henri Matisse, found the president’s portraiture “wonderful, unself-conscious, intense.”

Other photos showed Bush painting a picture of a house and posing with a cut-out of himself in an artist’s smock, beret and mustache.

SIX EMAIL ACCOUNTS HIT

The Smoking Gun site, known for posting legal documents and arrest records related to celebrities, said the hacker invaded six email accounts, including one belonging to Dorothy Bush Koch, daughter of George H.W. Bush, as well as other Bush family members and friends.

The U.S. Secret Service is investigating whether former President George H.W. Bush‘s email was hacked as well, the agency said on Friday. A Bush family spokesman declined to comment.

Among the material that was lifted were an October 2012 list of home addresses, cell phone numbers and email addresses for the former presidents and other relatives, according to the Smoking Gun.

The site said the emails revealed that when the elder Bush was in poor health, George W. Bush wrote his siblings the day after Christmas to say he was “thinking about eulogy.”

“Hopefully I’m jumping the gun,” he said, “but since the feeling is that you all would rather me speak than bubba, please help.”

“Bubba” is a well-known sobriquet for Clinton.

Since leaving office in 2009, Bush has taken up painting portraits of Texas landscapes and dogs. He has live a reserved life, largely hidden from view, with his wife, Laura, in Dallas.

Bush is likely to make a more sustained return to the spotlight when his presidential library, located at Southern Methodist University in Dallas, is completed and dedicated in April.

(Reporting by Daniel Trotta and Samuel P. Jacobs; Editing by Paul Thomasch, Doina Chiacu and Bill Trott)

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Venezuela, Despite Myriad Problems, Seizes On a Hat

Carlos Garcia Rawlins/Reuters

Vice President Nicolás Maduro of Venezuela wore a patriotic cap to a parade Monday in Caracas.

CARACAS, Venezuela — Venezuela seems to lurch from one crisis to another. President Hugo Chávez has virtually disappeared since going to Cuba for cancer surgery more than eight weeks ago. Last month, 58 people were killed in a prison when inmates clashed with soldiers. Inflation is spiking, the government just announced a currency devaluation and lurid murders are the stuff of daily headlines.

But high on the list of government priorities last week was an unexpected item: baseball caps.

Even in a country where political theater of the absurd is commonplace, the great cap kerfuffle took many Venezuelans by surprise.

It all started over the summer, when a young state governor, Henrique Capriles, ran for president against Mr. Chávez. Mr. Capriles started wearing a baseball cap decorated with the national colors — yellow, blue and red — and the stars of the Venezuelan flag.

In response, the electoral council, dominated by Chávez loyalists, threatened to sanction Mr. Capriles for violating a rule against using national symbols in the campaign. The move struck many people as patently partisan because Mr. Chávez regularly wore clothes made up of the national colors and patterned on the flag and used vast amounts of government resources to promote his re-election.

Suddenly, the tricolor cap became a symbol of Mr. Capriles’s underdog campaign, and soon it could be seen everywhere, on the noggins of his supporters.

But Mr. Capriles lost the election in October, and the cap was mostly forgotten. Until now.

At a rally on Monday to celebrate the anniversary of a failed 1992 coup led by Mr. Chávez, a host of government officials unexpectedly pulled out caps like the one Mr. Capriles had made famous and put them on.

Had Mr. Chávez’s top cadre switched sides? Nothing of the sort.

“It is the cap of the revolution,” Vice President Nicolás Maduro said from the stage. “They can’t steal it like they’re accustomed to stealing it.”

He held up the hat, which had a small emblem commemorating the coup’s anniversary, and shouted, “Cap in hand! Tricolor in hand, everyone!”

A day later, at a session of the National Assembly, legislators on both sides of the aisle showed up wearing caps. The chamber looked like the stands at a baseball game.

All of this has given rise to plenty of jokes.

“The cap — expropriate it!” said one wag on Twitter, referring to a famous episode when Mr. Chávez, a socialist, in what seemed like a spontaneous act, ordered the nationalization of several buildings in the center of Caracas.

Then came a new twist on Thursday night, when the government interrupted regular television and radio programming with a special broadcast. Anxious Venezuelans worried about Mr. Chávez’s long absence might have wondered if they were about to get an update on the president’s health.

Nope. The two-minute broadcast consisted of images of Mr. Chávez, at various points of his 14-year presidency, wearing the tricolor cap.

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Wisconsin beats No. 3 Michigan 65-62 in OT

MADISON, Wis. (AP) — When Ben Brust tied the game at the end of regulation with a shot just from just inside midcourt, his teammate Mike Bruesewitz looked over at Wisconsin coach Bo Ryan and saw something unusual.

His coach had both his arms in the air.

"You know when he shows some emotion, you've done something pretty special," Bruesewitz said.

Brust hit a tie-breaking 3-pointer with less than 40 seconds left in overtime as Wisconsin beat No. 3 Michigan 65-62 on Saturday.

"It was awesome, something I'll remember forever, and I'm sure a lot of people will," Brust said of the game, which ended with students storming the court and Bruesewitz taking the public address announcer's microphone to thank the crowd as students celebrated around him.

The Wolverines became the third top three team to lose this week as No. 1 Indiana lost to Illinois and No. 2 Florida was beaten by Arkansas. This should be the sixth straight week with a different No. 1 in The Associated Press' Top 25.

Brust's shot at the end of regulation was a dramatic turn of events for Wisconsin (17-7, 8-3 Big Ten) and a soul crusher for Michigan (21-3, 8-3).

Just moments earlier, Tim Hardaway Jr. hit a contested 3-pointer to put the Wolverines up 65-52 with less than 3 seconds left in regulation.

Following a timeout, Bruesewitz passed up his first option in the inbounds play and hit Brust in stride. The guard took one dribble across halfcourt and launched the shot, which hit nothing but net.

Ryan said the play was drawn up to see how Michigan defended the first cutter, Brust read the defense and reacted.

"The best thing was Mike's pass on the dime on the run, didn't have to reach back for it, able to catch it all in one motion," Ryan said.

Michigan still had fouls to give before the shot, and coach John Beilein said the order coming out of the timeout was to foul. He also put Caris LeVert on Brust to bolster the defense.

"We were definitely fouling, wanted to keep everyone in front of us and (Brust) turned the corner on (LeVert) just enough that he couldn't foul him," Beilein said. "I thought we had them once they couldn't get their initial guy.

"With Caris' quickness, we thought he could get there, but he didn't."

For all the fireworks in the final 3 seconds, the teams only managed seven points in overtime, including Brust's winning 3-pointer.

Following Brust's shot, Hardaway couldn't connect on his drive to the hoop on the next Michigan possession, and Glenn Robinson III fouled Jared Berggren on the rebound.

The Wolverines went to a full-court press with two more fouls to give. But the Badgers broke the press, and Michigan had to foul twice more to finally put Ryan Evans on the free throw line.

Evans, who shoots less than 43 percent from the line, missed the front end of a 1-and-1, and Burke couldn't connect in a rushed final possession for the Wolverines.

It was another grinding win for the Badgers keyed by their defense. Michigan came in as one of the top scoring teams in the country at almost 78 points per game. But Wisconsin held Michigan to less than 40 percent shooting from the field, including 5 of 18 from beyond the 3-point line.

Michigan was 1 for 7 from the field in overtime, and the offensive futility was highlighted by one sequence in which Mitch McGary stole the ball outside the 3-point line and drove the other way only to miss the layup with Berggren defending the rim.

Beilein said the Wolverines missed out on 14 points thanks to missed layups.

"I'm not talking about when they're really contesting," Beilein said. "I'm talking about we had the ball, the basket and us, and it didn't go in."

Brust scored 14 points for the Badgers, while Berggren added 13 and eight rebounds. Sam Dekker scored 12 points, while Evans finished with 11 points and nine rebounds.

Burke scored 19 points to lead Michigan, but needed 21 shots to do it. Hardaway added 18, and McGary had 12 points and eight rebounds.

It was the second straight game for both teams to go past regulation after the Badgers beat Iowa 74-70 in double overtime on Wednesday and Michigan downed Ohio State 76-74 in overtime on Tuesday.

Several Wisconsin players said consecutive overtime games exemplified their will to win even as critics contend they're not talented enough, not fast enough and, as Bruesewitz said he's seen on Twitter, not good-looking enough.

"We have a group of guys in that locker room that believe and is going to fight until the end until you tell us we can't play any more basketball," Berggren said. "We just find a way to get it done."

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In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

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Degrees of Debt: College Costs, Battled a Paycheck at a Time

If Steve Boedefeld graduates from Appalachian State University without any student loan debt, it will be because of the money he earned fighting in Iraq and Afghanistan and the money he now saves by eating what he grows or kills.

Zack Tolmie managed to escape New York University with no debt — and a degree — by landing a job at Bubby’s, the brunch institution in TriBeCa, where he made $1,000 a week. And he had entered N.Y.U. with sophomore standing, thanks to Advanced Placement credits. All that hard work also yielded a $25,000 annual merit scholarship.

The two are part of a rare species on college campuses these days, as the nation’s collective student loan balance hits $1 trillion and continues to rise. While many students are trying to defray some of the costs, few can actually work their way through college in a normal amount of time without debt and little or no need-based financial aid unless they have an unusual combination of bravery, luck and discipline.

“I literally never went out,” Mr. Tolmie says. “There just was not time to do that.”

Plenty of influential people assume that teenagers can ask parents for loans if all else fails, as Mitt Romney suggested during the 2012 presidential campaign. Others recall working their way through college themselves, including Representative Virginia Foxx, a Republican from North Carolina who heads a House subcommittee on higher education and work force training. “I spent seven years getting my undergraduate degree and didn’t borrow a dime of money,” she once said at a subcommittee meeting, adding that she was bewildered, given her own experience, by tales of woe she had heard from people with $80,000 in debt.

But students nowadays who try to work their way through college without parental support or loans face a financial challenge of a different order than the one that Ms. Foxx, 69, confronted as a University of North Carolina undergraduate more than 40 years ago. Today, a bachelor’s degree from Appalachian State, the largest university in her district, can easily cost $80,000 for a state resident, including tuition, room, board and other costs. Back in her day, the total was about $550 a year. Even with inflation, that would translate to just over $4,000 for each year it takes to earn a degree.

And the paychecks that Mr. Tolmie managed in the big city are only a dream in towns like Boone, where employers have their pick of thousands of Appalachian State undergraduates. Even the most industrious, like Kelsey Manuel, a junior who drives 10 miles each way to a job in a resort where she earns $10 to $11 an hour, often cannot work enough to finish college debt-free.

No one tracks how many students are trying to work their way through without parental assistance or debt, but plenty work long hours while also attending classes full time. As of 2010, some 17 percent of full-time undergraduates of traditional age worked 20 to 34 hours a week, according to the National Center for Education Statistics. About 6 percent worked 35 hours or more.

Students who work fewer than 30 hours a week (excluding federal work-study jobs) while in college were 1.4 times more likely to graduate within six years than students who spent more than 30 hours a week in a job, according to an article by Pilar Mendoza, an assistant professor of higher education administration at the University of Florida, in The Journal of Student Financial Aid last year. Their grades are likely to be better, too, since they have more time to study.

But working less has financial consequences. “You have two choices,” Ms. Mendoza says of students whose families could not or would not contribute to their college costs. “You either work, or you acquire debt.”

Banking on Brunch

Zack Tolmie chose to work. He first caught sight of New York University on television when he was a freshman in high school in Altamont, N.Y., outside Albany. While his parents wanted him to attend college, their savings suffered in the 2001 recession.

So Mr. Tolmie got a job at a Johnny Rockets restaurant. By the time he started college in 2007, he had saved $8,000, four times as much as his parents had accumulated for him.

Impressed by the pluck he had demonstrated in passing so many Advanced Placement tests, N.Y.U. guaranteed Mr. Tolmie $25,000 in merit scholarships each year, which left him with about $75,000 that he needed to earn over three years. “I had a chart on my desk so that every time I sat down I would need to look at it,” he says. “Every two weeks I needed X amount. That first year, it would have been around $600 after taxes.”

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Dell’s largest investor opposes buyout as too low

(Reuters) – Dell Inc’s largest independent shareholder Southeastern Asset Management said it plans to oppose the buyout of the personal computer maker, setting up a battle for founder Michael Dell who is leading the effort to operate the company away from public scrutiny.

Southeastern sent a letter to Dell’s board expressing its “extreme disappointment” in the offer price of $ 13.65 a share, it said in a regulatory filing.

It said it “currently intends to avail itself of all options at its disposal to oppose proposed transaction.”

Reuters had reported earlier that the Southeastern was unhappy with the offer.

The Memphis, Tennessee-based fund, which owns a 8.5 percent stake in Dell, said it values the entire company at about $ 24.00 per share.

The fund said it believes Dell board had several alternatives that would have produced far better outcome for public shareholders, including breaking up the company and selling the unit separately.

“Selling multiple business units to strategic buyers could easily exceed $ 13.65 per share,” it said.

A representative of Silver Lake declined to comment.

With Southeastern’s objections, shareholders representing 11 percent of the Dell shares not held by Michael Dell have now said they will vote against the deal.

Under the buyout’s terms, a majority of shares not held by Michael Dell must be voted in favor of the deal for it to proceed.

(Reporting by Poornima Gupta; Editing by Steve Orlofsky)

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European Union Leaders Agree to Slimmer Budget

BRUSSELS — As European Union leaders began their 14th hour of budget negotiations after a sleepless night, Valdis Dombrovskis, the prime minister of Latvia, took the floor early Friday to address what, for his Baltic nation of around just two million people, is a vital question: Why should a Latvian cow deserve less money than a French, Dutch and even Romanian one?

In a system that requires unanimous approval of budget decisions, what Latvia wants for its dairy farmers — or Estonia for its railways, Hungary for its poorer regions and Spain for its fishermen — is no small matter. It is this cacophony of local concerns that explains why, despite the outsize role in decision-making of Germany, the European Union has such trouble reaching an agreement on something as basic as a budget.

And if simply agreeing to a basic budget — the first decrease in its history — is so daunting to member countries, it also raised serious questions about the limits of political and economic integration that have long been the master plan for champions of European unity.

After a failed attempt to fix spending targets at the summit meeting in November and a 24-hour marathon of talks this week, European leaders finally agreed late Friday to a common budget for the next seven years. Slightly smaller than its predecessor, the new budget plan reflects the climate of austerity across a continent still struggling to emerge from a crippling debt crisis.

The colossal effort that was required to agree to a sum amounting to about €960 billion, or $1.28 trillion, or a mere 1 percent of the bloc’s gross domestic product, again exposed the stubborn attachment to national priorities that have made reaching agreements on how to save the euro so painful in recent years.

“We need to agree and to agree we need to take into account all countries,” said Mr. Dombrovskis in an interview. The Latvian leader, who rushed to his hotel for a shave, shower and change of shirt in the middle of the night, described the ordeal as “not a pleasant experience,” but said “it only happens every seven years so we can tolerate it.”

But toleration is not the same thing as cooperation.

“What we’re seeing is that European integration is very important to European leaders as long as it doesn’t imply that someone has to be paying for someone else,” said Daniel Gros, director for the Center for European Policy Studies, a research organization in Brussels.

“Sharing a European budget is not going to be the essence of the E.U., but crafting the rule books for open borders and stable banking systems will be,” said Mr. Gros.

For other observers, the spectacle of European leaders haggling through the night over amounts of money representing rounding errors in their national accounts once again demonstrated their reluctance to make policies together that erode their nations’ sovereignty.

“The budget negotiations are most visible sign of member states winning and losing from the European Union,” said Hugo Brady, a senior research fellow at the Center for European Reform, a research organization. “The result is a totally parochial budget that is poorly adapted to rapidly changing times,” he said.

The deal faces yet another hurdle before it becomes law at the European Parliament, which has the power to veto the budget.

Some of the most influential figures in Parliament have already signaled that they are prepared to reject a budget that foresees spending less on Europe in the years ahead.

Martin Schulz, the president of the Parliament, said this week he would not approve a budget that ended up widening the overall gap between the cash paid up-front by governments and the somewhat higher amounts, known as commitments, which make up the overall budget.

Britain, Sweden and the Netherlands were among the Northern European nations that fought hard to squeeze agricultural subsidies and increase spending on research and development to boost the bloc’s global competitiveness.

This article has been revised to reflect the following correction:

Correction: February 8, 2013

An earlier version of this article misspelled, on one reference, the last name of the Latvian prime minister. It is Dombrovskis, not Domobrovskis.

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AP Source: Hernandez on verge of new deal with M's

SEATTLE (AP) — Felix Hernandez and the Seattle Mariners are working on a $175 million, seven-year contract that would make him the highest-paid pitcher in baseball, according to a person with knowledge of the deal's details.

The person spoke to The Associated Press Thursday on condition of anonymity because the agreement has not been completed. USA Today first reported the deal.

Seattle would add $134.5 million of guaranteed money over five years to the contract of the 2010 AL Cy Young Award winner, whose current agreement calls for him to receive $40.5 million over the next two seasons.

Hernandez's total dollars would top CC Sabathia's original $161 million, seven-year contract with the New York Yankees and his $25 million average would surpass Zack Greinke's $24.5 million under his new contract with the Los Angeles Dodgers and tie him for the second-highest in baseball with Josh Hamilton and Ryan Howard behind Alex Rodriguez ($27.5 million). Hernandez's new money would average $26.9 million over five years.

Hernandez agreed to a $78 million, five-year contract in January 2010 and has earned an additional $2.5 million in escalators and $300,000 in bonuses. He is due $20 million this year and $20.5 million in 2014, which would be superseded by the new deal.

Seattle general manager Jack Zduriencik said he could not comment when reached on Thursday, and Hernandez's representatives didn't immediately return messages.

If the deal is finalized, it would leave Detroit's Justin Verlander and the Dodgers' Clayton Kershaw as the most attractive pitchers eligible for free agency after the 2014 season. Tampa Bay's David Price is eligible after the 2015 season.

Hernandez has become the face of Seattle's struggling franchise, transforming from a curly haired 19-year-old who wore his hat crooked to one of the most dominant and exciting pitchers in baseball. Known as "King Felix," he became the first Seattle pitcher to throw a perfect game in a 1-0 win over Tampa Bay last August.

His fiery enthusiasm on the mound and his willingness to first sign a long-term deal in 2010 have endeared him to fans in the Pacific Northwest who have gone more than a decade without seeing postseason baseball.

Hernandez, who will turn 27 on April 8, is 98-76 with a 3.22 ERA in eight seasons with the Mariners. He won a career-high 19 games in 2009 when he finished second in the Cy Young voting then won the award a year later when he went just 13-12 but had a 2.27 ERA and 232 strikeouts.

Hernandez appeared to be making another Cy Young push last year before going 0-4 in his last six starts, which left him at 13-9 with 223 strikeouts.

His career record would be even better if he didn't play with one of baseball's worst offenses. Seattle had the lowest batting average in the major leagues in each of the last three seasons. Hernandez has taken 10 losses during that span when he's given up two earned runs or less.

For his career, Hernandez has allowed two earned runs or less in 141 of 238 starts, but the team is only 99-42 in those games due to the offensive problems.

Locking up Hernandez long-term won't solve all of the problems that have left Seattle looking up at Texas, Oakland and the Los Angeles Angles in the AL West for most of the last 10 years. The Mariners have tried to address some of those issues this offseason by trading for Kendrys Morales and Michael Morse to provide more punch to go along with young prospects Dustin Ackley, Kyle Seager and Jesus Montero, who have all shown flashes early in their careers.

But should the deal be finalized, the Mariners at least have the security of knowing who'll be at the top of their rotation for most of this decade.

___

AP Sports Writer Ronald Blum contributed to this report.

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

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

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

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

The Presenting Problem:

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

The Patient’s Story:

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

A Sister’s Visit:

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

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

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

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

A Long Series of Illnesses:

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

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

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

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

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

Back to the Hospital:

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

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

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

Back to the Hospital, Again:

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

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

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

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

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

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

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

Solving the Mystery:

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

Friday Feb. 8 4:13 p.m. | Updated Thanks for all your responses. You can read about the winner at “Think Like a Doctor: A Confused and Terrified Patient Solved.”

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

Correction: The patient’s eyes were brown, not blue.

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European Union Leaders Agree to Slimmer Budget

BRUSSELS — As European Union leaders began their 14th hour of budget negotiations after a sleepless night, Valdis Dombrovskis, the prime minister of Latvia, took the floor early Friday to address what, for his Baltic nation of around just two million people, is a vital question: Why should a Latvian cow deserve less money than a French, Dutch and even Romanian one?

In a system that requires unanimous approval of budget decisions, what Latvia wants for its dairy farmers — or Estonia for its railways, Hungary for its poorer regions and Spain for its fishermen — is no small matter. It is this cacophony of local concerns that explains why, despite the outsize role in decision-making of Germany, the European Union has such trouble reaching an agreement on something as basic as a budget.

And if simply agreeing to a basic budget — the first decrease in its history — is so daunting to member countries, it also raised serious questions about the limits of political and economic integration that have long been the master plan for champions of European unity.

After a failed attempt to fix spending targets at the summit meeting in November and a 24-hour marathon of talks this week, European leaders finally agreed late Friday to a common budget for the next seven years. Slightly smaller than its predecessor, the new budget plan reflects the climate of austerity across a continent still struggling to emerge from a crippling debt crisis.

The colossal effort that was required to agree to a sum amounting to about €960 billion, or $1.28 trillion, or a mere 1 percent of the bloc’s gross domestic product, again exposed the stubborn attachment to national priorities that have made reaching agreements on how to save the euro so painful in recent years.

“We need to agree and to agree we need to take into account all countries,” said Mr. Dombrovskis in an interview. The Latvian leader, who rushed to his hotel for a shave, shower and change of shirt in the middle of the night, described the ordeal as “not a pleasant experience,” but said “it only happens every seven years so we can tolerate it.”

But toleration is not the same thing as cooperation.

“What we’re seeing is that European integration is very important to European leaders as long as it doesn’t imply that someone has to be paying for someone else,” said Daniel Gros, director for the Center for European Policy Studies, a research organization in Brussels.

“Sharing a European budget is not going to be the essence of the E.U., but crafting the rule books for open borders and stable banking systems will be,” said Mr. Gros.

For other observers, the spectacle of European leaders haggling through the night over amounts of money representing rounding errors in their national accounts once again demonstrated their reluctance to make policies together that erode their nations’ sovereignty.

“The budget negotiations are most visible sign of member states winning and losing from the European Union,” said Hugo Brady, a senior research fellow at the Center for European Reform, a research organization. “The result is a totally parochial budget that is poorly adapted to rapidly changing times,” he said.

The deal faces yet another hurdle before it becomes law at the European Parliament, which has the power to veto the budget.

Some of the most influential figures in Parliament have already signaled that they are prepared to reject a budget that foresees spending less on Europe in the years ahead.

Martin Schulz, the president of the Parliament, said this week he would not approve a budget that ended up widening the overall gap between the cash paid up-front by governments and the somewhat higher amounts, known as commitments, which make up the overall budget.

Britain, Sweden and the Netherlands were among the Northern European nations that fought hard to squeeze agricultural subsidies and increase spending on research and development to boost the bloc’s global competitiveness.

This article has been revised to reflect the following correction:

Correction: February 8, 2013

An earlier version of this article misspelled, on one reference, the last name of the Latvian prime minister. It is Dombrovskis, not Domobrovskis.

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