Well: Susan Love's Illness Gives New Focus to Her Cause

During a talk last spring in San Francisco, Dr. Susan Love, the well-known breast cancer book author and patient advocate, chided the research establishment for ignoring the needs of people with cancer. “The only difference between a researcher and a patient is a diagnosis,” she told the crowd. “We’re all patients.”

It was an eerily prescient lecture. Less than two months later, Dr. Love was given a diagnosis of acute myelogenous leukemia. She had no obvious symptoms and learned of her disease only after a checkup and routine blood work.

“Little did I know I was talking about myself,” she said in an interview. “It was really out of the blue. I was feeling fine. I ran five miles the day before.”

Dr. Love, a surgeon, is best known as the author of the top-selling “Dr. Susan Love’s Breast Book” (Da Capo Press, 2010) now in its fifth edition. She is also president of the Dr. Susan Love Research Foundation, which focuses on breast cancer prevention and research into eradicating the disease. But after decades of tireless advocacy on behalf of women with breast cancer, Dr. Love found herself in an unfamiliar role with an unfamiliar disease.

“There is a sense of shock when it happens to you,” she said. “In some ways I would have been less shocked if I got breast cancer because it’s so common, but getting leukemia was a world I didn’t know. Even when you’re a physician, when you get shocking news like this you sort of forget everything you know and are scared the same as everybody else.”

Because Dr. Love’s disease was caught early, she had a little time to seek second opinions and choose her medical team. She chose City of Hope in Duarte, Calif., because of its extensive experience in bone marrow transplants. At 65, Dr. Love was startled to learn she was considered among the “elderly” patients for this type of leukemia.

She was admitted to the hospital and underwent chemotherapy. Because her blood counts did not rebound after the treatment, her stay lasted a grueling seven weeks.

She went home for just two weeks, and then returned to the hospital for a bone-marrow transplant, with marrow donated by her younger sister, Elizabeth Love De Graci, 53, who lives in Mexico City.

Although the transplant itself was uneventful, the next four weeks were an ordeal. Dr. Love developed pain and neuropathy from the chemotherapy drugs. Dr. Love’s wife, Dr. Helen Cooksey; daughter, Katie Love-Cooksey, 24; and siblings offered round-the-clock support. Ms. Love-Cooksey slept in the hospital every night. “I wasn’t very articulate during that time, but I always had my family there,” Dr. Love said. “They were great advocates for me.”

The transplant “is quite an amazing thing,” Dr. Love said. Her blood type changed from O positive to B positive, the same type as her sister. She also has inherited her sister’s immune system, and a lifelong allergy to nickel has disappeared. “I can wear cheap jewelry now,” she said. She returned to work last month.

Dr. Love has been told her disease is in remission, though her immune system remains compromised and she is more susceptible to infection. So she avoids crowds, air travel and other potential sources of cold and flu viruses.

While Dr. Love has always been a strong advocate for women undergoing cancer treatment, she says her disease and treatment has strengthened her understanding of what women with breast cancer and other types of cancer go through during treatments.

“There are little things like having numb toes or having less stamina to building muscles back up after a month of bed rest,” she said. “There is significant collateral damage from the treatment that is underestimated by the medical profession. There’s a sense of ‘You’re lucky to be alive, so why are you complaining?’ ”

Dr. Love says her experience has emboldened her in her quest to focus on the causes of disease rather than new drugs to treat it.

“I think I’m more impatient now and in more of a hurry,” she said. “I’ve been reminded that you don’t know how long you have. There are women being diagnosed every day. We don’t have the luxury to sit around and come up with a new marketing scheme. We have to get rid of this disease, and there is no reason we can’t do it.”

People who remain skeptical about the ability to eradicate breast cancer should look to the history of cervical cancer, she said. Decades ago, a woman with an abnormal Pap smear would be advised to undergo hysterectomy. Now a vaccine exists that can protect women from the infection that causes most cervical cancers.

“We need to focus more on the cause of breast cancer,” she said. “I’m still very impressed with the fact that cancer of the cervix went from being a disease that robbed women of their fertility, if not their lives, to having a vaccine to prevent it.”

Dr. Love, who wrote a book called “Live a Little!,” said illness has also made her grateful that she didn’t put off her “bucket list” and that she has traveled the world and focused on work she finds challenging and satisfying.

“It just reminds you that none of us are going to get out of here alive, and we don’t know how much time we have,” she said. “I say this to my daughter, whether it’s changing the world or having a good time, that we should do what we want to do. I drink the expensive wine now.”

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The Media Equation: In Omaha Manhole Fire Photo, Logging Off in Search of Some Clues

Stephanie Sands

This image, which was taken after an underground fire cut power in half of downtown Omaha, captivated the Web last month.

When photographs of spontaneous events miraculously appear on the Web, it generally prompts two responses: wonder and skepticism.

Matt Miller/Omaha World-Herald

Matthew Hansen, a columnist at The Omaha World-Herald, showed how to follow a trail. 

So it was with an image of exploding manhole covers in Omaha that took over the Web last month. On Sunday, Jan. 27, an underground fire cut power in half of downtown. A vivid photograph of unknown provenance, showing fire shooting out of manholes on a city street, began popping up on Reddit, where it had 1.5 million views, and Gawker.

The photo — an indifferently composed shot of an event that looks very far away — would not win any Pulitzers, but something incredible seems to be under way at the precise moment it was taken. You can almost hear the sequential explosions emanating below the street: boom, boom, boom as flames appear to shoot up from hell itself.

In this age of Photoshop, it wasn’t long before the debates cropped up, on the Web and in Omaha, about the picture’s authenticity.

Matthew Hansen, a columnist at The Omaha World-Herald, wondered the same thing, and one night found himself in a bar engaged in the real-versus-fake debate. Like many photos on the Web, this one came from everywhere — forwarded, tweeted and blogged — and nowhere — there was no name on the image nor any text to indicate its origin.

Mr. Hansen, intrepid journalist that he is, solved the mystery and wrote a column about it. The photo was real, it turned out, but not in the way people thought. (More on that later.) So, did Mr. Hansen use deep photo analytics or examine metadata to peel back the truth?

Nope. There was a notebook involved, a lawyer, some phone calls, a cursory digital investigation and some street reporting, which included an interview with a man with no pants.

Shoe leather never looked or smelled so good.

Mr. Hansen’s first step in solving what he called the “Great Omaha Manhole Fire Photo of 2013” was to determine from the angle of the photo that it could have been taken from only one apartment building — called the Kensington Tower. He then used an architectural detail to conclude that it was shot from the top floor, on the west side.

He managed to gain entry to the building — that is, he sneaked in — and made his way to the top floor, where he began knocking on doors.

Mr. Hansen found a man named Kenneth who would not let Mr. Hansen in because he was indisposed — he became “Pantsless Kenneth” in the column — but said that he knew the photo in question and thought his neighbor had taken it.

But the neighbor wasn’t home, so Mr. Hansen stuck his business card in the door jamb and left.

When he returned to the office, Mr. Hansen jumped onto Reddit, found the person who had originally posted the photo there and through him found the person, Gwendolyn Olney, who had posted the photo on her Facebook page, the source for the Reddit posting.

Ms. Olney happened to be the associate counsel for The World-Herald. “Omaha is indeed a small town,” Mr. Hansen wrote in his column. He began to follow the pixilated bread crumbs.

“Gwen didn’t take the photo,” he added. “She got it from Rebecca, who didn’t take the photo. She got it from Brandon, who didn’t take the photo. They led me to Gwen’s friend Andrea, who didn’t take the photo, who led me to ... well, she couldn’t remember who she had gotten the photo from.”

Reading the column, you could almost hear his sigh when he wrote, “Dead end.”

Then his phone rang. “I took that photo,” the voice said.

The caller was Stephanie Sands, a graduate student at the University of Nebraska at Omaha. She said that the day after she took the photo, which she had no idea had become a sensation, she learned from her friends that a reporter was asking about it.

“I was impressed that he had sneaked upstairs and put a card in my door, so I called him,” she said in an interview by phone.

Ms. Sands agreed to meet Mr. Hansen and told him that she had heard the explosion and took two photos with her phone. She sent one to friends and thought nothing more of it.

“I was actually disappointed in how it turned out,” she told me. “Because I was shooting at a distance with an iPhone, it didn’t really capture the severity of what I saw and heard.”

This article has been revised to reflect the following correction:

Correction: February 17, 2013

An earlier version of this column misquoted Matthew Hansen, a columnist at The Omaha World-Herald, about the author of a profile on Edna Buchanan, a crime writer. Mr. Hansen said the writer of the profile was Calvin Trillin, not Gay Talese. 

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Play puts Russian justice system in dock over lawyer’s death

MOSCOW (Reuters) – In a poorly lit basement theatre in central Moscow, actors play out a symbolic trial of Russia‘s justice system over its failure to protect an anti-corruption lawyer who died in custody.

Without costumes or a set, the actors in “One Hour and Eighteen Minutes” take on the roles of judges, an investigator, doctor and medical assistants, reciting lines cobbled together from legal documents, media and public pronouncements on the case of Sergei Magnitsky.

His death in 2009, while awaiting trial on charges of tax evasion and fraud, has outraged human rights campaigners who see it as an example of arbitrary justice in Russia, and contributed to a rift in U.S.-Russian relations.

A nervous giggle runs through the audience, perched on wooden chairs and benches, when an actor playing a judge says that the justice system is the only thing that is still working in Russia.

The audience is visibly taken aback when a second judge, who prolonged Magnitsky‘s detention four days before his death, dismisses accusations of acting inhumanly when she says the judge’s role is not to act like a human being but as an executor of the state’s authority.

“The most horrifying moment for me was this judge saying she is not a human because she is a judge. This is very frankly put and how things really are,” said Lyudmila Alexeyeva, a veteran Russian human rights campaigner.

“Nowadays, theatre based on documents, on real life here, is more telling and, unfortunately, more scary than thrillers.”

No one has been convicted over the death of Magnitsky, who was arrested after accusing Russian police of stealing $ 230 million from the state in 2007 through fraudulent tax refunds.

But Russia is now pressing ahead with plans to stage a posthumous trial of the lawyer, putting a dead man in the dock.

This prompted Mikhail Ugarov, the director of Teatr.doc, to revive a play first staged in 2010 because it seemed to him that true justice was now more distant than ever.

“In the very heart of Russia a man is killed, and not by thieves and bandits, but by doctors and prison workers, people who are in general obliged to safeguard the lives of those arrested,” Ugarov told Reuters.

“We used to think there would at least be some justice done, but it turned out completely the other way, it went horribly wrong. So our logic was that if they were not able to give justice to Magnitsky, we will instead.”

SEEKING JUSTICE

Rights campaigners and critics of President Vladimir Putin say the Russian judiciary is weak and open to abuse by politicians, and suggest that the Kremlin uses it to intimidate or persecute adversaries.

The Kremlin has repeatedly denied those accusations, saying the judiciary is completely independent and that the government does not intervene in legal cases.

“Judges are independent and subject only to the Constitution of the Russian Federation and the federal law,” the Russian Justice Ministry said in response to a request to comment on the play.

The Kremlin also denies that there has been a crackdown on dissenters since Putin returned to the presidency last May, facing the largest protests since he first rose to power 13 years ago.

Magnitsky’s prison death has, however, damaged Russia’s image and, for critics of the Kremlin, come to symbolize what they see as the impunity of the Russian authorities and the dangers faced by those who challenge them.

It has also resulted in a political spat with Washington. The United States, in response to Magnitsky’s treatment, passed legislation late last year that is designed to punish officials linked to his case as well as other Russians deemed rights violators.

Russia hit back with a law to punish Americans it suspects of similar abuses.

The play’s title, “One Hour and Eighteen Minutes”, alludes to the time just before Magnitsky died when he was left without medical help in his cell despite repeated complaints about his health deteriorating while in custody.

Putin said in December that Magnitsky died of a heart attack, but the head of the Kremlin’s own human rights council had earlier said he was probably beaten to death.

Putin called the death a tragedy but said the late lawyer, who had two sons, was not tortured.

All the defendants in the symbolic court in the play deny any responsibility, saying it was not their job to help Magnitsky, that they were busy with other cases, or were paid too poorly to care. Some suggest he was asking for trouble.

In the play, the first judge at a pre-trial hearing denies a glass of water to Magnitsky, saying such requests are not his concern.

Later on, an investigator involved in the case laughs with contempt at the lawyer’s repeated complaints about the conditions of Magnitsky’s detention and lack of medical care, saying a prison is not meant to be comfortable.

One actor exclaims ironically: “A dead man is good for being tried, and should be, just like someone who is alive – or is even better for being tried.”

(Reporting by Gabriela Baczynska, editing by Paul Casciato)

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IHT Rendezvous: Taming the Runaway U.S. Budget

WASHINGTON — If Democrats and Republicans can’t agree on a deficit reduction plan, in two weeks automatic budget cuts will kick in that could severely weaken the U.S. economy and the American military.

As I write in my latest Letter From Washington, there are sensible ways to avoid this, though it is far from certain dysfunctional Washington can achieve them.

One reason is that so much of spending is now hard-wired into the system.

Representative John Dingell of Michigan is the only current member of Congress who served in 1962. Yet he would hard-pressed to recall the federal budget of a half century ago.
In those days, more than two-thirds, 67.5 percent, of spending was discretionary, meaning it had had to be appropriated annually. Almost half the budget went to defense and about 18 percent went to discretionary domestic programs.
Mandatory spending, or entitlements, was only a little more than a quarter of the budget, and more than half of that went for Social Security.
That picture is turned upside down in the current fiscal year. Almost 60 percent of the budget is mandatory spending with one $1 of every $5 going to Social Security and $1 in $7 to Medicare and Medicaid. Defense is almost 19 percent, a fraction of what it was in 1962, and domestic discretionary programs, at a little more than 16 percent, takes a smaller proportional bite out of the federal budget than they did a half century ago despite the creation of so many new initiatives.
This isn’t going to change. “Regardless of who is president, what will be spent in any given year will be determined by laws that are already set, some decades earlier,” says Stan Collender, an expert on the federal budget.
Despite the large budget deficits in recent years, interest on the debt payments, at 6.5 percent this year, is almost precisely what it was a half century ago. These payments, however, are expected to climb steadily over the next 50 years. Under current projections, Mr. Collender says, they are on track to become the fastest-growing area of the federal budget.

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Danica Patrick wins pole for NASCAR's Daytona 500

DAYTONA BEACH, Fla. (AP) — Danica Patrick has won the Daytona 500 pole, becoming the first woman to secure the top spot for any race in NASCAR's top circuit.

It was the biggest achievement of her stock-car career.

"We have a lot more history to make and we're eager to do it," Patrick said.

Patrick went out eighth in the qualifying session Sunday and covered the 2½-mile superspeedway in 45.817 seconds, averaging 196.434 mph.

She waited about two hours as 37 fellow drivers tried to take her spot. Only four-time Cup champion Jeff Gordon even came close to knocking her off.

"That's a huge accomplishment," team owner and fellow driver Tony Stewart said. "It's not like it's been 15 or 20 years she's been trying to do this. It's her second trip to Daytona here in a Cup car. She's made history in the sport. That's stuff that we're proud of being a part of with her. It's something she should have a huge amount of pride in.

"It's never been done. There's only one person that can be the first to do anything. Doesn't matter how many do it after you do, accomplish that same goal. The first one that does always has that little bit more significance to it because you were the first."

Gordon was the only other driver who topped 196 mph in qualifying. He locked up the other guaranteed spot in next week's season-opening Daytona 500.

"It's great to be part of history," Gordon said. "I can say I was the fastest guy today."

The rest of the field will be set in duel qualifying races Thursday.

However the lineup unfolds, all drivers will line up behind Patrick's No. 10 Chevrolet SS for "The Great American Race."

Patrick joked about wanting to get Monday and Tuesday off, but then quickly realized her accomplishment likely will result in more attention and more demands.

"I feel a scheme coming on," she said. "I feel a plane coming. I feel nervous."

Patrick has been the talk of Speedweeks. Not only did she open up about her budding romance with fellow Sprint Cup rookie Ricky Stenhouse Jr., but she was considered the front-runner for the pole after turning the fastest laps in practice Saturday.

And she didn't disappoint.

She kept her car at or near the bottom of the famed track and gained ground on the straightaways, showing lots of power from a Hendrick Motorsports engine.

"It's easy to come down here in your first or second year as a driver and clip the apron trying to run too tight a line or do something and scrub speed off," Stewart said. "That's something she did an awesome job. Watching her lap, she runs so smooth. ... She did her job behind the wheel, for sure."

The result surely felt good for Patrick, especially considering the former IndyCar driver has mostly struggled in three NASCAR seasons. Her best finish in 10 Cup races is 17th, and she has one top-five in 58 starts in the second-tier Nationwide Series.

She raced part-time in 2010 and 2011 while still driving a full IndyCar slate. She switched solely to stock cars last season and finished 10th in the Nationwide standings.

She made the jump to Sprint Cup this season and will battle Stenhouse for Rookie of the Year honors.

But taking the pole will make her the talk of the town for another week. She also won the pole at Daytona for last year's Nationwide race.

This is considerably bigger.

The previous highest female qualifier in a Cup race was Janet Guthrie. She started ninth at Bristol and Talladega in 1977.

Patrick shattered that mark Sunday, putting her squarely in the spotlight for the next week. It's a position she's comfortable in, evidenced by her racing career, her television commercials and her sudden openness about her personal life.

"I think when pressure's on and when the spotlight's on, I feel like it ultimately ends up becoming some of my better moments and my better races and better results," Patrick said. "I don't know why that it. I'm grateful for it because the opposite of that would be I probably wouldn't be here today, I wouldn't be in the position I'm in. I guess thanks mom and dad. Thanks for the genetics. Thank you for all that.

"I just understand that if you put the hard work in before you go out there that you can have a little peace and a little peace of mind knowing that you've done everything you can and just let it happen."

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Cuomo Bucks Tide With Bill to Lift Abortion Limits

ALBANY — Bucking a trend in which states have been seeking to restrict abortion, Gov. Andrew M. Cuomo is putting the finishing touches on legislation that would guarantee women in New York the right to late-term abortions when their health is in danger or the fetus is not viable.

Mr. Cuomo, seeking to deliver on a promise he made in his recent State of the State address, would rewrite a law that currently allows abortions after 24 weeks of pregnancy only if the pregnant woman’s life is at risk. The law is not enforced, because it is superseded by federal court rulings that allow late-term abortions to protect a woman’s health, even if her life is not in jeopardy. But abortion rights advocates say the existence of the more restrictive state law has a chilling effect on some doctors and prompts some women to leave the state for late-term abortions.

Mr. Cuomo’s proposal, which has not yet been made public, would also clarify that licensed health care practitioners, and not only physicians, can perform abortions. It would remove abortion from the state’s penal law and regulate it through the state’s public health law.

Abortion rights advocates have welcomed Mr. Cuomo’s plan, which he outlined in general terms as part of a broader package of women’s rights initiatives in his State of the State address in January. But the Roman Catholic Church and anti-abortion groups are dismayed; opponents have labeled the legislation the Abortion Expansion Act.

The prospects for Mr. Cuomo’s effort are uncertain. The State Assembly is controlled by Democrats who support abortion rights; the Senate is more difficult to predict because this year it is controlled by a coalition of Republicans who have tended to oppose new abortion rights laws and breakaway Democrats who support abortion rights.

New York legalized abortion in 1970, three years before it was legalized nationally by the Supreme Court in Roe v. Wade. Mr. Cuomo’s proposal would update the state law so that it could stand alone if the broader federal standard set by Roe were to be undone.

“Why are we doing this? The Supreme Court could change,” said a senior Cuomo administration official, who spoke on the condition of anonymity because the governor had not formally introduced his proposal.

But opponents of abortion rights, already upset at the high rate of abortions in New York State, worry that rewriting the abortion law would encourage an even greater number of abortions. For example, they suggest that the provision to allow abortions late in a woman’s pregnancy for health reasons could be used as a loophole to allow unchecked late-term abortions.

“I am hard pressed to think of a piece of legislation that is less needed or more harmful than this one,” the archbishop of New York, Cardinal Timothy M. Dolan, wrote in a letter to Mr. Cuomo last month. Referring to Albany lawmakers in a subsequent column, he added, “It’s as though, in their minds, our state motto, ‘Excelsior’ (‘Ever Upward’), applies to the abortion rate.”

National abortion rights groups have sought for years to persuade state legislatures to adopt laws guaranteeing abortion rights as a backup to Roe. But they have had limited success: Only seven states have such measures in place, including California, Connecticut and Maryland; the most recent state to adopt such a law is Hawaii, which did so in 2006.

“Pretty much all of the energy, all of the momentum, has been to restrict abortion, which makes what could potentially happen in New York so interesting,” said Elizabeth Nash, state issues manager at the Guttmacher Institute, a research group that supports abortion rights. “There’s no other state that’s even contemplating this right now.”

In most statehouses, the push by lawmakers has been in the opposite direction. The past two years has seen more provisions adopted at the state level to restrict abortion rights than in any two-year period in decades, according to the Guttmacher Institute; last year, 19 states adopted 43 new provisions restricting abortion access, while not a single significant measure was adopted to expand access to abortion or to comprehensive sex education.

“It’s an extraordinary moment in terms of the degree to which there is government interference in a woman’s ability to make these basic health care decisions,” said Andrea Miller, the president of NARAL Pro-Choice New York. “For New York to be able to send a signal, a hopeful sign, a sense of the turning of the tide, we think is really important.”

Abortion rights advocates say that even though the Roe decision supersedes state law, some doctors are hesitant to perform late-term abortions when a woman’s health is at risk because the criminal statutes remain on the books.

“Doctors and hospitals shouldn’t be reading criminal laws to determine what types of health services they can offer and provide to their patients,” said M. Tracey Brooks, the president of Family Planning Advocates of New York State.

For Mr. Cuomo, the debate over passing a new abortion law presents an opportunity to appeal to women as well as to liberals, who have sought action in Albany without success since Eliot Spitzer made a similar proposal when he was governor. But it also poses a challenge to the coalition of Republicans and a few Democrats that controls the State Senate, the chamber that has in the past stood as the primary obstacle to passing abortion legislation in the capital.

The governor has said that his Reproductive Health Act would be one plank of a 10-part Women’s Equality Act that also would include equal pay and anti-discrimination provisions. Conservative groups, still stinging from the willingness of Republican lawmakers to go along with Mr. Cuomo’s push to legalize same-sex marriage in 2011, are mobilizing against the proposal. Seven thousand New Yorkers who oppose the measure have sent messages to Mr. Cuomo and legislators via the Web site of the New York State Catholic Conference.

A number of anti-abortion groups have also formed a coalition called New Yorkers for Life, which is seeking to rally opposition to the governor’s proposal using social media.

“If you ask anyone on the street, ‘Is there enough abortion in New York?’ no one in their right mind would say we need more abortion,” said the Rev. Jason J. McGuire, the executive director of New Yorkers for Constitutional Freedoms, which is part of the coalition.

Members of both parties say that the issue of reproductive rights was a significant one in November’s legislative elections. Democrats, who were bolstered by an independent expenditure campaign by NARAL, credit their victories in several key Senate races in part to their pledge to fight for legislation similar to what Mr. Cuomo is planning to propose.

Republicans, who make up most of the coalition that controls the Senate, have generally opposed new abortion rights measures. Speaking with reporters recently, the leader of the Republicans, Dean G. Skelos of Long Island, strenuously objected to rewriting the state’s abortion laws, especially in a manner similar to what the governor is seeking.

“You could have an abortion up until the day the child would be born, and I think that’s just wrong,” Mr. Skelos said. He suggested that the entire debate was unnecessary, noting that abortion is legal in New York State and saying that is “not going to be changed.”

The Senate Democratic leader, Andrea Stewart-Cousins of Yonkers, who is the sponsor of a bill that is similar to the legislation the governor is drafting, said she was optimistic that an abortion measure would reach the Senate floor this year.

“New York State’s abortion laws were passed in 1970 in a bipartisan fashion,” she said. “It would be a sad commentary that over 40 years later we could not manage to do the same thing.”

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Obama’s Keystone Pipeline Decision Risks New Problems, Either Way

WASHINGTON — President Obama faces a knotty decision in whether to approve the much-delayed Keystone oil pipeline: a choice between alienating environmental advocates who overwhelmingly supported his candidacy or causing a deep and perhaps lasting rift with Canada.

Canada, the United States’ most important trading partner and a close ally on Iran and Afghanistan, is counting on the pipeline to propel more growth in its oil patch, a vital engine for its economy. Its leaders have made it clear that an American rejection would be viewed as an unneighborly act and could bring retaliation.

Secretary of State John F. Kerry’s first meeting with a foreign leader was with Canada’s foreign minister, John Baird, on Feb. 8. They discussed the Keystone pipeline project, among other subjects, and Mr. Kerry promised a fair, transparent and prompt decision. He did not indicate what recommendation he would make to the president.

But this is also a decisive moment for the United States environmental movement, which backed Mr. Obama strongly in the last two elections. For groups like the Sierra Club, permitting a pipeline carrying more than 700,000 barrels a day of Canadian crude into the country would be viewed as a betrayal, and as a contradiction of the president’s promises in his second inaugural and State of the Union addresses to make controlling climate change a top priority for his second term.

On Sunday, thousands of protesters rallied near the Washington Monument to protest the pipeline and call for firmer steps to fight emissions of climate-changing gases. Groups opposing coal production, fracking for natural gas and nuclear power were prominent; separate groups of Baptists and Catholics, as well as an interfaith coalition, and groups from Colorado, Toronto and Minneapolis joined the throng.

One speaker, the Rev. Lennox Yearwood, compared the rally to Martin Luther King’s 1963 March on Washington for civil rights, but, he said, “while they were fighting for equality, we are fighting for existence.” In front of the stage was a mockup of a pipeline, looking a bit like the dragon in a Chinese new year parade, with the motto, “separate oil and state.”

Michael Brune, executive director of the Sierra Club, predicted that Mr. Obama would veto the $7 billion project because of the adverse effects development of the Canadian oil sands would have on the global climate.

“It’s rare that a president has such a singular voice on such a major policy decision,” Mr. Brune said. “Whatever damage approving the pipeline would do to the environmental movement pales in comparison to the damage it could do to his own legacy.”

Mr. Brune was one of about four dozen pipeline protesters arrested at the White House on Wednesday, in an act of civil disobedience that was a first for the 120-year-old Sierra Club.

So far, Mr. Obama has been able to balance his promises to promote both energy independence and environmental protection, by allowing more oil and gas drilling on public lands and offshore while also pushing auto companies to make their vehicles more efficient. But the Keystone decision, which is technically a State Department prerogative but will be decided by the president himself, defies easy compromise.

“This is a tricky political challenge for the president,” said Michael A. Levi, an energy fellow at the Council on Foreign Relations. “The reality is everyone has defined the stakes on Keystone in such absolute terms that it is borderline impossible to see a compromise that will satisfy all the players.”

The proposed northern extension of the nearly 2,000-mile Keystone XL pipeline would connect Canada’s oil sands to refineries around Houston and the Gulf of Mexico, replacing Venezuelan heavy crude with similar Canadian grades.

Proponents say its approval would be an important step toward reducing reliance on the Organization of the Petroleum Exporting Countries for energy. Opponents say that the expansion of oil production in shale fields across the country has already reduced the need for imports, and that oil sands production emits more greenhouse gases than most other forms of crude consumed in the United States.

The State Department appeared poised to approve the pipeline in 2011, but Mr. Obama delayed a decision based on concerns about its route through vulnerable grasslands in Nebraska. The pipeline company, TransCanada, submitted a revised route, and the governor of Nebraska approved the plan last month, sending the final decision to Washington.

The Keystone pipeline is treated mainly as a domestic issue in Washington, but for Canadian leaders, it represents a crucial moment in Canada’s relationship with its most vital foreign partner.

Mr. Obama and Prime Minister Stephen Harper are not close, and the two make a portrait of contrasts in style and substance. While Mr. Obama comes from the liberal wing of his party and is known for stirring speeches, Mr. Harper is conservative even by the standards of his own Conservative Party and can be stiff and stern in public. His political base, the province of Alberta, is the heart of the Canadian oil patch and is sometimes compared socially and politically to Texas.

Mr. Obama’s recent expressions of concern about climate change contrast starkly with Mr. Harper’s stated priorities. Under Mr. Harper, Canada formally withdrew from the Kyoto Protocol on climate change, which was agreed to by a previous Liberal government. (The United States never ratified the protocol.)

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IHT Rendezvous: Should Common Plastics Be Labeled Toxic?

THE HAGUE — Hoping to reduce one of the most ubiquitous forms of waste, a global group of scientists is proposing that certain types of plastic be labeled hazardous.

The group, lead by two California scientists, wrote in this week’s issue of the scientific journal Nature:

We believe that if countries classified the most harmful plastics as hazardous, their environmental agencies would have the power to restore affected habitats and prevent more dangerous debris from accumulating.

While 280 million tons of plastic were produced globally last year, less than half of that plastic has ended up in landfills or was recycled, according to the scientists’ data. Some of the unaccounted for 150 million tons of plastic is still in use, but much of it litters roadsides, cities, forests, deserts, beaches and oceans. (Just think of the great floating garbage patches at sea).

Unlike other forms of solid waste, such as uneaten food, scrap metal or last year’s clothes, plastics take an especially long time to break down. And when they finally do, they create hazardous, even toxic particles that can harm wildlife, ecosystems and humans.

For now, the group — led by Chelsea M. Rochman of the School of Veterinary Medicine at the University of California, Davis, and Mark Anthony Browne at the National Center for Ecological Analysis and Synthesis in Santa Barbara, California — is calling for the reclassification of plastics that are particularly difficult to recycle and that are most toxic when degrading: PVC, polystyrene, polyurethane and polycarbonate.

The scientists say these types of plastics — used in construction, food containers, electronics and furniture — make up an estimated 30 percent of all plastics produced.

Join our sustainability conversation. Does it make sense to re-classify common plastics as hazardous, or are there better ways to reduce the amount of plastics we throw out?

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Pistorius' family strongly denies murder charge

PRETORIA, South Africa (AP) — Oscar Pistorius is "numb with shock as well as grief" after the shooting death of his model girlfriend at his home in South Africa, the runner's uncle said Saturday, as his family strongly denied prosecutors' claims that he murdered her.

Arnold Pistorius spoke with The Associated Press and two other South African journalists about his nephew's arrest in the killing of Reeva Steenkamp, who was shot four times on the morning of Valentine's Day. Arnold Pistorius spoke to reporters from the garden of his three-story home in the eastern suburbs of South Africa's capital, Pretoria.

The statement, the first on camera and directly made in person by Pistorius' family, also came out strongly against prosecutors seeking to upgrade the charge against Pistorius to one of premeditated murder, which carries a sentence of life in prison.

"After consulting with legal representatives, we deeply regret the allegation of premeditated murder," Arnold Pistorius said. "We have no doubt there is no substance to the allegation and that the state's own case, including its own forensic evidence, strongly refutes any possibility of a premeditated murder or murder as such."

He said the family was "battling to come to terms with Oscar being charged with murder."

The track star's arrest in the killing of 29-year-old Steenkamp shocked South Africa, where Pistorius was a national hero and icon dubbed the Blade Runner for his high-tech carbon fiber running blades and revered for overcoming his disability to compete at the London Olympics. She was discovered in a pool of blood before dawn Thursday by police called to Pistorius' upscale home in a gated community. Authorities said she had been shot four times, and a 9 mm pistol was recovered at the home.

Pistorius remains held at a police station pending a bail hearing Tuesday. Police have already said they'll oppose Pistorius being released before trial. A premeditated murder charge also makes it more difficult for his defense team to get bail.

On Saturday afternoon, Pistorius' lawyers visited the Brooklyn police station in Pretoria, where the athlete is being held. His younger sister Aimee, who stood alongside Arnold Pistorius when he made his statement, also was at the police station later.

There will be a variety of hearings before Pistorius, 26, could go on trial. In South Africa, there are no juries, so a judge ultimately would decide Pistorius' guilt or innocence, sometimes with the help of two advisers. At an initial hearing Friday, Pistorius sobbed and held his head in his hands at times. He has yet to enter a plea in the case.

The family denial that Pistorius committed murder doesn't necessarily mean that they say he didn't shoot her, as murder is a legal term. Initial speculation immediately after the shooting Thursday suggested that it could have been accidental, though police say they are not currently considering that.

Arnold Pistorius did not discuss the circumstances of the shooting, but said that his nephew and Steenkamp had become very close since they started dating in November.

"They had plans together and Oscar was happier in his private life than he had been for a long time," the uncle said.

As Arnold Pistorius read his statement, Pistorius' sister Aimee stood nearby and broke down in tears at one point. Her uncle stopped reading for a moment to put his right arm around her. Pistorius remains very close with his uncle, a man he once lived with as a teenager.

"Words cannot adequately describe our feelings," his uncle said. "The lives of our entire family have been turned upside down forever by this unimaginable human tragedy and Reeva's family have suffered a terrible loss. As a family we are trying to be strong and supportive to Oscar as any close family would be in these dreadful circumstances."

The entire family was "devastated," Pistorius' uncle said, and was "grieving for Reeva, her family and her friends."

Since news of the killing, shock waves have rippled across South Africa, a nation of 50 million where nearly 50 people are killed each day, one of the world's highest murder rates. U.N. statistics say the nation has the second highest rate of shooting deaths in the world, behind only Colombia. Others have focused their attention on Pistorius and his fascination with fast cars, cage fighting and firearms.

Steenkamp, who graduated from law school, is known in South Africa for appearing in commercials and as a bikini-clad model in men's magazines. On Saturday, South Africa's state broadcaster SABC planned to air a reality TV show featuring the model. Another portion of the show released earlier Saturday included a clip of her swimming with two dolphins, which tap her on the cheek with their snouts.

"I think the way that you go out, not just your journey in life, but the way that you go out and the way you make your exit is so important," the blonde-haired Steenkamp says in the video. "You either made an impact in a positive or a negative way, but just maintain integrity and maintain class and just remain true to yourself.

"I'm going to miss you all so much and I love you very, very much."

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Jon Gambrell reported from Johannesburg.

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Gerald Imray can be reached at www.twitter.com/geraldimrayAP . Jon Gambrell can be reached at www.twitter.com/jongambrellAP .

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Livestrong Tattoos as Reminder of Personal Connections, Not Tarnished Brand

As Jax Mariash went under the tattoo needle to have “Livestrong” emblazoned on her wrist in bold black letters, she did not think about Lance Armstrong or doping allegations, but rather the 10 people affected by cancer she wanted to commemorate in ink. It was Jan. 22, 2010, exactly a year since the disease had taken the life of her stepfather. After years of wearing yellow Livestrong wristbands, she wanted something permanent.

A lifelong runner, Mariash got the tattoo to mark her 10-10-10 goal to run the Chicago Marathon on Oct. 10, 2010, and fund-raising efforts for Livestrong. Less than three years later, antidoping officials laid out their case against Armstrong — a lengthy account of his practice of doping and bullying. He did not contest the charges and was barred for life from competing in Olympic sports.

“It’s heartbreaking,” Mariash, of Wilson, Wyo., said of the antidoping officials’ report, released in October, and Armstrong’s subsequent confession to Oprah Winfrey. “When I look at the tattoo now, I just think of living strong, and it’s more connected to the cancer fight and optimal health than Lance.”

Mariash is among those dealing with the fallout from Armstrong’s descent. She is not alone in having Livestrong permanently emblazoned on her skin.

Now the tattoos are a complicated, internationally recognized symbol of both an epic crusade against cancer and a cyclist who stood defiant in the face of accusations for years but ultimately admitted to lying.

The Internet abounds with epidermal reminders of the power of the Armstrong and Livestrong brands: the iconic yellow bracelet permanently wrapped around a wrist; block letters stretching along a rib cage; a heart on a foot bearing the word Livestrong; a mural on a back depicting Armstrong with the years of his now-stripped seven Tour de France victories and the phrase “ride with pride.”

While history has provided numerous examples of ill-fated tattoos to commemorate lovers, sports teams, gang membership and bands that break up, the Livestrong image is a complex one, said Michael Atkinson, a sociologist at the University of Toronto who has studied tattoos.

“People often regret the pop culture tattoos, the mass commodified tattoos,” said Atkinson, who has a Guns N’ Roses tattoo as a marker of his younger days. “A lot of people can’t divorce the movement from Lance Armstrong, and the Livestrong movement is a social movement. It’s very real and visceral and embodied in narrative survivorship. But we’re still not at a place where we look at a tattoo on the body and say that it’s a meaningful thing to someone.”

Geoff Livingston, a 40-year-old marketing professional in Washington, D.C., said that since Armstrong’s confession to Winfrey, he has received taunts on Twitter and inquiries at the gym regarding the yellow Livestrong armband tattoo that curls around his right bicep.

“People see it and go, ‘Wow,’ ” he said, “But I’m not going to get rid of it, and I’m not going to stop wearing short sleeves because of it. It’s about my family, not Lance Armstrong.”

Livingston got the tattoo in 2010 to commemorate his brother-in-law, who was told he had cancer and embarked on a fund-raising campaign for the charity. If he could raise $5,000, he agreed to get a tattoo. Within four days, the goal was exceeded, and Livingston went to a tattoo parlor to get his seventh tattoo.

“It’s actually grown in emotional significance for me,” Livingston said of the tattoo. “It brought me closer to my sister. It was a big statement of support.”

For Eddie Bonds, co-owner of Rabbit Bicycle in Hill City, S.D., getting a Livestrong tattoo was also a reflection of the growth of the sport of cycling. His wife, Joey, operates a tattoo parlor in front of their store, and in 2006 she designed a yellow Livestrong band that wraps around his right calf, topped off with a series of small cyclists.

“He kept breaking the Livestrong bands,” Joey Bonds said. “So it made more sense to tattoo it on him.”

“It’s about the cancer, not Lance,” Eddie Bonds said.

That was also the case for Jeremy Nienhouse, a 37-year old in Denver, Colo., who used a Livestrong tattoo to commemorate his own triumph over testicular cancer.

Given the diagnosis in 2004, Nienhouse had three rounds of chemotherapy, which ended on March 15, 2005, the date he had tattooed on his left arm the day after his five-year anniversary of being cancer free in 2010. It reads: “3-15-05” and “LIVESTRONG” on the image of a yellow band.

Nienhouse said he had heard about Livestrong and Armstrong’s own battle with the cancer around the time he learned he had cancer, which alerted him to the fact that even though he was young and healthy, he, too, could have cancer.

“On a personal level,” Nienhouse said, “he sounds like kind of a jerk. But if he hadn’t been in the public eye, I don’t know if I would have been diagnosed when I had been.”

Nienhouse said he had no plans to have the tattoo removed.

As for Mariash, she said she read every page of the antidoping officials’ report. She soon donated her Livestrong shirts, shorts and running gear. She watched Armstrong’s confession to Winfrey and wondered if his apology was an effort to reduce his ban from the sport or a genuine appeal to those who showed their support to him and now wear a visible sign of it.

“People called me ‘Miss Livestrong,’ ” Mariash said. “It was part of my identity.”

She also said she did not plan to have her tattoo removed.

“I wanted to show it’s forever,” she said. “Cancer isn’t something that just goes away from people. I wanted to show this is permanent and keep people remembering the fight.”

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