By Michael Ollove Stateline
Joe Takach talks to his friend Lillian Landry as she spends her last days in the hospice wing of an Oakland Park, Fla. hospital. Many states have adopted a new end-of-life document designed to ensure that a patient's wishes are respected as death approaches. (AP)
The emergency call came in at 10:47 on a Saturday night: "Woman in Overland Park with difficulty breathing. Code one closest." Angela Fera, a paramedic in Johnson County, Kan., and her partner raced to the house, sirens blaring. When they arrived, six minutes after the first dispatch, a man told them that his 62-year old wife had terminal cancer and was unconscious. The paramedics found her sitting upright in bed, ghostly pale with a weak pulse and shallow breathing. Death seemed imminent.
The woman was under hospice care, and had signed a "Do Not Resuscitate (DNR)" order. She had made her wishes clear: She did not want to be taken to the hospital if a life-threatening medical emergency arose. But the woman was not in cardiac arrest, the situation specified in the DNR order. Protocol required that Fera try to save her life, probably by inserting a plastic tube into her trachea to restore breathing and transporting her to a hospital, where she'd be put on a ventilator. Fera guessed that was precisely what the woman did not want. But the husband felt that his wife's children-his stepchildren-should be the ones to decide whether to withhold treatment.
"We were completely fighting all our instincts to jump in and save her, but on the other hand we really wanted to do what was right," Fera recalled. New End-Of-Life Document A new end-of-life document, more explicit and binding than a DNR and advanced directives, is designed to clarify patients' wishes-and spare caregivers such as Fera from facing such wrenching choices.
A "physician order for life-sustaining treatment" (POLST) is a medical order, signed by a doctor or other authorized medical provider. The product of a conversation between patient and provider, a POLST specifies a patient's goals and desires as death closes in. Unlike a traditional DNR, it covers such medical interventions as resuscitation, hospitalization, use of antibiotics, hydration, intubation and mechanical breathing ventilation. Without much opposition or attention, many states have adopted POLSTs. This year, Indiana and Nevada approved legislation to allow their use, leaving only seven states and the District of Columbia without POLSTs in at least some stage of development.show more
Air pollution reaches new, dangerous heights in Singapore By Freya Petersen GlobalPost
Singapore residents have been urged to stay indoors amid unprecedented levels of air pollution.
The prime minister of Singapore - which prides itself on its clean environment - has warned that the haze could hang over the city state for weeks.
The smog has been blamed on illegal forest fires on the Indonesian island of Sumatra. Companies burn forest to clear space for palm oil plantations, with most smoke haze problems arising during the dry season between June and September.
The Singapore government warned Singapore-linked companies against participating in the burn-offs, with Prime Minister Lee Hsien Loong saying: "If any Singapore companies are involved, or companies which are present in Singapore are involved, we will take it up with them."
At 1 p.m. local time in Singapore, the pollution standards index - provided by the National Environment Agency - reached 371, breaking all previous records and passing the "hazardous" mark.
Singapore's Environment Minister Vivian Balakrishnan wrote on his Facebook page: "This is now the worst haze that Singapore has ever faced. No country or corporation has the right to pollute the air at the expense of Singaporeans' health and wellbeing."
Meanwhile, the air quality over Kuala Lumpur, Malaysia's capital, remained relatively unaffected.
On the country's border with Singapore, however, "hazardous" pollution was recorded in at least one district and some 200 schools ordered shut. The Department of Environment has also banned open burning in the three states nearest Sumatra, making it punishable by up to five years in prison.
By Danielle Douglas, The Washington Post
In this Monday, May 6, 2013 file photo, a home is for sale in Mount Lebanon, Pa. (AP Photo/Gene J. Puskar, File) (Gene J. Puskar)
WASHINGTON - A new study confirms allegations made by state prosecutors that some of the nation's biggest banks are violating the terms of the $25 billion national mortgage settlement, the landmark agreement to clean up shoddy foreclosure practices. The court-appointed monitor of the settlement on Wednesday issued a report saying Citigroup, Bank of America, Wells Fargo and JPMorgan Chase have dragged their feet in processing homeowners' requests for lower monthly loan payments.
These are the same charges being lobbed against the banks by Illinois Attorney General Lisa Madigan and New York Attorney General Eric Schneiderman. The two were among the 49 state attorneys general who teamed with federal agencies to broker the settlement with the top five mortgage servicers last year. The deal was supposed to ensure that struggling homeowners would not have to endure the same miscommunication, delays and botched paperwork that was commonplace after the housing bust. But, according the monitor, it seems some things haven't changed.
Four out of five banks failed at least one of the 29 metrics the monitor used to measure their compliance with the 304 servicing standards outlined in the settlement. The report "affirms that the pattern of violations by Wells Fargo that my office documented in New York is harming homeowners nationwide," said Schneiderman, who threatened to sue Wells Fargo and Bank of America in May over the violations. "These flagrant violations put homeowners in New York and across the nation at greater risk of foreclosure."
The most common problem found among the servicers, in particular at Citigroup, Bank of America and Wells Fargo, was failure to notify homeowners of any missing documents in their modification requests within five days of receipt, according to the settlement monitor, Joseph A. Smith Jr. Citigroup and Bank of America were also cited for providing inaccurate information in letters they must send to borrowers before beginning a foreclosure. "Progress is being made in a number of areas, but other harmful practice endure," said Shaun Donovan, secretary of the Department of Housing and Urban Development, during a call with reporters. "It is time for [the banks] to live up to their end of the deal . . . if they don't we'll explore all options to remedy this situation from fining them to hauling them back into court."show more
By Bob Strauss, Los Angeles Daily News
This undated publicity photo, released by HBO, shows actor James Gandolfini in his role as Tony Soprano, head of the New Jersey crime family portrayed in HBO's "The Sopranos." HBO and the managers for Gandolfini say the actor died Wednesday, June 19, 2013, in Italy. He was 51. (Barry Wetcher)
Does anybody have a problem with how James Gandolfini humanized the mobster for, probably, forevermore?
I didn't think so. And keep your mouth shut if you do.
"The Sopranos" star, who died unexpectedly at the age of 51 Wednesday in Italy, led his TV mafia family to a very high perch of American culture. Not only did he make the East Coast gangster staple of thousands of shows psychologically relatable like never before, he spearheaded the transformation of U.S. television from highly censored, commercial-dependent broadcast to the freer and finer dominance of cable networks that we enjoy today.
the accomplishment for a chubby Jersey guy, but Gandolfini did a lot more than make Tony Soprano a pop criminal icon This undated publicity image released by HBO shows, from left, Tony Sirico, Steven Van Zandt, James Gandolfini, Michael Imperioli and Vicint Pastore,from the HBO drama series "The Sopranos." HBO and the managers for Gandolfini say the actor died Wednesday, June 19, 2013, in Italy. He was 51. (Anthony Neste) on a par with the Corleones and Scorsese's worst/best. The man was quite simply a brilliant actor all around, and what made that even better was that he was so humble and generous in sharing his talents in projects that never had a chance of gaining the spotlight "Sopranos" did. The TV fame was enough for him; otherwise, he did what a good actor should but rarely does, sought roles for no other reason than that he could really do something with them.
Last year alone, Gandolfini made riveting, wildly different supporting turns in three fascinating movies: as a dissolute hit man in the far-grungier-than-"The-Sopranos" crime thriller "Killing Them Softly," as "Zero Dark Thirty's" sardonic CIA director and, most poignantly, as an old-school dad not adjusting at all well to the changes of the 1960s in "Not Fade Away," "Sopranos" creator David Chase's beautifully observed, criminally underseen feature directing debut.
His other post-"Sopranos" work was consistently great, whether the projects it appeared in also were ("In the Loop," "Where the Wild Things Are," "Cinema Verite") or weren't so much ("Welcome to the Rileys," "The Incredible Burt Wonderstone"). Just a few weeks ago I saw a dreadful thing about fashion-obsessed young female assassins called "Violet & Daisy" - dreadful, that is, until Gandolfini entered the picture with authentic reserves of fatherly concern and self-sacrificing fatalism. Can't say I was glad I saw that movie, but now I'm grateful that I got to see him.
Needless to say, he was great on stage, too, in everything from "A Streetcar Named Desire" to "God of Carnage." Not casting Gandolfini in his film version of the latter will probably go down as the second-biggest mistake of Roman Polanski's life. Gandolfini was one of those actors we could tell didn't like to talk about themselves, but when you did interview him he turned on just enough charm to overcome his shyness, and spoke with real enthusiasm and intelligence about the work he loved. Celebrated as "The Sopranos" rightfully made him, this guy just wasn't ever, ever going to be a celebrity. And we liked that about him, too.
As mentioned, most of Gandolfini's non-"Sopranos" work was in very small, underseen movies. Of course he died too young, but he left a marvelous filmed legacy that I urge you to start checking out after your memorial re-viewings of all those "Sopranos" box sets. Trust me: You won't have a problem with that.