Surgery Returns to NYU Langone Medical Center

Chang W. Lee/The New York Times

Senator Charles E. Schumer spoke at a news conference Thursday about the reopening of NYU Langone Medical Center.

NYU Langone Medical Center opened its doors to surgical patients on Thursday, almost two months after Hurricane Sandy overflowed the banks of the East River and forced the evacuation of hundreds of patients.

While the medical center had been treating many outpatients, it had farmed out surgery to other hospitals, which created scheduling problems that forced many patients to have their operations on nights and weekends, when staffing is traditionally low. Some patients and doctors had to postpone not just elective but also necessary operations for lack of space at other hospitals.

The medical center’s Tisch Hospital, its major hospital for inpatient services, between 30th and 34th Streets on First Avenue, had been closed since the hurricane knocked out power and forced the evacuation of more than 300 patients, some on sleds brought down darkened flights of stairs.

“I think it’s a little bit of a miracle on 34th Street that this happened so quickly,” Senator Charles E. Schumer of New York said Thursday.

Mr. Schumer credited the medical center’s leadership and esprit de corps, and also a tour of the damaged hospital on Nov. 9 by the administrator of the Federal Emergency Management Agency, W. Craig Fugate, whom he and others escorted through watery basement hallways.

“Every time I talk to Fugate there are a lot of questions, but one is, ‘How are you doing at NYU?’ ” the senator said.

The reopening of Tisch to surgery patients and associated services, like intensive care, some types of radiology and recovery room anesthesia, was part of a phased restoration that will continue. Besides providing an essential service, surgery is among the more lucrative of hospital services.

The hospital’s emergency department is expected to delay its reopening for about 11 months, in part to accommodate an expansion in capacity to 65,000 patient visits a year, from 43,000, said Dr. Andrew W. Brotman, its senior vice president and vice dean for clinical affairs and strategy.

In the meantime, NYU Langone is setting up an urgent care center with 31 bays and an observation unit, which will be able to treat some emergency patients. It will initially not accept ambulances, but might be able to later, Dr. Brotman said. Nearby Bellevue Hospital Center, which was also evacuated, opened its emergency department to noncritical injuries on Monday.

Labor and delivery, the cancer floor, epilepsy treatment and pediatrics and neurology beyond surgery are expected to open in mid-January, Langone officials said. While some radiology equipment, which was in the basement, has been restored, other equipment — including a Gamma Knife, a device using radiation to treat brain tumors — is not back.

The flooded basement is still being worked on, and electrical gear has temporarily been moved upstairs. Mr. Schumer, a Democrat, said that a $60 billion bill to pay for hurricane losses and recovery in New York and New Jersey was nearing a vote, and that he was optimistic it would pass in the Senate with bipartisan support. But the measure’s fate in the Republican-controlled House is far less certain.

The bill includes $1.2 billion for damage and lost revenue at NYU Langone, including some money from the National Institutes of Health to restore research projects. It would also cover Long Beach Medical Center in Nassau County, Bellevue, Coney Island Hospital and the Veterans Affairs hospital in Manhattan.

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Starz will face new, challenging world as public company

Pay-TV channel Starz is trying to chart a new orbit.

Early next year, its parent company, Liberty Media, plans to spin off the premium network and its sister channel Encore into a new, stand-alone, publicly traded company.

Such a move would normally be cause for celebration. But for Starz, the separation comes amid uncertainty.

Its track record producing original shows has been mixed. The market is getting increasingly crowded not only from Starz's traditional competitors, HBO and Showtime, but also from new rivals including Netflix, Amazon and Redbox. And, starting in 2017, the network will lose one of its key suppliers of movies — Walt Disney Studios — to Netflix.

"It's an interesting time for Starz," said Matthew Harrigan, a media analyst with Wunderlich Securities. "Losing those Disney movies makes life a little more difficult, and it becomes even more important for them to create successful original programming."

STORY: On Location

Liberty Media is spinning off Starz in part to make it more attractive to potential buyers. Companies mentioned by analysts as possible suitors include Comcast Corp., parent of Universal Pictures. Other deep-pocketed prospective buyers could be News Corp., Walt Disney Co. and Viacom Inc. HBO and Showtime probably would face anti-trust issues if either of them made a run at Starz.

The shift also raises the stakes for Starz and its chief executive, Chris Albrecht, who has been given the task of building an original programming pipeline. Albrecht, who joined Starz nearly three years ago, has the experience. As the former head of HBO, he was a key architect of that network's success by helping nurture such culture-defining hits as "Sex and the City" and "The Sopranos."

Achieving those heights again, this time at Starz, has proved more elusive. Starz made a splash with its gladiator series "Spartacus," but another high-profile drama, "Boss," about a corrupt Chicago mayor played by Kelsey Grammer ("Frasier"), failed to deliver ratings to match its critical acclaim. "Boss" was canceled after two seasons. Last year's "Camelot," about a young King Arthur, started strong but then fell on its sword.

Starz, which has 20.8 million subscribers in the U.S., has spent the last few years playing catch-up. The network began developing original dramas much later than industry leaders HBO and Showtime, and also lags behind basic cable channels FX, AMC and USA Network.

At the same time, the availability of movies through other venues has increased dramatically, and film fans can just as easily get their fix by buying or renting DVDs — online or at supermarket kiosks — or through Internet streaming services. That makes the need for strong original content even greater.

Starz executives declined to comment for this story, citing the "quiet period" mandated by regulators before the public stock offering.

Hollywood movie studios have a strong incentive to protect the premium channels, which have long served as their unofficial ATMs. The channels, including HBO, Starz and Showtime, spit out hundreds of millions of dollars each year to movie studios in exchange for the first-run TV rights to recent releases. The fees — which can approach $30 million for a single blockbuster film — have helped studios turn deficits into profits for many movies.

The parent companies of HBO (Time Warner), Showtime (CBS Corp.) and Starz (Liberty Media), also have long collected hundreds of millions of dollars each year in profit from the channels in distribution fees from cable and satellite operators. According to consulting firm SNL Kagan, Starz and sister channel Encore this year will generate revenue of $1.34 billion and $414 million in cash flow, a metric similar to operating income.

Just a few years ago, Starz trailed HBO as the No. 2 movie channel in terms of distribution. But it has since been surpassed by Showtime. The CBS Corp. network has staged a string of hits including "Weeds," the serial killer drama "Dexter," the pill-popping dark comedy "Nurse Jackie" and its latest hit, the terrorist thriller "Homeland," which this fall won the Emmy for TV's best drama.

According to SNL Kagan, Showtime has 21 million subscribers and 2012 revenue of $1.6 billion. Cash flow for Showtime and its sister channels TMC and Flix should approach $690 million combined for this year. Showtime's programming expenses are slightly less because it ended its relationships with movie studios several years ago.

"Showtime has been doing something similar [to Starz] with their strategy, but they have programming that people are talking about," said BTIG analyst Richard Greenfield said. "The question is how does Starz stack up?"

Its shows have largely failed to attract the buzz that can drive subscriptions and ratings. "Spartacus" was Starz's most popular show, averaging more than 5 million viewers an episode during the third season when viewing on all platforms was counted. "Magic City," the channel's stylistic drama about Miami gangsters in the 1950s, averaged 3.1 million viewers an episode when it debuted this year, while "Boss" collared just 2.2 million an episode.

Starz is betting heavily on its lineup for next two years, which includes the second season of "Magic City" and the new prospects "Da Vinci's Demons," a drama about Leonardo's early days from David S. Goyer, a co-writer of the "Dark Knight Rises" film trilogy, and "Black Sails," a swashbuckling adventure from "Transformers" and "Pirates of the Caribbean" filmmaker Michael Bay.

The company this year is spending about $692 million on programming, with four-fifths of that amount earmarked for buying products from Disney and Sony Pictures Entertainment, according to SNL Kagan, which said Starz spends less than $100 million annually creating original series.

"They still need the movies to fill their schedule, but at the same time Starz needs some unique programs to define the channel," said Deana Myers, an SNL Kagan television analyst. "It's not an easy market to get into because a lot of other networks are doing original productions."

Although Starz will continue to receive the Disney movies for three years, the eventual loss puts pressure on the company to keep Sony as a supplier beyond 2016, when the parties' current arrangement ends. The loss of Disney movies and the coming end of the Sony contract could also complicate the picture as Starz tries to attract a new owner.

Potential suitor Viacom already has a presence in the premium channel business. The parent of Paramount Pictures teamed in 2009 with two other studios, Lions Gate Entertainment Corp. and Metro-Goldwyn-Mayer Studios Inc., to launch the movie service Epix. The upstart has struggled to make distribution deals with leading cable and satellite TV systems. That could make a merger between Epix and Starz enticing. Given that Epix is not nearly as powerful as HBO and Showtime, such a deal may also be able to pass regulatory muster.

meg.james@latimes.com

joe.flint@latimes.com

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Toyota to pay big to settle suits

Toyota Motor Corp., moving to put years of legal problems behind it, has agreed to pay more than $1 billion to settle dozens of lawsuits relating to sudden acceleration.

The proposed deal, filed Wednesday in federal court, would be among the largest ever paid out by an automaker. It applies to numerous suits claiming economic damages caused by safety defects in the automaker's vehicles, but does not cover dozens of personal injury and wrongful-death suits that are still pending around the nation.

The suits were filed over the last three years by Toyota and Lexus owners who claimed that the value of their vehicles had been hurt by the potential for defects, including floor mats that could cause the vehicles to surge out of control.

ROAD TO RECALL: Read The Times' award winning coverage

In addition, Toyota said it is close to settling suits filed by the Orange County district attorney and a coalition of state attorneys general who had accused the automaker of deceptive business practices. The costs of those agreements would be included in a $1.1-billion charge the Japanese automaker said it will take against earnings to cover the actions.

"We concluded that turning the page on this legacy legal issue through the positive steps we are taking is in the best interests of the company, our employees, our dealers and, most of all, our customers," Christopher Reynolds, Toyota's chief counsel in the U.S., said in a statement.

Toyota's lengthy history of sudden acceleration was the subject of a series of Los Angeles Times articles in 2009, after a horrific crash outside San Diego that took the life of an off-duty California Highway Patrol officer and his family.

Under terms of the agreement, which has not yet been approved in court, Toyota would install brake override systems in numerous models and provide cash payments from a $250-million fund to owners whose vehicles cannot be modified to incorporate that safety measure.

In addition, the automaker plans to offer extended repair coverage on throttle systems in 16 million vehicles and offer cash payments from a separate $250-million fund to Toyota and Lexus owners who sold their vehicles or turned them in at the end of a lease in 2009 or 2010. The total value of the settlement could reach $1.4 billion, according to Steve Berman, the lead plaintiff attorney in the case.

The lawsuits, filed over the last several years, had been seeking class certification.

News of the agreement comes scarcely a week after Toyota agreed to pay a record $17.35-million fine to the National Highway Traffic Safety Administration for failing to report a potential floor mat defect in a Lexus SUV. Those come on top of almost $50 million in fines paid by Toyota for other violations related to sudden acceleration since 2010.

The massive settlement does not, however, put Toyota's legal woes to rest. The automaker still faces numerous injury and wrongful death claims around the country, including a group of cases that have been consolidated in federal court in Santa Ana, and other cases awaiting trial in Los Angeles County.

The first of the federal cases, involving a Utah man who was killed in a Camry that slammed into a wall in 2010, is slated for trial in mid-February.

The California cases are set to begin in April, among them a suit involving a 66-year-old Upland woman who was killed after her vehicle allegedly reached 100 miles per hour and slammed into a tree.

Edgar Heiskell III, a West Virginia attorney who has a dozen pending suits against Toyota, said he is preparing to go to trial this summer in a case that involved a Flint, Mich., woman who was killed when her 2005 Camry suddenly accelerated near her home.

"We are proceeding with absolute confidence that we can get our cases heard on the merits and that we expect to prove defects in Toyota's electronic control system," he said.

Toyota spokesman Mike Michels said the settlement would have no bearing on the personal injury cases.

"All carmakers face these kinds of suits," he said. "We'll defend those as we normally would."

The giant automaker's sudden acceleration problems first gained widespread attention after the August 2009 crash of a Lexus ES outside San Diego.

That accident set off a string of recalls, an unprecedented decision to temporarily stop sales of all Toyota vehicles and a string of investigations, including a highly unusual apology by Toyota President Akio Toyoda before a congressional committee. Eventually Toyota recalled more than 10 million vehicles worldwide and has since spent huge sums — estimated at more than $2 billion, not including Wednesday's proposed settlement — to repair both its automobiles and public image.

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‘We Are Young’ Performed on Vintage Computer Parts

Old computer parts find new life as rock stars with a little help from YouTube user BD594. The “band” — we’ll just call ‘em the Ctrl-Alt-Deletes — perform a delightfully geeky rendition of the hit fun. song “We Are Young.”

[More from Mashable: If Santa Were a Hipster]

Vintage hard drives provide the beat as a Yamaha CX-5 tickles the ivories and an HP Scanjet 3C plays frontman with the vocals. Pssh, and you thought the Rolling Stones looked old and outdated.

[More from Mashable: 10 People Who Suffered Awkward Christmas Moments]

BONUS: Top 12 Memes of the Year

12. Photobombing Stingray

Five years ago, three college girls on a Caribbean vacation got a serious case of the heebeejeebies when a stingray photobombed their “say cheese” moment. The hilarious photograph could have ended up as just a fond vacay memory if it weren’t for a friend, who shared the image on Reddit in September of this year.

Click here to view this gallery.

Thumbnail image courtesy of YouTube, BD594

This story originally published on Mashable here.

Tech News Headlines – Yahoo! News

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Patrick Dempsey brews up coffee shop purchase

LOS ANGELES (AP) — Patrick Dempsey says he wants to rescue a coffee house chain and more than 500 jobs.

The "Grey's Anatomy" star said Wednesday he's leading a group attempting to buy Tully's Coffee. The Seattle-based company filed for Chapter 11 bankruptcy protection in October.

Dempsey said he's excited about the chance to help hundreds of workers and give back to Seattle.

The actor has a strong TV tie to the city: He plays Dr. Derek Shepherd on "Grey's Anatomy," the ABC drama set at fictional Seattle Grace Hospital.

Tully's has 47 company-run stores in Washington and California, as well as five franchised stores and 58 licensed locations in the U.S.

Any sale would have to be approved by a judge. A bankruptcy court hearing is set for Jan. 11 in Seattle.

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Creating the Ultimate Housework Workout

Robert Wright for The New York Times

Chris Ely, an English butler, and Carol Johnson, a fitness instructor at Crunch NYC, perfecting a houseworkout.

CAN housework help you live longer? A New York Times blog post by Gretchen Reynolds last month cited research linking vigorous activity, including housework, and longevity. The study, which tracked the death rates of British civil servants, was the latest in a flurry of scientific reports crediting domestic chores with health benefits like a lowered risk for breast and colon cancers. In one piquant study published in 2009, researchers found that couples who spent more hours on housework had sex more frequently (with each other) though presumably not while vacuuming. (The report did not specify.)

Intrigued by science that merged the efforts of a Martha with the results of an Arnold (a buffer buffer?), this reporter challenged a household expert and a fitness authority to create the ultimate housework workout — a houseworkout — in her East Village apartment. Perhaps she could add a few years to her own life while learning some fancy new moves for her Swiffer. Christopher Ely, once a footman at Buckingham Palace, and Brooke Astor’s longtime butler, was appointed cleaner-in-chief. Mr. Ely is a man who approaches what the professionals call household management with the range and depth of an Oxford don. Although he is working on his memoirs (he described his book as a room-by-room primer with anecdotes from his years in service), he was happy enough to put his writing aside for an afternoon. His collaborator was Carol Johnson, a dancer and fitness instructor who develops classes at Crunch NYC, including those based on Broadway musicals like “Legally Blonde” and “Rock of Ages.”

Mr. Ely arrived first, beautifully dressed in dark gray wool pants, a black suit coat and a crisp white shirt with silver cuff links. He cleans house in a white shirt? “I know how to clean it,” he countered, meaning the shirt. When Ms. Johnson appeared (in black spandex and a ruffly white chiffon blouse, which she switched out for a Crunch T-shirt), theory, method and materials were discussed.

“If you’re dreading the laundry,” Ms. Johnson said, “why not create a space where it’s actually fun to do by putting on some music?” If fitness is defined by cardio health, she added, it will be a challenge to create housework that leaves you slightly out of breath. “I’m thinking interval training,” she said. As it happens, one trend in exercise has been workouts that are inspired by real-world chores, or what Rob Morea, a high-end Manhattan trainer, described the other day as “mimicking hard labor activities.” In his NoHo studio, Mr. Morea has clients simulate the actions of construction workers hefting cement bags over their shoulders (Mr. Morea uses sand bags) or pushing a wheelbarrow or chopping wood.

Mr. Ely averred that service — extreme housekeeping — is physically demanding, with sore feet and bad knees the least of its debilitating byproducts. Mr. Ely still suffers from an injury he incurred while carrying a poodle to its mistress over icy front steps in Washington When the inevitable occurred, and Mr. Ely wiped out, he threw the dog to his employer before falling hard on his backside. And the right equipment matters: After two weeks’ employ in an Upper East Side penthouse, he was handed a pair of Reeboks by his new boss, the better to withstand the apartment’s wall-to-wall granite floors. (For cleaning, Mr. Ely wears slippers, deck shoes or socks.)

Mr. Ely, whose talents and expertise are wide-ranging (he can stock a wine cellar, do the flowers, set a silver service, iron like a maestro and clean gutters, as he did once or twice at Holly Hill, Mrs. Astor’s Westchester estate), is a minimalist when it comes to materials. He favors any simple dish detergent as a multipurpose cleaner, along with a little vinegar, for glass, and not much else. “Dish detergent is designed for cutting grease; there’s nothing better,” he said. He’s anti-ammonia, anti-bleach. He said bleach destroys fabric, particularly anything with elastic in it. “Knickers and bleach are a terrible combination,” he said. “I had a boss who thought he had skin cancer. His entire trunk had turned red and itchy.” It seems his underpants were being washed in bleach. (Collective wince.) “It’s horrible stuff.”

As for tools, he likes a cobweb cleaner — this reporter had bought Oxo’s extendable duster, which has a fluffy orange cotton duster that snaps onto a sort of wand, but Mr. Ely prefers the kind that looks like a round chimney brush. (If you live in a house, he also suggests leaving the cobwebs by the front and back doors, so the spiders can eat any mosquitoes coming or going.) Choose a mop with microfiber fronds (he suggested the O Cedar brand) because it dries quickly and doesn’t smell. And a sturdy vacuum. Also, stacks of microfiber cloths or a terry cloth towel ripped up.

But first, to stretch. Ms. Johnson took hold of this reporter’s Bona floor mop (it’s like a Swiffer, but with a reusable washcloth) and Mr. Ely followed along with an old-fashioned string mop. Though Mr. Ely has a kind of loose-limbed elegance, he is not exactly limber. He grimaced as he parroted Ms. Johnson, who used her mop as Gene Kelly did his umbrella, stretching her arms overhead, one by one, twisting from side to side, sucking in her stomach, rising up on tip toes. (Mr. Ely said his old poodle-hurling injury was kicking in.) Ms. Johnson adjusted his chin — “You’re going to hurt yourself if you keep sticking your neck out,” she warned — and Mr. Ely raised a black-socked foot napped with cat hair and chastised this reporter: “Would you look at that?” (The cat had vanished early on, but his “debris,” as Mr. Ely put it, was still very much in evidence. The reporter hung her head. Did she know that cat spit is toxic? Mr. Ely wondered.)

“We’re warming up the spine,” said Ms. Johnson. “Squeeze your abdominals.”

Mr. Ely looked worried: “I don’t think I have abdominals!”

MR. ELY’S technique is to clean a room from top to bottom. That means he begins with the cobweb cleaner, wafting it along ceiling corners, moldings, soffits and, uh, the top of the fridge (major dust harvest there). His form was pretty, like a serve by Roger Federer, if not exactly aerobic. For Mr. Ely kept stopping to lecture this reporter — on condensation; on the basic principles of heat transfer and why one needs to vacuum the refrigerator coils; on the movement of moist air in a kitchen; on floor care, which involved a long story about a Belgian monastery whose inhabitants never washed the kitchen floor; on how to dust the halogen spot lights (use a cotton cloth, not a microfiber one, and make sure the lights are off, and cool).  “I do rabbit on, don’t I?” he said. Ms. Johnson gamely hustled him along, noting that anytime you raise your arms over your head you can raise your heart rate. “What about a balance exercise?” she cajoled, executing a neat series of leg lifts. “That’s good for the butler’s booty!”

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Toyota to pay big to settle suits

Toyota Motor Corp., moving to put years of legal problems behind it, has agreed to pay more than $1 billion to settle dozens of lawsuits relating to sudden acceleration.

The proposed deal, filed Wednesday in federal court, would be among the largest ever paid out by an automaker. It applies to numerous suits claiming economic damages caused by safety defects in the automaker's vehicles, but does not cover dozens of personal injury and wrongful-death suits that are still pending around the nation.

The suits were filed over the last three years by Toyota and Lexus owners who claimed that the value of their vehicles had been hurt by the potential for defects, including floor mats that could cause the vehicles to surge out of control.

ROAD TO RECALL: Read The Times' award winning coverage

In addition, Toyota said it is close to settling suits filed by the Orange County district attorney and a coalition of state attorneys general who had accused the automaker of deceptive business practices. The costs of those agreements would be included in a $1.1-billion charge the Japanese automaker said it will take against earnings to cover the actions.

"We concluded that turning the page on this legacy legal issue through the positive steps we are taking is in the best interests of the company, our employees, our dealers and, most of all, our customers," Christopher Reynolds, Toyota's chief counsel in the U.S., said in a statement.

Toyota's lengthy history of sudden acceleration was the subject of a series of Los Angeles Times articles in 2009, after a horrific crash outside San Diego that took the life of an off-duty California Highway Patrol officer and his family.

Under terms of the agreement, which has not yet been approved in court, Toyota would install brake override systems in numerous models and provide cash payments from a $250-million fund to owners whose vehicles cannot be modified to incorporate that safety measure.

In addition, the automaker plans to offer extended repair coverage on throttle systems in 16 million vehicles and offer cash payments from a separate $250-million fund to Toyota and Lexus owners who sold their vehicles or turned them in at the end of a lease in 2009 or 2010. The total value of the settlement could reach $1.4 billion, according to Steve Berman, the lead plaintiff attorney in the case.

The lawsuits, filed over the last several years, had been seeking class certification.

News of the agreement comes scarcely a week after Toyota agreed to pay a record $17.35-million fine to the National Highway Traffic Safety Administration for failing to report a potential floor mat defect in a Lexus SUV. Those come on top of almost $50 million in fines paid by Toyota for other violations related to sudden acceleration since 2010.

The massive settlement does not, however, put Toyota's legal woes to rest. The automaker still faces numerous injury and wrongful death claims around the country, including a group of cases that have been consolidated in federal court in Santa Ana, and other cases awaiting trial in Los Angeles County.

The first of the federal cases, involving a Utah man who was killed in a Camry that slammed into a wall in 2010, is slated for trial in mid-February.

The California cases are set to begin in April, among them a suit involving a 66-year-old Upland woman who was killed after her vehicle allegedly reached 100 miles per hour and slammed into a tree.

Edgar Heiskell III, a West Virginia attorney who has a dozen pending suits against Toyota, said he is preparing to go to trial this summer in a case that involved a Flint, Mich., woman who was killed when her 2005 Camry suddenly accelerated near her home.

"We are proceeding with absolute confidence that we can get our cases heard on the merits and that we expect to prove defects in Toyota's electronic control system," he said.

Toyota spokesman Mike Michels said the settlement would have no bearing on the personal injury cases.

"All carmakers face these kinds of suits," he said. "We'll defend those as we normally would."

The giant automaker's sudden acceleration problems first gained widespread attention after the August 2009 crash of a Lexus ES outside San Diego.

That accident set off a string of recalls, an unprecedented decision to temporarily stop sales of all Toyota vehicles and a string of investigations, including a highly unusual apology by Toyota President Akio Toyoda before a congressional committee. Eventually Toyota recalled more than 10 million vehicles worldwide and has since spent huge sums — estimated at more than $2 billion, not including Wednesday's proposed settlement — to repair both its automobiles and public image.

Read More..

Police find New York gunman's threatening note but no motive

The New York felon who set a Christmas Eve trap for firefighters left a note saying he wanted to burn down the neighborhood and "do what I do best: killing people," police said Tuesday.

Investigators found human remains in the burned-out home of ex-con William Spengler, 62, a day after his rampage in Webster, a Rochester suburb. Officials said the remains probably were those of Spengler's missing sister, Cheryl, 67.

Spengler apparently set the blaze in or near his home and lay in wait, killing two firefighters and seriously wounding two more before taking his own life, officials said.

In his note, Spengler wrote, "I still have to get ready to see how much of the neighborhood I can burn down and do what I do best: killing people," police said at a Christmas Day news conference.

Officers characterized the note as "rambling" and said it did not include a motive. They declined to release more excerpts Tuesday.

"Motive is always the burning question, and I'm not sure we'll ever really know what was going through his mind," Webster Police Chief Gerald Pickering said.

Spengler appeared to have led an uneventful life for the last 14 years, but had a violent history: In 1980, he beat his grandmother to death with a hammer. He spent 18 years in prison and was released in 1998.

Monday's blaze — which officials think may have started as a vehicle fire — consumed seven homes and damaged two more in Webster, a sleepy community on the shores of Lake Ontario and Irondequoit Bay.

Police think Spengler used a military-style Bushmaster .223 rifle with a flash suppressor. They recovered the weapon along with a Smith & Wesson .38-caliber revolver and a Mossberg pump-action 12-gauge shotgun.

As a felon, Spengler was barred from owning guns. Officials were unsure how he had obtained them, but said he was armed to the teeth.

"He was equipped to go to war and kill innocent people," Pickering said.

Spengler's attack would mark the third time in two weeks that a gunman had attempted a mass killing with an assault rifle. On Dec. 14, Adam Lanza killed 20 grade-school students and six adults at Sandy Hook Elementary School in Newtown, Conn., using a military-style Bushmaster .223 rifle. Lanza also killed his mother and himself. On Dec. 11, Jacob Tyler Roberts opened fire in a Clackamas, Ore., mall with an AR-15-style rifle, killing two and wounding one before taking his own life.

The discovery that Spengler had a Bushmaster is likely to intensify the outcry for tighter gun controls that followed the Newtown massacre. The gun, which looks like a military assault rifle, also was used in the 2002 sniper attacks that left 10 dead and three wounded in the Washington, D.C., area.

President Obama is expected to begin pushing for specific gun control measures, including bans on assault weapons and high-capacity magazines, after he receives recommendations from Vice President Joe Biden in January. The National Rifle Assn., the nation's most powerful gun lobby, has vowed to fight any attempts to curtail gun ownership.

In Webster, during the first of two news conferences on Christmas Day, officials described Monday's chaotic "combat situation." Firefighters were targeted before getting out of their trucks, police said, and a Webster police officer used his duty rifle to trade fire with Spengler.

Rounds shattered the windshield of the firetruck that two of the firefighters were in; the wounded driver crashed trying to get away.

"Had that police officer not been there, more people would have been killed, because he immediately engaged the shooter," Pickering said of the officer, who has not been identified.

Another police officer from nearby Greece, N.Y., Jon Ritter, was driving behind the firetruck when he also came under fire. He was wounded by shrapnel from the bullets that struck his windshield and engine block, police said.

Ritter "tried to shelter some of the fallen firemen with his car when the other firefighters — that we later extracted from the location with the armored personnel carrier — had taken cover under the firetruck," Pickering said.

The two wounded firefighters remained in intensive care and were described as stable.

Officials said that 33 neighborhood residents had been displaced by the blaze and the investigation and that hotels had offered them places to stay.

"We all have been inundated from citizens, police agencies across the nation and really across the world, wanting to provide donations," Pickering said. The outpouring "has been incredible."

matt.pearce@latimes.com

Times staff writer John Hoeffel in Naples, N.Y., contributed to this report.

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Jessica Simpson's Christmas gift: She's pregnant

NEW YORK (AP) — Jessica Simpson's daughter has the news all spelled out: "Big Sis."

Simpson on Tuesday tweeted a photo of her baby daughter Maxwell playing in the sand, the words "Big Sis" spelled out.

The 32-year-old old singer and personality has been rumored to be expecting again. The tweet appears to confirm the rumors.

"Merry Christmas from my family to yours" is the picture's caption. Simpson used a tweet on Halloween in 2011 to announce she was pregnant with Maxwell. She is engaged to Eric Johnson and gave birth to Maxwell in May.

One possible complication regarding her pregnancy: She is a spokeswoman for Weight Watchers.

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Op-Ed Contributor: Our Failed Approach to Schizophrenia

TOO many pendulums have swung in the wrong directions in the United States. I am not referring only to the bizarre all-or-nothing rhetoric around gun control, but to the swing in mental health care over the past 50 years: too little institutionalizing of teenagers and young adults (particularly men, generally more prone to violence) who have had a recent onset of schizophrenia; too little education about the public health impact of untreated mental illness; too few psychiatrists to talk about and treat severe mental disorders — even though the medications available in the past 15 to 20 years can be remarkably effective.

Instead we have too much concern about privacy, labeling and stereotyping, about the civil liberties of people who have horrifically distorted thinking. In our concern for the rights of people with mental illness, we have come to neglect the rights of ordinary Americans to be safe from the fear of being shot — at home and at schools, in movie theaters, houses of worship and shopping malls.

“Psychosis” — a loss of touch with reality — is an umbrella term, not unlike “fever.” As with fevers, there are many causes, from drugs and alcohol to head injuries and dementias. The most common source of severe psychosis in young adults is schizophrenia, a badly named disorder that, in the original Greek, means “split mind.” In fact, schizophrenia has nothing to do with multiple personality, a disorder that is usually caused by major repeated traumas in childhood. Schizophrenia is a physiological disorder caused by changes in the prefrontal cortex, an area of the brain that is essential for language, abstract thinking and appropriate social behavior. This highly evolved brain area is weakened by stress, as often occurs in adolescence.

Psychiatrists and neurobiologists have observed biochemical changes and alterations in brain connections in patients with schizophrenia. For example, miscommunications between the prefrontal cortex and the language area in the temporal cortex may result in auditory hallucinations, as well as disorganized thoughts. When the voices become commands, all bets are off. The commands might insist, for example, that a person jump out of a window, even if he has no intention of dying, or grab a set of guns and kill people, without any sense that he is wreaking havoc. Additional symptoms include other distorted thinking, like the notion that something — even a spaceship, or a comic book character — is controlling one’s thoughts and actions.

Schizophrenia generally rears its head between the ages of 15 and 24, with a slightly later age for females. Early signs may include being a quirky loner — often mistaken for Asperger’s syndrome — but acute signs and symptoms do not appear until adolescence or young adulthood.

People with schizophrenia are unaware of how strange their thinking is and do not seek out treatment. At Virginia Tech, where Seung-Hui Cho killed 32 people in a rampage shooting in 2007, professors knew something was terribly wrong, but he was not hospitalized for long enough to get well. The parents and community-college classmates of Jared L. Loughner, who killed 6 people and shot and injured 13 others (including a member of Congress) in 2011, did not know where to turn. We may never know with certainty what demons tormented Adam Lanza, who slaughtered 26 people at an elementary school in Newtown, Conn., on Dec. 14, though his acts strongly suggest undiagnosed schizophrenia.

I write this despite the so-called Goldwater Rule, an ethical standard the American Psychiatric Association adopted in the 1970s that directs psychiatrists not to comment on someone’s mental state if they have not examined him and gotten permission to discuss his case. It has had a chilling effect. After mass murders, our airwaves are filled with unfounded speculations about video games, our culture of hedonism and our loss of religious faith, while psychiatrists, the ones who know the most about severe mental illness, are largely marginalized.

Severely ill people like Mr. Lanza fall through the cracks, in part because school counselors are more familiar with anxiety and depression than with psychosis. Hospitalizations for acute onset of schizophrenia have been shortened to the point of absurdity. Insurance companies and families try to get patients out of hospitals as quickly as possible because of the prohibitively high cost of care.

As documented by writers like the law professor Elyn R. Saks, author of the memoir “The Center Cannot Hold: My Journey Through Madness,” medication and treatment work. The vast majority of people with schizophrenia, treated or untreated, are not violent, though they are more likely than others to commit violent crimes. When treated with medication after a rampage, many perpetrators who have shown signs of schizophrenia — including John Lennon’s killer and Ronald Reagan’s would-be assassin — have recognized the heinousness of their actions and expressed deep remorse.

It takes a village to stop a rampage. We need reasonable controls on semiautomatic weapons; criminal penalties for those who sell weapons to people with clear signs of psychosis; greater insurance coverage and capacity at private and public hospitals for lengthier care for patients with schizophrenia; intense public education about how to deal with schizophrenia; greater willingness to seek involuntary commitment of those who pose a threat to themselves or others; and greater incentives for psychiatrists (and other mental health professionals) to treat the disorder, rather than less dangerous conditions.

Too many people with acute schizophrenia have gone untreated. There have been too many Glocks, too many kids and adults cut down in their prime. Enough already.

Paul Steinberg is a psychiatrist in private practice.

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