A group of Harvard scientists and students were poisoned in August after drinking from coffee contaminated with a chemical preservative known as sodium azide, according to an internal memorandum leaked to the Boston Herald yesterday. Seconds after sipping the coffee, all six victims felt dizzy and were rushed to a nearby hospital. The lab workers were released, but the jury’s still out on how the odorless white solid, which can be deadly, got in the single-serve coffee machine near the victims’ pathology lab. NEWSWEEK’s Johannah Cornblatt talked to Dr. Michael Greenberg, the president of the American Academy of Clinical Toxicology, about the dangers of sodium azide, as well as the chemical’s atypical use as a poison. Although Greenberg considers sodium azide a strange choice for a poisoning agent, he remains “very suspicious” that the chemical ended up in the Harvard coffeemaker by accident.

How is sodium azide typically used?
It’s usually used as a preservative. It used to be used in automobile airbags. It was used in farming. It’s also used as a pest control.

What happens if sodium azide comes in contact with your skin?
It can cause burns. They’re usually not terribly bad, but it depends on how much you get on your skin, where you get it on your skin, and how long it stays on.

What about if you inhale or ingest it?
If you breathe in sodium azide or you ingest it, it can be a serious problem. If you ingest it, it will form a gas. If the person is vomiting, that gas could come out of the vomit and harm the people around them. So people in the emergency department need to be careful dealing with the body waste and vomit of anyone poisoned by sodium azide. It can cause seizures, coma, death.

How likely is death? 
It depends on the duration and the concentration. It can be a lethal chemical if you drink it. If you drink enough of it, it can kill you for sure.

What are the long-term side effects if you do survive?
It depends on how sick you become. If you have low blood pressure because of it—which can happen—you can have various other problems related to low blood pressure, like cardiac injury or brain injury.

How often is sodium azide used as a poison?
We don’t commonly come across sodium azide as a poison. Usually when we see exposures, they’re accidental instead of homicidal. I don’t think I’ve seen a homicidal use of sodium azide in my career.

Is it possible that the sodium azide ended up in that coffee maker by accident?
I suppose if it was being stored improperly in a container that looked like another container. But it’s probably not something that’s going to naturally turn up in a coffeemaker.


 

Cheerleaders, who are basically just bundles of muscle fiber and energy in short skirts, get little respect as athletes. As intellectuals? Forget it. But Darlene Cavalier is banking on that very stereotype of the flighty, popular cheerleader to help make Americans more comfortable with core scientific concepts.

Cavalier, a former Philadelphia 76ers cheerleader and a senior manager of global business development for Walt Disney Publishing Worldwide, is a vocal advocate for adult science literacy─ensuring that people who pay taxes and are affected by policy have a grasp of how science influences their daily lives.

"Americans are afraid of science, in part because it feels unapproachable," she says. Enter the cheerleaders. In YouTube videos on the site, professional cheerleaders from the 76ers introduce 18 concepts essential to understanding how the universe works, developed by lead science-literacy expert James Trefil, a professor at George Mason University. (Trefil also blogs about the concepts on the site.) Future videos are planned with Philadelphia Eagles cheerleaders.

Cavalier hopes to reestablish the Office of Technology Assessment, an office that was shut down in the mid-'90s and would give citizens more of a voice in science policy. When she's not wrangling with legislatures in D.C., she's devoted to spreading the word about science and its real-world implications, two pompoms at a time.

She spoke to NEWSWEEK about science, feminism, and the surprising amount of scientists moonlighting as dancers, models, and cheerleaders.

What is the meaning of Matthew? At a time when the gay community is struggling to secure the right to marry, Matthew Shepard, the Wyoming student who died after being violently beaten because he was gay, may seem like an emblem from days long past. And though Shepard's death was seen as a turning point─a point when the majority of Americans decided that no one should be targeted because of whom they chose to love─the truth is, Shepard was not the last gay American to die from a hate-motivated attack.

It's been a little more than 10 years since Shepard died at age 21. Those 10 years have seen an increased visibility of gay Americans and increased acceptance of gays and lesbians by mainstream society, but the struggle still continues: both for equal civil rights, fought in courtrooms and legislative halls across the country, and basic human rights, fought every day with dignity by gay men and women everywhere.

In her moving new memoir, The Meaning of Matthew: My Son's Murder in Laramie, and a World Transformed (Hudson River Press), Judy Shepard writes about her family: first the joy and frustration of parenting a complicated teenager, then the horror and resolve when that child is the victim of an unspeakable crime, and how it felt to watch her dying son  become a symbol for the entire nation. The book is beautiful: heartbreaking, honest, and written with a lovely open voice that makes the familiar story of the Shepard family's loss all the more devastating. (Read an excerpt from the memoir on Newsweek.com.)

Judy Shepard, who is now the executive director of the Matthew Shepard Foundation, spoke to NEWSWEEK about her decision to offer more personal details about her family, why she wanted to revisit the past, and how she hopes to move forward while working to honor her late son. Excerpts:

Why did you decided to write this book now?
For a long time I had wanted to publish a book of letters that were sent to [my husband] Dennis and I while Matt was in the hospital, and then soon after he died. There were beautifully written notes and letters from all walks of life. I acquired a book agent who thought it would be good to start with my story, or our story, and then do the book of letters.

Was writing the book a collaboration with the whole family?
It was. I had to send Dennis memories and say, do you remember any more about this, or is this even right? Because people tend to forget and sometimes change what they remember.

Was the process it therapeutic, or just difficult?
It was really hard. I found myself remembering even more things as we started to unlock doors, and so did Dennis and so did [son] Logan. I said to Dennis, there may be a time I never really can finish this book. We just might remember forever and I might never be happy with it. Finally it just became, we've got to let it go and be what it’s going to be.

Therapeutic? I think maybe it was. It was much more difficult than I thought it was going to be, and things that you wouldn’t think would make me break down made me break down. I do deal with Matt’s death and that quite a lot in my work, and it was the little things that really broke my heart

Like what?

Just memories about Matt when he was growing up, and Logan and Matt’s high-school friends, going back and talking to them─see, I’m doing it right now─it was really hard. It was great to know how much they loved him, but it was really hard,
 
In the book you talk about the difficulty having to "share" Matt with the rest of the country while he was in a coma, and even after he died: on one hand being grateful that so many people supported him, on the other being overwhelmed by everyone who wanted to claim him. How has that feeling evolved over the years?
There are still some things that as a family that we’ve chosen to keep to ourselves. We’ve loosened up a little bit, but there just doesn’t seem to be a need for the world to know everything about us or Matt. The reason I wrote the book was because I wanted to reconcile the public Matthew with our Matt. As I said in the book, he had a life before he was killed.

The book is a very realistic portrayal of a teenage kid figuring himself out, and it's not always flattering.
We get so much mail and e-mail from young kids who say how much they admire Matt and want to emulate his life, and how they wish they could straighten out their drug use or their depression or whatever. They seem to have the misconception that Matt never went through all that angst, and he totally did. He’s just an everyday kid.

He was not by any means a perfect child─he would be the first to tell you that. Depression was a huge problem for Matt, from his younger years, even in junior high. It was something he was always battling.

I just want people to know that he just wasn’t that angelic young man that some have tried to portray him as or want him to be. It wouldn’t be fair to Matt to not remember him with all the foibles and wrinkles of his real life.

As you said, a lot of your job has to deal with talking about Matt and his death. Do you feel like that forces you to look back? Are there days where you'd rather just be moving forward?
Of course. It's yin and the yang, which has become my favorite thing: the yin and the yang to everything.  It does force me to go back when I’d kind of like to move on. In fact, sometimes I don’t even talk about the event anymore: I talk about where we are now and where we should be and where we're not.

On the other hand, I could tell stories about Matt endlessly, and no one says, "But Judy, I’ve heard that story a hundred times." I can keep him as close as I want and remember and tell stories as much as I want, so this whole last 11 years in my work and my private life and my grieving for Matt, it’s allowed me to grieve but also feel that I’m making a difference in Matt’s name.

Many people saw Matt’s death as turning point: never again. But of course, Matt isn't the last gay person to die at the hands of an attacker. Have things gotten better?
I think at the grassroots level, things have honestly gotten better. Legislatively, legally, I question that. There are pockets of this country where we will never be able to be totally accepting of the gay community, but I think that’s true of every minority.

I don’t think we’re any worse off than another minority. I think there’s a higher level of ignorance about the gay community out there, but that’s because people aren’t out. They don’t talk about their lives, and we absolutely need to do that. When I went to see Milk, even Harvey Milk was saying back then, "We need to tell our stories, we need to talk about who we are, because people never get to know us."

Can you talk about the legislative level, and specifically the hate-crimes bill?
We’ve been at it for a long time. Senator Kennedy was of course a great champion of our causes. We really lost a leader when we lost him.

Right now the legislation has passed the House on a stand-alone bill. It was in the Senate attached to the Department of Defense bill and it passed. Now because it changed from the House version, it's in committee.  We’re looking at maybe October before it’s actually out of committee. We know the president will sign it if gets to him, but we may run into more wrinkles like we did last time.

In the book you talk about not being completely convinced of the need for the bill at first. Why is it necessary? How do you legislate thought?
Hate crime is different on such an elementary level from other crimes. I didn’t realize that until I actually was part of one. You actually have to be a part of it to understand that the fear created by that crime doesn’t come from an ordinary─from a crime that’s not a hate crime. Hate crimes are committed to terrorize a collection of people, not an individual.

The part of the hate-crime bill that I think is most important and I wish was in every hate-crime legislation is education. If we find people doing basic things like graffiti on a synagogue, where there’s no actual person that’s the victim, you can educate them about what diversity is and how respect moves our country forward. If we could change one person’s mind, that’s brilliant. So like driver’s school: you get a speeding ticket, you go to driver’s school.

If laws prevented crimes, we wouldn’t need jails. On a very basic level, [the bill] sends a message of respect to the gay community that we realize this is a problem. Members of the gay community are singled out for violence above and beyond, so it’s actually a recognition factor.

If you're comfortable, can you talk about your son Logan and some of the challenges in devoting your life to protecting Matt’s legacy, while making sure your other son didn't feel overshadowed?
Logan works for the foundation and he wrote a blog on Matt’s birthday and sort of explained his journey of being─because he’s very shy─of being very afraid of people singling him out, and his friends being his friends for reasons other than him. It took him a while to get comfortable with the idea that Matt doesn’t dominate his life.

We’ve tried to do that with both boys when they were here: they were both so totally different in character that we tried to make sure neither one was overshadowed by what the other one was doing. I hope we laid a good groundwork for that. We knew Logan supported us in everything we did for Matt, but we also made a point of including Logan in all our decisions. Many things we didn’t do because Logan was uncomfortable with them.

He’s very comfortable with it now. He has many friends who are gay who sort of set him down and said, look, this is what’s going on, the work that your family is doing is really important to us. I think up until then he didn’t really understand what we were doing. He knew what we were doing, but he didn’t really understand the impact of what we were doing. It was a journey for him, for sure.

Often when a death occurs, especially one that's violent or traumatic, families are unable to stay together. They can't deal with emotions and responses as a family unit. How did you stay cohesive?

We all were very comfortable in our standing with Matt when he died. There was no blame put on anybody or on ourselves. We all felt we were in a good place with him when we lost hm. There was no talk about, well, my last conversation with him was angry.

We were very cognizant in our understanding that our family unit may very well suffer from what had happened to Matt if we weren’t careful about each other. We honestly made a really, really diligent effort to keep in contact with each other and talk things over and make sure everybody was comfortable with what was going on. We were scattered─Dennis was working in Saudi Arabia still because somebody had to have a real job, I was doing the work here, and Logan was in school─so it was a matter of e-mails and phone calls and an understanding that we had to be aware of what was going on.

Some of my friends even asked me, why do I want to keep this going in the press? Because they would have been a family who would have retreated rather than moved out. I knew that wouldn’t be right for Matt or for me. I would have gone crazy, we’d all have gone crazy. We thought there was a small amount of time, this window of opportunity for maybe our name, Matt’s name, could make a difference. We wanted to take advantage of that.

Michael Jackson’s death took a bizarre turn this afternoon when the Los Angeles County Coroner’s office announced it’d found the anesthetic propofol, usually used in general surgery, and two other sedatives to have caused the singer’s death in June. The drugs were no surprise—court testimony earlier this week established early on that Jackson was on myriad medications the day he died. The big shock came when the coroner announced that the death was being labeled a homicide.

It's important to note that homicide indicates that Jackson was killed; it does not, necessarily, mean he was murdered (homicide with intent to kill); many previous medical homicide cases have involved euthanasia. The Los Angeles County DA has not yet announced murder or manslaughter charges against Jackson's physician, Conrad Murray, who admits to giving Jackson the drugs.

Besides the fact that it made Jackson family whisperings of a conspiracy sound slightly less crazy, the homicide announcement left us wondering: what does medical homicide even mean? How do you draw the line between medical homicide and malpractice? And is as bad as it sounds?

Yes, actually. NEWSWEEK's Sarah Kliff spoke with Dr. Vincent DiMaio, editor of the American Journal of Forensic Medicine and Pathology and former chief medical examiner in Baxter County, Texas about what constitutes medical homicide, what doesn’t and why it’s actually not too difficult to tell the difference. Excerpts:

By classifying this death as a homicide, what is the Los Angeles County Coroner’s Office saying about the actions of Jackson’s doctor?
What they’re alleging is that [Michael Jackson’s doctor] gave [Jackson] a medication for a non-medical reason and that caused the death…The reason they can classify this as a homicide is that there is simply no medical reason for this drug to have been administered. Suppose he was in surgery, and the doctor had given him too much medication. That’s a different situation which would probably be signed off on as an accident. But in this situation, it’s clearly a homicide.

In general, how do you define a medical homicide? What makes it different from medical malpractice?
There are five ways that forensic pathologists categorize deaths: natural, accidental, homicide, suicide or undetermined. Essentially, homicide means that somebody has caused the death of another person…In terms of medical homicide specifically, I think the simplest way to say it is that it’s a medical decision that’s outrageous, that you could not justify your actions medically. Or you just go to extremes, like deciding to do an operative procedure for which you don’t have the support, doing an operation on your kitchen table. That’s essentially the way to say it: if you have a medical situation, where you’re using things inappropriately and have no medical justification, that’s homicide.

Is it difficult, in medical situations, to draw a line between accident and homicide? Are there cases that fall in between?
Usually, it’s actually really simple. If the doctor makes a mistake, you have records and other people who were in the room, and it would mostly be classified as malpractice. If it’s reasonable, and you screw up, it’s not going to be homicide. When you do something that’s really out there, that makes absolutely no medical sense at all, something like this, that’s when it’s no longer malpractice.

What about the Jackson case clearly indicates it was a homicide?
Even though there was no intention to kill, what he did was so beyond what normal people would consider reasonable medicine that it gets classified as a homicide. There was no medical justification and, besides that, he was using an anesthetic without an anesthesiologist. So not only do you have no medical justification, you also don’t have the right support system in place.

Will it be possible for the doctor to argue his case as a medical mistake, a case of negligence, not homicide?
You just can’t argue this one. Here’s the problem question for him: what is the medical justification for giving him this drug? And that’s where they’ve got him, because there is no medical reason for the situation he was in. He wasn’t even doing an operative procedure and there was no anesthesiologist. Moreover, he’s an internist. Even if the drug were warranted, the conditions would be inappropriate. It’s not his specialty, its not internal medicine and there were no support personnel.

How often do medical homicide cases come up in forensic pathology?
Very rarely. You do get some situations where doctors do medical procedures that are not recognized, causing the death of a patient, but most of these are medical malpractice. Most of the homicide cases that I know of are euthanasia, which is a bit different. It just gets to the point that, for something to be categorized as homicide, it would have to be something really gross, where there’s no real justification for what they are doing.

How does the Jackson case fit into the history of forensic pathology?
It’s completely unusual, not something that anyone, myself included, would ever expect to encounter. The only cases called homicide, that I know of, were where it was intended [the euthanasia cases]. But there’s nothing to this level.

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There is no ribbon for salivary-cancer awareness. That's probably because the disease is so rare—fewer than 1 percent of cancer cases attack the salivary glands. But after Beastie Boy Adam Yauch (MCA) revealed that he had recently been diagnosed with the disease, its profile went way up. NEWSWEEK's Matt Berman asked Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, for more information about the ailment. Excerpts below:

How common and threatening is salivary-gland cancer?
Salivary tumors are extremely rare. Using [National Cancer Institute] data from the years 2002 to 2006, malignant salivary tumors had an annualized incidence rate of 1.2 per 100,000 people. Death rates of malignant salivary tumors are 0.2 per 100,000 overall. Eighty-five percent of salivary-gland tumors are parotid [i.e., in the gland were Yauch's tumor is located].

A newly released study commissioned by the Israel Dental Association has found a link between increased cell-phone use and a rise in the incidence of salivary-gland cancer in Israel. Do you think there is anything to this?
They did not find a link, they found a time-wise association. They conclude maybe the increase is due to cell phones. They wrote, “We haven't gathered data on the use of cell phones on the part of the patients, but the rise [in cancer cases] absolutely could indicate increased exposure to cellular telephones and damage caused by radiation.” That is a very weak accusation. Many other things have changed over the past few years. I have seen other cancers flare in incidence because of changes in how a population prepares and stores food, how a population smokes, or even changes in sexual habits. While it is impossible to be definitive, it is still an open question as to whether cell phones cause parotid tumors, and it’s safe to say most epidemiologists with knowledge of the subject doubt that cell phones cause parotid tumors.
 
Are there any particular causes for the disease?
There is no known reason why people get parotid tumors. They are not associated with the typical head and neck cancer risk factors like smoking, alcohol, and HPV. The only real, established risk factor for parotid tumors is radiation therapy, which is an ionized form of radiation unlike cell-phone radiation. Ionized radiation is used to treat head and neck cancers and, ironically, parotid cancers. There were some folks who are now about 50 to 70 years of age who got radiation to the tonsils in the 1950s and 1960s who are at increased risk of radiation-induced cancer.

What are the different treatment options?
The treatment options depend on whether the cancer is benign or malignant, the stage of the cancer, the type of salivary gland the cancer is in, how the tumor looks under a microscope, and the patient’s age and general health. Some are treated with surgery, others with surgery and radiation therapy.

What are the major symptoms and long- or short-term setbacks related to the cancer?
I worry the most about dry mouth, which is a frequent side effect of surgery and radiation. 

How are these cancers discovered?
These cancers are almost always found when the patient notices a lump in the jaw or cheek. Any change on the side of the mouth or face should be reported to one's physician and checked out.

By Rebecca Shabad

Is South Carolina Gov. Mark Sanford OK? We get that things are a little tense, but he is not handling this well. First, he skips town, next he invents a hike on the Appalachian Trail, then it's an “exotic” trip to Buenos Aires. Now we learn Maria Chapur wasn’t the only one he “crossed the lines” with. His whirlwind of discombobulated statements leaves us a little concerned.

NEWSWEEK's Rebecca Shabad chatted with Dr. Mira Kirshenbaum, the clinical director of the Chestnut Hill Institute in Boston and author of When Good People Have Affairs: Inside the Hearts and Minds of People in Two Relationships. Kirshenbaum has never treated Sanford in a professional capacity, so is only basing her responses on years of experience and what she's seen of Sanford on TV and read in the news. Excerpts:

In a recent AP interview, Governor Sanford said, "This was a whole lot more than a simple affair; this was a love story. A forbidden one, a tragic one, but a love story at the end of the day." Is he nuts, in love, or is he really just a narcissist?
He’s probably nuts, but only in the sense that right now, he’s very emotional, and very confused, and in a panic, which is what all the people in his situation feel. Based on my clinical experience, he may very well think he loves this Maria and may very well want to fall back in love with his wife. It sounds like a complete contradiction, like gibberish. But that is the way people feel. They flip-flop from moment to moment. It really is a kind of insanity.

Sanford is in the 50 percentile of people who are more … I think I’ll just say self-involved; I don’t want to label him. Most politicians are on the narcissistic side of the spectrum. I would guess Sanford is someone who did not get as much affection and love in his marriage as he wanted and he was very, very hungry for it.

If Sanford came into your office, what would you tell him?
"You really, really have to stop and think. Acknowledging your guilt is a good step, but saving a marriage needs a lot more. It needs two people who want to be together. First, you have to stop contact with Maria." He has to regret-proof his decision. And for a certain amount of time, he has to do everything possible, including going to a therapist, including listening to Jenny and doing whatever she needs.

Why would the highest-ranking politician in a state concoct such an unbelievable, bizarre excuse for being absent?
Guys like Sanford got to where they are by doing things that no one thought was possible. You wouldn’t believe the stupid things the smartest men and women in the world have done in the name of love. Things happen in our lives much more often because we’re confused and stupid rather than because it’s what our unconscious really wants. He doesn’t know what he’s doing and why.

At the same time, he seemed to understand that what he was doing was wrong. He was obviously out of touch, especially not being there for his sons on Father’s Day.
I don’t know enough about him to really say, but I do know that he broke three important rules that you should never, ever break:

First, you should never change your story. Once your spouse has found you out, your only good option is to tell the whole truth and nothing but the truth. He made the mistake most people in his situation make. They want to dial back their guilt and culpability so they make things sound better than they were and inevitably more details come out.

Second, you should decide who you want to be with and decide fast. Marriages do and can survive this kind of betrayal.

And third, do all of this in private.

Have you ever seen someone act in such uneven ways while pursuing an affair?
All the time. Most of these cheaters are good people who are in way over their head.

Was the crying during the original news conference genuine or was he begging for sympathy?
Both, maybe? I don’t know. I don’t know him. I don’t judge people. I just assume he’s doing the best he knows how, he doesn’t know what to do, and he’s just making a bigger and bigger mess. 

Do you think he could have kept this secret?
People like Sanford just don’t confess to having an affair because you think that you’ll make yourself feel better or you think that you’ll make your marriage stronger. They think that they’re going to get it off their chest, they think everything is going to be better, but it just makes things worse.

What do you think was really going through his mind?
I’m guessing that he was in a panic and he didn’t have great advisers, they didn’t know what to do. No one knows how to do damage control in a situation like this. He really messed up royally.

More female video gamers are grabbing the controller this year, according to a report released yesterday by the  industry-tracking group NPD. The Gamer Augmentation 2009 report revealed that 28 percent of all console video gamers (those who play games on platforms like Wii, Playstation, and XBox) are now female, up from 23 percent last year. Less substantial research suggests that even more PC gamers are female, with  a Nielsen study indicating that women make up 50 percent of those who play video games on a computer. 

Despite the increasing number of women embracing video games, companies continue to ignore female players. Video-game site IGN recently ran a contest open only to males, offering a trip to Comic Con (in the face of online outrage, IGN opened the contest to women). Many female gamers felt further marginalized after the print version of Electronic Gaming Monthly folded and Dennis Publishing sent the men’s magazine Maxim to subscribers as a replacement.

These are just some of the most recent affronts to women gamers in the industry. Despite their increasingly strong presence, it appears that the only women game companies seem to be interested in are the scantily clad digital ones writhing on screens in games like Baldur’s Gate: Dark Alliance.

NEWSWEEK's Johannah Cornblatt talked to award-winning game designer Brenda Brathwaite about the progress that female developers and players have made in recent years, as well as the challenges they still face. Brathwaite, a 27-year veteran of the gaming industry, is a professor of game development and interactive design at the Savannah College of Art and Design and serves on the board of the International Game Developers Association. She was named one of the top 20 most influential women in the game industry by Gamasutra.com last year. A self-proclaimed “fighter not lover,” Brathwaite envisions a world of gaming where both men and women are welcome—and where the sex appeal extends to both scantily clad male and female characters. 

Excerpts after the jump. 

It appears that Michael Jackson died of cardiac arrest. 

The Los Angeles Times is reporting that paramedics were called to Jackson's rented Holmby Hills home after a call to 911 reported a man who was not breathing, and that he later died of massive cardiac arrest. Paramedics at the scene performed CPR, but they may have arrived too late. According to Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic, the window of opportunity emergency technicians have to revive those who suffer from a cardiac arrest is dangerously small—that is, assuming cardiac arrest was to blame. We asked Nissen, who has not treated Jackson, what could have precipitated Jackson’s sudden, shocking death.


Some sources are citing cardiac arrest as the cause of Michael Jackson's death.
There are several types of arrest, though the most common is certainly cardiac. It is very, very common. A fact that many people don’t know is that about a third of people who have a heart attack actually never make it to a hospital.

We do a great job of saving those that we actually get to a hospital alive. But many of them die outside the hospital. You have to get to the patient with a defibrillator within about four minutes to get a good outcome. [The Los Angeles Times reports that Jackson lived about six minutes from the hospital.] Between four and eight minutes things are a little bit questionable, and after eight minutes very, very few people will survive. And that’s why defibrillators have been put in airports and so many public places. Generally, you can’t get a paramedic crew to someone who is down that quickly. If you do good CPR, you can often extend that period some, but it’s still a problem of needing advanced life support—meaning paramedics with defibrillators, drugs, and so on—really within a few minutes or the outcome is generally not very good, which is what it sounds like it wasn’t here.

Some people who have a sudden event like that will have something other than a cardiac arrest; they’ll have a brain aneurysm that burst. We had a congresswoman here in Cleveland, a very wonderful person, Stephanie Tubbs Jones, and that happened to her at age 50 or so. He is in the age group when sudden cardiac death is not uncommon. It’s tragic. We’ve seen this with other celebrities. It’s not anything different from what happened to Tim Russert or any one of a number of other people, and it’s always a terrible tragedy when a person who is this young dies of a cardiac cause.

When the event is something other than cardiac, is it apparent to the paramedics?
It’s generally not. Often you don’t even know about it unless you do an autopsy. Because all you know when you get there is that the patient’s heart is not beating, but keep in mind that there are other reasons. Sudden cardiac death—as opposed to sudden death—sudden cardiac death is overwhelmingly the largest cause. We assume that any sudden death like this is cardiac unless it’s proven otherwise.

What are the risk factors?  He’s in the age range, but it does seem like the younger end of the age range.
We see people like this in their 30s, 40s, and 50s. It’s more common in older people, but it certainly happens in people in this age group. The risk factors are the risk factors for heart disease: smoking, diabetes, high blood pressure, high cholesterol, all the things we talk about incessantly. Of course, whether he had any of these things, it’s certainly an issue. Another thing that often comes up when a celebrity dies suddenly is a potential for drug use. That has happened in other famous cases: you may remember the basketball player Len Bias; first time in his life he ever used cocaine and he died suddenly. Again, I’m not saying that that’s a likely prospect here, but I’m just telling you how we tend to think about patients like this when we see them.
 
There’s a lot of speculation, and while you can’t speak to this case directly, I was hoping you could help us separate fact from fiction. He was working out pretty heavily with a trainer [Lou Ferrigno]. Can excessive training lead to cardiac arrest?
That’s just false. It’s not a common cause.

People are saying that he’s had a lot of surgery and been under a lot of anesthesia. Can repeated surgeries put you at risk for cardiac arrest?
That’s nonsense.

He’s African-American. Is that a risk factor in and of itself, or is just that African-Americans are more likely to have poor health care and poorer diets?
Generally, that’s a reflection of socio-economic status, and he clearly had the resources to have good health care, He certainly wouldn’t have been underprivileged in that sense, so I don’t think it’s a factor. The only factor that is important is that high blood pressure is genetically more common in African-Americans.

Is it possible to have a clean bill of health and still be at risk?
Absolutely. Every cardiologist I know has seen a patient in their office, done a complete examination, had a nice chat with them, given them all the reassurance possible that they were doing fine, then a week, a month later had this happen. There is no way you can predict these things.

Losing sleep? You’re not alone. According to the National Sleep Foundation, a third of Americans are losing zzz’s over the state of the economy, personal financial woes and stress on the job—assuming they still have a job. Drugs are the fastest, surest way to a night’s shuteye. But many people don’t like sleeping pills or, well, don’t have the insurance to pay for them.

If that’s you, sleep consultant Michael Krugman, founder of the Sounder Sleep System, may be able to help. Krugman holds “sleep sominars” in which he teaches drug-free approaches to shaking insomnia. More than 200 instructors in 12 countries are now teaching his method, which includes 50 different techniques. And in July, he will be issuing a set of three CD’s called “Rest Assured.”

Hey Slackers! Getting ready for the weekend? Big plans? Maybe eat some barbecue, hang out with the fam, hit the town?

Meet Dr. Dale Hull. Tomorrow morning, while we're sleeping off our Friday night festivities, he'll be running a marathon. Some of our readers who have similarly athletic plans may wonder why Dale Hull gets recognition and they do not.

After the jump, NEWSWEEK's Rebecca Shabad talks to Dr. Hull today about his recovery, his work, and his big day tomorrow:

In The Consult this morning, we linked to an article about a Jamaican dance craze called daggering. According to this article, doctors in Jamaica attribute daggering to a threefold increase in broken penises. As a result, government officials have banned any media promoting the dance, which simulates rough sex. Apparently, those who try to dagger in the bedroom--the same moves minus the "simulation"--are getting hurt.

Take a look at the example of daggering, shown here in a Mr. Vegas video. It's totally SFW, which prompts the question...

...is this really the root of an island-wide epidemic?

Rebecca Shabad investigaes and finds out more than you want to know, after the jump. 

By Rebecca Shabad 

For the millions of Americans suffering from pteromechanophobia (aka fear of flying), the presumed crash of an Air France flight off the cost of Brazil only solidified their belief that planes are nothing but death traps in the sky. But considering as many as two in five Americans may have a flying phobia, why is the entire nation collectively glued to the tube, waiting for more details about the crash? NEWSWEEK talked to Jonathan Bricker, an assistant professor-affiliate of psychology at the University of Washington in Seattle, to figure out why we need to know—and what all this information overload may be doing to our psyches.

 Get his take on TV news, the fear of driving vs. flying, and the need for more comprehensive data about who, exactly, fears the friendly skies after the jump.