Winter storm: Lingering snow could mean messy commute

Tom updates Tuesday's storm. (WGN - Chicago)

The storm that socked the Chicago area with the season's biggest snowfall by Tuesday evening has tapered off but not disappeared completely, and forecasters expect an additional inch or more to fall today.

That means the morning rush hour could be a bit messy, though it shouldn't be nearly as bad as Tuesday evening's commute was for motorists like Bob Reed, of Geneva. Speaking from a cellphone as he crawled west on Interstate 90, Reed blamed sloppy drivers more than sloppy roads.

"When it snows like this, it's like there are no traffic laws at all," Reed said. "Normally we have very aggressive drivers, but now we've got people going the wrong way down one-way streets, people jumping out of line to pass you."

The northern suburbs were hit hardest by the storm, with Waukegan reporting 11 inches of snow accumulation.

By midnight, 4.8 inches had fallen at O'Hare International Airport, according to the National Weather Service. That brought the official total for the season to 18.4 inches, and February's total to 14.9 inches.

Many city and suburban schools closed early and canceled sports games and practices. By 9 p.m., more than 500 departing flights had been canceled at O'Hare and Midway airports, with about the same number of arrivals also canceled, according to FlightStats, which gathers data from airports and airlines.

Cars and buses slid into ditches and crashed into each other on slick roads. The Illinois Tollway and Chicago's Department of Streets and Sanitation dispatched their full fleets of snowplows and salt trucks.

Snow fell at about 2 inches an hour in some northern suburbs. Any snow Wednesday or the rest of the week won't be nearly that intense, said meteorologist Casey Sullivan of the National Weather Service. Leaving early for the morning commute, however, won't be a bad idea, he said.

In a winter of sparse snowfall, some welcomed the storm with enthusiasm — particularly those who stand to profit from it. James Koch, the owner of Jimbo's Plowing Service in Tinley Park, said the snow was a gift in a winter that's been a bust for plow truck drivers.

Koch bought a new truck and plow after the record snowfall during the 2011 Groundhog Day blizzard. Since then he has failed to realize the returns he expected on his investment, he said.

"It ain't like what it used to be," Koch said. "Chicago always had a good snowfall, and now we're not getting snow until January. If you don't get a big snow in December in this business, you're basically playing catch-up all year."

The snow also gave fresh life to plans for winter recreation. Gloria Morison, of Highland Park, was at a brunch Tuesday morning when she saw the first flakes fall. She said she immediately started making plans to try out a new pair of cross country skis, thinking she could go down her street before the plows came to get to the Green Bay Trail.

Chicago Transit Authority buses had a hard time navigating some roads Tuesday. A few buses got stuck near North Stockton Drive and West Dickens Avenue, police said.

"Obviously, we're advising operators to drive with caution," CTA spokeswoman Lambrini Lukidis said.

With snow forecast to fall periodically Wednesday and Thursday, drivers should continue to heed that advice, said Sullivan of the weather service. Even after the storm passes there could be more in store, with unrelated lake-effect snow possible Friday, he said.

"We'll see."

Tribune reporters Ryan Haggerty and Naomi Nix contributed.

ehirst@tribune.com

jhuston@tribune.com

agrimm@tribune.com

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Well: What Housework Has to Do With Waistlines

Phys Ed

Gretchen Reynolds on the science of fitness.

One reason so many American women are overweight may be that we are vacuuming and doing laundry less often, according to a new study that, while scrupulously even-handed, is likely to stir controversy and emotions.

The study, published this month in PLoS One, is a follow-up to an influential 2011 report which used data from the U.S. Bureau of Labor Statistics to determine that, during the past 50 years, most American workers began sitting down on the job. Physical activity at work, such as walking or lifting, almost vanished, according to the data, with workers now spending most of their time seated before a computer or talking on the phone. Consequently, the authors found, the average American worker was burning almost 150 fewer calories daily at work than his or her employed parents had, a change that had materially contributed to the rise in obesity during the same time frame, especially among men, the authors concluded.

But that study, while fascinating, was narrow, focusing only on people with formal jobs. It overlooked a large segment of the population, namely a lot of women.

“Fifty years ago, a majority of women did not work outside of the home,” said Edward Archer, a research fellow with the Arnold School of Public Health at the University of South Carolina in Columbia, and lead author of the new study.

So, in collaboration with many of the authors of the earlier study of occupational physical activity, Dr. Archer set out to find data about how women had once spent their hours at home and whether and how their patterns of movement had changed over the years.

He found the information he needed in the American Heritage Time Use Study, a remarkable archive of “time-use diaries” provided by thousands of women beginning in 1965. Because Dr. Archer wished to examine how women in a variety of circumstances spent their time around the house, he gathered diaries from both working and non-employed women, starting with those in 1965 and extending through 2010.

He and his colleagues then pulled data from the diaries about how many hours the women were spending in various activities, how many calories they likely were expending in each of those tasks, and how the activities and associated energy expenditures changed over the years.

As it turned out, their findings broadly echoed those of the occupational time-use study. Women, they found, once had been quite physically active around the house, spending, in 1965, an average of 25.7 hours a week cleaning, cooking and doing laundry. Those activities, whatever their social freight, required the expenditure of considerable energy. (The authors did not include child care time in their calculations, since the women’s diary entries related to child care were inconsistent and often overlapped those of other activities.) In general at that time, working women devoted somewhat fewer hours to housework, while those not employed outside the home spent more.

Forty-five years later, in 2010, things had changed dramatically. By then, the time-use diaries showed, women were spending an average of 13.3 hours per week on housework.

More striking, the diary entries showed, women at home were now spending far more hours sitting in front of a screen. In 1965, women typically had spent about eight hours a week sitting and watching television. (Home computers weren’t invented yet.)

By 2010, those hours had more than doubled, to 16.5 hours per week. In essence, women had exchanged time spent in active pursuits, like vacuuming, for time spent being sedentary.

In the process, they had also greatly reduced the number of calories that they typically expended during their hours at home. According to the authors’ calculations, American women not employed outside the home were burning about 360 fewer calories every day in 2010 than they had in 1965, with working women burning about 132 fewer calories at home each day in 2010 than in 1965.

“Those are large reductions in energy expenditure,” Dr. Archer said, and would result, over the years, in significant weight gain without reductions in caloric intake.

What his study suggests, Dr. Archer continued, is that “we need to start finding ways to incorporate movement back into” the hours spent at home.

This does not mean, he said, that women — or men — should be doing more housework. For one thing, the effort involved is such activities today is less than it once was. Using modern, gliding vacuum cleaners is less taxing than struggling with the clunky, heavy machines once available, and thank goodness for that.

Nor is more time spent helping around the house a guarantee of more activity, over all. A telling 2012 study of television viewing habits found that when men increased the number of hours they spent on housework, they also greatly increased the hours they spent sitting in front of the TV, presumably because it was there and beckoning.

Instead, Dr. Archer said, we should start consciously tracking what we do when we are at home and try to reduce the amount of time spent sitting. “Walk to the mailbox,” he said. Chop vegetables in the kitchen. Play ball with your, or a neighbor’s, dog. Chivvy your spouse into helping you fold sheets. “The data clearly shows,” Dr. Archer said, that even at home, we need to be in motion.

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What's next for revitalized Chicago Loop?

Michael Edwards has only been in town for a few months, but the new executive director of the Chicago Loop Alliance says the warm reception he's getting makes him feel part of something distinctly Chicago.

There's the strong handshake upon meeting. Direct eye contact. A hearty "Welcome to Chicago," he notes. "It's really a dynamic thing," Edwards says with a laugh. "I get it all the time."

A Buffalo, N.Y., native who took the role in November, Edwards arrived at a crucial time for the alliance, which is charged with representing downtown businesses and promoting the area as a destination to live, work and play. On the rebound from the Great Recession, the Loop is aiming to solidify its place as a hub for businesses, retail and residents — from college students to urban professionals to empty nesters who seek easy access to transportation, Millennium Park and museums.

But the return hasn't been easy. During the economic downturn, vacancies shot up, but a rash of new apartments are under construction in downtown Chicago. Target Corp. filled the long-empty Carson Pirie Scott & Co. storefront with its new urban format on State Street in July, and a few blocks up The Gap will open a new store in the spring. State Street's crown jewel, Block 37, is still trying to land a big tenant to drive more foot traffic to the mall.

Now that vacancies are declining and rents are climbing, Edwards and other civic leaders are aiming to figure out what's next for the business district and State Street retail corridor.

At its annual meeting Tuesday, Edwards and the Chicago Loop Alliance announced development of a five-year strategic plan aimed at clarifying the organization's role in economic development, housing, transportation, tourism, culture and services in the Loop. It's the first ever in the organization's history.

The process will tap input from business owners, elected officials, civic leaders and alliance board members, said Edwards, who held similar positions in Pittsburgh and Spokane, Wash. He replaced executive director Ty Tabing, who left in the summer to head up an economic development organization in Singapore.

The strategic planning process is under way, and a draft is due in June. Oakland, Calif.- based MIG Inc. was hired to assist in developing the new strategy.

With the Loop moving in the right direction, it's time to shift gears and ask residents and business owners what they think of its opportunities and challenges, as well as the role of the alliance, Edwards says.

The need for a new plan is driven in part by Edwards' arrival, but also by the fact that the State Street special service area, one of 44 local tax districts that fund expanded services and programs with a property tax levy, is up for renewal in 2016. The State Street SSA collects about $2.5 million annually.

Part of the planning process will include determining whether the SSA, which is administered by the Chicago Loop Alliance and pays for such services as public way maintenance and district marketing, security and economic development, should be expanded to encompass all of the Loop's business and retail districts, including Dearborn Street and Wabash Avenue as well as North Michigan Avenue, he said.

No decisions have been yet, Edwards said. "We're pretty focused on State Street, but can we provide that level of service to other areas?" he said.

Edwards said the new strategy will also determine whether the alliance, which has an annual budget of about $3.4 million, should take on a larger role as an advocate for the Loop.

"We have a website that's all about our members that gets about 10,000 hits a year, and we need about 2 million hits a year. And we need to control the narrative about what's going on downtown," he said.

With other local organizations such as Choose Chicago and World Business Chicago tasked with touting the region, "Is there a role for us to amplify this notion that we're an authentic American city that's an economic engine for the region?" asked Edwards. "Is there a role for the CLA to help promote that or not?"

If the new focus of the alliance has yet to be determined, Edwards has few opinions. Any new partnerships with other local groups, he said, will have to be formed "organically."

And he predicts the alliance's focus will likely shift to "typical downtown management duties — keeping the area safe and clean," coupled with "a little more economic development sensibility as opposed to an arts sensibility," he said.

For years, the Chicago Loop Alliance has run the PopUp Art Loop program in which public art was showcased in vacant storefronts. But the number of empty retail spaces along State Street has been cut in half, to about six, Edwards said.

Now that State Street has evolved, it's time the alliance's role evolved too, according to officials.

"We're seeing a lot of tremendous opportunities for growth in the Loop, whether it's in retail, new companies coming downtown, new residents or tourism," said Martin Stern, executive vice president and managing director at US Equities Realty and board chairman of the Chicago Loop Alliance.

Added Edwards: "There's a sort of feeling that we need to be more focused, provide more value, provide more leadership."

crshropshire@tribune.com

Twitter @corilyns

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Chicago could see 6 inches of snow in Tuesday storm

Abundant sunshine and temperatures close to 50 degrees in the past few days teased sober Midwestern sensibilities.

Encouraged perhaps by spring training photos, some people deliberately ventured outside. Some even hopped on bicycles for spins. Maybe they dared to think that spring could break a little early this year.

But on Tuesday morning, for the second time in less than a week, a blustery mix of freezing rain, sleet and snow is forecast to hit the Chicago area. Accumulations could reach 6 inches.

Sure, weather predictions being what they are around here, many will shrug off the warnings and be brazenly optimistic. But it might be best to recall the adage that those who ignore history are sure to be victimized by it.

Chicago has plenty of late-season snow history and, regardless of what materializes, the prudent will keep their salt dry, snow shovels handy and snowblowers primed for the next couple of months.

National Weather Service records from 2011 show that 54 of the previous 139 years — nearly 40 percent — experienced at least one day with an inch or more of snowfall on or after March 25. A total of 17 of those years brought multiple days with more than an inch of snow to Chicago.

One year, 1926, included six days when more than an inch of snow fell after March 25.

And, like some cruel trick, the later in the season the snow falls, the heavier and deadlier it tends to be. On the other hand, it also generally melts faster.

Among the grimmest of those late snowfalls was the deadly storm of April 15-17, 1961, when a rainy low-pressure system stalled and kept looping over the Chicago region. It transformed cold rain into nearly 7 inches of snow. Six people died from the storm's effects; four were victims of snow-shoveling heart attacks.

That storm remains the latest major snowfall of 6 inches or more in the Chicago area.

More recently, the area was hit with nearly 2 inches of snow on March 27, 2008. On March 29, 2009, 1.2 inches accumulated. A week later, more than 2 inches of snow fell.

Tuesday's forecast, which calls for heavier snow north of Interstate 80 and winds whipping up to 35 mph, weighed on Jason Marker's mind while he stood at the Downers Grove Metra station Monday.

"I have a job interview tomorrow," said Marker, 30, of Downers Grove. "It's going to be tough getting there because I have to ride my bike."

Still, he said the winter has been a moderate one so far, "but maybe it will catch up with us tomorrow."

Ashley Feuillan and Bernard Thomas, also of Downers Grove, will be commuting in opposite directions Tuesday morning. Thomas commutes to a job in Aurora, which he starts at 7 a.m. Feuillan hops the train to Columbia College Chicago three times a week.

Both said they plan to leave earlier Tuesday.

"I actually like the snow," said Feuillan, 24, "but it can be a hassle when you're trying to get someplace."

Rather than focusing on what could be a nasty storm, Thomas, 40, kept an upbeat perspective.

"It hasn't been a bad winter," he said. "We haven't really had any big snowstorms."

If the forecast is accurate, Jake Weimer could receive a little relief.

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Horse Meat in European Beef Raises Questions on U.S. Exposure

The alarm in Europe over the discovery of horse meat in beef products escalated again Monday, when the Swedish furniture giant Ikea withdrew an estimated 1,670 pounds of meatballs from sale in 14 European countries.

Ikea acted after authorities in the Czech Republic detected horse meat in its meatballs. The company said it had made the decision even though its tests two weeks ago did not detect horse DNA.

Horse meat mixed with beef was first found last month in Ireland, then Britain, and has now expanded steadily across the Continent. The situation in Europe has created unease among American consumers over whether horse meat might also find its way into the food supply in the United States. Here are answers to commonly asked questions on the subject.

Has horse meat been found in any meatballs sold in Ikea stores in the United States?

Ikea says there is no horse meat in the meatballs it sells in the United States. The company issued a statement on Monday saying meatballs sold in its 38 stores in the United States were bought from an American supplier and contained beef and pork from animals raised in the United States and Canada.

“We do not tolerate any other ingredients than the ones stipulated in our recipes or specifications, secured through set standards, certifications and product analysis by accredited laboratories,” Ikea said in its statement.

Mona Liss, a spokeswoman for Ikea, said by e-mail that all of the businesses that supply meat to its meatball maker  issue letters guaranteeing that they will not misbrand or adulterate their products. “Additionally, as an abundance of caution, we are in the process of DNA-testing our meatballs,” Ms. Liss wrote. “Results should be concluded in 30 days.”

Does the United States import any beef from countries where horse meat has been found?

No. According to the Department of Agriculture, the United States imports no beef from any of the European countries involved in the scandal. Brian K. Mabry, a spokesman for the department’s Food Safety and Inspection Service, said: “Following a decision by Congress in November 2011 to lift the ban on horse slaughter, two establishments, one located in New Mexico and one in Missouri, have applied for a grant of inspection exclusively for equine slaughter. The Food Safety and Inspection Service (F.S.I.S.) is currently reviewing those applications.”

Has horse meat been found in ground meat products sold in the United States?

No. Meat products sold in the United States must pass Department of Agriculture inspections, whether produced domestically or imported. No government financing has been available for inspection of horse meat for human consumption in the United States since 2005, when the Humane Society of the United States got a rider forbidding financing for inspection of horse meat inserted in the annual appropriations bill for the Agriculture Department. Without inspection, such plants may not operate legally.

The rider was attached to every subsequent agriculture appropriations bill until 2011, when it was left out of an omnibus spending bill signed by President Obama on Nov. 18. The U.S.D.A.  has not committed any money for the inspection of horse meat.

“We’re real close to getting some processing plants up and running, but there are no inspectors because the U.S.D.A. is working on protocols,” said Dave Duquette, a horse trader in Oregon and president of United Horsemen, a small group that works to retrain and rehabilitate unwanted horses and advocates the slaughter of horses for meat. “We believe very strongly that the U.S.D.A. is going to bring inspectors online directly.”

Are horses slaughtered for meat for human consumption in the United States?

Not currently, although live horses from the United States are exported to slaughterhouses in Canada and Mexico. The lack of inspection effectively ended the slaughter of horse meat for human consumption in the United States; 2007 was the last year horses were slaughtered in the United States. At the time financing of inspections was banned, a Belgian company operated three horse meat processing plants — in Fort Worth and Kaufman, Tex., and DeKalb, Ill. — but exported the meat it produced in them.

Since 2011, efforts have been made to re-establish the processing of horse meat for human consumption in the United States. A small plant in Roswell, N.M., which used to process beef cattle into meat has been retooled to slaughter 20 to 25 horses a day. But legal challenges have prevented it from opening, Mr. Duquette said. Gov. Susana Martinez of New Mexico opposes opening the plant and has asked the U.S.D.A. to block it.

Last month, the two houses of the Oklahoma Legislature passed separate bills to override a law against the slaughter of horses for meat but kept the law’s ban on consumption of such meat by state residents. California, Illinois, New Jersey, Tennessee and Texas prohibit horse slaughter for human consumption.

Is there a market for horse meat in the United States?

Mr. Duquette said horse meat was popular among several growing demographic groups in the United States, including Tongans, Mongolians and various Hispanic populations. He said he knew of at least 10 restaurants that wanted to buy horse meat. “People are very polarized on this issue,” he said. Wayne Pacelle, chief executive of the Humane Society of the United States, disagreed, saying demand in the United States was limited. Italy is the largest consumer of horse meat, he said, followed by France and Belgium.

Is horse meat safe to eat?

That is a matter of much debate between proponents and opponents of horse meat consumption. Mr. Duquette said that horse meat, some derived from American animals processed abroad, was eaten widely around the world without health problems. “It’s high in protein, low in fat and has a whole lot of omega 3s,” he said.

The Humane Society says that because horse meat is not consumed in the United States, the animals’ flesh is likely to contain residues of many drugs that are unsafe for humans to eat. The organization’s list of drugs given to horses runs to 29 pages.

“We’ve been warning the Europeans about this for years,” Mr. Pacelle said. “You have all these food safety standards in Europe — they do not import chicken carcasses from the U.S. because they are bathed in chlorine, and won’t take pork because of the use of ractopamine in our industry — but you’ve thrown out the book when it comes to importing horse meat from North America.”

The society has filed petitions with the Department of Agriculture and Food and Drug Administration, arguing that they should test horse meat before allowing it to be marketed in the United States for humans to eat.

This article has been revised to reflect the following correction:

Correction: February 25, 2013

An earlier version of this article misstated how many pounds of meatballs Ikea was withdrawing from sale in 14 European countries. It is 1,670 pounds, not 1.67 billion pounds.

This article has been revised to reflect the following correction:

Correction: February 25, 2013

An earlier version of this article misstated the last year that horses were slaughtered in the United States. It is 2007, not 2006.

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5 of top 15 teaching hospitals in Chicago area

By Peter Frost




Tribune reporter

11:27 a.m. CST, February 25, 2013

Five of the country's top 15 major teaching hospitals are in the Chicago area, according to an annual study released Monday that evaluates performance in 10 categories of publicly available data.

The study, conducted by Truven Health Analytics, the former health care business of Thomson Reuters, listed seven Chicagoland hospitals among the nation's top 100, including four owned by Advocate Health Care.

Researchers evaluated 2,922 acute-care hospitals using information from the federal Centers for Medicare and Medicaid Services, including cost, patient satisfaction and quality measures, such as re-admission rates, patient safety, mortality and medical complications.  Hospitals do not apply or pay for inclusion on the list, which has been produced since 1993.

The seven Illinois hospitals that made the Top 100

• Advocate Christ Medical Center in Oak Lawn


• Advocate Illinois Masonic Medical Center in Chicago


• Advocate Lutheran General Hospital in Park Ridge


• Advocate Good Samaritan Hospital in Downers Grove


• Central DuPage Hospital in Winfield


• NorthShore University HealthSystem in Evanston


• Northwestern Memorial Hospital in Chicago

pfrost@tribune.com | Twitter: @peterfrost

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State lawmaker's bill seeks to limit use of drones to fight crime

SPRINGFIELD — As the Obama administration comes under fire for its use of unmanned drones in foreign lands, a state senator is pressing to have Illinois join the national debate on whether states should regulate drones to ensure the high-tech snooping isn't used to invade the privacy of ordinary citizens on U.S. soil.

Democratic Sen. Daniel Biss has introduced legislation that would require police to get a search warrant before using a drone to gather evidence. Along with banning the use of lethal and nonlethal weapons on the drones — except in emergencies — the proposal would require information a drone gathers to be destroyed unless it is part of an investigation.

Under the legislation, Illinois would step up to combat the issue of drones flying over U.S. airspace. President Barack Obama signed a Federal Aviation Administration mandate last year requesting the agency integrate unmanned aircraft into the national system.

With the possibility of drones becoming the latest aircraft traversing the skies, Biss said this is "the exact moment states should be looking into" unmanned aircraft legislation.

"We're heading into a world where technology surveillance is unreal," the Evanston lawmaker said.

More than 20 states are pursuing similar legislation, according to the National Conference of State Legislatures. While some states are trying to regulate unmanned aircraft use, others are trying to impose moratoriums that ban them, Biss said.

Virginia lawmakers approved a two-year moratorium on the aircraft in the state last week to allow time for a study. The legislation awaits the governor's signature.

In Illinois, authorities in Cook and Champaign counties are considering the use of drones to combat crime.

Cook County Sheriff Tom Dart is in the "exploratory stages" of looking into drone technology for future operations, spokesman Frank Bilecki said. If the county were to employ any drones, they would be "specifically for law enforcement use" and not to invade personal privacy, Bilecki said.

Dart's thinking is that drones would be cheaper to use and cost less taxpayer money than using helicopters for aerial operations, Bilecki said. A small, unmanned aircraft used for search and rescue can cost on average between $38,000 and $50,000, much less than in years past, said James Hill, president of AirCover Integrated Solutions, a California-based drone manufacturer.

To gain traction at the Capitol, Biss potentially might have to overcome resistance from law enforcement leaders. To that end, Biss said he's talking with police chiefs, the Illinois State Police and other police agencies to iron out any wrinkles.

The American Civil Liberties Union thinks the time is ripe to look at drone regulations.

"Technology is changing," said Ed Yohnka, spokesman for the ACLU's Illinois chapter. "And the idea is we need to get ahead of the technology to be better prepared."

raguerrero2@tribune.com

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‘Bloodless’ Lung Transplants for Jehovah’s Witnesses

Eric Kayne for The New York Times

SHARING HOME AND FAITH A Houston couple hosted Gene and Rebecca Tomczak, center, in October so she could get care nearby.

HOUSTON — Last April, after being told that only a transplant could save her from a fatal lung condition, Rebecca S. Tomczak began calling some of the top-ranked hospitals in the country.

She started with Emory University Hospital in Atlanta, just hours from her home near Augusta, Ga. Then she tried Duke and the University of Arkansas and Johns Hopkins. Each advised Ms. Tomczak, then 69, to look somewhere else.

The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life.

Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it?

By the time Ms. Tomczak found Dr. Scott A. Scheinin at The Methodist Hospital in Houston last spring, he had long since made peace with such quandaries. Like a number of physicians, he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.

By cherry-picking patients with low odds of complications, Dr. Scheinin felt he could operate almost as safely without blood as with it. The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.

“At the end of the day,” he had resolved, “if you agree to take care of these patients, you agree to do it on their terms.”

Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years — would become the latest test of an innovative approach that was developed to accommodate the unique beliefs of the world’s eight million Jehovah’s Witnesses but may soon become standard practice for all surgical patients.

Unlike other patients, Ms. Tomczak would have no backstop. Explicit in her understanding with Dr. Scheinin was that if something went terribly wrong, he would allow her to bleed to death. He had watched Witness patients die before, with a lifesaving elixir at hand.

Ms. Tomczak had dismissed the prospect of a transplant for most of the two years she had struggled with sarcoidosis, a progressive condition of unknown cause that leads to scarring in the lungs. The illness forced her to quit a part-time job with Nielsen, the market research firm.

Then in April, on a trip to the South Carolina coast, she found that she was too breathless to join her frolicking grandchildren on the beach. Tethered to an oxygen tank, she watched from the boardwalk, growing sad and angry and then determined to reclaim her health.

“I wanted to be around and be a part of their lives,” Ms. Tomczak recalled, dabbing at tears.

She knew there was danger in refusing to take blood. But she thought the greater peril would come from offending God.

“I know,” she said, “that if I did anything that violates Jehovah’s law, I would not make it into the new system, where he’s going to make earth into a paradise. I know there are risks. But I think I am covered.”

Cutting Risks, and Costs

The approach Dr. Scheinin would use — originally called “bloodless medicine” but later re-branded as “patient blood management” — has been around for decades. His mentor at Methodist, Dr. Denton A. Cooley, the renowned cardiac pioneer, performed heart surgery on hundreds of Witnesses starting in the late 1950s. The first bloodless lung transplant, at Johns Hopkins, was in 1996.

But nearly 17 years later, the degree of difficulty for such procedures remains so high that Dr. Scheinin and his team are among the very few willing to attempt them.

In 2009, after analyzing Methodist’s own data, Dr. Scheinin became convinced that if he selected patients carefully, he could perform lung transplants without transfusions. Hospital administrators resisted at first, knowing that even small numbers of deaths could bring scrutiny from federal regulators.

“My job is to push risk away,” said Dr. A. Osama Gaber, the hospital’s director of transplantation, “so I wasn’t really excited about it. But the numbers were very convincing.”

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2 hurt, 19 arrested in melee near Ford City Mall

Two people suffered minor injuries and police arrested 19 teenagers during a disturbance involving crowds of young people Saturday at Ford City Mall on the Southwest Side, authorities said.

About 4:45 p.m., a large group of disruptive teens ran yelling through the mall, which is located at 7601 S. Cicero Ave., according to a mall official.

Officials closed the mall minutes later, but the chaotic scene continued outside, where police found between 100 and 200 people damaging vehicles in the shopping center's parking lot, according to a police report.

Two people were taken to hospitals, according to Chicago Fire Department Chief Joe Roccasalva, a department spokesman.

A CTA bus driver suffered minor injuries and was taken to Holy Cross Hospital, said Roccasalva, who added he did not know what happened to him.
 
A “kid’’ was also hurt, and that person was taken to Advocate Christ Medical Center in Oak Lawn, also in good condition, Roccasalva said.

About 50 police squad cars assigned to multiple South Side districts, including Chicago Lawn, Englewood and Deering, and a helicopter responded to the scene, police said.

Traffic came to a standstill as teenagers jumped on cars, both parked and moving, according to a police report obtained by the Tribune. Many of those involved ignored orders to disperse, and police arrested 19 people between the ages of 13 and 17, according to police.

The teenagers all face minor misdemeanor charges.

Officers did their best to control the disturbance, "trying to get everyone out of there safely," Chicago Police Department News Affairs Officer Veejay Zala said.

During the disturbance the CTA had to reroute the No. 79 buses, which travel on 79th Street, as well as other buses in the immediate area.

Earlier in the afternoon, members of the teen band Mindless Behavior had appeared at the mall food court from 2 p.m. to 4 p.m. to promote their new release, "All Around the World," said John Sarama, the mall's senior general manager.

The band's autograph signing drew approximately 1,000 parents and children, primarily mothers and girls between the ages of 6 and 13, Sarama said.

About 45 minutes after the band left, the chaos began, Sarama said.

"A group of older youths came into the mall with the intent of causing havoc and chaos and were running through the mall, screaming, yelling and so forth," he said.

Security staff contacted the police department, and mall officials closed the mall about 5 p.m., Sarama said.

The mall did not sustain any property damage apart from a single broken planter, and it will reopen Sunday at 11 a.m. as usual, Sarama said.

In the meantime, mall officials are at a loss as they try to understand what happened.

"Ford City is a family-oriented mall," he said. "We have not had an incident like this [in the past], and I’m still in a little bit of a state of shock actually.

"What would make these youths comes here to try and cause this kind of commotion and trouble?" he continued. "I don’t know. But they did have a plan in mind."

Tribune reporter Adam Sege contributed.

rsobol@tribune.com

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The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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