Daley turns focus toward Gary

Richard M. Daley has kept a low profile since leaving office in 2011.

That doesn't mean he has lost interest in urban issues. The former mayor has turned his attention in a surprising direction, beyond Chicago's borders to one of the most intractable urban tragedies in America: the collapse of Gary, Ind.

"I always believe no part of America should be forgotten, and I think Gary has been forgotten," Daley said.

Daley is using his influence at the University of Chicago, where he is a distinguished senior fellow, to push a modest but growing amount of manpower toward Gary Mayor Karen Freeman-Wilson.

With guidance from Daley and Freeman-Wilson, University of Chicago graduate students are trying to figure out what to do with Gary's abandoned buildings and how to promote greater use of technology to help the city accomplish more with less, among other projects.

The hope is that the students will go on to help other cities after graduation. If successful, the U. of C.-Gary partnership could be replicated in other industrial towns grappling with decline.

Gary spans about 55 square miles, nearly a quarter of the size of Chicago. Yet the steel town's population has plummeted to an estimated 80,000, meaning the city has lost about half its people since 1960. The city's problems have mounted, including abandoned buildings and homes, sagging infrastructure and a declining budget to pay for services.

Outsiders have tried to fix Gary since at least the Lyndon B. Johnson administration. Freeman-Wilson, a former Indiana attorney general, judge and Harvard College and Harvard Law School graduate, has reinvigorated Gary's renewal efforts. And she's unafraid to ask for help.

Immediately after winning the 2011 Democratic primary, Freeman-Wilson called Daley for advice. They met, and Daley invited her to be the first guest speaker at his lecture series at the University of Chicago's Harris School of Public Policy, where Daley has a five-year appointment.

This quarter, 11 students from the university's public policy, business and social services schools are getting course credit for working on projects for Gary.

"It was Mayor Daley's idea," Freeman-Wilson said as she rode from a meeting on Chicago's West Side to Gary. "I had always envisioned getting the support and work from (University of Chicago Law School) alums, because there were issues around codes and things of that nature. It was not until the mayor came up with the idea of using students from the (Harris) School of Public Policy that I said, 'Oh yeah, that would work. That would work very well.'"

Daley does not teach a class at the University of Chicago. He runs an occasional lecture series.

Carol Brown, his last policy chief at City Hall, leads the program and the class, which is called the "Urban Revitalization Project: City of Gary, Ind." Grants from the Chicago-based Joyce and MacArthur foundations help pay administrative costs, including Brown's salary and that of a part-time assistant.

Last quarter's class was divided into three project teams. One team is cataloging Gary's abandoned buildings, which are magnets for crime and eyesores that further depress surrounding property values. Another is trying to recruit pro bono legal and consulting services for the city. And a third is trying to craft a strategy to clean up front stoops and empty lots one block at a time. This quarter's class also is tackling untapped funding opportunities and economic development.

Freeman-Wilson said a major benefit of the partnership is the fresh ideas from students "who aren't jaded by the limitations of government, whereas a 20-year employee might say, 'Oh, no, we can't do that in government because we don't have X, Y and Z.'"

Already their work has prompted more widespread use among Gary employees of a technology that stores and analyzes geographic data. City workers are now using the technology to map potholes, fallen tree limbs and illegal dump sites. That way work crews can be dispatched to neighborhoods where the problems are most severe.

"This partnership encourages urban planners to think broadly about regions instead of cities — greater Chicago instead of the city of Chicago," said Stephen Paul O'Hara, a historian at Xavier University who wrote a book about Gary.

The students operate as consultants. They gather best practices and ideas from cities around the country and then recommend a course of action. At the end of each 10-week quarter, students present their recommendations to Daley, Freeman-Wilson and their staffs. Their grades are based on those presentations and supporting reports.

"I will tell you, it never stops getting nerve-wracking," second-year graduate student Jocelyn Hare said of presenting to Daley. "But it gets easier."

Last spring, Hare, 32, responded to an email seeking student volunteers to conduct preliminary research to test the idea of a partnership. Hare then interned for the city of Gary during the summer. The Harris school paid her $15 an hour. She then enrolled in the first class in the fall and again this winter, when it was opened to graduate students outside of Harris for the first time.

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Lawyers: Jackson Jr., wife intend to plead guilty to charges

Jesse Jackson Jr. and his wife Sandi intend to plead guilty to federal charges alleging the former congressman misused $750,000 in campaign funds while she understated their income on  tax returns for six years, their lawyers say.

Jackson Jr., 47, a Democrat from Chicago, was charged in a criminal information today with one count of conspiracy to commit wire fraud, mail fraud and false statements. He faces up to five years in prison, a fine of up to $250,000 and other penalties.

Sandi Jackson was charged with one count of filing false tax returns. She faces up to three years in prison, a fine of up to $100,000 and other penalties.

Jackson Jr. is accused of diverting $750,000 in campaign funds for personal use.

Federal authorities allege that Jackson Jr. used campaign funds to purchase a $43,350 men’s gold-plated Rolex watch, $5,150 worth of fur capes and parkas, and $9,588 in children’s furniture. The purchases were made between 2007 and 2009, according to the criminal information, which authorities noted is not evidence of guilt.

Other expenditures listed by prosecutors include $10,105 on Bruce Lee memorabilia, $11,130 on Martin Luther King memorabilia and $22,700 on Michael Jackson items, including $4,600 for a "Michael Jackson fedora."

The government also alleged that Jackson Jr. made false statements to the House of Representatives because he did not report approximately $28,500 in loans and gifts he received.

"He has accepted responsibility for his actions and I can confirm that he intends to plead guilty to the charge in the information," Jackson Jr.'s attorney Brian Heberlig said.

Sandi Jackson is accused of filing incorrect joint tax returns with her husband for calendar years 2006 through 2011, reporting income “substantially less than the amount of income she and her husband received in each of the calendar years,” with a substantial additional tax due.

Her attorneys released a statement saying she has "reached an agreement with the U.S. attorney’s office to plead guilty to one count of tax fraud."

Jackson Jr. stepped down from the House of Representatives on Nov. 21, citing both his poor health and an ongoing federal probe of his activities. In a statement then, he said he was doing his best to cooperate with federal investigators and to accept responsibility for his “mistakes.”

In a statement today, Jackson Jr. said:

“Over the course of my life I have come to realize that none of us are immune from our share of shortcomings and human frailties. Still I offer no excuses for my conduct and I fully accept my responsibility for the improper decisions and mistakes I have made. To that end I want to offer my sincerest apologies to my family, my friends and all of my supporters for my errors in judgment and while my journey is not yet complete, it is my hope that I am remembered for the things that I did right.”

Sandi Jackson's attorneys released a statement saying she "has accepted responsibility for her conduct, is deeply sorry for her actions, and looks forward to putting this matter behind her and her family. She is thankful for the support of her family and friends during this very difficult time."

Jackson's father, the Rev.  Jesse Jackson Sr., said he wanted to attend President Barack Obama's speech Friday at Hyde Park Academy in Chicago but traveled to Washington, D.C., instead, to be with family members while they waited for the federal charges to come down.
 
"This has been a difficult and painful ordeal for our family," the civil rights leader said.
 
The Rev. Jesse Jackson said he would "leave it up to the courts system" to determine his son's fate.

"We express our love for him as a family," he said.

Jackson Jr.’s political fortunes sank beginning late in 2008, when he sought unsuccessfully to have Gov. Rod Blagojevich appoint him to the Senate seat that came open with the election of then-Sen. Barack Obama to the White House.

Jackson Jr. or an emissary reportedly offered to raise up to $6 million in campaign cash for Blagojevich, who now is in federal prison for crimes including trying to sell the Senate seat. Jackson Jr. was never charged in the case, which became the subject of an ethics probe in the House.

Last June, Jackson Jr. began a mysterious leave of absence for what originally was called “exhaustion” but later emerged as bipolar disorder. He spent months in treatment and won re-election Nov. 6 despite never returning to service in the House or staging a single campaign appearance.

A campaign to replace him is being conducted now in the 2nd Congressional District, which includes parts of the South Side and south suburbs.

Jackson Jr. was first elected to Congress in 1995. Sandi Jackson was a Chicago alderman until she resigned her post last month. They have two children.

Sandi Jackson’s firm, J. Donatella & Associates, has been paid at least $452,500 from her husband’s campaign committee since 2002, Federal Election Commission reports show.

The former congressman’s campaign committee reported $105,703 in cash on hand on last Nov. 26, FEC reports show. Leading up to the last election, it reported $1 million in contributions and $1.06 million in operating expenditures, reports show.

Once considered a potential candidate for mayor of Chicago, Jesse Jackson Jr.’s reputation has taken a hit in recent years because of the Blagojevich scandal and also because of news reports in 2010 that a suburban Chicago businessman told federal investigators he twice paid to fly a woman — a hostess from a Washington, D.C. bar — to Chicago at Jackson’s request.

In the wake of the reports, Jackson Jr. issued a statement calling the woman a “social acquaintance” and describing the matter as a  “private and personal matter between me and my wife that was handled some time ago.”

Jackson Jr. subsequently told the Tribune editorial board he had apologized to "my absolute best friend, my wife."

Still, he also acknowledged he asked longtime supporter Raghuveer Nayak to pay to fly the woman from Washington to Chicago. House ethics rules prohibit members from soliciting gifts of personal benefit. Jackson said Nayak’s purchase was "a friendly gesture" by "a close and dear friend of mine, one who knows members of my family, has worked with members of my family, has been a friend of our family's for a number of years."

The woman's travel was "not a personal benefit to me, I don’t believe, under the House rules. A benefit to the person for whom he bought the ticket. He didn't buy tickets for me. Did I direct him? I did."

Tribune reporters Kim Geiger, Rick Pearson and Patrick Svitek contributed.

kskiba@tribune.com

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Seth MacFarlane’s “Dads” series casts “Mindy Project” actor

LOS ANGELES (TheWrap.com) – Tommy Dewey has been cast in the Fox comedy “Dads,” from “Ted” team Seth MacFarlane, Alec Sulkin and Wellesley Wild.

Dewey, who’s appeared in a handful of episodes of Fox’s “The Mindy Project,” will play Warner, the co-owner of a successful videogame company and stable family man whose otherwise perfect life is cast into chaos when his feckless father Crawford moves in with him.

The series, which has been given the go-ahead for a six-episode season, revolves around Eli and Warner, two successful guys in their 30′s have their world turned upside down when their dads move in with them.

MacFarlane, Sulkin and Wild are executive producing the series, with Sulkin and Wild writing. Fuzzy Door Productions and Twentieth Century Fox Television are producing.

The series has also cast “The Suite Life on Deck” star Brenda Song, in the role of Veronica.

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Fat Dad: Baking for Love

Fat Dad

Dawn Lerman writes about growing up with a fat dad.

My grandmother Beauty always told me that the way to a man’s heart was through his stomach, and by the look of pure delight on my dad’s face when he ate a piece of warm, homemade chocolate cake, or bit into a just-baked crispy cookie, I grew to believe this was true. I had no doubt that when the time came, and I liked a boy, that a batch of my gooey, rich, chocolatey brownies would cast him under a magic spell, and we would live happily ever.

But when Hank Thomas walked into Miss Seawall’s ninth grade algebra class on a rainy, September day and smiled at me with his amazing grin, long brown hair, big green eyes and Jimi Hendrix T-shirt, I was completely unprepared for the avalanche of emotions that invaded every fiber of my being. Shivers, a pounding heart, and heat overcame me when he asked if I knew the value of 1,000 to the 25th power. The only answer I could think of, as I fumbled over my words, was “love me, love me,” but I managed to blurt out “1E+75.” I wanted to come across as smart and aloof, but every time he looked at me, I started stuttering and sweating as my face turned bright red. No one had ever looked at me like that: as if he knew me, as if he knew how lost I was and how badly I needed to be loved.

Hank, who was a year older than me, was very popular and accomplished. Unlike other boys who were popular for their looks or athletic skills, Hank was smart and talented. He played piano and guitar, and composed the most beautiful classical and rock concertos that left both teachers and students in awe.

Unlike Hank, I had not quite come into my own yet. I was shy, had raggedy messy hair that I tied back into braids, and my clothes were far from stylish. My mother and sister had been on the road touring for the past year with the Broadway show “Annie.” My sister had been cast as a principal orphan, and I stayed home with my dad to attend high school. My dad was always busy with work and martini dinners that lasted late into the night. I spent most of my evenings at home alone baking and making care packages for my sister instead of coercing my parents to buy me the latest selection of Gloria Vanderbilt jeans — the rich colored bluejeans with the swan stitched on the back pocket that you had to lie on your bed to zip up. It was the icon of cool for the popular and pretty girls. I was neither, but Hank picked me to be his math partner anyway.

With every equation we solved, my love for Hank became more desperate. After several months of exchanging smiles, I decided to make Hank a batch of my chocolate brownies for Valentine’s Day — the brownies that my dad said were like his own personal nirvana. My dad named them “closet” brownies, because when I was a little girl and used to make them for the family, he said that as soon as he smelled them coming out of the oven, he could imagine dashing away with them into the closet and devouring the whole batch.

After debating for hours if I should make the brownies with walnuts or chips, or fill the centers with peanut butter or caramel, I got to work. I had made brownies hundreds of times before, but this time felt different. With each ingredient I carefully stirred into the bowl, my heart began beating harder. I felt like I was going to burst from excitement. Surely, after Hank tasted these, he would love me as much as I loved him. I was not just making him brownies. I was showing him who I was, and what mattered to me. After the brownies cooled, I sprinkled them with a touch of powdered sugar and wrapped them with foil and red tissue paper. The next day I placed them in Hank’s locker, with a note saying, “Call me.”

After seven excruciating days with no call, some smiles and the usual small talk in math class, I conjured up the nerve to ask Hank if he liked my brownies.

“The brownies were from you?” he asked. “They were delicious.”

Then Hank invited me to a party at his house the following weekend. Without hesitation, I responded that I would love to come. I pleaded with my friend Sarah to accompany me.

As the day grew closer, I made my grandmother Beauty’s homemade fudge — the chocolate fudge she made for Papa the night before he proposed to her. Stirring the milk, butter and sugar together eased my nerves. I had never been to a high school party before, and I didn’t know what to expect. Sarah advised me to ditch the braids as she styled my hair, used a violet eyeliner and lent me her favorite V-neck sweater and a pair of her best Gloria Vanderbilt jeans.

When we walked in the door, fudge in hand, Hank was nowhere to be found. Thinking I had made a mistake for coming and getting ready to leave, I felt a hand on my back. It was Hank’s. He hugged me and told me he was glad I finally arrived. When Hank put his arm around me, nothing else existed. With a little help from Cupid or the magic of Beauty’s recipes, I found love.

---

Fat Dad’s ‘Closet’ Brownies

These brownies are more like fudge than cake and contain a fraction of the flour found in traditional brownie recipes. My father called them “closet” brownies, because when he smelled them coming out of the oven he could imagine hiding in the closet to eat the whole batch. I baked them in the ninth grade for a boy that I had a crush on, and they were more effective than Cupid’s arrow at winning his heart.

6 tablespoons unsalted butter, plus extra for greasing the pan
8 ounces bittersweet chocolate, chopped, or semisweet chocolate chips
3/4 cup brown sugar
2 eggs at room temperature, beaten
1 teaspoon vanilla extract
1/4 cup flour
1/2 cup chopped walnuts (optional)
Fresh berries or powdered sugar for garnish (optional)

1. Preheat oven to 350 degrees.

2. Grease an 8-inch square baking dish.

3. In a double boiler, melt chocolate. Then add butter, melt and stir to blend. Remove from heat and pour into a mixing bowl. Stir in sugar, eggs and vanilla and mix well.

4. Add flour. Mix well until very smooth. Add chopped walnuts if desired. Pour batter into greased baking pan.

5. Bake for 35 minutes, or until set and barely firm in the middle. Allow to cool on a rack before removing from pan. Optional: garnish with powdered sugar, or berries, or both.

Yield: 16 brownies

---

Dawn Lerman is a New York-based health and nutrition consultant and founder of Magnificent Mommies, which provides school lectures, cooking classes and workshops. Her series on growing up with a fat father appears occasionally on Well.

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Billionaire Sears CEO increases stake in Gap

Sears CEO Edward Lampert has upped his stake in Gap Inc. (Spencer Platt / Getty Images)

By Corilyn Shropshire




Tribune reporter

3:42 p.m. CST, February 15, 2013

Sears Chairman and CEO Edward Lampert boosted his stake in Gap Inc. according to regulatory filings.

Lampert is the billionaire hedge fund manager who engineered the merger of Sears and Kmart in 2005.  Since then, Sears has struggled to maintain its place with years of declining sales and executive changeover.  The company has focused on building loyalty rewards program and online business which officials said grew by 20 percent last year.

Lampert’s ESL Partners LP, took a 5.3 percent stake in San Francisco-based The Gap, on Dec. 31, according to documents filed Thursday with the Securities and Exchange Commission.

Shares of The Gap, which also operates brands Banana Republic, Old Navy, Piperlime and Athleta closed up nearly 5 percent at $32.87 on Friday, in part due to news about Lampert’s boosted interested in the retailer and on speculation that Uniqlo-owner and Japan-based Fast Retailing, Ltd.  is also interested in the retailer.

The Gap has been on an upswing beating analysts estimates with holiday and January sales.  The retailer said sales in stores open at least were up 8 percent to $1.13 billion in January. 

Lampert, who has several retail holdings including Columbus, Ohio-based Big Lots Inc., also decreased his interest Fort Lauderdale-based AutoNation, Inc. by about $13.5 million to $34.5 million and purchased 844, 926 shares of Pleasanton, Calif-based Safeway Inc. 

crshropshire@tribune.com | Twitter: @corilyns

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Stricken cruise ship reported awash in raw sewage nears port

MOBILE, Alabama—

Reeking of rotting food and sewage from overflowing toilets, a crippled cruise ship carrying more than 4,200 people was limping into Mobile, Alabama, on Thursday as passengers awaited the end of a vacation voyage some described as hellish.

The Carnival Triumph was being towed into port by tugboats as the drama played out live on U.S. cable news stations, creating another public relations nightmare for cruise giant Carnival Corp. Last year, its Costa Concordia luxury ship grounded off the coast of Italy, with 32 people killed.

Passengers described an overpowering stench on board the ship four days after an engine room fire knocked out power and plumbing across most of the 893-foot (272-metre) vessel and left it adrift in the Gulf of Mexico.

After the mishap, toilets overflowed, soaking many cabins and interior passages in raw sewage.

"Let's just say that I had a pair of shoes that I will not be bringing home with me," Julie Morgan told CNN.

"It is revolting," Morgan added, referring to the smell aboard the ship. "It's a mixture of sewage and rotting food."

But Terry Thornton, a senior Carnival Cruise Lines vice president, told reporters in Mobile that additional provisions were laid in on Wednesday and the ship was now "in excellent shape."

Passenger Donna Gutzman said those aboard the ship were treated to steak and lobster for lunch on Thursday afternoon.

"Our basic needs are being met. For the most part, they are making us happy," Gutzman told CNN.

The ship was expected to arrive in port around midnight CST (1.00 a.m. ET on Friday), Carnival said. A senior Carnival official said it could take up to five hours to remove all the passengers from the ship, which has only one functioning elevator.

Carnival Corp spokesman Vance Gulliksen said a tow line on one of four tugboats helping the Triumph get into port snapped on Thursday. But the tug was later reattached to the vessel.

Operated by Carnival Cruise Lines, the flagship brand of Carnival Corp, the ship left Galveston, Texas, a week ago carrying 3,143 passengers and 1,086 crew. It was supposed to return there on Monday.

A Coast Guard cutter has been escorting the Triumph on its long voyage into port since Monday, and a Coast Guard helicopter ferried about 3,000 pounds (1,360 kg) of equipment including a generator to the stricken ship late on Wednesday.

Earlier in the week, some passengers reported on the poor conditions on the Triumph when they contacted relatives and media before their cell phone batteries died. They said people were getting sick and passengers had been told to use plastic "biohazard" bags as makeshift toilets.

'VERY CHALLENGING CIRCUMSTANCES'

Carnival Cruise Lines Chief Executive Gerry Cahill said in a statement late on Wednesday that the company had decided to add further payment of $500 a person to help compensate passengers for "very challenging circumstances" aboard the ship.

"We are very sorry for what our guests have had to endure," Cahill said.

Mary Poret, who spoke to her 12-year-old daughter aboard the Triumph on Monday, rejected Cahill's apology in comments to CNN on Thursday, as she waited anxiously in Mobile with a friend for the Triumph's arrival.

"Seeing urine and feces sloshing in the halls, sleeping on the floor, nothing to eat, people fighting over food, $500? What's the emotional cost? You can't put money on that," Poret said.

Carnival Corp Chairman and CEO Micky Arison faced criticism in January 2012 for failing to travel to Italy and take personal charge of the Costa Concordia crisis after the luxury cruise shop operated by Carnival's Costa Cruises brand grounded on rocks off the Tuscan island of Giglio. The tragedy unleashed numerous lawsuits against his company.

The cruise ship mogul has taken a low-key approach to the Triumph situation as well, even as it grabbed a growing share of the U.S. media spotlight. His only known public appearance since Sunday was courtside on Tuesday at a game played by his Miami Heat championship professional basketball team.

"I think they really are trying to do the right thing, but I don't think they have been able to communicate it effectively," said Marcia Horowitz, an executive who handles crisis management at Rubenstein Associates, a New York-based public relations firm.

"Most of all, you really need a face for Carnival," she added. "You can do all the right things. But unless you communicate it effectively, it will not see the light of day."

Carnival Corp shares closed down $0.11 at $37.35 in trading on Thursday on the New York Stock Exchange. The shares closed down 4 percent at $37.46 on Wednesday after the company said voyage disruptions and repair costs related to Carnival Triumph could shave up to 10 cents a share off its second-half earnings.

The Triumph is a Bahamian-flagged vessel and the Bahamas Maritime Authority will be the primary agency investigating the cause of its engine room fire.

For all the passengers' grievances, they will likely find it difficult to sue the cruise operator for any damages, legal sources said. Over the years, the cruise industry has put in place a legal structure that ring-fences operators from big-money lawsuits.

Rules for seeking redress are spelled out in complex, multi-page ticket contracts that have been the subject of decades of court battles. Victims are often required to proceed with any litigation in remote jurisdictions.

(Writing and additional reporting by Tom Brown; Editing by Peter Cooney)

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Lady Gaga needs hip surgery, cancels remainder of tour

LOS ANGELES (Reuters) – Lady Gaga canceled the remainder of her “Born This Way Ball” concert tour to undergo hip surgery, promoters Live Nation said on Wednesday.

The 26-year-old singer announced she was suffering from an inflammation of the joints on Tuesday, but the tour operator said Gaga’s injuries were more serious than she realized.

“After additional tests this morning to review the severity of the issue, it has been determined that Lady Gaga has a labral tear of the right hip,” Live Nation said in a statement.

“She will need surgery to repair the problem, followed by strict downtime to recover. This, unfortunately, will force her to cancel the tour so she can heal,” it added.

Gaga has been on the road for two years, traveling across six continents.

On Tuesday, she postponed four U.S. shows saying she was suffering from synovitis that left her temporarily unable to walk. Synovitis is an inflammation of the joints that sometimes follows a sprain, strain or injury.

According to her website, the singer was due to play another 20 dates in the United States.

Live Nation said ticket holders would have their money refunded, starting on Thursday.

(Reporting By Jill Serjeant; Editing by Stacey Joyce)

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Doctor and Patient: Afraid to Speak Up to Medical Power

The slender, weather-beaten, elderly Polish immigrant had been diagnosed with lung cancer nearly a year earlier and was receiving chemotherapy as part of a clinical trial. I was a surgical consultant, called in to help control the fluid that kept accumulating in his lungs.

During one visit, he motioned for me to come closer. His voice was hoarse from a tumor that spread, and the constant hissing from his humidified oxygen mask meant I had to press my face nearly against his to understand his words.

“This is getting harder, doctor,” he rasped. “I’m not sure I’m up to anymore chemo.”

I was not the only doctor that he confided to. But what I quickly learned was that none of us was eager to broach the topic of stopping treatment with his primary cancer doctor.

That doctor was a rising superstar in the world of oncology, a brilliant physician-researcher who had helped discover treatments for other cancers and who had been recruited to lead our hospital’s then lackluster cancer center. Within a few months of the doctor’s arrival, the once sleepy department began offering a dazzling array of experimental drugs. Calls came in from outside doctors eager to send their patients in for treatment, and every patient who was seen was promptly enrolled in one of more than a dozen well-documented treatment protocols.

But now, no doctors felt comfortable suggesting anything but the most cutting-edge, aggressive treatments.

Even the No. 2 doctor in the cancer center, Robin to the chief’s cancer-battling Batman, was momentarily taken aback when I suggested we reconsider the patient’s chemotherapy plan. “I don’t want to tell him,” he said, eyes widening. He reeled off his chief’s vast accomplishments. “I mean, who am I to tell him what to do?”

We stood for a moment in silence before he pointed his index finger at me. “You tell him,” he said with a smile. “You tell him to consider stopping treatment.”

Memories of this conversation came flooding back last week when I read an essay on the problems posed by hierarchies within the medical profession.

For several decades, medical educators and sociologists have documented the existence of hierarchies and an intense awareness of rank among doctors. The bulk of studies have focused on medical education, a process often likened to military and religious training, with elder patriarchs imposing the hair shirt of shame on acolytes unable to incorporate a profession’s accepted values and behaviors. Aspiring doctors quickly learn whose opinions, experiences and voices count, and it is rarely their own. Ask a group of interns who’ve been on the wards for but a week, and they will quickly raise their hands up to the level of their heads to indicate their teachers’ status and importance, then lower them toward their feet to demonstrate their own.

It turns out that this keen awareness of ranking is not limited to students and interns. Other research has shown that fully trained physicians are acutely aware of a tacit professional hierarchy based on specialties, like primary care versus neurosurgery, or even on diseases different specialists might treat, like hemorrhoids and constipation versus heart attacks and certain cancers.

But while such professional preoccupation with privilege can make for interesting sociological fodder, the real issue, warns the author of a courageous essay published recently in The New England Journal of Medicine, is that such an overly developed sense of hierarchy comes at an unacceptable price: good patient care.

Dr. Ranjana Srivastava, a medical oncologist at the Monash Medical Centre in Melbourne, Australia, recalls a patient she helped to care for who died after an operation. Before the surgery, Dr. Srivastava had been hesitant to voice her concerns, assuming that the patient’s surgeon must be “unequivocally right, unassailable, or simply not worth antagonizing.” When she confesses her earlier uncertainty to the surgeon after the patient’s death, Dr. Srivastava learns that the surgeon had been just as loath to question her expertise and had assumed that her silence before the surgery meant she agreed with his plan to operate.

“Each of us was trying our best to help a patient, but we were also respecting the boundaries and hierarchy imposed by our professional culture,” Dr. Srivastava said. “The tragedy was that the patient died, when speaking up would have made all the difference.”

Compounding the problem is an increasing sense of self-doubt among many doctors. With rapid advances in treatment, there is often no single correct “answer” for a patient’s problem, and doctors, struggling to stay up-to-date in their own particular specialty niches, are more tentative about making suggestions that cross over to other doctors’ “turf.” Even as some clinicians attempt to compensate by organizing multidisciplinary meetings, inviting doctors from all specialties to discuss a patient’s therapeutic options, “there will inevitably be a hierarchy at those meetings of who is speaking,” Dr. Srivastava noted. “And it won’t always be the ones who know the most about the patient who will be taking the lead.”

It is the potentially disastrous repercussions for patients that make this overly developed awareness of rank and boundaries a critical issue in medicine. Recent efforts to raise safety standards and improve patient care have shown that teams are a critical ingredient for success. But simply organizing multidisciplinary lineups of clinicians isn’t enough. What is required are teams that recognize the importance of all voices and encourage active and open debate.

Since their patient’s death, Dr. Srivastava and the surgeon have worked together to discuss patient cases, articulate questions and describe their own uncertainties to each other and in patients’ notes. “We have tried to remain cognizant of the fact that we are susceptible to thinking about hierarchy,” Dr. Srivastava said. “We have tried to remember that sometimes, despite our best intentions, we do not speak up for our patients because we are fearful of the consequences.”

That was certainly true for my lung cancer patient. Like all the other doctors involved in his care, I hesitated to talk to the chief medical oncologist. I questioned my own credentials, my lack of expertise in this particular area of oncology and even my own clinical judgment. When the patient appeared to fare better, requiring less oxygen and joking and laughing more than I had ever seen in the past, I took his improvement to be yet another sign that my attempt to talk about holding back chemotherapy was surely some surgical folly.

But a couple of days later, the humidified oxygen mask came back on. And not long after that, the patient again asked for me to come close.

This time he said: “I’m tired. I want to stop the chemo.”

Just before he died, a little over a week later, he was off all treatment except for what might make him comfortable. He thanked me and the other doctors for our care, but really, we should have thanked him and apologized. Because he had pushed us out of our comfortable, well-delineated professional zones. He had prodded us to talk to one another. And he showed us how to work as a team in order to do, at last, what we should have done weeks earlier.

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Buffet, 3G to buy Heinz for $23B

Warren Buffett's Berkshire Hathaway and private equity firm 3G Capital will buy ketchup and baby food maker H.J. Heinz Co for $23.2 billion in cash, a deal that combines 3G's ambitions in the food industry with Buffett's hunt for growth.

Including debt assumption, Heinz valued the transaction, which it called the largest in its industry's history, at $28 billion. Berkshire and 3G will pay $72.50 per share, a 19 percent premium to the stock's previous all-time high. Heinz shares actually rose slightly above the offer price, although Buffett cautioned he had no intention of raising his bid.

Analysts said the deal could be the first step in a broader wave of mergers for the food and beverage industry.

"Maybe for the consumer staples group in general this may start some talk about consolidation. Even corporate entities are flush with cash, interest rates are low, it would seemingly make sense," Edward Jones analyst Jack Russo said.

Companies like General Mills and Campbell Soup - itself long seen as a potential Heinz merge partner - rose on the news.

BUFFETT HUNTING GROWTH

The surprise purchase satisfies, at least in part, Buffett's hunt for growth through acquisition. He was frustrated in 2012 by the collapse of at least two deals in excess of $20 billion and said he might have to do a $30 billion deal this year to help fuel Berkshire's growth engine. In this case, Berkshire is putting up about $12 billion to $13 billion cash, Buffett told CNBC, leaving it ample room for another major transaction.

Berkshire Hathaway already has a variety of food assets, including the Dairy Queen ice cream chain, chocolatier See's Candies and the food distributor McLane. Buffett, famed for a love of cheeseburgers, joked he was well acquainted with Heinz's products already and that this was "my kind of deal."

It does represent an unusual teaming of Berkshire with private equity, though; historically, Buffett's purchases have been outright his own. He and 3G founder Jorge Paulo Lemann have known each other for years, and Buffett said Lemann approached him with the Heinz idea in December. One Berkshire investor said he had mixed feelings about the deal because of the limited growth prospects domestically.

"We're a little hesitant on the staple companies because they don't have any leverage in the United States," said Bill Smead, chief investment officer of Smead Capital Management in Seattle. But at the same time, he said, Buffett was likely willing to accept a bond-like steady return even if it was not necessarily a "home run."

3G EXPANDS

For 3G, a little-known firm with Brazilian roots, the purchase is something of a natural complement to its investment in fast-food chain Burger King, which it acquired in late 2010 and in which it still holds a major stake. Lemann, a globe-trotting financier with Swiss roots, made his money in banking and gained notoriety for helping to pull together the deals that ultimately formed the beer brewing giant AB InBev.

3G's Alex Behring runs the fund out of New York. He appeared at a Pittsburgh news conference on Thursday with Heinz management to discuss the deal - and to reassure anxious local crowds that the company will remain based there and will continue to support local philanthropy.

But at the same time, Behring said it was too soon to talk about cost cuts at the company. Unlike Berkshire, which is a hands-off operator, 3G is known for aggressively controlling costs at its operations.

PITTSBURGH ROOTS Also to be determined is whether CEO Bill Johnson would stay on. Only the fifth chairman in the company's history, Johnson is widely credited with Heinz's recent strong growth.

"I am way too young to retire," he told the news conference, adding that discussions had not yet started with 3G over the details of Heinz's future management.

The company, known for its iconic ketchup bottles, Heinz 57 sauces as well as other brands including Ore-Ida frozen potatoes, has increased net sales for the last eight fiscal years in a row.

Heinz said the transaction would be financed with cash from Berkshire and 3G, debt rollover and debt financing from J.P. Morgan and Wells Fargo. Buffett told CNBC that Berkshire and 3G would be equal equity partners.

Heinz shares soared 19.9 percent, or $12.06, to $72.54 on the New York Stock Exchange. A week ago the stock hit a long-term high of $61 a share - near records it set in 1998 - having risen almost 5 percent this year and nearly 12 percent since the beginning of 2012.

The deal is also a potential boon for new U.S. Secretary of State John Kerry, whose wife Teresa is the widow of H.J. Heinz Co heir John Heinz.

Kerry's most recent financial disclosures from his time in the U.S. Senate show a position in Heinz shares of more than $1 million, although the precise size is unclear.

Centerview Partners and BofA Merrill Lynch were financial advisers to Heinz, with Davis Polk & Wardwell LLP the legal adviser. Moelis & Company was financial adviser to the transaction committee of Heinz's board and Wachtell, Lipton, Rosen & Katz served as its legal adviser. Lazard served as lead financial adviser. J.P. Morgan and Wells Fargo also served as financial advisers to the investment consortium. Kirkland & Ellis LLP was legal adviser to 3G Capital, and Munger, Tolles & Olson LLP was legal adviser to Berkshire Hathaway.

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Phys Ed: Getting the Right Dose of Exercise

Phys Ed

Gretchen Reynolds on the science of fitness.

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A common concern about exercise is that if you don’t do it almost every day, you won’t achieve much health benefit. But a commendable new study suggests otherwise, showing that a fairly leisurely approach to scheduling workouts may actually be more beneficial than working out almost daily.

For the new study, published this month in Exercise & Science in Sports & Medicine, researchers at the University of Alabama at Birmingham gathered 72 older, sedentary women and randomly assigned them to one of three exercise groups.

One group began lifting weights once a week and performing an endurance-style workout, like jogging or bike riding, on another day.

Another group lifted weights twice a week and jogged or rode an exercise bike twice a week.

The final group, as you may have guessed, completed three weight-lifting and three endurance sessions, or six weekly workouts.

The exercise, which was supervised by researchers, was easy at first and meant to elicit changes in both muscles and endurance. Over the course of four months, the intensity and duration gradually increased, until the women were jogging moderately for 40 minutes and lifting weights for about the same amount of time.

The researchers were hoping to find out which number of weekly workouts would be, Goldilocks-like, just right for increasing the women’s fitness and overall weekly energy expenditure.

Some previous studies had suggested that working out only once or twice a week produced few gains in fitness, while exercising vigorously almost every day sometimes led people to become less physically active, over all, than those formally exercising less. Researchers theorized that the more grueling workout schedule caused the central nervous system to respond as if people were overdoing things, sending out physiological signals that, in an unconscious internal reaction, prompted them to feel tired or lethargic and stop moving so much.

To determine if either of these possibilities held true among their volunteers, the researchers in the current study tracked the women’s blood levels of cytokines, a substance related to stress that is thought to be one of the signals the nervous system uses to determine if someone is overdoing things physically. They also measured the women’s changing aerobic capacities, muscle strength, body fat, moods and, using sophisticated calorimetry techniques, energy expenditure over the course of each week.

By the end of the four-month experiment, all of the women had gained endurance and strength and shed body fat, although weight loss was not the point of the study. The scientists had not asked the women to change their eating habits.

There were, remarkably, almost no differences in fitness gains among the groups. The women working out twice a week had become as powerful and aerobically fit as those who had worked out six times a week. There were no discernible differences in cytokine levels among the groups, either.

However, the women exercising four times per week were now expending far more energy, over all, than the women in either of the other two groups. They were burning about 225 additional calories each day, beyond what they expended while exercising, compared to their calorie burning at the start of the experiment.

The twice-a-week exercisers also were using more energy each day than they had been at first, burning almost 100 calories more daily, in addition to the calories used during workouts.

But the women who had been assigned to exercise six times per week were now expending considerably less daily energy than they had been at the experiment’s start, the equivalent of almost 200 fewer calories each day, even though they were exercising so assiduously.

“We think that the women in the twice-a-week and four-times-a-week groups felt more energized and physically capable” after several months of training than they had at the start of the study, says Gary Hunter, a U.A.B. professor who led the experiment. Based on conversations with the women, he says he thinks they began opting for stairs over escalators and walking for pleasure.

The women working out six times a week, though, reacted very differently. “They complained to us that working out six times a week took too much time,” Dr. Hunter says. They did not report feeling fatigued or physically droopy. Their bodies were not producing excessive levels of cytokines, sending invisible messages to the body to slow down.

Rather, they felt pressed for time and reacted, it seems, by making choices like driving instead of walking and impatiently avoiding the stairs.

Despite the cautionary note, those who insist on working out six times per week need not feel discouraged. As long as you consciously monitor your activity level, the findings suggest, you won’t necessarily and unconsciously wind up moving less over all.

But the more fundamental finding of this study, Dr. Hunter says, is that “less may be more,” a message that most likely resonates with far more of us. The women exercising four times a week “had the greatest overall increase in energy expenditure,” he says. But those working out only twice a week “weren’t far behind.”

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