Syrian Rebels Claim to Kill Dozens of Soldiers

SANA, via Associated Press

An image released by Syria’s official news agency showed Damascus residents gathering at the scene of a blast on Monday.

BEIRUT, Lebanon — Syria was convulsed by one of the most violent days in months on Monday, with heavy fighting reported around Palestinian neighborhoods in southern Damascus, at least two car-bomb explosions and strikes by government aircraft on numerous rebel targets.

Sharply conflicting accounts emerged from the government and the rebels on the toll from a car bombing near the central city of Hama, with the rebels reporting dozens of soldiers dead and the government saying just two civilians were killed.

The Syrian Observatory for Human Rights, a group based in Britain with a network of contacts inside Syria, said that Jabhet al-Nusra, a jihadist organization, and other rebel groups in the region collaborated in a suicide car bombing of a government checkpoint in a village near Hama, killing at least 50 soldiers.

“They targeted one of the biggest checkpoints in the region. It’s a big building where the regime forces were headquartered,” said Ahmad Raadoun, a member of the Free Syrian Army in the Hama suburbs, who was reached via Skype.

Mr. Raadoun, who said he was about 20 miles from the village of Ziyara, where the attack took place, said the bomb caused extensive casualties and other damage in what he described as a “big operation.”

The official news agency, SANA, said the explosion, outside a government building called the Rural Development Center, was orchestrated by terrorist groups and left 2 civilians dead and 10 wounded. The government has repeatedly labeled opposition groups seeking to topple President Bashar al-Assad as terrorist organizations.

The reasons for such divergent accounts could not be immediately ascertained.

Checkpoints in rural areas often serve as rudimentary bases for the government, with large numbers of men and matériel stationed in them to carry the fight across the province.

Another car bombing was reported in Mazzeh 86, a Damascus neighborhood on the slopes below the presidential palace, home to many members of the security forces. The forces are dominated by members of Mr. Assad’s Alawite minority, which controls the country.

The Free Syrian Army claimed responsibility for that attack, saying in a statement that its fighters had targeted officers as well as members of the armed militias who fight for the government. The statement, posted on Facebook, claimed a large number of casualties but did not give any figures.

The Syrian Observatory said the bomb, which it described as a booby-trapped car that exploded in Bride Square, killed 5 people and wounded more than 30, some of them critically.

Pictures posted on Facebook showed a large column of smoke rising from the area.

Damascus residents reached by telephone said that they were trying to flee the heavy fighting, but that there was so much going on in every direction that they did not quite know where to run.

“There is very, very intense shelling on southern Damascus right now,” said an activist reached by Skype who goes by Abu Qays al-Shami. At least 10 people were killed as government helicopters and tanks blasted the area, he said.

Residents said the fighting had erupted in and around the Yarmouk camp in southern Damascus, the center of Palestinian life in Syria for decades. Many Palestinians have sided with the nearly 20-month-old anti-Assad uprising, but the Popular Front for the Liberation of Palestine-General Command, a splinter Palestinian group long supported by the government, still backs Mr. Assad. The fighting erupted between the organization and government opponents.

Elsewhere in southern Damascus, government helicopters were shelling the restive neighborhood of Hajjar al-Aswad, a target of frequent attacks in recent weeks, according to the Local Coordinating Committees, an anti-Assad activist group that keeps track of casualties. SANA said five people were killed in Yarmouk, including a woman and three children, when a mortar shell hit a public minibus. The agency blamed terrorist organizations.

In its daily roundup of violence around the country, SANA also said that government forces clashed with opposition groups in the eastern city of Deir ez-Zour and in Aleppo, the northern city that has been a battleground since midsummer.

Activist organizations reported a number of airstrikes around the country.

One extremely graphic video posted from the village of Kafrnabel, near Idlib, shows bloodied victims dumped into a truck in the aftermath of what was described as an aerial assault. A shot of the main street shows flames leaping from vehicles and residents running around in panic. At least five men and one woman died, the Syrian Observatory said, but more victims were believed buried under the rubble. Video accounts cannot be independently confirmed.

Hania Mourtada contributed reporting from Beirut, and Hala Droubi from Dubai, United Arab Emirates.

Read More..

Massive Open Online Courses Are Multiplying at a Rapid Pace

Clockwise, from top left: an online course in circuits and electronics with an M.I.T. professor (edX); statistics, Stanford (Udacity); machine learning, Stanford (Coursera); organic chemistry, University of Illinois, Urbana (Coursera).

IN late September, as workers applied joint compound to new office walls, hoodie-clad colleagues who had just met were working together on deadline. Film editors, code-writing interns and “edX fellows” — grad students and postdocs versed in online education — were translating videotaped lectures into MOOCs, or massive open online courses. As if anyone needed reminding, a row of aqua Post-its gave the dates the courses would “go live.”

The paint is barely dry, yet edX, the nonprofit start-up from Harvard and the Massachusetts Institute of Technology, has 370,000 students this fall in its first official courses. That’s nothing. Coursera, founded just last January, has reached more than 1.7 million — growing “faster than Facebook,” boasts Andrew Ng, on leave from Stanford to run his for-profit MOOC provider.

“This has caught all of us by surprise,” says David Stavens, who formed a company called Udacity with Sebastian Thrun and Michael Sokolsky after more than 150,000 signed up for Dr. Thrun’s “Introduction to Artificial Intelligence” last fall, starting the revolution that has higher education gasping. A year ago, he marvels, “we were three guys in Sebastian’s living room and now we have 40 employees full time.”

“I like to call this the year of disruption,” says Anant Agarwal, president of edX, “and the year is not over yet.”

MOOCs have been around for a few years as collaborative techie learning events, but this is the year everyone wants in. Elite universities are partnering with Coursera at a furious pace. It now offers courses from 33 of the biggest names in postsecondary education, including Princeton, Brown, Columbia and Duke. In September, Google unleashed a MOOC-building online tool, and Stanford unveiled Class2Go with two courses.

Nick McKeown is teaching one of them, on computer networking, with Philip Levis (the one with a shock of magenta hair in the introductory video). Dr. McKeown sums up the energy of this grand experiment when he gushes, “We’re both very excited.” Casually draped over auditorium seats, the professors also acknowledge that they are not exactly sure how this MOOC stuff works.

“We are just going to see how this goes over the next few weeks,” says Dr. McKeown.

WHAT IS A MOOC ANYWAY?

Traditional online courses charge tuition, carry credit and limit enrollment to a few dozen to ensure interaction with instructors. The MOOC, on the other hand, is usually free, credit-less and, well, massive.

Because anyone with an Internet connection can enroll, faculty can’t possibly respond to students individually. So the course design — how material is presented and the interactivity — counts for a lot. As do fellow students. Classmates may lean on one another in study groups organized in their towns, in online forums or, the prickly part, for grading work.

The evolving form knits together education, entertainment (think gaming) and social networking. Unlike its antecedent, open courseware — usually written materials or videotapes of lectures that make you feel as if you’re spying on a class from the back of the room — the MOOC is a full course made with you in mind.

The medium is still the lecture. Thanks to Khan Academy’s free archive of snappy instructional videos, MOOC makers have gotten the memo on the benefit of brevity: 8 to 12 minutes is typical. Then — this is key — videos pause perhaps twice for a quiz to make sure you understand the material or, in computer programming, to let you write code. Feedback is electronic. Teaching assistants may monitor discussion boards. There may be homework and a final exam.

The MOOC certainly presents challenges. Can learning be scaled up this much? Grading is imperfect, especially for nontechnical subjects. Cheating is a reality. “We found groups of 20 people in a course submitting identical homework,” says David Patterson, a professor at the University of California, Berkeley, who teaches software engineering, in a tone of disbelief at such blatant copying; Udacity and edX now offer proctored exams.

Some students are also ill prepared for the university-level work. And few stick with it. “Signing up for a class is a lightweight process,” says Dr. Ng. It might take just five minutes, assuming you spend two devising a stylish user name. Only 46,000 attempted the first assignment in Dr. Ng’s course on machine learning last fall. In the end, he says, 13,000 completed the class and earned a certificate — from him, not Stanford.

Laura Pappano is author of “Inside School Turnarounds” and writer in residence at the Wellesley Centers for Women.

This article has been revised to reflect the following correction:

Correction: November 4, 2012

An earlier version of this article, using information from Coursera, misidentified the source of a study of peer grading in a Princeton sociology MOOC. The study is by Mitchell Duneier, the course’s teacher, not Coursera. Also, the student work was regraded by Professor Duneier and his assistants, not by Princeton instructors. Results have not been released. Also, the article misspelled the surname of a Udacity co-founder. He is Michael Sokolsky, not Sokolosky.

Read More..

A Wheelchair Tour of Morningside College in Sioux City, Iowa

Brian Lehmann for The New York Times

Alex Watters does a wheelie in a parking lot at his alma mater, Morningside College in Sioux City, Iowa. He damaged his spine in a diving accident freshman year. More Photos »

THE specially equipped Dodge Sprinter pulled into the Morningside College parking lot, transporting my campus guide and his Quickie 646 SE motorized wheelchair. Alex Watters was returning to this small liberal arts college in Sioux City, Iowa, for a wheelchair tour of the campus he had navigated as an undergraduate. Our mission was to understand some of the challenges faced by students with a physical disability for a book I was writing on the first-year college experience.

Brian Lehmann for The New York Times

A caregiver, Jennifer Mozak-Wubbena, helps Alex Watters prepare for the day. Mr. Watters can’t use his hands. More Photos »

I stuck my hand out. Alex could raise his arm but had no mobility in his hands, so I shook his outstretched fist. Freshman year, he had damaged his spinal cord in a diving accident and lost the use of his legs and hands. “Ready to go?” he asked as I grabbed my manually operated wheelchair, on loan from the nursing department.

“Ready as ever,” I said, not altogether sure how to operate the thing. As I struggled to get over the tiny ribbon of tar between the parking lot and sidewalk, Alex zipped around the lot doing wheelies, as if to say, “You have no idea what you’re in for.”

Motoring backward while talking, like an admissions office tour guide, he was contagiously optimistic. “Sure, I have challenges now,” he said, “but I’m not going to let them take over my life.”

ALEX WATTERS comes from Okoboji, a small town in the northwest corner of Iowa, on the border with Minnesota. He had applied to the University of Iowa and Drake but chose Morningside because he was heavily recruited to play golf. He had been captain of his high school team junior and senior years. When he arrived on campus — it was fall 2004 — he was full of excitement and expectation.

The second week there, Danielle Westphal — a classmate with whom he had won a dance contest during orientation — invited him to a family get-together on Lake Okoboji. He and a friend drove up to the cabin, arriving at about 10 p.m. As the guests toasted marshmallows around a bonfire, Alex and his hostess’s younger brother decided to go for a swim. The weather was beginning to get cold. He figured this would be his last swim of the season.

The two of them changed into their trunks and walked 150 feet out onto the dock. A gust of wind blew, and Alex’s hat flew off, landing near a boat hoist. He took off his shirt and dived in after it. But there was a sandbar. The water was only 18 inches deep. He heard his neck snap.

“I remember laying face-first underwater,” Alex said, a crack in his voice. “At first I tried to start swimming, but of course I couldn’t move. I thought, this was it. I’m a pretty religious person, so I was thinking, ‘I’m O.K. with this if it happens.’ And then I blacked out.”

At first the young boy thought Alex was playing a joke on him. Then he sensed something was terribly wrong. He ran back to the cabin to get help. They came running, and Danielle jumped into the water feetfirst and knelt beside Alex. He had now been under water more than two minutes. She turned him over and gave him mouth-to-mouth resuscitation. E.M.S. arrived, and from the local hospital he was quickly airlifted to Mercy Medical Center in Sioux City.

“Next thing I remember are Mom and Dad and our pastor standing by my bed and the surgeon telling them about the operation I would soon have,” he told me. His spinal cord wasn’t severed but pinched. “Your spinal cord is like a banana,” Alex said. “If you bend it severely enough it won’t necessarily break but it will be permanently damaged.”

After surgery to stabilize the vertebrae in his neck, Alex underwent therapy for six months at a rehabilitation hospital in Denver. I asked him what he was feeling at this point. He and his parents had become interested in stem cell research, and the possibility he would someday walk again. “But I really didn’t want to live my life hoping I would walk again when the chances were I might not,” he said. “Even at that point, I was pretty happy with who I was and even then I was thinking about the possibility of returning to college.”

He took courses at Iowa Lakes Community College that summer, and the next fall returned to Morningside to resume his first year.

Roger H. Martin is president emeritus of Randolph-Macon College and author of “Racing Odysseus: A College President Becomes a Freshman Again.”

Read More..

A Wheelchair Tour of Morningside College in Sioux City, Iowa

Brian Lehmann for The New York Times

Alex Watters does a wheelie in a parking lot at his alma mater, Morningside College in Sioux City, Iowa. He damaged his spine in a diving accident freshman year. More Photos »

THE specially equipped Dodge Sprinter pulled into the Morningside College parking lot, transporting my campus guide and his Quickie 646 SE motorized wheelchair. Alex Watters was returning to this small liberal arts college in Sioux City, Iowa, for a wheelchair tour of the campus he had navigated as an undergraduate. Our mission was to understand some of the challenges faced by students with a physical disability for a book I was writing on the first-year college experience.

Brian Lehmann for The New York Times

A caregiver, Jennifer Mozak-Wubbena, helps Alex Watters prepare for the day. Mr. Watters can’t use his hands. More Photos »

I stuck my hand out. Alex could raise his arm but had no mobility in his hands, so I shook his outstretched fist. Freshman year, he had damaged his spinal cord in a diving accident and lost the use of his legs and hands. “Ready to go?” he asked as I grabbed my manually operated wheelchair, on loan from the nursing department.

“Ready as ever,” I said, not altogether sure how to operate the thing. As I struggled to get over the tiny ribbon of tar between the parking lot and sidewalk, Alex zipped around the lot doing wheelies, as if to say, “You have no idea what you’re in for.”

Motoring backward while talking, like an admissions office tour guide, he was contagiously optimistic. “Sure, I have challenges now,” he said, “but I’m not going to let them take over my life.”

ALEX WATTERS comes from Okoboji, a small town in the northwest corner of Iowa, on the border with Minnesota. He had applied to the University of Iowa and Drake but chose Morningside because he was heavily recruited to play golf. He had been captain of his high school team junior and senior years. When he arrived on campus — it was fall 2004 — he was full of excitement and expectation.

The second week there, Danielle Westphal — a classmate with whom he had won a dance contest during orientation — invited him to a family get-together on Lake Okoboji. He and a friend drove up to the cabin, arriving at about 10 p.m. As the guests toasted marshmallows around a bonfire, Alex and his hostess’s younger brother decided to go for a swim. The weather was beginning to get cold. He figured this would be his last swim of the season.

The two of them changed into their trunks and walked 150 feet out onto the dock. A gust of wind blew, and Alex’s hat flew off, landing near a boat hoist. He took off his shirt and dived in after it. But there was a sandbar. The water was only 18 inches deep. He heard his neck snap.

“I remember laying face-first underwater,” Alex said, a crack in his voice. “At first I tried to start swimming, but of course I couldn’t move. I thought, this was it. I’m a pretty religious person, so I was thinking, ‘I’m O.K. with this if it happens.’ And then I blacked out.”

At first the young boy thought Alex was playing a joke on him. Then he sensed something was terribly wrong. He ran back to the cabin to get help. They came running, and Danielle jumped into the water feetfirst and knelt beside Alex. He had now been under water more than two minutes. She turned him over and gave him mouth-to-mouth resuscitation. E.M.S. arrived, and from the local hospital he was quickly airlifted to Mercy Medical Center in Sioux City.

“Next thing I remember are Mom and Dad and our pastor standing by my bed and the surgeon telling them about the operation I would soon have,” he told me. His spinal cord wasn’t severed but pinched. “Your spinal cord is like a banana,” Alex said. “If you bend it severely enough it won’t necessarily break but it will be permanently damaged.”

After surgery to stabilize the vertebrae in his neck, Alex underwent therapy for six months at a rehabilitation hospital in Denver. I asked him what he was feeling at this point. He and his parents had become interested in stem cell research, and the possibility he would someday walk again. “But I really didn’t want to live my life hoping I would walk again when the chances were I might not,” he said. “Even at that point, I was pretty happy with who I was and even then I was thinking about the possibility of returning to college.”

He took courses at Iowa Lakes Community College that summer, and the next fall returned to Morningside to resume his first year.

Roger H. Martin is president emeritus of Randolph-Macon College and author of “Racing Odysseus: A College President Becomes a Freshman Again.”

Read More..

Benghazi Attack Raises Doubts About U.S. Abilities in Region

Esam Omran Al-Fetori/Reuters

The attack at the American Mission on Sept. 11, seen here, and an annex in Benghazi, Libya, points to a limitation in the capabilities of the American military command responsible for countries swept up in the Arab Spring.

WASHINGTON — About three hours after the American diplomatic mission in Benghazi, Libya, came under attack, the Pentagon issued an urgent call for an array of quick-reaction forces, including an elite Special Forces team that was on a training mission in Croatia.

The team dropped what it was doing and prepared to move to the Sigonella naval air station in Sicily, a short flight from Benghazi and other hot spots in the region. By the time the unit arrived at the base, however, the surviving Americans at the Benghazi mission had been evacuated to Tripoli, and Ambassador J. Christopher Stevens and three other Americans were dead.

The assault, on the anniversary of the Sept. 11, 2001, attacks on the United States, has already exposed shortcomings in the Obama administration’s ability to secure diplomatic missions and act on intelligence warnings. But this previously undisclosed episode, described by several American officials, points to a limitation in the capabilities of the American military command responsible for a large swath of countries swept up in the Arab Spring.

At the heart of the issue is the Africa Command, established in 2007, well before the Arab Spring uprisings and before an affiliate of Al Qaeda became a major regional threat. It did not have on hand what every other regional combatant command has: its own force able to respond rapidly to emergencies — a Commanders’ In-Extremis Force, or C.I.F.

To respond to the Benghazi attack, the Africa Command had to borrow the C.I.F. that belongs to the European Command, because its own force is still in training. It also had no AC-130 gunships or armed drones readily available.

As officials in the White House and Pentagon scrambled to respond to the torrent of reports pouring out from Libya — with Mr. Stevens missing and officials worried that he might have been taken hostage — they took the extraordinary step of sending elite Delta Force commandos, with their own helicopters and ground vehicles, from their base at Fort Bragg, N.C., to Sicily. Those troops also arrived too late.

“The fact of the matter is these forces were not in place until after the attacks were over,” a Pentagon spokesman, George Little, said on Friday, referring to a range of special operations soldiers and other personnel. “We did respond. The secretary ordered forces to move. They simply were not able to arrive in time.”

An examination of these tumultuous events undercuts the criticism leveled by some Republicans that the Obama administration did not try to respond militarily to the crisis. The attack was not a running eight-hour firefight as some critics have contended, questioning how an adequate response could not be mustered in that time, but rather two relatively short, intense assaults separated by a lull of four hours. But the administration’s response also shows that the forces in the region had not been adequately reconfigured.

The Africa Command was spun off from the European Command. At the time it was set up, the Pentagon thought it would be devoted mostly to training African troops and building military ties with African nations. Because of African sensitivities about an overt American military presence in the region, the command’s headquarters was established in Stuttgart, Germany.

While the other regional commands, including the Pacific Command and the Central Command, responsible for the Middle East and South Asia, have their own specialized quick-reaction forces, the Africa Command has had an arrangement to borrow the European Command’s force when needed. The Africa Command has been building its own team from scratch, and its nascent strike force was in the process of being formed in the United States on Sept. 11, a senior military official said.

“The conversation about getting them closer to Africa has new energy,” the military official said.

Some Pentagon officials said that it was unrealistic to think a quick-reaction force could have been sent in time even if the African Command had one ready to act on the base in Sicily when the attack unfolded, and asserted that such a small force might not have even been effective or the best means to protect an embassy. But critics say there has been a gap in the command’s quick-reaction capability, which the force would have helped fill.

A spokesman for the command declined to comment on how its capabilities might be improved.

Read More..

Massive Open Online Courses Are Multiplying at a Rapid Pace

Clockwise, from top left: an online course in circuits and electronics with an M.I.T. professor (edX); statistics, Stanford (Udacity); machine learning, Stanford (Coursera); organic chemistry, University of Illinois, Urbana (Coursera).

IN late September, as workers applied joint compound to new office walls, hoodie-clad colleagues who had just met were working together on deadline. Film editors, code-writing interns and “edX fellows” — grad students and postdocs versed in online education — were translating videotaped lectures into MOOCs, or massive open online courses. As if anyone needed reminding, a row of aqua Post-its gave the dates the courses would “go live.”

The paint is barely dry, yet edX, the nonprofit start-up from Harvard and the Massachusetts Institute of Technology, has 370,000 students this fall in its first official courses. That’s nothing. Coursera, founded just last January, has reached more than 1.7 million — growing “faster than Facebook,” boasts Andrew Ng, on leave from Stanford to run his for-profit MOOC provider.

“This has caught all of us by surprise,” says David Stavens, who formed a company called Udacity with Sebastian Thrun and Mike Sokolosky after more than 150,000 signed up for Dr. Thrun’s “Introduction to Artificial Intelligence” last fall, starting the revolution that has higher education gasping. A year ago, he marvels, “we were three guys in Sebastian’s living room and now we have 40 employees full time.”

“I like to call this the year of disruption,” says Anant Agarwal, president of edX, “and the year is not over yet.”

MOOCs have been around for a few years as collaborative techie learning events, but this is the year everyone wants in. Elite universities are partnering with Coursera at a furious pace. It now offers courses from 33 of the biggest names in postsecondary education, including Princeton, Brown, Columbia and Duke. In September, Google unleashed a MOOC-building online tool, and Stanford unveiled Class2Go with two courses.

Nick McKeown is teaching one of them, on computer networking, with Philip Levis (the one with a shock of magenta hair in the introductory video). Dr. McKeown sums up the energy of this grand experiment when he gushes, “We’re both very excited.” Casually draped over auditorium seats, the professors also acknowledge that they are not exactly sure how this MOOC stuff works.

“We are just going to see how this goes over the next few weeks,” says Dr. McKeown.

WHAT IS A MOOC ANYWAY?

Traditional online courses charge tuition, carry credit and limit enrollment to a few dozen to ensure interaction with instructors. The MOOC, on the other hand, is usually free, credit-less and, well, massive.

Because anyone with an Internet connection can enroll, faculty can’t possibly respond to students individually. So the course design — how material is presented and the interactivity — counts for a lot. As do fellow students. Classmates may lean on one another in study groups organized in their towns, in online forums or, the prickly part, for grading work.

The evolving form knits together education, entertainment (think gaming) and social networking. Unlike its antecedent, open courseware — usually written materials or videotapes of lectures that make you feel as if you’re spying on a class from the back of the room — the MOOC is a full course made with you in mind.

The medium is still the lecture. Thanks to Khan Academy’s free archive of snappy instructional videos, MOOC makers have gotten the memo on the benefit of brevity: 8 to 12 minutes is typical. Then — this is key — videos pause perhaps twice for a quiz to make sure you understand the material or, in computer programming, to let you write code. Feedback is electronic. Teaching assistants may monitor discussion boards. There may be homework and a final exam.

The MOOC certainly presents challenges. Can learning be scaled up this much? Grading is imperfect, especially for nontechnical subjects. Cheating is a reality. “We found groups of 20 people in a course submitting identical homework,” says David Patterson, a professor at the University of California, Berkeley, who teaches software engineering, in a tone of disbelief at such blatant copying; Udacity and edX now offer proctored exams.

Some students are also ill prepared for the university-level work. And few stick with it. “Signing up for a class is a lightweight process,” says Dr. Ng. It might take just five minutes, assuming you spend two devising a stylish user name. Only 46,000 attempted the first assignment in Dr. Ng’s course on machine learning last fall. In the end, he says, 13,000 completed the class and earned a certificate — from him, not Stanford.

Laura Pappano is author of “Inside School Turnarounds” and writer in residence at the Wellesley Centers for Women.

Read More..

Opinion: Seeing Things? Hearing Things? Many of Us Do

HALLUCINATIONS are very startling and frightening: you suddenly see, or hear or smell something — something that is not there. Your immediate, bewildered feeling is, what is going on? Where is this coming from? The hallucination is convincingly real, produced by the same neural pathways as actual perception, and yet no one else seems to see it. And then you are forced to the conclusion that something — something unprecedented — is happening in your own brain or mind. Are you going insane, getting dementia, having a stroke?

In other cultures, hallucinations have been regarded as gifts from the gods or the Muses, but in modern times they seem to carry an ominous significance in the public (and also the medical) mind, as portents of severe mental or neurological disorders. Having hallucinations is a fearful secret for many people — millions of people — never to be mentioned, hardly to be acknowledged to oneself, and yet far from uncommon. The vast majority are benign — and, indeed, in many circumstances, perfectly normal. Most of us have experienced them from time to time, during a fever or with the sensory monotony of a desert or empty road, or sometimes, seemingly, out of the blue.

Many of us, as we lie in bed with closed eyes, awaiting sleep, have so-called hypnagogic hallucinations — geometric patterns, or faces, sometimes landscapes. Such patterns or scenes may be almost too faint to notice, or they may be very elaborate, brilliantly colored and rapidly changing — people used to compare them to slide shows.

At the other end of sleep are hypnopompic hallucinations, seen with open eyes, upon first waking. These may be ordinary (an intensification of color perhaps, or someone calling your name) or terrifying (especially if combined with sleep paralysis) — a vast spider, a pterodactyl above the bed, poised to strike.

Hallucinations (of sight, sound, smell or other sensations) can be associated with migraine or seizures, with fever or delirium. In chronic disease hospitals, nursing homes, and I.C.U.’s, hallucinations are often a result of too many medications and interactions between them, compounded by illness, anxiety and unfamiliar surroundings.

But hallucinations can have a positive and comforting role, too — this is especially true with bereavement hallucinations, seeing the face or hearing the voice of one’s deceased spouse, siblings, parents or child — and may play an important part in the mourning process. Such bereavement hallucinations frequently occur in the first year or two of bereavement, when they are most “needed.”

Working in old-age homes for many years, I have been struck by how many elderly people with impaired hearing are prone to auditory and, even more commonly, musical hallucinations — involuntary music in their minds that seems so real that at first they may think it is a neighbor’s stereo.

People with impaired sight, similarly, may start to have strange, visual hallucinations, sometimes just of patterns but often more elaborate visions of complex scenes or ranks of people in exotic dress. Perhaps 20 percent of those losing their vision or hearing may have such hallucinations.

I was called in to see one patient, Rosalie, a blind lady in her 90s, when she started to have visual hallucinations; the staff psychiatrist was also summoned. Rosalie was concerned that she might be having a stroke or getting Alzheimer’s or reacting to some medication. But I was able to reassure her that nothing was amiss neurologically. I explained to her that if the visual parts of the brain are deprived of actual input, they are hungry for stimulation and may concoct images of their own. Rosalie was greatly relieved by this, and delighted to know that there was even a name for her condition: Charles Bonnet syndrome. “Tell the nurses,” she said, drawing herself up in her chair, “that I have Charles Bonnet syndrome!”

Rosalie asked me how many people had C.B.S., and I told her hundreds of thousands, perhaps, in the United States alone. I told her that many people were afraid to mention their hallucinations. I described a recent study of elderly blind patients in the Netherlands which found that only a quarter of people with C.B.S. mentioned it to their doctors — the others were too afraid or too ashamed. It is only when physicians gently inquire (often avoiding the word “hallucination”) that people feel free to admit seeing things that are not there — despite their blindness.

Rosalie was indignant at this, and said, “You must write about it — tell my story!” I do tell her story, at length, in my book on hallucinations, along with the stories of many others. Most of these people have been reluctant to admit to their hallucinations. Often, when they do, they are misdiagnosed or undiagnosed — told that it’s nothing, or that their condition has no explanation.

Misdiagnosis is especially common if people admit to “hearing voices.” In a famous 1973 study by the Stanford psychologist David Rosenhan, eight “pseudopatients” presented themselves at various hospitals across the country, saying that they “heard voices.” All behaved normally otherwise, but were nonetheless determined to be (and treated as) schizophrenic (apart from one, who was given the diagnosis of “manic-depressive psychosis”). In this and follow-up studies, Professor Rosenhan demonstrated convincingly that auditory hallucinations and schizophrenia were synonymous in the medical mind.

WHILE many people with schizophrenia do hear voices at certain times in their lives, the inverse is not true: most people who hear voices (as much as 10 percent of the population) are not mentally ill. For them, hearing voices is a normal mode of experience.

My patients tell me about their hallucinations because I am open to hearing about them, because they know me and trust that I can usually run down the cause of their hallucinations. For the most part, these experiences are unthreatening and, once accommodated, even mildly diverting.

David Stewart, a Charles Bonnet syndrome patient with whom I corresponded, writes of his hallucinations as being “altogether friendly,” and imagines his eyes saying: “Sorry to have let you down. We recognize that blindness is no fun, so we’ve organized this small syndrome, a sort of coda to your sighted life. It’s not much, but it’s the best we can manage.”

Mr. Stewart has been able to take his hallucinations in good humor, since he knows they are not a sign of mental decline or madness. For too many patients, though, the shame, the secrecy, the stigma, persists.

Oliver Sacks is a professor of neurology at the N.Y.U. School of Medicine and the author, most recently, of the forthcoming book “Hallucinations.”

Read More..

Opinion: Seeing Things? Hearing Things? Many of Us Do

HALLUCINATIONS are very startling and frightening: you suddenly see, or hear or smell something — something that is not there. Your immediate, bewildered feeling is, what is going on? Where is this coming from? The hallucination is convincingly real, produced by the same neural pathways as actual perception, and yet no one else seems to see it. And then you are forced to the conclusion that something — something unprecedented — is happening in your own brain or mind. Are you going insane, getting dementia, having a stroke?

In other cultures, hallucinations have been regarded as gifts from the gods or the Muses, but in modern times they seem to carry an ominous significance in the public (and also the medical) mind, as portents of severe mental or neurological disorders. Having hallucinations is a fearful secret for many people — millions of people — never to be mentioned, hardly to be acknowledged to oneself, and yet far from uncommon. The vast majority are benign — and, indeed, in many circumstances, perfectly normal. Most of us have experienced them from time to time, during a fever or with the sensory monotony of a desert or empty road, or sometimes, seemingly, out of the blue.

Many of us, as we lie in bed with closed eyes, awaiting sleep, have so-called hypnagogic hallucinations — geometric patterns, or faces, sometimes landscapes. Such patterns or scenes may be almost too faint to notice, or they may be very elaborate, brilliantly colored and rapidly changing — people used to compare them to slide shows.

At the other end of sleep are hypnopompic hallucinations, seen with open eyes, upon first waking. These may be ordinary (an intensification of color perhaps, or someone calling your name) or terrifying (especially if combined with sleep paralysis) — a vast spider, a pterodactyl above the bed, poised to strike.

Hallucinations (of sight, sound, smell or other sensations) can be associated with migraine or seizures, with fever or delirium. In chronic disease hospitals, nursing homes, and I.C.U.’s, hallucinations are often a result of too many medications and interactions between them, compounded by illness, anxiety and unfamiliar surroundings.

But hallucinations can have a positive and comforting role, too — this is especially true with bereavement hallucinations, seeing the face or hearing the voice of one’s deceased spouse, siblings, parents or child — and may play an important part in the mourning process. Such bereavement hallucinations frequently occur in the first year or two of bereavement, when they are most “needed.”

Working in old-age homes for many years, I have been struck by how many elderly people with impaired hearing are prone to auditory and, even more commonly, musical hallucinations — involuntary music in their minds that seems so real that at first they may think it is a neighbor’s stereo.

People with impaired sight, similarly, may start to have strange, visual hallucinations, sometimes just of patterns but often more elaborate visions of complex scenes or ranks of people in exotic dress. Perhaps 20 percent of those losing their vision or hearing may have such hallucinations.

I was called in to see one patient, Rosalie, a blind lady in her 90s, when she started to have visual hallucinations; the staff psychiatrist was also summoned. Rosalie was concerned that she might be having a stroke or getting Alzheimer’s or reacting to some medication. But I was able to reassure her that nothing was amiss neurologically. I explained to her that if the visual parts of the brain are deprived of actual input, they are hungry for stimulation and may concoct images of their own. Rosalie was greatly relieved by this, and delighted to know that there was even a name for her condition: Charles Bonnet syndrome. “Tell the nurses,” she said, drawing herself up in her chair, “that I have Charles Bonnet syndrome!”

Rosalie asked me how many people had C.B.S., and I told her hundreds of thousands, perhaps, in the United States alone. I told her that many people were afraid to mention their hallucinations. I described a recent study of elderly blind patients in the Netherlands which found that only a quarter of people with C.B.S. mentioned it to their doctors — the others were too afraid or too ashamed. It is only when physicians gently inquire (often avoiding the word “hallucination”) that people feel free to admit seeing things that are not there — despite their blindness.

Rosalie was indignant at this, and said, “You must write about it — tell my story!” I do tell her story, at length, in my book on hallucinations, along with the stories of many others. Most of these people have been reluctant to admit to their hallucinations. Often, when they do, they are misdiagnosed or undiagnosed — told that it’s nothing, or that their condition has no explanation.

Misdiagnosis is especially common if people admit to “hearing voices.” In a famous 1973 study by the Stanford psychologist David Rosenhan, eight “pseudopatients” presented themselves at various hospitals across the country, saying that they “heard voices.” All behaved normally otherwise, but were nonetheless determined to be (and treated as) schizophrenic (apart from one, who was given the diagnosis of “manic-depressive psychosis”). In this and follow-up studies, Professor Rosenhan demonstrated convincingly that auditory hallucinations and schizophrenia were synonymous in the medical mind.

WHILE many people with schizophrenia do hear voices at certain times in their lives, the inverse is not true: most people who hear voices (as much as 10 percent of the population) are not mentally ill. For them, hearing voices is a normal mode of experience.

My patients tell me about their hallucinations because I am open to hearing about them, because they know me and trust that I can usually run down the cause of their hallucinations. For the most part, these experiences are unthreatening and, once accommodated, even mildly diverting.

David Stewart, a Charles Bonnet syndrome patient with whom I corresponded, writes of his hallucinations as being “altogether friendly,” and imagines his eyes saying: “Sorry to have let you down. We recognize that blindness is no fun, so we’ve organized this small syndrome, a sort of coda to your sighted life. It’s not much, but it’s the best we can manage.”

Mr. Stewart has been able to take his hallucinations in good humor, since he knows they are not a sign of mental decline or madness. For too many patients, though, the shame, the secrecy, the stigma, persists.

Oliver Sacks is a professor of neurology at the N.Y.U. School of Medicine and the author, most recently, of the forthcoming book “Hallucinations.”

Read More..

Petraeus’s Lower C.I.A. Profile Leaves Benghazi Void

WASHINGTON — In 14 months as C.I.A. director, David H. Petraeus has shunned the spotlight he once courted as America’s most famous general. His low-profile style has won the loyalty of the White House, easing old tensions with President Obama, and he has overcome some of the skepticism he faced from the agency’s work force, which is always wary of the military brass.

Brendan Smialowski/Getty Images

The low-profile style of David H. Petraeus, right, has won the loyalty of the White House, easing old tensions with President Obama.

Win Mcnamee/Getty Images

C.I.A. director, David H. Petraeus, right, appeared before the Senate Select Committee on Intelligence in Washington in January.

But since an attack killed four Americans seven weeks ago in Benghazi, Libya, his deliberately low profile, and the C.I.A.’s penchant for secrecy, have left a void that has been filled by a news media and Congressional furor over whether it could have been prevented. Rather than acknowledge the C.I.A.’s presence in Benghazi, Mr. Petraeus and other agency officials fought a losing battle to keep it secret, even as the events there became a point of contention in the presidential campaign.

Finally, on Thursday, with Mr. Petraeus away on a visit to the Middle East, pressure from critics prompted intelligence officials to give their own account of the chaotic night when two security officers died along with the American ambassador, J. Christopher Stevens, and another diplomat. The officials acknowledged for the first time that the security officers, both former members of the Navy SEALs, worked on contract for the C.I.A., which occupied one of the buildings that were attacked.

The Benghazi crisis is the biggest challenge so far in the first civilian job held by Mr. Petraeus, who retired from the Army and dropped the “General” when he went to the C.I.A. He gets mostly high marks from government colleagues and outside experts for his overall performance. But the transition has meant learning a markedly different culture, at an agency famously resistant to outsiders.

“I think he’s a brilliant man, but he’s also a four-star general,” said Senator Dianne Feinstein, the chairwoman of the Senate Intelligence Committee. “Four-stars are saluted, not questioned. He’s now running an agency where everything is questioned, whether you’re a four-star or a senator. It’s a culture change.”

Mr. Petraeus, who turns 60 next week, has had to learn that C.I.A. officers will not automatically defer to his judgments, as military subordinates often did. “The attitude at the agency is, ‘You may be the director, but I’m the Thailand analyst,’ ” said one C.I.A. veteran.

Long a media star as the most prominent military leader of his generation, Mr. Petraeus abruptly abandoned that style at the C.I.A. Operating amid widespread complaints about leaks of classified information, he has stopped giving interviews, speaks to Congress in closed sessions and travels the globe to consult with foreign spy services with little news media notice.

“He thinks he has to be very discreet and let others in the government do the talking,” said Michael E. O’Hanlon, a Brookings Institution scholar who is a friend of Mr. Petraeus’s and a member of the C.I.A.’s advisory board.

Mr. Petraeus’s no-news, no-nonsense style stands out especially starkly against that of his effusive predecessor, Leon E. Panetta, who is now the defense secretary.

Mr. Panetta, a gregarious politician by profession, was unusually open with Congress and sometimes with the public — to a fault, some might say, when he spoke candidly after leaving the C.I.A. about a Pakistani doctor’s role in helping hunt for Osama bin Laden, or about the agency’s drone operations.

Mr. Petraeus’s discretion and relentless work ethic have had a positive side for him: old tensions with Mr. Obama, which grew out of differing views on the wars in Iraq and Afghanistan, appear to be gone. Mr. Petraeus is at the White House several times a week, attending National Security Council sessions and meeting weekly with James R. Clapper Jr., the director of national intelligence, and Thomas E. Donilon, Mr. Obama’s national security adviser. Mr. Donilon said recently that the C.I.A. director “has done an exceptional job,” bringing “deep experience, intellectual rigor and enthusiasm” to his work.

Read More..

Bits Blog: Data Shows Twitter Posts That Resonate With Electorate

In Florida, voters responded most when Mitt Romney posted about education and when President Obama did the same about foreign affairs. In Ohio, Mr. Obama’s posted about gay rights, more so than any other topic, held the most traction. For Mr. Romney, it was his posts about the economy.

Twitter introduced an interactive map on Thursday showing which of the candidates’ tweets drove the most engagement — measured by the number of times the tweet was reposted or favorited — on Twitter at the national and state levels.

Nationwide, Mr. Obama’s most popular post was, “No family should have to set aside a college acceptance letter because they don’t have the money.” His second most popular post was actually a quote from Vice President Biden about women’s rights:  “VP Biden: I do not believe that we have a right to tell other people, women, that they can’t control their bodies.” Interestingly, at the state level, that post resonated most with voters in Wyoming, followed by Iowa, South Dakota and West Virginia — states where women’s rights are not considered the pivotal issue.

Mr. Romney’s most popular post was this remark on Sept. 11th: “On this most somber day, America is united under God in its quest for peace and freedom at home and across the world.” Second most popular was a comment about wealth distribution: “I am running for president to get us creating wealth again – not to redistribute it.”

In swing states, Twitter’s map tells an interesting, and sometimes counter intuitive story. According to the latest polls, Virginia, Wisconsin, Ohio, Iowa, Nevada, New Hampshire, Colorado and Florida are still toss-ups.

In the last presidential election, the President won Virginia by seven percentage points. This year, the race is expected to be much closer. There, voters’ response was highest when the candidates posted about issues related to retirement.

The same was true for Wisconsin. Democrats carried the state in the last six presidential elections, but the addition of one of their own, Representative Paul D. Ryan, to Mr. Romney’s ticket has kept the race tight. There, retirement was also the issue that seemed to have the most traction on Twitter.

In Iowa, where six electoral votes are up for grabs, voters were most engaged when Mr. Obama posted about topics related to energy and the environment and when Romney posted about health care.

Nevada voters responded most to Obama’s comments on taxes. Mr. Obama’s most popular post in that state was “1,240,000 middle-class families in Nevada could face a tax increase under Mitt Romney.” Mr. Romney’s posts about education drove the highest level of engagement. “With over 60k jobs lost & the highest unemployment rate in the nation, Nevadans aren’t better off under @BarackObama,” was Mr. Romney’s most popular post.

In Colorado, women’s issues have taken center stage after women proved crucial to two Democratic victories in the 2010 races for Senate and governor. But according to Twitter’s data, Colorado voters responded in the largest numbers when Mr. Obama posted about taxes. For Mr. Romney, it was his remarks about terrorism.

If, as in the 2004 election, the race comes down to Florida, then the candidates may do well to defy conventional wisdom that retirement is all Florida voters care about. Within Florida, Mr. Romney’s posts about retirement did not resonate as well as those about education and foreign affairs. Likewise, Mr. Obama’s posts about topics relevant to retirement had less traction than his those about terrorism and foreign affairs.

Despite the perception that Twitter is just a place for East and West coasters to talk to each other, Twitter’s map shows a surprising level of engagement in states like Wyoming, Utah, Texas, Mississippi and Oklahoma. The opposite proved true for New Hampshire and Vermont, where Twitter noted it was not able to collect enough data to draw conclusions.

Read More..