For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

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Bits Blog: Disruptions: Apple Is Said to Be Developing a Curved-Glass Smart Watch

Dick Tracy had one. As did Inspector Gadget and James Bond. A watch that doubled as a computer, two-way radio, mapping device or television.

Though such a device has been lost to science fiction comics and spy movies of the era before smartphones, the smart watch might soon become a reality, in the form of a curved glass device made by Apple.

In its headquarters in Cupertino, Calif., Apple is experimenting with wristwatch-like devices made of curved glass, according to people familiar with the company’s explorations, who spoke on the condition that they not be named because they are not allowed to publicly discuss unreleased products. Such a watch would operate on Apple’s iOS platform, two people said, and stand apart from competitors based on the company’s understanding of how such glass can curve around the human body.

Apple declined to comment on its plans. But the exploration of such a watch leaves open lots of exciting questions: If the company does release such a product, what would it look like? Would it include Siri, the voice assistant? Would it have a version of Apple’s map software, offering real-time directions to people walking down the street? Could it receive text messages? Could it monitor a user’s health or daily activity? How much will it cost? Could Timothy D. Cook, Apple’s chief executive, be wearing one right now, whispering sweet nothings to his wrist?

Such a watch could also be used to make mobile payments, with Apple’s Passbook payment software.

Although it would take Dick Tracy to find the answers to those questions, and it’s uncertain when Apple might unveil such a device, it’s clear that Apple has the technology.

Last year, Corning, the maker of the ultra-tough Gorilla Glass that is used in the iPhone, announced that it had solved the difficult engineering challenge of creating bendable glass, called Willow Glass, that can flop as easily as a piece of paper in the wind without breaking.

Pete Bocko, the chief technology officer for Corning Glass Technologies, who worked on Willow Glass, said via telephone that the company had been developing the thin, flexible glass for more than a decade, and that the technology had finally arrived.

“You can certainly make it wrap around a cylindrical object and that could be someone’s wrist,” Mr. Bocko said. “Right now, if I tried to make something that looked like a watch, that could be done using this flexible glass.”

But Mr. Bocko warns that it is still quite an engineering feat to create a foldable device. “The human body moves in unpredictable ways,” he said. “It’s one of the toughest mechanical challenges.”

To add to the excitement of an Apple watch, late last year the Chinese gadget site Tech.163 reported that the company had begun development of a watch featuring Bluetooth and a 1.5-inch display.

“Apple’s certainly made a lot of hiring in that area,” said Sarah Rotman Epps, a Forrester analyst who specializes in wearable computing and smartphones. “Apple is already in the wearable space through its ecosystem partners that make accessories that connect to the iPhone,” she said, adding: “This makes Apple potentially the biggest player of the wearables market in a sort of invisible way.”

“Over the long term wearable computing is inevitable for Apple; devices are diversifying and the human body is a rich canvas for the computer,” Ms. Epps said. “But I’m not sure how close we are to a new piece of Apple hardware that is worn on the body.”

Investors would most likely embrace an iWatch, with some already saying that wearable computing could replace the smartphone over the next decade.

“We believe technology could progress to a point where consumers have a tablet plus wearable computers, like watches or glasses, that enable simple things like voice calls, texting, quick searches, navigation,” Gene Munster, an analyst at Piper Jaffray, said in a report last month. “These devices are likely to be cheaper than an iPhone and could ultimately be Apple’s best answer to addressing emerging markets.”

Mr. Cook is clearly interested in wearables. In the past he has been seen wearing a Nike FuelBand, which tracks a user’s daily exertion. The FuelBand data is shared wirelessly with an iPhone app.

Bob Mansfield, Apple’s senior vice president for technologies, who previously ran hardware engineering, has also been particularly interested in wearables, an Apple employee said. Mr. Mansfield is engrossed by devices that connect to the iPhone, through Bluetooth, sharing information back and forth from the human body to the phone, including the Nike FuelBand and Jawbone Up.

If smartphones do become smart watches and smart glasses, Apple seems to have the technology to make standout wearable computers.

Last year the company filed patents for displays that sit over the eye and stream information to the retina. Given that the iPod Nano is about the size of an overfed ant, the company clearly knows how to make small devices, too.

But, maybe there are other devices coming before wearables. Apple has long been rumored to be working on a television-like experience. And, there is the possibility of an Apple car.

In a meeting in his office before he died, Steven P. Jobs, Apple’s co-founder and former chief executive, told John Markoff of The New York Times that if he had more energy, he would have liked to take on Detroit with an Apple car.

In August, during the company’s patent trial with Samsung, Philip W. Schiller, Apple’s senior vice president for worldwide product marketing, said on the stand that Apple had explored making “crazy stuff” before development of the iPhone and iPad, including a camera or a car. While Apple continues its experiments with wearables, its biggest competitor, Google, is pressing ahead with plans to make wearable computers mainstream.

According to a Google executive who spoke on the condition that he not be named, the company hopes its wearable glasses, with a display that sits above the eye, will account for 3 percent of revenue by 2015. Olympus is also working on wearable computers.

Google is holding private workshops in San Francisco and New York for developers to start building applications for its glasses. At the event in San Francisco last week, Hosain Rahman, chief executive of Jawbone, the maker of the Up, a wrist device that tracks people’s energy and sleep, said that “a decade from now we won’t be able to imagine life without the wearables that we use to access information, unlock our doors, pay for goods and most importantly track our health.”

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Venezuela, Despite Myriad Problems, Seizes On a Hat

Carlos Garcia Rawlins/Reuters

Vice President Nicolás Maduro of Venezuela wore a patriotic cap to a parade Monday in Caracas.

CARACAS, Venezuela — Venezuela seems to lurch from one crisis to another. President Hugo Chávez has virtually disappeared since going to Cuba for cancer surgery more than eight weeks ago. Last month, 58 people were killed in a prison when inmates clashed with soldiers. Inflation is spiking, the government just announced a currency devaluation and lurid murders are the stuff of daily headlines.

But high on the list of government priorities last week was an unexpected item: baseball caps.

Even in a country where political theater of the absurd is commonplace, the great cap kerfuffle took many Venezuelans by surprise.

It all started over the summer, when a young state governor, Henrique Capriles, ran for president against Mr. Chávez. Mr. Capriles started wearing a baseball cap decorated with the national colors — yellow, blue and red — and the stars of the Venezuelan flag.

In response, the electoral council, dominated by Chávez loyalists, threatened to sanction Mr. Capriles for violating a rule against using national symbols in the campaign. The move struck many people as patently partisan because Mr. Chávez regularly wore clothes made up of the national colors and patterned on the flag and used vast amounts of government resources to promote his re-election.

Suddenly, the tricolor cap became a symbol of Mr. Capriles’s underdog campaign, and soon it could be seen everywhere, on the noggins of his supporters.

But Mr. Capriles lost the election in October, and the cap was mostly forgotten. Until now.

At a rally on Monday to celebrate the anniversary of a failed 1992 coup led by Mr. Chávez, a host of government officials unexpectedly pulled out caps like the one Mr. Capriles had made famous and put them on.

Had Mr. Chávez’s top cadre switched sides? Nothing of the sort.

“It is the cap of the revolution,” Vice President Nicolás Maduro said from the stage. “They can’t steal it like they’re accustomed to stealing it.”

He held up the hat, which had a small emblem commemorating the coup’s anniversary, and shouted, “Cap in hand! Tricolor in hand, everyone!”

A day later, at a session of the National Assembly, legislators on both sides of the aisle showed up wearing caps. The chamber looked like the stands at a baseball game.

All of this has given rise to plenty of jokes.

“The cap — expropriate it!” said one wag on Twitter, referring to a famous episode when Mr. Chávez, a socialist, in what seemed like a spontaneous act, ordered the nationalization of several buildings in the center of Caracas.

Then came a new twist on Thursday night, when the government interrupted regular television and radio programming with a special broadcast. Anxious Venezuelans worried about Mr. Chávez’s long absence might have wondered if they were about to get an update on the president’s health.

Nope. The two-minute broadcast consisted of images of Mr. Chávez, at various points of his 14-year presidency, wearing the tricolor cap.

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Wisconsin beats No. 3 Michigan 65-62 in OT

MADISON, Wis. (AP) — When Ben Brust tied the game at the end of regulation with a shot just from just inside midcourt, his teammate Mike Bruesewitz looked over at Wisconsin coach Bo Ryan and saw something unusual.

His coach had both his arms in the air.

"You know when he shows some emotion, you've done something pretty special," Bruesewitz said.

Brust hit a tie-breaking 3-pointer with less than 40 seconds left in overtime as Wisconsin beat No. 3 Michigan 65-62 on Saturday.

"It was awesome, something I'll remember forever, and I'm sure a lot of people will," Brust said of the game, which ended with students storming the court and Bruesewitz taking the public address announcer's microphone to thank the crowd as students celebrated around him.

The Wolverines became the third top three team to lose this week as No. 1 Indiana lost to Illinois and No. 2 Florida was beaten by Arkansas. This should be the sixth straight week with a different No. 1 in The Associated Press' Top 25.

Brust's shot at the end of regulation was a dramatic turn of events for Wisconsin (17-7, 8-3 Big Ten) and a soul crusher for Michigan (21-3, 8-3).

Just moments earlier, Tim Hardaway Jr. hit a contested 3-pointer to put the Wolverines up 65-52 with less than 3 seconds left in regulation.

Following a timeout, Bruesewitz passed up his first option in the inbounds play and hit Brust in stride. The guard took one dribble across halfcourt and launched the shot, which hit nothing but net.

Ryan said the play was drawn up to see how Michigan defended the first cutter, Brust read the defense and reacted.

"The best thing was Mike's pass on the dime on the run, didn't have to reach back for it, able to catch it all in one motion," Ryan said.

Michigan still had fouls to give before the shot, and coach John Beilein said the order coming out of the timeout was to foul. He also put Caris LeVert on Brust to bolster the defense.

"We were definitely fouling, wanted to keep everyone in front of us and (Brust) turned the corner on (LeVert) just enough that he couldn't foul him," Beilein said. "I thought we had them once they couldn't get their initial guy.

"With Caris' quickness, we thought he could get there, but he didn't."

For all the fireworks in the final 3 seconds, the teams only managed seven points in overtime, including Brust's winning 3-pointer.

Following Brust's shot, Hardaway couldn't connect on his drive to the hoop on the next Michigan possession, and Glenn Robinson III fouled Jared Berggren on the rebound.

The Wolverines went to a full-court press with two more fouls to give. But the Badgers broke the press, and Michigan had to foul twice more to finally put Ryan Evans on the free throw line.

Evans, who shoots less than 43 percent from the line, missed the front end of a 1-and-1, and Burke couldn't connect in a rushed final possession for the Wolverines.

It was another grinding win for the Badgers keyed by their defense. Michigan came in as one of the top scoring teams in the country at almost 78 points per game. But Wisconsin held Michigan to less than 40 percent shooting from the field, including 5 of 18 from beyond the 3-point line.

Michigan was 1 for 7 from the field in overtime, and the offensive futility was highlighted by one sequence in which Mitch McGary stole the ball outside the 3-point line and drove the other way only to miss the layup with Berggren defending the rim.

Beilein said the Wolverines missed out on 14 points thanks to missed layups.

"I'm not talking about when they're really contesting," Beilein said. "I'm talking about we had the ball, the basket and us, and it didn't go in."

Brust scored 14 points for the Badgers, while Berggren added 13 and eight rebounds. Sam Dekker scored 12 points, while Evans finished with 11 points and nine rebounds.

Burke scored 19 points to lead Michigan, but needed 21 shots to do it. Hardaway added 18, and McGary had 12 points and eight rebounds.

It was the second straight game for both teams to go past regulation after the Badgers beat Iowa 74-70 in double overtime on Wednesday and Michigan downed Ohio State 76-74 in overtime on Tuesday.

Several Wisconsin players said consecutive overtime games exemplified their will to win even as critics contend they're not talented enough, not fast enough and, as Bruesewitz said he's seen on Twitter, not good-looking enough.

"We have a group of guys in that locker room that believe and is going to fight until the end until you tell us we can't play any more basketball," Berggren said. "We just find a way to get it done."

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In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

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Business Week in Pictures

Phil Libin, the chief executive of Evernote, during a staff meeting at Evernote’s headquarters in Redwood City, Calif. Evernote is among the privately held Silicon Valley start-ups that are worth more than $1 billion. An unprecedented number of high technology start-ups, easily 25 and possibly exceeding 40, have crossed that threshold. Many employees are quietly growing rich, or at least building a big cushion against a crash, as they sell shares to outside investors. Airbnb, Pinterest, SurveyMonkey and Spotify are among the better-known privately held companies that have reached $1 billion.

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IHT Rendezvous: French Communists Abandon Hammer and Sickle

LONDON — The Communist Party of France has sparked a revolution among the comrades by removing the hammer and sickle from their membership cards.

The iconic symbol of the international proletariat has been replaced with the star of the multi-party European Left alliance, much to the horror of traditionalists at the party’s 36th congress that opened near Paris on Thursday.

What was billed by the party leadership as a forward-looking move was denounced by others as revisionist backsliding and part of a conspiracy to abandon the movement to the embrace of social democracy.

Emmanuel Dang Tran, secretary of the party’s Paris section, told France Info radio that members were shocked at the abandoning of “what represents, for the working class of this country, a historic element in resistance against the politics of capitalism.”

An anonymous commenter on the radio’s website suggested wryly: “It’s natural that they’ve abandoned their tools. There’s no work anymore!”

Mr. Tran was among those who believed the symbol change amounted to the party paying allegiance to the European Left, a coalition of left-wing movements formed in 1999 to cooperate within the European Parliament.

He said the leadership was trying to create a social democracy mark-2 alongside “Greens, socialists, Trotskyists and I don’t know who else.”

Pierre Laurent, the party’s national secretary, defended the decision to dump the hammer and sickle, saying it no longer represented present-day realities. “We want to turn towards the future,” he said on Friday.

The internal spat was the latest upset for a communist party that was once powerful on the left in France, with ministers serving in a number of Socialist-led administrations.

It remains the country’s largest left-wing party in terms of membership. But its standing has declined rapidly since the collapse of communism in Eastern Europe.

For the first time last year, it failed to put up its own candidate at a presidential election and opted instead to support Jean-Luc Mélenchon of the Left Front.

Although the Communist Party is the largest grouping in the Left Front, hardliners complain it risks playing second fiddle to other movements in the alliance despite being its “sole historically revolutionary component.”

The 20Minutes news Website asked whether the loss of the hammer and sickle meant the party was becoming a “Communist Party light” and noted that this week’s congress had also adopted Mr. Mélenchon’s “people first” slogan.

“That is something to chew on for the many who fear the party will be dissolved into a Left Front led by Jean-Luc Mélenchon,” it wrote.

L’Humanité, the former official Communist newspaper that retains close links with the party, managed to remain upbeat as the congress opened. It ran a poll that indicated the party’s public image had improved since the creation of the Left Front.

It also interviewed the rank and file at the party congress who said that, among other things, they saw the gathering as an occasion for communists to go on the offensive, continue a citizens’ revolution, or simply spend a “fraternal moment with all the comrades.”

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AP Source: Hernandez on verge of new deal with M's

SEATTLE (AP) — Felix Hernandez and the Seattle Mariners are working on a $175 million, seven-year contract that would make him the highest-paid pitcher in baseball, according to a person with knowledge of the deal's details.

The person spoke to The Associated Press Thursday on condition of anonymity because the agreement has not been completed. USA Today first reported the deal.

Seattle would add $134.5 million of guaranteed money over five years to the contract of the 2010 AL Cy Young Award winner, whose current agreement calls for him to receive $40.5 million over the next two seasons.

Hernandez's total dollars would top CC Sabathia's original $161 million, seven-year contract with the New York Yankees and his $25 million average would surpass Zack Greinke's $24.5 million under his new contract with the Los Angeles Dodgers and tie him for the second-highest in baseball with Josh Hamilton and Ryan Howard behind Alex Rodriguez ($27.5 million). Hernandez's new money would average $26.9 million over five years.

Hernandez agreed to a $78 million, five-year contract in January 2010 and has earned an additional $2.5 million in escalators and $300,000 in bonuses. He is due $20 million this year and $20.5 million in 2014, which would be superseded by the new deal.

Seattle general manager Jack Zduriencik said he could not comment when reached on Thursday, and Hernandez's representatives didn't immediately return messages.

If the deal is finalized, it would leave Detroit's Justin Verlander and the Dodgers' Clayton Kershaw as the most attractive pitchers eligible for free agency after the 2014 season. Tampa Bay's David Price is eligible after the 2015 season.

Hernandez has become the face of Seattle's struggling franchise, transforming from a curly haired 19-year-old who wore his hat crooked to one of the most dominant and exciting pitchers in baseball. Known as "King Felix," he became the first Seattle pitcher to throw a perfect game in a 1-0 win over Tampa Bay last August.

His fiery enthusiasm on the mound and his willingness to first sign a long-term deal in 2010 have endeared him to fans in the Pacific Northwest who have gone more than a decade without seeing postseason baseball.

Hernandez, who will turn 27 on April 8, is 98-76 with a 3.22 ERA in eight seasons with the Mariners. He won a career-high 19 games in 2009 when he finished second in the Cy Young voting then won the award a year later when he went just 13-12 but had a 2.27 ERA and 232 strikeouts.

Hernandez appeared to be making another Cy Young push last year before going 0-4 in his last six starts, which left him at 13-9 with 223 strikeouts.

His career record would be even better if he didn't play with one of baseball's worst offenses. Seattle had the lowest batting average in the major leagues in each of the last three seasons. Hernandez has taken 10 losses during that span when he's given up two earned runs or less.

For his career, Hernandez has allowed two earned runs or less in 141 of 238 starts, but the team is only 99-42 in those games due to the offensive problems.

Locking up Hernandez long-term won't solve all of the problems that have left Seattle looking up at Texas, Oakland and the Los Angeles Angles in the AL West for most of the last 10 years. The Mariners have tried to address some of those issues this offseason by trading for Kendrys Morales and Michael Morse to provide more punch to go along with young prospects Dustin Ackley, Kyle Seager and Jesus Montero, who have all shown flashes early in their careers.

But should the deal be finalized, the Mariners at least have the security of knowing who'll be at the top of their rotation for most of this decade.

___

AP Sports Writer Ronald Blum contributed to this report.

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Well: Think Like a Doctor: A Confused and Terrified Patient

The Challenge: Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.

The Presenting Problem:

A 55-year-old man who is recovering from a devastating injury in a rehabilitation facility suddenly becomes confused, frightened and paranoid.

The Patient’s Story:

The patient, who was recovering from a terrible injury and was too weak to walk, had been found on the floor of his room at the extended care facility, raving that there were people out to get him. He was taken to the emergency room at the Waterbury Hospital in Connecticut, where he was diagnosed with a urinary tract infection and admitted to the hospital for treatment. Doctors thought his delirium was caused by the infection, but after 24 hours, despite receiving the appropriate antibiotics, the patient remained disoriented and frightened.

A Sister’s Visit:

The man’s sister came to visit him on his second day in the hospital. As she walked into the room she was immediately struck by her brother’s distress.

“Get me out of here!” the man shouted from his hospital bed. “They are coming to get me. I gotta get out of here!”

His brown eyes darted from side to side as if searching for his would-be attackers. His arms and legs shook with fear. He looked terrified.

For the past few months, the man had been in and out of the hospital, but he had been getting better — at least he had been improving the last time his sister saw him, the week before. She hurried into the bustling hallway and found a nurse. “What the hell is going on with my brother?” she demanded.

A Long Series of Illnesses:

Three months earlier, the patient had been admitted to that same hospital with delirium tremens. After years of alcohol abuse, he had suddenly stopped drinking a couple of days before, and his body was wracked by the sudden loss of the chemical he had become addicted to. He’d spent an entire week in the hospital but finally recovered. He was sent home, but he didn’t stay there for long.

The following week, when his sister hadn’t heard from him for a couple of days, she forced her way into his home. There she found him, unconscious, in the basement, at the bottom of his staircase. He had fallen, and it looked as if he may have been there for two, possibly three, days. He was close to death. Indeed, in the ambulance on the way to the hospital, his heart had stopped. Rapid action by the E.M.T.’s brought his heart back to life, and he made it to the hospital.

There the extent of the damage became clear. The man’s kidneys had stopped working, and his body chemistry was completely out of whack. He had a severe concussion. And he’d had a heart attack.

He remained in the intensive care unit for nearly three weeks, and in the hospital another two weeks. Even after these weeks of care and recovery, the toll of his injury was terrible. His kidneys were not working, so he required dialysis three times a week. He had needed a machine to help him breathe for so long that he now had to get oxygen through a hole that had been cut into his throat. His arms and legs were so weak that he could not even lift them, and because he was unable even to swallow, he had to be fed through a tube that went directly into his stomach.

Finally, after five weeks in the hospital, he was well enough to be moved to a short-term rehabilitation hospital to complete the long road to recovery. But he was still far from healthy. The laughing, swaggering, Harley-riding man his sister had known until that terrible fall seemed a distant memory, though she saw that he was slowly getting better. He had even started to smile and make jokes. He was confident, he had told her, that with a lot of hard work he could get back to normal. So was she; she knew he was tough.

Back to the Hospital:

The patient had been at the rehab facility for just over two weeks when the staff noticed a sudden change in him. He had stopped smiling and was no longer making jokes. Instead, he talked about people that no one else could see. And he was worried that they wanted to harm him. When he remained confused for a second day, they sent him to the emergency room.

You can see the records from that E.R. visit here.

The man told the E.R. doctor that he knew he was having hallucinations. He thought they had started when he had begun taking a pill to help him sleep a couple of days earlier. It seemed a reasonable explanation, since the medication was known to cause delirium in some people. The hospital psychiatrist took him off that medication and sent him back to rehab that evening with a different sleeping pill.

Back to the Hospital, Again:

Two days later, the patient was back in the emergency room. He was still seeing things that weren’t there, but now he was quite confused as well. He knew his name but couldn’t remember what day or month it was, or even what year. And he had no idea where he was, or where he had just come from.

When the medical team saw the patient after he had been admitted, he was unable to provide any useful medical history. His medical records outlined his earlier hospitalizations, and records from the nursing home filled in additional details. The patient had a history of high blood pressure, depression and alcoholism. He was on a long list of medications. And he had been confused for the past several days.

On examination, he had no fever, although a couple of hours earlier his temperature had been 100.0 degrees. His heart was racing, and his blood pressure was sky high. His arms and legs were weak and swollen. His legs were shaking, and his reflexes were very brisk. Indeed, when his ankle was flexed suddenly, it continued to jerk back and forth on its own three or four times before stopping, a phenomenon known as clonus.

His labs were unchanged from the previous visit except for his urine, which showed signs of a serious infection. A CT scan of the brain was unremarkable, as was a chest X-ray. He was started on an intravenous antibiotic to treat the infection. The thinking was that perhaps the infection was causing the patient’s confusion.

You can see the notes from that second hospital visit here.

His sister had come to visit him the next day, when he was as confused as he had ever been. He was now trembling all over and looked scared to death, terrified. He was certain he was being pursued.

That is when she confronted the nurse, demanding to know what was going on with her brother. The nurse didn’t know. No one did. His urinary tract infection was being treated with antibiotics, but he continued to have a rapid heart rate and elevated blood pressure, along with terrifying hallucinations.

Solving the Mystery:

Can you figure out why this man was so confused and tremulous? I have provided you with all the data available to the doctor who made the diagnosis. The case is not easy — that is why it is here. I’ll post the answer on Friday.

Friday Feb. 8 4:13 p.m. | Updated Thanks for all your responses. You can read about the winner at “Think Like a Doctor: A Confused and Terrified Patient Solved.”

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Rules and Regulations: Post your questions and diagnosis in the comments section below.. The correct answer will appear Friday on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

Correction: The patient’s eyes were brown, not blue.

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Dell’s Largest Investor to Oppose Buyout

(Reuters) - Dell Inc's largest independent shareholder, Southeastern Asset Management, on Friday vowed to fight a $24.4 billion buyout of the No. 3 PC maker led by CEO Michael Dell, cementing opposition to what would be the largest buyout since the start of the financial crisis.

Southeastern's opposition to the deal, which Reuters first reported late on Thursday, sets up a potential battle with billionaire founder Dell and private equity firm Silver Lake, who are pushing a deal to take the company private at $13.65 a share.

Southeastern, run by activist investor Mason Hawkins and owner of 8.5 percent of Dell, including options, argues that the company is worth $24 a share if its financial services division, recent acquisitions and other assets were factored in.

With Southeastern's objection, shareholders representing 11 percent of the Dell shares not held by Michael Dell have now said they will vote against the deal, according to news reports. Billionaire Dell, who created the computer maker out of his college dorm room in 1984, holds a roughly 16 percent stake.

Dell shares reversed course and climbed into positive territory on Friday after the announcement, and closed up 0.74 percent at $13.63.

"We are writing to express our extreme disappointment regarding the proposed go-private transaction, which we believe grossly undervalues the Company," Hawkins and Chief Investment Officer Staley Cates wrote in a letter.

"We retain and intend to avail ourselves of all options at our disposal to oppose the proposed transaction, including but not limited to a proxy fight, litigation claims and any available Delaware statutory appraisal rights."

Representatives of Dell and Silver Lake declined to comment on Southeastern's statement.

Sanford Bernstein analyst Toni Sacconaghi estimates Hawkins' asset management house paid an average of more $20 a share for its stake, meaning a loss of at least $825 million at the current $13.65 offer price.

A LOOMING BATTLE

Under the buyout's terms, a majority of shares not held by Michael Dell must be voted in favor of the deal for it to proceed.

Memphis, Tennessee-based Southeastern believes the Dell board had several alternatives that would have produced a far better outcome for public shareholders, including breaking up the company and selling the units separately.

"Selling multiple business units to strategic buyers could easily exceed $13.65 per share," the letter read.

Dell was regarded as a model of innovation as recently as the early 2000s, pioneering online ordering of custom PCs and working closely with Asian suppliers and manufacturers to assure rock-bottom production costs. But it missed the big industry shift to tablet computers, smartphones and high-powered consumer electronics such as music players and gaming consoles.

Michael Dell struck a deal early this week to take Dell private for $24.4 billion in the biggest leveraged buyout since the financial crisis, partnering with Silver Lake and Microsoft Corp. The aim is to facilitate Dell's difficult transition from a commodity maker of computers into a provider of services to enterprises as a private company, away from Wall Street's scrutiny.

But Southeastern, the most prominent of a clutch of investors, including the Alpine Capital Research and Schneider Capital funds, which have voiced opposition to the buyout, on Friday argued that the company had the capability to pay a $12 special dividend to shareholders, realizing much more value while still retaining significant cash-flow.

It also suggested a Dutch auction or some other structure that would involve a public tender of shares.

Dell has now gone into a go-shop process, during which it can solicit better offers. But Hawkins and Cates argue that Michael Dell's involvement may affect that procedure.

"We are concerned that given the participation of Michael Dell in this transaction, that a traditional go shop process is not sufficient to ensure that the Company receives superior offers," they wrote.

Morningstar analyst Carr Lanphie said it is not a surprise that some investors do not like the offer price, but said the stock would fall sharply if the deal does not go through.

"The point being that if this doesn't go through, you are going to swallow a 35-40 percent decline in share price," Lanphie said. "Then, your chairman just had his attempted buyout rejected.

"Given the management they have lost in the last couple of months, will they be able to continue to grow the company? That is something the investors will need to consider," he added.

(Reporting by Poornima Gupta; Editing by Steve Orlofsky, Gary Hill and Dan Grebler)

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