Jan 28, 2010

Obama at One

January 13, 2010

Looking back at President Obama's first year in office, what do you think the high point has been? And what has been your sharpest moment of disappointment? On this occasion, that's what The Nation asked members of our community, and beyond. Now we want to know what you think. Share your take on Obama's highest and lowest moments in the form provided here .

President Barack Obama's inauguration on January 20, 2009, ignited the hopes of millions of Americans seeking real change. One year later, many progressives are worried that the Obama administration's commitment to change is not as strong as it should be. Some of his stalwart supporters feel anguish at what they see as a betrayal or delay of his campaign's promises, while many of his longtime critics feel vindicated in their initial skepticism. Other progressives, however, take stock of the advances that have been made in Washington and urge the left against making definitive pronouncements on his presidency so soon. Here at The Nation, Obama's politics and policies have been at the center of vigorous, persistent discussion and debate among our writers, editors and contributors. How one views Obama's first year is no doubt guided by one's political beliefs, but also by sensibility and intuition. On this occasion, we canvassed an array of opinions from our community--and beyond. We asked the simple question: Looking back at President Obama's first year in office, what do you think the high point has been? And what has been your sharpest moment of disappointment? The answers appear below... from:

Michael Tomasky

Editor, Democracy: A Journal of Ideas

In straightforward policy terms, healthcare reform is the best thing Obama has done. Yes, expectations were raised for more, and the process was painful to watch, but the changes in this bill are greater than anything the Clintons tried to do, anything Al Gore ran on, anything John Kerry ran on, anything Howard Dean ran on, etc. It's a big, big, big deal. Assuming it passes.

The civil liberties area has been his worst. This is the one area in which the president's actions don't remotely match the candidate's promises. On everything else, whether you like the policies or not, he's doing pretty much what he said he would do (yes, even in Afghanistan).

In terms of style of governance, Obama has if anything over-learned some lessons of history: it was good that he didn't want to dictate a health bill to Congress, but he ceded too much authority; it was good that he didn't want to mollycoddle Israel, but he alienated even some friendly Kadima and Labour elements, etc. Those who pay too much attention to history are doomed to... well, maybe we'll see.

A difficult but good first year. His fate will be 80 percent dependent on the state of the economy. That's where the effort needs to go.

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Glenn Greenwald

Writer, Salon

The overarching attribute of Obama's first year in office was his eagerness to accommodate the various permanent power factions that have long ruled Washington, and one can view both his high and low points through this prism.

His high point came in mid-April, when he announced he would declassify and release four memos from the Bush Office of Legal Counsel that authorized and graphically described torture techniques used by the CIA. He did so in the face of furious opposition from the intelligence community and with the knowledge that he would be accused of endangering our security. Release of those memos revitalized debate over Bush's torture regime and was an all-too-rare instance of courage and commitment to transparency from the new president. American presidents simply do not disseminate to the world memos detailing our national crimes committed in secret, but Obama did exactly that.

Obama's low point was when he got caught in August having secretly negotiated various deals with PhARMA over healthcare reform. Substantively, the deals banned what he long vowed he would institute--bulk price negotiations and drug reimportation. Worse, they were a blatant violation of his pledge to conduct all healthcare negotiations in public (even on C-SPAN), in order to prevent exactly this type of sleazy deal-making with industry interests. Massive giveaways to the most powerful corporations, effectuated in the dark, were what Obama most railed against as a candidate, and what he has repeatedly done as president.

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Chris Bowers

Blogger, OpenLeft.com

The main hope for any administration is that it will
take the American people's side in the fight against the antidemocratic corporatists who are picking our pockets. During 2009, Obama chose different sides in that fight at different times, forming the lowlights and highlights of his first year.

The most negative example came in mid-December, when Senate Democrats agreed to a Medicare buy-in for Americans aged 55-64 as the compromise of a compromise in the grand fight over a public health insurance option.
Joe Lieberman, who had proposed the idea himself only three months earlier, flipped and swore a filibuster. Later that same day, the White House pressured the Senate to take sides with Lieberman and the health insurance industry, getting the Medicare buy-in stripped from the bill.

However, in October, Obama's FCC appointees began to draw up regulations to ensure net neutrality after Congress refused to restrain telecoms from controlling speech on the Internet. In addition, in December, Obama's EPA began
to draw up regulations to reduce emissions of the six most dangerous greenhouse gases, in the face of Senate inaction. These new regulations will bypass Congress and its corporate lobbyists.

Perhaps these are just glimmers of hope, but at least twice the Obama administration used its authority to circumvent a pro-plutocracy Congress. Those moments were the political highlights of 2009.

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Adolph Reed Jr.

Professor of Political Science, University of Pennsylvania

In January 1996 I wrote the following about Barack Obama in my Village Voice column: "In Chicago, we've gotten a foretaste of the new breed of foundation-hatched black communitarian voices; one of them, a smooth Harvard lawyer with impeccable do-good credentials and vacuous-to-repressive neoliberal politics, has won a state senate seat on a base mainly in the liberal foundation and development worlds. His fundamentally bootstrap line was softened by a patina of the rhetoric of authentic community, talk about meeting in kitchens, small-scale solutions to social problems, and the predictable elevation of process over program--the point where identity politics converges with old-fashioned middle-class reform in favoring form over substance. I suspect that his ilk is the wave of the future in U.S. black politics."

In 2007 Matt Taibbi described him as "an ingeniously crafted human cipher, a man without race, ideology, geographic allegiances, or, indeed, sharp edges of any kind. You can't run against him on the issues because you can't even find him on the ideological spectrum."

In 2006 Ken Silverstein noted Obama's deep financial industry connections. Glen Ford, Paul Street and many others have stressed those and other disturbing connections, including his penchant for supporting more conservative Democratic candidates against more liberal ones.

Obama indicated no later than the summer of 2007 that he intended, if elected, to extend the war in Afghanistan into Pakistan.

The only surprise about his presidency is how many ersatz leftists cling to the fiction that he's anything other than a superficially articulate neoliberal Democrat in the Clinton mold and that his administration would act in any other way.

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Hendrik Hertzberg

Senior Editor and Staff Writer, The New Yorker

No-Drama Obama--remember him? Remember that admirable temperament, that ability to peer over the horizon, that poker player's cool? That chess player's sense of where the game will be several moves ahead? That matter-of-fact, unsentimental empathy? That serene immunity to the 24/7 cable/talk-radio/Internet hysteria machine? These qualities of mind and character, which I admired in candidate Obama, I still admire in President Obama. Perhaps that's why I don't see his first year in terms of high points and sharp disappointments. There have been some of each, of course, but he's still up on the bridge, holding a steady course in a violent storm, even as many of the rest of us are clutching the railings and puking over the side.

I seldom miss a chance to bitch and moan about the flaws of our wheezing, rusted-out, barely functioning electoral and governmental machinery. So I haven't been terribly surprised at how difficult it has proved for Obama to get his modest, moderately liberal program through Congress, especially the Senate. These difficulties are not his fault. Blaming him--accusing him of cowardice, of not having "balls," of being a corporate shill, etc.--is infantile. To the extent that the left component of the center-left is indulging in that sort of self-destructive, misdirected petulance--well, I guess that's my "sharpest disappointment" of this president's first year.

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Marcia Angell, MD

Senior Lecturer, Harvard Medical School

President Obama's greatest success has been to show the rest of the world a new face of understanding and cooperation. Still, count me among those who are disappointed in his first year. He seems to lack the courage to push for the fundamental reforms necessary to deal with the enormous problems we face, and instead appeases the very forces that have gotten us into the mess. By appointing Geithner and Summers, for example, he ensured that Wall Street, but
not Main Street, would be rescued. More dismaying, he extended Bush's policy of detaining certain terrorism suspects indefinitely, and he is well on his way to expanding
the self-destructive war in Afghanistan.

As for healthcare, my area of expertise, the reform bill Obama is cobbling together wrongly retains the central role of the private insurance companies and requires millions of people to buy their products at whatever price they charge. True, some of the industry's discriminatory practices would be outlawed, but if that adds to their costs, they can simply raise premiums. The pharmaceutical industry can also continue to charge whatever it likes. If the bill is fully implemented (which I doubt), it may restrain the growth of government health spending, which is all the CBO cares about, but it will surely increase inflation in the rest of the system. Obama knows that a single-payer system is the only way to provide universal care while controlling costs, but he was unwilling to throw his weight behind it. All he seems to want now is the political victory of getting a health bill passed--any bill, no matter how untenable.

My sharpest moment of disappointment came when the administration supported the prohibition against buying lower-priced drugs from Canada and Europe. During his campaign, Obama promised to end this absurd restriction, but now he's siding with the pharmaceutical industry.

It's not enough to understand what needs to be done; the president has to be willing to fight for it and, yes, take political risks.

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Katherine Newman

Professor of Sociology and Public Affairs, Princeton University

For progressives who supported John Edwards--before his personal implosion--the first year of Obama's presidency has been, more or less, what we expected. The symbolic victory of our first African-American presidency gave way to disappointment over his centrism, which comes as no great surprise, since Obama never advertised himself as a man of the left. And indeed, he isn't.

Accordingly, we should not be surprised that Obama did not bring to heel the Bush administration's Great Giveaway to the nation's banking sector. This is a travesty of the highest order, a betrayal of millions of taxpayers whose savings have been swallowed by those well-heeled Wall Street tycoons busily doing "the Lord's work." Thousands have seen their savings go up in smoke, their homes fall into foreclosure and their jobs evaporate, only to witness the spectacle of stratospheric year-end bankers' bonuses. Efforts to bring the wildcat financial industry back under strict regulatory control appear to have taken a back seat to the "needs" of the industry to retain the best and the brightest. Why not let them go job hunting on their spectacular record of institutional collapse?

On the plus side of the equation, and with a nod once again to the erstwhile Mr. Edwards, we have to count the deeply flawed but nonetheless historic healthcare bill. It is
no panacea and may even drag the Democrats down if its benefits do not kick in before 2014. But the extension of health insurance to millions who were previously left on
their own is a social policy victory.

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WARD SUTTON


Andrew Bacevich

Professor of International Relations, Boston University

As a conservative who voted for Obama, I hoped his election would signal a clear repudiation of his predecessor's reckless and ill-advised approach to national security policy. A clear break from the past just might create the space for a principled debate about the proper direction of US policy after the cold war, after 9/11 and after the passing of the neoconservative moment. Out of that debate might come a more prudent and realistic appreciation of the capabilities and limitations of military power. Washington might wean itself from its infatuation with war--at least so I fancied. This has turned out to be a great illusion. Obama's decision to escalate the war in Afghanistan indicates that he will not break with the existing national security consensus. The candidate who promised to "change the way Washington works" has become Washington's captive. Obama's inauguration on January 20, 2009, was truly a great day, for all sorts of reasons. But it's been all downhill since then.

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Zbigniew Brzezinski

Former National Security Adviser

I think Obama's greatest moment was his speech rejecting the "war on terror" as an excessive and dangerous way of responding to the kind of terrorism that has been directed at the United States, because it was increasingly pitting the United States against the entire Islamic world. I think that was a wise course of action, I think it was a wise speech, I thought it was a wise redefinition of America's foreign policy. And the disappointment doesn't come with a single moment. I think it comes with the fact that his efforts to get the healthcare plan adopted have consumed so much of his time that he has slowed down his efforts to change American foreign policy.

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Ariel Dorfman

Chilean-American Author

Surely, even if there were no conditions for deep, radical transformations, we could have done better. I am most disappointed, in foreign policy, not by Afghanistan (I expected a surge of sorts, no matter how disastrous) but by the woeful mishandling of the Honduras coup, a botched chance to ensure that such adventures were a thing of the past. The best, internationally: Iran has not been bombed (yet!), the interceptor missiles in Poland were canceled, the radar in the Czech Republic was not deployed. And Obama's speech in Cairo was inspirational. Words still matter!

Nationally, his highest points may be the rejection of the F-22 bomber, his energy initiatives and all the people (not enough, but each of them is important) who are working because of the stimulus. I was distressed by how easily Van Jones was sacrificed, not only because we need wonderful men like him in the White House but because it is symptomatic of a lack of leadership and fighting spirit on far too many issues--healthcare being perhaps the most salient. Finally: I sent an open letter to Obama (through Amnesty International) asking that those who ordered torture in the name of America be brought to justice--and there has been, up till now, no reply. Lack of words also matter!

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Antonio Gonzalez

President, William C. Velasquez Institute

Naming the first Latina/o to the Supreme Court was definitely the highlight of Barack Obama's first year in office. Both symbolically and substantively meaningful, Justice Sonia Sotomayor's appointment will reverberate for years to come
in the consciousness of Latinas and Latinos, who have long yearned for that all too rare commodity in American society--respect. Furthermore, and perhaps more important, Justice Sotomayor will add a common-sense, ethnically aware perspective to the "out of touch" highest court in the land.

An equally obvious choice for lowlight of Obama's
first year is his continued delay of a push for justice for
12 million undocumented "indentured servants" in our midst. Having committed to immigration reform that "included legalization" in Obama's first hundred days, the administration shifted that promise to "first year" and now to the spring of 2010. But to repeat the well-known civil rights-era slogan, "Justice delayed is justice denied."

Even the most loyal of Latino Democratic leaders know that facing Latino voters empty-handed on this priority issue in November is a risky proposition.

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Glenn C. Loury

Professor of the Social Sciences, Brown University

From where I sit, the high point of President Obama's young administration was its inauguration. Much seemed possible on that glorious day, but it has been downhill since. Hope, it would appear, is more easily inspired than it is justified. And those eloquent speeches about change during Obama's historic and euphoric campaign look now to have been precisely what the candidate's detractors said they were--just words.

Specifically, my hope had been that elevating a progressive African-American Democrat to the nation's highest office would do two things: help to bring about an effective engagement with America's unresolved problems of racial inequality, and begin to reverse our headlong march toward a Hundred Years' War with radical Islam. I did not expect these things to happen overnight, but I did expect to see movement in this direction. This administration has shown scant inclination to do either, which is disappointment enough. But worse--far worse--is the likelihood that Obama's failure even to attempt such changes will discredit the very idea that these are worthy objectives for any Democrat.

Obama has said little of substance about racial inequality since moving into the Oval Office, and what he has said leaves much to be desired. His speech to the NAACP convention was a rehash of his by now familiar "family values" homily. His comments on the arrest last summer of a black Harvard professor were shockingly inept. Our black president seems eager to address the American public with passion about the race issue when his "friend" has been mistreated by the police, but not if it means stressing policy reforms that might keep tens
of thousands of troubled black men out of prison.

As for the new American militarism, Obama has not really changed the direction in which we are headed. Indeed, and ironically, his speech in Oslo accepting the Nobel Peace Prize attempted to justify American military hegemony as the necessary precondition of global security and prosperity in the second half of the twentieth century. His conduct of the "war on terror" and, most distressing, his escalation of our involvement in Afghanistan's civil war is eerily reminiscent of the approach of his immediate predecessor.

This is not change of any kind, let alone of the kind that we can believe in.

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Deepak Bhargava

Executive Director, Center for Community Change

The healthcare bill is, for all its flaws, a momentous accomplishment. It is the first major expansion of the federal safety
net since the 1960s, and not only extends coverage to more than
30 million Americans but reverses the conservative string of successes in shrinking the role of government. In light of the economic crisis, President Obama had an easy excuse not to pursue a grand healthcare agenda. Indeed, reports are that some of his close advisers told him to play small ball; that he ignored their advice is a credit to his leadership. Though I wish the president had fought harder for key progressive priorities, holding him solely to account for the realities of the Senate (and a closely divided country) is to forget that he is a president, not a magician. Progressives and community organizers can be proud of the role we played. Had we not outmatched the tea-baggers in our advocacy, and pushed hard for the public option, we would have ended up with a thin gruel or perhaps nothing at all.

On the downside, the president has put together an economic team that has delivered for Wall Street but not for hurting communities. Their caution in light of the unfolding unemployment crisis has created the conditions for a right-wing populism that could be the undoing of a progressive agenda for a generation. Unless we force Washington to reverse course and pursue a bold full-employment agenda, the window for big change could close very quickly. The president's odd decision to demobilize his base in 2009 in favor of an insider approach to governance was a colossal mistake, and underlines the critical role for independent movements to create political space.

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Edith Childs

County Councilwoman, Greenwood, South Carolina

My greatest moment of excitement was when Obama was given the oath to be the president, not just the black president but the president. He's not just some people's president but president of all of us, commander-in-chief of all of us.

My low moment has been the stimulus. In South Carolina, the money did not get down as far as it should have gotten. We are thankful for what we did get, but it is not as much as
I thought we should have gotten. I was hoping we could have done better job-wise.

I still have not, will not, give up on him as president, because I know he came into a lot of challenges from the outset, and it's going to take him a while to correct much of what was there when he became president. I still believe that we're going to get through it. And it's not going to take him alone. It's going to take his staff, and the House and the Senate working with him, as well as people down on the state and local level. As I told President Obama during the campaign, we all be "Fired Up and Ready to Go." We're going to work together and do what we have to do to move forward. And that will be what will get us through this recession.

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STEVE BRODNER


Eduardo Galeano

Author

The highest points have been his incarnation of the fight against racism, still alive after the long battle for civil rights and his plan for healthcare reform.

The sharpest disappoints:

§ Guantánamo, a universal disgrace

§ Afghanistan, a poisoned chalice, accepted and celebrated

§ His raising of the war budget, still called, who knows why, the defense budget

§ His nonanswer to the climate and yes-man answer to Wall Street, a contradiction captured perfectly on a poster outside the Copenhagen conference: "If the climate were a bank, it would be saved"

§ His green light to the authors of the military coup
in Honduras, betraying Latin hopes for change after
a century and a half of US-fabricated coups against democracy in the name of democracy

§ His recent speeches praising war, hymns to the ongoing butcheries for oil or the sacred cause of racketeer governments, so utterly divorced from the lively words that put him where he now sits

I don't know. Perhaps Barack Obama is a prisoner. The most powerful prisoner in the world. And perhaps he cannot notice it. So many people are in jail.

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Krishnan Subrahmanian

Former Field Staff, Obama for America

As a medical student, I am most thrilled that health insurance reform is closer to being a reality now than at any point in generations. When the House announced that it had passed a bill, it was an emotional moment as I began to think of the many people on the campaign who told horror stories about their experience with health insurance. I thought of the young mother of two who, lacking health insurance, ignored a pestering stomachache until it presented as a ten-inch tumor. The end of discrimination against pre-existing conditions and the insidious process of rescission is nearly at hand. Reform would expand coverage to include 94 percent of Americans.

This reform is not perfect, and I am sure improvements can and will be made. Current proposals lack a public option, and I am skeptical that pilot programs and comparative effectiveness research alone
will yield necessary reductions in healthcare expenditures. Despite imperfections, the president and his team have kept the complicated and unglamorous topic of health insurance reform at the forefront of public discussion and made monumental reform a real possibility.

Disappointment struck me most at a moment that should have been joyful: the presentation of the Nobel Peace Prize to Obama in December, just days after he announced troop escalation in Afghanistan. This paradox highlights the great gulf between the idealism of politics and the reality of government. Just as we had unyielding faith in the campaign, I hope Obama is right on Afghanistan. I hope that 30,000 additional troops can ensure the safety and security of Afghans and Americans. I fear the consequences of his being wrong--for Afghans, for Americans and for our brave men and women in uniform.

I was saddened because the symbol of the peace prize represents for me unambiguous good without the burdens of being politically correct or viable. It is an award of ideals. The presidency is an office of problem solving and pragmatism. Watching great ideals settle into the compromise of legislation and governance is a sobering reminder that Obama is no longer a hopeful symbol for so many of us but someone with an incredibly difficult job before him.

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Howard Zinn

Historian

I' ve been searching hard for a highlight. The only thing that comes close is some of Obama's rhetoric; I don't see any kind of a highlight in his actions and policies.

As far as disappointments, I wasn't terribly disappointed because I didn't expect that much. I expected him to be a traditional Democratic president. On foreign policy, that's hardly any different from a Republican--as nationalist, expansionist, imperial and warlike. So in that sense, there's no expectation and no disappointment. On domestic policy, traditionally Democratic presidents are more reformist, closer to the labor movement, more willing to pass legislation on behalf of ordinary people--and that's been true of Obama. But Democratic reforms have also been limited, cautious. Obama's no exception. On healthcare, for example, he starts out with a compromise, and when you start out with a compromise, you end with a compromise of a compromise, which is where we are now.

I thought that in the area of constitutional rights he would be better than he has been. That's the greatest disappointment, because Obama went to Harvard Law School and is presumably dedicated to constitutional rights. But he becomes president, and he's not making any significant step away from Bush policies. Sure, he keeps talking about closing Guantánamo, but he still treats the prisoners there as "suspected terrorists." They have not been tried and have not been found guilty. So when Obama proposes taking people out of Guantánamo and putting them into other prisons, he's not advancing the cause of constitutional rights very far. And then he's gone into court arguing for preventive detention, and he's continued the policy of sending suspects to countries where they very well may be tortured.

I think people are dazzled by Obama's rhetoric, and that people ought to begin to understand that Obama is going to be a mediocre president--which means, in our time, a dangerous president--unless there is some national movement to push him in a better direction.

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Ellen Miller

Executive Director, Sunlight Foundation

The president has established a new, very high standard regarding the use of technology for greater government transparency. He set a high-water mark on his second day in office, and now his early pledge has been followed by the Open Government Directive. It represents a fundamental shift in government's role in making information public, reversing decades during which government held its information close and conducted its policy-making almost entirely behind closed doors. The directive orders each cabinet-level agency to create plans and protocols for the release of government data online in tech- and citizen-friendly formats. It also charges the agencies to begin making data sets available to the public within a short period of time. Already the administration has established data clearinghouses such as data.gov and recovery.gov and dramatically strengthened lobbyist disclosure of contacts with the executive branch. There are positive harbingers.

But the president hasn't invested himself personally in the fight. And it will take his involvement to truly turn the culture of secrecy around. If this unfolds, it has the potential to dramatically alter the way Americans interact with their government. It can break the chokehold that insiders have on Washington, as information is put directly into the hands of citizens.

The administration clearly understands that "public information" means that it's online. This can mean nothing else in the twenty-first century. Now it's our job to hold the administration to its promises.

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Benjamin Jealous

President, NAACP

Barack Obama came to Washington riding a wave of movement activity that had been building for many years. It culminated in his successful insurgent primary battles and presidential campaign. The power of that surge has carried our nation forward on many fronts, including: stemming massive job losses, increasing women's ability to ensure fair treatment in the workplace, rebuilding the Justice Department's ability to protect Americans' basic individual rights and setting the stage for what appears to be the imminent passage of major healthcare reform.

The greatest victory of Obama's first year, in other words, occurred months before it began. It happened when he decided to stitch together the dreams of many stripes of American idealists into one powerful force for change.

The greatest failure of his administration's first year rests
in the hands of all of us who are committed to manifesting
our nation's dream of liberty and justice for all. In too many instances in the past twelve months we have powered down, left the field for the bleachers and chosen to play armchair pundit rather than continue leading.

Like every great wave, the one that brought change to Washington must be regenerated or it ebbs. More important, our communities' and families' fortunes, which in so many instances were already in perilous condition, will ebb with it. Real change emerges from the collective power of a robust and inspired movement. 2010 must be the year we begin to fight at scale again.

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Robert Caro

Author

Instead of a high point or a low point, how about a too-early-to-tell point? This is where I think we are during the first year of a four- or eight-year presidency.

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Randi Weingarten

President, American Federation of Teachers

What stands out in the president's first year is his tremendous leadership on the economy. While there is still a long way to go, his actions helped put us on the right track. From the start, he recognized the need to act quickly to save and create jobs. That's why he worked with Congress to enact the American Recovery and Reinvestment Act, which provided an infusion of funds into state budgets, thereby helping states avert draconian cuts in education, law enforcement, healthcare and other critical services. Further, by investing ARRA funds in our schools, the president helped protect a generation of young Americans from the harmful effects of disastrous school-budget cuts.

I haven't agreed with every action of the administration this year; no doubt, even among allies there will always be disagreements on aspects of policy. Through it all, though, we'll continue to respect this president because of his stewardship of the economy, his tangible support for public education and the respect he has shown us--even when we disagree.

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Ilyse G. Hogue

Campaign Director, MoveOn.org

It's hard to separate 2009 from 2008, because MoveOn's staff and members never missed a beat after the election. Despite being exhausted, we--like millions of progressive Americans--recognized that the window for transformational change could be brief and that seizing this moment required redoubling our efforts. What amazes me most is the sense of individual and group claim that people had on this new government. Millions of those who turned 2008 into a referendum on our entire system of governance went on to demand accountability from bank CEOs and insurance industries. From directing outrage at bank CEOs to account for missing TARP funds to insisting that legislators address the grave need for real health reform instead of pandering to the insurance industry, the renewed sense that government must protect its citizens from corporate abuse and greed was visceral. And to a degree, it was successful in cutting through the political gamesmanship.

What disappoints is that all this collective effort simply has not been enough to overcome the unfettered corporate influence that has governed our country for so long, or to move our new president to reject incrementalism in favor of more bold progressive change. The systems that govern Washington politics are too deep-seated to be overturned by a single election or a single president--even one more inclined toward radical reform than this one. Despite the tidal wave of momentum demanding accountability and change, progress proves to be modest and gradual. While this frustrates, I am buoyed by the fact that, having tasted their ability to affect their individual circumstances, people haven't stopped fighting for what they believe is right. Our 5 million members are proof of that.

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James Carr

Chief Operating Officer, National Community Reinvestment Coalition

President Barack Obama's election promised a fundamental policy shift away from the interests of America's wealthiest toward the needs of working families and historically disenfranchised communities. In his first year, Obama successfully steered the nation away from a second Great Depression. But the pursuit of fundamental change has not yet lived up to the inspirational pre-election rhetoric. The administration's reluctance to tackle adequately the foreclosure crisis that claimed 2.8 million additional homes in 2009 and will likely claim millions more in 2010 is disappointing.

Worse, however, is the reluctance to address economic challenges directly that are facing the most vulnerable communities and acknowledge the indisputable connection between race, injustice and economic outcomes. African-Americans, Latinos, Native Americans, and other people of color are experiencing foreclosures and unemployment at alarmingly disproportionate rates. Yet people of color will represent more than half of the US population within thirty-five years. Targeting economic resources to communities most in need is not only just and humane; it is critical to the future competitiveness of America. Many argue that expectations for the president are unrealistically high. But candidate Obama set the bar, and those expectations sealed his victory. The question remains, Will he rise to the challenge of this tumultuous economic time for America?

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Gara LaMarche

President, The Atlantic Philanthropies

The high points of the past year were not so much a moment as a steady series of them: seeing the country led by a gifted, progressive, eloquent, centered figure moving the ball forward each day on a range of huge, untended-to problems without allowing himself to be distracted too much by a virulent, nihilistic right or by elements of the left who seem not to have the stomach to fight their enemies for too long without turning fire on allies. The stimulus and coming healthcare bill represent massive advances for social welfare--something the right seems to understand better than we do, and we will pay a big price for that if we don't come to our senses and own our victories soon.

The disappointments have also been many. I don't believe many of us anticipated how fragile and fleeting the "transformational" moment might be, or how deeply sown the hostility to government would be, as a result of concentrated right-wing attacks over thirty years. Neither Hurricane Katrina or, it turns out, the financial meltdown, was enough to overcome it. Whatever the state of the "real" economy--which ought to be our primary focus, in human and political terms--the easing of the Wall Street crisis took the air out of the supposed Rooseveltian moment, and the president finds himself almost apologizing for each extension of government into a sick economy. If the president doesn't turn his considerable teaching talents toward making an overarching case for positive, strong, democratic government, and if progressives don't support and elevate that narrative, the next three years will be even tougher than the first.

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Jan 27, 2010

Centrism Died in Massachusetts

BOCA RATON, FL - MAY 22:  Democratic president...Image by Getty Images via Daylife


The surprising results of last week's special Senate election in Massachusetts have exposed all manner of Beltway shortcomings, but none so forcefully as the terminal exhaustion of the professional pundit corps.

Consider the wretchedness of the advice presently coming in from all quarters of the Washington establishment. It might be summed up as follows: The Democratic candidate for Ted Kennedy's old seat was beaten by a Republican, Scott Brown. Only one conclusion can be drawn from this, apparently: that the public has gone decisively to the right. Ergo, so must the president. Barack Obama must capture the center, even if it means leaving his party behind. He must do as Bill Clinton did. When faced with opposition, capitulate! When that opposition grows, cave faster!

The president needs to pick a fight with members of his own party in Congress, the Sunday talk show sinecurists have murmured. That will surely help matters. He must embrace a sort of transcendent bipartisanship, suggests Fareed Zakaria in the Washington Post. He needs to learn, like the New York Times's David Brooks believes our ancestors did, to "tolerate the excesses of traders" because that's the only way to have "vigorous financial markets." Thomas Friedman, a man as consistent as he is banal, opines that the way to turn things around is by . . . embracing entrepreneurship.

The awkward thing is, President Obama has already spent a year following this traditional script. He has repeatedly let down his party's base. His all-important economic team is filled with protégés of Robert Rubin, the centrist hero of the Clinton years—whose image should be irreparably tarnished thanks to his role in bank deregulation, that great centrist endeavor of the '90s.

But not only is this advice wrong, its premises are, too.

Here is an actual bit of data from the Massachusetts debacle. The AFL-CIO conducted a poll in the state and, according to the union's pollsters, it revealed that the election "was a working-class revolt" driven by a "huge swing among non-college voters," who went for President Obama in 2008 and for Mr. Brown this time around.

Here is a second data point: The Progressive Change Campaign Committee, together with two other liberal groups, did a poll of Massachusetts voters who voted for Mr. Obama in 2008 and then for Mr. Brown last week. Health-care reform was, as everyone knows, the most important issue in the Massachusetts race, and yet if this poll is to be believed, an incredible 82% of these swing voters favor the late "public option," a bête noir of the centrist punditry. Even if the poll is off by a few points, that number is shocking.

A third bit of data: A nonpartisan national poll of 800 voters who closely follow politics by Clarus Research Group in December found the Obama administration's most prominent centrists—its economic team of Larry Summers and Tim Geithner—to be its only members whose "disapproval" numbers were higher than their "approval" ratings.

And yet what our genius centrists are calling for, in effect, is to hand over even more authority to these least popular and least successful elements of the Obama administration. They are basically telling Mr. Obama that the way to court alienated blue-collar voters is by extolling entrepreneurship and toning down the administration's occasional anti-Wall Street rhetoric. It is like suggesting someone kick smoking by going from one pack a day to two.

I have my own suggestion for Mr. Obama as he prepares for his State of the Union address: Instead of knifing your allies, try fighting for the principles of your party. It's true, that's not what Mr. Clinton did. But it's what Franklin Roosevelt did, and Harry Truman, and John Kennedy—and it worked for them. In those days, "working-class revolts" helped Democrats, not Republicans.

Last year's dream of bipartisanship was an attractive one, but it should be clear to you by now that you will never win over the GOP. As you gaze over their contemptuous faces tonight, wondering what clever insults they will spontaneously blurt as you pause to take a breath, try to remember that, for the most part, they are not your friends; that many of them took the financial crisis as a signal to dedicate themselves even more wholeheartedly to the laissez-faire superstition. You cannot appease these zealots. No one can.

What you need to do now is pick a fight, preferably one that forces the obstructionists of the right to take the side of privilege. You need a battle that will expose their populism and their protest for the pretenses they are. Your target is obvious: the financial industry, from Wall Street to the credit card companies. Yes, taking them on will cost you campaign contributions for 2012, but take Wall Street down a few pegs and Americans might start to remember what it was their grandparents loved about Democrats all those years ago.

Write to thomas@wsj.com

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U.S. Keeps Foreign Ph.D.s

National Science Foundation (NSF) Logo, reprod...Image via Wikipedia

By DAVID WESSEL

Most foreigners who came to the U.S. to earn doctorate degrees in science and engineering stayed on after graduation—at least until the recession began—refuting predictions that post-9/11 restrictions on immigrants or expanding opportunities in China and India would send more of them home.

Newly released data revealed that 62% of foreigners holding temporary visas who earned Ph.D.s in science and engineering at U.S. universities in 2002 were still in the U.S. in 2007, the latest year for which figures are available. Of those who graduated in 1997, 60% were still in the U.S. in 2007, according to the data compiled by the U.S. Energy Department's Oak Ridge Institute for Science and Education for the National Science Foundation.

Foreigners account for about 40% of all science and engineering Ph.D. holders working in the U.S., and a larger fraction in engineering, math and computer fields. "Our ability to continue to attract and keep foreign scientists and engineers is critical to…increase investment in science and technology," Oak Ridge analyst Michael Finn said.

"Data for all available cohorts indicate that 'stay rates' of foreign science and engineering doctorate recipients in 2007 are slightly higher than they have been in recent years," Mr. Finn said. His findings, which use tax data to track graduates, cover the years before the U.S. plunged into a recession that damped job prospects in many U.S. industries and universities.

Other analysts see signs that recent foreign grads are increasingly likely to return home, particularly in today's weak job market. "I have no doubt that the 2009 data will show a dramatic shift," said Vivek Wadwha, executive in residence at Duke University's Pratt School of Engineering, who has been warning loudly about the threat that trend would pose to innovation in the U.S. In October 2008, Mr. Wadwha and others used Facebook to question 1,224 foreigners studying at U.S. institutions at all levels. More than half the Indians and 40% of the Chinese said they hoped to return home within five years.

Separate NSF surveys show the fraction of foreign Ph.D.s planning to stay in the U.S. dipped in the years following the Sept. 11, 2001, terrorist attack and then rebounded. Nearly 80% of those with temporary visas surveyed in 2007 said they planned to stay; more than half had definite plans to do so.

Joy Ying Zhang, the son of a primary-school teacher and a college professor, left China in 1999 for Detroit's Wayne State University, where he arrived with two suitcases and $2,000 in cash. He later transferred to Carnegie Mellon University, which awarded him a Ph.D. in computer science in 2008.

Four or five of his friends have returned to China, he said, and he has discussed doing so. But Mr. Zhang, now a research assistant professor at Carnegie Mellon's Silicon Valley campus, has decided stay. "I have spent 10 years here already," he said. "It took me some time to get used to American life. Now, it'd be hard to get used to China. It's called 'reverse culture shock.' "

In recruiting for Carnegie Mellon, he finds young Chinese less eager to come to the U.S. than those of his generation. "Life in China is getting better. There are research alternatives in China—like Microsoft China," he said. "They can get good mentoring and advice there, instead of coming to the U.S."

In 2007, foreign citizens accounted for 16,022 of the Ph.D.s awarded in science and engineering in the U.S., or 46% of the total, according to the Oak Ridge data. In contrast, the class of 1997 had 12,966 foreigners, or 30% of the total.

Graduates of Ph.D. programs in the physical sciences and computer science are more likely to remain in the U.S. than those in other fields, Mr. Finn said. Those programs are popular with Chinese and Indian students, who are more likely to remain in the U.S. than those from Taiwan, South Korea and Western Europe. Among 2002 graduates, 92% of the Chinese and 81% of the Indians were in the U.S. after five years; in contrast, 41% of South Koreans and 52% of Germans were.

Aranyak Mehta, 31, came from India nearly a decade ago to study algorithms at Georgia Institute of Technology and earned a Ph.D. in 2005. Today, he is a research scientist at Google—and planning, for now, to remain in the U.S. "There's always a trade-off—family, culture, and all that," he said. "One of the most important things with an academic background is the work that you do, and is it exciting?"

Using the LinkedIn online network, Mr. Wadhwa identified 1,203 skilled Indians and Chinese who had returned home. Three-quarters said visa issues weren't a factor. Rather, career opportunities, quality-of-life concerns and family ties were major factors. Some 70% of the Chinese and 61% of the Indians said opportunities for professional advancement were better at home.

The NSF recently said the number of foreign science and engineering students enrolled in graduate programs of all types hit 158,430 in April 2009, up 8% from the year before.

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Wangen Bei Olten Journal - A Swiss Treat for Muslim Diets Comes With an Aftertaste

Mosque of the Olten Turkish cultural associati...Image via Wikipedia

WANGEN BEI OLTEN, Switzerland — Bertram Decker’s second-floor office in Nestlé’s big food plant here looks out over the town’s only minaret, a wooden turret topped with a gilt star and crescent.

The minaret, atop a Turkish cultural association, is one of only four in all of Switzerland, and it has a special place in the country’s recent history. It touched off a local scrap that in November led more than 57 percent of Swiss voters to approve a call for a constitutional amendment to ban minarets.

Here in Wangen, 61 percent approved the measure, which is a little curious, since Mr. Decker’s factory produces, among other things, packages of feuilleté, or puff pastry, that adhere to Islam’s ritual halal requirements.

Last year, the factory’s assembly lines churned out 100 million packages of pastry, up from 80 million a decade ago. Though halal products represent at most 3 percent of the total, Mr. Decker said, “We see now that it’s growing.”

On a wall near the entrance, he points to a certificate from the Grand Mosque in Paris certifying the factory as halal, or free of impure products like alcohol or pork. “The original certification was for two years,” said Mr. Decker, 41, a German who was brought in 18 months ago to manage the plant, part of the Swiss multinational Nestlé. “We just got an extension until 2012.”

As incomes rise in the Islamic world and Muslims migrate increasingly to Europe and the United States, Wangen’s halal production is part of a thrust by Nestlé to carve a niche in the global market for halal products, including coffee, baked goods, breakfast cereals and baby food. Halal products now account for $5 billion of Nestlé’s global sales.

But while Switzerland benefits from factories like this one selling its products to Muslim customers in many countries, it appears the Swiss are adamantly opposed to the construction of more minarets like the one down the street.

In some ways, Wangen wears this contradiction on its sleeve. When the Turkish club decided in 2006 to erect the minaret atop its clubhouse, local residents took the association to court to prevent construction, arguing that the minaret violated building codes. The case went to Switzerland’s highest court, which approved construction, though not because the minaret was a form of religious expression. “The court ruled on conformity to the building codes,” said Beat Frey, 50, a regional court judge who is also Wangen’s part-time mayor. “Not on freedom of religion.”

The decision was seized upon by conservative parties, above all the Swiss People’s Party of Christoph Blocher, a right-wing industrialist-turned-politician, who demanded a referendum on the future construction of minarets. Of course, all politics is local, and not just in Massachusetts. The vote in tiny Wangen, population 4,950, many local people said, was not the expression of intolerance it might have seemed.

“There were many reasons, not above all the Muslims among us,” said Mr. Frey, who himself voted in favor of minarets. “Yes, there was fear of political Islam, but people also wanted to send a message to the federal government in Bern,” whose opposition to the amendment was viewed as interference in local affairs.

“There was also fear of the unknown,” he said, adding that about 18 percent of the town’s population is foreign, though the largest group among them are native Germans from nearby.

Down at the Turkish cultural association, Mustafa Karahan, 50, sometimes feels under siege. “The problem is, people don’t know us,” he said over coffee. “If they did, there wouldn’t have been the referendum.”

In 2006, when the club was considering construction of a minaret, members organized an open house, and more than 500 people came. “When we dedicated the minaret, the local Protestant pastor spoke and several government officials came,” said Mr. Karahan, a teacher who migrated to Switzerland in 1980 and works in a machine shop.

But the controversy over the minarets provoked a backlash. As the date for the vote approached, stones were thrown at the clubhouse windows and a bag of pork products was hung on the door. Parking for club members along the nearby railroad was suddenly made off limits by railway officials (and remains so).

“They played politics with us, particularly regarding the minaret, to gain votes,” Mr. Karahan said. “They have damaged Switzerland’s image.”

Mustafa Bakci, 27, a chemist with a Swiss pharmaceuticals company, said the club was open to all nationalities, not just Turks. “Libyans, Saudis — it’s open for everyone,” said Mr. Bakci, who was born in Switzerland. “From A to Z.”

Many foreigners work in the Nestlé plant and at the town’s other big employer, Coop, a Wal-Mart-like retailer. “My sister-in-law works for Nestlé,” Mr. Bakci said.

Walter Leisi, 64, remembers well when in 1962 his father, a baker from Basel, decided to build a factory in Wangen to produce his packaged puff pastry, which had been such a hit at home. “We had three nationalities back then,” he said, recalling the starting work force of about 70 people. “Swiss, Italians and Spaniards.”

In 1972 the factory passed into Nestlé’s hands, but the younger Mr. Leisi, who also voted against the minaret ban, managed it until last year. Now there are 400 employees, about two-thirds non-Swiss. “Many Swiss think it’s not necessary for them to work nights,” he said.

Signs on factory walls are in numerous languages, including Albanian, Serbian, Italian and Turkish. During the wars in the former Yugoslavia in the 1990s, Mr. Leisi said, “I had a bad feeling; would there be knifings here? Down there they were killing each other, yet here we never had a problem.”

Most of the factory’s halal products are exported to France, which has Europe’s largest Muslim population. To meet growing demand, the factory runs three eight-hour shifts a day, Mr. Decker said, sometimes Saturdays.

How does Mr. Leisi explain the resistance to minarets in a town that lives in part by selling food to Muslims?

“The problem is you had a certain category of extremist on one side, and another on the other side,” he said, shaking his head.

Gesturing over his shoulder toward the Turkish club, he added, “One of the reasons, of course, was that little minaret over there.”

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Books of The Times - Demick, Hassig, Oh and Myers on Kim Jong-Il’s North Korea

Kim Jong IlImage by Dunechaser via Flickr

Computers are rare in North Korea, and the Internet, for most of its citizens, is little more than a whispered rumor. It’s probable, in fact, that only one person surfs the Web in North Korea without someone monitoring every click: Kim Jong-il, that authoritarian regime’s supreme leader.

When he’s online, and not lurking on sites devoted to his obsessions (movies, fancy food, young women, nuclear weapons), Mr. Kim must sometimes see what his country looks like, to the rest of the world, in those haunting satellite photographs of the Far East at night.

You’ve probably seen them. The countries near North Korea — Japan, South Korea, China — are ablaze with splotches and pinpricks of light, with beaming civilization. But North Korea, a country nearly the size of England, home to some 23 million people, is a black hole, an ocean of dark. Barbara Demick, a foreign correspondent for The Los Angeles Times, begins her excellent new book, “Nothing to Envy: Ordinary Lives in North Korea,” by poring over these satellite images. She’s shocked by them, and moved. “North Korea is not an undeveloped country,” she observes. “It is a country that has fallen out of the developed world.”

Image by oceandesetoiles via Flickr

“Nothing to Envy” is one of three provocative new books about North Korea, from writers who are committed to parsing the slivers of light that escape this enigmatic and often baffling place. The others are “The Hidden People of North Korea,” by Ralph Hassig and Kongdan Oh, and “The Cleanest Race,” by B. R. Myers.

North Korea is not an easy country to observe. Few foreign journalists are allowed in, and then only with official minders and strictly limited itineraries. To get a sense of how ordinary citizens live, writers must rely primarily on the accounts of defectors.

If we have trouble seeing North Koreans plainly, they cannot see us at all. Telephone use is severely restricted. (Even the telephone book is a classified document marked “secret.”) Postal service is spotty. There is essentially no e-mail. Television and radios receive only approved channels. The country’s citizens are force-fed a steady, numbing diet of state propaganda devoted to sustaining the personality cult of Kim Jong-il and savaging all things American.

How are North Koreans taught to think about us? Well, here’s one indication. Children learn a ditty called “Shoot the Yankee Bastards” in music class. One verse goes:

Our enemies are the American bastards
Who are trying to take over our beautiful fatherland.
With guns that I make with my own hands
I will shoot them. BANG, BANG, BANG.

(The truly poignant words here are “with my own hands.”)

Ms. Demick’s book is a lovely work of narrative nonfiction, one that follows the lives of six ordinary North Koreans, including a female doctor, a pair of star-crossed lovers, a factory worker and an orphan. It’s a book that offers extensive evidence of the author’s deep knowledge of this country while keeping its sights firmly on individual stories and human details.

Immediate family of Kim Jong-il. Front left Ki...Image via Wikipedia

The people Ms. Demick observes lived, before their defections, in northeastern North Korea, far from the country’s tidy, Potemkin village-like capital, Pyongyang. The existences she describes sound brutal: there is often not enough food; citizens work long days that can be followed by hours of ideological training at night; spying on one’s neighbors is a national pastime; a nonpatriotic comment, especially an anti-Kim Jong-il wisecrack, can have you sent to a gulag for life, if not executed.

Ms. Demick writes especially well about the difficult lives of those who do manage to defect. Not only are they bewildered by life outside of North Korea, and have to be taught to do things like use an A.T.M., but they also live with deep shame and guilt, knowing that relatives left behind have probably been sent to prison as punishment for their escape.

Mr. Hassig and Ms. Oh’s book, “The Hidden People of North Korea: Everyday Life in the Hermit Kingdom,” is wonkier than Ms. Demick’s and less reader-friendly, but it covers more ground. The authors are married (Ms. Oh’s parents were North Koreans who fled to South Korea); he is an independent consultant specializing in North Korean affairs, and she is on the research staff of the Institute for Defense Analysis in Alexandria, Va.

Their book is based on more than 200 interviews with defectors, and it paints a picture of a restless populace, increasingly dubious about the official propaganda. “It would be a gross exaggeration to say that the people support Kim Jong-il,” they write. “Rather, it does not occur to them to oppose him.” North Koreans are too busy trying to survive, and too preoccupied by the tensions of the supposed mighty conflict with America, to be able to think about much else.

Mr. Hassig and Ms. Oh’s portrait of Mr. Kim’s hyper-sybaritic lifestyle is detailed and devastating. He may look like a man of the people, they write, with his tan slacks, zippered jackets and stout build that make him resemble Jackie Gleason as Ralph Kramden in “The Honeymooners.” But they chronicle his obsession with the latest electronics, the “pleasure teams” of girls he keeps handy, the Bordeaux wine he has flown in. While many of his people starve, they write, Mr. Kim “is such a connoisseur that, according to his former chef, every grain of rice destined for his dinner table is inspected for quality and shape.”

The authors are aware that Mr. Kim’s anti-American paranoia isn’t baseless. The leader of a different country in George W. Bush’s “axis of evil,” they note, was captured and later hanged.

Mr. Hassig and Ms. Oh’s book concludes with pointed policy recommendations. They think it is nearly hopeless to negotiate with Mr. Kim and suspect that “nonproliferation agreements with the regime will simply encourage it to brandish new threats in the future.” Instead of fixating on Korea’s weapons, the authors suggest bypassing the regime and reaching out to North Korea’s people, who sorely need humanitarian aid and “a new way of thinking about their government and their society.”

Mr. Myers, the author of “The Cleanest Race: How North Koreans See Themselves — and Why It Matters,” is a contributing editor to The Atlantic and famously the author of “A Reader’s Manifesto,” a controversial and humorless broadside against the literary writers (Annie Proulx and Cormac McCarthy among them) whom he finds pretentious or obscure. Mr. Myers directs the international studies department at Dongseo University in South Korea.

He is a crisp, pushy writer who is at his best when on the attack, and his often counterintuitive new book attempts a psychological profile of Kim Jong-il and his regime. Mr. Myers has pored through mountains of North Korean propaganda — from nightly news reports and newspapers to war movies, comics, wall posters and dictionaries — and he argues that the West is misreading the country’s core beliefs.

He explains that North Korea’s dominant worldview is “far removed” from the Communism, Confucianism and official “show-window” ideologies that Westerners analyze. Instead, he argues, this worldview “can be summarized in a single sentence: The Korean people are too pure-blooded, and therefore too virtuous, to survive in this evil world without a great parental leader.” His North Korea is guided by a “paranoid, race-based nationalism.”

Mr. Myers’s arguments are too wily and complex to be neatly summarized here, but he includes a fascinating analysis of Mr. Kim’s depiction as an essentially — and crucially — feminine military leader. His regime presents North Korea more as a motherland than a fatherland, Mr. Myers writes, and he cites official slogans about Mr. Kim like “We Cannot Live Away From His Breast.” The lack of a patriarchal authority figure, he says, “may also have helped the regime preserve stability by depriving people of a target to rebel against.”

Mr. Myers also cautions against the idea that the West can persuade North Korea to shed its nuclear weapons. Mr. Kim “cannot disarm and hope to stay in power,” he writes. At the same time, he notes, “blue jeans will not bring down this dictatorship.” Any signs of serious unrest, he observes, will encourage Mr. Kim to raise the level of the tension with the West, and possibly do something rash with his nuclear arsenal.

Kim Jong-il reportedly suffered a stroke in 2008 and has looked frail during his recent, and increasingly rare, public appearances. While the world speculates about his successor, almost certainly to be one of his sons, one of the lessons of these books is not to remove our eyes from the blinkered lives of the average North Korean.

“The Kim regime essentially holds its people hostage,” Mr. Hassig and Ms. Oh write, and they are dismayed to note that “the United States is much more interested in the hostage taker’s weapons of mass destruction than in the fate of his hostages.”

North Koreans sometimes joke, Ms. Demick writes in “Nothing to Envy,” that they live like “frogs in the well.” It’s a line that sends you back to study those satellite images, and to contemplate those who dwell under Mr. Kim’s inky moral darkness.

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The Radiation Boom - As Technology Surges, Radiation Safeguards Lag

Varian radiation therapy machineImage by IndyDina with Mr. Wonderful via Flickr

In New Jersey, 36 cancer patients at a veterans hospital in East Orange were overradiated — and 20 more received substandard treatment — by a medical team that lacked experience in using a machine that generated high-powered beams of radiation. The mistakes, which have not been publicly reported, continued for months because the hospital had no system in place to catch the errors.

In Louisiana, Landreaux A. Donaldson received 38 straight overdoses of radiation, each nearly twice the prescribed amount, while undergoing treatment for prostate cancer. He was treated with a machine so new that the hospital made a miscalculation even with training instructors still on site.

In Texas, George Garst now wears two external bags — one for urine and one for fecal matter — because of severe radiation injuries he suffered after a medical physicist who said he was overworked failed to detect a mistake. The overdose was never reported to the authorities because rules did not require it.

These mistakes and the failure of hospitals to quickly identify them offer a rare look into the vulnerability of patient safeguards at a time when increasingly complex, computer-controlled devices are fundamentally changing medical radiation, delivering higher doses in less time with greater precision than ever before.

Serious radiation injuries are still infrequent, and the new equipment is undeniably successful in diagnosing and fighting disease. But the technology introduces its own risks: it has created new avenues for error in software and operation, and those mistakes can be more difficult to detect. As a result, a single error that becomes embedded in a treatment plan can be repeated in multiple radiation sessions.

Clinac 2100 C accelerator in the polyclinique ...Image via Wikipedia

Many of these mistakes could have been caught had basic checking protocols been followed, accident reports show. But there is also a growing realization among those who work with this new technology that some safety procedures are outdated.

“Scientific societies haven’t been able to keep up with the rapid pace of technical improvements,” said Jeffrey F. Williamson, a professor of radiation oncology, who leads the medical physics division at the Massey Cancer Center at Virginia Commonwealth University in Richmond.

Hospitals, too, are lagging, sometimes failing to provide the necessary financial support to operate the sophisticated devices safely, according to accident reports and medical physicists, who set up and monitor radiological devices. And manufacturers sometimes sell machines before all the software bugs are identified and removed, records show.

At a 2007 conference on radiation safety, medical physicists went so far as to warn that radiation oncology “does indeed face a crisis.” The gap between advancing technology and outdated safety protocols leaves “physicists and radiation oncologists without a clear strategy for maintaining the quality and safety of treatment,” the group reported.

Endobronchial radiation therapy for non-small ...Image via Wikipedia

Government regulators have been slow to respond. Radiation accidents are chronically underreported, and a patchwork of laws to protect patients from harm are weak or unevenly applied, creating an environment where the new technology has outpaced its oversight, where hospitals that violate safety rules, injure patients and fail to report mistakes often face little or no punishment, The New York Times has found.

In this largely unregulated marketplace, manufacturers compete by offering the latest in technology, with only a cursory review by the government, and hospitals buy the equipment to lure patients and treat them more quickly. Radiation-generating machines are so ubiquitous that used ones are even sold on eBay.

“Vendors are selling to anyone,” said Eric E. Klein, a medical physicist and professor of radiation oncology at Washington University in St. Louis. “New technologies were coming into the clinics without people thinking through from Step 1 to Step 112 to make sure everything is going to be done right.”

A national testing service recently found unacceptable variations in doses delivered by a now common form of machine-generated radiation called Intensity Modulated Radiation Therapy, or I.M.R.T. To help institutions achieve more consistency, an association of medical physicists issued new I.M.R.T. guidelines in November.

The problems also extend to equipment used to diagnose disease.

More than 300 patients in four hospitals — and possibly many more — were overradiated by powerful CT scans used to detect strokes, government health officials announced late last year. The overdoses were first discovered at Cedars-Sinai Medical Center, a major Los Angeles hospital, where 260 patients received up to eight times as much radiation as intended.

Those errors continued for 18 months and were detected only after patients started losing their hair. The federal Food and Drug Administration is still struggling to understand and untangle the physics underlying the flawed protocols. The F.D.A. has issued a nationwide alert for hospitals to be especially careful when using CT scans on possible stroke victims.

Although the overdoses at Cedars-Sinai were displayed on computer screens, technicians administering the scans did not notice. In New York City, technologists who also did not watch their treatment computers contributed to two devastating radiation injuries documented in an article in The Times on Sunday.

The incidents not only highlight the peril of placing too much trust in computers, they also raise questions about the training and oversight of medical physicists and radiation therapists.

Despite the pivotal role medical physicists play in ensuring patient safety, at least 16 states and the District of Columbia do not require licensing or registration. “States can be either very tough or very lax,” said Dr. Paul E. Wallner, a director of the American Board of Radiology.

Eight states allow technologists to perform medical imaging other than mammographies with no credentials or educational requirements.

In those states, said Robert Pizzutiello, a medical physicist in New York who is part of a movement to license all medical physicists, “you could drive a truck in the morning and operate an X-ray in the afternoon.”

Turmoil at the V.A.

Frederick Stein, an Army veteran from New Jersey, was already suffering from a delayed diagnosis of laryngeal cancer when he began radiation treatments in late September 2006 at the Veterans Affairs Medical Center in East Orange. Within weeks of starting radiotherapy, his sore throat worsened and a rash appeared along with other skin problems, according to Mr. Stein’s family.

Swallowing became more difficult, causing him to lose weight. His skin eruptions worsened. Mr. Stein’s pain became so severe, he needed an injection of morphine. More painkillers followed. The hospital stopped chemotherapy, figuring it was causing his problems. But his condition continued to deteriorate.

If Mr. Stein’s skin damage was a mystery to his doctors, two therapists — Alisha High and Lorraine Raymond — had already concluded that he was being overradiated. Ms. High was so concerned that in December 2006 she refused to administer the radiation, records show. The next day, Ms. Raymond expressed her concerns as well.

The protest did not go over well. Their supervisor, Kirk Krickmier, admonished them for questioning doctors and the physics department, and later that month, both therapists were fired by the agency that had placed them in the veterans’ hospital, Rosato Associates, according to a lawsuit Ms. High and Ms. Raymond filed against Rosato.

Mr. Stein died of cancer in 2008 at age 71, but not before the hospital admitted that he had been overradiated. His wife, Eileen Stein, said the botched radiation treatments had shortened his life. “Oh, it was just awful,” Ms. Stein said in an interview. “They cooked him something terrible. He suffered awful.”

Ms. High and Ms. Raymond declined to be interviewed for this article. Steven Menaker, a lawyer who represented Rosato Associates, said his client disputed their account of why they left the hospital. Mr. Krickmier declined to be interviewed about the case, which has been settled.

It turned out that Mr. Stein was not the only victim. Having learned of the therapists’ complaints on Dec. 20, 2006, hospital administrators tracked them down a month later and interviewed them, according to Veterans Affairs. A week later, the director of the East Orange facility, Kenneth H. Mizrach, ordered the radiotherapy unit to stop accepting new patients, pending a full investigation.

That investigation found that of 160 cases reviewed, 56 patients were treated incorrectly for cancer of the prostate, head and neck, lung, breast and two other malignancies. Thirty-six had been overradiated and 20 more subjected to “errors in technique,” the hospital said. Although the patients were informed, the findings had not been publicly revealed until The Times uncovered them.

According to a confidential report by the American College of Radiology, which had been brought in to study the situation, the hospital’s radiotherapy unit was out of control: medical personnel lacked the training and knowledge to safely administer I.M.R.T. treatments, quality control was virtually nonexistent, vital safety procedures were performed by unqualified employees, and patients had little or no follow-up.

“Discontinuation of I.M.R.T. treatment is STRONGLY recommended until additional training is obtained by all staff including the physicians,” the college said. The reviewers reminded the hospital that the new technology was “VERY labor intensive, and requires not just sophisticated hardware and software, but a lot more training.”

The college said medical personnel were “really pushing the envelope of tolerances” and that nonphysicians were apparently approving — in the physician’s name — certain steps in the treatment process.

Investigators found that without proper follow-up, there was no way for the hospital to know whether its cancer treatments were successful or whether there were complications. In addition, the college of radiology found no evidence of peer review, quality assurance meetings, outcome studies or mortality and morbidity (known as M&M) conferences, where doctors meet to review cases.

“Several charts reviewed indicated that treatment had been discontinued or at least interrupted by a patient’s worsening condition, or in a few cases death, but there was no M&M review of these issues,” the report said. A spokeswoman for the V.A. said most of the affected patients suffered no apparent harm.

The unit remains closed; it is expected to reopen soon with all new personnel and equipment. “It took a long time to get here — three years in the making,” Mr. Mizrach said. “Without question, this was a dark part of this medical center, but I would hate this to be a defining moment of what this institution is about.”

Checks and Errors

When inspectors from the Radiological Physics Center, a federally financed testing service, arrived at the Moffitt Cancer Center in Tampa, Fla., in 2005, they uncovered something alarming: a miscalibrated machine that overradiated 77 brain cancer patients by 50 percent in 2004 and 2005.

A new linear accelerator had been set up incorrectly, and the hospital’s routine checks could not detect the error because they merely confirmed that the output had not changed from the first day.

“Errors of this magnitude are very rare,” said Geoffrey S. Ibbott, director of the physics center. But the center’s tests have shown that inaccuracies in the delivery of machine-generated radiation are not uncommon.

Dr. Ibbott’s group also reported in 2008 that among hospitals seeking admission into clinical trials, nearly 30 percent failed to accurately irradiate an object, called a phantom, that mimicked the human head and neck. The hospitals were all using I.M.R.T., which shapes and varies the intensity of radiation beams to more accurately attack the tumor, while sparing healthy tissue.

“This is a sobering statistic, especially considering that this is a sample of those institutions that felt confident enough in their I.M.R.T. planning and delivery process to apply for credentialing and presumably expected to pass,” said a task group investigating I.M.R.T. guidelines for the American Association of Physicists in Medicine.

The group’s report, published in November, said the failure rate “strongly suggests” that some clinics had not adequately performed the initial tests to make sure their equipment was set up correctly.

“Errors like the one at Moffitt, and other errors that we have detected at other facilities, would be much less likely to have occurred if, every time a new piece of radiation therapy equipment were installed, there was some sort of independent check of the type that we do,” Dr. Ibbott said in an interview last year. “If we had gone to Moffitt eight months earlier, perhaps none of those patients would have received the higher dose.”

Another set of tests from 2000 to 2008 found that 15 percent to 20 percent of hospitals using linear accelerators in clinical trials had at least one radiation beam outside the acceptable range.

“We haven’t been sufficiently outspoken about this, although we are now in the process of correcting that,” said Dr. Ibbott, whose group is based at the M. D. Anderson Cancer Center in Houston.

Hospitals sometimes embrace new technologies before medical personnel can agree on how best to use them.

James Deye, a program director in radiation research at the National Cancer Institute, watched with concern as the popularity of I.M.R.T. exploded before there were national standards. Dr. Deye said he established minimum I.M.R.T. guidelines for institutions wishing to participate in cancer trials. “The community was going along merrily and happily without those guidelines,” he said.

Dr. Ibbott’s testing service can help clinics improve the performance of their linear accelerators if they are in clinical trials. Operators not in trials can pay to have their units tested by a sister group of the Physics Center. Even so, many do not.

“There are clearly places that don’t avail themselves of the service, even though it is well known and very affordable,” Dr. Ibbott said. “I guess they don’t want someone else checking them for some reason.”

In radiotherapy, eschewing an outside, independent review is a calculated gamble.

“If you radiate a person wrong, there’s no repeat — you can’t say, ‘Let’s forget about that one and do it correct next time,’ ” said George X. Ding, a medical physicist at the Vanderbilt Center for Radiation Oncology in Nashville. “It’s not like you do a measurement of a phantom and it went wrong and you can do it again.”

Steeper Learning Curve

Last fall, in the vast exhibition hall at McCormick Place in Chicago, dozens of companies from around the world displayed their latest radiological weapons in the war on cancer.

“That’s our newest linear accelerator,” said Hans-Jörg Freyer of Siemens Healthcare, standing in front of his company’s Artiste model, which combines imaging with therapy. Sophisticated, yet easy to use, it is capable of treating 80 patients a day, Mr. Freyer said.

Dee Mathieson, of the Swedish company Elekta, said imaging technology in their linear accelerator improved accuracy. “What has changed is the software that allows us to unleash some of these new techniques,” Ms. Mathieson said.

Over the last two decades, the industry has developed generations of machines, each designed to more precisely attack tumors, allowing doctors to administer higher doses of radiation with less risk to healthy tissue.

Linear accelerators once used radioactive beams crudely shaped as blocks or rectangles. Since tumors do not grow in straight lines, healthy tissue was sometimes irradiated along with the cancer. To minimize collateral damage, technicians manually inserted blocks and filters, a task later taken over by computers.

Computers eventually were able to produce three-dimensional images of tumors — a major advancement — and linear accelerators used software that contoured beams to conform to the shape of the tumor. The next step, I.M.R.T., allowed doctors to more precisely tailor the shape and intensity of the beams. The latest generation of machines, which were on display at McCormick Place, incorporates sophisticated imaging.

The F.D.A. waved these advancements through with little review on the grounds that they just extended existing technology. But there are dissenters. “It’s so much more than that,” said Dr. Deye, the National Cancer Institute official. “The issues surrounding advanced technologies are far-reaching.”

Even if the devices work as intended, hospitals face a steep learning curve.

In 2005, when Landreaux A. Donaldson underwent therapy for prostate cancer at Mary Bird Perkins Cancer Center in Baton Rouge, La., the linear accelerator was so new the vendor’s training instructors were still in the hospital, records show. The accelerator delivered radiation in a radically different way, emitting tiny beams of radiation from many points on a spiral encircling the patient.

In treating Mr. Donaldson, the hospital used the wrong type of CT treatment scan for the machine, prompting medical personnel to compensate by doing what is called “a work around” — a departure from established procedure. But because they were unfamiliar with the treatment planning software, they made a miscalculation that affected all 38 treatments, stretching over two months, according to state records and a lawsuit filed by Mr. Donaldson.

The next year, Mr. Donaldson began experiencing stomach ulcers, anemia and urethral stricture, which required surgery. He also underwent hyperbaric oxygen treatments, where pure pressurized oxygen is used to promote healing. Neither the hospital nor Mr. Donaldson would comment on the lawsuit, which has been settled.

As therapies become more complex, there is more to check — sometimes too much, say some medical physicists.

“When it exceeds certain levels of complexity, there is not enough time and not enough resources to check the behavior of a complicated device to every possible, conceivable kind of input,” said Dr. Williamson, the medical physicist from Virginia.

As the person most responsible for ensuring that an optimal radiation dose is delivered safely, the medical physicist must make sure that new machines are set up properly; that daily warm-up checks are carried out, along with more extensive monthly and annual evaluations; and that individual treatments are administered as prescribed.

Computers can provide only so much help. In the past, they checked the work of radiotherapists, but now therapists check the computers, said Howard I. Amols, chief of clinical physics at Memorial Sloan-Kettering Cancer Center in New York.

The problem, Dr. Amols said, is that computers are better at checking humans than humans are at checking computers. “The responsibility on Day 1 to make everything right is much more important than it used to be,” he said. “We are still grappling with how we do that.”

Hospitals sometimes aggravate the problem, buying new technology without adding the employees needed to operate it safely, according to a report issued on a 2007 conference sponsored by two radiological associations and the National Cancer Institute.

And hospitals complain that manufacturers sometimes release new equipment with software that is poorly designed, contains glitches or lacks fail-safe features, records show.

Northwest Medical Physics Equipment in Everett, Wash., had to release seven software patches to fix its image-guided radiation treatments, according to a December 2007 warning letter from the F.D.A. Hospitals reported that the company’s flawed software caused several cancer patients to receive incorrect treatment, government records show.

In another case, an unnamed medical facility told federal officials in 2008 that Philips Healthcare made treatment planning software with an obscure, automatic default setting, causing a patient with tonsil cancer to be mistakenly irradiated 31 times in the optic nerve. “The default occurred without the knowledge of the physician or techs,” the facility said, according to F.D.A. records.

In a statement, Peter Reimer of Philips Healthcare said its software functioned as intended and that operator error caused the mistake.

Patchwork of Regulation

When George Garst was treated in 2004 for prostate cancer at Christus Spohn Hospital in Corpus Christi, Tex., his caregivers were subject to the following regulations:

The first half of his radiation treatment — external beam therapy — was overseen by the state radiological division operating under one set of rules. The second half of his treatment — radioactive seeds — was subject to a second set of rules established by the Nuclear Regulatory Commission, except that the commission passed its responsibility on to the state, which must follow some, but not all, of the commission’s rules. In any case, the second rules differ from the first.

State radiology officials have no enforcement power to punish a clinic if it botched the first half of a procedure like Mr. Garst’s, but they can for the second half. If any radiation equipment failed to work properly, resulting in a serious injury, that must be reported to the federal Food and Drug Administration, the manufacturer and the state.

As it turned out, Mr. Garst was overdosed and seriously injured, destroying his ability to urinate and move his bowels normally. Before two external bags were attached to collect his waste, Mr. Garst’s urine leaked into his rectum because a fistula had developed. He had so many infections, his doctors had to keep trying new antibiotics to replace those that no longer worked.

“He was very, very sick from all this,” said Dr. Norbert C. Brehm, one the doctors who treated Mr. Garst after the accident. “He was not sleeping. He had a feeling of worthlessness, hopelessness, appetite disturbance, mood swings.”

And yet, until The Times began investigating Mr. Garst’s injuries, no one in government — not Texas, not the Nuclear Regulatory Commission — was even aware of his overdose or of his devastating injuries.

The state and the commission initially told The Times that they had no jurisdiction in the case since neither the first nor second treatment was by itself an overdose, even though in combination they were. Despite their mandate to protect patients from radiation mistakes, the state and federal government said in essence that Mr. Garst was someone else’s problem.

Had regulators investigated, they would have found reasons for concern.

The medical physicist later said he had been overworked, rarely taking a day off, and that he had complained to hospital officials about staffing issues. Mr. Garst’s radiation oncologist failed to prescribe a dosage for the implanted radioactive seeds, and the actual dose ended up being too high, according to a lawsuit filed by Mr. Garst. The physicist then failed to catch the mistake. The oncologist also implanted seeds too close to Mr. Garst’s rectum, the physicist delayed performing a post-implant analysis, and the oncologist failed to promptly report the overdose to the patient’s doctor.

Mr. Garst said he did not learn of his overdose until about a year later.

In response to inquiries by The Times, the Nuclear Regulatory Commission said the state had opened an investigation into Mr. Garst’s care. “They’re going to look at why the licensee didn’t report it — was there a deficiency in their procedures or training?” said James G. Luehman, a deputy director in the commission.

Last week, Texas reported that its investigation had found no violations of state radiation regulations. The hospital declined to comment on the case, which has been settled.

Mr. Garst said that medically, he was at a dead end. “They couldn’t really do anything for me because I’m so burned up,” he said.

Last year, health officials in eight states sent a letter to Congress asking for a more rational way to regulate radiation. “There is no national program charged with the protection of the public from all radiation sources,” the letter stated. “Federal agencies pressure the states, most of which have comprehensive radiation programs, to provide protection from certain sources of radiation while ignoring other sources.”

Kirksey Whatley, director of the Alabama Office of Radiation Control, said radioactive materials, which are overseen by the N.R.C., received most of the government’s attention, while the much more common machine-generated radiation was largely unregulated by the federal government.

Thirteen states, including California, do not require that errors involving linear accelerators be reported to state health officials. Texas requires that they be reported, but has no enforcement authority to punish anyone. New York rarely fines radiotherapy units for substandard care, while Florida frequently does.

Part of the problem is that hospitals may skimp on quality assurance because, depending on the state, it is voluntary, medical physicists say.

Jared W. Thompson, an Arkansas radiation official, said he mostly worried about diagnostic radiation. “There are no limits about what can be done, how it can be used, when it is considered unsafe,” Mr. Thompson said.

There are no guarantees, Mr. Whatley said, that radiological devices have been inspected and that its operators are properly trained and qualified. Depending on the state, he added, “you may get two to three times more of the radiation you need.”

Even when overdoses occur, some medical practitioners are reluctant to publicly disclose them. An N.R.C. advisory group underscored that point when in 2005 it recommended that the agency adopt the “industry standard” when responding to a radiation error, called a medical event, or M.E. “Keeping M.E. reports, or at least the licensee’s identity out of the public record, is probably the single most useful improvement N.R.C. could make in this regard,” the advisory committee urged.

The commission rejected that recommendation.

Responding to Mistakes

Under Ohio law, Akron General Hospital was obliged to file a detailed written report no later than 15 days after it overdosed Myra Jean Garman, 76, a breast cancer patient, with high-dose radioactive seeds.

Instead, Akron General waited five months, records show.

Just two months before Mrs. Garman’s accident, at the same hospital, another patient was overdosed with 111 radioactive seeds that were too powerful. When the Ohio Bureau of Radiation Protection inspected the facility, it found that the hospital’s radiation safety officer was not even aware of the accident. Nor did the hospital’s radiation safety committee discuss the overdose when it met for its regular meeting, state regulators said.

Mrs. Garman’s accident occurred in September 2006, when she received twice her prescribed dose five separate times because a physicist had “entered an incorrect magnification factor into the treatment planning computer,” according to state regulators.

Five months later, she complained of severe pain, and doctors discovered that she had broken ribs, a known side effect of her type of overdose. Mrs. Garman’s daughter, Joyce Lilya, said her mother, who had walked two miles daily before the procedure, could now barely walk two blocks.

Even though her cancer did not reappear, a year after the overdose, Mrs. Garman ended up in intensive care with breathing troubles. No cause could be determined, her daughter said.

A month later, Mrs. Garman took an overdose of Tylenol, tied a plastic bag around her head and killed herself. “I was really trying, but it was too much for me,” she said in a note. “Let me go!!! Please.”

Ms. Lilya said she and her family were stunned, calling her mother a “positive person” who would never hurt herself even though her husband had died several months earlier. Seeking reasons for her mother’s suicide, Ms. Lilya began searching the Internet and reached out with dozens of calls and e-mail messages to professional groups and government agencies.

Only then, she said, did she learn of the radiation overdose. Much to her surprise, the state had cited the hospital only for failing to promptly report the mistake to state authorities. There was no fine. And while Mrs. Garman’s medical records show that she had asked for a written account of her overdose, the hospital could produce no such document nor was one in her medical file.

James Gosky, a spokesman for Akron General, said in a recent interview that Mrs. Garman had been informed of her overdose.

Still, Ms. Lilya said, “none of this made any sense.” So she kept pressing — without success — for a more thorough investigation of her mother’s accident.

In a conference call last summer, she said Lance D. Himes, assistant counsel for the Ohio Department of Health, explained part of the department’s enforcement philosophy.

“He told me they don’t get into assessing penalties because that is what malpractice is for,” she said.

A spokesman for the state said Mr. Himes denied making that statement. And in October 2007, the state did fine the hospital $4,000 for other infractions — but not for Mrs. Garman’s overdose.

Ms. Lilya said her investigation had taught her much about how hospitals respond when they make a mistake. “It has been a long and tragic journey for my family,” she said, And, she added, “No one was held accountable.”

Reporting was contributed by Simon Akam, Renee Feltz, Andrew Lehren, Kristina Rebelo and Rebecca R. Ruiz.

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