Inmate NN7687's Presence Certain to Offend Prisoner Honour Code

"Flanked by armed sheriff's deputies, he disappeared through an arched doorway, bound for a holding cell -- Cosby's first stop in a journey that will take him to a state prison where he'll be confined to a tiny cell that could have fit into the corner of a room in any of his mansions."
Manuel Roig-Franzia, The Washington Post

"It's basically his own space. He's a high-profile inmate ... and obviously, safety is the paramount issue inside a prison."
"He still has to do it. [Stand outside his cell for a regulated head count.] It's part of the prison ritual."
"He didn't have Jell-O [for his dessert]. The word 'Jell-O' may appear on the menu, but it is not a Jell-O brand [which brand Cosby touted on TV] product."
Amy Worden, press secretary, Pennsylvania Department of Corrections

"They're going to have to put him in protective custody."
"The problem is the nature of the crime. Rapists are frowned upon in prison."
O.J. Simpson

How utterly deranged, that a man who for many decades reached the pinnacle of public acclaim and respect for his immaculate personification as a trusted mentor to young black males, exhibiting good humour, impeccable social manners, empathy for those in trouble, and a masterful control of acting's accolades as a sterling example of the most respectable traits in human kindness, restraint, and strict adherence to society's contract with law and justice, would turn out to be among one of society's most reviled sexual predators.

His persona as the exemplary father-figure, the guide of the young and impressionable toward a life of service to others, tolerance for those who err, and a willingness to point them gently in the right direction was a carefully guarded facade, one which crumbled when the rising clamour of those whom he molested finally gained traction beyond their initial dismissal by authorities who simply couldn't conceive that this master thespian could possibly be the monster who stalked women, drugged them and raped them.

The long-awaited trial and the testimony aired therein was sufficiently convincing that one woman's tribulation and memory brought justice to the estimated sixty women who had suffered in silence. The celebrated master of comedy is no more. What is left is an elderly man whom his wife continues to support and who insists he is too ill to be incarcerated. A man who slept in a cot bolted to the floor of a cell, a man who is temporarily being kept incommunicado, who must undergo an evaluation before he is released from his current state of solitary sensory deprivation.

At the State Correctional Institution Phoenix, Bill Cosby is the lone occupant in a unit where he is in partial isolation, taking his meals without company, walking its yard on his own, standing to be counted by a guard to ensure that no prisoners are missing, though he is the lone prisoner in that unit; protocol and routine that he will become familiar with, barring some changes in the near future. Simply put, prison administrators are wrestling how they can accommodate the presence of an infamous sex offender for three to ten years.

To rise eventually from the ashes of his disgrace to embrace his legendary persona once again as the emblematic Phoenix of antiquity?

A tour group enters block D in the west section of the State Correctional Institution at Phoenix in Collegeville, Pa., June 1, 2018. Jacqueline Larma/AP, FILE

While there are roughly 3,600 inmates in this new prison -- or will be once it is at capacity -- how one singular inmate's needs will be catered to remains an as-yet unanswerable question. While the potential for "violence" to be wrought against this man by other prisoners contemptful of the acts he committed are for now held at bay, the man himself must contend with the debilitating psychological impact of loneliness and boredom.

Following this normally jovial man's sentencing he was driven to SCI Phoenix, through a rainstorm; even nature recognizing the solemn, dark occasion of a man fallen from grace; the institution a 164-acre compound of cellblocks surrounded by a mile and a half of razor wire and electronic fencing. Could anything be more foreign to this man's experience, more alienating, more deserving than his transition from admired social celebrity figure to scorned incarcerate?

Prison guards guided him into the prison's central building where the obligatory pose for his mug shot took place and he was outfitted in a prison uniform and boots and given his distinguishing number as Inmate NN7687. From someone to nothing in one fell swoop. In his empty corner of the prison, he eats, sleeps and takes his recreation.

A housing unit is pictured in the west section of the State Correctional Institution at Phoenix in Collegeville, Pa., June 1, 2018.   Jacqueline Larma/AP, FIL

Once he has undergone the formality of completing a standard battery of psychological and medical tests designed for new inmates and sex offenders -- a ten-day process -- he will be permitted family visits, he will be able to procure a TV and tablet for his cell. And he will be enabled to take advantage of available classes or work positions for inmates.

Word from the prison is that Cosby is adapting to his new life and appears to be in "good spirits". "We are taking all of the necessary precautions to ensure Mr. Cosby’s safety and general welfare in our institution. The long-term goal is for him to be placed in the general population to receive the programming required during his incarceration", explained corrections secretary John Wetzel.

The Aching Vacuum

"[It's not a specific dream, but] mostly the comfort of his presence, seeing  him, hearing his voice -- just a feeling that he is with me. [Dreaming, there is a brief reprieve from] the constant aching void that I feel for him every waking minute."
"...I didn't want to be that helicopter parent, the overprotective mother."
"It's such a backward and such a corrupt country [Peru]."
"At the cemetery [for her father's funeral, late August], I scooped up a shovel full of earth and dropped it on the coffin -- and said, 'Oh, my God, this is my goal'. It hit  me like a ton of bricks: I'm  trying to bring my son home in a coffin. But it's not even that; it's that I have to know what happened."
"Because I brought them [son and daughter] up alone and because he was the older one, he was my friend. Jesse was not just my son, but he was my best friend. We took ski  trips out west alone together annually, loved spending time together, and we talked about everything."
"We were closer than the usual mother-son relationship -- even through his teens. He was an enormous emotional support to me, and a huge part of my life."
"Every single time I go back [to Peru] with hope anew -- and I am disappointed. But I have to keep going. I can't finish it until I have an ending."
Alisa Clamen, 53, Montreal

Alisa Clamen at home in Côte-St-Luc. "Jesse was not just my son, but he was my best friend." John Mahoney / Montreal Gazette

"We built a psychology profile of Jesse to figure out what he considered and what he did not consider and to figure out how he made his decisions."
"Either he was carried out of the area [Santa Cruz Trail, Peru], or hidden very carefully."
"[Alisa Clamen is] one of the strongest people [I've ever encountered in such missing persons cases.] She is very strong, very rational and she is making every effort."
"Though it takes time, we believe we will reach a solution."
Magnus International Search & Rescue CEO Guy Atzmon

"To find him now is a matter of intelligence to point you in the right direction to look. It means very deep work, getting into small villages, local people."
"...My heart is with the mother. That's what is driving me, to try to raise the mystery out of those mountains."
"We would like to provide some peace for her soul."
Hilik Magnus, founder, Magnus International Search & Rescue

Jesse Galganov, 22, (right) is seen with his mother Alisa Clamen in this undated photo. (CP24)

He was 22 years old, a young man of adventurous spirit, about to begin medical school in Philadelphia, come July. Before then, he planned to satisfy his sense of adventure on a solo trip to South America and Asia, an eight-month travel venture. His mother drove him to the airport so he could board a flight for Peru. That was a year ago. On the 28th of September Jesse texted his mother, informing her he'd be out of touch for four days while he hiked the Santa Cruz trail along the world's highest tropical mountain range.

October 2 arrived and Jesse's mother felt certainthat her son must have set out on a longer trail. By the following week she contacted the Canadian embassy to be informed that a police report was required to alert Interpol. On October 17, the single mother of two young adults, a practising lawyer, set out herself for Peru. From her experience while there, she gained the indelible impression that authorities were not all that interested in tracking her son's whereabouts. Not did she get much help elsewhere.

She found a lack of security and organization. Registration trail logs were missing or incomplete; technology companies and service providers refused to release details of last use of Jesse's electronic devices. She quickly organized searches both by local teams and through an elite Israeli-based search-and-rescue group with equipment and advanced technology inclusive of underwater robots and drones, in the search and investigation. So far all that activity has come in at a cool $2 million. Helped by community support, fundraising, and mortgaging her home, she carried on.

She no longer hopes to find her son alive, but she desperately wants to know what happened to him, and if at all possible, to discover where his body is, and to bring it home to Canada. She has been long divorced; her daughter was one year old at the time, Jesse two. She is no longer capable of practising her profession as she once did; concentration eludes her. She now lives a fairly secluded life, unwilling to socialize, seeing none but close friends and family. "I don't have the desire or energy for anything else", she points out, understandably.

She is no longer "in step" with the world at large. She goes out of her way to avoid running into people she knows: "They don't know what to say. I hate putting them in that position." She continues to pay her son's cellphone invoices: "I can't bring myself to stop", and until recently maintained his car lease. People admire her strength and perseverance. "What's the alternative? I can fall apart and just stay in bed -- or I can try to function. If I don't continue the search for Jesse, who else will?"

The Magnus crew analyzed Jesse's trek, the environment in which he found himself, how he managed to forge ahead with his plans. They contacted close to 200 other travellers from around the world they managed to identify through Facebook photos, "to build the full picture of who Jesse met, whom he spoke to". Two hikers who had shared the same campsite with Jesse on September 30 for example. They discovered that on October 1, Jesse had enquired of a group of Czech tourists where he might find water. After that there was no sign of him.

There are those who feel Jesse may have been assailed with altitude sickness causing him to wander off trail where he succumbed to the elements. Possibly, someone might have come across his body, robbed him and moved him to a remote location by donkey or horse, or even thrown his body into a body of water nearby. Not content to allow others to do the searching Alisa Clamen spent four months in the past year in Peru, 21 nights of which were spent on the Santa Cruz trail, willing herself to view what her son encountered, to walk in his footsteps.

The trail, she found, is difficult to navigate, dangerous, poorly marked with ample hazards aside from altitude sickness. There are mud fields, jagged rock fragments (scree) and slippery rock sheets to negotiate. In July she went along with a local guide-company owner she trusts and his team on a glacier search on the trail, encountering a 50-cm snowfall that impeded progress on their search. A canine team trained to sniff out human remains failed to work due to the difficulty of the terrain.

Alisa Clamen yearns, and needs her son Jesse, alive or dead, to return home to her, so her soul can be at rest just as his will be put to rest.

Jesse Galganov Fund

Missing Children's Network Canada

The Boss of the House

"We called her our little unicorn because she had this bump on her head, but it would have killed her. It's pretty amazing what they did for my girl."
"Her head looks great, other than her crooked ear. Patches is now cancer-free."
"They felt she could recover from this. And to be part of cancer research was a big thing for me -- if they can learn something from animals to  help humans, that's pretty important."
Danielle Dymeck, Williamsport, Pennsylvania

"Our hope is this is something that could be more widely available on a broad scale. It went very well."
"[We had to create a] cutting guide [to follow during surgery]. There's very little room for error."
"We we're talking less than two millimetres or else the plate wouldn't fit."
Michelle Oblak, veterinary surgical oncologist, University of Guelph Ontario Veterinary College

Patches, a nine-year-old dachshund from Willamsport, Pa., is shown before surgery for a brain tumour that eventually grew through her skull. The Canadian Press

The plate that Dr. Oblak referred to was a custom-made titanium skull cap blueprinted to fit a dog. And the dog was Patches, a nine-year-old Dachshund with a brain tumour the size of an orange. As it grew, it eventually emerged right through her skull. Had it not been treated by surgery, that tumour would have been fatal. Patches required about seventy percent of her skull to be removed and replaced.

The surgery that Patches underwent is not entirely new. Veterinarians in the United Kingdom have performed quite similar surgery, but on a smaller scale. What is quite different about Patches' procedure is that 3D-printing technology was involved. Dr. Oblak, a researcher in Guelph, has studied the use of 3D-printing technology specifically for dogs. She explained that up to the time that Patches underwent her surgery -- the first of its kind using 3-D printing technology -- a different type of procedure prevailed.

On those other, earlier occasions, a tumour along with part of the skull would be surgically removed and while the animal was still anaesthetized, the surgeon would fit titanium mesh into place, an imprecise, costly and lengthy procedure, she stressed. The process that Dr. Oblak has pioneered is entirely new, where a 3D-printer is used to create a custom-made titanium skull cap that fits into place more accurately.

Danielle Dymeck, Patches' human, described the appearance of a small bump Patches wore on her head for years. And then it began to grow months earlier, in an aggressive manner. The veterinarian who normally looked after Patches mentioned to Dymeck that Cornell University, known for its veterinary program might help. A veterinarian at the university contacted Dr. Oblak, and that began Patches' journey to ridding her of the cancerous tumour and giving her a new lease on life.

Patches after the operation to replace part of her skull with a titanium implant. (Canadian Press)

A CT scan was taken, to provide an image of Patches' head and tumour. With the use of a number of different software programs on that image, Dr. Oblak and her team cut out the tumour digitally along disease-ridden portions of Patches' skull. They turned then to mapping out where a 3D-printed replacement would look like, along with where holes for screws should be located to hold the titanium skull plate in place.

The digital blueprints were forwarded on to ADEISS, a medical-grade 3D-printing company located in London, Ontario. There, a customized titanium skull cap was produced for Patches. With the aid of the "cutting guide" that Dr. Oblak had created, the procedure where several veterinary surgeons, software engineers and an industrial engineer lent their expertise, the surgery moved along expeditiously.

Researchers at Guelph University have performed what is believed to be the first major dog skull replacement using 3D-printing technology. (Canadian Press)

Two hours were taken to map out the plans, sending them to the printer, and the titanium skull cap was ready within two weeks. The surgery for Patches took four hours. And recovery was amazingly swift. Within a half-hour of coming out of the anaesthetic, Patches walked outside for a bathroom break, cancer-free.

There's more to Patches' story; she suffered a badly slipped disc in her back and hind legs a week after the surgery -- an incident unrelated to the surgery -- leaving her hind legs paralyzed. That hasn't stopped Patches, however. "She has a wheelchair that she refuses to use, so she pulls herself around on her two feet, but she’s pretty fast", said Ms. Dymeck. "I feel lucky to be her owner, and she’s still the boss of the house."

Technology Advancing Us Toward Hypochondria 

"The fear is we could end up with a lot of over-treatment, over-call and people waiting in emergency departments for no good reason."
"[Heart rate variations throughout the day are normal] and now we're going to pick up much more of that signal."
"[A single-lead ECG connection can't diagnose a heart attack] so that's important to get across."
Dr. Samuel Vaillancourt, St.Michael's Hospital, Toronto

"The danger with any new medical technology is that in the enthusiasm to be an early adapter, for what is an admittedly cool gadget, we risk engaging in a population-wide screening strategy that is decidedly flawed."
"[Guidelines don't recommend screening people for AF -- atrial fibrillation], so in a sense no one needs to wear this on the wrist."
"Since the people who are more likely to buy an Apple Watch are younger and probably therefore healthier [wearing an ECG on their wrist] 24/7 is likely going to create a lot of false positives."
"The main risk of AF is that it increases the risk of stroke."
Dr. Christopher Labos, Montreal cardiologist, associate, McGill Office of Science and Society

Tomohiro Ohsumi | Getty Images

A person uses an Apple Watch Series 3 at the Apple Omotesando store on September 22, 2017 in Tokyo, Japan

"This is going to create such a massive headache [for doctors]."
"Every worried [healthy] Tom, Dick and Harry are (sic) going to be freaking out about every blip thing that shows up on their Apple Watch."
Dr. Ethan Weiss, associate professor, University of California, San Francisco

"Often patients come to us saying that they feel stuff, but we don't have the rhythm recorded so we can't really tell what's going on."
"I think it behooves us as a medical profession to educate the public that, if you have Afib, it's not the end of the world. [Different if other risk factors for stroke are present, or if long periods of irregular rhythm arise] like days and days, and the heart is really fast."
"[Should the app pick up an abnormality, that should be shared with a doctor for further testing] to figure out if it's atrial fibrillation, or if it's nothing."
Dr. Andrew Ha, cardiac electrophysiologist, Peter Munk Cardiac Centre, University Health Network, Toronto

The people most likely to be or become candidates for atrial fibrillation are the elderly. How comfortable are those in that age category with the use of technologically advanced gadgets that send their younger contemporaries into paroxysms of desire to own the latest, hottest, coolest gadgets on the market? Those already suffering from compromised health conditions and whom readouts of their heart rhythm at any given time presented to their cardiologists for whom the Apple Watch with its over-the-counter ECG could be useful wouldn't be using it; too complex, too confusing.

AF is a leading cause of stroke, affecting approximately 34 million people worldwide. Apple's ECG app is not endorsed by the American Heart Association, but it does admit the device could possibly lead to swifter diagnoses of AF. The recordings, stored in a health app, can generate a PDF to be delivered to the wearer's doctor for consultation, in the best of all possible scenarios. However, given the demographic that will be wearing the watch, it isn't too likely that this scenario will emerge from a gadget that impresses with its capability but in reality is just another plaything.

According to the Apple Watch specifications, the ECG app detects signs of an erratic heart rhythm. But under many circumstances, some normal, some adverse, heart rhythm fluctuates during the space of a day. Separating the wheat from the chaff as it were, is a diagnostician's professional aptitude and concern, not the wearer of the watch who has no medical experience and would be prone to imagining worst-case scenarios unfolding.

So even though the app, according to Apple's description of its function, generates a "heart rhythm classification" with the potential of determining whether heart is beating normally, or whether signs of atrial fibrillation have been detected, what is the wearer going to do with that information aside from panicking? AF causes the heart to quiver and possibly beat chaotically rather than contract in a measured way with each heartbeat. The risk of AF is blood pooling in the heart's upper chamber, where clots can form and move through arteries feeding the brain, to cause a stroke.

A normal ECG has a dozen 'leads' placed on the chest for detection of symptoms, while the Apple ECG app has a single lead. What emerges from that single lead can be very misleading and certainly incomplete. Research studies on systematic screening of large populations for the presence of AF has not proven to be useful, according to Montreal cardiologist Labos, in an article published by McGill University's Office for Science and Society.

False positives are the major concern; false positives where a test indicates abnormality when in fact the results of the test fail to reveal anything abnormal at all, have been common occurrences among the healthier contingent of people tested. Should an individual be tested and found to have AF, the presence of additional risk factors like high blood pressure, diabetes or old age would indicate the use of blood thinners. But not everyone diagnosed with AF requires blood thinners.

And according to Dr. Ha, though the Apple app could provide health professionals with a measure of objective proof of an abnormal heart rhythm, that single lead test should never be considered a substitute for a standard, infinitely more accurate ECG interpreted by an expert. Bearing in mind at the same time that some people with AF have no symptoms whatever, while others are unable to function, continually exhausted.

Clearly, diagnosing such conditions can be complicated requiring medical devices more complex than the Apple app, and the experience leading to related treatment of a specialist. Piggy-backing a medical device onto a technological gadget speaks to the technology-fascinated aficionado's appetite to acquire the latest offering in technological advances and in this instance of health-monitoring and diagnosis, Apple has entered a realm where confusion and complication rule.

It should carry the caution of caveat emptor.

Daily Prayers

"I was on the raft for one month and 18 days. My food ran out after the first week. I had to soak my clothes in the sea, then I squeezed and drank the water."
"I thought I will never meet my parents again, so I just prayed every day."
"It was early morning on August 31 when I saw the ship and I lighted up the lamp and shouted 'help!' using the HT [handy-talky portable radio]."
"The ship had passed about one mile but then it turned to me. Might be because I used the English word [help]. Then they talked on the HT [hand-held radio]."
Aldi Novel Adilang, 18, Jakarta, Indonesia

"Aldi said he had been scared and often cried when adrift."
"Every time he saw a large ship, he said he was hopeful, but more than ten ships passed him, and none of them stopped."
Fajar Firdaus, Indonesian diplomat, Osaka, Japan

(Indonesian Consulate General Osaka/Facebook)

Adilang worked as a lamp lighter on a rompong since the time he was sixteen years of age. The rompong, a raft of wood topped by a hut is lit at night to attract ocean fish to the shoreline of Indonesia's coastal area of North Sulawesi, an aid to local fishermen whose living is crucial to the general diet of the population. Lamp lighters lead a solitary existence; the fishing rafts are moored at least 100 kilometres offshore, with no paddle, no engine, set dozens of kilometres apart.

The rafts are anchored with ropes but occasionally they break, from relentless friction. Once weekly supplies, fuel for a generator, food and any other necessities are dropped off for the minders who communicate with fishing boats via a hand-held radio they are supplied with. Work contracts are for six-month periods. For their efforts, the fish minders earn $130 monthly, a considerable assist to a large family whose children are expected to help support the family income.

Adilang's fish trap went adrift on the Pacific Ocean when its moorings slipped. To survive, he caught fish, cooking them by using the wooden fences along the top of the rompong to make cooking fires. Aspirants to the job must prove they are capable of fending for themselves and this young man certainly did. Ten ships passed the stranded youth and despite his efforts to bring his plight to their attention, none responded, "unaware of my ordeal", he explained. There were days with no rain, and that's when Adilang drank seawater.

After fifty days at sea the Panamanian-flagged MV Arpeggio off the island of Guam -- some 1,920 kilometre from where Adilang's wooden fish trap came loose -- stopped to rescue the boy. Although this was the third time his raft had come loose and drifted, on the other two occasions the raft had been rescued by the ship of the owner of the 50 rafts. When Adilang saw the ship passing he once again attempted to draw the attention of its crew as he had done with the previous ships that had failed to notice his efforts.

(ICGO/Facebook)

Once he had succeeded in alerting the crew of the ship to his presence, rescue was complicated by the condition of the ocean, assailed by high waves -- a completely agitated surface. The Arpeggio's crew threw a rope as the tanker circled around the raft. The rope was beyond Adilang's grasp, leading him in desperation to leap into the water. In his weakened condition he barely managed to grasp the rope. Eventually a member of the Arpeggio's crew was able to grasp his hand, pulling him to safety.

Once aboard and safe, the Arpeggio contacted the Indonesian mission in Japan when the ship docked and officials from the Osaka consulate arrived to take the boy into their custody on September 6, returning him to Indonesia two days later. The youngest son of four siblings, Adilang has decided that rompong work as a lamp lighter attracting fish is not a career he plans to carry on with. "My parents agree", he said.

Adilang (in white T-shirt) reunited with his family (ICGO/Facebook)

Surviving Natural Disasters

"I guarantee you, I can say this without a doubt, my husband saved my life and my son's life."
"We didn't get water inside the house, but at one point we were completely surrounded."
"I try to be positive, but it's getting harder and harder. I really feel like we're being tested. I'm a God-fearing woman but I'm confused right now."
"I have never heard my husband yell in that manner 'Get down here right now'!"
"A friend of mine was joking when she said, 'I will never live beside you'. This is following us. I said to our builder, I feel like this is my fault."
Nicole Lowden, Ottawa paramedic

Brian and Nicole Lowden’s house was destroyed by a tornado on Thomas Dolan Parkway in Dunrobin, September 23, 2018. Jean Levac / Postmedia News

"This is definitely not a short-term fix here. We're looking at weeks and months [of work to normalize the community struck by a category 3 tornado on Friday]."
"Dunrobin will bounce back and it will be rebuilt and we'll be stronger for it."
"There's a lot of heartache, but it's expressed in hope."
Greg Patacairk, president, Dunrobin Community Association

Last Friday was a really peculiar day weatherwise in Ottawa, Canada's capital city. The area, in the Ottawa Valley, is prone to freakish weather conditions, but this time the conditions were quite extraordinary. A year ago, areas of the city and across into the province next to Ontario, Quebec, there was flooding from incessant heavy spring rain. Built on Leda clay, susceptible to 'melting' when completely suffused with rain, there had been some mudslides, and the Ottawa River dividing the provinces, flooded.

Back then, the Lowden family living in the community of Constance Bay on Bayview Drive, just managed, with the help of sandbags and pumping the water out of their basement, to keep the floodwaters out of the house they had lived in for twenty years. They decided, however, to sell the house and move out of the area. Then, they planned to build a new house elsewhere in the community. Just as their old house sold, their daughter, age 21, was diagnosed with Stage 2 lymphoma. After chemotherapy treatment she is on the road to recovery.

Brian Lowden sits on an overturned boat in his backyard among debris left by the tornado that touched down in Dunrobin on Sept. 21. (Justin Tang/Canadian Press)

They have been living in a rented house in the community of Dunrobin, and disaster followed them to that location when on Friday, after a steaming, humid day of 29C with forceful winds prevailing and weather warnings of violent thunderstorms, one of those thunderstorms struck at 4:30 p.m., sending daggers of lightning from sky to ground. So much, so normal, for the Ottawa area. What was abnormal was the tornado that struck at five in the afternoon of the last day of summer. It swept through the community, ripping up trees, tumbling cars, tearing the roofs off homes and buildings.

The tornado broke hydro poles as though they were matchsticks, a quarter-of-a-million residents were without power and have been for days. And about 60 houses were completely destroyed. The Lowden family's rented house among them. Their adult son, tired after work, had arrived home to collapse on his bed upstairs. Nicole's husband Brian, a volunteer firefighter who had been on duty at a nearby fall fair, came home early in response to the severe weather warning. Nicole was upstairs closing windows against the wind and rain, when she heard her husband shout out from downstairs.

He bounded up the stairs to drag their son Daniel out of bed, and hauled her with them down the stairs to huddle in the kitchen beside the refrigerator in the basement-less house.  "I'm telling you, that's the only part of the house that is untouched", she later said. Daniel went in frantic search of their six-pound blind dog, Lola, as windows were breaking all around them, and lumber was splintering and flying through the air, and the roof flew off the house. They could look outside to see the house next door utterly gone, nothing but the foundation left.

They had no insurance on the house contents and nothing is salvageable. Escorted by firemen and other volunteers on Sunday the evacuated residents of Dunrobin were allowed to return to their homes -- what was left of them -- to look for items and keepsakes. And the Lowden family is looking for alternate rental accommodation, awaiting the completion of their new home whose construction is meant to be complete by next spring.

A firefighter hands Alex Carlson his laptop, which was recovered from the wreckage of his Dunrobin home. A volunteer firefighter for the local fire department, Carlson might have been called to the scene of his own home's destruction had he not been out of the city at the time. (Justin Tang/The Canadian Press)

Smashing Prescriptive Icons

"This should set the record straight. There's a lot of folks on both sides of this but this study should end the question. There is no benefit for seniors who do not have vascular disease."
"I've spent the last five, six years trying to get all my seniors to stop taking Aspirin [based on the clear risks and unproven benefit]."
"If you look at the new findings, at best it's neutral and at worst it increases the bleeding risk."
Dr. Vincent Bufalino, Advocate Heart Institute, Chicago

The study 'could not identify any subgroup in whom Aspirin was beneficial in preserving good health.' (Gary Cameron/Reuters)

"Taking low-dose aspirin daily doesn’t preserve good health or delay the onset of disability or dementia in healthy older people. This was one finding from our seven-year study that included more than 19,000 older people from Australia and the US."
"We also found daily low-dose aspirin does not prevent heart attack or stroke when taken by elderly people who hadn’t experienced either condition before. However it does increase the risk of major bleeding."
"It has long been established that aspirin saves lives when taken by people after a cardiac event such as a heart attack. And it had been apparent since the 1990s there was a lack of adequate evidence to support the use of low-dose aspirin in healthy older people. Yet, many healthy older people continued being prescribed aspirin for this purpose."
"It means millions of healthy older people around the world who are taking low-dose aspirin without a medical reason may be doing so unnecessarily, because the study showed no overall benefit to offset the risk of bleeding."

John McNeil, Professor, Head, School of Public Health & Preventive Medicine, Monash University, Australia

Published in three articles in the New England Journal of Medicine a week ago, a new study of over 19,000 people who were prescribed low-dose Aspirin to be taken daily for an average of 4.7 years found that the long-held trust that Aspirin would reduce the potential of stroke or prevent heart attacks, even dementia and cancer, was not borne out by the study results.

The elderly who were taking this prescribed medication for that very important purpose were not at all advantaged as it was presumed they should be. Their risks of cardiovascular disease, dementia or disability were not reduced, thanks to the supposedly miraculous effects of regularly taking low-dose Aspirin as a preventive. What that regular intake did do, however, was increase the risk to the individual of bleeding of a health-averse, significant effect in the digestive tract, brain or other sites, which required remedial blood transfusions and hospital admission. 

The study leader, Dr. John McNeil of the department of epidemiology and preventive medicine at Monash University in Melbourne, Australia, emphasized that "the ugly facts which slay a beautiful theory", came to the researchers as a surprise; not at all what they had anticipated would be the finding when they set out to test the medically accepted theory of Aspirin as a deterrent to adverse heart conditions in the elderly. They had in actual fact, anticipated that their research would support the belief that Aspirin would help prevent both heart attacks and strokes in the participants of the study.

Not only were the researchers taken by surprise, but it can be safely assumed so will doctors all over the world who have regularly prescribed Aspirin intake for their elderly patients as a preventive, much less the millions of patients who have been faithfully following doctors' orders. Of course, many of those patients, having taken low-dose Aspirin as prescribed in their advanced age for decades, may now be in the position of having heart disease, and the Aspirin use will be continued since under that condition, it is still recognized for its preventive effect in recurring heart attack, as example. 

The simple fact being that evidence does exist that Aspirin is still recommended for people who have already experienced heart attacks or strokes or who are in a  high-risk category that such will occur. For elderly people less at risk, however, the results of this research appear to clearly indicate that it helps not at all, but does pose a risk of internal bleeding. Moreover, the researchers were confronted with one result that has left them in a puzzled state for its inexplicability.

It was found that there was a slightly higher rate of death among those patients who took daily Aspirin, attributable for the most part to an increase in deaths from cancer. The researchers point out that a greater focus through additional studies must be undertaken before firm conclusions can be drawn from that finding, since they've no real idea what to make of it, all the more so since earlier studies suggested that Aspirin could in fact, lower the risk of colorectal cancer. 

A Mother's Challenge

"No regrets. I wouldn't change a thing. And I won't wonder about anything."
"You do anything for your kid. We were looking for quality. And the Mexican treatments were less invasive and gave her quality."
"I love all my girls for different reasons. I don't love any of my other girls for the same reasons I love Kaisy."
"She was the courageous one. The one who made me come out of my box. I said: 'You're doing it again, Kaisy. Making me do something I never thought I would do'. Then I busted out laughing."
"The funeral director looked at me like I was nuts."
Melany Knott, 40, mother of four girls, Mount Airy, Maryland

Kaisy Knott sits at Starbucks in August 2017, before heading to Mexico for experimental cancer treatment. (Jason Andrew/The Washington Post)

Daughter Kaisy, 13, the youngest of Melany Knott's four girls, turned to her mother and told her: "Mom, I can't do this anymore" on September 9, twenty-one months after she had been diagnosed with diffuse intrinsic pontine gliomas (DIPG) a dread cancer known to be aggressive, inoperable, incurable: A 100 percent lethal brain cancer. Kaisy was given eight months, tops, to live. "It felt like I was being stabbed in the head", explained Kaisy at an earlier time.

A day later, Kaisy uttered the word "Mom", and then she died. Two days later her mother arrived at the funeral home, fearful, distressed, forlorn and desolated. Melanie Knott suffered from a deep aversion to the cold, irreversibly final aspect of a dead body. Now, her beloved youngest daughter was that dead body. And the mother had to muster the courage to overcome her fear for her daughter's sake; so she could braid her hair, as Kaisy loved it to be done by her mother, for the very last time as she lay in her coffin.

The plan was that Kaisy was going to have her hair braided that week as she prepared and looked forward to attending her first day of school. That was back a few days earlier when she felt fine, her usual rambunctious self before her diagnosis, before she died on September 10. Kaisy had a Facebook following of thousands; her page titled Kick Butt KK. After Kaisy's diagnosis of a fatal brain cancer the doctor told her mother: "go home and make memories".

That's just what they did, but not quite in the way the doctor and conventional medicine might have imagined they would. Setting about raising the required funds, the rural, farming family auctioned off goats and guns, chainsaws and other implements usually found on a farm. They ran fundraisers at the country fair, and they used up all their savings, including the carefully padded funds for their other daughters' education -- and they worked double shifts.

They had decided to take Kaisy to Mexico, to a medical clinic specializing in untested treatment for cancer. A mystery treatment for which there have been no published studies and for which the ingredients of the customized chemotherapy cocktails have been maintained in absolute secrecy. Miraculously, Kaisy became animated, swam in the ocean, went kayaking, rode roller coasters and showed her prize hog and steer at 4-H competitions.

Kaisy Knott and her mom, Melany, waiting at Reagan National Airport for their plane to Mexico, where Kaisy is undergoing experimental treatments for a lethal form of brain cancer. (Jason Andrew/The Washington Post)

The dramatic change in Kaisy's condition became public knowledge and she became a celebrity figure among others in similar medical conditions, leading other families to fly to the Mexico City clinic from Norway, London, Italy, Australia, to themselves take part in the experimental, controversial cocktail of drugs injected into children's arteries to buy time, precious time to continue living.

Kaisy and her family went off on holiday junkets to "make memories". The original eight months that Kaisy was given left to live by the diagnosing medical community in the U.S. came and went, and Kaisy felt great, went swimming, paddle-boarding, everything she wanted to do. When President Trump signed the Right to Try Bill, allowing people with life-threatening illnesses to have access to experimental treatments and bypass the U.S. Food and Drug Administration for approval, Melany cheered.

Kaisy, whose life was being enriched when her body responded so positively to the unknown cocktail of drugs from the Mexican clinic, loved having her mother -- who lived her entire life in rural Maryland on farms, companion to hogs, horses, steers and chickens -- accompany her everywhere. Her fearful mother was persuaded to get on a roller coaster with her eager daughter, to go to the beach, to take time off work, to take air flights, leave the U.S. to rent an apartment in Mexico.

Each of those treatment cycles at the Mexican clinic came with a price tag of $33,000. A total of $695,000 was spent altogether in the 21 months when Kaisy's life was prolonged, her symptoms of medical duress relieved so she could feel her normal ebullient self and savour those adventures with her mother. Melany Knott figured it out that they spend about $1,100 for each of those days that preserved her daughter's life just a little longer.

Worth it. Every penny.

Melany Knott and her daughter Kaisy on a roller coaster for the first time. (Family photo)

Doctor Pot: PhD in Cannabis Production

"It [cannabis] is not really a big part of my life outside of the science."
"There is a need for the science and there is a market and there are people that are growing it and they are going to have to grow it safely and make money -- and they can't just make it all up themselves."
"They [University of Guelph] offered a number of plant courses and I took some on a whim and fell in love with it. I'd always been interested in economics and business and I figured I wanted to get into an exciting, fast-growing industry and unfortunately there's not much that qualifies in terms of the plant science."
"I was trying to graduate to be done by the time legalization [as of October 17 in Canada] was happening so I kind of had my head on the ground, not looking for work."
"But I had a number of companies contact me, some with some very serious interest in having me on to continue to do research with them or to help them improve their production practices."
"It's interesting and new and the fact that there is [little] research in the area [meant] I could have free rein of what I wanted to do. Being able to get into the forefront of a scientific topic these days doesn't seem like even an option, it's kind of just built upon the work of others."
"Any crop you're producing you have to know how much to fertilize it, how much to irrigate it, what to grow it in. And because there's not academic research on the topic, there's very little guidance for growers and growers are forced to rely on [often[ unreliable information."
"We custom=formulated and evaluated several growing substrates -- specifically for cannabis and determined what would work best."
"There's a lot of practices that we see with cannabis growers that are interesting and have some kind of logical explanation, but not necessarily one that's founded in plant science."
Deron Caplan, alumnus, University of Guelph

Deron Caplan will soon be what is believed to be North America’s first Ph.D in pot production. (Turgut Yeter/CBC)

This  enterprising young man who has earned Canada's first doctoral degree in cannabis production focused on the basic horticultural elements of cannabis production ... basically methodology which, during the era of prohibition -- soon to be concluded -- represented trial and error. His doctoral thesis in effect has resulted in an academic body of expertise on vital agricultural methodology relating to optimal fertilizer rates and growing mediums, useful for large licensed producers and at-home growers alike.

Methods of propagation and best practise in stem-cutting techniques also received their due. Although University of Guelph, best known in Canada as an outstanding agricultural institute of higher learning is the first to have produced a specialist in specifically growing marijuana crops McGill University also has three students with doctoral theses in neutral hemp production, none yet having earned their PhD with an emphasis on the medicinal and intoxicating marijuana strains that will become legal in Canada in October.

Other major agricultural schools across Canada have yet to focus on producing programs that will result in doctorates in marijuana production. Now, pot doctor Deron Caplan will find his academic skills in high demand. Though he is the first Canadian to emerge as a PhD in cannabis production he won't be the last as more postgraduate degrees will most certainly emerge, according to Anja Geitmann, dean of agriculture at McGill University in Montreal.

"I'm pretty sure it's going to change the research landscape in the sense that researchers now have access or can do research on the plant much easier", she commented. In so doing, scientific knowledge relating to the cannabis plant will expand as universities respond to the legalization of pot. Taking undergraduate classes in environmental sciences at Guelph, Caplan's interest in cannabis science was sparked leading to the serendipitous synchrony of his completed doctorate with the new cannabis law.

Once his undergraduate degree was realized, Caplan was inspired to approach horticulture professor Youbin Zheng who has worked extensively with cannabis, to enquire about the possibility of a master's study of the plant. While awaiting an opening for postgraduate studies in cannabis research, Caplan filled in the time by travelling for eight months to France, Germany, Croatia, the Netherlands, Greece, Japan, Korea, Thailand, Indonesia, Cambodia and Russia.

His travels came to an end when Professor Youbin messaged him that a project was at hand, compelling Caplan to return to Guelph to pursue the research in 2015, which he later combined with his doctoral work in 2016. Professor Zheng acted as thesis adviser which led to the two collaborating on the first research paper in North America to be published in a peer-reviewed journal on indoor cannabis production.

A worker at Cann Trust's Niagara region greenhouse cultivates marijuana plants. Cann Trust will be one of a number of licensed marijuana producers looking to hire graduates from Niagara College's new commercial cannabis program. (Turgut Yeter/CBC)

Whose Responsibility Avoidable Tragedies?

"Sheppard observed the defendant Saad yelling and screaming and attempting to resuscitate Mac Saini in a perfunctory way."
"Her experience in ... being present and witnessing the death of Mac Saini and seeing his lifeless body was shocking and horrifying to the plaintiff."
B.C.Lawsuit, B.C.Supreme Court, statement of claim

"The death of a child is a tragedy no parent should ever face, and our heartfelt condolences go out to the parents."
British Columbia Ministry of Children and Family Development

"Without commenting on this partiular case, the vast majority of daycares are meeting their regulatory requirements for providing appropriate and safe care to children."
"This is a tragic incident and our heartfelt condolences go out to the parents."
Vancouver Coastal Health

Sixteen-month-old Macallan Wayne Saini, seen here with his family, died on Jan. 18, 2017 at a daycare in East Vancouver. (John Sheppard)

The Sheppard family of Vancouver has filed a lawsuit alleging that their baby, Macallan "Mac" Saini died while in the care of a daycare operated by Yasmine Saad, because he was left alone and the misadventure that took his life was caused by his having choked on an electrical cord. The lawsuit names the operator, Yasmine Saad, the landlords of the building where the daycare is located for failing to supervise daycare operations, and failing to ensure safe and infant-suitable premises prevailed for the daycare.

Vancouver Coastal Health and the Ministry of Children and Family Development also stand accused in the lawsuit of not warning parents, or taking steps to close the daycare in the wake of "multiple complaints" that it was operating without a licence and was an overcrowded facility. The operator, despite being investigated in multiple years after complaints, was never fined, and nor were steps taken to prevent it from continuing its daycare function in the community.

The property owners in their own defence stated they were unaware that their premises hosted a daycare. Shelley Sheppard, mother of 16-month-old Macallan Saini had arrived to pick up her child from the Olive Branch Daycare on the eighth day that he attended and was in the care of Yasmine Saad. On arrival a fire truck was parked in front of the daycare; when she entered the premises she witnessed the operator attempting to resuscitate the child, and realized her son was lifeless.

The suit she and her husband filed states the daycare was "overcrowded" with children, one of whom was seen behind a couch, while other children were seen to be strapped to chairs. Child care providers are permitted up to two children or a sibling group who are not related to them, to be cared for without a licence. Over 1,100 daycare facilities are routinely inspected by Vancouver Coastal Health annually, posting inspection reports on its website.

The statement of claim emphasizes that the child's mother suffers from trauma and health problems linked to permanent disability leading to loss of earnings and is absent life's enjoyment, as a result of the death of her infant. Leaving the impression that the parents did all they possibly could to ensure that their child was in a safe and reliable environment but that through no fault of their own, their child is now lost to them.

Due diligence would have mandated that the reputation of the daycare be the first order of business to ascertain, and a quick look at the website of Vancouver Coastal Health should have raised flags. Since the parents were cognizant of the fact that too many children were being cared for and dubious practices were used in restraining the children to ensure their safety, the question arises, why did they opt to place their child in that situation?

Yet another circumstantial situation arose in North Battleford, Saskatchewan, when a mother left her six-year-old autistic, epileptic, non-verbal daughter seated in the family SUV which the mother left running while she tended to shopping at a strip mall. Someone got into the vehicle and drove off with it, with the child still seated in the back. This took place on Sunday night; it was dark out and there was snow falling, with temperatures at the freezing mark.

RCMP in Saskatchewan have issued an Amber Alert for a six-year-old girl who they say was abducted outside a strip mall in North Battleford. Police say Emma O'Keeffe, shown in an RCMP handout photo, is Caucasian, three-feet-six-inches tall, and weighs 44 pounds. RCMP / THE CANADIAN PRESS

"Words cannot express our emotions right now."
"Emma is safe at home sleeping soundly, peacefully, surrounded by all the love in the world."
Emma O'Keefe's mother

"This was obviously a horrific circumstance, but it was beautiful to see so many people just leave their homes, grab a flashlight and go out and help look [for the missing child]."
Ryan Bater, mayor, North Battleford

"We don't know what happened from when the car was taken until when the car was found."
"Someone took a vehicle that was not theirs with the child in the back seat and then was responsible for the child being left overnight [in the SUV on her own]."
RCMP Cpl. Rob King

It took 14 hours, but eventually the vehicle with the little girl still in the back seat was found, tucked away in bushes. Though the weather was bad, and the city of Battleford lost power after midnight for a period of time, the Amber Alert that was called brought people out in substantial numbers, even from surrounding municipalities, to search for the child.

No one seems to be questioning the intelligent sense of responsibility on the part of the mother, leaving a defenceless child in such a vulnerable situation.

The Perfect Female Body Image

"We are reporting an analysis of the largest prospective study to date on silicone breast implant safety. We are sharing critical information on complication rates and rare associations with systemic harms. This data gives women important safety information about silicone breast implants to have real expectations and to help them choose what is right for them."
"Despite abundant data collection, and open public access, the LPAS [large postapproval studies] database had not yet been analyzed and reported."
"These findings are associations compared to the general population and determining why these associations are observed or any causation requires further study."
"To resolve the remaining uncertainty in the evidence base, it is important that this data be analyzed in an unbiased manner. It remains the plastic surgery community's duty to provide definitive evidence for the risks associated with breast implants."
“This study did not report a direct link or causative effect between implants and these diseases. It is important to understand a limitation of the study was that some diseases were reported by patients and not necessarily diagnosed by a physician. This is important safety information for women to consider when thinking about cosmetic or reconstructive surgery with breast implants. It also underscores the need for more research in this area."
"It’s vital that women with implants be aware of the potential risks, so they can identify symptoms early and consult with their doctors. Fortunately, many of the diseases and conditions that have an association with implants are quite rare, so awareness is that much more important."
"Patients are seeking an assurance of safety. The FDA has deemed breast implants reasonably safe and effective, and being educated about potential complications is an important part of good health. All surgical procedures and implantable devices have potential complications and side effects. As plastic surgeons, it’s our responsibility to continually monitor the long-term safety of breast implants and make sure that all patients and physicians are aware of any possible adverse outcomes. This ensures that patients and their healthcare providers can weigh the potential risks and benefits together to make the best possible decisions on augmentation and reconstruction."
Mark W. Clemens, MD, University of Texas M.D. Anderson Cancer Center, Houston

What price beauty? For some there is no cost too dear. Women in Latin America in particular accept plastic surgery as a rite of passage as a woman, a desirable woman, a woman whose bodily features are to be admired, to gain attention, to be proud of herself. To these women their natural endowments need not necessarily represent the end result of what they can aspire to physically. It has become in many quarters, a classic formula when a teen enters her pre-adult years, to plan for breast augmentation surgery and for some, why stop there?

Still, it is in the United States that a greater percentage of women choose to undergo plastic surgery to amend errors that nature endowed them with. Simply put, the gold standard of plastic surgery is what takes place in the United States, followed by Brazil, and other countries where women see themselves not quite finished unless and until they have taken the necessary steps to pad their natural endowments so that their figures more closely resemble the ultimate ideal in female pulchritude.

Nearly all the cases of breast implant-associated anaplastic large-cell lymphoma have been linked to textured implants like this one.    CreditSouthern Illinois University, via Science Source

Silicone gel implants were associated with some horror stories in years past, from slippage to leaking, to infections and worse. A newly published independent analysis concluded with the suggestion that there are health problems associated more commonly with silicone gel implants; problems rare, it would seem, but troubling to no end for those unfortunate enough to be one of those whose breast implants are the cause of a medical condition.

Close to 100,000 women were included in the study published in the journal Annals of Surgery, representing the largest long-term safety analysis of silicone implants since 2006, the year the Food and Drug Administration permitted their re-entry on the American market following safety concerns leading to a 14-year gap. "We completely stand behind this study and we do feel it's our best data to date", assured Dr. Clemens, plastic surgeon, at University of Texas MD Anderson Cancer Center.

Women who have undergone breast cancer surgery with the removal of a breast understandably often choose to undergo reconstruction in an effort to resume a normal life and view of themselves as resembling how they had presented prior to surgery. Roughly 400,000 women in the United States choose to undergo surgical implant, mostly with silicone rather than saline. Of that number, three-quarters represent women who aspire to have larger breasts.

The website of the Food and Drug Administration warns women that "Breast implants are not lifetime devices", pointing out that up to 20 percent of women who have chosen to enlarge their breasts with silicone implants face removal within eight to ten years resulting from complications that include infections, wrinkling, scarring, pain, swelling and rupture of the implant. According to the FDA there is as well a small but increased rare lymphoma risk [type of cancer].

After learning she had breast cancer, Raylene Hollrah of Hermann, Mo., had a double mastectomy. But then cancer struck again — caused by the implants used to rebuild her chest.  Credit: Whitney Curtis for The New York Times

When the FDA approved implant devices from two manufacturers in 2006 it was with the proviso that the manufacturers conduct studies on how use of the implants affected women's lives. These reports contained in an FDA database were used by the researchers for their analysis. Women with silicone implants appeared to suffer greater rates of Sjogren syndrome, an immune system disorder, as well as a connective tissue disorder called scleroderma, and melanoma; skin cancer; albeit rarely.

Problems such as fibromyalgia appeared lower among women wearing implants, and birth defects and stillbirths were inconsistent and inconclusive. To add to the confusion a  higher rate of rheumatoid arthritis linked to one of the silicone brands, but with another a lower rate was seen. Dr. Andrea Pusic, plastic surgery chief at Brigham and Women's Hospital in Boston, president-elect of the Plastic Surgery Foundation was unimpressed with the report, considering its potential to create greater anxiety than insight.

That problems associated with silicone implants are real is beyond doubt, however. And that women are risking real inconvenience in their lives should they need to have serial implants over the course of their lives if they remain committed to breast augmentation, let alone facing the onset of some quite life-disruptive diseases, seems to make the choice for implants an irrational, rather than a considered condition of vanity.

Some of the complications and adverse outcomes of a boob job include:

• Additional surgeries, with or without removal of the device
• Capsular contracture– scar tissue that forms around the implant and squeezes the implant
• Breast pain
• Changes in nipple and breast sensation
• Rupture with deflation of saline-filled implants
• Rupture with or without symptoms (silent rupture) of silicone gel-filled implants

According to the FDA, as many as 20 percent of women who have a boob job need their implants removed within 8 to 10 years.