Drug-Testing Company Tied to N.C.A.A. Draws Criticism

KANSAS CITY, Mo. — A wall in one of the conference rooms at the National Center for Drug Free Sport displays magazine covers, each capturing a moment in the inglorious history of doping scandals in sports.

Steve Hebert for The New York Times

The National Center for Drug Free Sport, in Kansas City, Mo., tries to deter doping with programs for high school, college and professional leagues.

Monica Almeida/The New York Times

Don Catlin, formerly of U.C.L.A.’s Olympic Analytical Lab, has raised questions about drug testing at colleges.

The images show Ben Johnson, the sprinter who lost his 1988 Olympic gold medal after testing positive; and Barry Bonds, the tarnished home run king; and Lyle Alzado, one of the first pro football players to admit to steroid use.

“People always assume that it’s the athletes at the top of their sport or the top of their game that are using,” said Frank Uryasz, Drug Free Sport’s founder and president. “But I can assure you that’s not the case. There’s always that desire to be the best, to win. That permeates all level of sport — abuse where you just wouldn’t expect it.”

Over the past quarter-century, athletes like Johnson, Bonds and Alzado stirred widespread concern about doping in sports.

Professional leagues without drug-testing programs have put them in; leagues with drug-testing programs have strengthened them. Congress and medical experts have called on sports officials at all levels to treat doping like a scourge.

It was in this budding American culture of doping awareness that Uryasz found a niche business model. He has spent the past decade selling his company’s services to the country’s sports officials.

The company advises leagues and teams on what their testing protocols should look like — everything from what drugs to test for to how often athletes will be tested to what happens to the specimens after testing. It also handles the collection and testing of urine samples, often with the help of subcontractors.

Drug Free Sport provides drug-testing programs for high school, college and professional leagues.

A privately held company with fewer than 30 full-time employees, it counts among its clients Major League Baseball, the N.F.L., the N.B.A., the N.C.A.A. and about 300 individual college programs.

Many, if not all, of the players on the field Monday night for the Bowl Championship Series title game between Alabama and Notre Dame have participated in a drug-testing program engineered by Drug Free Sport.

Uryasz says his company’s programs provide substantial deterrents for athletes who might consider doping.

Critics, however, question how rigorous the company’s programs are. They say Drug Free Sport often fails to adhere to tenets of serious drug testing, like random, unannounced tests; collection of samples by trained, independent officials; and testing for a comprehensive list of recreational and performance-enhancing drugs.

The critics, pointing to a low rate of positive tests, question Drug Free Sport’s effectiveness at catching athletes who cheat. Since the company began running the N.C.A.A.’s drug-testing program in 1999, for example, the rate of positive tests has been no higher than 1 percent in any year — despite an N.C.A.A. survey of student-athletes that indicated at least 1 in 5 used marijuana, a banned substance. (The N.C.A.A. tests for marijuana at championship competitions but not in its year-round program.)

Uryasz said the rate of positive tests was not meaningful. “I don’t spend a lot of time on the percent positive as being an indicator of very much,” he said.

Independent doping experts contend that having a contract with Drug Free Sport allows sports officials to say they take testing seriously without enacting a truly stringent program.

Don Catlin, the former head of U.C.L.A.’s Olympic Analytical Lab, best known for breaking the Bay Area Laboratory Co-operative doping ring, oversaw the testing of many of Drug Free Sport’s urine samples when he was at U.C.L.A. He said the work by Drug Free Sport and similar companies could be used to mislead fans.

“The problem with these schools is they all want to say they’re doing drug testing, but they’re not really doing anything I would call drug testing,” he said.

A Company’s Origins

Uryasz said he became interested in working with student-athletes while tutoring them as an undergraduate at Nebraska. After he graduated, he earned an M.B.A. from Nebraska and worked in health care administration in Omaha. He said he heard about an opening at the N.C.A.A. through a friend.

Driven in part by scandals in professional sports, the N.C.A.A. voted at its 1986 annual convention to start a drug-testing program.

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Stocks open lower; S&P 500 eases from 5-year high

Stocks sank on Wall Street, pushing the Standard & Poor's 500 index down from the five-year high it reached Friday.

The move lower on Monday is likely the result of investors taking some winnings off the table after the stock market's surge last week, said Sam Stovall, chief equity strategist at S&P Capital IQ.

Investors are also preparing for corporate America's seasonal parade of earnings reports, which starts Tuesday.

“You can summarize it as profit-taking and preparation,” Stovall said. “Investors are digesting some of those gains from last week and positioning themselves so they're not too far extended if fourth-quarter earnings slip a bit.”

The S&P 500 dropped eight points to 1,457 as of 2:05 p.m. EST on Monday.

The Dow Jones industrial average lost 74 points to 13,360, while the Nasdaq composite dropped 11 points to 3,090.

Major bank stocks fell on news that JPMorgan Chase, Bank of America and others banks agreed to pay $8.5 billion to settle federal complaints that they foreclosed on people who should have been allowed to stay in their homes.

In a separate agreement, Bank of America settled with the mortgage-servicing company Fannie Mae over mortgage investments that lost value during the real-estate crash. Bank of America will pay Fannie Mae $3.6 billion and buy back $6.75 billion in loans that the North Carolina-based bank and its Countrywide unit sold from Jan. 1, 2000 through Dec. 31, 2008. BofA's stock fell 9 cents to $12.02.

The S&P 500 closed at a five-year high Friday after a report showed that hiring held up in December during the tense fiscal negotiations in Washington, with employers adding 155,000 jobs in the month. Market indexes soared at the start of last week as lawmakers passed a bill to avoid a combination of government spending cuts and tax increases that came to be known as the “fiscal cliff.” The law passed late Tuesday night avoided the full force of the budget cuts, which could have dragged the economy into a recession.

Investors are now shifting their focus to corporate profits. Aluminum producer Alcoa launches the reporting season for the fourth quarter of 2012 after the market closes on Tuesday.

Analysts forecast that companies in the S&P 500 will report that quarterly earnings increased 3.3 percent compared with the same period the year before, according to S&P Capital IQ. But all the events that took place in the last three months of 2012 -- Superstorm Sandy, the presidential election, and worries about the narrowly avoided “fiscal cliff” -- could make for some surprises.

In other trading, the yield on the 10-year Treasury note was 1.90 percent. The yield on the note hit an eight-month high of 1.97 percent in intraday trading Friday, according to prices from Tradeweb, an operator of fixed-income markets.

Among other stocks making big moves:

— Archer Daniels Midland dropped 4 percent. Analysts at JP Morgan Chase said the ongoing drought in the Midwest will likely squeeze the crop-processing company's profit margins. The analysts also started coverage on ADM's stock with a price target of $28, below where it opened for trading Monday. ADM fell $1.06 to $28.16.

— Lowe's Cos. fell 90 cents to $34.68 after analysts at the money-management firm Canaccord cut their rating on the company to “sell” from “hold,” saying that the home improvement company's efforts to improve stores and sales won't be successful.

— Walgreen Co. gained 82 cents to $38 after Jefferies analyst Scott A. Mushkin raised his rating on the drugstore chain to “buy” from “hold,” saying the company's profits may get a boost from the flu season, Medicare drug plans and President Obama's health-care overhaul.

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A solution to La Jolla's smell problem proves elusive

LA JOLLA — There's a political stink rising in this seaside community, blown ashore from the rocks of La Jolla Cove, where myriad seabirds and marine mammals roost, rest and leave behind what animals leave behind.

The offal accumulation is offending noses at trendy restaurants, tourist haunts, and expensive condos perched on some of the most pricey real estate in the country. But finding a solution to the olfactory assault has proved elusive.

Environmental regulations have thwarted proposals to cleanse the rocks with a non-toxic, biodegradable solution. Even a low-tech idea to scrub the rocks with brooms may need official approval.

The state-protected cove area falls under the permitting jurisdiction of the California Coastal Commission and San Diego Regional Water Quality Control Board. Since wildlife is involved, the National Oceanic and Atmospheric Administration and the U.S. Fish and Wildlife Service also have authority.

The normally low-key Sherri Lightner, who represents La Jolla on the San Diego City Council, has challenged — some say dared — Gov. Jerry Brown to tour the cove area in high stink season.

"Everybody is pointing fingers, and nobody is doing anything," said a La Jolla resident who strolled the sidewalk along the community's famed corniche on New Year's Day, tissue to her nose to battle the smell.

A San Diego park ranger assigned to the La Jolla beaches takes a more philosophic approach toward the excretory matter. "It's a natural process," said ranger Richard Belesky. "But would I want to buy a multimillion-dollar condo with the stink nearby? I don't think so."

The difficulty of reconciling the habits of sea creatures and the needs of humankind is not new to La Jolla. South of the La Jolla Cove is the Children's Pool where harbor seals lounge on the beach.

For two decades a legal and political dispute has raged between people who say the seals should be removed because they are blocking access to the water and those who say the seals should be allowed to stay, particularly during pupping season. Signs warn bathers that seal excrement has resulted in a high bacteria count that can cause disease.

At the La Jolla Cove, the droppings began to pile up after restrictions were put in place to keep people from climbing down the delicate bluffs to the rocks below. The birds and mammals suddenly had no reason to scatter.

The La Jolla Village Merchants Assn. gathered more than 1,000 signatures demanding an immediate solution. But immediate is not in the governmental lexicon when it comes to issues involving the ocean and wildlife.

To wash down the rocks would require a National Pollutant Discharge Elimination System permit from the San Diego Regional Water Quality Control Board. The city, probably the full City Council, would need to endorse a specific wash-down proposal — but that, according to Lightner's staff, would mean submitting the issue to an application process that could take at least two years, given the backlog at the water board.

And even if the water board approved the application, the issue would then proceed to the Coastal Commission, an agency not known for its speed.

In hopes of finding a faster, if more limited, solution, city officials are considering arming Park and Recreation Department employees with brooms to scrub down the rocks. They assure that steps will be taken to ensure that no runoff reaches the ocean and no birds or mammals are hurt.

Talks are planned with regional, state and federal agency staff members to see if such a limited approach could be taken without a full-tilt application process. A radio talk-show host has shown the way, taking his own broom to the cove.

Meanwhile, restaurateurs say the smell continues to discourage patrons. Some tourists complain that it mars their vacations. Shirley Towlson, a bookkeeper who arrived in La Jolla from Phoenix, was shocked at the smell along the promenade and outside her hotel.

"I thought La Jolla meant 'The Jewel,' '' she said. "This smells more like 'The Toilet.' "

Other tourists find the smell but a small downer amid the other joys of La Jolla as a seaside place of visual beauty, fine dining and chic shopping.

"It smells like fish," said Mark Bain, a general contractor from Sacramento, enjoying a New Year's week idyll. "It happens."

He said the smell is not nearly as noxious as when dead fish line the banks of the Sacramento River. "Now, that's really bad," he said.

tony.perry@latimes.com

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Kuwaiti gets two years for insulting emir on Twitter

KUWAIT (Reuters) – A Kuwaiti court sentenced a man to two years in prison for insulting the country’s ruler on Twitter, a lawyer following the case said, as the Gulf Arab state cracks down on criticism of the authorities on social media.

According to the verdict on Sunday, published by online newspaper Alaan, a tweet written by Rashid Saleh al-Anzi in October “stabbed the rights and powers of the Emir” Sheikh Sabah al-Ahmad al-Sabah.

Anzi, who has 5,700 Twitter followers, was expected to appeal, the lawyer, who asked not to be named, told Reuters.

Kuwait, a U.S. ally and major oil producer, has been taking a firmer line on politically sensitive comments aired on the Internet.

In June 2012, a man was sentenced to 10 years in prison after he was convicted of endangering state security by insulting the Prophet Mohammad and the Sunni Muslim rulers of Saudi Arabia and Bahrain on social media.

Two months later, authorities detained Sheikh Meshaal al-Malik Al-Sabah, a member of the ruling family, over remarks on Twitter in which he accused authorities of corruption and called for political reform, a rights activist said.

While public demonstrations about local issues are common in a state that allows the most dissent in the Gulf, Kuwait has avoided Arab Spring-style mass unrest that toppled three veteran Arab dictators last year.

But tensions have intensified between the hand-picked government, in which ruling family members hold the top posts, and the elected parliament and opposition groups.

(Reporting by Mahmoud Harbi; Writing by Mahmoud Habboush; Editing by Jason Webb)

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Michael J. Fox to play newscaster in new NBC show

PASADENA, Calif. (AP) — On his upcoming NBC comedy, Michael J. Fox will play a newscaster who quits his job because of Parkinson's Disease but returns to work in the show's first episode because a new medical regimen has helped him control many of the disease's symptoms.

NBC said Sunday the comedy closely tracks many aspects of Fox's personal life and tries to have fun with an image that has left him an object of pity-fueled admiration.

The show doesn't have a title yet. NBC Entertainment President Jennifer Salke said it will premiere in September. Although the schedule isn't set yet, NBC is aiming to put it on Thursday night, where "30 Rock" and "The Office" are leaving in the next few months.

Salke said Fox is meeting this week with actresses who could potentially play his wife on the show.

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Despite New Health Law, Some See Sharp Rise in Premiums

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

Bob Chamberlin/Los Angeles Times

Dave Jones, the California insurance commissioner, said some insurance companies could raise rates as much as they did before the law was enacted.

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

 In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

The proposed increases compare with about 4 percent for families with employer-based policies.

Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators’ evaluations.

The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.

New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.

The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.

While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.

The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. “We need these rates to even come reasonably close to covering the expenses of this population,” said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.

Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.

“There’s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,” said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.

Federal officials say the law has resulted in significant savings. “The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,” said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.

“Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,” he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.

As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.

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Reality shows may put crews too close to cutting edge

Monica Martino had filmed tornadoes in the Midwest, ship collisions in the Antarctic and crab fishermen in Alaska's Bering Sea. But those experiences didn't prepare her for a terrifying nighttime boat ride in the Amazon jungle.

In February, the 41-year-old co-executive producer was thrown into a murky river after getting footage for "Bamazon," a series for the History cable channel about out-of-work Alabama construction workers mining for gold in the rain forest of Guyana.

Martino says the captain was blind in one eye and sailing too fast without a proper light. He lost control of the boat while making a hard turn, sending the crew into the river, where Martino was knocked out by the impact of hitting the water at high speed.

Pulled back into the boat, Martino regained consciousness. But on the journey back to base camp, the vessel struck a tree, slamming Martino into the deck. Although she sustained a concussion, bruised ribs and a badly torn shoulder, Martino said, she had to wait 19 hours to receive medical care at a clinic in Venezuela because the production company had no viable medical evacuation plan for the crew.

History and the production company, Red Line Films, declined to comment.

"It was a whole cascade of negligence," said Martino, who lives in Santa Monica. "We were put in a situation far beyond what any production crew should be expected to handle."

As reality TV has boomed over the last decade, action-adventure shows have become a lucrative niche in a medium hungry for high ratings. But the growth has also stirred concerns that some reality TV programs are cutting corners on safety, exposing cast and crew members to hazardous conditions.

A combination of tight budgets, lack of trained safety personnel and pressure to capture dramatic footage has caused serious and in some cases fatal incidents, according to interviews with television producers, safety consultants and labor advocates.

Even the companies that provide insurance to Hollywood films and TV shows are reluctant to write policies for some of the edgier programs.

"These reality shows are getting riskier to get more ratings,'' said Wendy Diaz, senior underwriting director for the entertainment division of Fireman's Fund Insurance, one of the leading insurance carriers that serve the entertainment industry.

Records from OSHA and the state Division of Occupational Safety and Health show fewer than a dozen citations and accidents involving reality TV sets in the last five years, including a fatality that occurred this summer in Colorado during production of a proposed Discovery Channel series. But union officials, safety consultants and producers say those numbers don't begin to reveal the true extent of the problem.

PHOTOS: Where the last seasons left off

Many incidents go unreported because crew members sign non-disclosure agreements and fear being blacklisted if they file lawsuits. Record-keeping is further muddled by the fact that many of the shows are nonunion, and workers are often classified as independent contractors. OSHA typically tracks only serious accidents involving employees and has no jurisdiction if the incident occurs in a foreign country such as Guyana.

"Reality has a lot of near-misses and things that happen that you never hear about," said Vanessa Holtgrewe, an industry veteran and former camera operator on "The Biggest Loser" and "The X Factor" who now works as an organizer for the International Alliance of Theatrical Stage Employees. "On a lot of these shows, you're completely on your own. There is no one you can call if … you feel you're in a dangerous situation."

State and federal OSHA officials declined to comment specifically on incidents involving the reality TV sector.

Fireman's Fund estimated that it would underwrite 160 action-adventure reality shows in 2012, a 25% increase over the previous year. But it passed on about 50 other reality TV programs because they were deemed too risky, Diaz said.

"We had people who wanted to go to Mexico to follow the drug cartels around," Diaz said. "We had one show where they were going to blow up a mine. We told them we wouldn't insure the show."

Reality series — which cover everything from "Survivor" to "Keeping Up With the Kardashians" — have provided a huge revenue stream for cable and broadcast networks. The shows have lower production costs than scripted entertainment and tend to attract the younger viewers favored by advertisers.

CRITIC'S NOTEBOOK: Try to believe in the new TV season

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Report: Lance Armstrong weighing doping confession

Lance Armstrong reportedly is weighing confessing to using performance-enhancing drugs. (Thao Nguyen / Associated Press / February 15, 2011)

By Lance Pugmire

January 5, 2013, 7:11 a.m.

Lance Armstrong reportedly is weighing confessing to using banned performance-enhancing drugs and blood transfusions during his run of seven Tour de France titles.

Armstrong, who was stripped in October of his Tour titles and banned for life from competition by the U.S. Anti-Doping Agency, is pursuing the admission as a route to regain his eligibility to compete, the New York Times first reported Friday.

Armstrong’s attorney, Tim Herman, told the newspaper, “I suppose anything is possible. Right now, that’s not really on the table.”

Citing pressure from the cancer-fighting charity he helped create, Livestrong, Armstrong, 41, reportedly has held discussions with his longtime nemesis, USADA Chief Executive Travis Tygart, in an attempt to negotiate a lifting of the ban, one person told the New York Times.

Armstrong has competed in triathlons and running events since his lifetime ban took effect.

Efforts to reach Tygart and Armstrong’s representatives Friday night were not immediately successful.

The World Anti-Doping Code allows for lightened punishment for those who fully detail their doping protocol in a confession.

Armstrong lost a slew of endorsement deals after he was banned, and any confession would probably leave him in jeopardy of perjury accusations since he has given sworn statements denying he used banned substances in prior legal cases.

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Missoni scion on small plane missing in Venezuela

ROME (AP) — Rescue crews used boats and aircraft on Saturday to search for a small plane that disappeared in Venezuela carrying the CEO of Italy's iconic Missoni fashion house and five other people.

But 24 hours after the BN-2 Islander aircraft disappeared from radar screens on its short flight from Venzuela's coastal resort island of Los Roques to Caracas, the capital, no sign of the plane had been found, officials said.

"We have no other news" about the plane carrying Vittorio Missoni, the head of the company; his wife, Maurizia Castiglioni; two of their Italian friends; and two Venezuelan crew members, said Paolo Marchetti, a Missoni SpA official. He spoke briefly to reporters as he left company headquarters in the northern Italian town of Sumirago on Saturday afternoon.

Missoni's younger brother, Luca, who is active in the family-run business, was reportedly traveling to Venezuela on Saturday to monitor search efforts.

"We're holding onto a glimmer of hope," said Oswaldo Scalvenzi , a relative of Elda Scalvenzi, one of the Missoni friends aboard the flight. "Until we can see the wreckage" hope will remain, Scalvenzi told Italian state TV on Saturday night.

The La Repubblica.it, website of the Rome newspaper said Venezuelan aircraft, motorboats and helicopters took off at dawn Saturday to resume the search for the missing plane, which had been suspended on Friday night. The Italian news agency ANSA, reporting from Rome, said a specialized ocean-searching naval vessel also was being deployed.

Vittorio Missoni is the eldest son of the company's founder, Ottavio, who at 91 still follows the business.

The Corriere della Sera newspaper reported that Ottavio and his wife Rosita were at their home in Italy, along with their daughter Angela, creative director of the company, waiting for information about the search. Rosita Missoni designs housewares for the company, and Angela's daughter, Margherita, has been infusing its classic designs with fresh appeal.

The Missoni fashion house, with its trademark zigzag and other geometric patterns in sweaters, scarves and other knitwear, is one of Italy's most famous fashion brands abroad.

Vittorio Missoni played a key role in marketing the Missoni family creations in Asia, especially in Japan, Hong Kong and South Korea as general director of marketing for Missoni SpA. He also spearheaded a push for the company's products in the United States and France. His efforts to expand the brand abroad led Missoni to be dubbed the company's "ambassador."

On Friday, Venezuela's Interior Minister Nestor Reverol said the plane was declared missing hours after taking off from Los Roques, a string of islands popular for scuba diving, white beaches and coral reefs, and where the Missonis and their friends were on vacation.

Vittorio Missoni has been described as an active sportsman and lover of the outdoors. He and his wife and their friends from northern Italy were scheduled to fly back to Italy on Friday, but their internal flight never made it to Caracas.

La Repubblica said the plane disappeared off radar screens shortly after takeoff from Los Roques on what was to been a 90-mile (140-kilometer) flight to the mainland.

The Missoni brand is scheduled to display its latest menswear creations at a fashion show in Milan later this month.

On Jan. 4, 2008, another plane returning to the Venezuelan mainland from Los Roques disappeared with 14 people aboard, including eight Italians. The body of the plane's Venezuelan co-pilot later washed ashore, but despite a search lasting weeks no other victims or the wreckage were found.

In 2009, a small plane returning from Los Roques with nine people aboard plunged into the Caribbean Sea, but all survived.

____

Ian James contributed to this report from Caracas, Venezuela.

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The New Old Age: Murray Span, 1922-2012

One consequence of our elders’ extended lifespans is that we half expect them to keep chugging along forever. My father, a busy yoga practitioner and blackjack player, celebrated his 90th birthday in September in reasonably good health.

So when I had the sad task of letting people know that Murray Span died on Dec. 8, after just a few days’ illness, the primary response was disbelief. “No! I just talked to him Tuesday! He was fine!”

And he was. We’d gone out for lunch on Saturday, our usual routine, and he demolished a whole stack of blueberry pancakes.

But on Wednesday, he called to say he had bad abdominal pain and had hardly slept. The nurses at his facility were on the case; his geriatrician prescribed a clear liquid diet.

Like many in his generation, my dad tended towards stoicism. When he said, the following morning, “the pain is terrible,” that meant agony. I drove over.

His doctor shared our preference for conservative treatment. For patients at advanced ages, hospitals and emergency rooms can become perilous places. My dad had come through a July heart attack in good shape, but he had also signed a do-not-resuscitate order. He saw evidence all around him that eventually the body fails and life can become a torturous series of health crises and hospitalizations from which one never truly rebounds.

So over the next two days we tried to relieve his pain at home. He had abdominal x-rays that showed some kind of obstruction. He tried laxatives and enemas and Tylenol, to no effect. He couldn’t sleep.

On Friday, we agreed to go to the emergency room for a CT scan. Maybe, I thought, there’s a simple fix, even for a 90-year-old with diabetes and heart disease. But I carried his advance directives in my bag, because you never know.

When it is someone else’s narrative, it’s easier to see where things go off the rails, where a loving family authorizes procedures whose risks outweigh their benefits.

But when it’s your father groaning on the gurney, the conveyor belt of contemporary medicine can sweep you along, one incremental decision at a time.

All I wanted was for him to stop hurting, so it seemed reasonable to permit an IV for hydration and pain relief and a thin oxygen tube tucked beneath his nose.

Then, after Dad drank the first of two big containers of contrast liquid needed for his scan, his breathing grew phlegmy and labored. His geriatrician arrived and urged the insertion of a nasogastric tube to suck out all the liquid Dad had just downed.

His blood oxygen levels dropped, so there were soon two doctors and two nurses suctioning his throat until he gagged and fastening an oxygen mask over his nose and mouth.

At one point, I looked at my poor father, still in pain despite all the apparatus, and thought, “This is what suffering looks like.” I despaired, convinced I had failed in my most basic responsibility.

“I’m just so tired,” Dad told me, more than once. “There are too many things going wrong.”

Let me abridge this long story. The scan showed evidence of a perforation of some sort, among other abnormalities. A chest X-ray indicated pneumonia in both lungs. I spoke with Dad’s doctor, with the E.R. doc, with a friend who is a prominent geriatrician.

These are always profound decisions, and I’m sure that, given the number of unknowns, other people might have made other choices. Fortunately, I didn’t have to decide; I could ask my still-lucid father.

I leaned close to his good ear, the one with the hearing aid, and told him about the pneumonia, about the second CT scan the radiologist wanted, about antibiotics. “Or, we can stop all this and go home and call hospice,” I said.

He had seen my daughter earlier that day (and asked her about the hockey strike), and my sister and her son were en route. The important hands had been clasped, or soon would be.

He knew what hospice meant; its nurses and aides helped us care for my mother as she died. “Call hospice,” he said. We tiffed a bit about whether to have hospice care in his apartment or mine. I told his doctors we wanted comfort care only.

As in a film run backwards, the tubes came out, the oxygen mask came off. Then we settled in for a night in a hospital room while I called hospices — and a handyman to move the furniture out of my dining room, so I could install his hospital bed there.

In between, I assured my father that I was there, that we were taking care of him, that he didn’t have to worry. For the first few hours after the morphine began, finally seeming to ease his pain, he could respond, “OK.” Then, he couldn’t.

The next morning, as I awaited the hospital case manager to arrange the hospice transfer, my father stopped breathing.

We held his funeral at the South Jersey synagogue where he’d had his belated bar mitzvah at age 88, and buried him next to my mother in a small Jewish cemetery in the countryside. I’d written a fair amount about him here, so I thought readers might want to know.

We weren’t ready, if anyone ever really is, but in our sorrow, my sister and I recite this mantra: 90 good years, four bad days. That’s a ratio any of us might choose.

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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