Lens Blog: Sirkka-Liisa Konttinen's Photos of Her Newcastle Neighborhood

On clear days in Newcastle-Upon-Tyne, a small yet bustling working-class city in northeast England, the view from the hills of Byker can be spectacular. That shabby neighborhood’s rows of brick houses and terraced streets overlook a historic city center, the river and sometimes far beyond.

Those vistas were rare in 1969, when Sirkka-Liisa Konttinen, a 21-year-old Finnish photographer, arrived. The landscape was cloaked in an industrial fog belched from the coal and shipbuilding industries.

Despite the grayness, the laughter and vivacity that radiated from this close-knit community appealed to Ms. Konttinen. It welcomed a young foreigner whose presence stoked curiosity, but also generosity. They joked with her in pubs. Some of the older women took her under their wing — she kindled a protective instinct in them.

“People were baffled by my choice to live there,” Ms. Konttinen recalled. “Not that many people had any idea where Finland was, but if they did, they thought it such a beautiful clean country, and why would I choose to come to Byker?”

She had ventured there because of Amber Collective, a progressive documentary project that she helped found, which chronicled the lives of working people in northeast England. The group was formed in London by a handful of students who made a film following Vietnam War demonstrations at Grosvenor Square that turned violent. Titled “All You Need Is Dynamite,” it was just a student effort, but its makers found they shared a philosophy.

Before long, they had relocated to Newcastle.

The city was in decline. Urban planners sought flashy new development projects, and some sections, like Byker, were scheduled for demolition. Ms. Konttinen was unaware that she was documenting a place that was about to disappear. Not drawn to gloomy topics, she found the place spirited and interesting.

“Initially, I don’t think we ever thought that we need to document it because it will be the only thing left for people to remember the place and what the area was like,” she said. “I personally have never felt that that was my mission.”

The Amber Collective has produced an enormous amount of material, dating back decades, that is focused on the communities of northeast England, although Ms. Konttinen’s Byker pictures are probably the collective’s best-known project. That work was published as a book in 1983; Amber also released a film companion of the same name, and in 2011 her documentation was registered with the Unesco U.K. Memory of the World. For the first time in a commercial art space, photographs from the series will be shown in the United States, on view at the L. Parker Stephenson Gallery from Feb. 15 through May 11. Ms. Konttinen will also deliver a lecture at the International Center for Photography on Feb. 13.

In recent years, she returned to Byker. The new Byker is changed — more on that Friday — and the changes required her to reconsider her approach when she decided to photograph it. The newer project, “Byker Revisited,” is a result of a far more collaborative endeavor. Not that she hadn’t collaborated in other ways with a subject before. Her 1971 photo of Heather (Slide 3) brought about one such relationship.

“I heard music coming from a derelict house,” she said. “This was one of the last terraces before the final demolition, and there were no steps left to the house, but upstairs I heard music, piano, coming out the windows.”

She entered the house, climbing a rickety staircase to where the music was coming from. She found a girl, Heather, “playing the piano, banging the notes that were kind of stuck and unstuck.”

Ms. Konttinen and Heather started talking, and Ms. Konttinen taught her a simple tune.

“I told her if she ever wanted to come and play, she could come and play it again on my piano,” Ms. Konttinen said. Heather showed up a few days later, with her little brother. On Ms. Konttinen’s piano, they played the tune together.

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Friday: Returning to Byker, in color.

Photographs from “Byker” will be on view at the L. Parker Stephenson Gallery from Feb. 15 through May 11. Ms. Konttinen will also deliver a lecture at the International Center for Photography on Feb. 13.

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Illini buzzer-beater upsets No. 1 Hoosiers, 74-72

CHAMPAIGN, Ill. (AP) — Tyler Griffey made the easiest and biggest shot of his career.

The senior forward took an inbounds pass and made a wide-open layup with 0.9 seconds to play to give Illinois a 74-72 victory over No. 1 Indiana on Thursday night, the fifth straight week the nation's top-ranked team lost.

Hoosiers coach Tom Crean, whose team has been No. 1 for a total of seven weeks this season, doesn't have a reason for the recent weekly changes on top of the poll.

"I can't answer that. I'm not sure," Crean said. "I just know that these games are 40-minute games. We played at a high level for most of the game."

The Hoosiers were in charge until the final 3 1-2 minutes when the Illini (16-8, 3-7 Big Ten) finally put together a run to take and then retake the lead.

"I know this, when we turn the ball over we're not very good," Crean said. "And the biggest difference tonight was 28 points off turnovers to our 16."

And nothing could have been worse for the Hoosiers (20-3, 8-2) than the way the game ended.

With 0.9 seconds left Griffey left defenders Cody Zeller and Christian Watford behind on an inbounds play from the baseline, took the pass from Brandon Paul and delivered the uncontested buzzer-beater for the Illini.

The shot sent hundreds of students onto the court — holding their collective breath as officials checked the replay to make sure the clock hadn't beaten Griffey — and Paul and fellow guard D.J. Richardson hugged and teared up with relief.

Illinois had lost eight of 11 since starting the season 12-0. The Illini had been ranked as high as No. 10 and were now falling to the bottom of the Big Ten.

Griffey, accustomed to struggling in recent weeks, seemed surprised with the ease he was able to make the game-winner.

"I just made a simple curl cut and left two guys behind me, and Brandon got off a heck of a pass," he said. "Zeller and Watford were both right in front of me and just kind of stayed there."

Crean, whose team just moved into the No. 1 spot after knocking off then-No. 1 Michigan on Saturday, said the play was a lot like the other breakdowns in the Hoosiers' game that let Illinois climb back from a 12-point halftime deficit.

"We didn't communicate," Crean said.

"They're very deserving of the win, they never gave in," he added, but he qualified that with, "We didn't put them away when we had the opportunities."

Indiana's loss drops them into a three-way tie for first in the Big Ten with Michigan and Michigan State. For the Illini, the win means a move out of 10th in the 12-team conference up into a ninth-place tie with Iowa.

More importantly, it's a potential lifeline for an Illini team that still has to face No. 18 Minnesota on the road Sunday and had been watching its season slip away.

"It was good to get back to having that toughness and togetherness and trust that we needed," Illinois coach John Groce said.

Illinois hadn't beaten a No. 1 team since a 2004 win over Wake Forest. But the Illini had won nine of the last 10 against the Hoosiers in Champaign. And this season, whatever else has gone wrong, Illinois has delivered against the big boys. Coming into Thursday night the Illini had already beaten three teams now in the top 15: No. 6 Gonzaga, No. 10 Ohio State and No. 14 Butler.

Richardson had 23 points for Illinois, Paul had 21 and Griffey finished with 14 points and eight rebounds.

Zeller led Indiana with 14 points, while Will Sheehey had 13, Watford 12 and Jordan Hulls 11.

Indiana shot 50 percent from the field (25 of 50), 52.9 percent from 3-point range (9 of 17) and 93 percent from the free throw line (13 of 14). The Hoosiers led by an 8- to 10-point margin for most of the second half.

And when 6-foot-11 Nnanna Egwu fouled out with just under 5 minutes to play, Indiana looked in control. Egwu is the only Illini player with the size to realistically match up with the 7-0 Zeller.

Watford made two free throws after Egwu's fifth foul and, at 69-59, the Illini looked done.

But with the clock under 3 minutes, Richardson went on a run of his own, first burying consecutive 3-pointers and then hitting a midrange jumper on the run to tie the game at 70 with 1:17 to play.

Oladipo's layup put the Hoosiers back on top with 50 seconds left, but Paul answered with two free throws, the first banked in, to tie the score again at 72.

With the clock under 30 seconds, Indiana had the ball for what would have been a last shot but Oladipo fumbled the ball. Richardson picked it up and sprinted down court. Oladipo slapped Richardson's layup out of bounds to set up the final play.

Groce credited Richardson for sparking the comeback.

"I thought he was absolutely terrific on both ends of the floor," Groce said. "He battled, he fought."

Griffey was benched several weeks ago after a blowout loss at Wisconsin. On a team that had lost its shooting touch, the senior forward had grown especially cold. And, though one of Illinois' bigger players at 6-9, he wasn't adding much to the inside presence the Illini desperately needed.

The play that brought him to life Thursday, though, had nothing to do with Illinois' late surge. Griffey hit a 3-pointer less than 4 minutes into the second half. He had missed 20 straight 3-point attempts, dating to the start of the Big Ten season.

"I said to myself, 'Finally,'" said Griffey, who said he has been doing so much extra shooting that he's had to have regular ice treatments on his wrist.

Groce said that, even after he benched Griffey, he never gave up on him.

"I just have told him numerous times here I believe in him," the first-year Illinois coach said. "I do."

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Well: Old Age and Motorcycles Are a Dangerous Mix

If you’re over 40 and planning to hop on a motorcycle, take care. Compared with younger riders, the odds of being seriously injured are high.

That is the message of a new study, published this week in the journal Injury Prevention, which found that older bikers are three times as likely to be severely injured in a crash as younger riders.

The percentage of older bikers on the road is quickly rising, and their involvement in accidents is a growing concern. Nationwide, from 1990 to 2003, the percentage of motorcyclists over age 50 soared from roughly 1 in 10 to about 1 in 4. At the same time, the average age of riders involved in motorcycle crashes has also been climbing. Injury rates among those 65 and older jumped 145 percent from 2000 to 2006 alone.

Because of the increase in motorcycle ridership among older Americans, the researchers, led by Tracy Jackson, a graduate student in the epidemiology department at Brown University, wanted a closer look at their injury patterns. So she and her colleagues combed through a federal database of motorcycle crashes that were serious enough to require emergency medical care. That yielded about 1.5 million incidents involving motorcyclists 20 or older from 2001 to 2008.

The researchers then split them into groups: those in their 20s and 30s, another group between 40 and 59, and those 60 and older.

Over all, the study showed that injury rates for all three groups were on the rise. But the rise was steepest for the oldest riders. Compared with the youngest motorcyclists, those who were 60 and older were two and a half times as likely to end up with serious injuries, and three times as likely to be admitted to a hospital. The riders who were middle age were twice as likely as their younger counterparts to be hospitalized.

For older riders, the consequences of a collision were also especially alarming. Older and middle-aged bikers were more likely to sustain fractures and dislocations, and they had a far greater chance of ending up with injuries to internal organs, including brain damage.

The researchers speculated that it was very likely that a number of factors played a role in older riders’ higher injury rates. For one, declines in vision and reaction time may make older riders more prone to mistakes that end up in collisions. Another theory is that older riders tend to ride bigger bikes, “which may be more likely to roll or turn over,” Ms. Jackson said.

Then there is the greater fragility that comes with age. Older riders may be involved in the same types of accidents as younger riders, Ms. Jackson said, but in some cases, a collision that a 20-year-old would walk away from might send a 65-year-old to the hospital.

“Your bones become more brittle, and you lose muscle mass as you get older,” she said. “It could just be a matter of aging and the body being less durable.”

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Chinese Imports and Exports Soar in January

HONG KONG — January trade data from China on Friday showed a surge in exports and imports from a year earlier — a phenomenon that was largely due to the timing of the Lunar New Year holiday, but that also supported the view that the Chinese economy is firming.

Economic data from China are often severely distorted by the holiday, the highlight of the Chinese calendar, when many factories shut down for a week or more.

The holiday this year takes place in February — the first day of the Lunar New Year is on Sunday — but last year it fell squarely in January, cutting down on the number of working days during that month.

The trade data released Friday reflected this with a large increase compared with the year before, as analysts had expected. Exports climbed 25 percent from January 2012, according to the General Administration of Customs, and imports soared 28.8 percent.

Both figures beating expectations by a wide margin, however, supported the view that the rise was also caused in part by healthier domestic and overseas demand.

“This strong export number cannot be fully explained by the Chinese New Year effect alone,” Zhiwei Zhang, chief China economist at Nomura in Hong Kong, said in a research note.

“These data suggest that external and domestic demand are both strong, which supports our view that the economy is on track for a cyclical recovery” in the first half of this year, he added.

Dariusz Kowalcyk, an economist at Crédit Agricole in Hong Kong, said “we need to wait for February results to have the full picture of trade at the start of 2013.”

However, he added, “one trend is clear: exports have been doing very well recently. This may be a sign of improved external demand, but is also a testimony to the resilience of Chinese exporters and to their competitiveness.”

The Chinese economy has been accelerating gradually in the past few months, reversing a marked slowdown that had raised fears of a possible “hard landing” in China early last year.

Improved overseas demand, combined with a string of government-mandated stimulus measures, have gradually propped up growth and dispelled those fears.

Data released last month showed the Chinese economy expanded just 7.8 percent last year — down from 9.3 percent in 2011 and 10.4 percent in 2010 — but many analysts expect slightly faster growth again in 2013.

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Hagel Wouldn’t Be First Enlisted Man as Pentagon Chief

Stephen Crowley/The New York Times

Four secretaries of defense served as enlisted men before being promoted. Chuck Hagel, left, would be the only Pentagon chief to have served his entire military career as an enlisted man.

WASHINGTON — President Obama declared at the White House on Jan. 7 that Chuck Hagel, his nominee to be secretary of defense, would be the “first person of enlisted rank” to run the Pentagon. The distinction, which Mr. Obama called “historic,” quickly made its way into news media reports around the globe, including in The New York Times.

The problem is that at least four other American defense secretaries — Melvin R. Laird, Elliot L. Richardson, Caspar W. Weinberger and William J. Perry — served part of their military careers as enlisted men.

According to the Historical Office of the Secretary of Defense, Mr. Laird, who was President Richard M. Nixon’s first defense secretary, entered the Navy as an enlisted man before serving as a junior officer on a destroyer in the Pacific during World War II. Mr. Richardson, who served four months as Nixon’s second defense secretary, enlisted in the Army as a private in 1942. He was subsequently commissioned as an officer, and as a first lieutenant landed with the Fourth Infantry Division in Normandy on D-Day.

Mr. Weinberger, President Ronald Reagan’s first secretary of defense, entered the Army as a private in 1941, was commissioned and served in the Pacific, and by the end of World War II was a captain on Gen. Douglas MacArthur’s intelligence staff.

According to biographies on the Web site of Stanford University, Mr. Perry, who was defense secretary under President Bill Clinton, served in the Army Corps of Engineers from 1946 to 1947 and was in Japan during the American occupation after World War II. He later became an officer in the Army Reserves. Today, Mr. Perry is a senior fellow at the Freeman Spogli Institute for International Studies and the Hoover Institution, both at Stanford.

Mr. Obama’s omission of the four other defense secretaries was first reported by Robert Burns of The Associated Press.

White House officials insisted that Mr. Obama was not in error. “President Obama was precise and accurate in referring to the fact that Senator Hagel would be the ‘first person of enlisted rank’ to go on to serve as secretary of defense, and that experience on the front lines is part of the reason why President Obama chose him,” said Marie Harf, a White House spokeswoman who is working on Mr. Hagel’s nomination.

As Ms. Harf explained it, the use of the formulation “first person of enlisted rank” was meant to signal that Mr. Hagel had remained enlisted throughout his entire military career and to separate him from the other men, who had retired as officers. Mr. Hagel, who was wounded twice in Vietnam, would be the first defense secretary to have served in combat while enlisted. To Mr. Obama that distinction, at least, is crucial.

“Chuck knows that war is not a distraction,” Mr. Obama said in nominating Mr. Hagel. “He understands that sending young Americans to fight and bleed in the dirt and mud, that’s something we do only when it’s absolutely necessary.”

This article has been revised to reflect the following correction:

Correction: February 7, 2013

An earlier version of this article misspelled the surname of the World War II general for whom Caspar W. Weinberger served as an intelligence staff member. He was Gen. Douglas MacArthur, not McArthur.

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Signing Day: Ole Miss muscles in on power programs

Alabama. Ohio State. Michigan. Florida. Notre Dame. Mississippi?

Ole Miss muscled in on the powerhouses that usually dominate national signing day, landing some of the most sought-after prospects in the country on college football's annual first-Wednesday-in-February frenzy.

The Rebels, coming off a promising 7-6 season in their first season under coach Hugh Freeze, had the experts swooning by signing three of the bluest chips still on the board and building a well-rounded class otherwise.

"I do think (this class) has the possibility of being a program changer," Freeze said. "But it's all on paper right now.

The day started with defensive end Robert Nkemdiche from Loganville, Ga., rated the No. 1 recruit in the country by just about everyone who ranks them, deciding to join his brother, Denzel, in Oxford, Miss.

"I feel like it's the right place for me," Nkemdiche said after slipping on a red Ole Miss cap. "I feel like they can do special things and they're on the rise. I feel like going to play with my brother, we can do something special."

Nkemdiche originally committed to Clemson last year, then backed off that and narrowed his picks down to LSU, Florida and Mississippi — and the Rebels beat the big boys.

They weren't done. Coaches in the Ole Miss war room were exchanging hugs and high-fives again a couple hours later when Laremy Tunsil, a top-rated offensive tackle from Lake City, Fla., picked the Rebels over Florida State and Georgia.

"Tunsil to Ole Miss I think was the biggest surprise of the whole (recruiting season)," said JC Shurburtt, national recruiting director for 247Sports.com.

And, as if the Ole Miss needed more good news, highly touted defensive back Antonio Conner from nearby Batesville, Miss., chose the Rebels over national champion Alabama.

Ole Miss also landed Laquon Treadwell from Crete, Ill., one of the best receiver prospects in the country. He made a verbal commitment to the Rebels back in December, and sealed the deal Wednesday, the first day high school players can sign binding letters of intent.

The end result was a class good enough to even catch the attention of LeBron James.

"Ole Miss ain't messing around today! Big time recruits coming in. SEC is crazy," the NBA MVP posted on his Twitter account.

Crazy good. While the Rebels racked up, it's important to remember they still have plenty of ground to gain on the rest of their conference.

Nick Saban reloaded the Crimson Tide with a class that Rivals.com ranked No. 1 in the country.

SEC powers Florida, LSU and Georgia pulled in typically impressive classes. SEC newcomer Texas A&M cracked the top 10 of several rankings. Even Vanderbilt, coming off a nine-win season, broke into the top 25.

It's the cycle of life in the SEC, which has won seven straight BCS championships. Stock up on signing day and scoop up those crystal footballs at season's end.

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SLIPPING AWAY FROM USC

Signing day didn't do much to soothe the scars left from a difficult season for Southern California.

NCAA sanctions limited the number of scholarships coach Lane Kiffin and the Trojans could hand out this year, and then as signing day approached USC had several players who had given verbal commitments change their minds.

The most notable defection on signing day was five-star defensive back Jalen Ramsey of Brentwood, Tenn., who flipped to Florida State. Defensive end Jason Hatcher from Louisville, Ky., bailed on USC and signed with Kentucky, and defensive end Torrodney Prevot from Houston not only reneged on his USC commitment, but he landed at Pac-12-rival Oregon.

"People expected (Prevot) to flip from USC, but they thought it would be to Texas A&M," Shurburtt said.

USC's class won't be lacking blue chippers. Quarterback Max Browne from Washington is considered the next in a long line of topflight Trojans quarterbacks, and Kenny Bigelow from Maryland is rated among the best defensive linemen in the nation.

Kiffin will be banking on quality to make up for the lack of quantity, but that's a precarious way to play a game as uncertain as recruiting.

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IF MOMMA'S NOT HAPPY ...

Alex Collins, a top running back prospect out of Plantation, Fla., announced on Monday night that he was going to Arkansas instead of Miami.

It was considered a huge victory for new Razorbacks coach Bret Bielema.

But on Wednesday morning, when it was time to make it official, Collins' letter of intent didn't come spinning through the fax machine in Fayetteville, Ark.

There were some odd reports about Collins' mother not being happy with her son's decision to go so far from home.

College coaches aren't allowed to talk about specific players before they sign, but Bielema did acknowledge during his signing day news conference that Arkansas' class of 22 players could "grow by one."

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THE BIG TWO

Ohio State and Michigan received two thumbs up from experts on their signing day classes. They all had the Buckeyes and Wolverines around top five in the country.

After that, there was a drop off. Nebraska received solid grades and Penn State, despite NCAA sanctions that limited its class to 17 signees, held up pretty well.

"That's a tribute to the job (Penn State coach) Bill O'Brien and the staff did," Shurburtt said.

But signing day 2013 signaled that Urban Meyer's Buckeyes and Brady Hoke's Wolverines are primed to pull away from most of the Big Ten, and maybe — just maybe — give the league a team or two that can challenge those SEC teams for a national title.

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BUILT TO LAST

Notre Dame followed up its best season in more than two decades with a recruiting class that coach Brian Kelly hopes can keep the Fighting Irish contending for more national titles.

The class includes a famous name in Torii Hunter Jr., the son of the All-Star outfielder. Hunter Jr. is a top-notch receiver prospect, though he broke his leg during an All-Star game and it could be a while before he's back on the football field.

Linebacker Jaylon Smith from Fort Wayne, Ind., is generally regarded as the jewel of a class that experts have ranked among the best in the country.

"I love agreeing with experts," Kelly said.

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BASEBALL OR FOOTBALL?

Oklahoma hopes it has found the next Sam Bradford in Cody Thomas, a pocket passer from Colleyville, Texas.

One small problem. Thomas is also a big-time baseball player who could draw interest in the major league draft this summer.

"We wouldn't have pursued him if we didn't feel there was a great chance he'd be playing football," Oklahoma coach Bob Stoops said.

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QUOTABLE

South Carolina coach Steve Spurrier said recruiting classes "don't always pan out. Of course, they always seem to pan out at Alabama."

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AP Sports Writer David Brandt in Oxford, Miss., and Associated Press Writer Tom Coyne in South Bend, Ind., contributed.

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Follow Ralph D. Russo at www.Twitter.com/ralphdrussoap

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

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

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

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

The Presenting Problem:

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

The Patient’s Story:

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

A Sister’s Visit:

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

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

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

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

A Long Series of Illnesses:

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

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

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

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

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

Back to the Hospital:

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

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

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

Back to the Hospital, Again:

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

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

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

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

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

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

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

Solving the Mystery:

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

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

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Profound Weight of Layoffs Seen in Survey

Layoffs have touched nearly every American household in some fashion over the last few years, according to new survey data to be released Thursday by the John J. Heldrich Center for Workforce Development at Rutgers University.

Joe Raedle/Getty Images

Lissette Marquez, center, and Amiel Ali looked for jobs last week in Miami with the help of a South Florida Workforce customer service representative, Nelson Munoz, left.

While about 8 percent of Americans are unemployed, nearly a quarter of Americans say they were laid off at some point during the recession or afterward, according to the survey. More broadly, nearly eight in 10 say they know someone in their circle of family and friends who has lost a job.

“This to me is why the recession was so all-consuming and is likely to influence the American psyche,” said Cliff Zukin, a public policy and political science professor at Rutgers and co-author of the report. “Almost everyone, four out of five, were directly or one step removed from unemployment and all that goes with it financially, socially, psychologically.”

The survey presented a bleak view of the economic future.

A majority of Americans say they think it will be at least six years before the economy is made whole again, if ever. Three in 10 said the economy would never fully recover from the Great Recession.

“Despite significant improvements in the nation’s labor market, American workers’ concerns about unemployment, the job market, job security and the future of the economy have not changed much since we conducted a similar survey in August 2010,” the report said.

Just a third of Americans surveyed in this poll, conducted from Jan. 9-16, said they thought the economy would be better next year, the same share that said so two years earlier.

Of those laid off in recent years, nearly a quarter said they still had not found a job. Re-employment rates for older workers have been particularly bad, with nearly two-thirds of unemployed people 55 and older saying they actively sought a job for more than a year before finding one or had still not found work.

Not surprisingly, those who are unemployed are especially downbeat about many economic issues in addition to their own finances. Of those who were jobless and looking for work, 31 percent said their jobless benefits had run out and 58 percent said they were concerned their benefits would run out before they found work.

Of those who have found work, nearly half say their current job is a step down from the one they lost, and a slim majority say they earn less than they did in their previous job. A quarter of those re-employed said they thought that the hit to their standard of living would be permanent.

The reliance on one’s personal network and savings rather than the social safety net showed up frequently in the survey data.

More people reported borrowing money from friends and family than reported using food stamps. A third cut back on doctors’ visits or medical treatment. A quarter of the unemployed said they had enrolled in retraining programs of some kind; half of them reported paying for the education on their own or through family assistance. Twenty-three percent received some type of government financing for their training programs.

Unemployed workers were more likely than employed workers to say that the government is primarily responsible for helping the jobless. But even then, a majority of the unemployed thought that workers and employers were more responsible for getting people back to work than the government was.

Americans over all were also somewhat less critical of bankers this time than they were two years earlier. About one in three (35 percent) respondents attributed high unemployment levels to the actions of Wall Street, compared with 45 percent in 2010.

Americans were most likely to attribute high unemployment to cheap foreign labor. Four in 10 also said they believed illegal immigrants were taking Americans’ job opportunities — which does not bode well for political support for an amnesty program now being discussed in Washington.

Most people surveyed lost at least some of their savings. Asked about their financial health, six in 10 Americans said their finances would not improve in the next few years; just 16 percent said their family finances were already back to prerecession levels or suffered no loss in the first place.

More educated, better-off people were substantially more likely to report being as financially secure as they were before the recession began.

Responses are based on an online survey conducted by GfK using a nationally representative sample of 1,090 adults. The margin of sampling error is plus or minus three percentage points.

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Tsunami Fear After Quake Off Solomons

AUCKLAND, New Zealand — Residents of the South Pacific from island chains to Australia were alerted to the possibility of a damaging tsunami on Wednesday after an 8.0-magnitude earthquake off the Solomon Islands, according to scientists and news reports from the area, but the warnings were called off a few hours later.

Ednal Palmer, the chief reporter of the newspaper The Solomon Star in Honiara, the capital of the Solomon Islands, said in a telephone interview that reports from Lata, the capital of Temotu Province, were sketchy but indicated that a wave had apparently struck three villages.

“We have heard that a wave 103 centimeters high” — nearly three and a half feet — “has hit Lata, swamping the town, and five people are still missing at the moment,” Mr. Palmer said.

Lata, where the quake struck, is in Temotu Province, where the population is around 30,000. It is a three-hour flight from Honiara, which was not damaged by the earthquake or the tsunami.

Mr. Palmer said Honiara residents were not concerned about the tsunami. “Most of us are getting ready for tonight’s UB40 concert,” he said.

The Pacific Tsunami Warning Center said on its Web site, “Sea level readings indicate a tsunami was generated.” The earthquake struck around 11 a.m. local time in the Santa Cruz Islands, part of the Solomon chain. There were conflicting reports as to the depth of the quake.

The center said the tsunami warning was limited to the Solomon Islands, Vanuatu, Nauru, Papua New Guinea, Tuvalu, New Caledonia, Kosrae, Fiji, Kiribati, and Wallis and Futuna.

A lesser alert, a tsunami watch, was declared for American Samoa, Australia, Guam, the Northern Marianas, New Zealand and eastern Indonesia.

The earthquake was not only powerful but also shallow, giving it significant potential to cause damage, said Barry Hirshorn, a geophysicist with the National Weather Service in Hawaii. Moreover, it was a thrust earthquake, he said, meaning that the sea floor moved up or down, not sideways, contributing to the potential for a dangerous tsunami.

But after the earthquake, as scientists watched to see how far a tsunami might spread, there were few early indications of a major threat beyond the immediate area, Mr. Hirshorn said. A water rise of about three feet had been observed close to the quake, he said, still high enough to be potentially damaging but probably not big enough to threaten distant shores.

In New Zealand, thousands of people were at the beach, swimming in the sea on a glorious summer afternoon on Waitangi Day, a national holiday — quite oblivious to the potential for a tsunami. Tsunami sirens were set off late in the afternoon there, and people in coastal areas were being told to stay off beaches and out of the sea, rivers and estuaries.

The New Zealand Herald reported Wednesday afternoon on its Web site that tsunami sirens in Suva, the capital of Fiji, had been warning people to stay inside or go to higher ground.

The Sydney Morning Herald reported on its Web site on Wednesday that the Solomon Islands’ National Disaster Management Office had advised those living in low-lying areas, especially on Makira and Malaita, to move to higher ground.

This article has been revised to reflect the following correction:

Correction: February 6, 2013

An earlier version of this article misspelled the given name of the chief reporter of The Solomon Star. He is Ednal Palmer, not Edmal.

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Braun says he used Fla clinic owner as consultant

NEW YORK (AP) — Milwaukee Brewers slugger Ryan Braun said the person who ran the Florida clinic under investigation by Major League Baseball only was used as a consultant on his drug suspension appeal last year.

"I have nothing to hide," Braun said in a statement released by his representatives on Tuesday night.

Earlier in the day, Yahoo Sports reported the 2011 NL MVP's name showed up three times in records of the Biogenesis of America LLC clinic. Yahoo said no specific performance-enhancing drugs were listed next to his name.

The Miami New Times recently released clinic documents that purportedly linked Alex Rodriguez, Gio Gonzalez, Melky Cabrera and other players to purchases of banned drugs from the now-closed anti-aging center.

Rodriguez and Cabrera were on the list with Braun that also included New York Yankees catcher Francisco Cervelli and Baltimore Orioles infielder Danny Valencia.

Braun said his name was in the Biogenesis records because of an issue over payment to Anthony Bosch, who ran the clinic near Miami.

"There was a dispute over compensation for Bosch's work, which is why my lawyer and I are listed under 'moneys owed' and not on any other list," Braun said.

"I have nothing to hide and have never had any other relationship with Bosch," he said. "I will fully cooperate with any inquiry into this matter."

On Tuesday, MLB officials asked the Miami New Times for the records the alternative newspaper obtained for its story.

Asked specifically about Braun's name in the documents before the five-time All-Star released his statement, MLB spokesman Pat Courtney said: "Aware of report and are in the midst of an active investigation in South Florida."

Braun tested positive during the 2011 postseason for elevated testosterone levels. He maintained his innocence and his 50-game suspension was overturned during spring training last year when arbitrator Shyam Das ruled in favor of Braun due to chain of custody issues involving the sample.

With that, Braun became the first major leaguer to have a drug suspension overturned.

"During the course of preparing for my successful appeal last year, my attorneys, who were previously familiar with Tony Bosch, used him as a consultant. More specifically, he answered questions about T/E ratio and possibilities of tampering with samples," Braun said.

The T/E ratio is a comparison of the levels of testosterone to epitestosterone.

Braun led the NL in homers (41), runs (108) and slugging percentage (.595) last season while batting .319 with 112 RBIs and 30 stolen bases. He finished second to San Francisco catcher Buster Posey in MVP balloting."

Cervelli, who spent nearly all of last season in Triple-A, posted a statement on Twitter later Tuesday night.

"Following my foot injury in March 2011, I consulted with a number of experts, including BioGenesis Clinic, for (cont)," Cervelli posted, "(cont)legal ways to aid my rehab and recovery. I purchased supplements that I am certain were not prohibited by Major League Baseball."

An email sent to Valencia's agent was not returned.

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