U.S. Judges Offer Addicts a Way to Avoid Prison

Todd Heisler/The New York Times

Emily Leitch of Brooklyn, with her son, Nazir, 4, was arrested for importing cocaine but went to “drug court” to avoid prison.

Federal judges around the country are teaming up with prosecutors to create special treatment programs for drug-addicted defendants who would otherwise face significant prison time, an effort intended to sidestep drug laws widely seen as inflexible and overly punitive.

The Justice Department has tentatively embraced the new approach, allowing United States attorneys to reduce or even dismiss charges in some drug cases.

The effort follows decades of success for “drug courts” at the state level, which legal experts have long cited as a less expensive and more effective alternative to prison for dealing with many low-level repeat offenders.

But it is striking that the model is spreading at the federal level, where judges have increasingly pushed back against rules that restrict their ability to make their own determination of appropriate sentences.

So far, federal judges have instituted programs in California, Connecticut, Illinois, New Hampshire, New York, South Carolina, Virginia and Washington. About 400 defendants have been involved nationwide.

In Federal District Court in Brooklyn on Thursday, Judge John Gleeson issued an opinion praising the new approach as a way to address swelling prison costs and disproportionate sentences for drug trafficking.

“Presentence programs like ours and those in other districts mean that a growing number of courts are no longer reflexively sentencing federal defendants who do not belong in prison to the costly prison terms recommended by the sentencing guidelines,” Judge Gleeson wrote.

The opinion came a year after Judge Gleeson, with the federal agency known as Pretrial Services, started a program that made achieving sobriety an incentive for drug-addicted defendants to avoid prison. The program had its first graduate this year: Emily Leitch, a Brooklyn woman with a long history of substance abuse who was arrested entering the country at Kennedy International Airport with over 13 kilograms of cocaine, about 30 pounds, in her luggage.

“I want to thank the federal government for giving me a chance,” Ms. Leitch said. “I always wanted to stand up as a sober person.”

The new approach is being prompted in part by the Obama administration, which previously supported legislation that scaled back sentences for crimes involving crack cocaine. The Justice Department has supported additional changes to the federal sentencing guidelines to permit the use of drug or mental health treatment as an alternative to incarceration for certain low-level offenders and changed its own policies to make those options more available.

“We recognize that imprisonment alone is not a complete strategy for reducing crime,” James M. Cole, the deputy attorney general, said in a statement. “Drug courts, re-entry courts and other related programs along with enforcement are all part of the solution.”

For nearly 30 years, the United States Sentencing Commission has established guidelines for sentencing, a role it was given in 1984 after studies found that federal judges were giving defendants widely varying sentences for similar crimes. The commission’s recommendations are approved by Congress, causing judges to bristle at what they consider interference with their judicial independence.

“When you impose a sentence that you believe is unjust, it is a very difficult thing to do,” Stefan R. Underhill, a federal judge in Connecticut, said in an interview. “It feels wrong.”

The development of drug courts may meet resistance from some Republicans in Congress.

“It is important that courts give deference to Congressional authority over sentencing,” Representative F. James Sensenbrenner Jr., Republican of Wisconsin, a member and former chairman of the Judiciary Committee, said in a statement. He said sentencing should not depend “on what judge happens to decide the case or what judicial circuit the defendant happens to be in.”

At the state level, pretrial drug courts have benefited from bipartisan support, with liberals supporting the programs as more focused on rehabilitation, and conservatives supporting them as a way to cut spending.

Under the model being used in state and federal courts, defendants must accept responsibility for their crimes and agree to receive drug treatment and other social services and attend regular meetings with judges who monitor their progress. In return for successful participation, they receive a reduced sentence or no jail time at all. If they fail, they are sent to prison.

The drug court option is not available to those facing more serious charges, like people accused of being high-level dealers or traffickers, or accused of a violent crime. (These programs differ from re-entry drug courts, which federal judges have long used to help offenders integrate into society after prison.)

In interviews, the federal judges who run the other programs pointed to a mix of reasons for their involvement.

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Economix Blog: Bernanke Defends Stimulus as Necessary and Effective

The Federal Reserve’s chairman, Ben S. Bernanke, picked an unusual time to offer his most recent defense of the Fed’s campaign to stimulate the economy: 7 p.m. on a Friday night in San Francisco, 10 p.m. back home on the East Coast.

The basic message was the same as Mr. Bernanke delivered to Congress earlier this week: The Fed regards its current efforts as necessary and effective, and the risks, while real, are under control.

“Commentators have raised two broad concerns surrounding the outlook for long-term rates,” Mr. Bernanke told a conference at the Federal Reserve Bank of San Francisco. “To oversimplify, the first risk is that rates will remain low, and the second is that they will not.”

If rates remain low, it may drive investors to take excessive risks. If rates jump, investors could lose money – not least the Fed.

Regarding the first possibility, Mr. Bernanke said that the Fed was keeping a careful eye on financial markets. But he noted that rates were low in large part because the economy was weak, and that keeping rates low was the best way to encourage stronger growth. “Premature rate increases would carry a high risk of short-circuiting the recovery, possibly leading — ironically enough — to an even longer period of low long- term rates,” he said.

At the other extreme, Mr. Bernanke said the Fed could “mitigate” any jump in rates by prolonging its efforts to hold rates down, for example by keeping some of its investments in Treasury and mortgage-backed securities.

Three more highlights from the question-and-answer session after the speech.

1. Mr. Bernanke, asked about the outlook for the Washington Nationals, responded by accurately quoting the “Las Vegas odds” of a World Series appearance: 8/1.

2. Although the decision may be made under a future chairman, Mr. Bernanke said the Fed should continue to offer “forward guidance” — predicting its policies — even after it concludes its long effort to revive the economy.

“Providing information about the future path of policy could be useful, probably would be useful, under even normal circumstances,” he said in response to a question. “I think we need to keep providing information.”

3. Not surprisingly, Mr. Bernanke often is asked to reflect on the financial crisis. He offered something a little different than his normal response on Friday night.

“In many ways, in retrospect, the crisis was a normal crisis,” he said. “It’s just that the intuitional framework in which it occurred was much more complex.”

In other words, there was a panic, and a run, and a collapse – but rather than a run on bank deposits, the run was in the money markets. Improving the stability of those markets is something regulators have yet to accomplish.

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Death Toll From Bangladesh Unrest Hits 42

DHAKA, Bangladesh — Violent clashes between protesters and security forces erupted across Bangladesh on Thursday, leaving at least 44 people dead, after a special war crimes tribunal handed down a death sentence to an Islamic leader for crimes against humanity committed 42 years ago, during the country’s 1971 war of independence from Pakistan.

The verdict against Delawar Hossain Sayedee, a leader of Jamaat-e-Islami, an Islamist party, resonated across the country. It was celebrated by the hundreds of thousands of young protesters who have taken to the streets in recent weeks to condemn Jamaat and demand justice in the war crimes cases against other party leaders, insisting that those who were convicted be hanged.

“This verdict is a victory for the people,” declared Imran H. Sarkar, a blogger and an organizer of the protests, during a rally on Thursday afternoon.

But followers of Jamaat reacted with fury, saying the case brought against Mr. Sayedee and others was politically motivated and tainted by judicial irregularities. The police and witnesses said that of the 42 people killed in the unrest, six of them were policemen.

Jamaat leaders had called a nationwide strike on Thursday to protest the verdict, and by afternoon bloodshed had erupted across the country, as party workers fought with the police in the streets.

The protests for and against Jamaat have convulsed Bangladeshi politics, demonstrating that the country has still not healed from the bloody 1971 conflict, in which an estimated three million people were killed and thousands of women were raped. Before the war, Bangladesh was East Pakistan, separated from the rest of that country by a wide expanse of India. The war pitted Bangladeshi separatists against Pakistani soldiers and local collaborators, who were known then as the Razakar Bahini.

“As judges of this tribunal, we firmly hold and believe in the doctrine that ‘justice in the future cannot be achieved unless injustice of the past is addressed,’ ” Justice A. T. M. Fazle Kabir commented in a written summary of the judgment.

The war crimes tribunal has convicted three Jamaat leaders in connection with the war, and other cases are under way, including some against defendants not affiliated with the party.

Mr. Sayedee, 73, is a well-known religious speaker with a bright red beard who became a member of the Bangladeshi Parliament after the war. Prosecutors accused him of involvement in looting and burning villages, raping women and forcing members of religious minorities to convert to Islam during the war.

His defense lawyer, Abdur Razzaq, scoffed at the court’s verdict and accused the authorities of deliberately prejudicing the trial and preventing an important witness from testifying.

“This is unfortunate, and this is unexpected,” Mr. Razzaq said of the verdict and sentence in a telephone interview. “This is a perverse judgment. It is inconceivable that a court of law awarded him a conviction. This prosecution was for a political purpose.”

Jamaat leaders and other opposition politicians have said for months that the government was manipulating the war crimes process to go after political rivals, accusations that the authorities deny. The proceedings have already created dissent and some international criticism. The chief presiding judge resigned after reports, based on hacked Skype conversations, that the judge had improper contacts with a legal expert linked to prosecutors and the government.

But to many Bangladeshis, the real injustice has been that war criminals have remained free for decades. On Feb. 5, the tribunal convicted another Jamaat leader, Abdul Quader Mollah, and sentenced him to life in prison. Furious that the tribunal had not sentenced Mr. Mollah to death, protesters gathered in growing numbers, surpassing 200,000 on some days.

The protests have become known as the Shahbagh movement, named for a large intersection in central Dhaka where the main demonstrations have taken place. Many political analysts say the Shahbagh protests are the most significant spontaneous political movement in Bangladesh in decades. Though the movement may be suffused with idealism and proud nationalism, it also bears a hard edge, with demands for the execution of convicted war criminals.

Sultana Kamal, a prominent human rights leader in Dhaka, said that she disagreed with the calls for the death penalty, but that they reflected the cynicism of Bangladeshis who have seen war criminals evade punishment for decades. Many people were infuriated when Mr. Mollah flashed a victory sign after receiving his life sentence.

“We have a problem in accepting that they are demanding the death penalty,” Ms. Kamal said in a telephone interview. “But we understand that it was from a nervousness among the people here that unless they are given the highest penalty in the land, these people will come back out.”

Julfikar Ali Manik reported from Dhaka, and Jim Yardley from New Delhi.

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Jane C. Wright, Pioneering Oncologist, Dies at 93

Dr. Jane C. Wright, a pioneering oncologist who helped elevate chemotherapy from a last resort for cancer patients to an often viable treatment option, died on Feb. 19 at her home in Guttenberg, N.J. She was 93.

Her death was confirmed by her daughter Jane Jones, who said her mother had dementia.

Dr. Wright descended from a distinguished medical family that defied racial barriers in a profession long dominated by white men. Her father, Dr. Louis T. Wright, was among the first blacks to graduate from Harvard Medical School and was reported to be the first black doctor appointed to the staff of a New York City hospital. His father was an early graduate of what became the Meharry Medical College, the first medical school in the South for African-Americans, founded in Nashville in 1876.

Dr. Jane Wright began her career as a researcher working alongside her father at a cancer center he established at Harlem Hospital in New York.

Together, they and others studied the effects of a variety of drugs on tumors, experimented with chemotherapeutic agents on leukemia in mice and eventually treated patients, with some success, with new anticancer drugs, including triethylene melamine.

After her father died in 1952, Dr. Wright took over as director of the center, which was known as the Harlem Hospital Cancer Research Foundation. In 1955, she joined the faculty of the New York University Medical Center as director of cancer research, where her work focused on correlating the responses of tissue cultures to anticancer drugs with the responses of patients.

In 1964, working as part of a team at the N.Y.U. School of Medicine, Dr. Wright developed a nonsurgical method, using a catheter system, to deliver heavy doses of anticancer drugs to previously hard-to-reach tumor areas in the kidneys, spleen and elsewhere.

That same year, Dr. Wright was the only woman among seven physicians who, recognizing the unique needs of doctors caring for cancer patients, founded the American Society of Clinical Oncologists, known as ASCO. She was also appointed by President Lyndon B. Johnson to the President’s Commission on Heart Disease, Cancer and Stroke, led by the heart surgeon Dr. Michael E. DeBakey. Its recommendations emphasized better communication among doctors, hospitals and research institutions and resulted in a national network of treatment centers.

In 1967, Dr. Wright became head of the chemotherapy department and associate dean at New York Medical College. News reports at the time said it was the first time a black woman had held so high a post at an American medical school.

“Not only was her work scientific, but it was visionary for the whole science of oncology,” Dr. Sandra Swain, the current president of ASCO, said in a telephone interview. “She was part of the group that first realized we needed a separate organization to deal with the providers who care for cancer patients. But beyond that it’s amazing to me that a black woman, in her day and age, was able to do what she did.”

Jane Cooke Wright was born in Manhattan on Nov. 30, 1919. Her mother, the former Corinne Cooke, was a substitute teacher in the New York City schools.

Ms. Wright attended the Ethical Culture school in Manhattan and the Fieldston School in the Bronx (now collectively known Ethical Culture Fieldston School) and graduated from Smith College, where she studied art before turning to medicine. She received a full scholarship to New York Medical College, earning her medical degree in 1945. Before beginning research with her father, she worked as a doctor in the city schools.

Dr. Wright’s marriage, in 1947, to David D. Jones, a lawyer, ended with his death in 1976. She is survived by their two daughters, Jane and Alison Jones, and a sister, Barbara Wright Pierce, who is also a doctor.

As both a student and a doctor, Dr. Wright said in interviews, she was always aware that as a black woman she was an unusual presence in medical institutions. But she never felt she was a victim of racial prejudice, she said.

“I know I’m a member of two minority groups,” she said in an interview with The New York Post in 1967, “but I don’t think of myself that way. Sure, a woman has to try twice as hard. But — racial prejudice? I’ve met very little of it.”

She added, “It could be I met it — and wasn’t intelligent enough to recognize it.”

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F-35 Jets Returned to Service by Pentagon

The Pentagon lifted its grounding of the new F-35 jet fighter on Thursday after concluding that a turbine blade had cracked on a single plane after it was overused in test operations.

The office that runs the program said no other cracks were found in inspections of the other engines made so far, and no engine redesign was needed.

It said the engine in which the blade cracked was in a plane that “had been operated at extreme parameters in its mission to expand the F-35 flight envelope.”

The program office added that “prolonged exposure to high levels of heat and other operational stressors on this specific engine were determined to be the cause of the crack.”

All flights were suspended last week for the 64 planes built so far once the crack, which stretched for six-tenths of an inch, was found during a routine inspection.

Pratt & Whitney, which makes the engines, investigated the problem with military experts. The company, a unit of United Technologies, said on Wednesday that the crack occurred after that engine was operated more than four times longer in a high-temperature flight environment than the engines would in normal use.

The F-35, a supersonic jet meant to evade enemy radar, is the Pentagon’s most expensive program and has been delayed by various technical problems. The program could cost $396 billion if the Pentagon builds 2,456 jets by the late 2030s.

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India Ink: Big Hikes in Rural, Social Spending in India’s New Budget

Finance Minister Palaniappan Chidambaram presented the Union budget in Parliament on Thursday morning. When Mr. Chidambaram walked into the Lok Sabha, or lower house of Parliament, carrying the ceremonial budget briefcase, it was eighth time he had presented the country’s annual budget, and the 82^nd national budget presented in India.

As the last Union Budget to be presented before the national elections in 2014, the finance minister faced a difficult task of balancing good politics with good economics, particularly in trying to rein in a record-high national deficit.

He was, nonetheless, upbeat. “I acknowledge that the Indian economy is challenged, but I am absolutely confident that, with your cooperation, we will get out of the trough and get on to the high growth path,” he said, before presenting the budget in a speech that lasted nearly two hours. “There is no reason for gloom or pessimism,” he said. “Even now, of the large countries of the world, only China and Indonesia are growing faster than India in 2012-13.”

Here is a brief overview of the Union Budget for the fiscal year that begins April 1, 2013:

Total Expenditure:

Planned expenditure in 2013-2014 is 5.55 trillion rupees, or $103 billion, up 29.4 percent from revised estimates for the year before. Total expenditure for 2013-2014 will be 16.7 trillion rupees, up 16 percent from the total expenditure in the fiscal year 2012-2013 of 14.3 trillion rupees.

Full year economic growth projections for the year beginning April 1, 2013:

Gross domestic product growth for 2013-2014 will be 6.1 to 6.7 percent, up from 5 percent the year before. In a budget that emphasized growth, Mr. Chidambaram said that his aim was to get back to an 8 percent growth rate. “Our mantra is, higher growth leading to inclusive and sustainable development,” he said.

Fiscal Deficit:

The fiscal deficit for the current year was contained at 5.2 percent, Mr. Chidambaram said. For the fiscal year 2013-2014, which begins April 1, the estimated fiscal deficit is 4.8 percent and the revenue deficit is 3.3 percent. By 2016-2017, the finance minister said, he aimed to bring down fiscal deficit to 3 percent and revenue deficit to 1.5 percent

Trade:

Exports fell 5.5 percent in the 2012-2013 fiscal year to $ 214.1 billion, compared to their 21.3 percent growth in fiscal 2011-12, when they reached $226.5 billion.

Imports fell 0.7 percent percent in the 2012-2013 fiscal year to $361.3 billion, down from $ 363.9 billion in the corresponding period of 2011-12.

Current Account Deficit

The current account deficit, a measure of the difference between the value of exports and imports, is caused by high oil, coal and gold imports and a slowdown in exports, the finance minister said. This figure is a “bigger worry” than the fiscal deficit, he said. In the first half of the fiscal year 2012-2013, the latest figures available, the current account deficit worsened to $39 billion, or 4.6 percent of G.D.P, versus $36.4 billion, or 4 percent, in the corresponding period of 2011-12.

In order to finance the current account deficit, foreign investment must be increased. Over the next two years, $75 billion is needed to finance the current account deficit, Mr. Chidambaram said.

Rural Spending

The budget for the Ministry of Rural Development will rise by a staggering 46 percent, to 802 billion rupees, or $14.9 billion.

Agriculture Spending:

The Union budget 2013-2014 allocated 270 billion rupees, or $5.02 billion to the Agriculture Ministry, an increase of 22 percent from the previous budget.

Food Security:

The National Food Security Bill, which will provide subsidized food to poor people, is a “promise” of the United Progressive Alliance government, the finance minister said, and he hopes that the Parliament will pass the bill soon. The budget has set aside 100 billion rupees ($1.86 billion) for costs likely under the food security bill, he said.

Health and Education

“Health for all and education for all remain our priorities,” Mr. Chidambaram said. In 2013-2014 he allocated 373 billion rupees, or $6.93 billion to the Ministry of Health and Family Welfare. This includes 212 million rupees for the National Health Mission, a program to improve healthcare in rural India, an increase of 24.3 percent from the year before.

He also proposed to provide rupees 47 billion rupees, or $878 million for medical education, training and research.

Defense Spending:

Allocations for defense in the upcoming year rose by 4.5 percent from the year before, to 2 lakh crore, or 2 trillion rupees. In 2012-2013 fiscal year, defense spending allocation was 1.94 trillion rupees ($38.7 billion), up 17.6 percent over the year before.

Taxes: Tax rates will remain the same, the finance minister said, but there will be a one-time surcharge imposed on the 42,800 Indians who report income of more than 10 million rupees ($186,000) to the tax department. This will be imposed for one year only, he said, adding that he hoped these rich Indians would feel a little of the spirit of Azim Premji, the Wipro founder and philanthropist.

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Well: Think Like a Doctor: The Man Who Wobbled

The Challenge: Can you solve the medical mystery of a man who suddenly becomes too dizzy to walk?

Every month, the Diagnosis column of The New York Times Magazine asks Well readers to try their hand at solving a medical mystery. Below you will find the story of a 56-year-old factory worker with dizziness and panic attacks. I have provided records from his two hospital visits that will give you all the information available to the doctor who finally made the diagnosis.

The first reader to offer the correct diagnosis gets a signed copy of my book, “Every Patient Tells a Story,” and the satisfaction of solving a case that stumped a roomful of specialists.

The Patient’s Story:

The middle-aged man clicked his way through the multiple reruns of late-late-night television. He should have been in bed hours ago, but lately he hadn’t been able to get to sleep. Suddenly his legs took on a life of their own. Stretched out halfway to the center of the room, they began to shake and twitch and jump around. The man watched helplessly as his legs disobeyed his mental orders to stop moving. He had no control over them. He felt nauseous, sweaty and out of breath, as if he had been running some kind of race. He called out to his wife. She hurried out of bed, took one look at him and called 911.

The Patient’s History:

By the time the man arrived at Huntsville Hospital, in Alabama, the twitching in his legs had subsided and his breathing had returned to normal. Still, he had been discharged from that same hospital for similar symptoms just two weeks earlier. They hadn’t figured out what was going on then, so they weren’t going to send him home now.

The patient considered himself pretty healthy, but the past year or so had been tough. In 2011, at the age of 54, he had had a mild stroke. He had no medical problems that put him at risk for stroke — no high blood pressure, no high cholesterol, no diabetes. A work-up at that time showed that he had a hole in his heart that allowed a tiny clot from somewhere in his body to travel to the brain and cause the stroke. He was discharged on a couple of blood thinners to keep his blood from making more clots. He hadn’t really felt completely well, though, ever since. His balance seemed a little off, and he was subject to these weird panic attacks, in which his heart would pound and he would feel short of breath whenever he got too stressed. Mostly he could manage them by just walking away and focusing on his breathing. Still, he never felt as if he was the kind of guy to panic.

And he had always been quick on his feet. The first half of his career he had been in the steel business — building huge metal trusses and supports. He and his team put together 60-plus tons of steel structures every day. For the past decade he had been machining car parts. After his stroke, work seemed to get a lot harder.

The Dizziness:

A few weeks ago, he stood up and wham — suddenly the whole world went off-kilter. He felt as if he was constantly about to fall over in a world that no longer lay down flat. His first thought was that he was having another stroke. He went straight to his doctor’s office. The doctor wasn’t sure what was going on and sent him to that same emergency room at Huntsville Hospital. After three days of testing and being evaluated by lots of specialists, his doctors still were not sure what was going on. He hadn’t had a heart attack; he hadn’t had a stroke. There was no sign of infection. All the tests they could think of were normal.

The only abnormal finding was that when he stood up, his blood pressure dropped. Why this happened wasn’t clear, but the doctors in the hospital gave him compression stockings and a pill — both could help keep his blood pressure in the normal range. Then they sent him home. He was also started on an antidepressant to help with the panic attacks he continued to have from time to time.

You can read the report from that hospital admission below.

You can also read the consultation and discharge notes from that hospital visit here.

He had been home for nearly two weeks and still he felt no better. He tried to go back to work after a week or so at home, but after driving for less than five miles, he felt he had to turn around. He wasn’t sure what was wrong; he just knew he didn’t feel right. Then his legs started jumping around, and he ended up back in the hospital.

The Doctor’s Exam:

It was nearly dawn by the time Dr. Jeremy Thompson, the first-year resident on duty that night, saw the patient. Awake but tired, the patient told his story one more time. He had been at home, watching TV, when his legs started jumping on their own and he started feeling short of breath. His wife sat at the bedside. She looked just as worried and exhausted as he did. She told the resident that when he spoke that night at home, his speech was slurred. And when the ambulance came, he could barely walk. He has never missed this much work, she told the young doctor. It’s not like him. Can’t you figure out what’s wrong?

The resident had already reviewed the records from the patient’s previous hospital admissions. He asked a few more questions: the patient had never smoked and rarely drank; his father died at age 80; his mother was still alive and well. The patient exam was normal, as were the studies done in the E.R.

The first E.R. doctor thought that his symptoms were a result of anxiety, culminating in a full-blown panic attack. The resident thought that was probably right. In any case he would discuss the case with the attending in a couple of hours during rounds on the new patients. Till then, he told the worried couple, they should just try to get a little sleep.

An Important Clue:

Dr. Robert Centor was definitely a morning person. His cheerful enthusiasm about teaching and taking care of patients made him a favorite among residents. At 7:30 that morning, he stood outside the patient’s door as Dr. Thompson relayed the somewhat frustrating case of the middle-aged man with worsening dizziness and panic attacks. Then they went into the room to meet the patient. He was a big guy, tall and muscular with the first signs of middle-aged thickening around his middle. His complexion had the look of someone who spent a lot of time outdoors. Dr. Centor introduced himself and pulled up a chair as the rest of the team watched. He asked the patient what brought him to the hospital.

“Every time I get up, I get dizzy,” the man replied. Sure, he had had some balance problems ever since his stroke, he explained, but this felt different – somehow worse. He could hardly walk, he told the doctor. He just felt too unstable.

“Can you get up and show us how you walk?” Dr. Centor asked.

“Don’t let me fall,” the patient responded. He carefully swung his legs over the side of the bed. The resident and intern stood on either side as he slowly rose. He stood with his feet far apart. When asked to close his eyes as he stood there, he wobbled and nearly fell over. When he took a few steps, his heel and toes hit the ground at the same time, making a strange slapping sound.

Seeing that, Dr. Centor knew where the problem lay and ordered a few tests to confirm his diagnosis.

You can see the review report and notes for the patient’s second hospital visit below.

Solving the Mystery:

What tests did Dr. Centor order? Do you know what is making this middle-aged man wobble? Enter your guesses below. I’ll post the answer tomorrow.

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Rules and Regulations: Post your questions and diagnosis in the Comments section below. The correct answer will appear tomorrow 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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European Union Agrees on Plan to Cap Banker Bonuses

BRUSSELS — Bankers in Europe face a cap on bonuses as early as next year, after an agreement on Thursday to introduce what would be the world’s strictest pay curbs in a move politicians hope will address public anger at financial-sector greed.

The provisional agreement, announced by diplomats and officials after late-night talks between E.U. member representatives and the bloc’s parliament, means bankers face an automatic cap that sets bonuses at the level of their salaries.

If a majority of a bank’s shareholders vote in favor, that ceiling can be raised to two times a banker’s pay.

“For the first time in the history of E.U. financial market regulation, we will cap bankers’ bonuses,” said Othmar Karas, the Austrian lawmaker who helped negotiate the deal.

The backing of a majority of E.U. states is needed for the deal to be finalized.

Such limits, which are set to enter E.U. law as part of a wider overhaul of capital rules to make banks safer, will be popular on a continent struggling to emerge from the ruins of a 2008 financial crisis.

But it represents a setback for the British government, which had long argued against such absolute limits. The City of London, the region’s financial capital, with 144,000 banking staff and many more in related jobs, will be hit hardest.

As it stands in draft legislation, the cap would also apply to bankers employed by an E.U. institution but based elsewhere globally, for instance in New York, according to one official, who was not authorized to speak to the media.

There are also provisions for adjusting the value of long-term non-cash payments, so more bonuses could be paid that way without breaking through the new ceiling.

Ireland, which holds the rotating E.U. presidency and negotiated what it called a “breakthrough,” will now present the agreement to E.U. countries.

Irish Finance Minister Michael Noonan said he would ask his peers to back it at an EU ministers’ meeting on March 5 in Brussels.

The change in the law is set to be introduced as part of a wider body of legislation demanding banks set aside roughly three times more capital and build up cash buffers to cover the risk of unpaid loans, for example.

Some experts have criticized the E.U., however, for failing to keep to all of the so-called Basel III code of capital standards drawn up by international regulators to reform banking after the financial crash.

The agreement on Thursday will also require banks to outline profits and other details of operations on a country-by-country basis.

A ceiling on bonuses, the only one of its kind globally, is perhaps the most radical aspect of the new rules.

Many in banking argue, however, that such reform will do little to lower pay in finance, where head-hunters say some annual packages in London approach £5 million, or about $7.6 million.

“If the cap is implemented, it could result in significantly more complex pay structures within banks as they try to fall outside the restrictions to remain competitive globally,” said Alex Beidas, a pay specialist with the law firm Linklaters.

An earlier attempt to limit bankers’ pay with an E.U. law forcing financiers to defer bonus payments for up to five years merely prompted lenders to increase base salaries. But it would be harder for banks to raise base pay this time around.

Hedge funds and private equity firms will be excluded from such curbs, although they face restrictions on pay later this year under another E.U. law.

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Pope Benedict Prepares for Final General Audience

Agence France-Presse — Getty Images

Tens of thousands of believers gathered for Pope Benedict XVI’s final general audience in St. Peter’s Square on Wednesday.

ROME — In the waning hours of his troubled papacy, Pope Benedict XVI prepared on Wednesday to hold his final general audience as tens of thousands of believers gathered in St. Peter’s Square a day before his resignation takes formal effect.

Vatican officials said around 50,000 tickets had been requested for the occasion, which is likely to draw many more pilgrims into the broad boulevard leading toward the Vatican from the River Tiber.

The pope sent shock waves around the Roman Catholic world on Feb. 11 when he announced he would resign on Thursday — the first pope to have done so voluntarily in six centuries.

The announcement left officials scrambling to deal with the protocols of his departure as he ceases to be the leader of the world’s 1.1 billion Roman Catholics. Only on Tuesday did the Vatican announce that he will keep the name Benedict XVI and will be known as the Roman pontiff emeritus or pope emeritus.

He will dress in a simple white cassock, forgoing the mozzetta, the elbow-length cape worn by some Catholic clergymen, the Vatican spokesman, the Rev. Federico Lombardi, told reporters at a news briefing on Tuesday.

And he will no longer wear the red shoes typically worn by popes, symbolizing the blood of the martyrs, Father Lombardi said, opting instead for a more quotidian brown.

Benedict’s looming departure has also triggered a surge of maneuvering among the 117 cardinals who will elect his successor in a conclave starting next month, reviving concerns about the clerical abuse scandals that dogged Benedict’s time at the Vatican.

Indeed, the abrupt resignation of the most senior Roman Catholic cardinal in Britain on Monday — after accusations that he made unwanted sexual advances toward priests years ago — showed that the taint of scandal could force a cardinal from participating in the selection of a new pope.

His exit came as at least a dozen other cardinals tarnished with accusations that they had failed to remove priests accused of sexually abusing minors were among those gathering in Rome to prepare for the conclave.

But there was no indication that the church’s promise to confront the sexual abuse scandal had led to direct pressure on those cardinals to exempt themselves from the conclave.

Rachel Donadio reported from Rome, and Alan Cowell from Paris.

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Minnesota takes down No. 1 Indiana 77-73

MINNEAPOLIS (AP) — Retaining that No. 1 national ranking has been elusive throughout this wild season in college basketball, and Indiana was the latest to lose at the top — again.

Most important and maybe more challenging for the Hoosiers, however, is holding on to first place in the tough-as-ever Big Ten.

Trevor Mbakwe had 21 points on 8-for-10 shooting and 12 rebounds to help Minnesota take down top-ranked Indiana 77-73 on Tuesday night, the seventh time the No. 1 team in the Associated Press poll has lost this season. Three of those losses were by the Hoosiers, who were No. 1 when they fell to Butler and Wisconsin earlier this season. All three opponents were unranked at the time.

Indiana (24-4, 12-3) has held the No. 1 ranking for 10 of the 17 polls by the AP this season, including the last four, and that will likely change next week. But fending off Michigan, Michigan State and Wisconsin is what's on the minds of the Hoosiers, who'll take a one-game lead in the conference race into Saturday's game against Iowa.

"Winning the Big Ten was going to be tough whether we won today or lost," said star guard Victor Oladipo, who had 16 points. "We knew it was going to be tough from the jump. Now it's even tougher. But I think my team is ready for it. We just have to go back and see what we did wrong and correct it."

Andre Hollins added 16 points for the Gophers (19-9, 7-8), who outrebounded Cody Zeller and the Hoosiers by a whopping 44-30 and solidified their slipping NCAA tournament hopes with an emphatic performance against the conference leader. The fired-up fans swarmed the court as the last seconds ticked off, the first time that's happened here since a 2002 win over Indiana.

"There were just too many times when that first shot went up and they were there before we were because we didn't get into their bodies," Hoosiers coach Tom Crean said. "We weren't physical enough on the glass. That's the bottom line."

Zeller, the second-leading shooter in the Big Ten, went 2 for 9. He had nine points with four turnovers. Minnesota had 40 points in the paint to Indiana's 22.

Mbakwe, a sixth-year senior, had a lot to do with that. While positing his conference-leading seventh double-double of the season, the 24-year-old Mbakwe was a man among boys in many ways in this game, dominating both ends of the court when the Gophers needed him most. He grabbed six of Minnesota's 23 offensive rebounds, two of them to keep a key possession alive. His off-balance put-back drew contact for a three-point play with 7:22 left that gave the Gophers a 55-52 lead.

Mbakwe was called for a loudly questioned blocking foul, his fourth, with 4:39 remaining on Zeller's fast-break layup and free throw that put the Hoosiers up 59-58. But Austin Hollins answered with a pump-fake layup that drew a foul for a three-point play and a two-point advantage for the Gophers.

The Hoosiers didn't lead again, and Joe Coleman's fast-break dunk with 2:35 left gave Minnesota a 68-61 cushion that helped it withstand a couple of 3-pointers by Christian Watford and one by Jordan Hulls in the closing minutes. That was the only basket Hulls made after halftime. He had 17 points.

"Just the way we bounced back is unbelievable. We showed that we can beat one of the best teams in the country. Now we have to build off this," said Mbakwe, whose team lost eight of its previous 11 games starting with an 88-81 loss at Indiana on Jan. 12. The Gophers were ranked eighth then. They didn't even receive a vote in the current poll. That could change next week.

The Hoosiers are still in position for their first outright Big Ten regular-season championship since 1993. With another home game against Ohio State on March 5, Indiana could still clinch the title before the finale at Michigan on March 10.

For now, though, the Hoosiers have to regroup and re-establish their inside game after the trampling in the post they endured here.

"They were relentless on the glass. We just didn't do a great job of boxing them out," Oladipo said.

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Follow Dave Campbell on Twitter: http://www.twitter.com/DaveCampbellAP

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