Gays in Pakistan Move Cautiously to Gain Acceptance


Max Becherer for the International Herald Tribune


HIDING IN PLAIN SIGHT Ali, a gay man who lives in Lahore, is in a support group for lesbian, gay, bisexual and transgender Pakistanis. “The gay scene here is very hush-hush,” he says.







LAHORE, Pakistan — The group meets irregularly in a simple building among a row of shops here that close in the evening. Drapes cover the windows. Sometimes members watch movies or read poetry. Occasionally, they give a party, dance and drink and let off steam.




The group is invitation only, by word of mouth. Members communicate through an e-mail list and are careful not to jeopardize the location of their meetings. One room is reserved for “crisis situations,” when someone may need a place to hide, most often from her own family. This is their safe space — a support group for lesbian, gay, bisexual and transgender Pakistanis.


“The gay scene here is very hush-hush,” said Ali, a member who did not want his full name used. “I wish it was a bit more open, but you make do with what you have.”


That is slowly changing as a relative handful of younger gays and lesbians, many educated in the West, seek to foster more acceptance of their sexuality and to carve out an identity, even in a climate of religious conservatism.


Homosexual acts remain illegal in Pakistan, based on laws constructed by the British during colonial rule. No civil rights legislation exists to protect gays and lesbians from discrimination.


But the reality is far more complex, more akin to “don’t ask, don’t tell” than a state-sponsored witch hunt. For a long time, the state’s willful blindness has provided space enough for gays and lesbians. They socialize, organize, date and even live together as couples, though discreetly.


One journalist, in his early 40s, has been living as a gay man in Pakistan for almost two decades. “It’s very easy being gay here, to be honest,” he said, though he and several others interviewed did not want their names used for fear of the social and legal repercussions. “You can live without being hassled about it,” he said, “as long as you are not wearing a pink tutu and running down the street carrying a rainbow flag.”


The reason is that while the notion of homosexuality may be taboo, homosocial, and even homosexual, behavior is common enough. Pakistani society is sharply segregated on gender lines, with taboos about extramarital sex that make it almost harder to conduct a secret heterosexual romance than a homosexual one. Displays of affection between men in public, like hugging and holding hands, are common. “A guy can be with a guy anytime, anywhere, and no one will raise an eyebrow,” the journalist said.


For many in his and previous generations, he said, same-sex attraction was not necessarily an issue because it did not involve questions of identity. Many Pakistani men who have sex with men do not think of themselves as gay. Some do it regularly, when they need a break from their wives, they say, and some for money.


But all the examples of homosexual relations — in Sufi poetry, Urdu literature or discreet sexual conduct — occur within the private sphere, said Hina Jilani, a human rights lawyer and activist for women’s and minority rights. Homoeroticism can be expressed but not named.


“The biggest hurdle,” Ms. Jilani said, “is finding the proper context in which to bring this issue out into the open.”


That is what the gay and lesbian support group in Lahore is slowly seeking to do, even if it still meets in what amounts to near secrecy.


The driving force behind the group comes from two women, ages 30 and 33. They are keenly aware of the oddity that two women, partners no less, have become architects of the modern gay scene in Lahore; if gay and bisexual men barely register in the collective societal consciousness of Pakistan, their female counterparts are even less visible.


“The organizing came from my personal experience of extreme isolation, the sense of being alone and different,” the 30-year-old said.


She decided that she needed to find others like her in Pakistan. Eight people, mostly the couple’s friends, attended the first meeting in January 2009.


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Google's Android software in 3 out of 4 smartphones

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NYC Marathon runners fill unexpected free time

NEW YORK (AP) — Sue Johnson refuses to give New York City any more money.

She preferred to shell out for the change fee to move her flight home to Pittsburgh up by 24 hours - leaving on the day she was supposed to run the New York City Marathon.

Many of the runners who had descended on the city from all over the globe worked out their frustrations with a jog Saturday through Central Park, site of a finish line that will never be crossed. Some scrambled to rebook return flights. Others made sightseeing plans for the unexpected free time.

Whether from Europe, South America or elsewhere, their sentiment was the same. Sympathy for the victims of Superstorm Sandy. Understanding of why city officials canceled Sunday's race. But bitterness that the decision was made Friday instead of earlier in the week, before they boarded planes.

And some, like Johnson, voiced suspicions that the last-minute announcement was a ploy by city officials to lure entrants to New York so they would still spend money at local businesses.

"They get the best of both worlds," she said after wrapping up a run Saturday.

The runners had dragged their bodies through months of training, often making preparations years in advance and saving money for what costs thousands of dollars for many international entrants.

Diego Pellegrino and his wife kept their plans to stay in New York through Friday. But he had imagined biking around, shopping and eating well all week with the sense of accomplishment of completing his first marathon.

"The illusion is broken," he said.

Pellegrino will still take part in a sporting event midday Sunday: With no race to run, he'll make his first visit to Madison Square Garden for an NBA game, cheering on fellow Argentine Pablo Prigioni of the Knicks against the Philadelphia 76ers.

On a crisp, sunny Saturday, Central Park looked the part of the usual telegenic backdrop to the marathon's final miles. Other than some downed branches, the runners who chugged along the paths saw no evidence of the storm that knocked out power and flooded homes all over the metropolitan area.

A block of sidewalk just outside the park was cordoned off, stacks and stacks of boxes of orange jackets originally intended for marathon volunteers waiting to be donated to shelters. On this Saturday, runners would usually carb load at Marathon Eve Dinner. That, too, was canceled.

More New Yorkers got electricity Saturday, but frustrations mounted over gasoline shortages as refueling sites turned into traffic jams of horn-honking confusion. Gas rationing went into effect in northern New Jersey, while crowds lined up at free fuel distribution sites in New York's boroughs.

The blue and orange structure above the finish line remained up, though nobody could run under it. Barricades kept people a few yards away, creating the feel of a tourist attraction: Runners stood against them to have their photo taken with "Finish" in the background. Many wore NYC Marathon gear, souvenirs from an event that never occurred.

Some runners organized their own impromptu marathon routes this weekend. Others will gather on Staten Island on Sunday morning as they would have for the marathon. They'll take off running — to deliver supplies to residents devastated by the storm.

"We initially were bummed, but also saddened by the perception that runners were indifferent to the needs of other people," said Jordan Metzl, a sports medicine doctor in New York. "We wanted to turn a negative to a positive."

American star Meb Keflezighi, the 2009 men's champion, said some of the elite runners were considering entering upcoming marathons in Japan and Philadelphia to take advantage of their training. But he may take some time off.

For all the conspiracy theories from out-of-town runners, the city will take in far less than the estimated $340 million the marathon would have brought.

Anthony King, owner of the bar Finnegans Wake along the race course on Manhattan's East Side, had the mixed feelings of a New Yorker and a local businessman. He felt for other merchants who would lose much-needed revenue, but agreed with the mayor's ultimate decision.

"We're going to miss all the excitement," he said.

Race organizer New York Road Runners has cancellation insurance but must sort out the effects on contracts with elite runners, sponsors and broadcasters. NYRR President Mary Wittenberg said Friday that for now organizers were sticking with their policy of not refunding entry fees, but it would be reviewed.

Susan Bourque was in the car, halfway between Boston and New York, when her father called Friday evening to say the race was canceled. Still on the road, Bourque started researching whether she could enter a different marathon in the next couple weeks so as not to waste her training. Sure enough, Sunday's race in Manchester, N.H., had extended its registration deadline to attract jilted New York runners.

Bourque and her husband kept on driving because their two children had never been to the Big Apple. They arrived at 9:30 p.m. and squeezed in visits to the Empire State Building and Times Square before heading back to New England at midday Saturday, pleasantly surprised their hotel refunded the rate with their early departure.

Francesco Caielli, Mario Di Sabato and Luciano Sala were two hours from landing in New York on Friday when they saw the news on the plane's video screens. At least their trip was smooth: A friend whose initial flight was canceled flew from their native Italy to Hong Kong then New York, determined to make the marathon.

And now there's no race.

Di Sabato scoffed that if the same thing happened in his home country, outsiders would accuse the Italians of stereotypical disorganization. But this fiasco took place under the watch of New York City Mayor Michael Bloomberg.

In his first comments since canceling the race, Bloomberg told WCBS-TV on Saturday his message to out-of-town runners was: "I'm sorry. I fought the battle, and sometimes things don't work out."

Runners signed up this year will be guaranteed entry into the 2013 marathon or the half-marathon in March, a valuable promise since it's so hard to get into the race. That could leave few spots next year for anyone else, though.

But some vowed to never again enter the NYC Marathon. Pia Nielsen, who flew in from Copenhagen, said city and race officials would have to regain her trust.

Lucy Marquez said she would come back, even as tears filled her eyes at the thought of the three young children she left at home in Mexico to race what would have been her first marathon.

"Shock. Denial. Rage," is how Marquez described the stages of digesting the news that the race had been scrapped. Twelve years ago, she watched her father run the course.

"I love New York City," she said. "This is the marathon I want to run."

___

Cara Anna, James Martinez and Karen Matthews contributed to this report.

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Second Illness Infects Meningitis Sufferers





Just when they might have thought they were in the clear, people recovering from meningitis in an outbreak caused by a contaminated steroid drug have been struck by a second illness.




The new problem, called an epidural abscess, is an infection near the spine at the site where the drug — contaminated by a fungus — was injected to treat back or neck pain. The abscesses are a localized infection, different from meningitis, which affects the membranes covering the brain and spinal cord. But in some cases, an untreated abscess can cause meningitis. The abscesses have formed even while patients were taking powerful antifungal medicines, putting them back in the hospital for more treatment, often with surgery.


The problem has just begun to emerge, so far mostly in Michigan, which has had more people sickened by the drug — 112 out of 404 nationwide — than any other state.


“We’re hearing about it in Michigan and other locations as well,” said Dr. Tom M. Chiller, the deputy chief of the mycotic diseases branch of the Centers for Disease Control and Prevention. “We don’t have a good handle on how many people are coming back.”


He added, “We are just learning about this and trying to assess how best to manage these patients. They’re very complicated.”


In the last few days, about a third of the 53 patients treated for meningitis at St. Joseph Mercy Hospital in Ann Arbor, Mich., have returned with abscesses, said Dr. Lakshmi K. Halasyamani, the chief medical officer.


“This is a significant shift in the presentation of this fungal infection, and quite concerning,” she said. “An epidural abscess is very serious. It’s not something we expected.”


She and other experts said they were especially puzzled that the infections could occur even though patients were taking drugs that, at least in tests, appeared to work against the fungus causing the infection, a type of black mold called Exserohilum.


The main symptom is severe pain near the injection site. But the abscesses are internal, with no visible signs on the skin, so it takes an M.R.I. scan to make the diagnosis. Some patients have more than one abscess. In some cases, the infection can be drained or cleaned out by a neurosurgeon.


But sometimes fungal strands and abnormal tissue are wrapped around nerves and cannot be surgically removed, said Dr. Carol A. Kauffman, an expert on fungal diseases at the University of Michigan. In such cases, all doctors can do is give a combination of antifungal drugs and hope for the best. They have very little experience with this type of infection.


Some patients have had epidural abscesses without meningitis; St. Joseph Mercy Hospital has had 34 such cases.


A spokesman for the health department in Tennessee, which has had 78 meningitis cases, said that a few cases of epidural abscess had also occurred there, and that the state was trying to assess the extent of the problem.


Dr. Chiller said doctors were also reporting that some patients exposed to the tainted drug had arachnoiditis, a nerve inflammation near the spine that can cause intense pain, bladder problems and numbness.


“Unfortunately, we know from the rare cases of fungal meningitis that occur, that you can have complicated courses for this disease, and it requires prolonged therapy and can have some devastating consequences,” he said.


The meningitis outbreak, first recognized in late September, is one of the worst public health disasters ever caused by a contaminated drug. So far, 29 people have died, often from strokes caused by the infection. The case count is continuing to rise. The drug was a steroid, methylprednisolone acetate, made by the New England Compounding Center in Framingham, Mass. Three contaminated lots of the drug, more than 17,000 vials, were shipped around the country, and about 14,000 people were injected with the drug, mostly for neck and back pain. But some received injections for arthritic joints and have developed joint infections.


Inspections of the compounding center have revealed extensive contamination. It has been shut down, as has another Massachusetts company, Ameridose, with some of the same owners. Both companies have had their products recalled.


Compounding pharmacies, which mix their own drugs, have had little regulation from either states or the federal government, and several others have been shut down recently after inspections found sanitation problems.


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Google Casts a Big Shadow on Smaller Web Sites


Annie Tritt for The New York Times


Jeffrey G. Katz, the chief executive of Wize Commerce, seen with employees. He says that about 60 percent of the traffic for the company’s Nextag comparison-shopping site comes from Google.





In a geeky fire drill, engineers and outside consultants at Nextag scrambled to see if the problem was its own fault. Maybe some inadvertent change had prompted Google’s algorithm to demote Nextag when a person typed in shopping-related search terms like “kitchen table” or “lawn mower.”


But no, the engineers determined. And traffic from Google’s search engine continued to decline, by half.


Nextag’s response? It doubled its spending on Google paid search advertising in the last five months.


The move was costly but necessary to retain shoppers, Mr. Katz says, because an estimated 60 percent of Nextag’s traffic comes from Google, both from free search and paid search ads, which are ads that are related to search results and appear next to them. “We had to do it,” says Mr. Katz, chief executive of Wize Commerce, owner of Nextag. “We’re living in Google’s world.”


Regulators in the United States and Europe are conducting sweeping inquiries of Google, the dominant Internet search and advertising company. Google rose by technological innovation and business acumen; in the United States, it has 67 percent of the search market and collects 75 percent of search ad dollars. Being big is no crime, but if a powerful company uses market muscle to stifle competition, that is an antitrust violation.


So the government is focusing on life in Google’s world for the sprawling economic ecosystem of Web sites that depend on their ranking in search results. What is it like to live this way, in a giant’s shadow? The experience of its inhabitants is nuanced and complex, a blend of admiration and fear.


The relationship between Google and Web sites, publishers and advertisers often seems lopsided, if not unfair. Yet Google has also provided and nurtured a landscape of opportunity. Its ecosystem generates $80 billion a year in revenue for 1.8 million businesses, Web sites and nonprofit organizations in the United States alone, it estimates.


The government’s scrutiny of Google is the most exhaustive investigation of a major corporation since the pursuit of Microsoft in the late 1990s.


The staff of the Federal Trade Commission has recommended preparing an antitrust suit against Google, according to people briefed on the inquiry, who spoke on the condition they not be identified. But the commissioners must vote to proceed. Even if they do, the government and Google could settle.


Google has drawn the attention of antitrust officials as it has moved aggressively beyond its dominant product — search and search advertising — into fields like online commerce and local reviews. The antitrust issue is whether Google uses its search engine to favor its offerings like Google Shopping and Google Plus Local over rivals.


For policy makers, Google is a tough call.


“What to do with an attractive monopolist, like Google, is a really challenging issue for antitrust,” says Tim Wu, a professor at Columbia Law School and a former senior adviser to the F.T.C. “The goal is to encourage them to stay in power by continuing to innovate instead of excluding competitors.”


SPEAKING at a Google Zeitgeist conference in Arizona last month, Larry Page, the company’s co-founder and chief executive, said he understood the government scrutiny of his company, given Google’s size and reach. “There’s very many decisions we make that really impact a lot of people,” he acknowledged.


The main reason is that Google is continually adjusting its search algorithm — the smart software that determines the relevance, ranking and presentation of search results, typically links to other Web sites.


Google says it makes the changes to improve its service, and has long maintained that its algorithm weeds out low-quality sites and shows the most useful results, whether or not they link to Google products.


“Our first and highest goal has to be to get the user the information they want as quickly and easily as possible,” says Matt Cutts, leader of the Web spam team at Google.


But Google’s algorithm is secret, and changes can leave Web sites scrambling.


Consider Vote-USA.org, a nonprofit group started in 2003. It provides online information for voters to avoid the frustration of arriving at a polling booth and barely recognizing half the names on the ballot. The site posts free sample ballots for federal, state and local elections with candidates’ pictures, biographies and views on issues.


In the 2004 and 2006 elections, users created tens of thousands of sample ballots. By 2008, traffic had fallen sharply, says Ron Kahlow, who runs Vote-USA.org, because “we dropped off the face of the map on Google.”


As founder of a search-engine optimization company and a recipient of grants that Google gives nonprofits to advertise free, Mr. Kahlow knows a thing or two about how to operate in Google’s world. He pored over Google’s guidelines for Web sites, made changes and e-mailed Google. Yet he received no response.


“I lost all donations to support the operation,” he said. “It was very, very painful.”


A breakthrough came through a personal connection. A friend of Mr. Kahlow knew Ed Black, chief executive of the Computer & Communications Industry Association, whose members include Google. Mr. Black made an inquiry on Mr. Kahlow’s behalf, and a Google engineer investigated.


Read More..

Petraeus’s Lower C.I.A. Profile Leaves Benghazi Void





WASHINGTON — In 14 months as C.I.A. director, David H. Petraeus has shunned the spotlight he once courted as America’s most famous general. His low-profile style has won the loyalty of the White House, easing old tensions with President Obama, and he has overcome some of the skepticism he faced from the agency’s work force, which is always wary of the military brass.







Brendan Smialowski/Getty Images

The low-profile style of David H. Petraeus, right, has won the loyalty of the White House, easing old tensions with President Obama.








Win Mcnamee/Getty Images

C.I.A. director, David H. Petraeus, right, appeared before the Senate Select Committee on Intelligence in Washington in January.






But since an attack killed four Americans seven weeks ago in Benghazi, Libya, his deliberately low profile, and the C.I.A.’s penchant for secrecy, have left a void that has been filled by a news media and Congressional furor over whether it could have been prevented. Rather than acknowledge the C.I.A.’s presence in Benghazi, Mr. Petraeus and other agency officials fought a losing battle to keep it secret, even as the events there became a point of contention in the presidential campaign.


Finally, on Thursday, with Mr. Petraeus away on a visit to the Middle East, pressure from critics prompted intelligence officials to give their own account of the chaotic night when two security officers died along with the American ambassador, J. Christopher Stevens, and another diplomat. The officials acknowledged for the first time that the security officers, both former members of the Navy SEALs, worked on contract for the C.I.A., which occupied one of the buildings that were attacked.


The Benghazi crisis is the biggest challenge so far in the first civilian job held by Mr. Petraeus, who retired from the Army and dropped the “General” when he went to the C.I.A. He gets mostly high marks from government colleagues and outside experts for his overall performance. But the transition has meant learning a markedly different culture, at an agency famously resistant to outsiders.


“I think he’s a brilliant man, but he’s also a four-star general,” said Senator Dianne Feinstein, the chairwoman of the Senate Intelligence Committee. “Four-stars are saluted, not questioned. He’s now running an agency where everything is questioned, whether you’re a four-star or a senator. It’s a culture change.”


Mr. Petraeus, who turns 60 next week, has had to learn that C.I.A. officers will not automatically defer to his judgments, as military subordinates often did. “The attitude at the agency is, ‘You may be the director, but I’m the Thailand analyst,’ ” said one C.I.A. veteran.


Long a media star as the most prominent military leader of his generation, Mr. Petraeus abruptly abandoned that style at the C.I.A. Operating amid widespread complaints about leaks of classified information, he has stopped giving interviews, speaks to Congress in closed sessions and travels the globe to consult with foreign spy services with little news media notice.


“He thinks he has to be very discreet and let others in the government do the talking,” said Michael E. O’Hanlon, a Brookings Institution scholar who is a friend of Mr. Petraeus’s and a member of the C.I.A.’s advisory board.


Mr. Petraeus’s no-news, no-nonsense style stands out especially starkly against that of his effusive predecessor, Leon E. Panetta, who is now the defense secretary.


Mr. Panetta, a gregarious politician by profession, was unusually open with Congress and sometimes with the public — to a fault, some might say, when he spoke candidly after leaving the C.I.A. about a Pakistani doctor’s role in helping hunt for Osama bin Laden, or about the agency’s drone operations.


Mr. Petraeus’s discretion and relentless work ethic have had a positive side for him: old tensions with Mr. Obama, which grew out of differing views on the wars in Iraq and Afghanistan, appear to be gone. Mr. Petraeus is at the White House several times a week, attending National Security Council sessions and meeting weekly with James R. Clapper Jr., the director of national intelligence, and Thomas E. Donilon, Mr. Obama’s national security adviser. Mr. Donilon said recently that the C.I.A. director “has done an exceptional job,” bringing “deep experience, intellectual rigor and enthusiasm” to his work.


Read More..

Google's Android software in 3 out of 4 smartphones

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Read More..

NYC Marathon is canceled following storm damage

NEW YORK (AP) — Under growing pressure with thousands still shivering from Sandy, the New York City Marathon was canceled Friday by Mayor Michael Bloomberg after mounting criticism that this was not the time for a race.

With the death toll in the city at 41 and power not yet fully restored, many New Yorkers had recoiled at the prospect of police officers being assigned to protect a marathon, storm victims being evicted from hotels to make way for runners, and big generators humming along at the finish-line tents in Central Park.

Around 47,500 runners — 30,000 of them from outside New York — had been expected to take part in the 26.2-mile event Sunday, with more than 1 million spectators usually lining the route. The world's largest marathon had been scheduled to start in Staten Island, one of the storm's hardest-hit places.

Bloomberg had pressed ahead with plans to run the marathon on schedule, but opposition intensified quickly Friday afternoon from the city comptroller, the Manhattan borough president and sanitation workers unhappy that they had volunteered to help storm victims but were assigned to the race instead.

Finally, about three hours later, the mayor relented.

"We would not want a cloud to hang over the race or its participants, and so we have decided to cancel it," Bloomberg said in a statement. "We cannot allow a controversy over an athletic event — even one as meaningful as this — to distract attention away from all the critically important work that is being done to recover from the storm and get our city back on track."

City and race officials considered several alternatives: a modified course, postponement or an elite runners-only race. But they decided cancellation was the best option.

Organizers will donate various items that had been brought in for the race to relief efforts, from food, blankets and portable toilets to generators already set up on Staten Island.

The cancellation means there won't be another NYC Marathon until next year.

"I understand why it cannot be held under the current circumstances," Meb Keflezighi, the 2009 men's champion and a former Olympic silver medalist, said in a statement. "Any inconveniences the cancellation causes me or the thousands of runners who trained and traveled for this race pales in comparison to the challenges faced by people in NYC and its vicinity."

Bloomberg called the marathon an "integral part of New York City's life for 40 years" and "an event tens of thousands of New Yorkers participate in and millions more watch."

He still insisted that holding the race would not have required diverting resources from the recovery effort. But he said he understood the level of friction.

"It is clear it that it has become the source of controversy and division," Bloomberg said. "The marathon has always brought our city together and inspired us with stories of courage and determination.

Bloomberg's decision came just a day after he appealed to the grit and resiliency of New Yorkers, saying, "This city is a city where we have to go on."

The nationally televised race winds through the city's five boroughs and has been held annually since 1970, including 2001, about two months after the 9/11 terrorist attacks.

Mary Wittenberg, president of the organizing New York Road Runners, said it was the right move to cancel.

"This is what we need to do and the right thing at this time," she said.

"It's been a week where we worked very closely with the mayor's office and felt very strongly, both of us together, that on Tuesday it seemed that the best thing for New York on Sunday would be moving forward. As the days went on, just today it got to the point where that was no longer the case."

Wittenberg said she sensed an animosity toward runners in general as the week wore on. About 10,000 runners were expected to drop out after the storm arrived, she said.

Howard Wolfson, deputy mayor for government affairs and communications, said the mayor's office consulted with officials in all levels of government during the week. There was no one tipping point, he said.

Wolfson acknowledged that local businesses won't take in all of the $340 million the marathon was estimated to attract. But because many runners had already traveled to the city, money will still pour in.

Wittenberg said the relief fund announced Thursday had already raised $2.6 million.

Patrick Lynch, president of the Patrolmen's Benevolent Association — the police department's largest union — called the decision to cancel the marathon "a wise choice."

ING, the financial company that is the title sponsor of the marathon, said it supported the decision to cancel. The firm's charitable giving arm has made a $500,000 contribution to help with relief and recovery efforts, and is matching employee donations.

As of now, NYRR is sticking to its policy of no refunds for the runners, but will guarantee entry to next year's marathon. But Wittenberg said that stance will be reviewed.

Eric Jones said he was part of a group from the Netherlands that collected $1.5 million to donate to a children's cancer charity if the runners competed.

"We understand, but maybe the decision could have been made earlier, before we traveled this far," said Jones, whose group came to New York a day earlier.

Steve Brune, a Manhattan entrepreneur, was set to run his fourth NYC Marathon.

"I'm disappointed, but I can understand why it's more important to use our resources for those who have lost a lot," he said.

Brune said he thinks foreign runners who traveled for the race will be even more disappointed.

"When you have a significant amount of people voicing real pain and unhappiness over its running, you have to hear that. You have to take that into consideration," Wolfson said.

"Something that is such a celebration of the best of New York can't become divisive. That is not good for the city now as we try to complete our recovery effort, and it is not good for the marathon in the long run," he said.

Earlier in the day, race preparations seemed under way as normal.

White tents where the runners would meet were already erected. Plastic crates lined the park's wall for two blocks, with tangles of electric wires and other setup equipment where workers buzzed around. A few TV news crews set up camp.

Along the race route in Queens, a couple of marathon banners hung from street lamps.

"I'm not a fan of what he's doing," Manhattan resident Michael Folickman said of Bloomberg's decision. "I think that if the bridge is cleared and the streets are clear, I don't think it'll wreak any more havoc than what's already been wreaked."

"And I think it could be an uplifting experience for the city to have something exciting like that happen on top of this terrible hurricane," he said.

In Brooklyn, the effects of the storm were more apparent. One gas station had a long line of cars extending down the block. Another had dozens of people standing on the sidewalk, clutching red fuel cans.

In Staten Island, Eddie Kleydman said ruined neighborhoods like his are still waiting for help.

"Look at this," he said, motioning toward the huge piles of discarded furniture and household items that line his street. "Who cares about the marathon? We need garbage trucks, we need FEMA to act quicker. He's worried about the marathon; I'm worried about getting power.

"So he called it off. He has to come here and help us clean," Kleydman said.

At the midtown New Yorker Hotel, the lobby was filled with anguished runners, some crying and others with puffy eyes. In one corner, a group of Italian runners watched the news with blank looks.

"I have no words," said Roberto Dell'Olmo, from Vercelli, Italy. Then later: "I would like that the money I give from the marathon goes to victims."

Gisela Clausen, of Munich, told her fellow runners about the cancellation as they walked in.

"You don't understand. We spend a year on this. We don't eat what we want. We don't drink what we want. And we're on the streets for hours. We live for this marathon, but we understand," she said.

___

Associated Press writers Cara Anna, Verena Dobnik, Melissa Murphy, Christina Rexrode, Michael Rubinkam in New York contributed to this report.

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Urban Athlete: Discover Outdoors Offers Mountain Fitness Class


Willie Davis for The New York Times


Rey Soriano, foreground, holding himself on suspension trainers in a workout run by Discover Outdoors.







I HAVE spent a small fortune over the years on gym memberships. But all you really need to get in shape, I now know, are a few granite paving stones, some sandbags and a backpack full of water jugs.








Willie Davis for The New York Times

David Tacheny, center, leading an exercise known as “pack mule,” as Courtney McBride pulls May Yu Whu.






Willie Davis for The New York Times

Mr. Tacheny explaining how to use paving stones as weights.






Willie Davis for The New York Times

Wendy Tsang, left, lifting a Bulgarian sandbag.






Early one Sunday morning I arrived at the entrance to Riverside Park for an exercise class called Mountain Fitness. A Manhattan adventure outfitter, Discover Outdoors, describes the class as a way to “train like a guide,” and uses rocks, logs, sandbags and water jugs in a quest to improve “functional fitness.” The company started offering the class a year ago after customers asked how they should train for the more challenging hiking and trekking adventures it offers.


Our instructor, David Tacheny, a guide and personal trainer, told us that a typical gym workout doesn’t engage all the muscles you’ll use on, say, a rock-climbing excursion. A leg press machine, for instance, works the pushing muscles of the legs. Squatting while raising a heavy rock above your head, on the other hand, also uses the back, abdominal muscles and shoulders, and it better approximates what it’s like to lift an overstuffed backpack.


“This is how guides train,” he said. “We don’t go run miles on flat terrain. We don’t just pump iron.”


All the exercises can be adapted to different levels of fitness. Our group of eight (including one man) looked plenty fit and included several people who belonged to social sports clubs in the city and competed in triathlons. Melanie Pessin, a triathlon competitor, did an eight-mile run before showing up for class. “I’m training for a half-marathon,” she said.


After a 10-minute warm-up, Mr. Tacheny took us to a pile of rectangular paving stones, each weighing 25 to 40 pounds. Standing with legs apart, we swung our stones out from between our legs into the air, using our hips instead of our arms for power.


The “halo” routine entailed holding the stone at chin level and circling it in a tight arc around the head. Next were squat presses, with the stones raised over our heads. At this point my back muscles went on strike, forcing me to switch to an imaginary stone.


Why just lift stones, though, when you can run with them — or throw them? Mr. Tacheny had us hold our stones at chest level, heave them as far as we could toward a tree in the distance, then run to pick them up; we were to repeat the move until we reached the tree.


Next, he divided us into two groups for a rousing game of what I came to call ducking stones. Each team started with an equal number of stones at the base of a tree. We were supposed to fetch a stone and run with it, depositing it at the base of the opposing team’s tree. After two minutes, whichever team had the fewest stones remaining would win. Mayhem ensued, with stones flying everywhere, to the point where I would yell out, “Don’t hit me!” whenever I stooped to pick one up.


Next, Mr. Tacheny introduced the “pack mule” exercise. Each team of two received a harness made of straps. One person held the straps and pulled while the teammate, attached to the harness at the other end, resisted. To inspire us, he recounted the story of two guides who pulled 100-pound sleds up a glacier while carrying 85-pound backpacks.


Freed from their harnesses, the class members followed Mr. Tacheny on a five-minute jog to a remote section of the park. There, he had stored a jump rope, a backpack full of water jugs, two crescent-shaped Bulgarian sandbags and some straps that he tied around tree branches. Instant exercise stations: pull-ups and push-ups using the straps; squats and leg lifts with the backpack or with a sandbag draped over the shoulders; a cardio workout using the jump rope.


After completing our circuits, we gathered in a circle and applauded ourselves for our hard work. “You got a sense of how to vary your workouts a little,” Mr. Tacheny told us, adding that gym routines didn’t appeal to him anymore, and that riding his bike 60 to 70 miles a day had gotten old. “But this stuff,” he said as we all dragged ourselves out of the park, “you won’t get bored with it.”


Discover Outdoors holds 90-minute Mountain Fitness classes for $20 at Riverside Park in Manhattan; (212) 579-4568, discoveroutdoors.com.



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A Promising Drug With a Flaw





Dr. Bryan A. Cotton, a trauma surgeon in Houston, had not heard much about the new anticlotting drug Pradaxa other than the commercials he had seen during Sunday football games.




Then people using Pradaxa started showing up in his emergency room. One man in his 70s fell at home and arrived at the hospital alert and talking. But he rapidly declined. “We pretty much threw the whole kitchen sink at him,” recalled Dr. Cotton, who works at Memorial Hermann-Texas Medical Center. “But he still bled to death on the table.”


Unlike warfarin, an older drug, there is no antidote to reverse the blood-thinning effects of Pradaxa.


“You feel helpless,” Dr. Cotton said. The drug has contributed to the bleeding deaths of at least eight patients at the hospital. “And that’s a very bad feeling for us.”


Pradaxa has become a blockbuster drug in its two years on the market, bringing in more than $1 billion in sales for its maker, the privately held German drug maker Boehringer Ingelheim.


But Pradaxa has been linked to more than 500 deaths in the United States, and a chorus of complaints has risen from doctors, victims’ families and others in the medical community, who worry that the approval process was not sufficiently rigorous because it allowed a potentially dangerous drug to be sold without an option for reversing its effects.


Pradaxa is an example, some critics say, of what can happen when a drug that performs well in tightly controlled trials is released into the messy world of real-life medicine. Boehringer Ingelheim said it was working on developing an antidote but that even without one, patients in a large clinical trial died at roughly the same rate as those who were taking warfarin.


The Food and Drug Administration released a report on Friday that found that the drug did not show a higher risk of bleeding than for patients taking warfarin. The report did not address the lack of an antidote for Pradaxa.


“The evolving spontaneous reporting patterns do not indicate a change in the favorable benefit-risk profile of Pradaxa, when used correctly according to the approved label,” Boehringer Ingelheim said in a statement. In other words, the drug is still safe. But some reports have indicated that doctors are not sufficiently cautious when prescribing Pradaxa, giving the drug to older people or those with kidney problems even though there is evidence that the bleeding risks are higher in those groups. The company recommends testing patients’ kidney function before prescribing Pradaxa and notes that the risk of bleeding increases with age.


“The problem is that the people that prescribe this, as a general rule, are cardiologists and family practitioners,” said Dr. Mark L. Mosley, director of the emergency room at Wesley Medical Center in Wichita, Kan. “The people that see the harm are your E.R. docs and your trauma docs.”


Critics say that at least until an antidote is found, better disclosure or more limited use of Pradaxa may be preferable. Patients’ lawyers have begun turning their attention to the drug. More than 100 lawsuits have been filed in federal courts and lawyers say thousands more are expected.


When the F.D.A. approved Pradaxa in October 2010, the drug was hailed as the first in a new category of replacements for warfarin, the nearly 60-year-old drug used to prevent strokes in people with a heart-rhythm disorder known as atrial fibrillation.


Warfarin requires careful monitoring of a patient’s diet and drug regimen, and frequent blood tests to ensure that it is working. Pradaxa required no such monitoring and, compared with warfarin, appeared to be better at preventing strokes.


Sales of the drug took off. By the end of 2011, after just over a year on the market, 17 percent of patients with atrial fibrillation were being prescribed Pradaxa, compared with 44 percent for warfarin, according to a study released in September. About 725,000 patients in the United States have used the drug, according to the F.D.A.


But almost as soon as doctors started prescribing Pradaxa, concerns surfaced about its safety. Pradaxa was identified as the primary suspect in 542 patient deaths reported to the F.D.A. in 2011, and was linked to more reports of injury or death than any of the more than 800 drugs regularly monitored by the Institute for Safe Medication Practices, a nonprofit based in Pennsylvania that monitors medicine safety.


Dr. Mosley said he found it “shocking, just shocking” that the F.D.A. approved Pradaxa, which is also called dabigatran, even though no antidote was available.


In a statement, the F.D.A. said, “the lack of an antidote notwithstanding, dabigatran was superior to warfarin in preventing strokes in a large clinical trial. The rates of bleeding were similar.” In the study it released on Friday, the F.D.A. examined health insurance claims and hospital data and reached a similar conclusion.


Warfarin, which is also known by the brand name Coumadin, can often be reversed by giving a patient vitamin K or other substances. Warfarin, too, can be deadly but, doctors said, they at least have options.


“The practical experience is that once hemorrhagic complications occur in this drug, it is much more likely to be a catastrophe than with Coumadin,” said Dr. Richard H. Schmidt, an associate professor of neurosurgery at the University of Utah, who treated an 83-year-old man who died from bleeding and was using Pradaxa.


Boehringer Ingelheim recommends treating bleeding patients with dialysis to help flush the drug from the body, although it notes that “the amount of data supporting this approach is limited.”


Several doctors said that option was not realistic. “People that are bleeding to death aren’t going to tolerate being put on dialysis,” Dr. Cotton said.


Two other new drugs intended as warfarin replacements also lack antidotes. Doctors said they had not seen as many bleeding deaths associated with Xarelto, which was approved in 2011 and is sold by Bayer and Johnson & Johnson. On Friday, the F.D.A. approved Xarelto to also treat deep vein thrombosis and pulmonary embolism, two kinds of blood clots. Pradaxa is approved in the United States only to prevent stroke in patients with atrial fibrillation. A third drug, Eliquis, by Bristol-Myers Squibb and Pfizer, has not yet been approved by the F.D.A. Representatives for both drugs said trials showed their products were safe, adding that the companies were investigating different antidotes. Boehringer Ingelheim is expected to present several new studies of Pradaxa’s safety and efficacy — including one that examines potential antidotes — at the American Heart Association scientific conference next week in Los Angeles.


Some cardiologists have said that Pradaxa and the other new drugs represent real advances over warfarin. Around 40 percent of people with atrial fibrillation do not take any drugs for it, a recent study showed, putting them at risk for strokes.


“I think the benefit of the drug clearly exceeds the risk because to me, a disabling stroke has a greater weight than a bleeding complication,” said Dr. Sanjay Kaul, a cardiologist at Cedars-Sinai Medical Center in Los Angeles and a member of the F.D.A. committee that voted to approve Pradaxa.


But those calculations make little sense to Walter Daumler, who said he watched his 78-year-old sister, Doris, bleed to death in May. Mr. Daumler, who lives in Wisconsin, has hired a lawyer and is considering suing. He said the doctors told him that because she was on Pradaxa, there was nothing they could do.


“My No. 1 goal is to stop this insidious drug,” Mr. Daumler said. “To get this off the market, so others will not undergo or witness what I saw.”


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