ABCDE HEALTH&SCIENCE tuesday, december 21, 2010


URBANJUNGLE Honk if you


love geese ‘Please eat them,’ begs a hunter, referring to invasive Canada geese. E6


Q&A


Again, you’re worried about your drinking water Experts answer questions about lead, carcinogens, tests, treatment. E6


Health&Science is taking a holiday and won’t appear next Tuesday. We’ll be back in the new year!


OOPS When docs fail


to ‘do no harm’ Think of medical errors the way you think of car accidents. E5


Whatmy stutter said about you


DOUG KAPUSTIN FOR THE WASHINGTON POST


GeraldineMiller is examined by optometrist JeremyGoldman at ElderPlus, which offers comprehensive services to about 150 people.


Caregivers aim to trim costs by helping seniors stay at home


PACE tries to keep frail people out of hospitals and nursing homes


BY SUSAN JAFFE Kaiser Health News


Several mornings a week, a


white van stops at Geraldine Miller’s house just east of Balti- more to pick her up for Elder- Plus, a government-subsidized day-care program for adults on the campus of the JohnsHopkins BayviewMedical Center. Because Miller, who is 75 and


uses awalker, has trouble getting down the stairs fromher second- floor apartment, the driver comes inside to help. When she feels wobbly, he lends her an arm. When she feels strong, he faces her and steps down back- ward on the steps so he can catch her if she falls.When it rains, he shelters her with an umbrella. This the sort of extra care that makes ElderPlus different. ElderPlus is part of PACE, the


Program for All-Inclusive Care for Elderly, which provides com- prehensive medical and social services to frail, low-income se- niors with serious health prob- lems. More than 23,000 people are


enrolled at 166 sites in 29 states, according to the National PACE Association, a trade group. There


are no PACE sites in the Wash- ington area now, but Inova Health System plans to open a Northern Virginia location next fall, and seniors’ advocates are working to bring a PACE site to the District. PACE, first authorized by Con-


gress in the 1980s as a pilot project, is intended to help se- niors stay in their homes as long as possible. If done effectively, supporters say, the program can reduce costly hospital and nurs- ing home stays. And keeping seniors healthy can save money for Medicare, the federal pro- gram for the elderly, and Medic- aid, the state-federal programfor the poor and disabled. Seniors like the program


because it “honors what the elderly want, which is to stay in their familiar surroundings, to be autonomous,” says Terry Smith, director of long-termcare at the Virginia Department of Medical Assistance Services, which operates the state’sMedic- aid program. Miller, the ElderPlus enrollee,


says her friends and staff in the program are “like a family.” The medical team there spotted her kidney cancer early and treated it successfully. “It’s just like you are at home, and if you have a problem, you always have some- one you can go to.” Under an innovative financing


pace continued on E5 ELLEN WEINSTEIN FOR THE WASHINGTON POST


HOW & WHY Brian Palmer


Robots that think they’re smart have got another think coming


C


omputers these dayshave serioushumanenvy. Whenyou call your bank,


the robot onthe other end doesn’t want you to communicate using your touch-tone keypad anymore. No, it insists that you just speak to it, sometimes evenadding, “You canuse awide variety ofwords.” What a showoff. Your car is trying to emasculate


you by taking over the parallel parking duties.And computers have long since drained all the funout of chess. Fortunately,most robots aren’t


the complicated emotional beings that star inmovies, andwe’re still pretty good at identifying android impostors.Evenif you don’t rec- ognize the stilted robotic diction over the phone, they usually give themselves awaywhenthey can’t understand a thing you’re saying. Buthowlongwill it be before you have anentire conversationwith amachinewithout realizing it? This isn’t just cocktail party


chatter; it’s the long-termgoal of artificial intelligence research. AlanTuring, themanmany iden- tify as the father ofAI, in1950 de- fined anintelligentmachine as one that couldmasquerade as a


And how I learned to get the words out BY DAN SLATER Special to The Washington Post What I remember most about my stutter is not the stupefying vocal paralysis, the


pursed eyes or the daily ordeal of gagging onmy own speech, sounds ricocheting off the back of my teeth like pennies trying to escape a piggy bank. Those were merely the mechanics of stuttering, the realities towhich onewho stutters adjusts his expectations of life. Rather, what wasmost pervasive aboutmy stutter is the strange role it played in determining how I felt about others, about you.


My stutterbecame abarometer of


how much confidence I felt in your presence. Did I perceive you as friendly, patient, kind? Or as brash and aggressive? How genuine was your smile? Did you admiremy talents, or were you wary of my more unseemly traits? In this way I divided the world into two types of people: those around whom I stuttered and those around whomImight not. The onset of my stutter occurred


human. Evenwithouthaving to talk or


understand the spokenword, there isn’t amachine that can pass theTuring test.Trulyhu- manlike intelligencehas frustrat- edAI researchers because it in-


how continued on E3


under typical circumstances: I was 4; I had a father who carried a stutter into adulthood; and, at the time,my parents were engaged in a bitter, protracted, Reagan-era divorce that seemed des- tined formutually assured destruction. My mother chronicled my speech


problems inherdiaries fromtheperiod. Sept. 26, 1981: “Daniel has been biting his fingernails for the past several weeks; alongwith stuttering up.” July 8,


Colin Firth as Britain’s stuttering


George VI in “The King’s Speech.”


1982: “After phone call [with his father] Danny stuttering quite a bit, blocking on words.” In fact, my father and I had


different stutters. His was what speech therapists consider the more traditional kind, in which the first syllable of a word gets repeated. “Bus” might sound like “aba-aba-abus.” Mine was a block- age, a less extreme version of what King George VI, portrayed by Colin Firth,must dealwith in the newmovie


“The King’s Speech.” My vocal cords would strangle certain


sounds.Hard consonants— k’s, d’s, hard c’s andhardg’s—gavemehell.Ayear of speech therapy in childhood helped me develop a set of tools for defeating the impediment, or at least concealing it well enough to fool most of the people most of the time. Like many other stutterers, I evolved a verbal dexterity. Embarking on a sentencewas like


stutter continued on E4 E EZ


OLIVER BURSTON FOR THE WASHINGTON POST


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56