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Health&Science


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KLMNO URBAN JUNGLE


The changing natural world at our doorsteps. Letting its fruit flag fly | As autumn nears its midpoint, Virginia creeper leaves turn brilliant red, a signal for nomadic birds to stop for an in-flight meal.


If “leaves of three, let it be” is good advice for poison ivy, then “leaves of five, let it thrive” should be the maxim for Virginia creeper.


Te native vine plays a major role in feeding fruit-eating songbirds on their way south, especially thrushes, gray catbirds and common yellowthroats.


Leaves turn red just as the blue-gray fruits ripen. Te plant may rely on this foliar fruit flag to alert migrating birds to a food opportunity. Timing is critical: Te fruits are high in lipids (fats), which don’t stay fresh for long.


While birds may wolf down the berries, people shouldn’t follow suit, as the fruits are potentially toxic to humans.


Te leaves aren’t so people-friendly, either. When they are bruised, specialized cells rupture, releasing irritating microscopic needles of calcium oxalate, which can trigger contact dermatitis.


INSURING YOUR HEALTH Michelle Andrews


Now’s the time to reassess drug plans T


hismonthmarks the beginning of the annual enrollment time for the


MedicarePartDprogram,when beneficiaries cantry topick the planthatprovides the best coverage for theirprescription drugs.But eventhough switchingplansmay sometimes be a smartmove, saysDan Mendelson, chief executive of AvalereHealth, a consulting firmbasedinWashington, “seniors are remarkablypassive whenit comes to changing plans.” Don’t be. Inpart because of


thehealth-care overhaul law, there are some changes inthe PartDprogramthatmay affect your out-of-pocket costs and coverage for 2011.By investing timeduring the enrollment period—Nov. 15 toDec. 31—to evaluate your options onthe MedicareWeb site (www. medicare.gov), youcanmake sure you’re signedupfor the planthat’s best for you. Analyses byhealth-policy


experts indicate thatPartD premiums are goingupan average of 10percent, to$40.72 monthly.Butplansmay depart significantly fromthat average, depending onsuchfactors as deductibles, coinsurance and whether they coverprescription drugswhile a beneficiary is in the so-calleddoughnuthole. Therewill be somenewplan


options aswell, including Humana’sWalmart-PreferredRx Plan,whichcarries a$14.80 premiuminevery regionof the country. That bargainpricemay well attractmany seniors, but premiums are onlypart of the equation.ByNov. 15 eachplan’s formulary—the list of covered drugs—andcostdetailswill be available. It’s important toplug yourdrug informationinto the Medicareplanfinder and compare costs. “Evenina low-premiumplan,


someone couldhave relatively highspendingdepending onthe drugs they take,” saysTricia Neuman,director of the MedicarePolicyProject for the KaiserFamilyFoundation. (KHNis aprogramof the foundation.) It’s also important to


Medicare Part D: Coming in 2011


Average monthly premium


Average number of plans to choose from


$40.72 33


Enrollment start date 11/15


investigate otherplanfeatures thatmight limit your coverage, says JoeBaker,president of the MedicareRightsCenter, a consumer advocacy organization. Inparticular, beneficiaries shouldkeepaneye out for limits onhowmuchof a drug canbeprescribedover a certainperiodandrestrictions that requireproviders to explain why aparticulardrug is medicallynecessary. “Itmight be better topick theplanwithout the restrictions, evenif costs a bitmore, because you’re going to have aneasier time,”he says. As a result of regulations


aimedat getting ridofplans that wereduplicative orhadlow enrollment, therewill benearly one-thirdfewerdrugplans offeredinthe coming year, according to aKaiserFamily Foundationanalysis. Seniors will stillhave anaverage of 33 plans to choose from,however. If yourplanis being


eliminatedin2011, you’ll be automatically assignedto anotherplaninyour area.Don’t assume that this replacement is themost cost-effective choice for you, say experts.Runthe numbers forplans inyour area tomake sure you’re getting the bestdeal. ForMedicare beneficiaries


withhighdrug costs, 2011will bring some relief, as the federal healthoverhaul lawcontinues to close thedoughnuthole—the gapincoverage that occurs whena senior reaches$2,840 in totaldrug spending byhimself andhishealthplan, and continuesuntil the total exceeds $6,448.Under the overhaul law, seniorswill get a 50percent


discount onbrand-namedrugs while inthedoughnuthole, and a 7percentdiscount onthe cost of generics. Thesediscountswill be


important toClaudette and RichardTherriault.Until last summer, the couplewas insured throughClaudetteTherriault’s job at a seniorhousing facility near the couple’shome in Sabattus,Maine.Butwhenshe turned66 lastMay,Therriault saysher company cut backher hours andshe couldno longer affordto keepherhusbandon herplan. RichardTherriault, 67, takes a


number of brand-namedrugs, includingNovoLog fordiabetes, OxyContinfor chronicpainand Nexiumfor gastricproblems.He enrolledinMedicare inMay, and inJunewas already inthe doughnuthole.After three monthspaying 100percent of his bills,he reachedthe maximumandtheplanstarted paying 95percent ofhis costs. But by thenhe’dspent$4,550 out-of-pocket (his share of the $6,448). “Itwasdevastating,” says


ClaudetteTherriault, adding that the couple almost lost their house.Nowthey’re chipping away at a$3,500 loanfroma local charity that got them throughthat stretch. Next year, they’ll bothbe on


Medicare.After another cutback inherhours,Claudette is leaving her job inDecember. She takes the anti-inflammatorydrug Celebrex forher knees and Singulair for asthma; she estimates she’llprobably enter thedoughnuthole inNovember. The 50percentdiscountwill make a bigdifference for bothof them. “Youhaveno ideawhat a relief thatwill be,” she says. “We’llprobablypay$2,000less thanlast year.”


This column is produced through a collaboration between The Post and KaiserHealthNews. KHN, an editorially independent news service, is a programof theKaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliatedwithKaiser Permanente. E-mail: questions@ kaiserhealthnews.org.


The overhaul law will give seniors in the doughnut hole a 50 percent discount on brand-name drugs.


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Parthenocissus quinquefolia


Scaling trees, rocks and houses, Virginia creeper secures itself with tendrils tipped with tiny pads that cement themselves to vertical surfaces.


A creeper-covered brick wall will stay cool in the summer, the masonry undamaged by the vine’s tendrils. Wood siding, however, will rot in the humid environment harbored by the vine.


SOURCES: Edmund W. Stiles, “Patterns of fruit presentation and seed dispersal in bird-disseminated woody plants in the eastern deciduous forest,” the American Naturalist; USDA; “Interactions between passerines and woody plants at a migratory stop-over site: Fruit consumption and the potential for seed dispersal,” Claramarie Moss, University of Virginia


TUESDAY, NOVEMBER 2, 2010


PATTERSON CLARK/THE WASHINGTON POST To learn more, go to washingtonpost.com/urbanjungle. clarkp@washpost.com


Sci-fi’s eclipsed classics urbanjungle101102.HEA books from E1


‘DARK UNIVERSE’ (BY DANIEL F. GALOUYE)


Nominated by Richard Dawkins, biologist: “ ‘Dark Universe’ is hauntingly imaginative and uses the medium of


science fiction to let the reader reconstruct howmyths can start.”


Outline: Deprived of light in their refuge far underground, the descendants of the survivors of a nuclear holocaust have heightened hearing. They navigate using the echoes from clicking stones and develop a religion around the memory of lost light. Then the protagonist, Jared, begins to question his tribe’s beliefs. “Dark Universe,” published in 1961, was nominated for the prestigious Hugo Award for its ability to draw readers into this strange underground world.


‘JOURNEY OF JOENES’ (BY ROBERT SHECKLEY)


Nominated by James Lovelock, futurologist and originator of Gaia


hypothesis: “ ‘Journey of Joenes’ is a mid-20th-century version of Voltaire’s ‘Candide.’ I like it because I am often asked to predict the future state of the world, and authors like Voltaire,Wells, Orwell and others of their kind appeal more than purely technical prophets. Both are needed, but as an inventor I assume that I know how unknowable the technological future is.”


Outline: Perhaps more sociopolitical fiction than science fiction, this satirical tale (also published as “Journey Beyond Tomorrow”) takes place after the world as we know it has ended. The few survivors, living on Pacific islands, tell folk tales of mythical remembrances of 1970s America, through the travels of a legendary character called Joenes.


‘WE’ (BY EUGENE ZAMIATIN)


Nominated by Margaret Atwood, novelist: “ ‘We’ contains the rootstock of two later streams—the creepy, too- smiley Utopia, as


in ‘Brave NewWorld,’ and the Big Brother Dystopia, as in ‘Nineteen Eighty-Four.’ It isn’t well known because it hasn’t been available in an up-to-date translation until recently.”


Outline: Set in the 26th century in a glass-enclosed city of absolute straight lines, ruled over by the all-powerful Benefactor, the citizens of the totalitarian society of OneState live out lives devoid of passion and creativity—until D-503, a mathematician who dreams in numbers, makes a discovery: He has an individual soul.


‘LAST AND FIRSTMEN’ (BY OLAF STAPLEDON)


Nominated by Stephen Baxter, science-fiction writer: “I suspect most general readers won’t have heard of Olaf Stapledon. He knew H.G. Wells and


influenced Arthur C. Clarke, and so was an essential link in the development of the genre. And his own greatest novel, ‘Last and First Men,’ a kind of god’s-eye- view survey of the human far future, is as bracing and original today as it was when it was published around 80 years ago —and in terms of technique it pushes the form of the novel about as far as it can go.”


Outline: “Last and First Men” is one of the most ambitious novels of the 20th century. It imagines how humans might evolve in the next 2 billion years, covering 18 distinct human species. It was first published in 1930 and speculates about evolution, terraforming and genetic engineering.


on washingtonpost.com 6


Join a live chat with science fiction author Orson Scott Card Wednesday at 1 p.m. at washingtonpost.com/liveonline.


PLUS: What is your favorite sci-fi novel? Join the conversation on Facebook at www.facebook.com/washingtonpost and Twitter at http://twitter.com/washingtonpost.


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‘THE LISTENERS’ (BY JAMES GUNN)


Nominated by Seth Shostak, astronomer: “I read this book two decades ago as I was first becoming involved with the search for cosmic company


—at the suggestion of a colleague at the Search for Extraterrestrial Intelligence Institute. This year, the SETI endeavor passed its half-century mark, and ‘The Listeners’ rings particularly true. If only we could find that signal . . .”


Outline: For 50 years humankind listened to the stars and heard nothing. But one day an answer came. An answer no one was expecting, and almost no one wanted. “The Listeners,” published in 1972, is credited with inspiring the real-life hunt for extraterrestrial life, and perhaps even Carl Sagan’s more famous book, “Contact.”


‘EARTH ABIDES’ (BY GEORGE R. STEWART)


Nominated by Freeman Dyson, physicist: “It’s a sensitive human drama, with California providing the enduring natural environment as background.”


Outline:When a deadly epidemic almost wipes out the human race, Isherwood Williams, one of the few survivors, ventures into a world without people. A classic tale of life after global disaster, “Earth Abides,” published in 1949, was novelist George R. Stewart’s only venture into science fiction.


This article is excerpted from one that appeared in New Scientist magazine. The original is available through www.newscientist. com.


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