Movie massacre: Defense challenges police on suspect's notebook

CENTENNIAL, Colo. -- The handling of a key piece of evidence in the Aurora movie massacre fell under scrutiny on Monday as defense attorneys raised the question of whether law enforcement officers were careless when they confiscated a notebook that might have detailed suspect James E. Holmes’ plans in advance.

An intriguing, even eerie, fact emerged about the notebook tied to the man who is accused of opening fire on a crowded theater showing a Batman movie: The notebook  has been stuffed with money that had been burned. Burned money appeared in the Batman movie "The Dark Knight."

The spiral notebook was sent by Holmes to Dr. Lynne Fenton, a University of Colorado-Denver psychiatrist, on July 19, hours before he is alleged to have unleashed an attack on a packed screening of the Batman movie “The Dark Knight Rises.” The July 20 rampage killed 12 and wounded at least 58.

Fenton counseled Holmes once on June 11, four days after he failed a key exam as a doctoral neuroscience student and one day after he began to withdraw from the university.

Public defenders in the case also sought Monday to determine who leaked details about the contents of the notebook to the press in violation of a strict gag order.

Detective Alton Reed of the Aurora Police Department testified that he “fanned” through the notebook addressed to Fenton from Holmes on July 23 in the mailroom of the Anschutz Medical Campus. However, he did not disclose the contents in court beyond saying he saw writing and money that had been burned. He also insisted he did not tell the news media about the notebook.

It is unclear what significance, if any, the burned money has to the case but there is some speculation it is tied to a scene in a previous Batman movie in which the homicidal Joker burns piles of money. Holmes has reportedly said he thought of himself as the Joker. Before the shooting Holmes had dyed his brown hair a neon orange, perhaps to evoke the Joker, though the character's hair is green.

On July 23, the Aurora police, FBI agents and the Adams County bomb squad were called to the university mailroom after employees and campus police searched for anything addressed to Fenton or Dr. Robert Feinstein, chairman of the university’s outpatient psychiatric clinic. Holmes’ public defenders had alerted Fenton the day before that a package would be arriving for her and that they wanted it back.

Although Reed said he wore protective gloves to preserve the evidence as he briefly examined the notebook, campus police Chief Douglas Abraham admitted he did not when he briefly shook the notebook to see if anything else was inside.  “I was careless,” he testified.

The defense team has been strongly critical not just of press leaks but also of the prosecution for making what the defense calls false statements about Holmes’ time at the university. Previously prosecutors have said Holmes was banned from campus after making unspecified threats to a professor. University officials immediately denied that, saying Holmes’ campus pass was deactivated as part of his withdrawal process.

Holmes was admitted to the elite neuroscience doctoral program in June 2011 but withdrew a year later. He is being held without bond.

Holmes was back in court Monday. He seemed alert as he glanced around the courtroom.

Last month a pretrial hearing was abruptly postponed after his lawyers said he had been taken to the hospital for an undisclosed reason. Local media outlets reported he had tried to bash his head against a wall in his cell.

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Two Cheers for <em>Zero Dark Thirty'</em>s Torture Scenes

One scene features a bloodied, disoriented and humiliated man strapped to a wall with his pants around his ankles. A second scene depicts the same man having liquid forcibly poured down his throat; later, he’s shoved into a box that could barely hold your stereo. And all of this takes place in the first 45 minutes or so of Zero Dark Thirty, the new movie about the hunt for Osama bin Laden. It’s enough to make you wretch. It’s arguably the best and most important part of the movie.

Kathryn Bigelow’s new film about the decade-long manhunt for Osama bin Laden begins with an unsparing, nauseating and frighteningly realistic look at how the CIA tortured many people and reaped very little intelligence. Never before has a movie grappled with post-9/11 torture the way Zero Dark Thirty does. The torture on display in the film occurs at the intersection of ignorance and brutality, while the vast, vast majority of the intelligence work that actually does lead to bin Laden’s downfall occurs after the torture has ended.

You wouldn’t know this from the avalanche of commentary greeting the film. Bigelow is being presented as a torture apologist, and it’s a bum rap. David Edelstein of New York says her movie borders on the “morally reprehensible” for presenting “a case for the efficacy of torture.” The New York Times’ Frank Bruni suspects that Dick Cheney will give the film two thumbs up. Bruni is probably right, since defenders of torture have been known to latch onto any evidence they suspect will vindicate them as American heroes. But that’s not Zero Dark Thirty.

Bigelow instead presents a graphic depiction of what declassified CIA documents indicate the torture program really was. (A caveat: The CIA has actively blocked disclosure into that program, going so far as to destroy video recordings of it.) The first detainee we meet, in 2003, is a bruised and mentally unstable man forced to stay awake by having his arms strapped to thick ropes suspended from the walls of his undisclosed torture chamber. Or, in the bureaucratic language of former Justice Department official Steven Bradbury: “The primary method of sleep deprivation involves the use of shackling to keep the detainee awake.”

Later, the detainee — apparently Amar al-Baluchi, nephew of 9/11 conspirator Khalid Shaikh Mohammed, or based on him — is shown to be kept hooded in that position, in a dark room while deafening music blasts. (Specifically, “Pavlov’s Dogs” by cerebral early-’90s New York hardcore band Rorshach.) He is interrupted by his captor, CIA agent “Dan,” who informs him: “When you lie to me, I hurt you” and that “partial information” will be treated as a lie. The detainee is stripped from the waist down to be humiliated in front of a woman CIA agent — the film’s protagonist, Maya; more on her in a second — before being stuffed into a wooden box the size of a child’s dresser. That would be the “confinement box,” one of the earliest torture techniques the CIA used on an al-Qaida detainee known as Abu Zubaydah. (The agency wanted to put insects in it, to heighten Abu Zubaydah’s fear levels.)

The film goes on like this for about 45 brutal minutes. “Uncooperative” detainees are held down by large men and doused through a towel with water until they spew it up. (There’s no “boarding” in this “waterboarding.) Helpless detainees are shown with rheumy eyes, desperate for the torture to stop, while their captors promise them nourishment and keep their promises by forcing Ensure down their throats through a funnel. Amar al-Baluchi, mocked for defecating on himself, is stripped and forced to wear a dog collar while Dan rides him, to alert the detainee to his helplessness.

These are not “enhanced interrogation techniques,” as apologists for the abuse have called it. There is little interrogation presented in Zero Dark Thirty. There is a shouted question, followed by brutality. At one point, “Maya,” a stand-in for the dedicated CIA agents who actually succeeded at hunting bin Laden, points out that one abused detainee couldn’t possibly have the information the agents are demanding of him. The closest the movie comes to presenting a case for the utility of torture is by presenting the name of a key bin Laden courier, Abu Ahmed al-Kuwaiti, as resulting from an interrogation not shown on screen. But — spoiler alert — the CIA ultimately comes to learn that it misunderstood the context of who that courier was and what he actually looked like. All that happens over five years after the torture program initiated. Meanwhile, the real intelligence work begins when a CIA agent bribes a Kuwaiti with a yellow Lamborghini for the phone number of the courier’s mother, and through extensive surveillance, like a police procedural, the manhunt rolls to its climax. If this is the case for the utility of torture, it’s a weak case — nested within a strong case for the inhumanity of it.

Nor does Bigelow let the CIA off the hook for the torture. “You agency people are sick,” a special operator tells Dan. Dan, the chief torturer of the movie, is shown as not only a sadist but a careerist. “You don’t want to be the last one holding the dog collar when the oversight committee comes,” he tells Maya before decamping to Washington. Other CIA bureaucrats are shown sneering at the idea of canceling the torture program — more fearful of congressional accountability than of losing bin Laden. Maya is more of a cipher: she is shown coming close to puking when observing the torture. But she also doesn’t object to it — “This is not a normal prison. You choose how you will be treated,” she tells a detainee — and Maya is the hero of the film.

“It’s a movie, not a documentary,” screenwriter Mark Boal told The New Yorker. “We’re trying to make the point that waterboarding and other harsh tactics were part of the C.I.A. program.” That quote has electrified the internet as a statement of intent to gussy up the importance of torture. But the fact is torture was part of the CIA’s post-9/11 agenda: dispassionate journalists like Mark Bowden presents it as such in his excellent recent book.

Zero Dark Thirty does not present torture as a silver bullet that led to bin Laden; it presents torture as the ignorant alternative to that silver bullet. Were a documentarian making the film, there would surely be less torture in the movie: CNN’s Peter Bergen deems the scenes overwrought, both in their gruesomeness and in their seeming estimation of their role in nabbing bin Laden.

But that would also come at the expense of making a viewer come to grips with what Dick Cheney euphemistically called the “dark side” of post-9/11 counterterrorism. Meanwhile, former Bush administration aide Philip Zelikow, who termed the torture a “war crime” in a recent Danger Room interview, will probably find the movie more amenable than Cheney will. What endures on the screen are scenes that can make a viewer ashamed to be American, in the context of a movie whose ending scene makes viewers very, very proud to be American.

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‘Skyfall’ launches back to top spot with $10.8M

LOS ANGELES (AP) — The James Bond blockbuster “Skyfall” has risen back to the No. 1 spot at the weekend box office, taking in $ 10.8 million.

That brought its domestic total to $ 261.4 million and its worldwide haul to a franchise record of $ 918 million.

The top 20 movies at U.S. and Canadian theaters Friday through Sunday, followed by distribution studio, gross, number of theater locations, average receipts per location, total gross and number of weeks in release, as compiled Monday by Hollywood.com are:

1. “Skyfall,” Sony, $ 10,780,201, 3,401 locations, $ 3,170 average, $ 261,400,281, five weeks.

2. “Rise of the Guardians,” Paramount, $ 10,400,618, 3,639 locations, $ 2,858 average, $ 61,774,192, three weeks.

3. “The Twilight Saga: Breaking Dawn — Part 2,” Summit, $ 9,156,265, 3,646 locations, $ 2,511 average, $ 268,691,029, four weeks.

4. “Lincoln,” $ 8,916,813, 2,014 locations, $ 4,427 average, $ 97,137,447, five weeks.

5. “Life of Pi,” Fox, $ 8,330,764, 2,946 locations, $ 2,828 average, $ 60,948,293, three weeks.

6. “Playing For Keeps,” FilmDistrict, $ 5,750,288, 2,837 locations, $ 2,027 average, $ 5,750,288, one week.

7. “Wreck-It Ralph,” Disney, $ 4,859,368, 2,746 locations, $ 1,770 average, $ 164,402,934, six weeks.

8. “Red Dawn,” FilmDistrict, $ 4,236,105, 2,754 locations, $ 1,538 average, $ 37,240,920, three weeks.

9. “Flight,” Paramount, $ 3,130,305, 2,431 locations, $ 1,288 average, $ 86,202,541, six weeks.

10. “Killing Them Softly,” Weinstein Co., $ 2,806,901, 2,424 locations, $ 1,158 average, $ 11,830,638, two weeks.

11. “Silver Linings Playbook,” Weinstein Co., $ 2,171,665, 371 locations, $ 5,854 average, $ 13,964,405, four weeks.

12. “Anna Karenina,” Focus, $ 1,544,859, 422 locations, $ 3,661 average, $ 6,603,042, four weeks.

13. “The Collection,” LD Entertainment, $ 1,487,655, 1,403 locations, $ 1,060 average, $ 5,455,328, two weeks.

14. “Argo,” Warner Bros., $ 1,482,346, 944 locations, $ 1,570 average, $ 103,160,015, nine weeks.

15. “End of Watch,” Open Road Films, $ 751,623, 1,259 locations, $ 597 average, $ 39,989,766, 12 weeks.

16. “Hitchcock,” Fox Searchlight, $ 712,544, 181 locations, $ 3,937 average, $ 1,661,670, three weeks.

17. “Talaash,” Reliance Big Pictures, $ 449,195, 161 locations, $ 2,790 average, $ 2,397,909, two weeks.

18. “Taken 2,” Fox, $ 387,227, 430 locations, $ 901 average, $ 137,700,304, 10 weeks.

19. “Pitch Perfect,” Universal, $ 305,765, 387 locations, $ 790 average, $ 63,517,408, 11 weeks.

20. “The Sessions,” Fox, $ 218,973, 197 locations, $ 1,112 average, $ 4,948,342, eight weeks.

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Online:

http://www.hollywood.com

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Universal and Focus are owned by NBC Universal, a unit of Comcast Corp.; Sony, Columbia, Sony Screen Gems and Sony Pictures Classics are units of Sony Corp.; Paramount is owned by Viacom Inc.; Disney, Pixar and Marvel are owned by The Walt Disney Co.; Miramax is owned by Filmyard Holdings LLC; 20th Century Fox and Fox Searchlight are owned by News Corp.; Warner Bros. and New Line are units of Time Warner Inc.; MGM is owned by a group of former creditors including Highland Capital, Anchorage Advisors and Carl Icahn; Lionsgate is owned by Lions Gate Entertainment Corp.; IFC is owned by AMC Networks Inc.; Rogue is owned by Relativity Media LLC.

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Vital Signs: Smoking Tied to Less Dense Bones for Girls

Smoking in teenage girls is associated with slower development of bone mineral density, a new study reports.

The scientists studied 262 healthy girls ages 11 to 19, using questionnaires and interviews to assess their smoking habits. The researchers also measured the girls’ bone density at the hip and lumbar spine three times at one-year intervals.

Smokers entered adolescence with the same lumbar and hip bone density as nonsmokers, but by age 19, they were about a year behind on average. After adjusting for other factors that affect bone health — height, weight, hormonal contraceptive use and more — the researchers found that even relatively low or irregular rates of smoking were independently associated with lower bone density.

The study, published last week in The Journal of Adolescent Health, used a sample that fell below national averages for calcium intake and physical activity, so the results may not be generalizable to wider populations.

The lead author, Lorah D. Dorn, a professor of pediatrics at Cincinnati Children’s Hospital, pointed out that this is only one study and that more research is needed. Still, she said, “It tells me that for care providers — clinicians and parents — this needs to be something they’re vigilant about.”

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Disruptions: Disruptions: How Smartphones Are Making Wallets Obsolete

Growing up, I noticed that something happened to my father as he aged: his wallet expanded with each passing year.

There were new credit cards, membership cards, coffee cards, business cards, pictures of his family, stamps and other plastic and paper things, added almost weekly. Eventually, his wallet grew so large that he would pull it out of his back pocket when he sat down, dropping it on the table like a brick.

As I’ve grown older, something entirely different has happened to my wallet: each year, it has become slimmer. Things that once belonged there have gradually been siphoned out by my smartphone. Last week, I realized I didn’t need to carry a wallet anymore. My smartphone had replaced almost everything in it.

So, it’s gone. Add that to the pile of things — my address books, Filofax, portable music player, point-and-shoot camera, printouts of maps — that have melded into the smartphone.

So where did the things that used to live in my wallet go?

Printed photos, which once came in “wallet size,” have been replaced by an endless roll of snapshots on my phone. Business cards, one of the more archaic forms of communication from the last few decades, now exist as digital rap sheets that can be shared with a click or a bump.

As for cash, I rarely touch the stuff anymore. Most of the time I pay for things — lunch, gas, clothes — with a single debit card. Increasingly, there are also opportunities to skip plastic cards. At Starbucks, I often pay with my smartphone using the official Starbucks app. Other cafes and small restaurants allow people to pay with Square. You simply say your name at a register and voilà, transaction complete.

But wait, what did I do with all of the other cardlike things, like my gym membership I.D., discount cards, insurance cards and coupons? I simply took digital pictures of them, which I keep in a photos folder on my smartphone that is easily accessible. Many stores have apps for their customer cards, and insurance companies have apps that substitute for paper identification.

Because I own an iPhone, I don’t have to carry tickets around, either. I use Passbook, a free Apple app that can store boarding passes, movie tickets, coupons and loyalty cards. I’ve used these digital replicas to board a flight to Los Angeles and to get into a movie and a baseball game.

Some people might cringe at the thought of putting a picture of an insurance card on their phone, but if I lose my phone, there is a password to stop someone from opening it. My wallet never came with a password.

There are a couple of things I still carry in my pocket, held together with a money clip: the debit card and my driver’s license. But I’m confident that those, too, will someday disappear.

Soon enough, my phone will become my sole credit card, and the only thing left in my pocket will be my driver’s license. And at some point, the government will enter the 21st century and offer a digital alternative for that.

Or maybe I won’t need a driver’s license at all: when cars drive themselves in the not-too-distant future, I’ll be taking a nap while my car takes me to work.

E-mail: bilton@nytimes.com

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3 killed, 4 wounded in Tulare County shooting

Three people were fatally shot and four others wounded, including two young children, Saturday night on the Tule River Reservation in Tulare County, authorities said.

The suspect, who fled with his two young daughters, was later shot by sheriff’s deputies and taken into custody, according to the Tulare County Sheriff’s Department. The two girls, who were among those shot, were rescued.

The incident began about 7:45 p.m. when the Sheriff’s Department received a 911 call about shots fired in the 100 block of Chimney Road of the Tule River Indian Reservation about 60 miles northeast of Bakersfield, according to a Sheriff’s Department statement.

In a trailer on the property, deputies discovered an adult male and an adult female who had been fatally shot, authorities said. A male juvenile who suffered a gunshot wound was transported to a hospital. 

At a shed on the property, deputies found another male victim who had been fatally shot, authorities said.

The suspect, identified as Hector Celaya, 31, of the Tule River Indian Reservation, fled the scene in a Jeep Cherokee with his two daughters, Alyssa, 8, and Linea, 5, authorities said. An Amber Alert was issued around 11 p.m.

Detectives used Celaya’s cellphone to locate him.

A deputy spotted the vehicle and after failing to make a traffic stop, a slow-speed pursuit began, authorities said.

The suspect eventually stopped and fired his weapon at deputies, who returned fire and struck the suspect twice, seriously wounding him, authorities said.

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Wired Science Space Photo of the Day: Star Formation in Carina

The spectacular star-forming Carina Nebula has been captured in great detail by the VLT Survey Telescope at ESO’s Paranal Observatory. This picture was taken with the help of Sebastián Piñera, President of Chile, during his visit to the observatory on 5 June 2012 and released on the occasion of the new telescope’s inauguration in Naples on 6 December 2012.

Image: ESO. Acknowledgement: VPHAS+ Consortium/Cambridge Astronomical Survey Unit [high-resolution]

Caption: ESO

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Bond movie “Skyfall” beats “Lincoln” at box office

(Reuters) – James Bond showed remarkable staying power as the latest installment of the spy series, “Skyfall,” captured the box office title and collected $ 11 million in its fifth week in U.S. and Canadian movie theaters, outgunning Steven Spielberg‘s “Lincoln” and “The Twilight Saga: Breaking Dawn – Part 2,” the final installment of the blockbuster vampire series.

“Skyfall,” the 23rd film in the series featuring Agent 007, also led movies at the box office when it first opened on November 2 and is already the best-selling movie in the 49-year old series. This weekend, it became the highest grossing movie in Sony Pictures‘ history with $ 918 million in ticket sales worldwide. The film distributed by Sony‘s Hollywood studio, has collected nearly $ 262 million in domestic sales, according to the movie tracking site Hollywood.com.

The animated “Rise of the Guardians” from Dreamworks Animation was second with $ 10.5 million in ticket sales. The movie, which was made for $ 145 million, opened with a disappointing $ 23.8 million when it first hit movie theaters on November 21. Since then, it has been steadily working its way toward becoming a solid family hit this season.

“Rise of the Guardians, which features Santa Claus, the Easter Bunny and other childhood favorites who join together to save the world, was one of two family movies in a season traditionally heavy in family films. The other, Disney’s “Wreck-it Ralph,” collected $ 4.9 million for seventh place.

“Breaking Dawn – Part 2,” the box office leader for the past three weeks, tallied $ 9.2 million in ticket sales. The five-movie series, released by Lions Gate Entertainment, is based on Stephenie Meyer‘s best-selling book about young vampire love and has collected more than $ 1.3 billion in overall domestic ticket sales.

“Lincoln,” which chronicles the 16th president’s successful fight to pass a constitutional amendment outlawing slavery, had total ticket sales of $ 9.1 million, according to studio estimates provided by the box office division of Hollywood.com.

“Life of Pi,” director Ang Lee’s movie about a boy who escapes a shipwreck but then shares his lifeboat with a tiger, sold $ 8.3 million in tickets to finish in fifth place. The movie, released by the Fox studio, is based on a best-selling 2001 novel by Yann Martel.

Hollywood studios shied away from scheduling major movies this weekend, steering clear of the expected blockbuster “The Hobbit: An Unexpected Journey,” which Warner Brothers will release on December 14. The movie, based on the J.R.R. Tolkien fantasy novel about wizards and dwarves, features many of the same actors from the blockbuster “The Lord of the Rings” trilogy.

The only new major release, the romantic comedy “Playing for Keeps” starring Gerard Butler and Jessica Biel, opened with a lackluster $ 6 million, which was on target with forecasts by industry experts.

(Reporting by Ronald Grover and Andrea Burzynski; Editing by Bill Trott and Jackie Frank)

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A Breakthrough Against Leukemia Using Altered T-Cells

PHILIPSBURG, Pa. — Emma Whitehead has been bounding around the house lately, practicing somersaults and rugby-style tumbles that make her parents wince.

It is hard to believe, but last spring Emma, then 6, was near death from leukemia. She had relapsed twice after chemotherapy, and doctors had run out of options.

Desperate to save her, her parents sought an experimental treatment at the Children’s Hospital of Philadelphia, one that had never before been tried in a child, or in anyone with the type of leukemia Emma had. The experiment, in April, used a disabled form of the AIDS virus to reprogram Emma’s immune system genetically to kill cancer cells.

The treatment very nearly killed her. But she emerged from it cancer-free, and seven months later is still in complete remission. She is the first child and one of the first humans ever in whom new techniques have achieved a long-sought goal — giving a patient’s own immune system the lasting ability to fight cancer.

Emma had been ill with acute lymphoblastic leukemia since 2010, when she was 5, her parents, Kari and Tom, said. She is their only child.

She is among just a dozen patients with advanced leukemia to have received the experimental treatment, which was developed at the University of Pennsylvania. Similar approaches are also being tried at other centers, including the National Cancer Institute and Memorial Sloan-Kettering Cancer Center in New York.

“Our goal is to have a cure, but we can’t say that word,” said Dr. Carl June, who leads the research team at the University of Pennsylvania. He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.

Three adults with chronic leukemia treated at the University of Pennsylvania have also had complete remissions, with no signs of disease; two of them have been well for more than two years, said Dr. David Porter. Four adults improved but did not have full remissions, and one was treated too recently to evaluate. A child improved and then relapsed. In two adults, the treatment did not work at all. The Pennsylvania researchers are presenting their results on Sunday and Monday in Atlanta at a meeting of the American Society of Hematology.

Despite the mixed results, cancer experts not involved with the research say it has tremendous promise, because even in this early phase of testing it has worked in seemingly hopeless cases.

“I think this is a major breakthrough,” said Dr. Ivan Borrello, a cancer expert and associate professor of medicine at the Johns Hopkins University School of Medicine.

Dr. John Wagner, director of pediatric blood and marrow transplantation at the University of Minnesota, called the Pennsylvania results “phenomenal,” and said they were “what we’ve all been working and hoping for but not seeing to this extent.”

A major drug company, Novartis, is betting on the Penn team, and has committed $20 million to building a research center on the Penn campus to bring the treatment to market.

Hervé Hoppenot, president of Novartis Oncology, called the research “fantastic” and said it had the potential — if the early results hold up — to revolutionize the treatment of leukemia and related blood cancers. Researchers say the same approach, reprogramming the patient’s immune system, may also be used eventually against tumors like breast and prostate cancer.

To perform the treatment, doctors remove millions of the patient’s T-cells — a type of white blood cell — and insert new genes that enable the T-cells to kill cancer cells. The new genes program the T-cells to attack B-cells, a normal part of the immune system that turns malignant in leukemia.

The altered T-cells — called chimeric antigen receptor cells — are then dripped back into the patient’s veins, and if all goes well they multiply like crazy and start destroying the cancer.

The T-cells home in on a protein called CD-19 that is found on the surface of most B-cells, whether they are healthy or malignant.

A sign that the treatment is working is that the patient becomes terribly ill, with raging fevers and chills — a reaction that oncologists call “shake and bake,” Dr. June said. Its medical name is cytokine-release syndrome, or cytokine storm, referring to the natural chemicals that pour out of cells in the immune system as they are being activated, causing fevers and other symptoms. The storm can also flood the lungs and cause perilous drops in blood pressure — effects that nearly killed Emma.

Steroids sometimes ease the reaction, but did not help Emma. Her temperature hit 105. She wound up on a ventilator, unconscious and swollen almost beyond recognition, surrounded by friends and family who had come to say goodbye.

But at the eleventh hour, a battery of blood tests gave the researchers a clue as to what might help save Emma: Her level of one of the cytokines, interleukin-6 or IL-6, had shot up a thousandfold. Doctors had never seen such a spike before and thought it might be what was making her so sick. Dr. June knew that a drug could lower IL-6 — his daughter takes it, for rheumatoid arthritis. It had never been used for a crisis like Emma’s, but there was little to lose. Her oncologist, Dr. Stephan A. Grupp, ordered the drug. The response, he said, was “amazing.”

Within hours, Emma began to stabilize. She woke up a week later, on May 2, the day she turned 7; the intensive-care staff sang “Happy Birthday.”

Since then, the research team has used the same drug, tocilizumab, in several other patients.

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Fed Likely to Sustain Bond-Buying Program to Stimulate Growth

WASHINGTON — The Federal Reserve is widely expected to announce on Wednesday that it will continue buying Treasury securities to stimulate growth in the new year.

The Fed’s public declaration in September that it would buy bonds until the outlook for the labor market “improved substantially” has cleared away much of the uncertainty and controversy that usually precedes such announcements.

The economic recovery remains lackluster and millions are looking for work. But while some analysts question the central bank’s ability to improve the situation, few doubt that the Fed, under its chairman, Ben S. Bernanke, is determined to keep trying.

Indeed, while Fed officials continue to warn that a failure to avert scheduled tax increases and spending cuts next year would overwhelm their efforts and plunge the economy back into recession, they have also said that even if Congress and the White House negotiate a compromise, the Fed’s efforts would continue.

“I am not prepared to say we are remotely close to substantial improvement on the employment front,” Dennis P. Lockhart, president of the Federal Reserve Bank of Atlanta, said in a recent speech. “I expect that continued aggressive use of balance sheet monetary tools will be appropriate and justified by economic conditions for some time, even if fiscal cliff issues are properly addressed.”

The remarks were particularly significant because Mr. Lockhart is among the moderate members of the Federal Open Market Committee whose support Mr. Bernanke invested months in winning before starting the new policy.

With the direction of policy clearly set, debate has turned to the details. The Fed, whose policy-making committee is meeting on Tuesday and Wednesday, still must determine what to buy and how much to spend, and officials continue to debate the best way to describe when the agency is likely to stop buying.

In making those decisions, the Fed must balance its conviction that buying bonds reduces borrowing costs for businesses and consumers against concerns the purchases might disrupt financial markets or inhibit its control of inflation.

Analysts say the immediate answer is likely to be more of the same. The Fed currently buys $40 billion of mortgage-backed securities and $45 billion of Treasury securities a month. Officials highlighted that $85 billion figure in September, and have indicated since that it remained their rough target.

“It would be odd for them to disappoint the expectations that they have created themselves,” Kris Dawsey of Goldman Sachs wrote in a note to clients predicting that the Fed would maintain both the dollar amount and the division. Other analysts have suggested the Fed might slightly decrease the total amount of purchases, to $80 billion, or increase the share of mortgage securities.

The Fed is unlikely to announce a new timetable this week, analysts said. The committee has said that it does not plan to raise interest rates before the middle of 2015, and that it will stop buying bonds before it starts raising rates.

Many officials on the 12-member committee — perhaps even the majority — would prefer to substitute economic objectives for guidance set by the calendar. The Fed’s ability to reduce borrowing costs derives in part from persuading investors that interest rates will remain low. Telling investors how the economic situation must change in order to warrant a change in policy could be more convincing, and therefore more potent, than simply publishing an estimated endpoint, these officials say.

But an account of the committee’s previous meeting, in late October, showed that officials remained divided about which economic objectives to use.

The most vocal proponent of focusing on economic goals, Charles L. Evans, president of the Federal Reserve Bank of Chicago, said last month that the Fed should declare its intent to keep short-term interest rates near zero until the unemployment rate fell below 6.5 percent, provided that the rate of inflation did not exceed 2.5 percent.

“I believe we have the ability to go even further in reassuring financial markets and the general public that policy will stay appropriately accommodative,” Mr. Evans said in advocating the change during a speech in Toronto.

Other officials have misgivings about placing such emphasis on any single economic indicator, or on the unemployment rate in particular.

The discussions are moving slowly, in part because it is not clear the changes being contemplated would have significant benefits. The targets the Fed is considering closely resemble its own past practice, meaning the new thresholds would tend to reinforce rather than shift expectations.

Lou Crandall, chief economist at the research firm Wrightson ICAP, noted in a recent analysis that the unemployment rate exceeded 7 percent in the mid-1980s and again in the early 1990s, and in both cases the Fed waited until the rate fell well into the 6 percent range before it began to raise interest rates.

The relative complacency of Fed officials also reflects their judgment that the mortgage-bond purchases announced in September are working. Average interest rates on 30-year mortgages are at the lowest levels on record, averaging 3.35 percent in November, according to Freddie Mac’s regular survey.

“This is solid evidence that our policy has been and continues to be effective — though it is certainly not all-powerful in current circumstances,” William C. Dudley, president of the Federal Reserve Bank of New York, said last week.

To continue the companion purchases of Treasury securities, the Fed will need to change its approach. It is now buying long-term securities with proceeds from the sale of short-term securities, but it is running out of inventory to sell.

The most likely alternative is to create money by crediting the accounts of banks that sell bonds to the Fed, the same method now being used to buy mortgage bonds and also to finance earlier rounds of the Fed’s so-called quantitative easing.

The Fed has repeatedly overestimated the health of the economy and the impact of its efforts. This time, officials have promised to maintain their efforts even as the economy shows signs of improvement. But they are once again sounding notes of cautious optimism about the coming year — if Washington does not interfere.

A budget deal reducing deficits in the long term, Mr. Bernanke said in November, “could help make the new year a very good one for the American economy.”

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