Sidney Gilman’s Shift Led to Insider Trading Case

Speaking in front of a packed convention hall in Chicago, a top Alzheimer’s researcher, Sidney Gilman, presented the results of a drug trial that had the potential to change the fate of elderly patients everywhere.

Fabrizio Costantini for The New York Times

Dr. Gilman’s lifestyle was a well-kept secret among colleagues at the University of Michigan medical school.

But as he worked through the slides, it became clear to the audience on that day in July 2008 that the drug was not delivering and that its makers, Elan and Wyeth, could lose out on blockbuster profits. Along with other Wall Street analysts in the front rows, David Moskowitz zapped messages to clients to dump shares of the companies. “I can remember gasping” at the results, Mr. Moskowitz said.

Little did anyone in the room know that 12 days earlier, Dr. Gilman had e-mailed a draft of the presentation to a trader at an affiliate of one of the nation’s most prominent hedge funds, according to prosecutors, allowing the fund, SAC Capital, and its affiliate to sell over $700 million of Elan and Wyeth stock before Dr. Gilman’s public talk.

Last month, the trader was arrested on insider trading charges after Dr. Gilman agreed to cooperate with prosecutors to avoid charges.

While he appeared a grandfatherly academic, Dr. Gilman, 80, was living a parallel life, one in which he regularly advised a wide network of Wall Street traders through a professional matchmaking system. Those relationships afforded him payments of $100,000 or more a year — on top of his $258,000 pay from the University of Michigan — and travels with limousines, luxury hotels and private jets.

The riddle for Dr. Gilman’s longtime friends and colleagues is why a nationally respected neurologist was pulled into the high-rolling life of a consultant to financiers and how he, by his own admission, crossed the line into criminal behavior.

“My first reaction was, ‘That can’t possibly be right,’ ” said Dawn Kleindorfer, a former student of Dr. Gilman’s at Michigan.

What is clear is that Dr. Gilman made a sharp shift in his late 60s, from a life dedicated to academic research to one in which he accumulated a growing list of financial firms willing to pay him $1,000 an hour for his medical expertise, while he was overseeing drug trials for various pharmaceutical makers. Among the firms he was advising was another hedge fund that was also buying and selling Wyeth and Elan stock, though the authorities have given no sign they have questioned those trades.

His conversion to Wall Street consultant was not readily apparent in his lifestyle in Michigan and was a well-kept secret from colleagues. Public records show no second home, and no indication of financial distress. Nevertheless, he was willing to share a glimpse of his lifestyle with a 17-year-old student whom he sat next to on a flight from New York to Michigan a few months ago, telling her how his Alzheimer’s research allowed him to enjoy fine hotels in New York and limousine rides to the airport.

“I wouldn’t say he was egotistical because he didn’t come across as obnoxious, but he definitely mentioned the kind of lifestyle that he had,” said the student, Anya Parampil, who had been upgraded to first class.

Dr. Gilman’s role in the case involving SAC Capital has largely been overshadowed by the possibility that investigators may be narrowing in on the firm’s billionaire founder, Steven A. Cohen. Mr. Cohen and his firm have not been accused of wrongdoing in acting on the insider information.

Colleagues now say Dr. Gilman’s story is a reminder of the corrupting influence of money. The University of Michigan, where he was a professor for decades, has erased any trace of him on its Web sites, and is now reviewing its consulting policy for employees, a spokesman said.

The case also turns the spotlight back onto the finance world’s expert networks, which match sources in academia and at publicly traded companies — like Dr. Gilman — with traders at hedge funds and financial firms.

The networks have been a central target of prosecutors in the sprawling insider trading investigations that have resulted in dozens of convictions in recent years.

Some networks have closed, and many are shifting their focus outside the financial world, hoping to make up revenue by consulting for corporate America.

Days after the charges were filed, Dr. Gilman retired and has gone into seclusion at his home on a wooded lot overlooking the Huron River on the outskirts of Ann Arbor, which is listed in public records as worth $400,000. He declined to open the door to a reporter last week, directing questions to his lawyer. “I can’t discuss it,” he said. “I’m sorry.”

Stephanie Steinberg contributed reporting.

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Life Expectancy Rises Around World, Study Finds

A sharp decline in deaths from malnutrition and infectious diseases like measles and tuberculosis has caused a shift in global mortality patterns over the past 20 years, according to a report published on Thursday, with far more of the world’s population now living into old age and dying from diseases mostly associated with rich countries, like cancer and heart disease.

Tony Karumba/Agence France-Presse — Getty Images

Children in Nairobi, Kenya. Sub-Saharan Africa lagged in mortality gains, compared with Latin America, Asia and North Africa.

The shift reflects improvements in sanitation, medical services and access to food throughout the developing world, as well as the success of broad public health efforts like vaccine programs. The results are striking: infant mortality declined by more than half from 1990 to 2010, and malnutrition, the No. 1 risk factor for death and years of life lost in 1990, has fallen to No. 8.

At the same time, chronic diseases like cancer now account for about two out of every three deaths worldwide, up from just over half in 1990. Eight million people died of cancer in 2010, 38 percent more than in 1990. Diabetes claimed 1.3 million lives in 2010, double the number in 1990.

“The growth of these rich-country diseases, like heart disease, stroke, cancer and diabetes, is in a strange way good news,” said Ezekiel Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania. “It shows that many parts of the globe have largely overcome infectious and communicable diseases as a pervasive threat, and that people on average are living longer.”

In 2010, 43 percent of deaths in the world occurred at age 70 and older, compared with 33 percent of deaths in 1990, the report said. And fewer child deaths have brought up the mean age of death, which in Brazil and Paraguay jumped to 63 in 2010, up from 30 in 1970, the report said. The measure, an average of all deaths in a given year, is different from life expectancy, and is lower when large numbers of children die.

But while developing countries made big strides the United States stagnated. American women registered the smallest gains in life expectancy of all high-income countries’ female populations between 1990 and 2010. American women gained just under two years of life, compared with women in Cyprus, who lived 2.3 years longer and Canadian women who gained 2.4 years. The slow increase caused American women to fall to 36th place in the report’s global ranking of life expectancy, down from 22nd in 1990. Life expectancy for American women was 80.5 in 2010, up from 78.6 in 1990.

“It’s alarming just how little progress there has been for women in the United States,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation, a health research organization financed by the Bill and Melinda Gates Foundation at the University of Washington that coordinated the report. Rising rates of obesity among American women and the legacy of smoking, a habit women formed later than men, are among the factors contributing to the stagnation, he said. American men gained in life expectancy, to 75.9 years from 71.7 in 1990.

Health experts from more than 300 institutions contributed to the report, which provided estimates of disease and mortality for populations in more than 180 countries. It was published in The Lancet, a British medical journal.

The World Health Organization issued a statement on Thursday saying that some of the estimates in the report differed substantially from those done by United Nations agencies, though others were similar. All comprehensive estimates of global mortality rely heavily on statistical modeling because only 34 countries — representing about 15 percent of the world’s population — produce quality cause-of-death data.

Sub-Saharan Africa was an exception to the trend. Infectious diseases, childhood illnesses and maternity-related causes of death still account for about 70 percent of the region’s disease burden, a measure of years of life lost due to premature death and to time lived in less than full health. In contrast, they account for just one-third in South Asia, and less than a fifth in all other regions. Sub-Saharan Africa also lagged in mortality gains, with the average age of death rising by fewer than 10 years from 1970 to 2010, compared with a more than 25-year increase in Latin America, Asia and North Africa.

Globally, AIDS was an exception to the shift of deaths from infectious to noncommunicable diseases. The epidemic is believed to have peaked, but still results in 1.5 million deaths each year.

Over all, the change means people are living longer, but it also raises troubling questions. Behavior affects people’s risks of developing cancer, heart disease and diabetes, and public health experts say it is far harder to get people to change their ways than to administer a vaccine that protects children from an infectious disease like measles.

“Adult mortality is a much harder task for the public health systems in the world,” said Colin Mathers, a senior scientist at the World Health Organization.

Tobacco use is a rising threat, especially in developing countries, and is responsible for almost six million deaths a year globally. Illnesses like diabetes are also spreading fast.

Donald G. McNeil Jr. contributed reporting.

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Life Expectancy Rises Around World, Study Finds

A sharp decline in deaths from malnutrition and infectious diseases like measles and tuberculosis has caused a shift in global mortality patterns over the past 20 years, according to a report published on Thursday, with far more of the world’s population now living into old age and dying from diseases mostly associated with rich countries, like cancer and heart disease.

Tony Karumba/Agence France-Presse — Getty Images

Children in Nairobi, Kenya. Sub-Saharan Africa lagged in mortality gains, compared with Latin America, Asia and North Africa.

The shift reflects improvements in sanitation, medical services and access to food throughout the developing world, as well as the success of broad public health efforts like vaccine programs. The results are striking: infant mortality declined by more than half from 1990 to 2010, and malnutrition, the No. 1 risk factor for death and years of life lost in 1990, has fallen to No. 8.

At the same time, chronic diseases like cancer now account for about two out of every three deaths worldwide, up from just over half in 1990. Eight million people died of cancer in 2010, 38 percent more than in 1990. Diabetes claimed 1.3 million lives in 2010, double the number in 1990.

“The growth of these rich-country diseases, like heart disease, stroke, cancer and diabetes, is in a strange way good news,” said Ezekiel Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania. “It shows that many parts of the globe have largely overcome infectious and communicable diseases as a pervasive threat, and that people on average are living longer.”

In 2010, 43 percent of deaths in the world occurred at age 70 and older, compared with 33 percent of deaths in 1990, the report said. And fewer child deaths have brought up the mean age of death, which in Brazil and Paraguay jumped to 63 in 2010, up from 30 in 1970, the report said. The measure, an average of all deaths in a given year, is different from life expectancy, and is lower when large numbers of children die.

But while developing countries made big strides the United States stagnated. American women registered the smallest gains in life expectancy of all high-income countries’ female populations between 1990 and 2010. American women gained just under two years of life, compared with women in Cyprus, who lived 2.3 years longer and Canadian women who gained 2.4 years. The slow increase caused American women to fall to 36th place in the report’s global ranking of life expectancy, down from 22nd in 1990. Life expectancy for American women was 80.5 in 2010, up from 78.6 in 1990.

“It’s alarming just how little progress there has been for women in the United States,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation, a health research organization financed by the Bill and Melinda Gates Foundation at the University of Washington that coordinated the report. Rising rates of obesity among American women and the legacy of smoking, a habit women formed later than men, are among the factors contributing to the stagnation, he said. American men gained in life expectancy, to 75.9 years from 71.7 in 1990.

Health experts from more than 300 institutions contributed to the report, which provided estimates of disease and mortality for populations in more than 180 countries. It was published in The Lancet, a British medical journal.

The World Health Organization issued a statement on Thursday saying that some of the estimates in the report differed substantially from those done by United Nations agencies, though others were similar. All comprehensive estimates of global mortality rely heavily on statistical modeling because only 34 countries — representing about 15 percent of the world’s population — produce quality cause-of-death data.

Sub-Saharan Africa was an exception to the trend. Infectious diseases, childhood illnesses and maternity-related causes of death still account for about 70 percent of the region’s disease burden, a measure of years of life lost due to premature death and to time lived in less than full health. In contrast, they account for just one-third in South Asia, and less than a fifth in all other regions. Sub-Saharan Africa also lagged in mortality gains, with the average age of death rising by fewer than 10 years from 1970 to 2010, compared with a more than 25-year increase in Latin America, Asia and North Africa.

Globally, AIDS was an exception to the shift of deaths from infectious to noncommunicable diseases. The epidemic is believed to have peaked, but still results in 1.5 million deaths each year.

Over all, the change means people are living longer, but it also raises troubling questions. Behavior affects people’s risks of developing cancer, heart disease and diabetes, and public health experts say it is far harder to get people to change their ways than to administer a vaccine that protects children from an infectious disease like measles.

“Adult mortality is a much harder task for the public health systems in the world,” said Colin Mathers, a senior scientist at the World Health Organization.

Tobacco use is a rising threat, especially in developing countries, and is responsible for almost six million deaths a year globally. Illnesses like diabetes are also spreading fast.

Donald G. McNeil Jr. contributed reporting.

Read More..

On Instagram, a Thriving Bazaar Taps a Big Market

Instagram, the picture-sharing application that Facebook bought earlier this year, has not yet figured out a way to make money. But some of its users have.

Peter DaSilva for The New York Times

Services like Prinstagram let people turn their Instagram images into prints, wall calendars and stickers.

These entrepreneurs have realized that they can piggyback on the popularity of Instagram, which has more than 100 million users, and create their own businesses, some of which have turned out to be quite profitable. They join a long line of innovators who have found creative ways to build new services on top of existing sites and platforms.

Services like Printstagram, for example, let people turn their Instagram images into prints, wall calendars and stickers. A group of designers are building a digital picture frame for Instagram photos. Some early users of the service are leveraging their expertise and sizable followings and starting consulting agencies, advising big-name brands on how best to use Instagram themselves.

And others have simply realized that the app is a great place to post photos of things they are trying to sell. Jenn Nguyen, 26, who lives in Irvine, Calif., has 8,300 followers on Instagram, where she posts images of lavishly made-up women who are wearing her brand of false eyelashes.

“When we post a new picture of someone wearing our lashes, we instantly see sales,” she said.

Ms. Nguyen is part of a wave of entrepreneurial Instagrammers who have transformed their feeds into virtual shop windows, full of handmade jewelry, retro eyewear, high-end sneakers, cute baking accessories, vintage clothing and custom artwork.

Those who want to sell things on Instagram have to resort to surprisingly low-tech tactics. Instagram does not allow users to add links to their photo posts, so merchants have to list a phone number for placing orders, or hope their followers will type the Web address of their store into a browser.

Shoppers seem willing to put up with that hassle. Ms. Nguyen said that during a recent holiday sale, she offered Instagram followers a coupon for 35 percent off their orders. That day, she said, she netted 100 orders, about $4,000 in sales, up from her usual $500. In her photo captions she mentions her online store and highlights products that are new or soon to be sold out.

Most of the people taking this sales approach are small-scale entrepreneurs and artists, looking for another way to find customers for their consignment shops and jewelry businesses. Hundreds of larger companies and big-name brands have accounts on Instagram, but only a few have taken steps toward actually selling there. Bergdorf Goodman, the luxury retailer, has posted photographs of women’s shoes and jewelry alongside telephone numbers for the store.

Instagram is a compelling medium “because a photo translates to any language,” said Liz Eswein, one of the founders of the Mobile Media Lab, a digital agency focused entirely on helping companies figure out their Instagram strategies. “It’s easier to get lost in the shuffle on other networks” like Facebook and Twitter, she added.

Ms. Eswein, Brian DiFeo and Anthony Danielle formed the company in March after realizing that their collective Instagram followers — nearly 850,000 — and understanding of the service could be valuable to companies like Nike, Delta, Samsung and Marc Jacobs who were hoping to reach fans of their brands. Now Mobile Media Lab runs promotions and special campaigns for those clients and others.

“We aren’t saying ‘Click here and buy this product’ — it’s more about putting the image in their head and introducing them to a product within the service,” said Ms. Eswein. In that way, it’s closer to traditional advertising, Mr. DiFeo said: “It’s classic marketing. You see an ad on a billboard, or on a bus as it goes by, on TV and now, in an Instagram post. It sticks.”

The mini-industries cropping up on and around Instagram are fueled by the service’s explosive growth. In April, Instagram had 25 million users. Eight months later it has quadrupled that figure and amassed more than five billion photos. In October, the mobile service had 7.8 million daily active visitors, according to comScore, more than Twitter’s 6.6 million.

Both Facebook and Instagram declined to talk about how Instagram might make money directly. But analysts suspect that Facebook will try to weave advertising into the Instagram app at some point, much as it has with its own app.

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Avigdor Lieberman, Israeli Foreign Minister, Resigns

JERUSALEM — Facing indictment for breach of trust and fraud, Israel’s foreign minister, Avigdor Lieberman, resigned his post Friday afternoon amid mounting political pressure, upending the campaign landscape five weeks before national elections.

Mr. Lieberman, a powerful but polarizing figure, wrote on his Facebook page, “I know that I committed no crime,” but said he was stepping down so “I will be able to put an end to this matter swiftly and without delay and to clear my name completely.”

Mr. Lieberman, who is also a member of Parliament, indicated that he still hoped to compete in the Jan. 22 balloting, suggesting a possible plea bargain. The expected indictment, which prosecutors announced on Thursday, concerns a relatively minor offense compared with a broader case of money laundering and fraud that was dropped after an investigation stretching for more than 12 years.

“I believe that the citizens of the State of Israel are entitled to go to the polling stations after this matter has already been resolved,” Mr. Lieberman’s statement said. If a legal ruling could be made before the elections, “I might continue to serve the State of Israel and the citizens of Israel as part of a strong and united leadership that will cope with the security, political and economic challenges facing the State of Israel.”

Mr. Lieberman, 54, leads the secular, ultranationalist Yisrael Beiteinu party, which joined forces in October with Prime Minister Benjamin Netanyahu’s Likud Party. A populist immigrant from the former Soviet Union, he was widely considered as a potential successor to Mr. Netanyahu as leader of Israel’s right wing, though his hard line on the Palestinian question, among other issues, alienated many Western allies.

After the charges were announced, Mr. Lieberman told supporters that he had been hounded by corruption accusations since July 1996, when he served as a top aide to Mr. Netanyahu during his first term as prime minister. “Since then till today, not a day has passed without me being referred to as ‘a suspect,’ ‘being under investigation,’ ‘being an intelligence target,’ ” Mr. Lieberman said. “This has been one long and rolling case, receiving a different title every now and then.”

The conduct for which Mr. Lieberman will face indictment stems from an investigation into other allegations. He is accused of promoting Israel’s former ambassador to Belarus for another post after the ambassador gave him confidential information regarding an Israeli police investigation into Mr. Lieberman’s activities.

But Mr. Lieberman will not face charges on the underlying, more serious case, in which he was suspected of receiving millions of dollars from international tycoons with business interests in Israel through companies formally led by family members or associates.

Israel’s attorney general, Yehuda Weinstein, said Thursday in a report announcing his decision that he could not adequately prove a link between Mr. Lieberman and the money, though he said, “The suspicions against Lieberman’s series of intricate and intertwined, underhanded actions cannot be ruled out.”

Born in Moldova, Mr. Lieberman enjoys wide support among Israel’s one million immigrants from the former Soviet Union. He lives in a West Bank settlement considered illegal under international law, and he is perhaps the government’s harshest critic of President Mahmoud Abbas of the Palestinian Authority, having called for his ouster and denounced as “diplomatic terrorism” his recent bid for upgraded Palestinian status at the United Nations.

Polls have consistently shown that Mr. Lieberman’s joint ticket with Mr. Netanyahu, known here as Likud Beiteinu, is expected to receive up to 40 of the 120 seats in Israel’s next Parliament, by far the largest bloc. The merger was seen as crowning him a top contender to eventually follow Mr. Netanyahu as prime minister.

Opposition leaders, who on Thursday had called for Mr. Lieberman’s resignation, were swift to embrace it on Friday, but not without adding jabs.

Zahava Gal-On, chairwoman of the left-wing Meretz party, said Mr. Lieberman had “spared himself ignobility and disgrace” by stepping down, according to the Web site of Channel 2 News. Shelly Yacimovich, chairwoman of the Labor Party, said he had “severely undermined the rule of law and damaged the public’s faith in its elected officials and democracy.”

Tzipi Livni, a former foreign minister who now heads the new Hatnua Party, issued a more moderate statement, saying: “Avigdor Lieberman performed the right and necessary action. We hope he will receive a swift legal proceeding.”

Mr. Netanyahu had no immediate comment on Mr. Lieberman’s resignation Friday, but on Thursday had offered only support. “I believe in Israel’s legal system and respect it,” the prime minister said in a statement. “The right that it grants any Israeli citizen to defend himself also extends to Minister Lieberman, and I hope for him that he’ll be able to prove that he’s also innocent regarding the only case that remains.”

Under Israeli law, when a cabinet minister resigns, the prime minister becomes “custodian” of his portfolio, and Mr. Netanyahu is expected to handle foreign affairs himself at least until after the elections.

Jonathan Rosen contributed reporting.

This article has been revised to reflect the following correction:

Correction: December 14, 2012

An earlier version of this article misstated the timing of the forming of a coalition between Yisrael Beiteinu and Likud. It took place in October, not last month.

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Shares Continue to Slide, Awaiting a Budget Accord

Stocks fell on Friday as another decline in Apple took a toll and investors unloaded some shares because of the uncertainty surrounding the budget negotiations in Washington.

All three major stock indexes ended the week slightly lower, the Nasdaq for the second consecutive week.

Apple’s stock slid 3.76 percent, to $509.79, after the iPhone 5 received a tepid reception in China.

UBS maintained its buy rating on Apple, but cut its price target to $700 from $780 and expressed concerns that iPhone production may be dropping.

Shares of Apple have fallen 27.4 percent since their closing high of $702.10 on Sept. 19.

The S.& P. Information Technology Index lost 1 percent as Apple fell and Jabil Circuit fell 5.5 percent, to $17.51, after UBS cut its price target.

Stocks have been treading water as the possibility of not reaching a deal to settle the budget impasse until early next year is rising.

“We’re faced with uncertainty,” said Larry Peruzzi, senior equity trader at Cabrera Capital Markets in Boston. “And that’s going to continue now into January. It basically puts everybody on hold and just have the markets kind of thrash around.”

President Obama and the House speaker, John A. Boehner, held a “frank” meeting on Thursday at the White House to discuss how to avoid the tax increases and spending cuts set to kick in early in 2013.

The Dow Jones industrial average slipped 35.71 points, or 0.27 percent, to 13,135.01. The Standard & Poor’s 500-stock index fell 5.87 points, or 0.41 percent, to 1,413.58. The Nasdaq composite index lost 20.83 points, or 0.70 percent, to 2,971.33.

For the week, the Dow slipped 0.15 percent, while the S.& P. 500 fell 0.3 percent and the Nasdaq declined 0.2 percent.

Among other Nasdaq decliners, shares of the chip maker Qualcomm slid 4.7 percent, to $59.83.

Best Buy slid 14.7 percent, to $12.05, after the electronics retailer agreed to extend the deadline for the company’s founder to make a bid.

Among the day’s economic data, consumer prices fell in November for the first time in six months, indicating inflation pressures were muted.

A separate report showed manufacturing grew at its swiftest rate in eight months in December.

Chinese data was encouraging, as Chinese manufacturing grew at its fastest rate in 14 months in December. The news was deemed as helpful for materials companies in the United States, including United States Steel, which rose 6.8 percent, to $23.85.

Interest rates were lower. The Treasury’s benchmark 10-year note rose 8/32, to 99 9/32, and the yield fell to 1.70 percent from 1.73 percent late Thursday.

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My Story: Taking on Cancer Again, This Time With the Wisdom of Age

After I finished eight months of treatment for testicular cancer in my mid-20s, my psychologist said, “Well, that was like having five years of therapy all at once.” What he meant was that you learn a lot about yourself in weekly talk sessions, but during a life-threatening illness, the “issues” come at you nonstop. I relished the slow unfolding of myself in the first, but I resented — no, hated — every step of the second. Nearly two decades later, when confronted with the same diagnosis, I finally understood the benefits of that earlier trial by fire, much as I did the wisdom of Ralph Waldo Emerson when he wrote, “The years teach much which the days never knew.”

To be sure, there were benefits to being young — I was 26 — when I was first diagnosed, not the least of which was my competitive swimmer’s body. After almost dying in the I.C.U. and becoming a “patient-in-residence,” I plunged back into the pool (and my day job) just a fortnight after my release.

Ah, the determination — and denial — of youth.

But facing cancer at that young age had more drawbacks than benefits, not the least of which was losing my sense of invulnerability when confronted with the prospect of disfigurement and disability, even death.

Less obvious, but still unsettling, was the loss of my laissez-faire attitude toward life itself. I had always been the kind of guy who focused on the journey (the experience) more than the destination (winning). During backstroke events prior to falling ill I was more interested in watching the clouds race overhead than the swimmer racing in the next lane. This mindset didn’t do much for my success in the pool, but it helped define who I was.

To make matters worse, conventional wisdom says only one thing matters when it comes to cancer: Beating the hell out of it. Suddenly I had to find an emotional depth I hadn’t sought before, a passion for a fight that I didn’t want.

Am I the kind of person who can win this battle? I asked myself early on.

To ensure that I was, I did a complete about-face, saying “No way” to the journey and “Hell, yes” to the destination. Every decision began to turn on life and longevity, and for that I tolerated side effects like hair loss, neuropathy and “dry ejaculation” — because I simply had to win.

I re-read Dylan Thomas, who told me to “rage, rage against the dying of the light,” and I did. I became a rager. And it almost ruined my life.

Not in terms of my health, because in fact my treatment was effective. I was “clinically cured” and chalked up that achievement to my new “Top Gun” mentality. Then I jumped back into daily life — and managed to mess everything up. I applied my new approach to relationships (“My way or the highway”), and got dumped by my boyfriend. In graduate school, I aced my studies but lost friends.

Fortunately, my best friends didn’t hold back on telling me I had become a jerk, and that got my attention. I had upshifted at the start of my treatment, but now I needed to downshift. I struggled to find my pace, but eventually found a middle gear, more vulnerable than I cared to be but also more human.

The second time I was diagnosed, the oncologist sat me down to give me the new installment of the old bad news. I surprised myself and my friends with a very different approach.

I did not rage, which isn’t to say I was happy about this predicament. And I had moved on from my original question to a new one: How can I go through this and still be the kind of person I want to be?

In the intervening years, I had come to realize that cancer victories are not won by personality types, but by a combination of doggedness (choosing the best physician, getting the right diagnosis and treatment), responsibility (doing your own research and taking care of your overall health), and plain old luck.

From that very first day of my second time around, I challenged myself not to shift into that “win at any cost” mentality. That’s where the gift of age and experience came to my aid, even if my older body did not. Over the years I had learned that life was not a series of choices between winners and losers — I knew that way of seeing things to be oversimplified, if not dead wrong. You can be stronger than an ox, never miss a day of work, or swim your lungs out and, damn it, still die.

I could become a jerk again and focus on the end point, or I could accept that the journey is the destination – which I did.

Two months after I had been diagnosed and two days before the surgeon was scheduled to excise my remaining testicle, I had a dream so vivid — “I am cancer-free!” — that I demanded to go on a “surveillance” protocol. Reluctantly my doctor agreed, but by year’s end I had “won” the debate when my so-called tumor was reclassified as a benign nodule.

The years had taught me much — both to listen to my body and to trust in its wisdom. And, most importantly, to find the courage to speak its truth — whether in the doctor’s office or out in the world.

Steven Petrow writes the Civil Behavior column for Booming, addressing questions about gay and straight etiquette for a boomer-age audience. You can find him on Facebook and Twitter.

You can follow Booming via RSS here or visit nytimes.com/booming.

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My Story: Taking on Cancer Again, This Time With the Wisdom of Age

After I finished eight months of treatment for testicular cancer in my mid-20s, my psychologist said, “Well, that was like having five years of therapy all at once.” What he meant was that you learn a lot about yourself in weekly talk sessions, but during a life-threatening illness, the “issues” come at you nonstop. I relished the slow unfolding of myself in the first, but I resented — no, hated — every step of the second. Nearly two decades later, when confronted with the same diagnosis, I finally understood the benefits of that earlier trial by fire, much as I did the wisdom of Ralph Waldo Emerson when he wrote, “The years teach much which the days never knew.”

To be sure, there were benefits to being young — I was 26 — when I was first diagnosed, not the least of which was my competitive swimmer’s body. After almost dying in the I.C.U. and becoming a “patient-in-residence,” I plunged back into the pool (and my day job) just a fortnight after my release.

Ah, the determination — and denial — of youth.

But facing cancer at that young age had more drawbacks than benefits, not the least of which was losing my sense of invulnerability when confronted with the prospect of disfigurement and disability, even death.

Less obvious, but still unsettling, was the loss of my laissez-faire attitude toward life itself. I had always been the kind of guy who focused on the journey (the experience) more than the destination (winning). During backstroke events prior to falling ill I was more interested in watching the clouds race overhead than the swimmer racing in the next lane. This mindset didn’t do much for my success in the pool, but it helped define who I was.

To make matters worse, conventional wisdom says only one thing matters when it comes to cancer: Beating the hell out of it. Suddenly I had to find an emotional depth I hadn’t sought before, a passion for a fight that I didn’t want.

Am I the kind of person who can win this battle? I asked myself early on.

To ensure that I was, I did a complete about-face, saying “No way” to the journey and “Hell, yes” to the destination. Every decision began to turn on life and longevity, and for that I tolerated side effects like hair loss, neuropathy and “dry ejaculation” — because I simply had to win.

I re-read Dylan Thomas, who told me to “rage, rage against the dying of the light,” and I did. I became a rager. And it almost ruined my life.

Not in terms of my health, because in fact my treatment was effective. I was “clinically cured” and chalked up that achievement to my new “Top Gun” mentality. Then I jumped back into daily life — and managed to mess everything up. I applied my new approach to relationships (“My way or the highway”), and got dumped by my boyfriend. In graduate school, I aced my studies but lost friends.

Fortunately, my best friends didn’t hold back on telling me I had become a jerk, and that got my attention. I had upshifted at the start of my treatment, but now I needed to downshift. I struggled to find my pace, but eventually found a middle gear, more vulnerable than I cared to be but also more human.

The second time I was diagnosed, the oncologist sat me down to give me the new installment of the old bad news. I surprised myself and my friends with a very different approach.

I did not rage, which isn’t to say I was happy about this predicament. And I had moved on from my original question to a new one: How can I go through this and still be the kind of person I want to be?

In the intervening years, I had come to realize that cancer victories are not won by personality types, but by a combination of doggedness (choosing the best physician, getting the right diagnosis and treatment), responsibility (doing your own research and taking care of your overall health), and plain old luck.

From that very first day of my second time around, I challenged myself not to shift into that “win at any cost” mentality. That’s where the gift of age and experience came to my aid, even if my older body did not. Over the years I had learned that life was not a series of choices between winners and losers — I knew that way of seeing things to be oversimplified, if not dead wrong. You can be stronger than an ox, never miss a day of work, or swim your lungs out and, damn it, still die.

I could become a jerk again and focus on the end point, or I could accept that the journey is the destination – which I did.

Two months after I had been diagnosed and two days before the surgeon was scheduled to excise my remaining testicle, I had a dream so vivid — “I am cancer-free!” — that I demanded to go on a “surveillance” protocol. Reluctantly my doctor agreed, but by year’s end I had “won” the debate when my so-called tumor was reclassified as a benign nodule.

The years had taught me much — both to listen to my body and to trust in its wisdom. And, most importantly, to find the courage to speak its truth — whether in the doctor’s office or out in the world.

Steven Petrow writes the Civil Behavior column for Booming, addressing questions about gay and straight etiquette for a boomer-age audience. You can find him on Facebook and Twitter.

You can follow Booming via RSS here or visit nytimes.com/booming.

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Citing Internet Standoff, U.S. Rejects International Telecommunications Treaty

DUBAI — Talks on a proposed treaty governing international telecommunications collapsed in acrimony on Thursday when the United States rejected the agreement on the eve of its scheduled signing, citing an inability to resolve an impasse over the Internet.

“It is with a heavy heart that I have to announce that the United States must communicate that it is unable to sign the agreement in its current form,” Terry Kramer, head of the American delegation, announced moments after a final draft appeared to have been approved by a majority of nations.

The United States announcement was seconded by Canada and several European countries after nearly two weeks of talks that had often pitted Western governments against Russia, China and developing countries. The East-West and North-South divisions harked back to the cold war, even though that conflict did not stop previous agreements to connect telephone calls across the Iron Curtain.

While the proposed agreement was not set to take effect until 2015 and was not legally binding, Mr. Kramer insisted that the United States and its supporters had headed off a significant threat to the “open Internet.”

The messy end to the proceedings highlighted intractable differences of opinion over the ever-growing importance of digital communications networks as tools for personal communications, global commerce, political proselytization and even unconventional warfare.

“The word ‘Internet’ was repeated throughout this conference and I believe this is simply a recognition of the current reality — the two worlds of telecommunications and Internet are inextricably linked,” said Hamadoun Touré, secretary general of the International Telecommunication Union.

The United States has consistently maintained that the Internet should not have been mentioned in the proposed treaty, which dealt with technical matters like connecting international telephone calls, because doing so could lead to curbs on free speech and replace the existing, bottom-up form of Internet oversight with a government-led model.

“We cannot support a treaty that is not supportive of the multistakeholder model of Internet governance,” Mr. Kramer said. His announcement came moments after the telecommunication union, the United Nations agency that convened the talks here, announced that a final version of the text had been formulated.

A bloc of countries led by Russia that included China and the host nation, the United Arab Emirates, argued throughout the negotiations that the Internet was within the scope of the talks because Internet traffic traveled through telecommunications networks.

The goal of the talks, which were led by Mohamed Nasser al-Ghanim, director general of the Telecommunications Regulatory Authority of the United Arab Emirates, was to revise a document that was last updated in 1988, when the Internet was in its early stages of development.

Agreement was never going to be easy. Like most U.N. agencies, the International Telecommunication Union tries to operate by consensus, resorting to majority vote only when this fails.

The United States delegation was apparently angered by developments early Wednesday, when Russia and its allies succeeded in winning, by a mere show of hands, approval of a resolution that mentioned the Internet. The informal vote followed an attempt by Mr. Ghanim to gauge, as he put it, “the temperature of the room.”

The United States and its supporters interpreted the wording of the resolution as supporting a shift in the governance of the Internet to bring it under the regulatory framework of the telecommunication union.

The Internet is currently overseen by a loose grouping of organizations, mostly in the private sector, rather than by governments. But at least one, the Internet Corporation for Assigned Names and Numbers, operates under a contract from the United States government.

Resolutions are not officially part of the treaty wording, and Russia and its allies previously tried to include a similar clause in the actual treaty. But under a compromise, it agreed this week to withdraw that proposal and settle for the lesser measure. Even that, however, was insufficient to address the concerns of the United States and its supporters.

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S.&P. Streak Comes to an End on Fiscal Worries

The Standard & Poor’s 500-stock index ended its six-day winning streak Thursday, retreating as worries intensified that Washington’s fiscal negotiations were dragging on with little progress.

Anxiety about the talks between Democrats and Republicans was enough to offset encouraging data on retail sales and jobless claims.

Investors are concerned that tax increases and spending cuts, set to begin in 2013 if a deal is not reached in Washington, will hurt growth. The stock market had taken the heated talk in stride lately, but downbeat remarks from the House speaker, John A. Boehner of Ohio, prompted some selling Thursday.

Mr. Boehner accused President Obama of “slow walking” the economy toward the automatic tax increases and spending cuts that will occur on Jan. 1, 2013, if no deal is reached. He was scheduled to meet with Mr. Obama later on Thursday.

“There is no conviction here and Boehner’s comments — as harsh as they were — were realistic,” said Jason Weisberg, managing director at the Seaport Securities Corporation in New York.

“The fiscal cliff is already built in,” Mr. Weisberg said. “That being said, people don’t like to be told the apocalypse is coming over and over and over again. The real players in this market have already closed their books.”

After nearing a 1 percent decline for the day, the S.& P. 500 pared losses late in the session. The index had posted six consecutive sessions of gains through Wednesday, and at one point Wednesday, the S.& P. 500 touched its highest intraday level since Oct. 22.

While the Federal Reserve’s announcement on Wednesday of a new round of economic stimulus bolstered stocks, Chairman Ben Bernanke’s comments that monetary policy would not be sufficient to offset the impact of the fiscal crisis weighed on sentiment.

The Dow Jones industrial average tumbled 74.73 points, or 0.56 percent, to 13,170.72 at the close. The S.& P. 500-stock index fell 9.03 points, or 0.63 percent, to 1,419.45. The Nasdaq composite index slid 21.65 points, or 0.72 percent, to end at 2,992.16.

Apple’s stock, down 1.7 percent at $529.69, was among the biggest drags on the Nasdaq, while I.B.M., down 0.5 percent at $191.99, was among the biggest weights on the Dow. A federal jury in Delaware Thursday found that Apple’s iPhone infringed on three patents owned by MobileMedia Ideas.

Among the day’s biggest gainers, Best Buy shares shot up 15.9 percent to $14.12 after a report that the company’s founder, Richard M. Schulze, was expected to offer to buy the consumer electronics retailer this week.

The energy and information technology sectors were the S.& P.’s weakest performers, with the S.& P. energy index declining 0.9 percent. Shares of the American refining company Phillips 66 lost 1.6 percent to $52.21.

The day’s data sent some positive signals on the economy, with weekly claims for jobless benefits dropping to nearly the lowest level since February 2008, and retail sales rising in November after an October decline, improving the picture for consumer spending.

In Europe, European Union finance ministers reached agreement to make the European Central Bank the bloc’s top banking supervisor, which could increase confidence in the ability of European Union leaders to confront the euro zone’s sovereign debt crisis.

The Treasury’s 10 year note fell 9/32 to 99 1/32, with the yield rising to 1.73 from 1.70 on Wednesday.

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