A Controversial ‘Cure’ for Multiple Sclerosis

The defining element of Adam Gottschalk's life today is that he has multiple sclerosis. This wasn't always the case. He lived a more-or-less-normal life for a while, even after his diagnosis, but like most people with M.S., he was always bracing for the next relapse of partial paralysis or numbness or vision failure or any of the other attacks the disease unleashes unpredictably on the nervous system. Thirteen years after his diagnosis, Adam is now a case study of the degeneration that eventually occurs in everyone who gets M.S. He is only 42, but his physical capabilities are like those of an 80-year-old. His hands tremble, he walks with difficulty and his speech is labored and halting.

Christopher Morris/ VII, for The New York Times

Adam Gottschalk, left, who has M.S., and his older brother, Chris, a neuorologist, have differing opinions on a treatment Adam received.

Nathan Denette/The Canadian Press/Associated Press

Dr. Paolo Zamboni

For a time in the early 1990s, Gottschalk busked outside the Shinjuku subway station in Tokyo, playing Dylan and Beatles songs, and of all the things M.S. robbed him of, it's the ability to play guitar that he longs for the most. "I miss that part of myself," he told me when we met at his home last winter. Because he can't drive, Gottschalk spends most of his time inside his single-story house north of Tampa, Fla. He works part time operating a natural-perfume business, writes plays and poems, listens to obscure music at high volume and smokes a lot of pot (he says marijuana helps with the chronic pain that's one of M.S.'s more baffling symptoms). Several times a day Gottschalk takes five different drugs: one to keep his M.S. from getting even worse, three for his seizures and an antidepressant that helps him sleep. Dietary supplements cover the buffet in his dining room.

In the last couple of decades, nine new drugs have come on the market to treat M.S.; at least four more are currently being tested on humans. Few diseases have seen such radical transformation of treatment options in such a short time. Yet for all the new options, many of the 2.1 million people worldwide afflicted with the disease (400,000 of them in the United States) have not seen improvements, and some M.S. patients find that the adverse reactions from the drugs aren't worth the benefits.

Gottschalk's neurologist started him on the M.S. drug Copaxone in 2000, but he had a relapse a few years later. So Gottschalk started taking Rebif, giving himself two shots a week until the drug's side effects — severe flulike symptoms for 24 hours — became too much to bear. Next, about once a month for five years, Gottschalk was given an infusion of Tysabri, an even newer M.S. drug. A rare side effect landed him in the hospital in 2010 and almost killed him.

Surfing Facebook one day shortly after the Tysabri scare, Gottschalk learned that an Italian vascular surgeon named Paolo Zamboni had hypothesized that the real cause of M.S. was something called chronic cerebrospinal venous insufficiency, or CCSVI. For decades, doctors have been confident that M.S. comes about because the immune system attacks the brain, though they don't know why it does so. Zamboni contended instead that blocked veins prevent blood from draining from the head, causing iron to back up in the brain and damage nerves that send messages to the body.

Zamboni's first study, published in 2009 in a small neurological journal, purported to find CCSVI in 100 percent of M.S. sufferers at one stage of the disease, and he developed a surgical procedure to treat it: opening the veins that carry blood away from the head with the aim of restoring normal blood flow. This would be done by inflating a small balloon inside the vein to widen the passage, and in rare instances by placing a device to keep it open (as is commonly performed in the arteries of patients with heart disease). Zamboni's study was small, just 65 subjects, and though he had compared them with a control group, he knew which patients had M.S. and which did not. But news of CCSVI traveled quickly, and M.S. patients started seeking diagnostic procedures to see if they had CCSVI, as well as the surgery to treat it.

This article has been revised to reflect the following correction:

Correction: October 29, 2012

An earlier version of this article misstated the surname of a man who underwent what is believed to have been the first surgery in the United States to treat chronic cerebrospinal venous insufficiency (CCSVI). He is Jeff Beal, not Beals.

18.37 | 0 komentar | Read More

Still Waiting for the Narrator in Chief

Illustration by Matt Dorfman. Original photograph by Nikki Kahn/The Washington Post/Getty Images.

Presidents generally don't like to admit mistakes, so it was interesting when Barack Obama owned up to one during an interview with Charlie Rose on CBS last summer. It was the job of the president, Obama said, to "tell a story to the American people that gives them a sense of unity and purpose and optimism," and it was on this score that he had fallen short. Conservatives gleefully mocked the president, saying that the country needed jobs more than it needed stories, and the remark did seem to hint at some genuine denial. After 40-plus months of high unemployment, a president who thinks his mistakes rest not in his policy choices but rather in his ability to articulate them is probably telling himself a story, if no one else.

And yet Obama's admission resonated with his supporters, who can be forgiven for wondering why he hasn't been better at promoting what is, by any standard, an impressive series of accomplishments. (As the comedian Chris Rock tweeted recently: "Only Pres Obama could prevent a depression, end a war, get bin Laden, bring unemployment below 8 percent, then be told he can't run on his record.") In books and speeches before he became president, Obama showed himself to be an evocative storyteller; even the controversy over his memoir, in which Obama condensed some characters into one, says something about his narrative sophistication, his novelistic instinct for developing themes and characters that make his point.

All of which makes it even more baffling that Obama's presidential alter-ego, this grayer and more somber version of his literary self, spent the past four years immersed in legislative minutiae and marching out dull slogans — "an economy built to last," "winning the future" and so on — while failing to advance any larger theory of the moment confronting the country and what it required. "They haven't talked about how the pieces of the puzzle fit together and move us forward from where we've been," says Don Baer, who served as President Clinton's communications director and now runs the public relations giant Burson-Marsteller. "It's been random and unconnected." David Gergen, who advised four presidents on communications, likens the larger story of an administration to a clothesline. "You adopt your clothesline, and then you hang all your policies from it," he told me. "They're missing the clothesline."

If Obama somehow manages to lose an election that seemed well within his grasp a few months ago, this question of how he squandered his narrative mojo will pain Democrats for years to come. As with so much else about this presidency, the answers can probably be traced back to those first overwhelming months after the 2008 election. Remember that John McCain's most effective line of attack against Obama during the campaign was that he was more of a motivational speaker than a leader. And so, having won the election and facing crises on several fronts, the president's advisers were understandably wary of too much speechifying, which might have underscored the idea that Obama was going to orate his way through the presidency while leaving the business of governing to others. As a result, Obama spent much of his first months — the period when he might have been speaking directly to an anxious public, much as Franklin Roosevelt did in a less technological age — holed up with aides and members of Congress, rather than pushing any kind of overarching narrative.

Remember, too, that Obama and Joe Biden were the first president and vice president to be elected directly from the Senate since 1960, and most of the senior aides they brought with them came from Capitol Hill. This had real consequences. Congressional aides know a lot about how to slap around their opponents, but because they're always either taking direction from a president or trying to thwart one, they think very little about how to build support for a governing agenda. A classic case here was the controversial stimulus measure passed in the early days of Obama's presidency; the White House and its allies skillfully managed to win approval for nearly $800 billion in aid to states, long-term investment and tax cuts, but they gave almost no thought to whether the public understood the differences between these categories of spending or the economic reasoning behind them.

Matt Bai is the magazine's chief political correspondent. He last wrote about the economy in Ohio.

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How Do You Raise a Prodigy?

Photo illustration by Peter Yang for The New York Times

Drew Petersen didn't speak until he was 3½, but his mother, Sue, never believed he was slow. When he was 18 months old, in 1994, she was reading to him and skipped a word, whereupon Drew reached over and pointed to the missing word on the page. Drew didn't produce much sound at that stage, but he already cared about it deeply. "Church bells would elicit a big response," Sue told me. "Birdsong would stop him in his tracks."

May Armstrong

Kit Armstrong at 5; he graduated from high school at 9.

Sue, who learned piano as a child, taught Drew the basics on an old upright, and he became fascinated by sheet music. "He needed to decode it," Sue said. "So I had to recall what little I remembered, which was the treble clef." As Drew told me, "It was like learning 13 letters of the alphabet and then trying to read books." He figured out the bass clef on his own, and when he began formal lessons at 5, his teacher said he could skip the first six months' worth of material. Within the year, Drew was performing Beethoven sonatas at the recital hall at Carnegie Hall. "I thought it was delightful," Sue said, "but I also thought we shouldn't take it too seriously. He was just a little boy."

On his way to kindergarten one day, Drew asked his mother, "Can I just stay home so I can learn something?" Sue was at a loss. "He was reading textbooks this big, and they're in class holding up a blowup M," she said. Drew, who is now 18, said: "At first, it felt lonely. Then you accept that, yes, you're different from everyone else, but people will be your friends anyway." Drew's parents moved him to a private school. They bought him a new piano, because he announced at 7 that their upright lacked dynamic contrast. "It cost more money than we'd ever paid for anything except a down payment on a house," Sue said. When Drew was 14, he discovered a home-school program created by Harvard; when I met him two years ago, he was 16, studying at the Manhattan School of Music and halfway to a Harvard bachelor's degree.

Prodigies are able to function at an advanced adult level in some domain before age 12. "Prodigy" derives from the Latin "prodigium," a monster that violates the natural order. These children have differences so evident as to resemble a birth defect, and it was in that context that I came to investigate them. Having spent 10 years researching a book about children whose experiences differ radically from those of their parents and the world around them, I found that stigmatized differences — having Down syndrome, autism or deafness; being a dwarf or being transgender — are often clouds with silver linings. Families grappling with these apparent problems may find profound meaning, even beauty, in them. Prodigiousness, conversely, looks from a distance like silver, but it comes with banks of clouds; genius can be as bewildering and hazardous as a disability. Despite the past century's breakthroughs in psychology and neuroscience, prodigiousness and genius are as little understood as autism. "Genius is an abnormality, and can signal other abnormalities," says Veda Kaplinsky of Juilliard, perhaps the world's pre-eminent teacher of young pianists. "Many gifted kids have A.D.D. or O.C.D. or Asperger's. When the parents are confronted with two sides of a kid, they're so quick to acknowledge the positive, the talented, the exceptional; they are often in denial over everything else."

We live in ambitious times. You need only to go through the New York preschool application process, as I recently did for my son, to witness the hysteria attached to early achievement, the widespread presumption that a child's destiny hinges on getting a baby foot on a tall ladder. Parental obsessiveness on this front reflects the hegemony of developmental psychiatry, with its insistence that first experience is formative. We now know that brain plasticity diminishes over time; it is easier to mold a child than to reform an adult. What are we to do with this information? I would hate for my children to feel that their worth is contingent on sustaining competitive advantage, but I'd also hate for them to fall short of their potential. Tiger mothers who browbeat their children into submission overemphasize a narrow category of achievement over psychic health. Attachment parenting, conversely, often sacrifices accomplishment to an ideal of unboundaried acceptance that can be equally pernicious. It's tempting to propose some universal answer, but spending time with families of remarkably talented children showed me that what works for one child can be disastrous for another.

Andrew Solomon is a lecturer in psychiatry at Cornell. His book "Far From the Tree," from which this essay is adapted, will be published this month by Scribner.

Editor: Jillian Dunham

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Talk: Sister Florence Deacon, the Rebel Nun

In April, the Vatican accused your group, the Leadership Conference of Women Religious, the country's most influential nuns' organization, of "radical feminism." Did that surprise you?
I was surprised by us being called radical feminists. I could introduce them to some real radical feminists.

Part of the criticism was that the sisters weren't speaking against issues like abortion, contraception and gay marriage.
But if you look at the Gospel, Jesus welcomed sinners with the idea that they would be drawn to change their lives. Human beings are frail. None of us always act the way we wish we would act.

Cardinal Levada, who oversaw the assessment of the L.C.W.R., has been questioned for his handling of sex-abuse cases.
I'm not going there.

Do you have feelings about the sex-abuse scandal?
I don't want to go there. I'll tell you personally, I'm appalled, but so is everyone else. We're all appalled.

Why does the L.C.W.R. take political stances, like protesting the Bush tax cuts?
The Gospel encourages Catholics to create a world in which everyone has what they need so they can live as full human beings and develop their faith. If we believe the most vulnerable need to be cared for, some of it has to rely on services provided by the government.

One theory about why the assessment came out when it did is that the sisters supported Obama's health care plan, and the bishops were against it.
The review was started before that. I've heard those suggestions as well, but we have no way of knowing if that's true. It's particularly tense right now because we have an election coming up.

My 6-year-old son is obsessed with the election. Do you have advice for how to keep him from becoming . . .
A political junkie? Help him volunteer at food pantries. Have him see you getting involved in direct service. Have him see you vote. Foster a moral outlook.

I noticed you have a Facebook page. Do you like Facebook?
I do. Initially, I was only friending relatives. More and more people were trying to friend me, and at first I was just ignoring them all, but then I decided to go a little further. I keep in touch with a group of former students in their 40s and 50s that way.

You were a teacher too. What about the stereotype of the scary nun with a ruler?
That wasn't really part of the culture when I was a teacher. People are forgetting there was a different sense of physical discipline in the past, "If you spare the rod, you spoil the child." We certainly see now that it's not a way to inspire responsibility and self-confidence. In Texas, it's still legal, and that's in public school.

What do you say to people who complain that some charities, famously Mother Teresa's missions, don't actually fix the problem of poverty?
There are a couple of approaches to poverty. One is what you would call charity. Mother Teresa chose to pick the babies out of the gutter, to do direct service with God's most vulnerable. The other is called justice. It has to be both-and. It can't be either-or.

Did you hear about the imprisonment of this feminist punk band in Russia, Pussy Riot?
Yes. It seemed to me to be quite political. The women said they didn't mean any disrespect to religion.

You entered the convent at 16, in 1961. Did you miss out on pop culture, like the Beatles?
The first time I heard of the Beatles, it had snowed and someone had stamped "Beatles" in the snow. I said, "Why is someone stamping the word 'beetles' in the snow?" Then I found out it was this new rock band.

What was the first song of theirs you heard?
I don't remember! I did like their "Sounds of Silence."

That was Simon and Garfunkel.
Then I don't know. But I do know that when I hear their songs now, they sound so tame, and I think, What were people so upset about?

INTERVIEW HAS BEEN CONDENSED AND EDITED.

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A Controversial ‘Cure’ for Multiple Sclerosis

The defining element of Adam Gottschalk's life today is that he has multiple sclerosis. This wasn't always the case. He lived a more-or-less-normal life for a while, even after his diagnosis, but like most people with M.S., he was always bracing for the next relapse of partial paralysis or numbness or vision failure or any of the other attacks the disease unleashes unpredictably on the nervous system. Thirteen years after his diagnosis, Adam is now a case study of the degeneration that eventually occurs in everyone who gets M.S. He is only 42, but his physical capabilities are like those of an 80-year-old. His hands tremble, he walks with difficulty and his speech is labored and halting.

Christopher Morris/ VII, for The New York Times

Adam Gottschalk, left, who has M.S., and his older brother, Chris, a neuorologist, have differing opinions on a treatment Adam received.

Nathan Denette/The Canadian Press/Associated Press

Dr. Paolo Zamboni

For a time in the early 1990s, Gottschalk busked outside the Shinjuku subway station in Tokyo, playing Dylan and Beatles songs, and of all the things M.S. robbed him of, it's the ability to play guitar that he longs for the most. "I miss that part of myself," he told me when we met at his home last winter. Because he can't drive, Gottschalk spends most of his time inside his single-story house north of Tampa, Fla. He works part time operating a natural-perfume business, writes plays and poems, listens to obscure music at high volume and smokes a lot of pot (he says marijuana helps with the chronic pain that's one of M.S.'s more baffling symptoms). Several times a day Gottschalk takes five different drugs: one to keep his M.S. from getting even worse, three for his seizures and an antidepressant that helps him sleep. Dietary supplements cover the buffet in his dining room.

In the last couple of decades, nine new drugs have come on the market to treat M.S.; at least four more are currently being tested on humans. Few diseases have seen such radical transformation of treatment options in such a short time. Yet for all the new options, many of the 2.1 million people worldwide afflicted with the disease (400,000 of them in the United States) have not seen improvements, and some M.S. patients find that the adverse reactions from the drugs aren't worth the benefits.

Gottschalk's neurologist started him on the M.S. drug Copaxone in 2000, but he had a relapse a few years later. So Gottschalk started taking Rebif, giving himself two shots a week until the drug's side effects — severe flulike symptoms for 24 hours — became too much to bear. Next, about once a month for five years, Gottschalk was given an infusion of Tysabri, an even newer M.S. drug. A rare side effect landed him in the hospital in 2010 and almost killed him.

Surfing Facebook one day shortly after the Tysabri scare, Gottschalk learned that an Italian vascular surgeon named Paolo Zamboni had hypothesized that the real cause of M.S. was something called chronic cerebrospinal venous insufficiency, or CCSVI. For decades, doctors have been confident that M.S. comes about because the immune system attacks the brain, though they don't know why it does so. Zamboni contended instead that blocked veins prevent blood from draining from the head, causing iron to back up in the brain and damage nerves that send messages to the body.

Zamboni's first study, published in 2009 in a small neurological journal, purported to find CCSVI in 100 percent of M.S. sufferers at one stage of the disease, and he developed a surgical procedure to treat it: opening the veins that carry blood away from the head with the aim of restoring normal blood flow. This would be done by inflating a small balloon inside the vein to widen the passage, and in rare instances by placing a device to keep it open (as is commonly performed in the arteries of patients with heart disease). Zamboni's study was small, just 65 subjects, and though he had compared them with a control group, he knew which patients had M.S. and which did not. But news of CCSVI traveled quickly, and M.S. patients started seeking diagnostic procedures to see if they had CCSVI, as well as the surgery to treat it.

This article has been revised to reflect the following correction:

Correction: October 29, 2012

An earlier version of this article misstated the surname of a man who underwent what is believed to have been the first surgery in the United States to treat chronic cerebrospinal venous insufficiency (CCSVI). He is Jeff Beal, not Beals.

18.37 | 0 komentar | Read More

Still Waiting for the Narrator in Chief

Illustration by Matt Dorfman. Original photograph by Nikki Kahn/The Washington Post/Getty Images.

Presidents generally don't like to admit mistakes, so it was interesting when Barack Obama owned up to one during an interview with Charlie Rose on CBS last summer. It was the job of the president, Obama said, to "tell a story to the American people that gives them a sense of unity and purpose and optimism," and it was on this score that he had fallen short. Conservatives gleefully mocked the president, saying that the country needed jobs more than it needed stories, and the remark did seem to hint at some genuine denial. After 40-plus months of high unemployment, a president who thinks his mistakes rest not in his policy choices but rather in his ability to articulate them is probably telling himself a story, if no one else.

And yet Obama's admission resonated with his supporters, who can be forgiven for wondering why he hasn't been better at promoting what is, by any standard, an impressive series of accomplishments. (As the comedian Chris Rock tweeted recently: "Only Pres Obama could prevent a depression, end a war, get bin Laden, bring unemployment below 8 percent, then be told he can't run on his record.") In books and speeches before he became president, Obama showed himself to be an evocative storyteller; even the controversy over his memoir, in which Obama condensed some characters into one, says something about his narrative sophistication, his novelistic instinct for developing themes and characters that make his point.

All of which makes it even more baffling that Obama's presidential alter-ego, this grayer and more somber version of his literary self, spent the past four years immersed in legislative minutiae and marching out dull slogans — "an economy built to last," "winning the future" and so on — while failing to advance any larger theory of the moment confronting the country and what it required. "They haven't talked about how the pieces of the puzzle fit together and move us forward from where we've been," says Don Baer, who served as President Clinton's communications director and now runs the public relations giant Burson-Marsteller. "It's been random and unconnected." David Gergen, who advised four presidents on communications, likens the larger story of an administration to a clothesline. "You adopt your clothesline, and then you hang all your policies from it," he told me. "They're missing the clothesline."

If Obama somehow manages to lose an election that seemed well within his grasp a few months ago, this question of how he squandered his narrative mojo will pain Democrats for years to come. As with so much else about this presidency, the answers can probably be traced back to those first overwhelming months after the 2008 election. Remember that John McCain's most effective line of attack against Obama during the campaign was that he was more of a motivational speaker than a leader. And so, having won the election and facing crises on several fronts, the president's advisers were understandably wary of too much speechifying, which might have underscored the idea that Obama was going to orate his way through the presidency while leaving the business of governing to others. As a result, Obama spent much of his first months — the period when he might have been speaking directly to an anxious public, much as Franklin Roosevelt did in a less technological age — holed up with aides and members of Congress, rather than pushing any kind of overarching narrative.

Remember, too, that Obama and Joe Biden were the first president and vice president to be elected directly from the Senate since 1960, and most of the senior aides they brought with them came from Capitol Hill. This had real consequences. Congressional aides know a lot about how to slap around their opponents, but because they're always either taking direction from a president or trying to thwart one, they think very little about how to build support for a governing agenda. A classic case here was the controversial stimulus measure passed in the early days of Obama's presidency; the White House and its allies skillfully managed to win approval for nearly $800 billion in aid to states, long-term investment and tax cuts, but they gave almost no thought to whether the public understood the differences between these categories of spending or the economic reasoning behind them.

Matt Bai is the magazine's chief political correspondent. He last wrote about the economy in Ohio.

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Practicing Yoga, Family Style

Jeff Minton for The New York Times

The Killicks posing near the North Saskatchewan River in Alberta. From left, Sami, 15; Tobi, 13; Gil, 17; Von, 21; Glenna (mother); Tyler (father).

Dropping in on the Killick family, 45 minutes outside Edmonton, Alberta, feels like dropping into a Wes Anderson movie about Canadian rustics. Glenna and Tyler Killick and their four children — Von, 21; Gil, 17; Sami, 15; Tobi, 13 — live off a dirt road in a farmhouse they built themselves. A 1965 Ford Galaxie 500 sits out front, near the cow trough where they all bathed straight through Canadian winters, before they installed indoor plumbing in 2005. Out back are raspberry bushes that won't fruit, chickens that run away and corn that's starting to bolt. "We're terrible farmers!" Glenna says.

For a while, the kids, who are home-schooled, got their exercise in the home-schoolers' basketball league, but they didn't like it much. As Sami, the lone girl, says, "Half the court are people scared of the ball, and the other half are kids whose dad plays with them three hours a day." Then three years ago, Tyler, a plumber, threw out his back on a job, and his client gave him a 10-day pass to a Bikram yoga studio in West Edmonton. Tyler and Glenna practiced for a month and loved it. Then they took their kids. Attending four or five classes a week, the children learned quickly. Tobi was 9 at the time, too young for the 104-degree yoga room, so he sat in the lobby with his siblings while his parents took a class, then with his parents when his siblings took class. Eventually he joined in.

After about a year, a teacher invited the Killick children to train for a yoga competition in Alberta. Yogis have mixed feeling about the discipline being a competitive sport, and the Killicks rarely seek official validation. As Glenna puts it, "We are not institution-style people." But they prepared, did well in Alberta and in June flew to Los Angeles for the International Yoga Asana Championship. Gil, Sami and Tobi placed in their divisions. (Only five boys and eight girls entered the competition.) Gil lost points when he fell out of Peacock Pose a second too soon. "It's a very hero-to-zero scenario," Tyler says.

One rainy day recently, the Killicks drove from the prairie to the studio. Inside, Sami, the family cook (the older boys are trained as plumbers), placed a tin filled with vegan pumpkin muffins in the kitchen to be shared after class. Then she stripped down to a sports bra and hot pants and joined her family in the furnacelike yoga room for the 90-minute class. Gil likes the strength poses; his siblings grouse, "He was born with a six-pack!" Sami, according to her brothers, is a "legalist"; she has to do every posture exactly right. When Sami did Half Moon Pose, pressing her hands together overhead and leaning to one side, the bottom of her rib cage touched the top of her pelvic bone.

Back at home, the kids fanned out in the living room and played music — Sami and Von on guitars, Gil on ukulele, Tobi on a Peruvian box drum. Like an updated Partridge Family, they sang delightful indie-rock covers of "Five Years Time," by Noah and the Whale, and "Hey Ho," by the Lumineers. Along with being good at singing and yoga, the Killicks are also excellent whistlers. Von, who last year declared he was moving out of the house but then decided to stay, explained, "We have a lot of time to practice in the winter."

Shortly after the sun set, the Killicks went down to the basement and, on black interlocking mats near a wall of mirrors, worked more advanced yoga poses. Von pressed into a handstand and then folded his legs in lotus. Sami extended one foot behind her and up over her head, until her ankle rested under her chin. Tobi worked on Bowlegged Peacock, balancing his body in a horizontal plank atop his elbows with his knees bent all the way back. The siblings like the intimacy of family yoga. "The facade is gone," Von says. "Everybody is stripped down to the basics. There's no real hiding."

Elizabeth Weil is a contributing writer for the magazine and the author of a memoir about marriage, ''No Cheating, No Dying.''

Editor: Ilena Silverman

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Safety Lessons From the Morgue

Eric Ogden for The New York Times

Susan P. Baker, an epidemiologist who has spent more than four decades trying to find out why people are dying and what could be done to stop it.

On a bright, chilly morning in February, Susan P. Baker sat in her fifth-floor office at the Johns Hopkins University Bloomberg School of Public Health in Baltimore, staring at her computer screen. She had just completed a search for the word "sightseeing" in a federal database of U.S. aviation crashes between 2000 and 2010. Now she was scrolling through a seemingly endless list of grim case histories of people who were killed or injured when their sightseeing aircraft or balloon crashed.

Richard Holden/Getty Images

Susan Baker demonstrating a car seat in 1983.

A month before, she read a news story about the crash of a tour helicopter in Nevada. Five people died, including a couple celebrating their 25th anniversary. "It made me sad and angry," she recalled. "Such senseless deaths!" So Baker, an epidemiologist, did what she's been doing for more than four decades. She decided to find out why people were dying and what could be done to stop it.

Working with Sarah-Blythe Ballard, a doctoral candidate and Navy flight surgeon, Baker prepared an abstract and sent it to the Aerospace Medical Association. When it's finished, the article will delineate the number of fatalities for each mode of sightseeing flight, including balloon, helicopter and fixed-wing; describe the circumstances that led to each crash, like encounters between hot-air balloons and power lines; and offer suggestions for reducing the risk of a crash — for example, increasing training for pilots on landing in unfavorable wind conditions and avoiding power lines. Then, if everything goes the way it usually does when Baker publishes her work, the article will be picked up by the media, putting pressure on the businesses that run sightseeing flights, as well as the legislative committees and agencies that oversee their operations, to improve the way these flights are conducted. Over time, the hope is, fewer people will die in these sorts of accidents.

Baker has had a hand in more than 250 such research papers, as well as her nearly 40 monographs and textbook chapters and 5 books. She has endlessly lobbied, in person and in print, for gun control and air bags, motorcycle helmets and home sprinkler systems. She has fought to put the discipline of injury prevention on the nation's public-health agenda, leading to the creation of the National Center for Injury Prevention and Control and nearly a dozen injury-research centers at universities and hospitals around the country.

Dr. Gary Smith is the president of the Child Injury Prevention Alliance, in Columbus, Ohio. He is also one of the hundreds of today's injury-prevention leaders who decided on their life's work while sitting in Baker's classroom. "Sue is to injury prevention what Einstein was to theoretical physics," he says. "There were people there before them, some remarkable people, but these two changed everything."

At 82, Baker is still pursuing the grisly facts behind deadly statistics. More than 120,000 Americans die from accidental injuries each year, and Baker believes many of them can be saved. As she explains it, "To say that a car crash is an accident is to say it's a matter of chance, a surprise, but car crashes happen all the time, and the injuries that people sustain in those crashes are usually predictable and preventable."

When Baker started her career in the 1960s, public health was still mostly about preventing disease, not injury. Tuberculosis and influenza killed tens of millions in the first part of the 20th century. To the extent that people were injured or lost their lives in accidents at home or at work or on the roads in between, corporate and government leaders generally viewed that as a cost of doing business, an unfortunate accompaniment to progress. It was the responsibility of the individual to keep himself safe from these dangers.

That focus on individual behavior led to the licensing of drivers and to decades of safety slogans in schools and factories and on the highways. By the 1930s, Burma Shave's billboards were ubiquitous: "Keep well/To the right/Of the oncoming car/Get your close shaves/From the half-pound jar/Burma-Shave." Over the years, though, it became evident that education had its limits, and engineers began examining the environments in which most injuries occurred: homes, workplaces and roadways.

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The 6th Floor Blog: Behind the Body Issue: Dan Buettner on Places Where People Live Longest

In this week's Body Issue, the magazine included an adaptation of new material being published in the second edition of Dan Buettner's book "Blue Zones." (National Geographic is publishing the book next month.) The article described a Greek island where many people live into their late 90s and beyond.

For more than a decade you have been looking into why some people manage to live so long. How did you first get interested in the topic?

I was leading scientific expeditions for National Geographic, often oriented around a mystery or a question. We had done expeditions around the collapse of the ancient Mayan civilization and followed Marco Polo's path across China, and then the Japanese government suggested we do a trip there. We looked around for a good mystery and I stumbled on a World Health Organization finding from 2000 that showed that Okinawa had the longest disability-free life expectancy in the world. I figured that the answer to why had to lie in traditional wisdom, because it is a genetically heterogeneous place. So perhaps they were doing something that made them live for a long time, and I wanted to figure out what that was.

The magazine article focuses on the Greek island Ikaria, but you've looked at other diverse places where people live a really long time. Costa Rica, for example — except unlike Greece, maybe, it's not usually recognized for its healthful diet.

Right, we were working with a demographer who had all the birth and death records. National Geographic spent a lot of money — way over $300,000 — just to do the demographic work before we would go into these places. The longevity phenomenon on the Nicoya Peninsula of Costa Rica is inland, not on the coast where Americans go on vacation. There is a fairly isolated area where Chorotega indigenous people had some contact with Spanish settlers and intermarried — but it has been isolated for a long time. The isolation allowed a certain diet to survive based mostly on beans and squash and a special kind of corn tortilla made with nixtamal, corn that has been soaked in lye, which releases niacin and gives the body access to all the amino acids. Yes, meat and fruit come into the picture, and in some of the bigger cities the American food diet is coming into the picture and that will probably wipe out the Nicoya Peninsula's longevity gains within a generation.

Americans may focus on diet because it seems to be something we can actually change. But you emphasize the communitarian aspects of life in these places. Is that true in that part of Costa Rica?

It's true in all these areas of increased longevity. I like to use the metaphor of collagen. They eat the right way and get physical activity but what holds those behaviors in place like collagen holds your skin in place is belonging and having a sense of purpose, often through a faith-based community. Health habits are as contagious as catching a cold. Another interesting thing about the Nicoya Peninsula is that we had the water there tested, and unlike other parts of Costa Rica, which are volcanic, the Nicoya Peninsula is made from fossilized microscopic seashells. And the water that burbles up through this is very high in calcium. You combine calcium with Vitamin D, which they are getting from the sun, and not coincidentally you have very low rates of hip fractures and fatal falls. The water also has a high magnesium content.

When you first arrive in one of these places that you call blue zones, what's the first thing you notice? Do they all have something obviously in common?

They are culturally or geographically isolated, which isolates them from the forces of globalism. They are all big gardeners — even people in their 100s. There is always a garden out back. Of course there is usually a clean atmosphere, with the exception of the Seventh-day Adventists I looked at in California. It's harder to put the science on this, but after looking at this phenomenon for over a decade, it seems that if you give older people the message that they are needed then they will live much longer. In Sardinia, for example, and Okinawa and to a certain extent in Ikaria, there is no real concept of retirement. As an older person you don't just receive care — you are also expected to cook and help take care of kids or tend the garden. In Ikaria, often they live under the same roofs as their children — or there is a small house for grandma right on the property.

It sounds like the worst threat to Ikaria might be Coca-Cola. These communities seem somewhat removed from capitalism and globalization.

I wouldn't necessarily draw the line politically, although a lot of these people are living a more traditional way of life. I'd point out that all of these particular places are in capitalist countries. But I will tell you that they usually have access to good public health, especially the Costa Ricans. There are little health clinics dotted all over that country with nurse practitioners who make sure kids get their vaccinations or take care of emergency health situations.

So, would you move to Ikaria? Have you found ways to incorporate your findings there into your own life?

Well, yes. I have a garden and I certainly justify my social life, and going out every night, to myself in a different way. You can change your environment, socially, without moving so far. Instead of trying to change your habits — which are always short-term changes and long-term failures — you can model your environment on some of these places like Ikaria. I've reconnected with my church, and I come from a family of gardeners, so planting a garden was an obvious thing to do. Also, remember that Americans move an average of nine and a half times between the age of 18 and when they retire. That's nine opportunities to move somewhere that will make you happier and healthier — somewhere like Ikaria.

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The Island Where People Forget to Die

Andrea Frazzetta/LUZphoto for The New York Times

Stamatis Moraitis tending his vineyard and olive grove on Ikaria. More Photos »

In 1943, a Greek war veteran named Stamatis Moraitis came to the United States for treatment of a combat-mangled arm. He'd survived a gunshot wound, escaped to Turkey and eventually talked his way onto the Queen Elizabeth, then serving as a troopship, to cross the Atlantic. Moraitis settled in Port Jefferson, N.Y., an enclave of countrymen from his native island, Ikaria. He quickly landed a job doing manual labor. Later, he moved to Boynton Beach, Fla. Along the way, Moraitis married a Greek-American woman, had three children and bought a three-bedroom house and a 1951 Chevrolet.

Andrea Frazzetta/LUZphoto for The New York Times

Residents of the island Ikaria in Greece live profoundly long and healthful lives. More Photos »

One day in 1976, Moraitis felt short of breath. Climbing stairs was a chore; he had to quit working midday. After X-rays, his doctor concluded that Moraitis had lung cancer. As he recalls, nine other doctors confirmed the diagnosis. They gave him nine months to live. He was in his mid-60s.

Moraitis considered staying in America and seeking aggressive cancer treatment at a local hospital. That way, he could also be close to his adult children. But he decided instead to return to Ikaria, where he could be buried with his ancestors in a cemetery shaded by oak trees that overlooked the Aegean Sea. He figured a funeral in the United States would cost thousands, a traditional Ikarian one only $200, leaving more of his retirement savings for his wife, Elpiniki. Moraitis and Elpiniki moved in with his elderly parents, into a tiny, whitewashed house on two acres of stepped vineyards near Evdilos, on the north side of Ikaria. At first, he spent his days in bed, as his mother and wife tended to him. He reconnected with his faith. On Sunday mornings, he hobbled up the hill to a tiny Greek Orthodox chapel where his grandfather once served as a priest. When his childhood friends discovered that he had moved back, they started showing up every afternoon. They'd talk for hours, an activity that invariably involved a bottle or two of locally produced wine. I might as well die happy, he thought.

In the ensuing months, something strange happened. He says he started to feel stronger. One day, feeling ambitious, he planted some vegetables in the garden. He didn't expect to live to harvest them, but he enjoyed being in the sunshine, breathing the ocean air. Elpiniki could enjoy the fresh vegetables after he was gone.

Six months came and went. Moraitis didn't die. Instead, he reaped his garden and, feeling emboldened, cleaned up the family vineyard as well. Easing himself into the island routine, he woke up when he felt like it, worked in the vineyards until midafternoon, made himself lunch and then took a long nap. In the evenings, he often walked to the local tavern, where he played dominoes past midnight. The years passed. His health continued to improve. He added a couple of rooms to his parents' home so his children could visit. He built up the vineyard until it produced 400 gallons of wine a year. Today, three and a half decades later, he's 97 years old — according to an official document he disputes; he says he's 102 — and cancer-free. He never went through chemotherapy, took drugs or sought therapy of any sort. All he did was move home to Ikaria.

I met Moraitis on Ikaria this past July during one of my visits to explore the extraordinary longevity of the island's residents. For a decade, with support from the National Geographic Society, I've been organizing a study of the places where people live longest. The project grew out of studies by my partners, Dr. Gianni Pes of the University of Sassari in Italy and Dr. Michel Poulain, a Belgian demographer. In 2000, they identified a region of Sardinia's Nuoro province as the place with the highest concentration of male centenarians in the world. As they zeroed in on a cluster of villages high in Nuoro's mountains, they drew a boundary in blue ink on a map and began referring to the area inside as the "blue zone." Starting in 2002, we identified three other populations around the world where people live measurably longer lives than everyone else. The world's longest-lived women are found on the island of Okinawa. On Costa Rica's Nicoya Peninsula, we discovered a population of 100,000 mestizos with a lower-than-normal rate of middle-age mortality. And in Loma Linda, Calif., we identified a population of Seventh-day Adventists in which most of the adherents' life expectancy exceeded the American average by about a decade.

This article is adapted from new material being published in the second edition of "Blue Zones," by Dan Buettner, out next month from National Geographic.

Editor: Dean Robinson

This article has been revised to reflect the following correction:

Correction: October 28, 2012

An article on Page 36 this weekend about the reasons people on the Greek Island of Ikaria live long lives misstates the period when fasting is practiced by the island's inhabitants. They fast before Orthodox feast days, not during Orthodox feast days.

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My Multiday Massage-a-Thon

Illustrations by Paul Pope

About a month ago, editors from this magazine, which employs me, and from which I am therefore loath to turn down assignments even when they are horrifying, assigned me to get a series of massages and other body treatments here in the coastal town where I live, Wilmington, southeastern N.C., Port City of Progress and Pleasure. There was a semi-legitimate journalistic impulse behind it, but it was also billed as an act of mercy. I'd been traveling and writing a lot for them, spending a lot of time in middle seats on international flights, and my body had reached new levels of vileness. The yellowish gray-green circles under my eyes had a micropebbled texture, and my skin gave off a sebaceousy sheen of coffee-packet coffee. My calves had developed a vague thrombotic throb. It was the kind of premature aging where you think, I'll come back from this but not all the way.

When you feel like that, you don't leap to be naked in rooms with an assortment of strangers while they rub their hands all over your bare flesh — there's probably a fetish group for becoming as physically disgusting as you can and then procuring massages, but that's not my damage. Also, there's something about massage in general that makes me less, not more, relaxed. The boredom of it, the entrapment. Like you, probably, I know a couple of people who go around parties rubbing other people's backs, and I cringe at their approaching hands. One of these shoulder-pirates laughed at me for it once, after I flinched, telling me I needed to "learn to receive love," and I thought, That's probably true, I'd bet I do. Faux-wise passive-aggressive hippie maxims always seem true and wounding in the moment.

Still, everyone, including my mother, who was visiting, said: "Your job! To get paid to get massages!" So I tried to embrace that. It seemed churlish not to. Even my body deserved to be touched, to be kneaded and ministered to. I drove around town checking out different places — only a couple looked sketchy; I think Wilmy has a pretty light scene when it comes to massage of the highway-billboard variety. I made a few appointments and then canceled them. Massage and I were just teasing each other.

Then one morning, inevitably, I woke up with a headache. Not a migraine, but a kind of necky, achy number. I rang up Miller-Motte College, a technical school on Market Street with a locally recognized department in Massage Therapy.

The next morning, a brown-haired young woman who looked to be in her very early 20s — and turned out to be 19 — introduced herself as Victoria and said that she would be my therapist. The room she led me to was spare, with a kind of maroon-gray-olive palette, hotel-conference-room colors. Victoria opened the blinds on the door window — it was one of the things the therapists had to do, so that their teachers could look in.

The erotic element of nonerotic massage is somehow comical. Even to mention it seems louche, but to glide past it is bizarre. My spouse, for instance, would say it's creepy that I noticed it, but if I were blind to it, that would mean I was a sexually dead person, and she wouldn't love me, and would be seen to be keeping me around purely in a "Weekend at Bernie's" kind of way. When you think about it, there's no other situation in life in which a man or woman touches you the way a massage artist touches you except in bed, or on the way there. It doesn't matter if your person is attractive to you or not, and it can be the opposite sex from the one you're attracted to if you're attracted to only one. It's just the simple act of someone rubbing her hands all over you, and not with the precise, deliberate motions of a medical procedure, but with, you hope, a certain tenderness and warmth. Even the traditional phrases — "I'm going to step out; you undress to your comfort level" — imply a problem, that a wrong move could make things uncomfortable. Nothing wrong with all this, of course — it probably adds to the health benefits — I merely mark the static.

I can't say that the first massage penetrated very far. I had thousands of hours of Quasimodo-like keyboard-hunching stored in my torso, so it would have taken a genius to break through in an hour. Thankfully, Wilmington is full of massage places — there's one in every strip mall practically — and I'd soon booked some tables. My take had shifted. The first massage was nice, and now I remembered that I could get unlimited free massages anywhere, which suddenly seemed exciting and like something I'd been cryptically but deeply deserving for a long time. I shaved, I took a shower, I took a couple of walks, I didn't want to be quite as gross for the next one — motivation was creeping in. It's like what they say: If you leave the house, you'll want to go out more.

This article has been revised to reflect the following correction:

Correction: October 28, 2012

An article on Page 30 this weekend about one man's experience in the world of massages and other body treatments misspells the given name of an artist known for his densely-painted, realist studies of the human body.  He was Lucian Freud, not Lucien.

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Practicing Yoga, Family Style

Jeff Minton for The New York Times

The Killicks posing near the North Saskatchewan River in Alberta. From left, Sami, 15; Tobi, 13; Gil, 17; Von, 21; Glenna (mother); Tyler (father).

Dropping in on the Killick family, 45 minutes outside Edmonton, Alberta, feels like dropping into a Wes Anderson movie about Canadian rustics. Glenna and Tyler Killick and their four children — Von, 21; Gil, 17; Sami, 15; Tobi, 13 — live off a dirt road in a farmhouse they built themselves. A 1965 Ford Galaxie 500 sits out front, near the cow trough where they all bathed straight through Canadian winters, before they installed indoor plumbing in 2005. Out back are raspberry bushes that won't fruit, chickens that run away and corn that's starting to bolt. "We're terrible farmers!" Glenna says.

For a while, the kids, who are home-schooled, got their exercise in the home-schoolers' basketball league, but they didn't like it much. As Sami, the lone girl, says, "Half the court are people scared of the ball, and the other half are kids whose dad plays with them three hours a day." Then three years ago, Tyler, a plumber, threw out his back on a job, and his client gave him a 10-day pass to a Bikram yoga studio in West Edmonton. Tyler and Glenna practiced for a month and loved it. Then they took their kids. Attending four or five classes a week, the children learned quickly. Tobi was 9 at the time, too young for the 104-degree yoga room, so he sat in the lobby with his siblings while his parents took a class, then with his parents when his siblings took class. Eventually he joined in.

After about a year, a teacher invited the Killick children to train for a yoga competition in Alberta. Yogis have mixed feeling about the discipline being a competitive sport, and the Killicks rarely seek official validation. As Glenna puts it, "We are not institution-style people." But they prepared, did well in Alberta and in June flew to Los Angeles for the International Yoga Asana Championship. Gil, Sami and Tobi placed in their divisions. (Only five boys and eight girls entered the competition.) Gil lost points when he fell out of Peacock Pose a second too soon. "It's a very hero-to-zero scenario," Tyler says.

One rainy day recently, the Killicks drove from the prairie to the studio. Inside, Sami, the family cook (the older boys are trained as plumbers), placed a tin filled with vegan pumpkin muffins in the kitchen to be shared after class. Then she stripped down to a sports bra and hot pants and joined her family in the furnacelike yoga room for the 90-minute class. Gil likes the strength poses; his siblings grouse, "He was born with a six-pack!" Sami, according to her brothers, is a "legalist"; she has to do every posture exactly right. When Sami did Half Moon Pose, pressing her hands together overhead and leaning to one side, the bottom of her rib cage touched the top of her pelvic bone.

Back at home, the kids fanned out in the living room and played music — Sami and Von on guitars, Gil on ukulele, Tobi on a Peruvian box drum. Like an updated Partridge Family, they sang delightful indie-rock covers of "Five Years Time," by Noah and the Whale, and "Hey Ho," by the Lumineers. Along with being good at singing and yoga, the Killicks are also excellent whistlers. Von, who last year declared he was moving out of the house but then decided to stay, explained, "We have a lot of time to practice in the winter."

Shortly after the sun set, the Killicks went down to the basement and, on black interlocking mats near a wall of mirrors, worked more advanced yoga poses. Von pressed into a handstand and then folded his legs in lotus. Sami extended one foot behind her and up over her head, until her ankle rested under her chin. Tobi worked on Bowlegged Peacock, balancing his body in a horizontal plank atop his elbows with his knees bent all the way back. The siblings like the intimacy of family yoga. "The facade is gone," Von says. "Everybody is stripped down to the basics. There's no real hiding."

Elizabeth Weil is a contributing writer for the magazine and the author of a memoir about marriage, ''No Cheating, No Dying.''

Editor: Ilena Silverman

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Lives: Is My Son’s Purple Hair Asking for Trouble?

One evening in the spring of my son Joseph's freshman year in high school, he brought up something he said he'd been thinking over since the previous summer. "I really want to dye my hair purple," he said.

When he was little, Joe wanted to paint his room purple. It had always been his favorite color. He came out to us a couple of years before and made no secret of his sexual orientation to his fellow students, who, for the most part, supported him. But this would be taking things a step further.

My wife, Jeanne, and I didn't try to argue him out of it; dye, unlike, say, a tattoo, isn't permanent. Besides, adolescence is a time to try on selves. But I did want him to consider the possible consequences.

"You know, Joe, there is a pretty significant possibility that you will get pounded at school." That was certainly what would have happened to a purple-haired me in my high-school days in the '70s, even if purple and gold were the school colors. Joe said that he understood but told me he didn't really think that would happen.

I called around to the local salons in the leafy suburbs west of Newark; none said they could do a purple dye job. So the next Saturday, after Joe's regular discussion for teenagers at the Lesbian, Gay, Bisexual and Transgender Community Center on 13th Street in Manhattan, we headed over to Astor Place Hairstylists, the venerable salon in the East Village.

The colorist tried to talk him out of his purple idea. "Purple is for ladies," she said. "It's not a good color for a boy." She recommended blue. Joe agreed, and she set to work applying the peroxide that would bleach his dark brown hair enough to take the dye.

As his hair was going yellowish white — and his scalp was burning from the harsh chemicals — Joe decided to dig in. He got up and told the colorist, "I really want the purple." She nodded and got out two small jars of dye. After a couple of hours (and about a hundred bucks, with a very nice haircut thrown in), his hair was an eye-popping shade of purple.

We drove back across the Hudson, and Joe reminded me that he wanted to attend the school play that evening. I walked him into the school to buy the ticket and saw the principal from across the entryway. And the principal saw Joseph. His eyes got big. I couldn't read his expression exactly, but if I were to guess, it was one of self-pity — as in, "I'm going to be dealing with this on Monday. . . . "

I went home and posted a few pictures to Facebook with the caption "Joseph Schwartz has decided to see what life is like with purple hair for a while. . . . "

My brother Bob, who is bald, wrote, "I am jealous."

A friend, who is a professor at a top-ranked law school, wrote: "Buy black towels and pillowcases. I speak from experience here."

I waited nervously for something bad to happen, but disaster never came. Then, a few days after going purple, Joe was in the locker room after gym when one of the jocks came up to him and asked, "Why did you dye your hair purple?"

"Because it's awesome," Joe said, with insouciance.

The other boy didn't accept that answer. "Yeah, but — why didn't you dye it orange, or something?"

"Because orange would not look good with my coloring," Joe explained.

The kid became even more insistent and pulled out some of the high-dollar vocabulary words from SAT prep: "But don't you understand — don't you understand — that the color purple has been appropriated by the homosexuals?"

A kid piped up from across the room, "He's really aware of that."

The jock responded, "I was just trying to warn him — "

At that point, another of the jocks came up and slammed Joe's questioner into a bank of lockers. "He can dye his hair hot pink if he wants to," the boy shouted, adding an unprintable expletive along the way. "He can dye it any color he wants!" The two boys walked out of the locker room, arguing with each other about Joe's hair as if it were a controversial call in a football game, a fact that could be debated but not refuted.

Joe later said he felt unsettled, as if a storm had passed over. But in the moment he simply turned to the boy he shared a locker with as they packed up their things. "That was surreal," he said.

John Schwartz is a national correspondent for The Times. His memoir, "Oddly Normal," from which this essay is adapted, will be published next month by Gotham Books.

E-mail submissions for Lives to lives@nytimes.com. Because of the volume of e-mail, the magazine cannot respond to every submission.

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The Island Where People Forget to Die

Andrea Frazzetta/LUZphoto for The New York Times

Stamatis Moraitis tending his vineyard and olive grove on Ikaria. More Photos »

In 1943, a Greek war veteran named Stamatis Moraitis came to the United States for treatment of a combat-mangled arm. He'd survived a gunshot wound, escaped to Turkey and eventually talked his way onto the Queen Elizabeth, then serving as a troopship, to cross the Atlantic. Moraitis settled in Port Jefferson, N.Y., an enclave of countrymen from his native island, Ikaria. He quickly landed a job doing manual labor. Later, he moved to Boynton Beach, Fla. Along the way, Moraitis married a Greek-American woman, had three children and bought a three-bedroom house and a 1951 Chevrolet.

Andrea Frazzetta/LUZphoto for The New York Times

Residents of the island Ikaria in Greece live profoundly long and healthful lives. More Photos »

One day in 1976, Moraitis felt short of breath. Climbing stairs was a chore; he had to quit working midday. After X-rays, his doctor concluded that Moraitis had lung cancer. As he recalls, nine other doctors confirmed the diagnosis. They gave him nine months to live. He was in his mid-60s.

Moraitis considered staying in America and seeking aggressive cancer treatment at a local hospital. That way, he could also be close to his adult children. But he decided instead to return to Ikaria, where he could be buried with his ancestors in a cemetery shaded by oak trees that overlooked the Aegean Sea. He figured a funeral in the United States would cost thousands, a traditional Ikarian one only $200, leaving more of his retirement savings for his wife, Elpiniki. Moraitis and Elpiniki moved in with his elderly parents, into a tiny, whitewashed house on two acres of stepped vineyards near Evdilos, on the north side of Ikaria. At first, he spent his days in bed, as his mother and wife tended to him. He reconnected with his faith. On Sunday mornings, he hobbled up the hill to a tiny Greek Orthodox chapel where his grandfather once served as a priest. When his childhood friends discovered that he had moved back, they started showing up every afternoon. They'd talk for hours, an activity that invariably involved a bottle or two of locally produced wine. I might as well die happy, he thought.

In the ensuing months, something strange happened. He says he started to feel stronger. One day, feeling ambitious, he planted some vegetables in the garden. He didn't expect to live to harvest them, but he enjoyed being in the sunshine, breathing the ocean air. Elpiniki could enjoy the fresh vegetables after he was gone.

Six months came and went. Moraitis didn't die. Instead, he reaped his garden and, feeling emboldened, cleaned up the family vineyard as well. Easing himself into the island routine, he woke up when he felt like it, worked in the vineyards until midafternoon, made himself lunch and then took a long nap. In the evenings, he often walked to the local tavern, where he played dominoes past midnight. The years passed. His health continued to improve. He added a couple of rooms to his parents' home so his children could visit. He built up the vineyard until it produced 400 gallons of wine a year. Today, three and a half decades later, he's 97 years old — according to an official document he disputes; he says he's 102 — and cancer-free. He never went through chemotherapy, took drugs or sought therapy of any sort. All he did was move home to Ikaria.

I met Moraitis on Ikaria this past July during one of my visits to explore the extraordinary longevity of the island's residents. For a decade, with support from the National Geographic Society, I've been organizing a study of the places where people live longest. The project grew out of studies by my partners, Dr. Gianni Pes of the University of Sassari in Italy and Dr. Michel Poulain, a Belgian demographer. In 2000, they identified a region of Sardinia's Nuoro province as the place with the highest concentration of male centenarians in the world. As they zeroed in on a cluster of villages high in Nuoro's mountains, they drew a boundary in blue ink on a map and began referring to the area inside as the "blue zone." Starting in 2002, we identified three other populations around the world where people live measurably longer lives than everyone else. The world's longest-lived women are found on the island of Okinawa. On Costa Rica's Nicoya Peninsula, we discovered a population of 100,000 mestizos with a lower-than-normal rate of middle-age mortality. And in Loma Linda, Calif., we identified a population of Seventh-day Adventists in which most of the adherents' life expectancy exceeded the American average by about a decade.

This article is adapted from new material being published in the second edition of "Blue Zones," by Dan Buettner, out next month from National Geographic.

Editor: Dean Robinson

This article has been revised to reflect the following correction:

Correction: October 27, 2012

An article on Page 36 this weekend about the reasons people on the Greek Island of Ikaria live long lives misstates the period when fasting is practiced by the island's inhabitants. They fast before Orthodox feast days, not during Orthodox feast days.

18.37 | 0 komentar | Read More

My Multiday Massage-a-Thon

Illustrations by Paul Pope

About a month ago, editors from this magazine, which employs me, and from which I am therefore loath to turn down assignments even when they are horrifying, assigned me to get a series of massages and other body treatments here in the coastal town where I live, Wilmington, southeastern N.C., Port City of Progress and Pleasure. There was a semi-legitimate journalistic impulse behind it, but it was also billed as an act of mercy. I'd been traveling and writing a lot for them, spending a lot of time in middle seats on international flights, and my body had reached new levels of vileness. The yellowish gray-green circles under my eyes had a micropebbled texture, and my skin gave off a sebaceousy sheen of coffee-packet coffee. My calves had developed a vague thrombotic throb. It was the kind of premature aging where you think, I'll come back from this but not all the way.

When you feel like that, you don't leap to be naked in rooms with an assortment of strangers while they rub their hands all over your bare flesh — there's probably a fetish group for becoming as physically disgusting as you can and then procuring massages, but that's not my damage. Also, there's something about massage in general that makes me less, not more, relaxed. The boredom of it, the entrapment. Like you, probably, I know a couple of people who go around parties rubbing other people's backs, and I cringe at their approaching hands. One of these shoulder-pirates laughed at me for it once, after I flinched, telling me I needed to "learn to receive love," and I thought, That's probably true, I'd bet I do. Faux-wise passive-aggressive hippie maxims always seem true and wounding in the moment.

Still, everyone, including my mother, who was visiting, said: "Your job! To get paid to get massages!" So I tried to embrace that. It seemed churlish not to. Even my body deserved to be touched, to be kneaded and ministered to. I drove around town checking out different places — only a couple looked sketchy; I think Wilmy has a pretty light scene when it comes to massage of the highway-billboard variety. I made a few appointments and then canceled them. Massage and I were just teasing each other.

Then one morning, inevitably, I woke up with a headache. Not a migraine, but a kind of necky, achy number. I rang up Miller-Motte College, a technical school on Market Street with a locally recognized department in Massage Therapy.

The next morning, a brown-haired young woman who looked to be in her very early 20s — and turned out to be 19 — introduced herself as Victoria and said that she would be my therapist. The room she led me to was spare, with a kind of maroon-gray-olive palette, hotel-conference-room colors. Victoria opened the blinds on the door window — it was one of the things the therapists had to do, so that their teachers could look in.

The erotic element of nonerotic massage is somehow comical. Even to mention it seems louche, but to glide past it is bizarre. My spouse, for instance, would say it's creepy that I noticed it, but if I were blind to it, that would mean I was a sexually dead person, and she wouldn't love me, and would be seen to be keeping me around purely in a "Weekend at Bernie's" kind of way. When you think about it, there's no other situation in life in which a man or woman touches you the way a massage artist touches you except in bed, or on the way there. It doesn't matter if your person is attractive to you or not, and it can be the opposite sex from the one you're attracted to if you're attracted to only one. It's just the simple act of someone rubbing her hands all over you, and not with the precise, deliberate motions of a medical procedure, but with, you hope, a certain tenderness and warmth. Even the traditional phrases — "I'm going to step out; you undress to your comfort level" — imply a problem, that a wrong move could make things uncomfortable. Nothing wrong with all this, of course — it probably adds to the health benefits — I merely mark the static.

I can't say that the first massage penetrated very far. I had thousands of hours of Quasimodo-like keyboard-hunching stored in my torso, so it would have taken a genius to break through in an hour. Thankfully, Wilmington is full of massage places — there's one in every strip mall practically — and I'd soon booked some tables. My take had shifted. The first massage was nice, and now I remembered that I could get unlimited free massages anywhere, which suddenly seemed exciting and like something I'd been cryptically but deeply deserving for a long time. I shaved, I took a shower, I took a couple of walks, I didn't want to be quite as gross for the next one — motivation was creeping in. It's like what they say: If you leave the house, you'll want to go out more.

This article has been revised to reflect the following correction:

Correction: October 27, 2012

An article on Page 30 this weekend about one man's experience in the world of massages and other body treatments misspells the given name of an artist known for his densely painted, realist studies of the human body. He was Lucian Freud, not Lucien.

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Eat: Four Ways to Cook a Pumpkin, No Matter How You Slice It

Marcus Nilsson for The New York Times; Food stylist: Brian Preston-Campbell

You're carving your jack-o'-lanterns now; soon you'll buy canned pumpkin for pie. Join the club. Almost no one in this country cooks fresh pumpkin.

Yet the pumpkin — or those squashes whose non-English names translate as "pumpkin" — is a staple the world over, turned into substantial dishes celebrated for their sweetness and density. So-called sugar pumpkins, which are smaller and more flavorful than anything you might carve, are the best for cooking and available even in supermarkets. But you can tackle the big boys too.

All four of the recipes are global classics, and all use cubes of pumpkin flesh; admittedly, getting at the good stuff is the tricky part. And of course you can use any orange-fleshed squash in any pumpkin recipe. But given the season, let's assume you're working with a pumpkin. Start just as if you were carving a jack-o'-lantern: cut a circle around the stem, then pull up on the stem and discard it. Using the cavity as a handle, peel the pumpkin with a sturdy vegetable peeler. Yes, it will take a while.

Then cut the pumpkin in half and scrape out the seeds with an ice cream scoop or heavy spoon. You can discard the seeds or roast them. (More on that in a moment.) Cut or scrape off any excess string and cut the pumpkin into approximately 1-inch cubes. (A 4-pound pumpkin will yield about 8 cups of cubes.)

Every recipe is substantial, even if you make them vegetarian. (To make them without meat, simply skip the beef in the Japanese and Afghan recipes, and substitute more pumpkin for lamb in the Moroccan dish.)

Now the seeds, which you can do even if you are just going to put a candle in your pumpkin. Rinse all the goop off them and pat dry with paper towels; let them dry overnight. Then toss with olive or neutral oil, salt and, if you like, spices. Roast them on a baking sheet at 350 for at least 15 minutes, stirring occasionally, until crisp and golden.

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Riff: How I Learned to Love Yoko Ono

Illustration by Tom Gauld

Yoko Ono is not pretty, she is not easy, her paintings aren't recognizable, her voice is not melodious, her films are without plot and her Happenings make no sense. One of her paintings you are told to sleep on. One of her paintings you are told to burn. One of her paintings isn't a painting at all — it's you going outside and looking at the sky. Most of her stuff is not even there. This is why I love her. This is why we need her. We have too much stuff already. It clutters our view, inward and outward.

We need more impossible in our culture. Go out and capture moonlight on water in a bucket, she commands. Her art is instructions for tasks impossible to complete. We already have a billion lovely things and a million amazing artists who have honed their talent and have lorded it above us. People who have achieved the highest of the possible. People wearing their roles as artist or writer or filmmaker or spokesman as a suit of armor or as an invisibility cloak or as an intimidatingly, unacquirably tasteful outfit.

Even other artists can't figure out Ono or accept her as legit, nor can she obey the club rules. Her stuff is all wrong. She tells you to spend a whole year coughing. Listen to a two-minute song of recorded silence, music lovers. As for you, the most imperialist and arms-profiteering superpower in the history of the world, give peace a chance.

There are two schools of art. One is what is made beautiful by the artist; the other is to make way for the viewer to see or feel what is already beautiful.

The first is to make something ornate and unreachably special with skills. The viewer or listener is awed, their belief regarding the order of things is confirmed and they are reminded by this unachievable beauty of their own powerlessness. And I do love that kind of art, the beautiful kind.

The other way to make art is to tear down what's between us and nature, us and eternity, us and the realization that everything is already perfect. In this experience of art, the viewer or listener loses respect for the current order or arrangement of civilization and thus becomes powerful, like King Kong, and outside civilization, like God — or simply like the shuffling janitor who is pleased with his own work and sleeps well.

I always admired the Japanese use of negative space in decorating and the unspoken in conversations (or so I gather from old films). Ono uses the negative positively. She is a classically trained operatic student who uses silence or screeches in her singing; a recipient of coveted gallery showings who hangs unpainted canvases with requests for you to pound holes in them or to walk on them. She was the first woman admitted to the philosophy program at Gakushuin University in Tokyo, and could travel the world discoursing multisyllabically, yet instead she tries lying in bed and not lifting a finger to cure a war.

It takes an enormous lack of ego to not put your imprint on everything you do, to not employ your learning and position. To stand back, to hold back, to keep your mouth shut. To yell with your silence, when you know you very well could make soothing and welcomed sounds at the drop of a hat. She could sing; she knows how. And being a Beatles wife could have been a magic charm — but she wasn't interested. It takes willpower to overpower the will to power. To be accepted, to be thought nice, is traditionally woman's power. That is something Ono doesn't need.

She uses nonexistence in art, and she uses absence in her private life. Her first husband was the composer Toshi Ichiyanagi. They grew apart then flew apart. Her second husband, the film producer and promoter Tony Cox, same thing. Only he took their daughter, Kyoko, and hid with her, joining a religious cult.

At first Ono allowed her third husband, John Lennon, to do what came naturally to him: to hunt for the lost daughter through private detectives and the courts. Only after John's death, when Ono wrote an open letter to her grown daughter, saying how deeply she loved her but that "you should not feel guilty if you choose not to reach me" and that she would no longer try to locate Kyoko, did her daughter slowly come back into her life.

This essay was adapted from "Reaching Out With No Hands: Reconsidering Yoko Ono," published this month by Backbeat Books.

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The 6th Floor Blog: Five-Ku: Short Poems on the Career of Russell Crowe

Bud White to John Nash;
Maximus to "Insider."
Rave reviews, all earned.

Reportedly turned
Down the role of Wolverine.
Hugh Jackman says thanks!

Channeled young Brando.
Will soon channel old Brando
Reprising Jor-El.

A shame his expert
Acting sometimes eclipsed by
Phone-throwing antics.

To answer famous
"Gladiator" entreaty:
We are entertained.

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Practicing Yoga, Family Style

Jeff Minton for The New York Times

The Killicks posing near the North Saskatchewan River in Alberta. From left, Sami, 15; Tobi, 13; Gil, 17; Von, 21; Glenna (mother); Tyler (father).

Dropping in on the Killick family, 45 minutes outside Edmonton, Alberta, feels like dropping into a Wes Anderson movie about Canadian rustics. Glenna and Tyler Killick and their four children — Von, 21; Gil, 17; Sami, 15; Tobi, 13 — live off a dirt road in a farmhouse they built themselves. A 1965 Ford Galaxie 500 sits out front, near the cow trough where they all bathed straight through Canadian winters, before they installed indoor plumbing in 2005. Out back are raspberry bushes that won't fruit, chickens that run away and corn that's starting to bolt. "We're terrible farmers!" Glenna says.

For a while, the kids, who are home-schooled, got their exercise in the home-schoolers' basketball league, but they didn't like it much. As Sami, the lone girl, says, "Half the court are people scared of the ball, and the other half are kids whose dad plays with them three hours a day." Then three years ago, Tyler, a plumber, threw out his back on a job, and his client gave him a 10-day pass to a Bikram yoga studio in West Edmonton. Tyler and Glenna practiced for a month and loved it. Then they took their kids. Attending four or five classes a week, the children learned quickly. Tobi was 9 at the time, too young for the 104-degree yoga room, so he sat in the lobby with his siblings while his parents took a class, then with his parents when his siblings took class. Eventually he joined in.

After about a year, a teacher invited the Killick children to train for a yoga competition in Alberta. Yogis have mixed feeling about the discipline being a competitive sport, and the Killicks rarely seek official validation. As Glenna puts it, "We are not institution-style people." But they prepared, did well in Alberta and in June flew to Los Angeles for the International Yoga Asana Championship. Gil, Sami and Tobi placed in their divisions. (Only five boys and eight girls entered the competition.) Gil lost points when he fell out of Peacock Pose a second too soon. "It's a very hero-to-zero scenario," Tyler says.

One rainy day recently, the Killicks drove from the prairie to the studio. Inside, Sami, the family cook (the older boys are trained as plumbers), placed a tin filled with vegan pumpkin muffins in the kitchen to be shared after class. Then she stripped down to a sports bra and hot pants and joined her family in the furnacelike yoga room for the 90-minute class. Gil likes the strength poses; his siblings grouse, "He was born with a six-pack!" Sami, according to her brothers, is a "legalist"; she has to do every posture exactly right. When Sami did Half Moon Pose, pressing her hands together overhead and leaning to one side, the bottom of her rib cage touched the top of her pelvic bone.

Back at home, the kids fanned out in the living room and played music — Sami and Von on guitars, Gil on ukulele, Tobi on a Peruvian box drum. Like an updated Partridge Family, they sang delightful indie-rock covers of "Five Years Time," by Noah and the Whale, and "Hey Ho," by the Lumineers. Along with being good at singing and yoga, the Killicks are also excellent whistlers. Von, who last year declared he was moving out of the house but then decided to stay, explained, "We have a lot of time to practice in the winter."

Shortly after the sun set, the Killicks went down to the basement and, on black interlocking mats near a wall of mirrors, worked more advanced yoga poses. Von pressed into a handstand and then folded his legs in lotus. Sami extended one foot behind her and up over her head, until her ankle rested under her chin. Tobi worked on Bowlegged Peacock, balancing his body in a horizontal plank atop his elbows with his knees bent all the way back. The siblings like the intimacy of family yoga. "The facade is gone," Von says. "Everybody is stripped down to the basics. There's no real hiding."

Elizabeth Weil is a contributing writer for the magazine and the author of a memoir about marriage, ''No Cheating, No Dying.''

Editor: Ilena Silverman

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Eat: Four Ways to Cook a Pumpkin, No Matter How You Slice It

Marcus Nilsson for The New York Times; Food stylist: Brian Preston-Campbell

You're carving your jack-o'-lanterns now; soon you'll buy canned pumpkin for pie. Join the club. Almost no one in this country cooks fresh pumpkin.

Yet the pumpkin — or those squashes whose non-English names translate as "pumpkin" — is a staple the world over, turned into substantial dishes celebrated for their sweetness and density. So-called sugar pumpkins, which are smaller and more flavorful than anything you might carve, are the best for cooking and available even in supermarkets. But you can tackle the big boys too.

All four of the recipes are global classics, and all use cubes of pumpkin flesh; admittedly, getting at the good stuff is the tricky part. And of course you can use any orange-fleshed squash in any pumpkin recipe. But given the season, let's assume you're working with a pumpkin. Start just as if you were carving a jack-o'-lantern: cut a circle around the stem, then pull up on the stem and discard it. Using the cavity as a handle, peel the pumpkin with a sturdy vegetable peeler. Yes, it will take a while.

Then cut the pumpkin in half and scrape out the seeds with an ice cream scoop or heavy spoon. You can discard the seeds or roast them. (More on that in a moment.) Cut or scrape off any excess string and cut the pumpkin into approximately 1-inch cubes. (A 4-pound pumpkin will yield about 8 cups of cubes.)

Every recipe is substantial, even if you make them vegetarian. (To make them without meat, simply skip the beef in the Japanese and Afghan recipes, and substitute more pumpkin for lamb in the Moroccan dish.)

Now the seeds, which you can do even if you are just going to put a candle in your pumpkin. Rinse all the goop off them and pat dry with paper towels; let them dry overnight. Then toss with olive or neutral oil, salt and, if you like, spices. Roast them on a baking sheet at 350 for at least 15 minutes, stirring occasionally, until crisp and golden.

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