Illini buzzer-beater upsets No. 1 Hoosiers, 74-72

CHAMPAIGN, Ill. (AP) — Tyler Griffey made the easiest and biggest shot of his career.

The senior forward took an inbounds pass and made a wide-open layup with 0.9 seconds to play to give Illinois a 74-72 victory over No. 1 Indiana on Thursday night, the fifth straight week the nation's top-ranked team lost.

Hoosiers coach Tom Crean, whose team has been No. 1 for a total of seven weeks this season, doesn't have a reason for the recent weekly changes on top of the poll.

"I can't answer that. I'm not sure," Crean said. "I just know that these games are 40-minute games. We played at a high level for most of the game."

The Hoosiers were in charge until the final 3 1-2 minutes when the Illini (16-8, 3-7 Big Ten) finally put together a run to take and then retake the lead.

"I know this, when we turn the ball over we're not very good," Crean said. "And the biggest difference tonight was 28 points off turnovers to our 16."

And nothing could have been worse for the Hoosiers (20-3, 8-2) than the way the game ended.

With 0.9 seconds left Griffey left defenders Cody Zeller and Christian Watford behind on an inbounds play from the baseline, took the pass from Brandon Paul and delivered the uncontested buzzer-beater for the Illini.

The shot sent hundreds of students onto the court — holding their collective breath as officials checked the replay to make sure the clock hadn't beaten Griffey — and Paul and fellow guard D.J. Richardson hugged and teared up with relief.

Illinois had lost eight of 11 since starting the season 12-0. The Illini had been ranked as high as No. 10 and were now falling to the bottom of the Big Ten.

Griffey, accustomed to struggling in recent weeks, seemed surprised with the ease he was able to make the game-winner.

"I just made a simple curl cut and left two guys behind me, and Brandon got off a heck of a pass," he said. "Zeller and Watford were both right in front of me and just kind of stayed there."

Crean, whose team just moved into the No. 1 spot after knocking off then-No. 1 Michigan on Saturday, said the play was a lot like the other breakdowns in the Hoosiers' game that let Illinois climb back from a 12-point halftime deficit.

"We didn't communicate," Crean said.

"They're very deserving of the win, they never gave in," he added, but he qualified that with, "We didn't put them away when we had the opportunities."

Indiana's loss drops them into a three-way tie for first in the Big Ten with Michigan and Michigan State. For the Illini, the win means a move out of 10th in the 12-team conference up into a ninth-place tie with Iowa.

More importantly, it's a potential lifeline for an Illini team that still has to face No. 18 Minnesota on the road Sunday and had been watching its season slip away.

"It was good to get back to having that toughness and togetherness and trust that we needed," Illinois coach John Groce said.

Illinois hadn't beaten a No. 1 team since a 2004 win over Wake Forest. But the Illini had won nine of the last 10 against the Hoosiers in Champaign. And this season, whatever else has gone wrong, Illinois has delivered against the big boys. Coming into Thursday night the Illini had already beaten three teams now in the top 15: No. 6 Gonzaga, No. 10 Ohio State and No. 14 Butler.

Richardson had 23 points for Illinois, Paul had 21 and Griffey finished with 14 points and eight rebounds.

Zeller led Indiana with 14 points, while Will Sheehey had 13, Watford 12 and Jordan Hulls 11.

Indiana shot 50 percent from the field (25 of 50), 52.9 percent from 3-point range (9 of 17) and 93 percent from the free throw line (13 of 14). The Hoosiers led by an 8- to 10-point margin for most of the second half.

And when 6-foot-11 Nnanna Egwu fouled out with just under 5 minutes to play, Indiana looked in control. Egwu is the only Illini player with the size to realistically match up with the 7-0 Zeller.

Watford made two free throws after Egwu's fifth foul and, at 69-59, the Illini looked done.

But with the clock under 3 minutes, Richardson went on a run of his own, first burying consecutive 3-pointers and then hitting a midrange jumper on the run to tie the game at 70 with 1:17 to play.

Oladipo's layup put the Hoosiers back on top with 50 seconds left, but Paul answered with two free throws, the first banked in, to tie the score again at 72.

With the clock under 30 seconds, Indiana had the ball for what would have been a last shot but Oladipo fumbled the ball. Richardson picked it up and sprinted down court. Oladipo slapped Richardson's layup out of bounds to set up the final play.

Groce credited Richardson for sparking the comeback.

"I thought he was absolutely terrific on both ends of the floor," Groce said. "He battled, he fought."

Griffey was benched several weeks ago after a blowout loss at Wisconsin. On a team that had lost its shooting touch, the senior forward had grown especially cold. And, though one of Illinois' bigger players at 6-9, he wasn't adding much to the inside presence the Illini desperately needed.

The play that brought him to life Thursday, though, had nothing to do with Illinois' late surge. Griffey hit a 3-pointer less than 4 minutes into the second half. He had missed 20 straight 3-point attempts, dating to the start of the Big Ten season.

"I said to myself, 'Finally,'" said Griffey, who said he has been doing so much extra shooting that he's had to have regular ice treatments on his wrist.

Groce said that, even after he benched Griffey, he never gave up on him.

"I just have told him numerous times here I believe in him," the first-year Illinois coach said. "I do."

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Well: Old Age and Motorcycles Are a Dangerous Mix

If you’re over 40 and planning to hop on a motorcycle, take care. Compared with younger riders, the odds of being seriously injured are high.

That is the message of a new study, published this week in the journal Injury Prevention, which found that older bikers are three times as likely to be severely injured in a crash as younger riders.

The percentage of older bikers on the road is quickly rising, and their involvement in accidents is a growing concern. Nationwide, from 1990 to 2003, the percentage of motorcyclists over age 50 soared from roughly 1 in 10 to about 1 in 4. At the same time, the average age of riders involved in motorcycle crashes has also been climbing. Injury rates among those 65 and older jumped 145 percent from 2000 to 2006 alone.

Because of the increase in motorcycle ridership among older Americans, the researchers, led by Tracy Jackson, a graduate student in the epidemiology department at Brown University, wanted a closer look at their injury patterns. So she and her colleagues combed through a federal database of motorcycle crashes that were serious enough to require emergency medical care. That yielded about 1.5 million incidents involving motorcyclists 20 or older from 2001 to 2008.

The researchers then split them into groups: those in their 20s and 30s, another group between 40 and 59, and those 60 and older.

Over all, the study showed that injury rates for all three groups were on the rise. But the rise was steepest for the oldest riders. Compared with the youngest motorcyclists, those who were 60 and older were two and a half times as likely to end up with serious injuries, and three times as likely to be admitted to a hospital. The riders who were middle age were twice as likely as their younger counterparts to be hospitalized.

For older riders, the consequences of a collision were also especially alarming. Older and middle-aged bikers were more likely to sustain fractures and dislocations, and they had a far greater chance of ending up with injuries to internal organs, including brain damage.

The researchers speculated that it was very likely that a number of factors played a role in older riders’ higher injury rates. For one, declines in vision and reaction time may make older riders more prone to mistakes that end up in collisions. Another theory is that older riders tend to ride bigger bikes, “which may be more likely to roll or turn over,” Ms. Jackson said.

Then there is the greater fragility that comes with age. Older riders may be involved in the same types of accidents as younger riders, Ms. Jackson said, but in some cases, a collision that a 20-year-old would walk away from might send a 65-year-old to the hospital.

“Your bones become more brittle, and you lose muscle mass as you get older,” she said. “It could just be a matter of aging and the body being less durable.”

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European Leaders Struggle to Bridge Budget Gaps

BRUSSELS — European Union leaders on Friday morning edged closer to agreeing a budget worth nearly €1 trillion, or $1.3 trillion, to support farming, transportation and other infrastructure, as well as big research projects for the 27-nation bloc.

But after 15 hours of talks, the leaders were still seeking unanimity while also attempting to satisfy the wide array of national interests demanding attention.

The budget is negotiated every seven years and involves furious horse-trading as leaders focus on getting the best deal for their own countries’ citizens, rather than emphasizing pan-European considerations.

The marathon session was the second attempt to reach a deal on the funding package, which should run from 2014 to 2020, after the first attempt collapsed in November.

Another failure to strike a deal on a sum of money that represents only about 1 percent of the Union’s Gross Domestic Product would be a severe embarrassment for the leaders, who already have spent years bickering over how to save the euro.

The European Commission, the bloc’s policymaking arm, had sought an increase in the overall budget of around 5 percent to more than €1 trillion.

Herman Van Rompuy, the president of the European Council, which represents E.U. leaders, pruned that sum to about €973 billion at the previous summit in November.

On Friday morning, Mr. Van Rompuy presented further revisions lowering the overall sum to about €960 billion but holding down the amount of cash governments pay up-front to around €908 billion.

That formula was designed, in part, to satisfy countries like Britain and the Netherlands that pay more into the budget than they receive, while also accommodating the demands of countries like France and Italy that want to maintain generous payments for agriculture and infrastructure.

Some of the deepest cuts would be made to pan-European projects to improve transport, energy, and digital services that are overseen by the commission. About €1 billion in cuts would be made to the part of the budget used to employ 55,000 people, including 6,000 translators, most of them in Brussels, who run the Union’s day-to-day affairs.

Expert national advisors were reviewing the proposals on Friday morning, and leaders were expected to reconvene for further talks.

Leaders also were wrestling over demands by some countries to renew a system of rebates that raises the costs for other countries.

One of the complications in the current round of negotiations has been the call for budgetary rigor from leaders like David Cameron, the British prime minister, who says the Union should tighten its belt at a time when many European governments have been compelled to impose stringent budget cuts.

Mr. Cameron, in particular, has earned the enmity of some European leaders by demanding a renegotiation of Britain’s treaty with the Union and promised a referendum on his nation’s membership in 2017.

Reflecting growing irritation with Britain among a number of European leaders, Martin Schulz, the president of the European Parliament, told a news conference late on Thursday night that leaders should not go out of their way to appease Mr. Cameron.

Because Britain could be outside the bloc by later this decade, there was little need to make concessions to Mr. Cameron that potentially jeopardized “the security of our financial planning,” Mr. Schulz suggested.

Mr. Van Rompuy, the president of the European Council, had intended to start the session during the mid-afternoon on Thursday to force leaders to make their complaints clear in a roundtable session rather than being allowed to break into small groups.

But his plan was derailed, and the first roundtable session was delayed until late in the evening, as leaders formed the kind of pre-summit huddles that he seemingly wanted to avoid.

President François Hollande of France was an hour late to a meeting during the afternoon with Mr. Cameron, Angela Merkel, the German chancellor, and Mr. Van Rompuy.

Mr. Hollande’s lateness was a sign of French displeasure with British demands that included strict limits on agriculture spending cherished by French farmers, according to an E.U. diplomat, who spoke on condition of anonymity because of the sensitivity of the talks.

Even if leaders eventually agree to a deal, it faces still more hurdles before it becomes law at the European Parliament, which has the power to veto the budget.

Some of the most influential figures in Parliament have already signaled that they are prepared to reject a budget that foresees spending less on Europe in the years ahead.

Guy Verhofstadt, the head of the alliance of liberals in the Parliament, called on Thursday for a full-revision clause to be inserted into the budget, so that it could be increased after three years if economic conditions improved.

Mr. Schulz, the president of the Parliament, said on Thursday that he would not approve a budget that ended up widening the overall gap between the amount of cash paid up-front by governments and the somewhat higher amounts known as commitments, which make up the overall budget.

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IHT Rendezvous: 'Rigoletto' in Vegas, 'Manon Lescaut' in the Metro

BRUSSELS—The day after the Metropolitan Opera in New York unveiled a production of Verdi’s “Rigoletto” set in Las Vegas during the 1960s, I was in Belgium, where another exercise in operatic updating is underway at the Théâtre royal de la Monnaie. Here, Mariusz Trelinski’s staging of Puccini’s “Manon Lescaut” — through Feb. 8 — situates the opera in the waiting room of a subway station.

Opera goers are often incensed by productions like these, yet updating is potentially a relatively mild device. Once the new setting is established, the action can play out coherently and essentially traditionally. This happened with “La Bohème” last summer at the Salzburg Festival, staged by Damiano Michieletto.

One could object to the hovel of the bohemians’ Parisian loft, but there was something touching about seeing Anna Netrebko as Mimì crouched in the snow behind a hotdog truck near the city’s peripheral expressway, as she overheard Rodolfo and Marcello discussing her fragile health.

By contrast, La Scala’s recent “Lohengrin” directed by Claus Guth, which focused on the repressiveness of German society at the time of the opera’s composition and, in Mr. Guth’s fanciful interpretation, its bizarre effects on the psyche of the title character, counts as truly radical.

The Met’s take on “Rigoletto” had a widely acknowledged antecedent in Jonathan Miller’s production of the opera for the English National Opera, which was set in New York’s Little Italy and seen in that city on a 1984 tour. The Met’s new production by Michael Mayer is reportedly less successful. Writing in The New York Times, Anthony Tommasini detected “dynamic elements in this colorful, if muddled and ill-defined ‘Rigoletto’” but noted that “there are big holes” in Mr. Mayer’s concept. The criticism is directed not so much at the updating itself but the lack of disciplined follow-through.

The updating of “Manon Lescaut,” which is specified to take place in the 18th century, comes off as inherently misguided. Boris Kudlicka’s chic-looking set is essentially all in black, although city lights are sometimes visible, as if seen from a moving train. A system map is on one wall, pay telephones on another.

The mismatch is apparent from the first measures of Puccini’s sparkling orchestral introduction to Act 1. This is music designed for the outdoors—a public square in Amiens—not a space underground. It announces something special is in the works, not dreary routine. It conveys youthful high spirits, not gloom. Also, the mores of pre-revolutionary France are important in the opera.

Whether Mr. Trelinski’s conception of Manon herself is an outgrowth of his updating, or the other way around, it robs her of her allure. When, early on, the smitten Des Grieux declares his love for her, Manon sits at the end of a bar wearing a red coat and dark glasses and smoking a cigarette—the very image of a prostitute. Manon is a material girl all right, but one with such irresistible femininity she gets what she wants from men without having to market herself. You never sense this here. Further, a demimonde element weighs on the first two acts. Manon’s benefactor, Geronte (the bass Giovanni Furlanetto, in excellent voice), is depicted as a crime figure, and there is some curious activity involving topless girls and golf clubs.

Mr. Trelinski’s approach also intensifies an acknowledged structural weakness of the opera. All the opera’s gaiety is concentrated in the first two acts, whereas Act 3 and 4—in which Manon is deported from France and then dies in the New World—are uniformly gloomy. But here, Acts 1 and 2 are gloomy too.

Mr. Trelinski, who is artistic director of the Teatr Wielki in Warsaw, where the production originated, is a respected director with some notable achievements. I have admired his double bill of Bartok’s “Bluebeard’s Castle” and Tchaikovsky’s “Iolanta,” which will be seen at the Met in a future season. His work here has some redeeming aspects, especially in Act 4. Puccini’s setting for this act—a vast desert near the outskirts of New Orleans—is one of opera’s most implausible, so it is no great loss to see it supplanted. Fascinatingly, Mr. Trelinski ensures that Des Grieux suffers here as much as Manon does, as he becomes delusional and, apparently, starts to see double. A second Manon appears, whom Des Grieux cannot seem to distinguish from the first.

Carlo Rizzi presides over a colorful reading of the score and a cast headed by an excellent pair of lovers in Eva-Maria Westbroek and Brandon Jovanovich. When the two sang their big duet in Act 2, you could forget about the production and become wrapped up in Puccini’s drama. Ms. Westbroek’s commanding soprano is a bit large for Manon, whose music can profit from greater tonal delicacy. Still, she offers some splendid singing, apart from some difficulty on top, and gives an especially gripping account of Manon’s final aria, “Solo, perduta, abbandonata.”

In this production Des Grieux emerges as the more emotionally vibrant lover, and Mr. Janovich’s clear, virile singing makes the most of the opportunity. Unfortunately, he was in ill health and departed the performance after Act 2, but the intervention of Hector Sandoval, the alternate Des Grieux, allowed the performance, which was streamed to movie theaters, to continue without a hitch. He sang well and knew intricacies of the staging, flaws and all.

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Signing Day: Ole Miss muscles in on power programs

Alabama. Ohio State. Michigan. Florida. Notre Dame. Mississippi?

Ole Miss muscled in on the powerhouses that usually dominate national signing day, landing some of the most sought-after prospects in the country on college football's annual first-Wednesday-in-February frenzy.

The Rebels, coming off a promising 7-6 season in their first season under coach Hugh Freeze, had the experts swooning by signing three of the bluest chips still on the board and building a well-rounded class otherwise.

"I do think (this class) has the possibility of being a program changer," Freeze said. "But it's all on paper right now.

The day started with defensive end Robert Nkemdiche from Loganville, Ga., rated the No. 1 recruit in the country by just about everyone who ranks them, deciding to join his brother, Denzel, in Oxford, Miss.

"I feel like it's the right place for me," Nkemdiche said after slipping on a red Ole Miss cap. "I feel like they can do special things and they're on the rise. I feel like going to play with my brother, we can do something special."

Nkemdiche originally committed to Clemson last year, then backed off that and narrowed his picks down to LSU, Florida and Mississippi — and the Rebels beat the big boys.

They weren't done. Coaches in the Ole Miss war room were exchanging hugs and high-fives again a couple hours later when Laremy Tunsil, a top-rated offensive tackle from Lake City, Fla., picked the Rebels over Florida State and Georgia.

"Tunsil to Ole Miss I think was the biggest surprise of the whole (recruiting season)," said JC Shurburtt, national recruiting director for 247Sports.com.

And, as if the Ole Miss needed more good news, highly touted defensive back Antonio Conner from nearby Batesville, Miss., chose the Rebels over national champion Alabama.

Ole Miss also landed Laquon Treadwell from Crete, Ill., one of the best receiver prospects in the country. He made a verbal commitment to the Rebels back in December, and sealed the deal Wednesday, the first day high school players can sign binding letters of intent.

The end result was a class good enough to even catch the attention of LeBron James.

"Ole Miss ain't messing around today! Big time recruits coming in. SEC is crazy," the NBA MVP posted on his Twitter account.

Crazy good. While the Rebels racked up, it's important to remember they still have plenty of ground to gain on the rest of their conference.

Nick Saban reloaded the Crimson Tide with a class that Rivals.com ranked No. 1 in the country.

SEC powers Florida, LSU and Georgia pulled in typically impressive classes. SEC newcomer Texas A&M cracked the top 10 of several rankings. Even Vanderbilt, coming off a nine-win season, broke into the top 25.

It's the cycle of life in the SEC, which has won seven straight BCS championships. Stock up on signing day and scoop up those crystal footballs at season's end.

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SLIPPING AWAY FROM USC

Signing day didn't do much to soothe the scars left from a difficult season for Southern California.

NCAA sanctions limited the number of scholarships coach Lane Kiffin and the Trojans could hand out this year, and then as signing day approached USC had several players who had given verbal commitments change their minds.

The most notable defection on signing day was five-star defensive back Jalen Ramsey of Brentwood, Tenn., who flipped to Florida State. Defensive end Jason Hatcher from Louisville, Ky., bailed on USC and signed with Kentucky, and defensive end Torrodney Prevot from Houston not only reneged on his USC commitment, but he landed at Pac-12-rival Oregon.

"People expected (Prevot) to flip from USC, but they thought it would be to Texas A&M," Shurburtt said.

USC's class won't be lacking blue chippers. Quarterback Max Browne from Washington is considered the next in a long line of topflight Trojans quarterbacks, and Kenny Bigelow from Maryland is rated among the best defensive linemen in the nation.

Kiffin will be banking on quality to make up for the lack of quantity, but that's a precarious way to play a game as uncertain as recruiting.

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IF MOMMA'S NOT HAPPY ...

Alex Collins, a top running back prospect out of Plantation, Fla., announced on Monday night that he was going to Arkansas instead of Miami.

It was considered a huge victory for new Razorbacks coach Bret Bielema.

But on Wednesday morning, when it was time to make it official, Collins' letter of intent didn't come spinning through the fax machine in Fayetteville, Ark.

There were some odd reports about Collins' mother not being happy with her son's decision to go so far from home.

College coaches aren't allowed to talk about specific players before they sign, but Bielema did acknowledge during his signing day news conference that Arkansas' class of 22 players could "grow by one."

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THE BIG TWO

Ohio State and Michigan received two thumbs up from experts on their signing day classes. They all had the Buckeyes and Wolverines around top five in the country.

After that, there was a drop off. Nebraska received solid grades and Penn State, despite NCAA sanctions that limited its class to 17 signees, held up pretty well.

"That's a tribute to the job (Penn State coach) Bill O'Brien and the staff did," Shurburtt said.

But signing day 2013 signaled that Urban Meyer's Buckeyes and Brady Hoke's Wolverines are primed to pull away from most of the Big Ten, and maybe — just maybe — give the league a team or two that can challenge those SEC teams for a national title.

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BUILT TO LAST

Notre Dame followed up its best season in more than two decades with a recruiting class that coach Brian Kelly hopes can keep the Fighting Irish contending for more national titles.

The class includes a famous name in Torii Hunter Jr., the son of the All-Star outfielder. Hunter Jr. is a top-notch receiver prospect, though he broke his leg during an All-Star game and it could be a while before he's back on the football field.

Linebacker Jaylon Smith from Fort Wayne, Ind., is generally regarded as the jewel of a class that experts have ranked among the best in the country.

"I love agreeing with experts," Kelly said.

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BASEBALL OR FOOTBALL?

Oklahoma hopes it has found the next Sam Bradford in Cody Thomas, a pocket passer from Colleyville, Texas.

One small problem. Thomas is also a big-time baseball player who could draw interest in the major league draft this summer.

"We wouldn't have pursued him if we didn't feel there was a great chance he'd be playing football," Oklahoma coach Bob Stoops said.

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QUOTABLE

South Carolina coach Steve Spurrier said recruiting classes "don't always pan out. Of course, they always seem to pan out at Alabama."

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AP Sports Writer David Brandt in Oxford, Miss., and Associated Press Writer Tom Coyne in South Bend, Ind., contributed.

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Follow Ralph D. Russo at www.Twitter.com/ralphdrussoap

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Well: Think Like a Doctor: A Confused and Terrified Patient

The Challenge: Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.

The Presenting Problem:

A 55-year-old man who is recovering from a devastating injury in a rehabilitation facility suddenly becomes confused, frightened and paranoid.

The Patient’s Story:

The patient, who was recovering from a terrible injury and was too weak to walk, had been found on the floor of his room at the extended care facility, raving that there were people out to get him. He was taken to the emergency room at the Waterbury Hospital in Connecticut, where he was diagnosed with a urinary tract infection and admitted to the hospital for treatment. Doctors thought his delirium was caused by the infection, but after 24 hours, despite receiving the appropriate antibiotics, the patient remained disoriented and frightened.

A Sister’s Visit:

The man’s sister came to visit him on his second day in the hospital. As she walked into the room she was immediately struck by her brother’s distress.

“Get me out of here!” the man shouted from his hospital bed. “They are coming to get me. I gotta get out of here!”

His blue eyes darted from side to side as if searching for his would-be attackers. His arms and legs shook with fear. He looked terrified.

For the past few months, the man had been in and out of the hospital, but he had been getting better — at least he had been improving the last time his sister saw him, the week before. She hurried into the bustling hallway and found a nurse. “What the hell is going on with my brother?” she demanded.

A Long Series of Illnesses:

Three months earlier, the patient had been admitted to that same hospital with delirium tremens. After years of alcohol abuse, he had suddenly stopped drinking a couple of days before, and his body was wracked by the sudden loss of the chemical he had become addicted to. He’d spent an entire week in the hospital but finally recovered. He was sent home, but he didn’t stay there for long.

The following week, when his sister hadn’t heard from him for a couple of days, she forced her way into his home. There she found him, unconscious, in the basement, at the bottom of his staircase. He had fallen, and it looked as if he may have been there for two, possibly three, days. He was close to death. Indeed, in the ambulance on the way to the hospital, his heart had stopped. Rapid action by the E.M.T.’s brought his heart back to life, and he made it to the hospital.

There the extent of the damage became clear. The man’s kidneys had stopped working, and his body chemistry was completely out of whack. He had a severe concussion. And he’d had a heart attack.

He remained in the intensive care unit for nearly three weeks, and in the hospital another two weeks. Even after these weeks of care and recovery, the toll of his injury was terrible. His kidneys were not working, so he required dialysis three times a week. He had needed a machine to help him breathe for so long that he now had to get oxygen through a hole that had been cut into his throat. His arms and legs were so weak that he could not even lift them, and because he was unable even to swallow, he had to be fed through a tube that went directly into his stomach.

Finally, after five weeks in the hospital, he was well enough to be moved to a short-term rehabilitation hospital to complete the long road to recovery. But he was still far from healthy. The laughing, swaggering, Harley-riding man his sister had known until that terrible fall seemed a distant memory, though she saw that he was slowly getting better. He had even started to smile and make jokes. He was confident, he had told her, that with a lot of hard work he could get back to normal. So was she; she knew he was tough.

Back to the Hospital:

The patient had been at the rehab facility for just over two weeks when the staff noticed a sudden change in him. He had stopped smiling and was no longer making jokes. Instead, he talked about people that no one else could see. And he was worried that they wanted to harm him. When he remained confused for a second day, they sent him to the emergency room.

You can see the records from that E.R. visit here.

The man told the E.R. doctor that he knew he was having hallucinations. He thought they had started when he had begun taking a pill to help him sleep a couple of days earlier. It seemed a reasonable explanation, since the medication was known to cause delirium in some people. The hospital psychiatrist took him off that medication and sent him back to rehab that evening with a different sleeping pill.

Back to the Hospital, Again:

Two days later, the patient was back in the emergency room. He was still seeing things that weren’t there, but now he was quite confused as well. He knew his name but couldn’t remember what day or month it was, or even what year. And he had no idea where he was, or where he had just come from.

When the medical team saw the patient after he had been admitted, he was unable to provide any useful medical history. His medical records outlined his earlier hospitalizations, and records from the nursing home filled in additional details. The patient had a history of high blood pressure, depression and alcoholism. He was on a long list of medications. And he had been confused for the past several days.

On examination, he had no fever, although a couple of hours earlier his temperature had been 100.0 degrees. His heart was racing, and his blood pressure was sky high. His arms and legs were weak and swollen. His legs were shaking, and his reflexes were very brisk. Indeed, when his ankle was flexed suddenly, it continued to jerk back and forth on its own three or four times before stopping, a phenomenon known as clonus.

His labs were unchanged from the previous visit except for his urine, which showed signs of a serious infection. A CT scan of the brain was unremarkable, as was a chest X-ray. He was started on an intravenous antibiotic to treat the infection. The thinking was that perhaps the infection was causing the patient’s confusion.

You can see the notes from that second hospital visit here.

His sister had come to visit him the next day, when he was as confused as he had ever been. He was now trembling all over and looked scared to death, terrified. He was certain he was being pursued.

That is when she confronted the nurse, demanding to know what was going on with her brother. The nurse didn’t know. No one did. His urinary tract infection was being treated with antibiotics, but he continued to have a rapid heart rate and elevated blood pressure, along with terrifying hallucinations.

Solving the Mystery:

Can you figure out why this man was so confused and tremulous? I have provided you with all the data available to the doctor who made the diagnosis. The case is not easy — that is why it is here. I’ll post the answer on Friday.

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Rules and Regulations: Post your questions and diagnosis in the comments section below.. The correct answer will appear Friday on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

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Profound Weight of Layoffs Seen in Survey

Layoffs have touched nearly every American household in some fashion over the last few years, according to new survey data to be released Thursday by the John J. Heldrich Center for Workforce Development at Rutgers University.

Joe Raedle/Getty Images

Lissette Marquez, center, and Amiel Ali looked for jobs last week in Miami with the help of a South Florida Workforce customer service representative, Nelson Munoz, left.

While about 8 percent of Americans are unemployed, nearly a quarter of Americans say they were laid off at some point during the recession or afterward, according to the survey. More broadly, nearly eight in 10 say they know someone in their circle of family and friends who has lost a job.

“This to me is why the recession was so all-consuming and is likely to influence the American psyche,” said Cliff Zukin, a public policy and political science professor at Rutgers and co-author of the report. “Almost everyone, four out of five, were directly or one step removed from unemployment and all that goes with it financially, socially, psychologically.”

The survey presented a bleak view of the economic future.

A majority of Americans say they think it will be at least six years before the economy is made whole again, if ever. Three in 10 said the economy would never fully recover from the Great Recession.

“Despite significant improvements in the nation’s labor market, American workers’ concerns about unemployment, the job market, job security and the future of the economy have not changed much since we conducted a similar survey in August 2010,” the report said.

Just a third of Americans surveyed in this poll, conducted from Jan. 9-16, said they thought the economy would be better next year, the same share that said so two years earlier.

Of those laid off in recent years, nearly a quarter said they still had not found a job. Re-employment rates for older workers have been particularly bad, with nearly two-thirds of unemployed people 55 and older saying they actively sought a job for more than a year before finding one or had still not found work.

Not surprisingly, those who are unemployed are especially downbeat about many economic issues in addition to their own finances. Of those who were jobless and looking for work, 31 percent said their jobless benefits had run out and 58 percent said they were concerned their benefits would run out before they found work.

Of those who have found work, nearly half say their current job is a step down from the one they lost, and a slim majority say they earn less than they did in their previous job. A quarter of those re-employed said they thought that the hit to their standard of living would be permanent.

The reliance on one’s personal network and savings rather than the social safety net showed up frequently in the survey data.

More people reported borrowing money from friends and family than reported using food stamps. A third cut back on doctors’ visits or medical treatment. A quarter of the unemployed said they had enrolled in retraining programs of some kind; half of them reported paying for the education on their own or through family assistance. Twenty-three percent received some type of government financing for their training programs.

Unemployed workers were more likely than employed workers to say that the government is primarily responsible for helping the jobless. But even then, a majority of the unemployed thought that workers and employers were more responsible for getting people back to work than the government was.

Americans over all were also somewhat less critical of bankers this time than they were two years earlier. About one in three (35 percent) respondents attributed high unemployment levels to the actions of Wall Street, compared with 45 percent in 2010.

Americans were most likely to attribute high unemployment to cheap foreign labor. Four in 10 also said they believed illegal immigrants were taking Americans’ job opportunities — which does not bode well for political support for an amnesty program now being discussed in Washington.

Most people surveyed lost at least some of their savings. Asked about their financial health, six in 10 Americans said their finances would not improve in the next few years; just 16 percent said their family finances were already back to prerecession levels or suffered no loss in the first place.

More educated, better-off people were substantially more likely to report being as financially secure as they were before the recession began.

Responses are based on an online survey conducted by GfK using a nationally representative sample of 1,090 adults. The margin of sampling error is plus or minus three percentage points.

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IHT Rendezvous: IHT Quick Read: Feb. 6

NEWS Individual strikes by Predator and Reaper drones are almost never discussed publicly by U.S. officials. But the clandestine war will receive a rare moment of public scrutiny on Thursday, when its chief architect, John O. Brennan, the White House counterterrorism adviser, faces a Senate confirmation hearing as President Obama’s nominee for C.I.A. director. Robert F. Worth reports from Sana, Yemen, and Mark Mazzetti and Scott Shane from Washington.

Bulgaria’s interior minister announced that two of the people behind a July 18 bombing, which killed five Israeli tourists, a Bulgarian bus driver and the bomber, were believed to be members of the military wing of Hezbollah. The finding could have wide-reaching repercussions for Europe’s détente with the Lebanese militant group. Nicholas Kulish and Matthew Brunwasser report from Sofia, and Eric Schmitt from Washington.

President Mahmoud Ahmadinejad made the first visit by an Iranian leader to Egypt since the two countries broke off diplomatic relations three decades ago. Kareem Fahim and Mayy El Sheikh report from Cairo.

The House of Commons voted overwhelmingly to approve a bill legalizing same-sex marriage in Britain, indicating that the bill is assured of passage as it moves through further legislative stages. John F. Burns and Alan Cowell report from London.

Zhu Ruifeng, who became a celebrity of sorts after posting online a sex video involving a Chinese government official, says he will release more videos involving others. Andrew Jacobs reports from Beijing.

Dell announced that had agreed to go private in a $24 billion deal led by its founder and the investment firm Silver Lake, in the biggest leveraged buyout since the financial crisis. Michael J. de la Merced and Quentin Hardy report.

Liberty Global, the international cable company owned by the American billionaire John C. Malone, agreed to buy the British cable company Virgin Media for about $16 billion. Mark Scott reports from London and Eric Pfanner from Paris.

Asia Pulp and Paper, one of the largest pulp and paper producers in the world, said that it had stopped clearing natural forests across its supply chains in Indonesia, accelerating an earlier commitment to do so by 2015. Sara Schonhardt reports from Jakarta.

ARTS Have you ever awakened from a dream wanting to replay events? That’s just the start of the appeal of the West End revival of “Old Times,” the Harold Pinter play being presented with its two exemplary actresses, Kristin Scott Thomas and Lia Williams, swapping roles. Matt Wolf reviews from London.

The Netherlands Opera perseveres in presenting imaginative repertory absorbingly staged. Last week it turned to a masterpiece of the 19th century with an uplifting new production of Rossini’s final opera, “Guillaume Tell.” George Loomis reviews from Amsterdam.

SPORTS The Olympic champion Lindsey Vonn, whose record-breaking ski racing career has frequently mixed stirring triumph with frightening spills, tore two knee ligaments in a tumbling crash Tuesday and will need reconstructive surgery. Kelley McMillan reports from Schladming, Austria, and Bill Pennington from New York.

When England and Brazil face off Wednesday in London, the two soccer teams will feature players who will have the chance to show they now have the responsibility to match their sizable talents. Rob Hughes reports from London.

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Braun says he used Fla clinic owner as consultant

NEW YORK (AP) — Milwaukee Brewers slugger Ryan Braun said the person who ran the Florida clinic being investigated by Major League Baseball was used only as a consultant on his drug suspension appeal last year.

"I have nothing to hide," Braun said in a statement released by his representatives on Tuesday night.

Earlier in the day, Yahoo Sports reported the 2011 NL MVP's name showed up three times in records of the Biogenesis of America LLC clinic. Yahoo said no specific performance-enhancing drugs were listed next to his name.

The Miami New Times recently released clinic documents that purportedly linked Alex Rodriguez, Gio Gonzalez, Melky Cabrera and other players to purchases of banned drugs from the now-closed anti-aging center.

Rodriguez and Cabrera were on the list with Braun that also included New York Yankees catcher Francisco Cervelli and Baltimore Orioles infielder Danny Valencia.

Braun said his name was in the Biogenesis records because of an issue over payment to Anthony Bosch, who ran the clinic near Miami.

"There was a dispute over compensation for Bosch's work, which is why my lawyer and I are listed under 'moneys owed' and not on any other list," Braun said.

"I have nothing to hide and have never had any other relationship with Bosch," he said. "I will fully cooperate with any inquiry into this matter."

On Tuesday, MLB officials asked the Miami New Times for the records the alternative newspaper obtained for its story.

Asked specifically about Braun's name in the documents before the five-time All-Star released his statement, MLB spokesman Pat Courtney said: "Aware of report and are in the midst of an active investigation in South Florida."

Braun tested positive during the 2011 postseason for elevated testosterone levels. He maintained his innocence and his 50-game suspension was overturned during spring training last year when arbitrator Shyam Das ruled in favor of Braun due to chain of custody issues involving the sample.

With that, Braun became the first major leaguer to have a drug suspension overturned.

"During the course of preparing for my successful appeal last year, my attorneys, who were previously familiar with Tony Bosch, used him as a consultant. More specifically, he answered questions about T/E ratio and possibilities of tampering with samples," Braun said.

The T/E ratio is a comparison of the levels of testosterone to epitestosterone.

Braun led the NL in homers (41), runs (108) and slugging percentage (.595) last season while batting .319 with 112 RBIs and 30 stolen bases. He finished second to San Francisco catcher Buster Posey in MVP balloting."

Cervelli, who spent nearly all of last season in Triple-A, posted a statement on Twitter later Tuesday night.

"Following my foot injury in March 2011, I consulted with a number of experts, including BioGenesis Clinic, for (cont)," Cervelli posted, "(cont)legal ways to aid my rehab and recovery. I purchased supplements that I am certain were not prohibited by Major League Baseball."

An email sent to Valencia's agent was not returned.

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Economic Scene: Immigration Reform Issue: The Effect on the Budget

The stars could hardly have shone brighter on the prospects for immigration reform than in the early months of 2007.

The coalition pushing for change included the oddest of bedfellows — roping together business groups like the United States Chamber of Commerce with the Service Employees International Union, the fastest-growing union in the country. It had an impeccable bipartisan pedigree, including President George W. Bush and Senator Jon Kyl, a staunchly conservative Republican, as well as the Democrats’ liberal lion, Senator Ted Kennedy.

The economy was growing. The unemployment rate was at its lowest level since the dot-com bubble burst six years before. And the flaws of our immigration laws — impotent to stop a river of unauthorized immigrants drawn across the border by job opportunities — were obvious to all.

Immigration reform, however, was not to be.

Immigrants’ rights groups balked at the hurdles put in immigrants’ path toward legalization. The A.F.L.-C.I.O. hated a provision creating temporary work visas, arguing that it was a license for businesses to bring in cheap foreign labor. Then, a Senate Democrat, Byron Dorgan, offered the coup de grâce with an amendment to phase out the worker visa program after five years. Though proposed at the behest of organized labor, the amendment got the support of some of the most anti-union Republicans in the Senate. And it killed the entire enterprise, stripping away corporate America’s main reason to support a deal.

Today, the economy is not growing much. Unemployment remains stubbornly high. Yet President Obama thinks the stellar alignment may be  better than six years ago. He is proposing a wholesale change to the same flawed immigration laws. He trusts that Republicans, who lost the Hispanic vote by an enormous margin in November, cannot afford to further alienate Hispanics by voting against their top priority.

Despite the strong case for an overhaul, however, changing our immigration laws may be tougher than the president appears to believe. While we may have overcome some of the obstacles of 2007, reform will probably face deep-seated opposition from many Americans — including most conservative Republicans — to what they will view as a potentially large expansion of welfare.

President Obama’s proposal is based on principles similar to those of the 2007 attempt: a path to citizenship for millions of illegal immigrants in the country, a legal channel for future immigrant workers and their families, and a plan to better enforce the nation’s borders and immigration laws.

Yet immigration reform today means something quite different than it did in 2007. Notably, the elements needed to stop the flow of illegal immigrants north are much less important to the enterprise. The Obama administration has already spent huge amounts of money on border enforcement. Today, border policing costs about $18 billion a year — nearly 50 percent more than it did in 2006. And deportations have soared. What’s more, illegal immigration has slowed to a trickle, as Mexico has grown more robustly than the United States. The illegal immigrant population has even been shrinking in the last few years. And it may continue to do so as the Mexican population of prime migration-age people stops growing.

Also, many employers have already gotten some of what they wanted: the number of workers entering the United States on temporary visas for low-end jobs in agriculture and other industries has increased sharply.

“The discussion is in a different environment,” said Gordon H. Hanson, an expert on the economics of immigration at the University of California, San Diego. “The flow of new immigrants is not the story anymore.”

This might help the cause of reform in some ways. It could allow the discussion about work visas to focus on the highly educated workers coveted by technology companies and pre-empt the kind of argument between business and labor over visas for cheap immigrant workers that sank reform in 2007. The A.F.L.-C.I.O., for instance, has heartily embraced President Obama’s plan.

But what supporters of an overhaul of immigration law seem to be overlooking is that these very changes could also make it more difficult to build a coalition across the political divide. If reform is mainly about granting citizenship to 11 million mostly poor illegal immigrants with relatively little education, it is going to land squarely in the cross hairs of our epic battle about taxes, entitlements and the role of government in society.

It’s hard to say with precision what impact offering citizenship would have on the budget, but the chances are good that it would cost the government money. Half to three-quarters of illegal immigrants pay taxes, according to studies reviewed in a 2007 report by the Congressional Budget Office. And they are relatively inexpensive, compared with Americans of similar incomes. Their children can attend public schools at government expense — putting a burden on state and local budgets. But they are barred from receiving federal benefits like the earned-income tax credit, food stamps and Medicaid. Only their American-born children can get those.

Government revenue might not change much with legalization. Most illegal immigrants who don’t pay taxes probably work in the cash economy — as nannies or gardeners — where tax compliance among citizens is low. Costs, of course, would increase. Once they became citizens, immigrants would be entitled to the same array of government benefits as other Americans. For Social Security and Medicare alone, offering citizenship to illegal immigrants would mean losing a subsidy worth several billion dollars a year in payroll taxes from immigrants who can’t collect benefits in old age.

The White House and other backers of reform have made much of a 2007 Congressional Budget Office analysis concluding that the failed immigration overhaul would have increased government revenue by $48 billion over a decade while adding only $23 billion to direct spending on entitlements and other programs. But the report also said that including the costs of carrying out the new law would actually increase the budget deficit by $18 billion over the decade and several billion a year after that. What’s more, it noted that most of the expected new tax revenue came from new immigrant workers, not from the newly legalized population.

Our history suggests we could have much to gain by turning illegal immigrants into citizens and putting an end to unauthorized immigration. The last time we permitted illegal immigrants to legalize, in 1986, incomes jumped for those who took advantage of the opportunity. Their children became more proficient in English and completed more years of school — becoming more productive and paying more taxes over their lifetimes.

But the same history underscores how immigration sets off fears about further sharing of government resources. Ten years after the immigration reform of 1986, reeling from some public anger, Congress passed a law barring legal immigrants from means-tested government services. The same issue is likely again to be a major flash point. Professor Hanson pointed to “the older white man who sees his entitlements at risk because of the demands placed by legalization on our fiscal resources.”

Conservative Republicans set on cutting government spending share those concerns. And for all their reasons to reach out to Hispanics, they might not find making illegal immigrants legal politically advantageous. On Tuesday, Republicans in the House argued against granting citizenship to illegal immigrants at all.

Hispanics are more liberal than the general population on economic matters, polls suggest, and more supportive of Big Government initiatives. Granting them citizenship would give them the vote.

As Steven A. Camarota, director of research at the Center for Immigration Studies, an advocacy group in Washington that favors more limits on immigration, said, “They will see legalization as a voter-registration drive for Democrats.”

E-mail: eporter@nytimes.com; Twitter: @portereduardo

This article has been revised to reflect the following correction:

Correction: February 5, 2013

An earlier version misspelled the first name of one of the two United States senators from Arizona.  His name is Jon Kyl, not John.

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