insert witty title here

A long-running row over a move to rename the South African capital, Pretoria, [to Tshwane] is a reminder of the popular significance attached to city names - and the sensitivities that can be stirred by trying to change them.

Pretoria was named after a settler and folk hero from the Afrikaner group, which went on to create the apartheid system. It is now expected to take the name Tshwane, after a black tribal leader who ruled long before white colonisation. The name also means "we are the same" in the Tswana language...

...The trend, of course, extends beyond post-colonial Africa.
In some cases, cities are renamed to assert local pronunciation over foreign.

The Burmese government has decreed the capital there should be known as Yangon - and not as Rangoon, as spelled by the British after they annexed the city in 1852.

In 1949, Chinese communist leader Mao Zedong ordered that the Chinese capital should be rendered in the Latin script as Beijing, a closer approximation of the way it is pronounced by its local, Mandarin-speaking inhabitants.

Until then, it had been largely referred to in the wider world as Peking - said to reflect Cantonese pronunciation, as heard by foreigners in Hong Kong...

...Renaming cities has been one way in which India has sought to reclaim national identity since throwing off British colonial rule in 1947.

The British colonial capital, Calcutta, was renamed Kolkata in 1999, following the renaming of Bombay as Mumbai and Madras as Chennai in the mid-1990s.

Popular lore has it that the names Bombay and Madras originate from the language of early Portuguese colonisers...

...But their renaming was not without controversy. Opinion polls at the time suggested local people were divided over the renaming.

"The weather will be just as sultry in Chennai as it used to be in Madras. But are we Indians so insecure in our independence that we still need to prove to ourselves that we are free?" asked Indian writer and UN diplomat Shashi Tharoor in a newspaper column in 2002...

...Modernisation

The renaming of cities can also reflect their boom or decline. The Japanese port city of Edo (literally "Door to the Bay") was renamed Tokyo ("Eastern Capital") in 1868, when the city became the formal capital...

...Sometimes cities can even mark changing civilisations. The Turkish city now known as Istanbul has been through many reincarnations.

It was founded as the Greek city of Byzantium, becoming Constantinople under the Romans, and then conquered by the Ottomans to be reborn as Istanbul.

The history of St Petersburg reflects political twists in Russia's past.

It was founded in 1703 on the marshlands next to the river Neva on the order of Peter the Great, who wanted to match the splendour of European ports. He named it after his patron saint, Peter.

But as the European powers went to war in 1914, the name was changed to Petrograd to sound less German. Ten years later, the city was renamed Leningrad in honour of the deceased leader of the Russian revolution.

The city's inhabitants voted to revert to the name St Petersburg in a referendum in 1991, following the collapse of the Soviet Union - but there was significant dissent...

...Yet other cities' names can reflect a cult of personality.
In 1993, Turkmenistan's main port was renamed Turkmenbashi in honour of President Saparmyrat Niyazov.

The name means "leader of all Turkmen", and is the title Mr Niyazov took when he went from being communist leader of Soviet Turkmenistan to the independent country's president for life.

An oil refinery, airports, numerous towns, farms and even a meteorite which landed in the republic in 1998 have all been named after Mr Niyazov.

Dr. Hager's Family Values
by AYELISH MCGARVEY

[from the May 30, 2005 issue of The Nation]

Late last October Dr. W. David Hager, a prominent obstetrician-gynecologist and Bush Administration appointee to the Advisory Committee for Reproductive Health Drugs in the Food and Drug Administration (FDA), took to the pulpit as the featured speaker at a morning service. He stood in the campus chapel at Asbury College, a small evangelical Christian school nestled among picturesque horse farms in the small town of Wilmore in Kentucky's bluegrass region. Hager is an Asburian nabob; his elderly father is a past president of the college, and Hager himself currently sits on his alma mater's board of trustees. Even the school's administrative building, Hager Hall, bears the family name.

That day, a mostly friendly audience of 1,500 students and faculty packed into the seats in front of him. With the autumn sunlight streaming through the stained-glass windows, Hager opened his Bible to the Old Testament Book of Ezekiel and looked out into the audience. "I want to share with you some information about how...God has called me to stand in the gap," he declared. "Not only for others, but regarding ethical and moral issues in our country."

For Hager, those moral and ethical issues all appear to revolve around sex: In both his medical practice and his advisory role at the FDA, his ardent evangelical piety anchors his staunch opposition to emergency contraception, abortion and premarital sex. Through his six books--which include such titles as Stress and the Woman's Body and As Jesus Cared for Women, self-help tomes that interweave syrupy Christian spirituality with paternalistic advice on women's health and relationships--he has established himself as a leading conservative Christian voice on women's health and sexuality.

And because of his warm relationship with the Bush Administration, Hager has had the opportunity to see his ideas influence federal policy. In December 2003 the FDA advisory committee of which he is a member was asked to consider whether emergency contraception, known as Plan B, should be made available over the counter. Over Hager's dissent, the committee voted overwhelmingly to approve the change. But the FDA rejected its recommendation, a highly unusual and controversial decision in which Hager, The Nation has learned, played a key role. Hager's reappointment to the committee, which does not require Congressional approval, is expected this June, but Bush's nomination of Dr. Lester Crawford as FDA director has been bogged down in controversy over the issue of emergency contraception. Crawford was acting director throughout the Plan B debacle, and Senate Democrats, led by Hillary Clinton and Patty Murray, are holding up his nomination until the agency revisits its decision about going over the counter with the pill.

When Hager's nomination to the FDA was announced in the fall of 2002, his conservative Christian beliefs drew sharp criticism from Democrats and prochoice groups. David Limbaugh, the lesser light in the Limbaugh family and author of Persecution: How Liberals Are Waging Political War Against Christianity, said the left had subjected Hager to an "anti-Christian litmus test." Hager's valor in the face of this "religious profiling" earned him the praise and lasting support of evangelical Christians, including such luminaries as Charles Colson, Dr. James Dobson and Franklin Graham, son of the Rev. Billy Graham.

Back at Asbury, Hager cast himself as a victim of religious persecution in his sermon. "You see...there is a war going on in this country," he said gravely. "And I'm not speaking about the war in Iraq. It's a war being waged against Christians, particularly evangelical Christians. It wasn't my scientific record that came under scrutiny [at the FDA]. It was my faith.... By making myself available, God has used me to stand in the breach.... Just as he has used me, he can use you."

Up on the dais, several men seated behind Hager nodded solemnly in agreement. But out in the audience, Linda Carruth Davis--co-author with Hager of Stress and the Woman's Body, and, more saliently, his former wife of thirty-two years--was enraged. "It was the most disgusting thing I've ever heard," she recalled months later, through clenched teeth.

According to Davis, Hager's public moralizing on sexual matters clashed with his deplorable treatment of her during their marriage. Davis alleges that between 1995 and their divorce in 2002, Hager repeatedly sodomized her without her consent. Several sources on and off the record confirmed that she had told them it was the sexual and emotional abuse within their marriage that eventually forced her out. "I probably wouldn't have objected so much, or felt it was so abusive if he had just wanted normal [vaginal] sex all the time," she explained to me. "But it was the painful, invasive, totally nonconsensual nature of the [anal] sex that was so horrible."

Not once during the uproar over Hager's FDA appointment did any reporter solicit the opinion of the woman now known as Linda Davis--she remarried in November 2002 to James Davis, a Methodist minister, and relocated to southern Georgia--on her husband's record, even though she contributed to much of his self-help work in the Christian arena (she remains a religious and political conservative). She intermittently thought of telling her story but refrained, she says, out of respect for her adult children. It was Hager's sermon at Asbury last October that finally changed her mind. Davis was there to hear her middle son give a vocal performance; she was prepared to hear her ex-husband inveigh against secular liberals, but she was shocked to hear him speak about their divorce when he took to the pulpit.

"In early 2002," Hager told the churchgoers that day, "my world fell apart.... After thirty-two years of marriage, I was suddenly alone in a new home that we had built as our dream home. Time spent 'doing God's will' had kept me from spending the time I needed to nourish my marriage." Hager noted with pride that in his darkest hour, Focus on the Family estimated that 50 million people worldwide were praying for him.

Linda Davis quietly fumed in her chair. "He had the gall to stand under the banner of holiness of the Lord and lie, by the sin of omission," she told me. "It's what he didn't say--it's the impression he left."

David Hager is not the fringe character and fundamentalist faith healer that some of his critics have made him out to be. In fact, he is a well-credentialed doctor. In Kentucky Hager has long been recognized as a leading Ob-Gyn at Lexington's Central Baptist Hospital and a faculty member at the University of Kentucky's medical school. And in the 1990s several magazines, including Modern Healthcare and Good Housekeeping, counted him among the best doctors for women in the nation.

Yet while Hager doesn't advocate the substitution of conservative Christianity for medicine, his religious ideology underlies an all-encompassing paternalism in his approach to his women patients. "Even though I was trained as a medical specialist," Hager explained in the preface to As Jesus Cared for Women, "it wasn't until I began to see how Jesus treated women that I understood how I, as a doctor, should treat them." To underscore this revelation, Hager recounted case after case in which he acted as confidant, spiritual adviser and even father figure to his grateful patients. As laid out in his writings, Hager's worldview is not informed by a sense of inherent equality between men and women. Instead, men are expected to act as benevolent authority figures for the women in their lives. (In one of his books, he refers to a man who raped his wife as "selfish" and "sinful.") But to model gender relations on the one Jesus had with his followers is to leave women dangerously exposed in the event that the men in their lives don't meet the high standard set by God Himself--trapped in a permanent state of dependence hoping to be treated well.

In tandem with his medical career, Hager has been an aggressive advocate for the political agenda of the Christian right. A member of Focus on the Family's Physician Resource Council and the Christian Medical and Dental Society, Hager assisted the Concerned Women for America in submitting a "Citizen's Petition" to the FDA in August 2002 to halt distribution and marketing of the abortion pill, RU-486. It was this record of conservative activism that ignited a firestorm when the Bush Administration first floated his name for chairman of the FDA's advisory committee in the fall of 2002. In the end, the FDA found a way to dodge the controversy: It issued a stealth announcement of Hager's appointment to the panel (to be one of eleven members, not chairman) on Christmas Eve. Liberals were furious that they weren't able to block his appointment. For many months afterward, an outraged chain letter alerting women to the appointment of a man with religious views "far outside the mainstream" snaked its way around the Internet, lending the whole episode the air of urban legend.

Back in Lexington, where the couple continued to live, Linda Hager, as she was still known at the time, was sinking into a deep depression, she says. Though her marriage had been dead for nearly a decade, she could not see her way clear to divorce; she had no money of her own and few marketable skills. But life with David Hager had grown unbearable. As his public profile increased, so did the tension in their home, which she says periodically triggered episodes of abuse. "I would be asleep," she recalls, "and since [the sodomy] was painful and threatening, I woke up. Sometimes I acquiesced once he had started, just to make it go faster, and sometimes I tried to push him off.... I would [confront] David later, and he would say, 'You asked me to do that,' and I would say, 'No, I never asked for it.'"

I first heard of Davis's experience in 2004 through a friend of hers. After a few telephone conversations, she agreed to have me fly down to see her in her modest parsonage in Georgia, to tell me her story on the record. With her mod reading glasses, stylish bob and clever outfits, Davis, 55, is a handsome woman with a sharp wit. She spoke with me over two days in January.

Linda Davis (née Carruth) first met David Hager on the campus of Asbury College in 1967. "On the very first date he sat me down and told me he was going to marry me," Davis remembers. "I was so overwhelmed by this aggressive approach of 'I see you and I want you' that I was completely seduced by it."

Davis, a former beauty queen, was a disengaged student eager to get married and start a family. A Hager-Carruth marriage promised prestige and wealth for the couple; her father was a famous Methodist evangelist, and his father was then president of Asbury. "On the surface, it just looked so good," she remembers. The couple married in 1970, while Hager completed medical school at the University of Kentucky.

"I don't think I was married even a full year before I realized that I had made a horrible mistake," Davis says. By her account, Hager was demanding and controlling, and the couple shared little emotional intimacy. "But," she says, "the people around me said, 'Well, you've made your bed, and now you have to lie in it.'" So Davis commenced with family making and bore three sons: Philip, in 1973; Neal, in 1977; and Jonathan, in 1979.

Sometime between the births of Neal and Jonathan, Hager embarked on an affair with a Bible-study classmate who was a friend of Davis's. A close friend of Davis's remembers her calling long distance when she found out: "She was angry and distraught, like any woman with two children would be. But she was committed to working it out."

Sex was always a source of conflict in the marriage. Though it wasn't emotionally satisfying for her, Davis says she soon learned that sex could "buy" peace with Hager after a long day of arguing, or insure his forgiveness after she spent too much money. "Sex was coinage; it was a commodity," she said. Sometimes Hager would blithely shift from vaginal to anal sex. Davis protested. "He would say, 'Oh, I didn't mean to have anal sex with you; I can't feel the difference,'" Davis recalls incredulously. "And I would say, 'Well then, you're in the wrong business.'"

By the 1980s, according to Davis, Hager was pressuring her to let him videotape and photograph them having sex. She consented, and eventually she even let Hager pay her for sex that she wouldn't have otherwise engaged in--for example, $2,000 for oral sex, "though that didn't happen very often because I hated doing it so much. So though it was more painful, I would let him sodomize me, and he would leave a check on the dresser," Davis admitted to me with some embarrassment. This exchange took place almost weekly for several years.

Money was an explosive issue in their household. Hager kept an iron grip on the family purse strings. Initially the couple's single checking account was in Hager's name only, which meant that Davis had to appeal to her husband for cash, she says. Eventually he relented and opened a dual account. Davis recalls that Hager would return home every evening and make a beeline for his office to balance the checkbook, often angrily summoning her to account for the money she'd spent that day. Brenda Bartella Peterson, Davis's friend of twenty-five years and her neighbor at the time, witnessed Hager berate his wife in their kitchen after one such episode. For her part, Davis set out to subvert Hager's financial dominance with profligate spending on credit cards opened in her own name. "I was not willing to face reality about money," she admits. "I thought, 'Well, money can't buy happiness, but it buys the kind of misery you can learn to live with.'"

These financial atmospherics undoubtedly figured into Linda's willingness to accept payment for sex. But eventually her conscience caught up with her. "Finally...I said, 'You know, David, this is like being a prostitute. I just can't do this anymore; I don't think it's healthy for our relationship,'" she recalls.

By 1995, according to Davis's account, Hager's treatment of his wife had moved beyond morally reprehensible to potentially felonious. It was a uniquely stressful year for Davis. Her mother, dying of cancer, had moved in with the family and was in need of constant care. At the same time, Davis was suffering from a seemingly inexplicable exhaustion during the day. She began exhibiting a series of strange behaviors, like falling asleep in such curious places as the mall and her closet. Occasionally she would--as she describes it--"zone out" in midsentence in a conversation, and her legs would buckle. Eventually, Davis was diagnosed as having narcolepsy, a neurological disorder that affects the brain's ability to regulate normal sleep-wake cycles.

For Davis, the diagnosis spelled relief, and a physician placed her on several medications to attain "sleep hygiene," or a consistent sleep pattern. But Davis says it was after the diagnosis that the period of the most severe abuse began. For the next seven years Hager sodomized Davis without her consent while she slept roughly once a month until their divorce in 2002, she claims. "My sense is that he saw [my narcolepsy] as an opportunity," Davis surmises. Sometimes she fought Hager off and he would quit for a while, only to circle back later that same night; at other times, "the most expedient thing was to try and somehow get it [over with]. In order to keep any peace, I had to maintain the illusion of being available to him." At still other moments, she says, she attempted to avoid Hager's predatory advances in various ways--for example, by sleeping in other rooms in the house, or by struggling to stay awake until Hager was in a deep sleep himself. But, she says, nothing worked. One of Davis's lifelong confidantes remembers when Davis first told her about the abuse. "[Linda] was very angry and shaken," she recalled.

As Hager began fielding calls from the White House personnel office in 2001, the stress in the household--and, with it, the abuse--hit an all-time high, according to Davis. She says she confronted her husband on numerous occasions: "[I said to him,] 'Every time you do this, I hate your guts. And it blows a bridge out between us that takes weeks, if not months, to heal.'" She says that Hager would, in rare instances, admit what he had done and apologize, but typically would deny it altogether.

For a while, fears of poverty, isolation and damnation were enough to keep Davis from seeking a divorce. She says that she had never cheated on Hager, but after reuniting with a high school sweetheart (not her current husband) in the chaotic aftermath of September 11, she had a brief affair. En route to their first, and only, rendezvous, she prayed aloud. "I said to the Lord, 'All right. I do not want to die without having sex with someone I love,'" she remembers. "'I want to know what that's like, Lord. I know that it's a sin, and I know this is adultery. But I have to know what it's like.'"

Davis was sure that God would strike her dead on her way home that weekend. But when nothing happened, she took it as a good sign. Back in Lexington, she walked through her front door and made a decision right there on the spot. "I said, 'David, I want a divorce.'"

Marital rape is a foreign concept to many women with stories like this one. Indeed, Linda Davis had never heard the term until midway through her divorce. In Kentucky a person is guilty of rape in the first degree when he engages in sexual intercourse with another person by "forcible compulsion"; or when the victim is incapable of consent because she is physically helpless. The same standards apply to the crime of sodomy in the first degree (equivalent to rape, and distinct from consensual sodomy). Both are felonies.

In sexual assault cases, the outcome hinges on the issue of consent. A high-level domestic violence prosecutor in Kentucky confirmed that a scenario such as this one, in which Davis was in a deep sleep from the narcolepsy, could meet the "physically helpless" standard required for a first-degree offense. A prosecutor could also argue that Hager engaged in sodomy with Davis by means of forcible compulsion, even though the alleged encounters did not involve violence. According to the Kentucky Supreme Court's decision in 1992 in Yarnell v. Commonwealth, a climate of abuse involving "constant emotional, verbal, and physical duress" is tantamount to forcible compulsion. In that case, the victims submitted to the sex acts to avoid a loss of financial security, as well as to maintain peace in the household.

Historically, the legal system has long been indifferent to the crime of marital sexual assault; as recently as twelve years ago in some states, it was legal for a man to force his wife physically into sex, or commence having sex without her consent--actions that could land a stranger in jail. Until 2000 the Kentucky Penal Code still contained archaic procedural obstacles for prosecuting marital rape, including a requirement that it be reported within one year of the offense. (No other felony--including "stranger rape"--contains a statute of limitations.) Even today, marital sexual assault is a notoriously difficult crime to prosecute. Women like Davis often have strong financial incentives to stay with their spouses; those who speak out frequently face an uphill battle to convince people that their husbands, who may be well liked and respected, are capable of something this ugly at home. Also, because marriages play out over many years, some sex is consensual, while other sex is not--a fact that may complicate matters for a jury in a criminal proceeding.

Linda Davis chose not to bring allegations of marital rape into her divorce proceedings; her foremost desires at the time were a fair settlement and minimal disruption for her sons. Nonetheless, she informed her lawyer of the abuse. Natalie Wilson, a divorce attorney in Lexington, asked Linda to draw up a working chronology of her marriage to Hager. "[It] included references to what I would call the sexual abuse," Wilson explained. "I had no reason not to believe her.... It was an explanation for some of the things that went on in the marriage, and it explained her reluctance to share that information with her sons--which had resulted in her sons' being very angry about the fact that she was insisting on the divorce."

As it turned out, when the dust settled after their divorce, nearly everyone in the Hagers' Christian and medical circles in Lexington had sided with Hager, who told people that his wife was mentally unstable and had moved in with another man (she moved in with friends).

Davis had only told a handful of people about the abuse throughout her marriage, but several of her longtime confidantes confirmed for this article that she had told them of the abuse at the time it was occurring. Wilson, the attorney, spoke to me on the record, as did Brenda Bartella Peterson, Davis's close friend of twenty-five years. Several others close to Davis spoke to me off the record. Two refused to speak to me and denounced Davis for going public, but they did not contest her claims. Many attempts to interview nearly a dozen of Hager's friends and supporters in Lexington and around the country were unsuccessful.

As for David Hager, after repeated attempts to interview him for this story, we finally spoke for nearly half an hour in early April. That conversation was off the record. "My official comment is that I decline to comment," he said.

As disturbing as they are on their own, Linda Davis's allegations take on even more gravity in light of Hager's public role as a custodian of women's health. Some may argue that this is just a personal matter between a man and his former wife--a simple case of "he said, she said" with no public implications. That might be so--if there were no allegations of criminal conduct, if the alleged conduct did not bear any relevance to the public responsibilities of the person in question, and if the allegations themselves were not credible and independently corroborated. But given that this case fails all of those tests, the public has a right to call on Dr. David Hager to answer Linda Davis's charges before he is entrusted with another term. After all, few women would knowingly choose a sexual abuser as their gynecologist, and fewer still would likely be comfortable with the idea of letting one serve as a federal adviser on women's health issues.

(Lest inappropriate analogies be drawn between the Hager accusations and the politics of personal destruction that nearly brought down the presidency of Bill Clinton, it ought to be remembered that President Clinton's sexual relationship with Monica Lewinsky was never alleged to be criminal and did not affect his ability to fulfill his obligations to the nation. This, of course, did not stop the religious right from calling for his head. "The topic of private vs. public behavior has emerged as perhaps the central moral issue raised by Bill Clinton's 'improper relationship,'" wrote evangelist and Hager ally Franklin Graham at the time. "But the God of the Bible says that what one does in private does matter. There needs to be no clash between personal conduct and public appearance.")

Hager's FDA assignment is an object lesson in the potential influence of a single appointment to a federal advisory committee that in turn affects thousands, even millions, of lives. Witness the behind-the-scenes machinations that set the stage for the FDA's ruling against Plan B, a decision that the American College of Obstetricians and Gynecologists called a "dark stain on the reputation of an evidence-based agency like the FDA."

On December 16, 2003, twenty-seven of the FDA's advisers on women's health and nonprescription drugs gathered in Gaithersburg, Maryland, to evaluate the safety and efficacy of emergency contraception for over-the-counter use. (The Plan B pill, which drastically reduces the risk of pregnancy when used within seventy-two hours after intercourse, has long been available by prescription only; its advocates say its greater availability could significantly reduce the nation's abortion rate.) After a long day of highly technical deliberation, the advisers voted 23 to 4 to drop the prescription-only status of emergency contraception. "I've been on this committee...for almost four years, and I would take this to be the safest product that we have seen brought before us," announced Dr. Julie Johnson, a professor at the University of Florida's Colleges of Pharmacy and Medicine.

But on May 6, 2004, the FDA rejected the advice of its own experts and refused to approve the sale of Plan B over the counter. In his letter to Barr Laboratories, Steven Galson, acting director of the FDA's Center for Drug Evaluation and Research, claimed that Barr had not provided adequate data showing just how young adolescent women would actually use the drug.

That issue was never voted on by the committee. It was, however, broached by Hager at the meeting; he mentioned his concern for these "younger adolescents" several times.

In his private practice back in Kentucky, Hager doesn't prescribe emergency contraception, because he believes it is an abortifacient, and, not surprisingly, his was one of the four votes against widening its availability. But rather than voice his ethical opposition to the product, Hager emphasized his concern about adolescents, which other committee members have since called a "political fig leaf." According to Dr. James Trussell, who voted in favor of Plan B, the FDA had at hand six studies examining whether teens as young as 15 would increase their "risky" behavior if they knew they had a backup emergency contraceptive--and none of the studies showed any evidence for that contention.

In his sermon at Asbury College last fall, Hager proudly recounted his role in the Plan B decision. "After two days of hearings," he said, "the committees voted to approve this over-the-counter sale by 23 to 4. I was asked to write a minority opinion that was sent to the commissioner of the FDA.... Now the opinion I wrote was not from an evangelical Christian perspective.... But I argued it from a scientific perspective, and God took that information, and He used it through this minority report to influence the decision." [Emphasis added.]

None of the four panel members I spoke with for this article were aware of Hager's "minority opinion." An FDA spokeswoman told me that "the FDA did not ask for a minority opinion from this advisory committee," though she was unable to say whether any individual within the agency had requested such a document from Hager. This past January the FDA missed a deadline to respond to a new application from Barr Laboratories, and any forward motion on making Plan B more widely available has completely stalled.

Meanwhile, David Hager's stock has been rising among conservatives. Though his term on the FDA panel is set to expire on June 30, observers on both sides of the political divide anticipate his reappointment. In March I spoke with Janice Shaw Crouse, executive director and senior fellow at the Beverly LaHaye Institute, the research arm of Concerned Women for America. She is one of Hager's staunchest advocates in Washington (some credit her with engineering his FDA appointment); Crouse sits alongside Hager on Asbury College's board of trustees. In May, when informed of the allegations against him, she declined to revise her earlier statement. "I would not be at all surprised to see Dr. Hager elevated to a higher position or to another very influential position when it comes to women's care," she told me. "Because he has shown that he does care about women regardless of...the [religious] issues that people want to try to raise.... When people try to discredit him, he continues on. He hasn't caved in, and he hasn't waffled. He has been a gentleman. He is a person of character and integrity, and I think people admire that."

This article describes an unusual rectal foreign body resulting from homosexual anal erotic activities. The patient had used an enema containing a concrete mix which became impacted and required surgical removal. The use, abuse, and complications of enemas are reviewed.

CASE REPORT
A 20-year-old man presented to the emergency room complaining of rectal pain. A well-nourished, well-developed man without signs of intoxication was admitted in no apparent distress. Digital examination of the rectum revealed a stony hard mass. Abdominal plain films showed a vertically oriented, low-lying radiopaque object in the rectum. A spherical radiolucency was noted in the upper pole of the mass. A blood alcohol level was negative. No other drug testing was performed.

Upon further questioning, the patient said that approximately 4 hrs earlier he and his boyfriend had been "fooling around." After stirring a batch of concrete mix, the patient laid on his back with his feet against the wall at a 45-degree angle while his boyfriend poured the mixture through a funnel into his rectum. After the concrete mass hardened, it became so painful that he sought medical care.

Under general anesthesia, the anus was dilated and two Foley catheters were inserted alongside the rectal mass to relieve suction. A concrete case of the rectum was delivered without incident. The rectal mucosa was intact with a hyperemic and edematous appearance.

The patient was kept overnight and discharged uneventfully the following morning. The attending physician recommended a psychiatric consultation, but the patient declined.

PATHOLOGIC EXAMINATION
Examination of the specimen revealed a perfect concrete cast of the rectum, measuring 12 X 7 X 5 cm and weighing 275 g (Fig. 2). A thin layer of feces coated the surface and crevices. Grooves in the mass were consistent with rectal mucosal folds. A layer of concrete was chipped off the upper part of the specimen and revealed a white plastic ping-pong ball. This corresponded to the radiolucency observed in the abdominal x-ray.

The hug, long reserved for women, celebrating sports victories, and men from other countries, is muscling its way into everyday American Guydom.

Stoic machismo still thrives, but at its heels yaps a touchier, Dr. Phil version of virility. Boundaries are eroding. Defenses are being scaled.

The male hug is complicating everything.

Men accustomed to the automatic and dependable hand clasp accompanied with a brisk up-and-down pump at dinner parties and college reunions, now must preface their greetings or goodbyes with intricate and split-second calculations based on body language, length of friendship and other factors.

Do I shake or do I hug?

Making the right choice matters. If one guy goes for the hug, but the other decides upon a handshake, they might collide. An excruciating dance will follow, as the poor lads work feverishly to determine what to do with their hands, their arms, their bodies...

...it's tricky, says Jason Tesauro, the author of "The Modern Gentleman," a guide to the protocols of maleness.

Absent any formal rules about the matter, Tesauro says that "if you are in a casual scenario and you are greeting someone, I don't think a hug is out of place. It says you are an extroverted, demonstrative person."

He hugs most of his male friends, he says, although he usually does not hug men upon meeting them for the first time. After that initial handshake, though, the hug could happen any time.

"Saying goodbye is always safer," he says. "You've built up fellowship. It's the difference between a hello kiss on a first date and a good-night kiss."

...

Former Denver City Councilman Ed Thomas, a big hugger, says rules are few when it comes to the man-to-man embrace.

Just don't take a hug too far, he warns. "If a hug becomes a mug, then you've got problems. You just have to know what that line is."

A hug to Thomas is a "higher level of greeting," one he doesn't bestow upon other guys right away but will unleash with abandon at any point after introductions.

He's an unabashed, eager hugger, but he's no Norm Early, former Denver district attorney and now private businessman.

Early is "the hug captain of the world," Thomas says. "When you get around that guy, he takes the cake. There's no two ways around it."

Soon after becoming district attorney, Early recalls, "I remember when one cop said to another, 'You might as well go over and hug him because he's going to get you sooner or later."'

Early advocates the full-on bear hug. He does not feel compelled to demonstrate his masculinity by slapping his partner's back mid-hug. He does not shrink from the male hug during introductions.

"What often happens when you meet somebody the first time, the other people you already know, so you hug them, and then you say, 'I'm going to have to hug you too,"' he says. Otherwise, he says, if the new guy has his hand out, ready for a firm clench, "what I will normally do is say, 'Hey, I'm a hugger, not a shaker,' and basically take my hug."

Whether, and how, to hug or not falls along cultural lines too. One of them involves a handshake, a mutual tug inward, and a shoulder-bump.

When Duke University professor of black popular culture Mark Anthony Neal is with men, he'll go right in for a certain kind of hug - as long as the other guy also is African-American.

"If I was greeting a white guy, I would probably never go for the hug, it would always immediately be the handshake," says Neal, the author of the just-released book "New Black Man," about black masculinity in the 21st century. "In the case of black males, particularly around my age, 40, it's the hip-hop hug: a handshake, you pull yourselves together, and you bump."

The alternating approach - a handshake for a white guy, a hug for a black guy - is cultural, he says.

"There are shared assumptions when I am greeting an African-American man ... there is a shared experience that connects us," he says.

Hugging between African-American men, though common now, wasn't always so, Neal says.

"For older African-American men, I would be more apt to handshake," he says. "I cannot imagine hugging my father."

At least two professors - Kory Floyd at Arizona State University and Mark Morman at Baylor University in Waco, Texas - have dedicated part of their careers to studying the male hug. The two often collaborate on research.

Floyd, for example, has studied the forms and duration of hugs between men. Rarely do they last much longer than one second. As hugs extend to two seconds or more, men watching the huggers quickly begin assuming the embraces are romantic, instead of just friendly.

Only men too engage in the combination handshake-hug, says Floyd.

"It follows what we call an 'A-frame' configuration; the only body contact is the shoulders," he says. "Men often do it with their handshake in between them, so there is a physical barrier. The third thing is the aggressive patting on the back that comes along with it, which is a very combative gesture. It's a way for men to say, 'I have positive feelings for you, but let's show them in a way that is masculine and gender validating.' All of those things - distance, a barrier, the combative movement - are all stereotypically masculine ways of behaving."

Morman says male fear of hugging other men revolves around homophobia and family.

Some straight guys worry that if they are seen hugging other men, they will be viewed as gay, he says.

And for most men, he says, "fathers are the first role models we have for how to be men, and if Dad isn't hugging and kissing, chances are we aren't either."

While Morman agrees that hugging among American men is spreading, he says it always has occurred in certain contexts.

The more "emotionally charged" the environment, he says, the more freedom men feel to hug one another.

"If you are in the office, generally there is not a lot of emotion there," he says, and hugging remains taboo. But at a wedding or a funeral, or on a battlefield or basketball court, men for a long time have hugged without much hesitation.

Watch ESPN for a few hours, and there's a fair chance you'll encounter lots of big men embracing, especially after a big play or a victory.

Hugging is OK in sports, Floyd says, because a sporting event is "a very gender-validating environment."

On the court or the field, he says, "I'm not worried that my teammate will view (a hug) as a sexual type of behavior."

It doesn't take a touchdown to compel Tony Nalepa, 25, a Denver geophysicist with an Abe Lincoln beard, to embrace a buddy.

"I'll hug my friends," he says, but his love of the hug doesn't extend to the office. "I certainly wouldn't hug my co-workers. I think they would get scared."

To which Eric Mackey, 21, one of his office-mate lunch partners at an outdoor downtown table, let loose a mock sniffle and whimper, saying, "You'll hug your other friends, but not me."

Nalepa's brother is "uncomfortable" with the hug, Nalepa says, "but I hug him anyway. It's more fun that way."

Another lunch partner, Heath Robertson, 37, says he started hugging when he worked in South America, where people "thought I was strange because I didn't hug."

Now, he says, "usually it's the handshake and the pat on the back deal," and it's reserved for family and close friends. He'll hug his martial-arts buddies, he says, "but usually we start grappling."

Robertson's experience in South America illustrates how hugging and handshaking have little to do with gender alone: Contact between males always is yoked to culture.

In "high contact" cultures in southern Europe, the Middle East and Africa, men will hug, hold hands, even kiss - "something most American men would consider a very intimate action," Floyd says.

"In a lot of cultures, that kind of high contact - lots of touching, close personal space - isn't necessarily any more intimate than a handshake would be to us," he says.

America qualifies as a "medium-touch" culture, Floyd says, with some Northern European and Asian cultures - in Japan, for example, where people bow to one another instead of touching - registering as "low touch."

In some places, everybody hugs, or everybody bows. In America, it's mixed. The handshake remains the standard greeting, but some guys hug with relish. Others recoil from outstretched male arms. Most men probably sit somewhere in between. It's when two on-the-fence huggers meet that it can get messy.

...

If guys are OK with male hugging but still tentative, for fear of embarrassment, they should bury their worries, writes Michael Flocker, author of "The Metrosexual Guide to Style," in an e-mail.

"If, however, you do get caught going in for the hug and have second thoughts, don't panic," he says. "Just follow through, go for a quick pat on the back, and move on."

Many people believe the route to success is to be interesting-to show off or act like someone else. For example, many teenagers can’t understand why they are unpopular. They learned as children that to get attention they should act up a little; to be as interesting as possible.

Yet acting interesting does not make a teenager popular. To handle their unpopularity, they might decide to despise people or become loners. Or they try harmful acts to gain respect: smoking, drinking, graffiti, shoplifting, drugs, sex, guns and so on.

Acting interesting can ruin your adult life as well. Show-off employees, self-centered managers and pompous business owners rarely do well for long.

The secret to popularity is not to be interesting, but to be interested.

"When a person becomes terribly interesting he has lots of problems, believe me. That is the chasm which is crossed by all of your celebrities, anybody who is foolish enough to become famous. He crosses over from being interested in life to being interesting. And people who are interesting are really no longer interested in life. It’s very baffling to some young fellow why he can’t make some beautiful girl interested in him. Well, she is not interested, she is interesting."

If you are an actor on stage, you are interesting while acting. Seminar speakers are interesting. Comedians, models and magicians are interesting.

Yet in real life, on a one-on-one basis, interesting people are irritating. They only do things to get your attention and admiration. They believe they are on stage acting for an audience of one.

If you want people to cooperate with you, to like you or to open up to you, you must be interested.

Instead of focusing on yourself, you start to focus on others. You notice what makes them happy or unhappy. Your attention comes off of you and onto others.

When your thoughts are more on others than on yourself, you feel little stress. You act and respond with more intelligence. Your production level increases and you have more fun.

When you are interested, people love your interest in them. They want to be around you. You are popular.

Five Ways to Be More Interested

1. Strive to shift your attention from yourself onto other people or objects. This is a great stress reliever.

2. Find things about people that interest you. Force yourself to look for interesting things. Soon you will automatically take interest in people without thinking about it.

3. If you catch yourself acting like someone else, you are being interesting. Simply get interested in the person in front of you and you’ll feel more natural. You are most effective when you are simply being yourself.

4. When someone makes you nervous or shy, get interested in them. Take your attention off of yourself and on to others. With practice, you will be calm, even bold.

5. Focus on how you can help others. Let your interest in helping people replace your tendency to act interesting. Your effectiveness and popularity will soar.

WAUPACA — A rural New London woman is charged with substantial battery for allegedly cutting her husband’s penis with a scissors — an injury that required 15 stitches to repair.

Theresa L. Hedtke, 42, N2631 Hutchinson Road, appeared Monday before Waupaca County Circuit Judge Raymond Huber, who released her on a $5,000 signature bond. She faces further proceedings next Tuesday.

As a condition of her bond, she is not allowed to have contact with her 38-year-old husband.

She allegedly cut him because she was trying to get him to confess to having an affair. Hedtke allegedly told police she didn’t intend to cut her husband.

The husband was taken to New London Family Medical Center, where he received treatment.

Preparations for a Sunday morning fishing trip resulted in a man allegedly being assaulted after stymieing sexual advances from his wife.

The husband, Richard Brown, of Exeter Drive, stated in a Murfreesboro Police report that his wife, Misty Brown, also of Exeter Drive, walked into the back yard and was "trying to act sexy" as he was preparing for a fishing trip.

According to the report, the wife told her husband to "bite her on the butt." When the husband told his wife no, she became very angry. The husband reported his wife was still mad and sitting on the living room couch when he went inside their home.

Richard Brown reported his wife told him that she did not want to go fishing. She allegedly proceeded to pick up a large wine glass and throw it at her husband. The glass broke and cut him behind the left leg, stated Officer Kevin Dunn in the report.

Misty Brown allegedly picked up a broken piece of glass and threw it at her husband, according to the report. The glass cut her husband's arm. He told officers he fell to the floor bleeding and in pain and begging for his wife to help him.

The husband was transported to Middle Tennessee Medical Center for treatment. A warrant was issued for the arrest of Misty Brown.

Nearly two-thirds (63 percent) of employers surveyed in November reported that their employees access non-work-related Internet sites, and 27 percent have experienced an increase in inappropriate employee Internet usage, according to a survey by Websense, an employee Internet management software company, and psychologist and business consultant David Greenfield of The Center for Internet Studies.

Of the companies that do filter employee access, the top five categories blocked were: pornography (71 percent), hate groups (39 percent), gambling (34 percent), chat rooms/personals (27 percent) and music downloads (24 percent).

The survey was based on telephone interviews Nov. 17-28 with 245 human-resource managers at companies ranging in size from seven to 45,000 employees.