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Analysis, background reports and updates from the PBS NewsHour putting today's news in context.

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    People protest President Donald Trump's travel ban outside of the U.S. Court of Appeals in Seattle, Washington. Photo by David Ryder/Reuters

    People protest President Donald Trump’s travel ban outside of the U.S. Court of Appeals in Seattle, Washington. Photo by David Ryder/Reuters

    WASHINGTON — Lawyers for Hawaii told the Supreme Court Monday that letting the Trump administration enforce a ban on travel from six mostly Muslim countries would “thrust the country back into the chaos and confusion” that resulted when the policy was first announced in January.

    The state urged the justices to deny an administration plea to reinstate the policy after lower courts blocked it. The high court is considering the administration’s request and could act before the justices wind up their work at the end of June.

    The state says the policy is unconstitutional because it shows anti-Muslim bias. Hawaii points to comments President Donald Trump made last week on Twitter to underscore its argument that the policy is a “thinly veiled Muslim ban.”

    Immigration officials would have 90 days to decide what changes are necessary before people from Iran, Libya, Somalia, Sudan, Syria and Yemen may resume applying for visas. The U.S. refugee program would be halted for 120 days.

    It would take a majority of the court, at least five justices, to put the policy into effect.

    The 4th U.S. Circuit Court of Appeals called the national security concerns an after-the-fact justification for a policy that was “rooted in religious animus and intended to bar Muslims from this country.”

    A federal judge in Hawaii also blocked the temporary ban on refugees, and that issue is now being considered by the 9th U.S. Circuit Court of Appeals.

    Trump signed his first executive order on travel a week after he took office in January. It applied to travelers from the six countries as well as Iraq and took effect immediately, leading to commotion at U.S. airports as the Homeland Security Department scrambled to figure out who the order covered and how it was to be implemented.

    A federal judge blocked it eight days later, an order that was upheld by a 9th Circuit panel. Rather than pursue an appeal, the administration said it would revise the policy.

    In March, Trump issued a narrower order, but federal courts that have examined it so far have blocked it as well.

    On Twitter last week, Trump said the “courts are slow and political” and he said the government already is “EXTREME VETTING people coming into the U.S.”

    Hawaii’s lawyers said Trump had provided evidence that his administration already was doing the work that it said required a halt in travel to accomplish.

    “Thus, by the Government’s own account, the need for the travel and refugee bans has passed,” they wrote.

    The administration has argued to the court that the judge in Hawaii has limited what it can do to assess screening procedures.

    READ MORE: Legal experts to Trump on travel ban: Put down the Twitter

    The post Hawaii urges Supreme Court to keep hold on Trump travel ban appeared first on PBS NewsHour.

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    White House press secretary Sean Spicer faced questions at Monday’s news briefing about Attorney General Jeff Sessions’ upcoming testimony in the ongoing Russia probe.

    WASHINGTON — White House spokesman Sean Spicer is declining to say whether Attorney General Jeff Sessions should invoke executive privilege in testimony to Congress Tuesday.

    Spicer told reporters Monday that it “depends on the scope of the questions” and said it was “premature” to say.

    Sessions will testify in open session Tuesday before the Senate Intelligence committee, where he’ll face questions over his role in the controversy around possible ties between the Trump presidential campaign and Russia.

    Spicer also declined to say whether Trump agrees with Sessions’ decision to testify. But he says the president “believes that the sooner we can get this addressed and dealt with” the better.

    Spicer is also refusing to say whether tapes exist of the president’s conversations with FBI Director James Comey before Trump fired him. Comey told Congress last week that Trump urged him to drop a probe of former National Security Adviser Michael Flynn.

    PBS NewsHour will update this story as it develops.

    The post WATCH: Spicer won’t say if Sessions may claim privilege in Tuesday’s testimony appeared first on PBS NewsHour.

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    Republican congressional candidate Greg Gianforte looks on during a May meet and greet in Great Falls, Montana. Photo by Justin Sullivan/Getty Images

    Republican congressional candidate Greg Gianforte looks on during a May meet and greet in Great Falls, Montana. Photo by Justin Sullivan/Getty Images

    BOZEMAN, Mont. — Montana’s next congressman, Greg Gianforte, avoided jail time Monday after pleading guilty to assaulting a reporter the day before he was elected.

    Gallatin County Justice of the Peace Rick West sentenced the Republican technology entrepreneur to 40 hours of community service, 20 hours of anger management counseling and ordered him to pay a $385 fine for the misdemeanor. If he remains law abiding for 180 days, he can petition for the conviction to be removed from his record.

    Gianforte’s attorneys noted that he had already paid more than $4,600 in restitution to Guardian reporter Ben Jacobs for the assault, which cast a pall over his May 25 victory to serve the remainder of Ryan Zinke’s term. Zinke resigned to become Interior Department secretary.

    Gianforte, 56, is expected to be sworn in to the state’s sole U.S. House seat later this month.

    Jacobs said Gianforte knocked him to the ground when he asked the candidate a question May 24. Audio taken by Jacobs recorded sounds of a scuffle, followed by Gianforte yelling for the reporter to “get the hell out of here.” Gianforte was cited that night.

    In an attempt to put the matter behind him, Gianforte first settled all civil claims with Jacobs before requesting that Monday’s court date cover both his arraignment and sentencing.

    In the civil settlement, Gianforte agreed to give $50,000 to the Committee to Protect Journalists and wrote Jacobs a letter of apology in which he acknowledged assaulting the reporter for asking a “legitimate question about health care policy.”

    In exchange, Jacobs agreed not to sue Gianforte and said he would not object if Gianforte entered a no-contest plea to the criminal charge, which would have allowed Gianforte to concede to the charge without admitting guilt.

    But Gallatin County Attorney Marty Lambert said Friday that he had not agreed to any deal in which Gianforte would plead no contest.

    Gianforte, who sold the software company he founded to Oracle for $1.8 billion in 2011, won his first political office over Democrat Rob Quist after a short but intense campaign set off by Zinke’s appointment to the Cabinet post by President Donald Trump.

    The special election drew millions of dollars in donations from across the U.S.

    Analysis: 3 factors that helped decide the wild card Montana election

    The post Montana’s Gianforte avoids jail time for assault on reporter appeared first on PBS NewsHour.

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    The Bears Ears buttes, located in Utah. The Bears Ears National Monument in Utah is one of two designations President Barack Obama made at the end of his term, granting protection to land considered to be sacred. Photo by Witold Skrypczak/Getty Images

    The Bears Ears National Monument in Utah is one of two designations President Barack Obama made at the end of his term, granting protection to land considered to be sacred. Interior Secretary Ryan Zinke is recommending that the new Bears Ears National Monument in Utah be reduced in size and says Congress should step in to designate how selected areas of the 1.3 million-acre site are categorized. Photo by Witold Skrypczak/Getty Images

    WASHINGTON — Interior Secretary Ryan Zinke on Monday recommended that the new Bears Ears National Monument in Utah be reduced in size and said Congress should step in to designate how selected areas of the 1.3 million-acre site are managed.

    Zinke made the recommendation as part of an interim report to President Donald Trump on the scenic swath of southern Utah with red rock plateaus, cliffs and canyons on land considered sacred to tribes.

    Trump signed an executive order in April directing Zinke to review the designation of dozens of national monuments on federal lands, calling the protection efforts “a massive federal land grab” by previous administrations.

    Trump and other Republicans have singled out former President Barack Obama’s designation of Bears Ears, calling it an unnecessary layer of federal control that hurts local economies by closing the area to new energy development. They also say it isn’t the best way to protect the land.

    READ MORE: Democrats urge Trump to keep protections for national monuments

    Zinke toured Bears Ears last month on foot, horseback and helicopter and met with Utah Gov. Gary Herbert and other state leaders. Herbert and other Utah Republicans oppose Obama’s designation of the Bears Ears National Monument.

    Zinke, a former Republican congressman from Montana, said he wants to make sure Native American culture is preserved and said Congress should approve legislation granting tribes legal authority to “co-manage” some of the Bears Ears site.

    “I have enormous respect for tribes,” Zinke said, adding that he supports Native American efforts to restore “sovereignty, respect and self-determination.”

    Instead of the monument designation, which prevents a range of development, Zinke said some of the sprawling, 1.3 million acre site should be designated for conservation or recreation. He called on Congress to approve a land-management bill for Bears Ears and other federal lands.

    The Republican-controlled Congress has failed to approve significant public lands bills in recent years, but Zinke said that was because of veto threats by Obama.

    He summed up his optimism in two words: “President Trump.”

    The post Interior secretary recommends scaling back Bears Ears, a protected national monument appeared first on PBS NewsHour.

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    50 years ago, the Supreme Court ruled unanimously that a Virginia law banning marriage between mixed races was unconstitutional, thus nullifying similar statues in 15 other states. We visited Caroline County, where the case, Loving v. Virginia, began. Photo by Getty Images

    On July 11, 1958, five weeks after their wedding date, Mildred and Richard Loving woke to a flashlight shining in their eyes and the sheriff of Caroline County, Virginia, standing above their bed. They were under arrest.

    Their crime was interracial marriage. Mildred was part black, part Native-American, Richard was a white man, and their marriage was illegal in Virginia. Sheriff Garnett Brooks had acted on a warrant issued by the commonwealth’s attorney. What followed was a nine-year fight to live as a married couple in the hometown they loved.

    “They asked Richard, who was that woman he was sleeping with, and I said, ‘I’m his wife.’” Mildred Loving said, according to archival video of the Loving case. And the sheriff said, ‘Not here you’re not,’” Their D.C. marriage certificate hung on their bedroom wall.

    In 1963, Mildred wrote a letter to Senator Robert Kennedy, “At the time we did not know there was a law in Virginia against mixed marriages,” she told him. “Therefore we were jailed and tried in a little town of Bowling Green. We were to leave the state to make our home…We know we can’t live there, but we would like to go back once and a while [sic.] to visit our families and friends.”

    Their case resulted in the landmark 1967 Supreme Court ruling that declared unconstitutional state laws banning mixed-race marriage.

    In 1967, only 3 percent of marriages were interracial, according to the Pew Research Center. By 2015, that number had risen to 17 percent.

    “What happened, we real­ly didn’t intend for it to happen,” Mildred said in 1992. “What we wanted, we wanted to come home.”

    Last year’s Oscar-nominated film, “Loving,” was filmed in part in Caroline County. With their town’s Main Street cast into a 1950s version of itself, the townspeople found a resurged interest in the case.

    In 2016, Virginia Governor Terry McAuliffe declared June 12 a holiday: Loving Day. Last week, we traveled to Caroline County to talk to its residents about Richard, Mildred and the story that changed their town and nation.

    Gloria Gentry

    Gloria Gentry, 64, is a cook, and Dorothy Courtney, 54, is assistant manager at Dishman’s Corner Store. Photo by Alison Thoet

    “It’s a lesson we all need to learn, to respect people and our personal lives. That they do what they want to do. You can’t judge a person just because they’re not the same color, because God made us all. That’s the way I look at it.” — Gloria Gentry

    “All I know is they were run out of Caroline County due to the race of each one. What does it mean? I think it’s crazy. I think everyone should have their own rights to who they fall in love with… I think it was due to the sheriff of the town. Garnett Brooks. He’s the one that I guessed pushed the issue. He’s deceased now, but to be honest, nobody liked him. I didn’t, and I grew up not liking him.” — Dorothy Courtney

    Wayne Brooks

    Wayne Brooks, 69, is president of the Caroline County Historical Society. Photo by Alison Thoet

    Wayne Brooks, 69, is president of the Caroline County Historical Society. Photo by Alison Thoet

    “I knew Garnett well, he passed away about three years ago…. He was my father’s first cousin, so that makes him my second cousin…I think a lot of news media blamed him for [the Lovings’ arrest] and portrayed him afterwards in, I think, a way that he shouldn’t have been shown. He was a tough sheriff.”

    Jessie Rollins

    Rollins on the Caroline County Courthouse lawn. Photo by Alison Thoet

    Jessie Rollins, 59, is an involved community member and volunteer with youth organizations 4H and Caroline’s Promise. Photo by Alison Thoet

    “A lot of the young kids, they’re very proud of the movie. There’s a lot of kids who go to school with kids who are of the family. So especially for the children, it’s like telling their grandparents’ story in a way that gives honor to how courageous they were — to be as private as they were and to be bold enough to write that letter and see things through, to defend their right to just get married and fall in love…She [Mildred] reminded me of my grandmother. My grandmother had a meek, quiet spirit, like her, but had a very powerful impact.”

    Jessica Beale

    Beale in her coffee shop, The Mix House, one of the newest businesses in downtown. Photo by Alison Thoet

    Jessica Beale, 27, in her coffee shop, The Mix House, one of the newest businesses in downtown. Photo by Alison Thoet

    “They closed the street down for a couple of days. It was just exciting; you could walk around the town at some points and see all the antique cars they brought in. For a little town it was big stuff.”

    Carrie Wright

    Wright outside her antique store in downtown Bowling Green. Photo by Alison Thoet

    Carrie Wright, 55, outside her antique store in downtown Bowling Green. Photo by Alison Thoet

    “A guy from the movie, the prop department, came down looking for props, and I didn’t have what he was looking for. And then one day he came down and bought one glass. It was a little drinking glass. He said it was going to be on the judge’s bench.”

    Wendy Jones

    Jones at a stand for the local police department at the Bowling Green farmer’s market. Photo by Alison Thoet

    Wendy Jones, 35, is chief of police for Bowling Green Police Department. Photo by Alison Thoet

    “One of the last nights we had filming the Loving movie in Bowling Green…some of the family members came in and actually sat down and ate dinner with the actors and the actresses that were in the movie. They pretty much, I guess the phrase goes ‘broke bread together,’ and sat there as a community, a joint endeavor of family, friends, police officers, actors, actresses, directors, all sat there and ate together and shared that experience.”

    Jason Satterwhite

    Satterwhite outside the Caroline County Courthouse. Photo by Alison Thoet

    Bowling Green Mayor Jason Satterwhite, 39, outside the Caroline County Courthouse. Photo by Alison Thoet

    “They’re just sweet, loving people. And to know that this little small town played a part in the history and the changing of the country…just for two people that wanted a simple life. All they wanted was to love each other and live in the community they loved.”

    Jared and Jaden Hageman

    Jared and Jaden Hageman at the hardware store where they work in downtown Bowling Green. Photo by Alison Thoet

    Jared Hageman (R), 38, and his son Jaden Hageman (L), 17, at the hardware store where they work in downtown Bowling Green. Photo by Alison Thoet

    “Without the case, legally, [my wife and I]wouldn’t be allowed to date or marry. I think it’s great that it happened here. There used to be more looks or people saying things. They would say things behind your back then. Nowadays, it’s kind of chilled out, and you don’t really hear about anyone saying anything anymore… It’s more accepted now with time, a new generation.” — Jared Hageman

    “It’s a big deal… If it hadn’t been done, I probably wouldn’t be here right now. It just affects a lot of people’s lives, a lot of interracial couples. I do have hope for more kids in the future like me, I feel like it will get better over time. I do believe it should be talked about more.” — Jaden Hageman

    The post The landmark Loving interracial marriage case began in this county, 50 years ago appeared first on PBS NewsHour.

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    Attorney General Jeff Sessions will testify Tuesday at a Senate Intelligence Committee hearing that will likely focus on his meetings with Russian officials during the 2016 presidential campaign.

    Sessions is scheduled to appear before the Senate Intelligence Committee around 2:30 p.m. Tuesday. Watch live in the player above.

    The hearing comes days after former FBI Director James Comey testified about the agency’s investigation of Russia’s role in last year’s presidential election and possible ties to President Donald Trump’s campaign, along with his relationship with Trump in the weeks before his firing.

    READ MORE: Important takeaways from Comey’s Senate hearing

    Sessions may also be questioned Tuesday about his role in Comey’s firing.

    On Monday, White House press secretary Sean Spicer said he wasn’t sure whether Sessions would invoke executive privilege to limit the range of topics covered in the hearing. It “depends on the scope of the questions,” he told reporters.

    Tuesday’s hearing will be Sessions’ first public testimony since March, when he recused himself from the Russia investigations after failing to disclose meetings with Russian ambassador Sergey Kislyak. During his January confirmation hearings, while under oath, he told senators he hadn’t had any contact with Russian officials.

    READ MORE: All the ambassadors Jeff Sessions met in 2016

    Later, he acknowledged twice meeting with Kislyak before taking office, but said he never intended to mislead senators.

    “Let me be clear: I never had meetings with Russian operatives or Russian intermediaries about the Trump campaign,” he said as he stepped down from the investigations.

    Sessions and Republicans also stressed there was a difference between meeting with foreign officials as a senator and as a member of a campaign. Sessions said he never discussed Trump’s campaign with Russian officials.

    In Comey’s prepared remarks last week, the former FBI director said he expected Sessions to recuse himself from Russia investigations two weeks before Sessions decided to step down — prompting lawmakers to question what led Comey to that conclusion.

    PBS NewsHour will update this story as it develops.

    The post WATCH LIVE: Sessions testifies about Russia meetings in Senate hearing appeared first on PBS NewsHour.

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    U.S. President Donald Trump signs an executive order on the establishment of office of trade and manufacturing policy during a tour at The Ames Companies in Harrisburg, Pennsylvania, U.S. April 29, 2017. REUTERS/Carlos Barria - RTS14I1F

    U.S. President Donald Trump signs an executive order on the establishment of office of trade and manufacturing policy during a tour at The Ames Companies in Harrisburg, Pennsylvania, on April 29, 2017. Photo by Carlos Barria/Reuters

    Editor’s Note: Joel Mokyr is among the world’s premier historians of the economic miracles of technology, which he has called “the lever of riches.” In today’s Making Sen$e column, Mokyr joins the debate over President Trump’s novel approach to international economics: going it alone.

    — Paul Solman, Economics Correspondent

    “America First” has become the declared trade policy of the current administration. It is based on the assumption that international economic relations are basically a zero-sum game: if another nation gains from trading with us, they do so at our expense. Yet economic international relations — like all international relations — are never zero sum.

    When two nations engage in trade, both normally stand to gain, and both typically wind up better off. If nations coordinate on the right policies (think environmental policies, for instance, or fiscal harmony), it is a win-win. To be sure, trade — much like technological progress — does not make every single person better off. But the winners’ gains exceed the losers’ losses and wise government policies can cushion the losers’ pain.

    READ MORE: Column: Trump’s trade policy is a recipe for recession, history says

    On the other hand, when one nation invades and colonizes another, takes part in the slave trade, say, or even just imposes trade restrictions, it is almost always a negative sum game, in which the gains of the aggressor are smaller than the losses of the victims. In the 17th and 18th-century African slave trade, some traders and slave owners became immensely rich, but their gains were more than offset by the colossal damage inflicted on African societies, whose poverty can be linked to the slave trade even today. And there were losses to everyday Europeans as well, as their governments sustained the slave trade through costly military force and colonial administration.

    Today, we see threats to free trade through “border adjustment taxes” (protective tariffs), “renegotiating” (that is, disrupting) trade agreements, or announcing that we are now engaged in a “trade war,” as Commerce Secretary Wilbur Ross seems to believe. Such economic nationalism is based on the hope of gaining an advantage, and indeed the U.S. might gain a bit for a while. But if so, other nations will lose much more.

    What’s likely to happen, therefore, is that our trading partners would respond in kind, trying to put themselves first. As a result, the volume of global trade would decline and all sides would experience a drop in real income and quite possibly employment as well.

    In international trade, the notion that “it’s us against them” has a long and unhappy lineage.

    This would be stupid. In the 1930s, such “beggar thy neighbor” policies aggravated and lengthened the global Great Depression. “America First,” “Deutschland über alles” and their equivalent slogans in other countries reflected disastrous economic policies. But the slogans won out over enlightened self-interest.

    In international trade, the notion that “it’s us against them” has a long and unhappy lineage. For centuries, European economic policies were dominated by a primitive form of economic nationalism known as mercantilism. In the name of “Spain First” or “England First” or “France First,” mercantilism placed its countries’ special interests above those of the rest of the citizens and absurdly encouraged exports while discouraging imports (all the while providing the politically influential special interests of the exporters with substantial benefits). Consumers paid higher prices; the special interests — mainly well-connected merchants — got richer. And richer.

    Adam Smith, in his 1776 bible of economics, “The Wealth of Nations,” railed against this doctrine of what we would today call “crony capitalism,” pointing out its awful effects on trade and general prosperity. And thankfully, in the century that followed the book’s publication, many nations realized the truth of Smith’s critique and slowly moved toward freer trade. But sadly, in the late 19th century, when nationalism became increasingly prevalent, protectionist policies became the norm once again. World War I and its aftermath made things worse. Only after 1945 did free trade experience a revival, and its power to enrich us was felt by all. But in the marketplace for ideas, ignorance is a tenacious weed that keeps sprouting up.

    It should be acknowledged that some moderate economic nationalism can be a force for growth and wealth. But this is chiefly true within the context of competition that freer trade encourages. Sovereign nations compete with one another on a variety of fronts, and such competition can be healthy if it spurs nations to stay “ahead of the competition” through research and invention that lead to higher productivity and better economic performance.

    READ MORE: Column: The great irony of the Mexico tariff is that Americans would pay for it too

    Indeed, Europe’s enormous economic successes in the 19th century were in part driven by what Adam Smith’s friend David Hume called “the jealousy of trade.” Nations did not want to fall behind their neighbors, and even if their motives may have been military and aggressive, they often ended up doing the smart thing for the wrong reasons. Thus, Russia’s czar Peter the Great traveled to the West to learn the most advanced technologies and methods (so as to have a better chance to fight his enemies) and in the process made a small start in Russia’s economic development. During the Industrial Revolution, Britain’s Parliament repeatedly denied petitions of wool manufacturers to block new and productive machinery, as otherwise such machinery would be left to its  enemies (in this case, France). On the eve of World War I, German scientists (worried about their country being cut off economically in the event of war) developed a process to convert atmospheric nitrogen into ammonia, one of the greatest inventions of the 20th century. Nitrates were essential in the production of fertilizer and explosives, and Germany depended on imports from South America for its supply. The rivalry between the U.S. and the Soviet Union after the launching of the Sputnik in 1957 is another example: the “jealousy” driven by their national rivalry provided a huge stimulus to scientific research and education in the U.S. and put a man on the moon in 1969. Again, the great minds of the Enlightenment saw this reality. Writing a few years after Adam Smith, Edward Gibbon noted that the competition among Europe’s states “restrained the abuses of tyranny” and “the progress of knowledge and industry is accelerated by the emulation [competition] of so many active rivals.”

    The U.S. and its trading partners should trade with one another in a competitive free system, in which all participants respect the rules. We should outdo one another through better science, better technology, higher productivity and superior quality rather than threatening trade.

    Ancient Jewish wisdom has it that “the jealousy of the learned shall increase wisdom” — the same can be said about the rivalry of nations. The U.S. and its trading partners should trade with one another in a competitive free system, in which all participants respect the rules. We should outdo one another through better science, better technology, higher productivity and superior quality rather than threatening trade. The benighted mercantilist policies reflected in slogans such as “America First” and “Take back control” will be disastrous. If “America First” were to mean anything economically useful, it would be a slogan promoting massive investment in cutting-edge research and STEM education to outcompete both our partners and our enemies. Instead, for political reasons, it seems, these budgets are in danger of being cut back. To the extent they are, America will inevitably be worse and worse off relative to the competition. And some day, we could end up “Last.”

    The post Column: How ‘America First’ could become America last appeared first on PBS NewsHour.

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    Bruce Mead-e, 63, who has advanced lung cancer, stands in the garden at his home in Georgetown, Del. Over four years, he has undergone two major surgeries, multiple rounds of radiation and chemotherapy. (Eileen Blass for Kaiser Health News)

    Bruce Mead-e, 63, who has advanced lung cancer, stands in the garden at his home in Georgetown, Del. Over four years, he has undergone two major surgeries, multiple rounds of radiation and chemotherapy. (Eileen Blass for Kaiser Health News)

    In the past four years, Bruce Mead-e has undergone two major surgeries, multiple rounds of radiation and chemotherapy to treat his lung cancer.

    Yet in all that time, doctors never told him or his husband whether the cancer was curable — or likely to take Mead-e’s life.

    “We haven’t asked about cure or how much time I have,” said Mead-e, 63, of Georgetown, Del., in a May interview. “We haven’t asked, and he hasn’t offered. I guess we have our heads in the sand.”

    At a time when expensive new cancer treatments are proliferating rapidly, patients such as Mead-e have more therapy choices than ever before. Yet patients like him are largely kept in the dark because their doctors either can’t or won’t communicate clearly. Many patients compound the problem by avoiding news they don’t want to hear.

    Surprisingly, huge numbers of cancer patients lack basic information, such as how long they can expect to live, whether their condition is curable or why they’re being prescribed chemotherapy or radiation, said Dr. Rab Razzak, director of outpatient palliative medicine at Johns Hopkins Medicine in Baltimore.

    The result: People with advanced cancer don’t know enough about their disease to make informed decisions about treatment or how they want to spend their remaining time.

    “Avoiding these issues is really irresponsible,” said Dr. Ira Byock, executive director at the Institute for Human Caring of Providence Health & Services, based in Torrance, Calif.

    Even the oncologists who prescribe cancer treatment might not realize that so many of their patients are clueless about what’s going on. “I don’t think they recognize the enormity of it,” Razzak said.

    Some patients approaching the end of life are in denial, assuming that they’ll live much longer than is realistic. Yet doctors often have a far more pessimistic estimate of their life expectancy, said Dr. Robert Gramling, the Holly & Bob Miller chair in palliative medicine at the University of Vermont College of Medicine.

    In a study published last year in the Journal of Clinical Oncology, only 5 percent of cancer patients with less than six months to live had an accurate understanding of their illness. Thirty-eight percent couldn’t remember ever talking to their doctor about their life expectancy.

    And in a 2012 study in The New England Journal of Medicine, 69 percent of patients with metastatic lung cancer and 81 percent of people with advanced colorectal cancer thought they could still be cured, although both conditions are generally considered fatal, said study co-author Dr. Nancy Keating, a professor of health care policy and medicine at Harvard Medical School.

    Such misunderstandings can have profound consequences for patients and their caregivers. Patients who don’t understand how long they have to live often choose overly aggressive therapy that can cause pointless pain and suffering.

    Nearly one-third of cancer patients end up in the intensive care unit, or ICU, in the last month of life, according to the Dartmouth Atlas of Health Care. Although intensive care can save the lives of younger, healthier people, it doesn’t improve or lengthen the lives of people with terminal cancer.

    “It’s surprising how many people end up in an ICU, critically ill and dying, without realizing they’re dying,” said Dr. Mark Siegel, a professor of internal medicine and critical care specialist at the Yale School of Medicine.

    These last-ditch measures to extend life can leave families with extended grief and trauma, Siegel said. Although almost half of Americans use hospice care — which focuses on comfort care at the end of life — studies show that many people enter hospice very late in their illness, often only a week before death.

    “The real question is, ‘How do these patients become overly optimistic about their prognosis and what part do physicians play in this?’” Siegel said. “What do physicians tell the patients? What are patients hearing?”

    In some cases, oncologists fail to tell patients how long they have to live. In others, patients are clearly told their prognosis, but are too overwhelmed to absorb the information. Some doctors and patients enter into an implicit agreement to avoid talking about dying, a pact that researchers have described as “necessary collusion.”

    New treatments have made discussions about prognosis even more complicated, said Dr. Jennifer Temel, director of cancer outcomes research at the Massachusetts General Hospital Cancer Center. Although advanced cancers are still usually fatal, a fraction of patients are living much longer due to these drugs.

    Doctors can’t always be sure, though, which patients are likely to benefit, Temel said. Many patients who put their hopes in new therapies end up delaying critical decisions about end-of-life care, said Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medical College in New York.

    “All of these changes are requiring us to rethink how we talk to patients,” Temel said.

    Bruce Mead-e, left, and his husband, Chuck Mead-e, 60, had a meeting with a pastoral care provider who emphasized the bright side of things, Bruce says. It helped me feel hopeful. (Eileen Blass for Kaiser Health News)

    Bruce Mead-e, left, and his husband, Chuck Mead-e, 60, had a meeting with a pastoral care provider who emphasized the bright side of things, Bruce says. It helped me feel hopeful. (Eileen Blass for Kaiser Health News)

    The Optimism Bias

    When in doubt, both doctors and patients tend to err on the side of optimism, assuming that a treatment will work.

    Delivering bad news, particularly to longtime patients, can be painful, said Dr. Ronald Adelman, co-chief of geriatrics and palliative medicine at New York-Presbyterian Hospital/Weill Cornell Medical Center.

    “They have a long, connected relationship and it’s very hard to not be able to deliver what the patients are hoping for,” Adelman said.

    Even doctors who want to be honest are often unable to forecast how long patients will live.

    In a study of 468 terminally ill cancer patients, only 20 percent of hospice doctors accurately predicted how long patients would survive. Most weren’t even close, estimating that patients would live five times longer than they did.

    Significantly, the longer that doctors knew their patients, the more likely they were to get it wrong, suggesting that emotional bonds clouded doctors’ thinking.

    Even patients with early, curable cancers often lack key information.

    Nicole Wesolowski was diagnosed with early rectal cancer last year at age 27, and has endured surgery and chemotherapy in the hopes of curing it. But she said her doctor has never told her what the chances are that her cancer will come back.

    “Doctors don’t want to tell you something they don’t know,” said Wesolowski, of New York City, who said there are no studies to help predict her chances of cure, both because she’s so much younger than the typical cancer patient and because she received an experimental treatment. “I don’t think [my doctor] has an answer. It might be better if I don’t know.”

    For Wesolowski, her doctor’s demeanor tells her all she needs to know.

    “My surgeon seems very confident,” Wesolowski said. “Statistics aren’t going to help me be less afraid. … I’m just going to trust the people who have gotten me so far in such a small amount of time.”

    Saying A Lot, But Communicating Little

    Oncologists have long been criticized for failing to give patients the news they need to plan their futures. In a 2001 study, 40 percent said they would give inaccurate survival estimates — mostly painting an overly sunny picture.

    Recordings of clinic visits show that oncologists devote less than 10 percent of their time to talking about patients’ prognosis, according to a March study in the Journal of Oncology Practice, in which researchers listened to 128 audio recordings of oncologists and patients.

    One doctor in the study obscured the news that a patient’s cancer had gotten worse by quickly transitioning to treatment choices.

    “The good news is there’s lots of other options here,” he said.

    Doctors in the study also overused medical terms that patients might not understand, said co-author Dr. Toby Campbell, chief of palliative care at the University of Wisconsin School of Medicine and Public Health.

    Such medical jargon gave Carolyn McClanahan’s mother false hope after she was diagnosed with terminal liver cancer at age 66.

    A doctor told her mother that there was a 25 percent chance that her tumor would “respond” to chemo, meaning that it would shrink. McClanahan’s mother, desperate for good news, assumed this meant she had a 25 percent chance of cure — even though her cancer was incurable. While shrinking a tumor can provide some relief from symptoms, it doesn’t necessarily prolong life.

    The chemo caused McClanahan’s mother to develop painful ulcers in her mouth and esophagus, which prevented her from eating or drinking, said McClanahan, a former family physician and emergency medicine doctor from Jacksonville, Fla.

    Her mother became dehydrated and was hospitalized for two weeks, taking in nutrition only through a tube, McClanahan said.

    Her mother entered hospice care, which focuses on providing comfort at the end of life, and died two weeks later.

    “Thankfully, we had a couple good weeks before she died,” said McClanahan, who now works as a financial planner. “I’m still so angry at myself for what she went through.”

    Shopping For Good News

    In surveys, people with cancer overwhelmingly say they want doctors to be honest with them.

    In the real world, doctors can pay a price for honesty.

    Cancer patients tend to prefer doctors who deliver optimistic messages, rating them as more compassionate and trustworthy, according to a 2015 study in JAMA Oncology.

    In fact, patients with the least accurate idea of their prognosis — who mistakenly believe that chemo can cure an incurable cancer — give their doctors the highest scores for communication.

    “Patients want doctors to be honest with them, and they want doctors to honestly tell them that their disease can be cured,” Gramling said.

    When faced with traumatic news, some patients are unable to process the information, even when doctors are blunt, studies suggest.

    One-third of patients with advanced cancer in a small 2011 study mistakenly believed their disease was curable, even after reading educational material that stated, “In this setting, there is no chance of cure.”

    “What doctors say and what patients hear are very different,” said Dr. Leonard Saltz, chief of the gastrointestinal oncology service at New York’s Memorial Sloan Kettering Cancer Center. “There are coping mechanisms that help people get through the day by simply not hearing that they’re going to die.”

    If doctors’ words fail to get through to patients, it may be because patients value other opinions more highly.

    In a 2016 study in Cancer, more than 70 percent of patients based how long they expected to live on personal beliefs. Six percent based their estimates on religious beliefs, while 18 percent based their estimates on information from their doctor.

    “When the physician says, ‘We’ll give you this chemo and it may prolong your life,’ the patient thinks, ‘I’m sure the cure is just a few more months down the road, and this will keep me alive until the cure comes along,’” said Betty Ferrell, director of nursing research and education at City of Hope National Medical Center in Duarte, Calif.

    Oncologists say they struggle to provide accurate information, without scaring patients away.

    If doctors appear too negative, “patients will go out the door and see another doctor who will tell them what they want to hear,” Saltz said.

    Paulette Thompson-Clinton said she “fired” an oncologist for being too negative. Thompson-Clinton, a minister with breast cancer that has spread to her bones, said she chooses to live with “faith and optimism.”

    “My oncologist said, ‘The average life span is three years, so you’ll probably live about that amount of time,’” said Thompson-Clinton, 49, of Bethany, Conn., who has since survived 7½ years. “There just seemed to be no hope. I was looking for someone to partner with. It takes a lot of energy and effort.”

    Paulette Thompson-Clinton, a minister with breast cancer that has spread to her bones, stands with her husband and son. Thompson-Clinton said she fired an oncologist for being too negative. (Courtesy of Ameer Brooks/DJAmeerPhotography)

    Paulette Thompson-Clinton, a minister with breast cancer that has spread to her bones, stands with her husband and son. Thompson-Clinton said she fired an oncologist for being too negative. (Courtesy of Ameer Brooks/DJAmeerPhotography)

    Today, Thompson-Clinton said she again finds herself at a crossroads. Her previous cancer treatments have stopped working, and her doctor has recommended intravenous chemotherapy — something she doesn’t want to do. She’s considering alternative medicine, including a clinic in Tijuana, Mexico.

    “I’m in a harder place than I’ve ever been,” Thompson-Clinton said. “I feel like I’m at the end of my options.”

    Tailoring The Message To The Patient

    Being diagnosed with breast cancer over eight years ago forced Heather Block to learn two foreign languages: the medical jargon spoken by her oncologist and the even more arcane vocabulary of insurance companies.

    To avoid confusion, Block brings a notebook to every doctor’s visit, then gives her oncologist a written summary about what she sees as the next steps in treatment.

    “I put it in writing so I make sure that we’re on the same page,” said Block, 54, a resident of Lewes, Del.

    Like Block, some people with cancer “want to know everything.” For others, too much information is overwhelming, and they cope better knowing as little as possible, Razzak said.

    Some of the women at Block’s cancer support group keep the names of their medications on cards in their handbags. It’s the only way they can remember them, she said.

    That’s why it helps if doctors tailor their messages to the needs of the individual, said Dr. Richard Schilsky, chief medical officer of the American Society of Clinical Oncology. When meeting a new patient, he asks two questions: “What do you know about your cancer?” and “What do you want to know?”

    These questions allow patients to take the lead, receiving only as much information as they want, Schilsky said.

    Studies suggest that palliative care — which focuses on quality of life in people with serious illness and their caregivers — improves patients’ understanding of their disease.

    For patients near the end of life, talking about their goals and values can help people avoid unwanted medical interventions, said Dr. Rachelle Bernacki, associate director of the Serious Illness Care Program at Ariadne Labs, a health care research center led by Dr. Atul Gawande.

    In a 2015 study, patients who had end-of-life discussions were half as likely to wind up in the ICU before they died, compared to patients who didn’t have such conversations.

    The American Society of Clinical Oncology, the country’s largest group of cancer specialists, now recommends that everyone with advanced cancer receive palliative care within eight weeks of diagnosis. Several studies show that early palliative care has been shown to help patients live longer and better.

    Palliative care conversations include questions such as “How can we continue to hope for the best but prepare for the worst?” said Ferrell, who helped write the palliative care guidelines.

    Yet palliative care specialists are in short supply, Ferrell said.

    That’s why Ariadne Labs has created a “Serious Illness Conversation Guide,” meant to help all health providers lead these discussions. Bernacki and others have trained more than 1,700 doctors, nurses and others to use it.

    After talking to a reporter for this story, Bruce Mead-e — the Delaware man with advanced lung cancer — decided to ask his oncologist whether his disease was curable.

    Mead-e wasn’t surprised by what he heard. “It’s not like it will ever really be cured,” Mead-e said. With treatment, however, the cancer “could go into remission.”

    His doctor typed out the goals of treatment — to slow the growth of Mead-e’s cancer, relieve symptoms and side effects of treatment, and keep him comfortable if pain arises.

    Mead-e and his husband, Chuck, also have met with a pastoral care provider who works with a local hospice. The experience, which included prayer, was uplifting for both of them. The pastoral care provider “sees the bright side of things, and doesn’t dwell on what you could have or should have done,” Mead-e said. “It helped me feel hopeful.”

    Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with KaiserPermanente. You can view the original report on its website.

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    A satirical pop poem by Thom Young.

    A satirical poem by Thom Young. After it was posted to Instagram, it received 2,236 likes.

    When Texas-based poet Thom Young joined Instagram around 2009, he noticed a number of poets were already using the platform to share their work. At first, he found this encouraging abd began sharing his work there as well, amassing several thousand followers. But as he continued to look around, he also noticed something strange: While most serious, award-winning poets — those who did thoughtful work — got hardly any attention, people who wrote short, trite poetry got tons of likes and followers. Some of these “pop poets,” as he calls them, had become social media celebrities overnight.

    And so Young, a Pushcart Prize-nominated poet, decided to do an experiment. He thought he’d try writing the most vapid, simplistic poetry he could and post it to Instagram to see what happened.

    “I decided that a parody or satire was needed to demonstrate how easy it was to get popular on social media, particularly on Instagram, writing this short, trite poetry,” he said. “And right away I started getting followers and likes like crazy” — going from 9,000 to 46,000 followers on Instagram in less than a year, he said.

    Thom Young, courtesy of Thom Young.

    Thom Young, courtesy of Thom Young.

    Along with the the poetry, Young also created a sort of alter ego, presenting himself as a hipster poet he called Tyler, even using a stock image of a man with a beard. For the past year, he has continued this social media experiment with increasing popularity. He eventually dropped the alter ego, and now uses his real name or initials; just this week, he posted the incredibly short poems: “wait.” and “love made / her wild” against a white background, both of which garnered thousands of likes. While some of his followers clearly understand it’s satire, many others seem not to.

    To those who might say the experiment is condescending, Young says that’s not his goal. He does not want to criticize those who write or like pop poetry, he said, but instead hopes it leads younger people to think more about what they read (in addition to being a poet, Young is also a high school English teacher).

    “I think the younger generation is mostly interested in ‘fidget-spinner’ poetry. Like they’re just scrolling on their devices, to read something instantly, while the libraries are empty. I think people today don’t want to read anything that causes a whole lot of critical thinking,” he said. “And so in a lot of my captions, I try to talk about the real stuff.”

    “Real stuff” means he often points out in his captions that the poetry he’s posting is satire. Or he’ll talk about how smartphone or social media culture can be problematic. He also sometimes points his followers to what he sees as better poetry – including his own. According to Young, sales of his recent poetry books, “A Little Black Dress Called Madness” and “Coffee Nightmares,” have spiked on Amazon since he started posting about them alongside his pop poetry. And some of his followers have now asked him to start posting that poetry instead.

    “That was the goal: to expose people to the real poetry and the real craft,” he said. In his English class, he notices that it’s always an uphill battle to get students to read a serious writer like Oscar Wilde, but after they do, some of them really love it and ask to read other books by Wilde. Similarly, on Instagram, “I see that when people read my real poetry, they want more.”

    Below, read some of Young’s Instagram poems and captions, as well as a surrealistic poem of his called “Gills,” from his 2015 collection “A Little Black Dress Called Madness.”

    Instagram Photo

    Instagram Photo

    Instagram Photo


    by Thom Young

    She came home
    and had grown gills
    and he sat in a pool
    of water with dull black eyes
    and a tongue that swatted
    flies out of the hot dry air
    later that night
    they ate fried steaks
    and hash
    things were different
    but they didn’t say
    as they watched
    Johnny Carson
    knowing he died
    long ago

    This poem was first published in The Commonline Journal.

    Thom Young is a writer from Texas. His 2015 poetry collection, “A Little Black Dress Called Madness,” hit No. 1 for poetry sold in Germany. He is a 2017 Pushcart Prize nominee and his work has appeared in a number of literary journals, including the International Journal of Poetry, Poetry Quarterly, 3am magazine, Word Riot, Thirty West, and more. He is writing a novel about social media culture and poetry called “Instapoet.”

    The post This poet is trolling everyone on Instagram to show how social media glorifies pop poetry appeared first on PBS NewsHour.

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    Photo of President Donald Trump by Yuri Gripas/Reuters

    The U.S. Secret Service said Monday it doesn’t have any recordings or transcripts of any tapes recorded within President Donald Trump’s White House. Photo of President Donald Trump by Yuri Gripas/Reuters.

    WASHINGTON — The U.S. Secret Service said Monday it doesn’t have any recordings or transcripts of any tapes recorded within President Donald Trump’s White House, a disclosure that failed to rule out whether any tapes exist of Trump’s conversations with ousted FBI Director James Comey.

    The agency made the disclosure in response to a freedom of information request by The Wall Street Journal. The newspaper noted that it doesn’t exclude the possibility of recordings created by another entity.

    Trump has been coy about whether any recordings exist of his private conversations with Comey, who was fired by the president in May. Trump raised the possibility of tapes last month and told reporters last week that he would discuss their potential existence “in the very near future.”

    “I’ve seen the tweet about tapes. Lordy, I hope there are tapes,” Comey said at a hearing last week.

    White House press secretary Sean Spicer said Monday an announcement would come “when the president is ready to make it.”

    Comey suggested in his high-profile Senate testimony last week that any recordings would back up his account over the president’s, adding, “Lordy, I hope there are tapes.”

    The Secret Service has handled recording systems within the White House for previous presidents. The request from the Journal sought recordings or transcripts of any recordings made after Jan. 20 at the White House. The agency said a review of its main indices found no records related to the request.

    White House spokeswoman Sarah Huckabee Sanders said last week she wasn’t aware of whether the White House had any kind of taping system and suggested reporters check with the Secret Service on any security-related questions.

    Asked whether she would find out, Sanders joked that she would “look under the couches.”

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    President Donald Trump could be weighing the termination of special counsel Robert Mueller from his oversight of the federal Russia investigation, Christopher Ruddy, CEO of the conservative Newsmax Media and a friend of President Trump, told PBS NewsHour’s Judy Woodruff on Monday.

    “I think he’s considering perhaps terminating the special counsel. I think he’s weighing that option,” Ruddy said when asked by Woodruff whether the president was prepared to let the special counsel pursue the Russia investigation. “I think it’s pretty clear by what one of his lawyers said on television recently.”

    “I personally think it would be a very significant mistake,” Ruddy added.

    The comments come the day before Attorney General Jeff Sessions is set to testify before the Senate Intelligence Committee, the same panel before which former FBI director James Comey appeared last week.

    WATCH LIVE: Sessions testifies about Russia meetings in Senate hearing

    In his testimony June 8, Comey detailed his meetings with Trump before he was fired May 9, including conversations in which the president referred to the Russia investigations as a cloud over his presidency. Comey also detailed conversations in which he said the president told him he hoped the director could “let go” of investigations into former National Security Adviser Michael Flynn’s contacts with Russia.

    READ MORE: Important takeaways from Comey’s Senate hearing

    Ruddy told Woodruff that Trump was optimistic after the Comey hearing and “generally felt he had won a victory.”

    “Director Comey’s testimony once again proved that there was no obstruction” of the Russia investigations, Ruddy said, adding the president and his top aides felt that some people in Washington were trying to undermine Trump’s agenda by focusing on the investigations.

    Ruddy also said Mueller was under consideration for the director of the FBI before he was appointed special counsel, as reported earlier by NPR.

    “The president did talk with him in the days before he was named special counsel. I think there’s a conflict there,” Ruddy said.

    “There’s some real conflicts,” Ruddy continued. “He comes from a law firm that represents members of the Trump family. He interviewed the day before, a few days before, he was appointed special counsel, with the president, who was looking at him potentially to become the next FBI Director. That hasn’t been published, but it’s true. And I think it would be strange that he would have a confidential conversation and then a few days later become the prosecutor of the person he may be investigating.”

    READ MORE: President Trump calls appointment of special counsel a ‘witch hunt’

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    NewsHour shares web small logoIn our NewsHour Shares series, we show you things that caught our eye recently on the web. What about you? Leave your suggestions in the comments below, or tweet to @NewsHour using #NewsHourShares. We might share it on air.

    JUDY WOODRUFF: Now to our NewsHour Shares, something that caught our eye that may be of interest to you, too.

    Allegiances to sports teams run deep in many families, but one Virginia man decided to let the nation’s Major League Baseball franchises make their own pitch for his son’s affection.

    The NewsHour’s Julia Griffin explains.

    PETE VAN VLEET, Father: This photo is good for two Astros tickets.

    JULIA GRIFFIN: So, when are you going to redeem that?

    PETE VAN VLEET: If it were up to me, we’re having such a good year, we’d go this season, but that would be unfair for Jack.


    JULIA GRIFFIN: Right, because he wouldn’t remember it.

    PETE VAN VLEET: He wouldn’t remember it.

    JULIA GRIFFIN: Jack wouldn’t remember a Houston Astros game because he was just born in February.

    And while his father, Pete Van Vleet, is a lifelong Astros fan, he wants Jack, like his 5-year-old daughter, Madeline, to choose his own allegiance.

    PETE VAN VLEET: I didn’t want to force anything on my own kids, especially in the realm of baseball, so I let them pick their own team.

    JULIA GRIFFIN: A few seasons ago, Madeline picked Detroit, reasoning that Tigers are fierce.

    PETE VAN VLEET: A friend of mine asked when, after Jack was born, is he going to be an Astros fan? I said, no, he can root for whomever he wants. And then it dawned on me, why not let the teams have a say?

    JULIA GRIFFIN: When spring training got under way, Pete, who, for the record, is an employee of PBS, mailed letters to all 30 Major League Baseball teams. The query was simple, but serious.

    PETE VAN VLEET: “I want to give you, the Pittsburgh Pirates, the San Francisco Giants, the Washington Nationals, a chance to make your own case as to why my son should pick your team to root for. I must tell you, I do not take this lightly. Friends may come and go. Political affiliations and beliefs in higher powers may change, but one’s team is one’s team forever.”

    JULIA GRIFFIN: It wasn’t long before responses, or, arguably, bribes, began to arrive.

    From the Milwaukee Brewers, a letter and autographed baseball.

    PETE VAN VLEET: From Matt Garza, their ace pitcher.

    JULIA GRIFFIN: From the Miami Marlins.

    PETE VAN VLEET: “Billy the Marlin, our mascot is goofy, adorable and is blatantly superior to all other Major League mascots.” So, if he’s fishing for a team, the Marlins are a good one there.

    JULIA GRIFFIN: Pittsburgh Pirates president Frank Coonelly wrote a personal note.

    PETE VAN VLEET: “The Pirate ship has plenty of room on it for a young fan from Ashland, Virginia.”

    JULIA GRIFFIN: Nationals team manager Dusty Baker sent pint-sized team gear and an invitation.

    PETE VAN VLEET: “We want to get you started by inviting you to our ballpark to catch a game, visit the field during batting practice, and, of course, a sharp outfit for you to start your collection.”

    JULIA GRIFFIN: While the Chicago Cubs sent an array of 2016 world champions memorabilia and made a play for Madeline.

    PETE VAN VLEET: “I know big sisters have a lot of influence over their little brothers, so maybe you can help us convince Jack to be a Cubs fan.”

    Why not? That’s very smart of them.

    JULIA GRIFFIN: Not only did they send all the swag, but they are going after the sister vote as well.

    PETE VAN VLEET: Exactly.

    JULIA GRIFFIN: A total of 13 teams have replied so far, but have any knocked their argument out of the park? Is 4-month-old Jack persuaded?

    There is a smile.

    PETE VAN VLEET: Maybe that’s it

    JULIA GRIFFIN: Well, for now, no comment. Jack is just enjoying the pennant pursuers’ pursuit.

    For the PBS NewsHour, I’m Julia Griffin in Ashland, Virginia.

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    JUDY WOODRUFF: Next: screening for cervical cancer in places where the disease rarely gets priority, amid other pressing problems.

    Special correspondent Fred de Sam Lazaro has a report on one effort to prevent a disease that afflicts about 500,000 women across the world every year, but has the most deadly outcomes in India.

    It’s part of his ongoing series Agents for Change.

    FRED DE SAM LAZARO: In a village just outside Lucknow, India, recently, there was a rare opportunity for many women like 35-year-old Kiran Rawat. For the first time in her life, she saw a doctor. Her timing couldn’t be better.

    WOMAN (through interpreter): There are some white spots that I found when I applied the medicine. It’s nothing to be afraid of.

    FRED DE SAM LAZARO: The white spots are lesions. If left untreated, they can lead to cervical cancer in women usually between 30 and 60 years old. It is preventable and treatable if detected early.

    Yet, more than half the cases worldwide are fatal, the vast majority of them in developing countries. In India, cervical cancer claims almost 70,000 lives a year, more than anywhere else in the world. That’s because, for millions of women here, seeing a doctor is the last resort, an often unaffordable luxury.

    But a pilot program run by the global nonprofit Population Services International, or PSI, aimed to change that. The organization set up medical screening camps in Uttar Pradesh, India’s most populous and one of its most impoverished state. Sixty women came to this one. Four tested positive for the pre-cancerous lesions

    DR. UMA SINGH: Pick up a nice ball of cotton, dip it in freshly made acetic acid solution.

    FRED DE SAM LAZARO: In rich countries, Pap smears and follow-up treatment are the standard, but that’s neither affordable nor practical here. Instead, obstetrics professor Uma Singh demonstrated to students a low-tech, low-cost alternative being used in the pilot, a simple swab of the cervix with vinegar.

    DR. UMA SINGH: So, after one minute, what you do is, do — do the inspection with good light. So, if you see a white area, you treat it by a procedure which is called cryotherapy.

    FRED DE SAM LAZARO: Literally freezing it off.

    DR. UMA SINGH: Yes, that’s the right word, freezing it off.

    FRED DE SAM LAZARO: The lesions are a virus called HPV. The patient can’t see or feel it, and the immune system usually fights it off.

    However, about one in every 100 infections turns cancerous. Vaccines are available and have proven effective in preventing HPV. But the cost puts them out of reach of most Indian women.

    DR. SMITHA SINGH (through interpreter): Don’t be afraid. I will remove them. It’s a very simple thing, just 10 minutes.

    FRED DE SAM LAZARO: The approach here is to remove any lesions right away. There’s no time or resources to monitor or biopsy, no assurance the women will return for follow-up treatment.

    It is likely that in many, if not most cases, you are over-treating the patient.

    DR. UMA SINGH: Yes, it may be a little bit of over-treating, but it has been seen that it doesn’t produce any substantial harm to the woman in relation to producing any long-term effects on the cervix.

    FRED DE SAM LAZARO: But, often, women who test positive are scared off by the prospect of cryotherapy.

    DR. SMITHA SINGH: They feel a big treatment will be done. And at times, they do not give consent for the cryo.

    FRED DE SAM LAZARO: PSI canvasser Pinky Rawat says that happens for a simple reason.

    PINKY RAWAT, Population Services International (through interpreter): They hear the word cancer and they say, if I do have cancer, what can I do? They get very scared when they hear cancer.

    FRED DE SAM LAZARO: But even as there’s fear of cancer, getting women to the screening was a tough sell. These women complained that they need help for far more mundane health care issues, which no one provides.

    WOMAN (through interpreter): My legs hurt all the time. Give me something for my gout.

    FRED DE SAM LAZARO: Many women labor in the field and in households struggling to get by, and they neglect their own health.

    SONI GUPTA, Population Services International (through interpreter): It’s affected my own family. It’s been three months since my mother died.

    FRED DE SAM LAZARO: PSI worker Soni Gupta says early screening and treatment might have saved her mother, who died from cervical cancer.

    SONI GUPTA (through interpreter): I feel terrible. Even though I work in this field for women, my own mother died.

    FRED DE SAM LAZARO: Of the four women who tested positive for the pre-cancerous lesions, the social workers the next morning were able to find just one willing to go in and get treated.

    WOMAN (through interpreter): I’m afraid. I have four children.

    FRED DE SAM LAZARO: It was Kiran Rawat who needed a lot of coaxing and reassurance by a PSI outreach worker.

    WOMAN (through interpreter): There’s nothing to worry about. It will just take a few minutes. And you have my phone number. You can call me for anything.

    FRED DE SAM LAZARO: A few minutes later, accompanied by her husband, they were on the way to Dr. Smitha Singh’s clinic. Soon, the 10-minute procedure was done.

    WOMAN (through interpreter): I was afraid at first.

    WOMAN (through interpreter): But, today, no problems, right?

    WOMAN (through interpreter): No problem today, but I didn’t sleep all night.

    FRED DE SAM LAZARO: The hope is that she will help spread the word and a culture of preventive care, says Dr. Uma Singh.

    DR. UMA SINGH: So, it is like motivating them to go for the checkup for prevention of cancer, for hypertension, for diabetes, for anemia and multiple things. Then you have to ensure that there have to be good facilities.

    FRED DE SAM LAZARO: That much larger job of building a better public health system will take time, but PSI says its screening program is set to scale up. The state government has begun to train workers to offer it in all public health clinics based on results in the pilot, which concluded in January.

    Seven thousand cases were positive for the pre-cancerous lesions. About two-thirds of these women had them removed.

    For the PBS NewsHour, this is Fred de Sam Lazaro outside Lucknow, India.

    JUDY WOODRUFF: Fred’s reporting is a partnership with the Under-Told Stories Project at University of St. Thomas in Minnesota.

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    JUDY WOODRUFF: And to continue our politics conversation, we’re joined now by Tamara Keith of NPR and Stu Rothenberg, senior editor at Inside Elections.

    Thank you both. It’s good to have you.

    So, Tam, you just heard Chris Ruddy, who does talk to people in the White House — he said he talked to the president on Friday — say that he thinks the president is considering terminating Robert Mueller.

    Is that something we were aware of?

    TAMARA KEITH, NPR: Certainly, there has been stuff around on Twitter of other Republicans raising questions about Mueller.

    But the way that Ruddy just couched that, he made it clear that — and maybe he was protecting himself and the president, but he made it clear that he was basing that on something that one of the president’s lawyers had said on TV over the weekend.

    The other thing that stood out to me is talking about Robert Mueller having had a meeting at the White House, having met with the president, possibly to take the job of FBI director, which is a job he had held before.

    NPR and Carrie Johnson, my colleague at NPR, had been reporting that Mueller had met with Justice Department officials and also White House officials. But the idea that he also met with the president himself is new, to me at least.

    JUDY WOODRUFF: Stu Rothenberg, this is — these are — the story just keep bubbling up about Mr. Mueller, Mr. Comey, the president, the Russia investigation.

    This is a White House that, this week, is trying to get — clearly get away from this.

    STUART ROTHENBERG, Inside Elections: Right.

    JUDY WOODRUFF: They have labeled it Workforce Development Week.

    What — can they have — can they make any progress in changing direction when you have this kind of conversation going on?

    STUART ROTHENBERG: Right. I think it’s a great idea that they should try to change the discussion and narrative.

    But, in this case, as you point out, there’s too much is going on. During Workforce Development Week, tomorrow, we have the Sessions testimony on the Hill. We have two attorneys general, one from D.C., one from Maryland, announced that they’re going to sue the president over the Emoluments Clause. We had today the Ninth Circuit Court issuing an opinion upholding the travel ban.

    It’s as if the president has already kind of broken so many bottles and glasses that there is glass strewn on the floor and any step he takes, he’s going to crunch something.

    So, I think it would be a wonderful idea for the White House to change the subject, but you can see what happened in the last 24 hours.

    JUDY WOODRUFF: But, Tam, they’re still trying. Last week, it was infrastructure week.

    TAMARA KEITH: And that was not…

    JUDY WOODRUFF: And Mr. Comey.



    TAMARA KEITH: And Mr. Comey week is actually what it was.

    And so the president is flying tomorrow. He’s going to Waukesha, Wisconsin, to tour a technical college and talk about apprenticeships.

    On a slow news day, any other president, that might sort of be a headline, but it certainly wouldn’t be a front-page headline. If you’re trying to distract some very big headlines, going to a technical college isn’t necessarily the answer.

    Here’s the other thing. We have been trying to press the White House to find out what policy change the president actually envisions or they say that they want more private-to-private partnerships, to do more apprenticeships.

    JUDY WOODRUFF: Around this work force development, right.

    TAMARA KEITH: Exactly, around this work force development.

    But then they’re saying, well, you will have to wait until Wednesday to find out exactly what we’re talking about. And that’s a long time to wait and it’s a long time to expect people to pay attention to something that is not related to the biggest news of the day.

    STUART ROTHENBERG: Two other points.

    One is, are there tapes? That hasn’t been answered, so, every day, reporters are going to ask that. And the other thing was, I think Chris Ruddy made some news today. He said the president is considering the firing of the special counsel.

    Isn’t that the next week’s discussion now? So, it’s hard for me to believe that…

    JUDY WOODRUFF: Well, and we couldn’t tell — as Tamara was saying, we couldn’t tell if he was just referring to what one of the president’s lawyers is saying, but the fact that he said it has…

    STUART ROTHENBERG: And the way he said it, yes, absolutely.

    JUDY WOODRUFF: .. has to make us wonder.

    TAMARA KEITH: Stunning.

    JUDY WOODRUFF: Well, as you mentioned, Stu, you have got the travel ban decision today by the federal court.

    There doesn’t seem to be good news. I mean, health care reform seems to be, at least for the time being, slogged, stopped up. Stopped up, is that the word in the Senate? There is nothing happening yet. Maybe it will happen. We haven’t seen a tax reform plan.

    Are we just going to watch the news develop every week like this? And…

    STUART ROTHENBERG: Yes, I think so.

    So, there is a problem for the White House on a number of levels. The president wants to change the narrative. He also wants to accomplish things. He hasn’t yet. Maybe he will.

    But one of the things I believed for many weeks and months is that he has to worry about the fatigue factor on the American public. I remember thinking back to Bill Clinton and all the drama in the Clinton White House. And after a while, people thought, ay yi yi, another thing we have. Oy gevalt, as we say.

    This is the same kind of thing. It’s — there is another crisis every day. And after a while, people just — they don’t want that. They want things to return to normal.

    And Donald Trump’s — the whole premise of Donald Trump is upsetting normal. Well, you can only do that if you accomplish certain things and people start to feel better about themselves and the country.

    JUDY WOODRUFF: How much do they recognize this at the White House, do you think, Tam?

    TAMARA KEITH: Well, they’re obviously trying to correct it.

    They’re trying to do things that normal presidents do, like hold a Cabinet meeting, as they did today, though it turned into somewhat unusual session of every Cabinet head praising the president in very effusive ways that is sort of beyond what would be normal for one of these types of events, one of these types of photo-ops.

    JUDY WOODRUFF: I want to turn you to something — because we do pay attention to parts of the country, Stu, outside of Washington occasionally.

    But there are a couple of elections coming up. Tomorrow in Virginia, there’s a primary as they choose their governor.


    JUDY WOODRUFF: A week from tomorrow, there’s a much-watched vote to choose the next member of Congress from the 6th District in Atlanta, Georgia.

    STUART ROTHENBERG: Yes, and I think that special election is a really big deal.


    STUART ROTHENBERG: I think Democrats have been hoping…

    JUDY WOODRUFF: In Georgia.

    STUART ROTHENBERG: In Georgia, right, the Georgia 6th special.


    STUART ROTHENBERG: Democrats have been hoping for a victory to take off over a Republican seat.

    This one was very close. Donald Trump won it by a point in November. And the Democrats feel like they have a great opportunity here. And if they do, then we will have another news story, another data point that the White House will have to respond to.

    If the Democrats lose, I think, after losing in Kansas and Montana — and, yes, the Democrats kind of exceeded expectations — but losing in the Georgia seat, there will be a sense of just, are the voters really turning on Donald Trump or not?

    So I think it’s a big deal for both parties.

    JUDY WOODRUFF: Is the White House watching that one?

    TAMARA KEITH: Oh, absolutely they’re watching it.

    And just today, President Trump was saying, look, we did well in Kansas, we did well in Montana, Democrats think they have something going on, but, no, they don’t, look at what we have done.

    So, the president himself is watching this closely.

    JUDY WOODRUFF: And he said complimentary things about Karen Handel, the Republican candidate.

    TAMARA KEITH: I think he would take it as a personal loss if she loses.

    JUDY WOODRUFF: Because — is it, Stu?

    STUART ROTHENBERG: It would be. It would be.

    JUDY WOODRUFF: A statement about Donald Trump?


    Neither Karen Handel, the Democrat — the Republican, nor Jon Ossoff, the Democrat, are perfect candidates. They have raised a lot of money. There is a lot of energy, and most of it is national money and energy.

    But I don’t — think there’s no doubt. If there was a Democrat in the White House, I would expect the Republican to win the race easily. And now, with a controversial Republican in the White House, no, this election is — it’s about Donald Trump.

    JUDY WOODRUFF: Stu Rothenberg, Tamara Keith, this is about the two of you. Thank you.


    TAMARA KEITH: Thank you.

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    JUDY WOODRUFF: But first: There is a new and potentially-explosive battleground shaping up in Syria’s civil war, in the country’s southeast, as is retreats from its makeshift capital, Raqqa, and the larger fight for Syria grinds on.

    Along the border shared by Syria, Iraq and Jordan, American and British special operations troops are training rebel fighters — operating in close proximity, forces from the Syrian army, Russia, Iran, and Hezbollah.

    As special correspondent Jane Ferguson reports, the Lebanese militant group is a unique force in the shifting political landscape in the Middle East. While it has been integral to the Syrian regime’s survival, it also remains committed to its original goal, the destruction of Israel.

    JANE FERGUSON: Forged amid the bloodletting of Lebanon’s civil war from 1975 to 1990, Hezbollah was created to fight Israel, whose army invaded and occupied the country halfway through the conflict after attacks by Palestinian groups.

    Hezbollah means Party of God in Arabic, but members often call themselves simply the resistance. It is a secretive militant movement of the Shia sect of Islam, largely funded and armed by Iran. To the U.S. and many of its allies, Hezbollah is a terrorist organization.

    Inside Lebanon, it is regarded as much a political and social movement as an armed one. In 2006, it fought Israel to a bloody draw during a 33-day war, which the militants declared a victory. It was celebrated around the Arab world, where the group’s popularity rose.

    After the war, with Iran’s help, Hezbollah reorganized to become one of the most powerful militant groups in the Middle East. In 2013, however, it entered a much more controversial war, stepping into Syria’s chaos to shore up the regime of President Bashar al-Assad.

    Timur Goksel was the spokesperson for the U.N. peacekeeping mission in Lebanon throughout the civil war. He has seen firsthand the emergence of Hezbollah and its evolution over the years from a small group of fighters to a massive movement. He’s asking the same question many others are.

    TIMUR GOKSEL, Former Spokesperson, U.N. Peacekeeping Mission in Lebanon: Why did Hezbollah get so much involved in Syria? Because of their love for Bashar al-Assad? I don’t think so. You have to think of what is happening in Lebanon and what are Hezbollah’s concerns for their own survival.

    JANE FERGUSON: The answer to that question lies in geography. Designated by foreign governments as a terrorist organization, Hezbollah is blocked from using the sea and air. To the south sits Israel, with whom Lebanon is still officially at war. Hezbollah’s weaponry and financing comes from Iran, across Shia-dominated Iraq, through Syria and into Lebanon.

    The Shia axis, as it is often called, would be broken if the Sunni-dominated opposition took over Syria.

    TIMUR GOKSEL: For them, survival of the Syrian regime, a friendly regime in Syria, is Hezbollah’s existence. It’s their survival.

    JANE FERGUSON: On the battlefield in Syria, Hezbollah has proved its effectiveness. Those injured during battles in Syria rely on the organization’s extensive network and assistance.

    The NewsHour was given exclusive access to this Hezbollah treatment center in Beirut, where the group’s war wounded from Syria received treatment and physical therapy. We were not allowed to speak with these fighters, but Imad Khoshman, who lost a leg fighting the Israeli army in the past and now runs the center, told us about the kind of injuries he sees here.

    IMAD KHOSHMAN, Hezbollah Rehabilitation Treatment Center (through interpreter): They are normally very painful, such as spinal cord injuries or in the brain. They lead to a person being paralyzed, not being able to speak, not being able to move, or losing limbs.

    JANE FERGUSON: This young fighter is recovering from a devastating head injury, struggling to relearn names for everyday objects.

    However, the war wounded are just one type of patient here. The center mostly offers medical care to civilians from the local community. It’s all part of a policy cultivated by Hezbollah’s leader, Hassan Nasrallah.

    Since becoming the group’s leader in 1992 after Israel killed his predecessor, Nasrallah has expanded Hezbollah as a militant group, and supervised the creation of extensive social programs for its community, effectively creating a state within a state inside Lebanon.

    Hezbollah runs its own schools, medical facilities and even sports clubs across Lebanon. They may also be used to control that society, too.

    Andrew Exum was the top Middle East policy official at the Pentagon at the end of the Obama administration and he lived in Lebanon for several years.

    ANDREW EXUM, Former Pentagon Official: The services that Hezbollah provides to its constituency are services that, quite frankly, the Lebanese government has failed to provide historically. And, so, you can’t blame Lebanon’s Shia constituency for accepting the services provided by Hezbollah.

    On the other hand, it creates a real dilemma for them when they — if they were to think about ever moving away from Hezbollah.

    JANE FERGUSON: Hezbollah is estimated to have lost over 1,300 fighters in the war, more than they ever lost fighting Israel. Most of these women have male loved ones fighting in Syria. This woman lost a son. As the mother of a man seen as a martyr, her emotions are complicated.

    WOMAN (through interpreter): The feeling of my son being martyred is powerful. He will attain a high position in heaven for what he did for us and for our dignity, even though it is difficult. Because he is my child, it is difficult.

    JANE FERGUSON: To followers of Hezbollah, this sacrifice is not made for politics. It is a religious duty. And that duty is absolute devotion and loyalty to the global Shia community’s guardian, regardless of national boundaries. Currently, that guardian is Iranian cleric and supreme Leader Ayatollah Khomeini.

    Hezbollah has taken Iran’s side in the region-wide rift between Shia Iran and Sunni Saudi Arabia. And Syria’s war is part of that rift. Saudi Arabia and Iran back opposing sides in the sectarian conflict.

    While Hezbollah’s supporters in Lebanon remain loyal, its popularity in Sunni countries across the Middle East, which had risen after the 2006 war with Israel, has now plummeted. The group is now perceived as killing Sunni civilians inside Syria on Iran’s request.

    ANDREW EXUM: They very much played a role in the regime tactics to isolate, surround and starve out communities, and the siege and ultimate fall of Eastern Aleppo had Hezbollah’s fingerprints all over it.

    JANE FERGUSON: But Hezbollah claims it is fighting terrorists in Syria and making sure they don’t cross over into Lebanon.

    IMAD KHOSHMAN (through interpreter): Our fighters are injured fighting terrorists and protecting our borders. They are protecting our people, our villages and our towns.

    JANE FERGUSON: However, for all it has lost in regional popularity, the group has become hugely strengthened militarily. And it is capitalizing on that by pursuing further involvement in the region.

    The group is also fighting in Iraq, taking on the Sunni extremists ISIS. At the same time, the U.S.-led coalition is also fighting the Islamic State in Iraq, and operating on the same side as Shia militias, including Hezbollah.

    This indirect relationship of convenience is an irony of the war against the Islamic State. The Trump administration has talked tough about containing Iran, but given little explanation of how it would play a role in curbing Iran and its ally here in Lebanon Hezbollah, while continuing to fight the common enemy of ISIS.

    America has long viewed Hezbollah as a terrorist organization and a deadly enemy. In 1983, the group killed 241 U.S. servicemen in Lebanon when it blew up a U.S. Marine barracks. Israel is anxiously watching Hezbollah’s evolution.

    The Israeli military has conducted airstrikes against Hezbollah targets inside Syria throughout the war, although that hasn’t stopped the group from expanding its arms supplies, which could threaten Israel. In February, Hezbollah leader Nasrallah leader threatened to strike a nuclear facility in Israel.

    HASSAN NASRALLAH (through interpreter): They know that, if rockets hit this reactor, what would befall them and their entity. They are aware of the risks which would be inflicted on them.

    JANE FERGUSON: Both Israel and Hezbollah know a war between them will bring more devastation than ever before for communities on each side.

    This, for now, seems to be the most effective conflict prevention. It is not one, however, guaranteed to keep this fragile truce.

    For the PBS NewsHour, I’m Jane Ferguson in Beirut, Lebanon.

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    JUDY WOODRUFF: This is an important week for the fate of a bill designed to replace and potentially overhaul the health care law often referred to as Obamacare.

    Republican senators are trying to finish drafting key portions of their own bill affecting coverage and costs. But Democrats say the entire battle over repealing the law is quite different from standard operating procedure, and not nearly transparent enough.

    Lisa Desjardins looks at how it’s playing out in the Senate.

    LISA DESJARDINS: Right now the debate over health care is red hot in Congress, but only behind closed doors, as Republicans privately try to craft a Senate bill.

    And that is something Democrats, like Senator Claire McCaskill last week, have been raising publicly.

    SEN. CLAIRE MCCASKILL, D-Mo.: We have no idea what’s being proposed. There’s a group of guys in a backroom somewhere that are making these decisions. There were no hearings in the House. I mean, listen, this is hard to take, because I know we made mistakes on the Affordable Health Care Act, Mr. Secretary.

    And one of the criticisms we got over and over again, that the vote was partisan. Well, you couldn’t have a more partisan exercise than what you’re engaged in right now. We’re not even going to have a hearing on a bill that impacts one-sixth of our economy.

    LISA DESJARDINS: McCaskill wants something called regular order. What is that? Well, it used to be the normal process. A bill goes through committee hearings, where experts and those affected by an issue ring in.

    Then senators on the committee can vote to change the bill with amendments. And then, when a bill gets to the Senate floor, regular order means another chance to change it with amendment votes there too.

    In 2009, with the Affordable Care Act, two Senate committees held three months of hearings and went through weeks of voting on amendments.

    More recently, Senate Leader Mitch McConnell said he wanted regular order when Republicans took over in 2015.

    SEN. MITCH MCCONNELL, Majority Leader: We need to open up, open up the legislative process in a way that allows more amendments from both sides.

    LISA DESJARDINS: But that’s not how Republicans so far have planned this health care debate. Again, in regular order, bills go through committees and amendment votes. Instead, this time around, Senate Republicans have indicated they may send their health care bill straight to the Senate floor with little, maybe no chance to amend it. And they have held no hearings on the bill so far.

    Leading this process is Republican Senate Finance Chairman Orrin Hatch.

    SEN. ORRIN HATCH, R-Utah: Well, I don’t know that there’s going to be another hearing, but we have invited you to participate.

    LISA DESJARDINS: Who stressed to McCaskill that he wants Democratic ideas, if not more hearings and votes. But that differs from Hatch in 2009, when Republicans were the minority, and he thought Democrats were moving too fast on health care.

    SEN. ORRIN HATCH: We at least ought to take the time to do this right.

    LISA DESJARDINS: In the end, it took Democrats 14 months to pass their health care bill in 2009 and 2010. That’s why this moment is critical. The Senate will make or break health care reform. And Senate leaders, including Hatch, have said they want to pass a full health care bill by the end of this month. That’s just nine or 10 legislative days away.

    For the PBS NewsHour, I’m Lisa Desjardins.

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    JUDY WOODRUFF: Last year, former President Obama and China’s President Xi Jinping announced on the same day that the U.S. and China would join the Paris climate agreement, in an effort to forestall climate change through capping and reducing emissions.

    China’s participation was seen as key. It is the world’s largest emitter of carbon dioxide, with the United States running second.

    But on June 1, this month, President Trump announced his intention to withdraw from the agreement, citing possible economic harm to the U.S. Four days later, the top American official in China, the charge d’affaires in Beijing, tendered his resignation, citing the president’s withdrawal.

    His name is David Rank. He served 27 years in the Foreign Service. And he joins me now for his first interview since leaving government.

    David Rank, welcome.

    You knew, when Donald Trump was running for president, that he had said that the U.S. shouldn’t be in this climate accord. What was your thinking then?

    DAVID RANK, Former U.S. Diplomat: Boy, I have served five presidents over 27 years. I have been through a lot of presidential campaigns. I have heard a lot of things both about the U.S.-China relationship and about other issues.

    I suppose I thought, boy, that’s bad idea but there are a lot of bad ideas talked about in presidential campaigns, and we will see what happens when he becomes president.

    JUDY WOODRUFF: And so, when he made that announcement, what was your reaction?

    DAVID RANK: You know, Judy, up until the day he — in fact, I would say the day before, I — it kind of caught me off-guard. It seemed so improbable that the U.S. would pull out, because Paris is a symbol of U.S. leadership in the region, in the world.

    I mean, the benefits that accrue from being a leader and being in Paris just seemed to be so obvious that it sort of caught me off-guard.

    JUDY WOODRUFF: What were the benefits, in your mind?

    DAVID RANK: Look, the — how many agreements are there in the world where two countries, now all but three countries in the world, are members, countries that are sort of the closest partners we have had for 70 years?

    It’s one of the most important issues to those countries. And so the benefits of being the leader in that, of, as you said, working together with China to bring about, to make the Paris agreement possible, and being the true leader on climate issues, really is a remarkable benefit.

    JUDY WOODRUFF: Why does climate matter to you?

    DAVID RANK: Well, as I explained to my staff when I went, not only did it bother me from the perspective of bad policy, but also the obligation we have to our kids and, frankly, the moral obligation I feel to take care of the planet we have been given and the planet we leave our children and their children, and, you know, realizing that if we — from all of those perspectives, ask even to take very small steps, I realized that I couldn’t do it.

    I couldn’t in good conscience be party to the U.S. withdrawal. And so we have a disciplined service. You either agree to implement the president’s policy or you step aside. And so that was the solution I put forward.

    JUDY WOODRUFF: So, his argument that this was doing economic harm to the U.S., he talked about draconian repercussions for the U.S. thanks to the accord, and he said he wanted to negotiate a new deal on climate?

    DAVID RANK: I’m quick to admit I’m not an expert on climate. And had there been a serious proposal, had we said, look, Paris is — instead of Paris, we want to do X, Y or Z, you probably would have changed the way I looked at it.

    There hasn’t been any real indication of that. And I suspect — well, I will wait and see from the outside.

    JUDY WOODRUFF: How difficult a decision is this for you? You have been in the Foreign Service for 27 years.

    DAVID RANK: Yes, I love my job. I love the people I work with.

    I think — I would like to think I got up every morning, and with a feeling of gratitude for the ability to do what I was doing, to serve the American people, to work with a group of colleagues who were committed to the same sorts of goals I am. And it was tough. It was very difficult.

    JUDY WOODRUFF: And you could have stayed. And I guess did anybody make the argument you could stay and fight and stand up for what you believe in?

    DAVID RANK: Absolutely.

    And I think there’s honor in that. And I made the case to the folks, because there are a lot of people who I think, not just in the embassy in Beijing, but across the State Department and across the government, who are asking themselves, if I fundamentally disagree, what do I do?

    And my answer to that is, look, I have my own particular personal situation. I’m relatively close to the end of my career, or I was. I had been in for almost 30 years.

    But if you have got 20 years ahead of you, then there’s real honor, honor to doing the sort of tough work, the slow and steady work that we as diplomats and really people throughout the U.S. government — I mean, that’s the role of the civil servant, the role of the public servant. And I think it is and will continue to be an honorable role.

    JUDY WOODRUFF: Last thing, and separate from this decision, how do you see the state of relations right now between the United States and China, with President Trump pressing the Chinese in particular to lean on the North Koreans to pull back their nuclear program?

    DAVID RANK: I think we’re early in the Trump administration.

    I think it’s a positive thing that the president and his senior advisers have made it clear that it’s an important issue, that we have to grapple with North Korea. You know, it’s not the only issue between the United States and China, but certainly it is the one that is on the front burner.

    But I think it will be a challenge. It will take hard work every day, not just by the president, not just by the secretary of state, but by the colleagues of mine who are still in Beijing and colleagues in the State Department and the Department of Defense and elsewhere in the U.S. government. It’s a real challenge to the United States.

    JUDY WOODRUFF: David Rank, the former charge d’affaires at the U.S. Embassy in Beijing, China, up until, what, about eight or 10 days ago.

    DAVID RANK: That’s right.

    JUDY WOODRUFF: Thank you very much for talking with us.

    DAVID RANK: Judy, thank you very much.

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    JUDY WOODRUFF: The White House isn’t saying tonight whether tape recordings do exist of President Trump’s conversations with former FBI Director James Comey.

    Over the weekend, several Republican senators urged the president to answer that question, yes or no.

    At the White House today, reporters pressed Press Secretary Sean Spicer on the subject.

    SEAN SPICER, White House Press Secretary: I think the president made it very clear on Friday that he would get back as soon as possible on this and his position on that conversation.

    QUESTION: Right, but what is he waiting for? What’s the delay?

    SEAN SPICER: He’s waiting — he’s not waiting for anything. When he’s ready to further discuss it, he will.

    JUDY WOODRUFF: Spicer also wouldn’t say if Attorney General Jeff Sessions will invoke executive privilege when he goes before a Senate committee tomorrow. Sessions faces questions about his contacts with Russia’s ambassador during the presidential race.

    A second U.S. appeals court has upheld a block on President Trump’s modified travel ban. In Seattle today, three judges of the Ninth Circuit Court agreed with a ruling by a lower court in Hawaii that the ban discriminates against Muslims. A federal appeals court in Virginia already issued a similar ruling in a separate case.

    The attorneys general of Maryland and the District of Columbia charged today that the president’s ongoing business ties violate the Constitution. They sued in federal court, citing the Emoluments Clause, designed to head off conflicts of interest.

    In Washington, the two officials, both Democrats, said it’s a matter of saving democracy.

    KARL RACINE, D.C. Attorney General: We’re concerned that foreign governments are coming to the Trump businesses for the single purpose of currying special favor from the president of the United States, so that their interests can get a higher priority than the interests of the American people.

    JUDY WOODRUFF: A White House spokesman said the suit is motivated by partisan politics. A similar lawsuit is pending in New York state.

    The White House also condemned Russia’s crackdown today on protesters against corruption. More than a thousand people were arrested across the country.

    Alex Thomson of Independent Television News filed this report.

    ALEX THOMSON: Hundreds arrested in Moscow alone on a day of protests nationwide against corruption generally and Vladimir Putin particularly. “Putin is a thief,” the chant, and “Russia without Putin” — all of this organized by the Kremlin’s most prominent critic by far, the anti-corruption campaigner and presidential hopeful Alexei Navalny.

    If Navalny’s plan was to rain on President Putin’s parade, it’s certainly succeeding in this part of the demonstration. Thousands of people gathered here, plainly the vast majority of them here pro-Navalny.

    MAN (through interpreter): Putin is killing our people. He’s killing you and me. He’s sending people to Ukraine and Syria to die for his interests. Let’s tell him we’re not having it.

    WOMAN (through interpreter): I came here for the truth. Our government is not conducting itself properly.

    ALEX THOMSON: Navalny was allowed to demo in Moscow, just not here, on the main road leading straight up to Red Square. But late last night, he ordered his people to this illegal location. That made confrontation inevitable.

    “Muscovites,” he told people in a late-night appeal, “come to Tverskaya Street. Don’t go anywhere else.”

    Alexei Navalny himself never made it to his own protest, arrested at his home in Moscow. He could now be detained for up to 30 days.

    Across Moscow, as across Russia, these were the official independence day celebrations, the kind the Kremlin wanted people to see and, let’s face it, most Russians. Putin remains hugely popular. Navalny’s support runs at just 2 percent.

    WOMAN (through interpreter): I don’t think protesting today makes any sense. People are celebrating. They’re happy. Why spoil the mood?

    ALEX THOMSON: This was Vladivostok demonstrations and arrests well before most of Moscow had even got up this morning, north to Siberia, Novosibirsk, and another of more than 200 cities where anti-corruption protesters gathered, and west to St. Petersburg, the same pattern, gathering chanting and arresting.

    JUDY WOODRUFF: And back in this country, newly elected Montana Congressman Greg Gianforte will not go to jail after all for assaulting a reporter. The Republican pleaded guilty today to a misdemeanor charge, and was sentenced to 40 hours of community service. He will also attend 20 hours of anger management counseling and pay a fine of $385.

    A Pennsylvania jury has begun deliberating in Bill Cosby’s sexual assault trial. The defense rested abruptly today. Cosby himself, accompanied by his wife for the first time, declined to testify. His defense team argued the comedian and his accuser had a consensual relationship. Prosecutors argued that Cosby drugged the woman.

    In Orlando, Florida, today, they remembered the deadliest mass shooting in modern U.S. history. A gunman, Omar Mateen, killed 49 people at a gay nightclub last June 12, before police killed him. He’d pledged allegiance to the Islamic State group. This morning, a vigil began at 2:00 a.m., the same hour as the rampage. Names of the victims were read aloud, and hundreds carried candles and laid flowers.

    BUDDY DYER, Mayor of Orlando, Florida: We are not here to relive the horror of that day. We’re here for a greater purpose. We’re here to remember the innocent lives that were lost. We’re here to honor them.

    Orlando has been anointed to show the world how to combat hatred and evil and promote quality and embrace diversity. And we don’t just have the opportunity to do this. We now have the responsibility to do this.

    JUDY WOODRUFF: The owner of the Pulse nightclub said that she plans to turn the site into a memorial.

    The U.S. Interior Department is recommending the Bears Ears National Monument in Utah be downsized. It now covers 1.3 million acres. President Trump has said the protective designations amount to — quote — “a massive federal land grab.” He’s ordered reviews of Bears Ears and 27 other sites.

    Wall Street’s week is off to a sluggish start. The Dow Jones industrial average lost 36 points today to close at 21235. The Nasdaq fell 32, and the S&P 500 slipped two.

    And the first family is finally under one roof again at the White House. First lady Melania Trump and the couple’s 11-year-old son, Barron, arrived Sunday night to take up residence. They’d stayed in New York until the school year ended.

    The post News Wrap: Anti-corruption protesters arrested across Russia appeared first on PBS NewsHour.

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    Attorney General Jeff Sessions has angrily denied that there were problems related to his decision to recuse himself from the FBI’s investigation into Russian activities during the election.

    WATCH LIVE: Sessions testifies about Russia meetings in Senate hearing

    Former FBI Director James Comey testified earlier before the Senate intelligence committee said he knew of reasons why it would be problematic for Sessions to remain involved in the Russia investigation, even before he recused himself.

    Sessions raised his voice to the Democratic senator pressing him for an answer, insisting there were no such reasons.

    Sen. Ron Wyden, D-Ore., opened his questioning of Attorney General Jeff Sessions by saying he thinks the American people are tired of officials “stonewalling” Congress in hearings.

    Sessions said to Sen. Ron Wyden: “There are none.”

    Sessions bristled at Wyden, telling the Oregon senator that people are suggesting through innuendo that he has not been honest.

    READ MORE: Sessions says he did not have third meeting with Russian ambassador

    The post Sessions to Sen. Wyden: ‘Secret innuendo’ about my contact with Russia isn’t true appeared first on PBS NewsHour.


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