By Clayton Trosclair

A drop of blood is 78% water. In the world of medicine, the other 22% might as well be magic. Scientists can tell you precisely what you’d see if you put that drop on a slide and viewed it through a microscope. What they cannot do is figure out a way to replicate it. With rare exception, the only blood that works in the human body is that which has formed within the marrow of our bones.

For at least 500 years, long before doctors ever imagined replacing an eye, a hip or a kidney, they thought about replicating blood. It comprises seven percent of the entire human body, yet doctors in medieval times ascribed to it an even greater importance, considering it one of four “humours” that should be kept in perfect alignment.

Their earliest attempts at creating a blood substitute were not imaginative, and involved simply borrowing some from pigs, cows or other humans. Those early scientists tried and failed, just as modern ones have been thwarted by more complicated arrangements with fancier names like hemoglobin and perfluorocarbon.

But the search for a blood substitute remains alive today in a handful of academic and private laboratories across the country, and if one of those researchers were to succeed, the discovery would mark one of the greatest feats in medical history. Artificial blood could save innumerable lives, especially in the developing world where the risk of blood infections still runs high. It could also become an essential tool for every ambulance, emergency room and doctor in the west, where it would be prized for its convenience and cost efficiency.

This is how the search began.

In the summer of 1492, Pope Innocent VIII was dying. His body, which appeared enormous even when unburdened by the heavy robes and vestments of his position, lay in a fleshy, immobile pile. No longer able to eat or drink, his mind already departed, chances of a recovery grew slimmer each hour. The pope’s inner circle gathered in his opulent Roman apartment. So, too, did his personal physician, summoned earlier when His Holiness suffered a violent stroke.

The doctor proposed a radical idea: the pope would be sustained with a transfusion of blood from three healthy Christian boys. Volunteers were procured with the promise of a gold coin, but it must have been a higher calling that compelled them to give. Surely God would reward the innocent child who shares his blood with the head of all Christendom.

Physicians were still 200 years away from mastering the basics of injections, so the boys, not yet adolescents, would have been cut with knives. Their blood offering was likely poured into the open mouth of Innocent VIII then massaged down his throat and into his prodigious gut.

The secretary of the Roman Senate at the time, Stefano Infessura, described the ordeal in his diary. Believed to be the first blood transfusion in history, it was nonetheless a failure that led to the deaths of the pope and his three young donors.

Since then, scientists have hoped to improve upon the technique, using both human and animal blood, as well as newly found matter including stem cells and completely synthetic compounds.

By the early twentieth century, researchers had a better grasp of the complexity of blood and its four main components: red blood cells, white blood cells, platelets and plasma. This discovery, and the understanding that each component carries out a radically different function, helped explain why blood transfusions were not a magical cure-all.

Red blood cells deliver oxygen, white cells fight off infection and platelets are programmed to huddle together and seal off external wounds. The straw-colored soup that contains and binds them all together is called plasma.

Scientists who are trying to develop artificial blood are chiefly focused on replicating one of these functions: transporting oxygen. Their scientific quest has involved billions of dollars, years of laboratory time and unlikely alliances with partners as diverse as the US Army, Jehovah’s Witnesses and a wealthy ice cream executive.

Each year, 15 million pints of blood are transfused in the US. Because of blood’s scarcity, the risk of infection and the difficulty of finding regular, qualified donors, some companies are betting they can produce an artificial version that costs less than the $270 many hospitals now pay for a pint of red blood cells.

A blood substitute, scientists say, would need none of the expensive tests that are used to screen for HIV, hepatitis, mad cow disease and half a dozen other blood-borne illnesses. Nor would a synthetic blood need to be matched by type to each individual patient, eliminating potentially deadly surgical disasters. Doctors would no longer worry whether a patient’s blood is A-, O+ or one of at least 20 other types that have been identified.

(Each drop of human blood contains a specific kind of antigen, a substance that orders the immune system to create antibodies and fight off non-matching blood that enters the body. Synthetic blood bears no antigens and would, in theory, be accepted by all patients regardless of their blood type.)

A further advantage of artificial blood would be its longevity. Researchers are confident that if such a substance can be created, it would have a much longer shelf life than real blood, which goes bad after 42 days.

So far, most of the biotechnology companies working in this field have focused on one of two substances: hemoglobin or perfluorocarbon.

In San Francisco, a team of researchers led by Dr. Michael Marletta has decided neither of these options is viable. Dr. Marletta, a biochemist at the University of California, Berkeley, is trying to design a protein that can deliver oxygen, the most important and urgent function of blood in cases of traumatic injury.

His company, Omniox, leases a tiny lab space at UC San Francisco’s Mission Bay biotech research campus. On the second floor of a beige stone building with oversized glass windows is a room called The Garage. Inside, Omniox and five other biotech start-ups share a small room partitioned by three rows of lab equipment. Dr. Marletta’s company has its own row, running no more than 25 feet long, where five employees conduct all their experiments.

Dr. Greg Kapp, a young, straight-faced scientist in sneakers and khakis, opened the glass door of an Omniox refrigerator and pulled out a beaker containing a small dose of the protein creation. He gave it a swirl. The liquid is thin and the color of cherry Kool-Aid.

”Seeing where other people have failed can be really constructive,” he said, acknowledging that no government-approved artificial blood product exists today. “This is not a radical therapy. It’s something that has been through Phase I, II, and even III clinical trials,” Dr. Kapp said, citing earlier experiments on blood substitutes by an Illinois company, Baxter International, Inc.

Baxter decided to abandon work on its HemAssist blood substitute when Phase III studies on trauma patients in Europe showed recipients were dying at a higher rate than those receiving regular blood transfusions.

“I think we can look at those failures and for most of those situations we have a reason why we think our protein will be different,” Dr. Kapp said. “We may have different problems. But we have reason to believe we won’t encounter the same problems.”

Dr. Marletta oversees this work from UC Berkeley, where he chairs the chemistry department. “The grim reality of the blood substitute area is that it’s littered with failure,” he said, “but the failures are pretty clear.”

Hemoglobin, the primary component of red blood cells, is a rust-colored protein that easily binds to oxygen, Dr. Marletta explained. Researchers have tried to take hemoglobin from existing sources, usually outdated donor blood or cow blood, tinker with its molecules, and get it to do the same work outside of red blood cells. This approach is not without risk, because hemoglobin, although chemically similar to oxygen, is extremely toxic under certain conditions.

When hemoglobin is injected into the blood vessels, for example, it comes into contact with nitric oxide and changes into nitrate. This so-called “scavenging” effect causes the walls of the blood vessels to contract, making it harder for blood to flow and leading to higher blood pressure or even a heart attack.

Dr. Marletta said he had discovered on a molecular level how enzymes, special proteins that trigger chemical reactions, can tell the difference between nitric oxide and oxygen, despite their chemical similarity.

“With that in hand,” he said, “We realized we could design proteins that could bind and deliver nitric oxide, bind and deliver oxygen and wouldn’t interfere with one another.”

Omniox has found early supporters in the federal government and the private sector. In 2006, the company received a $250,000 grant from T. Gary Rogers, a businessman who made a fortune by buying and turning around Dreyer’s Grand Ice Cream, Inc. The company, known for creating the Rocky Road flavor, was sold to the international conglomerate Nestle in 2006 for $2.6 billion, and Rogers left to become chairman of Levi Strauss & Co. Rogers said at the time he wanted to help scientists bridge the “valley of death,” a funding gap that prevents some promising research from ever leaving a laboratory.

The National Cancer Institute, a division of the National Institutes of Health in Bethesda, Md., has also awarded a grant to Omniox because of the potential its technology has in fighting cancer. When tumors are exposed to oxygen, they become extremely vulnerable to radiation. If Omniox can find a way to deliver oxygen directly to the cells of a tumor, the therapy could be used as a partner to radiation and would, if validated in clinical trials, represent a major breakthrough in cancer treatment.

Omniox officials declined to specify the size of that grant, but they say the NCI funding is dictating their current course of research, and sometime in the second quarter of 2010 their protein product will be tested on tumors in mice.

“In a perfect world, we’ll make radiation better, we’ll show we can deliver oxygen and we can move on to the blood substitute area,” Dr. Marletta said.

II.

One key advantage artificial blood might have is speed – not the rate of efficiency within the body, but the speed at which it can be delivered to remote areas in need. In disaster zones, it would be a welcome tool in the first crucial hours when the real thing is unavailable, as Dr. Paul Auerbach, a professor of surgery at Stanford University’s School of Medicine, discovered in Haiti.

He stepped off a plane in Port-au-Prince, part of the first wave of medical volunteers who arrived after a devastating 7.0-magnitude earthquake in January, and made the short trek to University Hospital.

It was a “mixture of adrenaline, enthusiasm for what we were going to do, and fear of the unknown,” he recalled. “It was intimidating.”

Many of the buildings in the University Hospital complex had collapsed. The nursing school was in ruins and the hospital itself was just a shell. There was no electricity, no running water and no sanitation system. The number of injured people waiting for help could not be counted.

Tens of thousands of people died in the quake itself, as rickety buildings rattled apart in the violent, half-minute seizure. Dr. Auerbach’s team was treating a steady stream of patients who had clung to life and somehow survived the initial tragedy and the next four days without any real medical attention.

The wounds were severe, graphic, and the kind not typically encountered by first-world doctors. “We saw a lot of injuries from rubble landing on people, and a number of infectious complications – gangrene and tetanus, wounds infested with maggots.”

By Dr. Auerbach’s estimation, he treated at least 1,500 patients in the span of two weeks, using the few bandages, splints and medications that doctors thought to throw in their bags. At this point, seven days after the earthquake, blood supplies had still not arrived at University Hospital. While making his rounds, Dr. Auerbach overheard a nurse describing a young boy with anemia who needed a transfusion and was on the verge of death.

Relief coordinators were still busy sorting out logistics. In Washington, Bill Fitzgerald, a biomedical advisor at the headquarters of the American Red Cross, took a phone call from an official across town at a division of the World Health Organization called PAHO, or the Pan American Health Organization. His counterpart there was asking for 249 units of red blood cells to be loaded onto a commercial plane and delivered to a warehouse near the Port-au-Prince airport where relief supplies were being collected.

Two days later – and nine days after the quake – the blood requested from the American Red Cross landed in Haiti. By then, officials from the Haitian Red Cross had scrounged up enough units of blood to open a tiny blood bank on the grounds of University Hospital.

“That was a huge advance for the care that we were able to render for our patients,” Dr. Auerbach said. “Up to that time, if someone needed blood, we didn’t have it.” The anemic boy was one of the first to be treated with the newly arrived blood, and “just in the nick of time,” according to the doctor. “He would have died without getting blood.”

It is impossible to know how many victims of the Haitian earthquake were less fortunate because of supply shortages. Traumatic, blood-draining injuries were among the most prevalent type, according to American Red Cross officials and relief workers at the scene.

“Crushed arms, crushed limbs, crushed feet, crushed hands,” said Daniel Epstein, a spokesman for PAHO. “Wounds of all sorts from falling rubble and falling buildings. Secondary wounds and injuries from people trying to get out of buildings. They had do a lot of amputations and in many cases that required blood,” he said.

Some earthquake victims with crushed limbs may have died within minutes of their injuries. As blood drained from the wounds, their brains and hearts would have been cheated of oxygen. After about four minutes in this state, the cells in those organs begin to die off, and only vast transfusions can prevent this. In a similar traumatic injury such as a car accident, a patient may require as many as 100 pints of blood.

An artificial blood, in powder form perhaps, would offer major logistical advantages over pure blood. It could be manufactured in vast quantities, and as researchers envision it, would not require refrigeration. It would be the difference between sending sacks of flour to Haiti, and sending cartons of eggs.

III.

The field of artificial blood suffered a major setback last year when the Journal of the American Medical Association published a comprehensive review of research into hemoglobin-based blood substitutes. The analysis, authored by Dr. Charles Natanson, a senior investigator at the National Institutes of Health, considered five leading products that had progressed to Phase III clinical trials involving humans: PolyHeme, HemAssist, Hemospan, Hemolink and HemoPure. Together, these products had been subjected to 16 trials involving 3,711 patients.

Dr. Natanson found the trial products led to a statistically significantly increase in the risk of death and heart attack, in some cases as high as a 30 percent increase. He also scolded the companies for withholding publication of trial results by as much as a year. Chiding their work as “secret science,” Dr. Natanson accused the companies of putting their test patients at risk and hampering the work of other scientists.

Within months, several of the companies in the JAMA study declared bankruptcy. Many leading blood scientists now consider working with hemoglobins a waste of time.

One of those products, Hemopure, which is made with red blood cells extracted from cows, is approved in South Africa for the treatment of anemic surgery patients. Officials there, acknowledging that up to 12% of the population may be infected with HIV, told newspapers the drug was ideally suited to South Africa.

Perfluorocarbons, a completely synthetic compound created by re-arranging carbon and fluorine atoms, have proven to be a much more successful type of artificial blood. Some types can haul 50 times the amount of oxygen that hemoglobin can. So it was no surprise that when scientists first began looking for a way to chemically reproduce blood, they thought of PFCs at once.

IV.

Outside of scientific circles, most people are aware of artificial blood, if at all, because of a television show. In the wildly popular HBO series “True Blood,” vampires have come out of their cold, dark castles and joined human society. They drive cars, host television talk shows and solve crimes, all thanks to the creation of a synthetic blood. The bottled drink, called TruBlood, is sold in bars and supermarkets, allowing the cast of sexy, brooding actors to focus on plot developments besides feeding.

HBO even markets the drink on a website, trubeverage.com, where online shoppers eventually discover what they’re paying for is a four-pack of “carbonated, slightly tart, lightly sweet blood orange drink,” for $16.

The show gives credit to the Japanese for inventing synthetic blood. This is, in a way, true.

Green Cross Corporation was founded in Osaka, Japan in 1950 as a blood bank. The company also made and sold blood derivatives, things like coagulants, anti-inflammatory solutions and other things that are pumped through intravenous tube. By the late 1970s researchers had created a substance that seemed to replicate one of the most important functions of blood: delivering oxygen. The milk-colored product was a synthetically produced combination of two kinds of perfluorocarbons. Named Fluosol-DA, it was tested first on primates. (“Monkeys that underwent nearly total exchange of transfusion survived well for over a year, without any untoward reaction,” according to the clinical trial report.)

The Green Cross artificial blood later was tested on 186 people, a relatively small number of trial patients, at Kobe National Hospital. The study group was made up of several categries of patients, including those who refused real blood for religious reasons, and those for whom matching blood could not be found or was delayed in transit.

The first large-scale human tests did not begin until 1982, when Fluosol was licensed to a California company, Alpha Therapeutic Corp. American scientists had no trouble finding a suitable group of test subjects for their first study, on anemic patients who refused real blood on religious grounds. Anemia, an abnormally low amount of red blood cells, is the world’s most common blood disorder.

“A big use was Jehovah’s Witnesses,” said Dr. Thomas Drees, who was president and CEO of Alpha Therapeutic at the time. “They would let their own children die rather than give them a transfusion.”

He and other scientists quickly realized that a synthetic blood could overcome their religious objections and possibly save lives.

Keeping an eye on the small trials with Jehovah’s Witnesses, the FDA soon determined that Fluosol was ineffective at treating anemia because it failed to stay in the body long enough. Alpha Therapeutics pitched other possible uses, though, and suggested Fluosol could be used to protect blood clots from being damaged, to protect heart muscles in the middle of a heart attack, or as a bath for storing transplant organs.

Federal officials had faith in only one of the treatments, for use in angioplasty, a surgical procedure that uses a balloon to widen obstructed arteries of the heart. In 1989, the US and eight other countries formally approved Fluosol – for use in one procedure only – as the world’s first artificial blood.

During the operation, surgeons would inject as much as 60 milliliters of Fluosol, or about a shot glass size, into the blood vessels every minute as a way of feeding extra oxygen to the heart. It was not an immediate success.

“Fluosol’s biggest problem was that it was unstable and had to be frozen,” Dr. Drees said. Busy surgeons didn’t like to waste time waiting for it to be warmed in a microwave oven, which could take up to thirty minutes. “The prima donna surgeons didn’t want to take time standing there while they thawed it,” he said.

Alpha Therapeutics pulled Fluosol from the market in 1994, just four years after it was approved by the FDA. The company estimates 40,000 people were treated with it, and to this day, Fluosol-DA is the only blood substitute ever approved by U.S. regulators.

Dr. Drees, now 80 years old, refuses to give up on artificial blood. He formed a new company, Sanguine Corporation in Pasadena, Calif., in 1990 to develop a second-generation of Fluosol that does not need to be frozen. He envisions that product, called Pher-O2, one day being used in every ambulance and emergency room in America.

“Simply on the basis of transfusion, this would be the largest drug in the history of medicine,” Dr. Drees said. Analysts have estimated the worldwide market for a blood substitute is in the range of $7 billion. Lipitor, a cholesterol fighter made by Pfizer Inc., is currently the world’s best selling drug, with $7.5 billion in sales in 2009.

A huge client of artificial blood would be the US military, which could spend huge sums of money to get a stable supply to distant battlefields. According to the US Army Medical Department, some medics on the front lines in Afghanistan have strapped to them a container that keeps four units of red blood cells cool. The contraption weighs 10 pounds, though, and the blood is safe for only 78 hours once the temperature hits 105 degrees Fahrenheit, not unusual weather for the country.

The Pentagon is prepared to pay for an improvement, and in 2005 it gave $750,000 to Dendritech, a Michigan company that works with a class of molecules known as dendrimers. (A Dendritech press release quoted its lead scientist as saying, “The battlefield isn’t the only place this blood substitute could save lives; imagine Emergency Medical Technicians having a resource like this on hand at the scene of an accident. It’s not difficult to see how this project could be a real success, both scientifically and commercially.”)

According to the Journal of the Royal Academy of Medical Corps, a British journal of military medicine, the US military has spent at least $30 million dollars on artificial blood research.

Dr. Janine Tappenden of Northern General Hospital in Sheffield, England, wrote for the journal in 2007, “The wastage of blood resources during war is also of great concern. Sixty percent of the 1.3 million units of blood dispatched during the Vietnam War and 95% of 120,000 units during the Gulf War were discarded. This was largely due to the units passing their expiry date.”

Dr. Drees has told the Pentagon his synthetic blood would eliminate that problem. He said he decided to reach out to military officials after reading a news article about the Iraq War asserting that many deaths result from injuries to arms and legs which are uncovered by body armor.

“I sent a copy of that to [Donald] Rumsfeld, then the Department of Defense chief and said, ‘You guys ought to be interested in this.’

“He didn’t answer the first letter but he answered the second letter and said, ‘You’re absolutely right. We’ll have somebody look into it.’ We’ve talked to the Army and Navy on and off, but they haven’t put any money into it,” Dr. Drees said.

Sanguine Corp. has been waiting on FDA approval nearly since its inception twenty years ago. Dr. Drees said regulators had recently decided to classify the substance as a medical device rather than as a blood product, which could simplify its route to approval. A spokesperson for the FDA refused to comment on Sanguine’s case, except to say it is not an approved product.

In an emailed statement, Shelley Burgess, the FDA spokesperson, wrote, “We do not have any approved artificial blood products nor can we comment on any Investigational New Drugs under review or who those companies or what the classification of the product may be.”

Dr. Drees claims political factors are behind some of the delays.

“The biggest problem we have had is with the Red Cross. They see this as something that would destroy them,” he said. “I think they do a marvelous job of providing disaster relief for floods and fires and whatever. But they don’t get any money for that. With their blood, they sell a billion dollars a year. And so they are fighting us tooth and nail because we would put them out of business.”

A spokeswoman for the Red Cross declined to respond directly to the allegation. In an emailed statement, Stephanie Millian said, “Blood substitutes are an exciting prospect, but they are most likely several years away and are likely to find limited application in their first iterations. It should be noted that the need for blood remains constant, regardless of potential breakthroughs in technology. The Red Cross is dedicated to serving patients and fully encourages the development of new technologies that may help save lives.”

Sanguine reported a net loss of more than $1.1 million in 2008, and ended the year with $1,159 in cash, according to SEC filings. Those documents show Dr. Drees has paid some employees and contractors in Sanguine stock, which recently traded at $0.18 per share. In the early months of 2000, when investors still believed Pher-O2 was a serious candidate for federal approval, Sanguine stock traded at $37.50.

The failures of Sanguine and companies like it prove that, for now, artificial blood has more cachet and usefulness on the small screen, where it serves as a prop on a cable vampire show, than it does as a medical tool that can save lives.

PALM SPRINGS

On his 47^th birthday, Steve Pougnet, the Democratic mayor of Palm Springs, stood at the foot of a kidney-shaped pool and addressed the well-wishers gathered around him. In a backyard in a well-to-do neighborhood here, Pougnet pressed the same argument he’s been making for the past year: that he is the party’s best hope at unseating Mary Bono Mack, a Republican who has represented this area in Congress since 1998.

Pougnet, an openly gay man who married his partner in the brief window in 2008 when same-sex marriages were legal in California, insists this race is vastly different from the five challenges Bono Mack has previously survived. For one thing, he has raised serious money and attracted the attention of Democratic leaders in Washington, D.C, even making it onto the party’s Red-to-Blue campaign, which spotlights the 13 most promising congressional candidates across the country.

“There’s never been a candidate who’s spent money against her,” Pougnet said. “You can’t win with $400,000.” By the end of the first quarter of 2010, Pougnet had raised twice that, or $867,615, almost entirely from individuals. The Bay Area’s congressional delegation has rallied around him, too. PACs affiliated with House Speaker Nancy Pelosi and Rep. Mike Honda contributed to his campaign, while Reps. Jackie Speier and George Miller co-hosted a fundraiser for him in San Francisco. Bono Mack raised $1,330,186 through the same period.

Pougnet announced his candidacy in April 2009, while Democrats nationwide were basking in the glow of Barack Obama’s new presidency, then just four months old. The race in California’s 45^th congressional district, as a Republican-leaning district won by Obama, may serve as a clear referendum of how independents and swing voters are gauging his administration. Since the inauguration, voter sentiment has shifted with rising frustrations over health care reform, the collapse of the financial industry and the rise of Tea Party activism.

“They targeted every single district where Obama won,” Bob Richmond, the former chair of the Riverside County Republican party, said about Democrats. “So they were therefore very energetic and excited when they made their plans. Now things have changed and he’s been president for one year and the public is not buying what he’s selling. It’s going to be a lot tougher for them to go ahead and win this district.”

Pougnet is hoping to catch Bono Mack, 48, off guard. His campaign staff say she’s in the district less often these days, now that she’s married to Connie Mack IV, a conservative Republican congressman from Fort Myers, Fla. They also accuse her of not working hard enough to secure federal funding for the district.

Bono Mack’s campaign manager, Ryan Mahoney, declined repeated requests for an interview, referring this reporter instead to her website and Facebook fan page.

But supporters here say she’s well liked and has high name recognition thanks to her 12 years in Congress and prior marriage to Sonny Bono, whose seat she took after his death in a skiing accident. (The Bono name is attached to a concourse at the Palm Springs International Airport, a stretch of Interstate 10, and the Salton Sea National Wildlife Refuge.)

“She’s battle-tested, and the worst she’s done is 59% in the highpoint of a Democratic year,” Allan Hoffenblum, publisher of the California Target Book, said, referring to the 2008 election when large numbers of Democrats turned out to vote for Barack Obama. Obama carried this district by 51.5% to John McCain’s 47%.

“Her supporters are mad at this government,” said Richard Oliphant, the former mayor of Indian Wells and current chair of the Coachella Valley Lincoln Club, a Republican group. “He has worn out his welcome, and that will be reflected in this election. He is very disliked, and [so are] his policies and the direction he’s taking to make this a socialist country.”

Republicans slightly outnumber Democrats in the desert here, but GOP registration has steadily declined since 2003, when 48% of district voters were registered Republicans and 34% were Democrats. Figures released by the Secretary of State’s office this year show Republicans now account for 42% of voters, compared with 38% for Democrats. A sizeable group, 16% declined to state a party.

“2010 is not the year that the Democrats are going to be able to unseat her,” Kevin Spillane, a Republican consultant with the Stone Creek Group in Sacramento, said. “She’s well-positioned for her district. She is popular. And she’s fared much better than other representatives in California districts in the last few cycles.”

Political prognosticators inside the Beltway agree. The Cook Political Report, Congressional Quarterly and Larry Sabato of the University of Virginia put the race in the “Likely Republican” column. Bono Mack’s supporters say she has a wide base of support that includes independents and gay and lesbian voters.

Both candidates have a weakness in common – the western half of the district, which includes the cities of Moreno Valley, Hemet and Temecula. They hold about half of the district’s votes, yet are culturally and physically cut off from the Coachella Valley. Residents there, on the western side of the San Jacinto Mountains, live within commuting distance of jobs in Los Angeles and San Diego, and share less of an affinity with the tony resort towns in the east. Pougnet says he is trying to raise enough money to buy television commercials on cable stations in Los Angeles as a way of reaching these voters. He also says he plans to open satellite campaign offices there.

“That will be a tough nut for him to crack,” Art Copleston, a Pougnet supporter and the chair of the Desert Foundation for Democracy, said. “On the other hand, people in Moreno Valley don’t know who the hell Mary Bono Mack is. She doesn’t work this district. She works the small communities where her money comes from: Indian Wells, La Quinta, Rancho Mirage.”

Republicans and Democrats alike are expecting the race to get dirty. One of Pougnet’s close friends, Scott Hines – also a married gay father and Democratic politician – was elected in April to the Rancho Mirage City Council by a margin of 11 votes. A group connected to the Riverside County Republican Party used robocalls and direct mailers that claimed Hines would “infect” Rancho Mirage city government. They also noted Hines’ close connection to Pougnet.

Many people in Palm Springs considered the ads an anti-gay attack, and Pougnet called them a precursor of what is to come between now and November.

“That was a hit piece done by the Republican party,” Pougnet said. “That piece was against me as much as it was against Scott.”

“I say, ‘Bring it on.’ I will talk about my family and my children to anybody. We will fight for the future of my children and your children,” he told supporters at his birthday party. The crowd applauded as Pougnet’s husband, Christopher Green, stood by the pool, smiling. Their 4-year old twins, Beckham and Julia, dug into a chocolate cake with American flags and icing that read “Happy Birthday Steve – Our Next Congressman.”

Bono Mack’s campaign released an animated web ad on April 1 titled “Tell Mr. Pougnet to Stop Hiding.” It was a demand that Pougnet stake out a position on the Democratic health care reform bill, as well as a thinly veiled message about his sexuality and a way of linking him to President Obama’s most controversial initiative. Pougnet later told a newspaper reporter he was generally supportive of the legislation, and the Bono Mack campaign bragged on its website it had forced Pougnet “out of hiding.”

Bono Mack has enjoyed support from her district’s gay and lesbian community, thanks to votes against constitutional bans on gay marriage, and efforts to fund the Ryan White HIV/AIDS Act. But many note she did not take a position on Proposition 8, which amended California’s constitution to ban gay marriage

In Washington, D.C., a city politely described as Hollywood for plain-looking people, Bono Mack stands apart. She has been described as a celebrity member of the House, partly because of her glamorous, toned look, earned through years of gymnastics, tae kwan do and karate. In 2008, the men’s magazine Maxim named her the 7^th hottest politician in the world. This has drawn a different degree of support from the gay community.

“She has a very strong presence,” said Art Copleston of the Democratic foundation. “She is known by and large throughout the area because she decorates cocktail parties. The gay community in Palm Springs loves to have her show up at events in skintight dresses cut down to her navel. She walks in looking gorgeous and everyone goes gaga,” he said. “That is one of her strengths.”

As mayor, Pougnet claims to have performed 118 same-sex marriages, more than any other mayor in California. His campaign website links to an online petition asking Congress to repeal the law known as Don’t Ask, Don’t Tell, which bars openly gays from serving in the military. And if elected, he would be the first gay married member of Congress. Gay voters may find it tough to vote against such a candidate.

Though visible, wealthy and often powerful, the district’s gay community is not the only force at work in this race. Bono Mack is touting endorsements from prominent Republicans such as Newt Gingrich, who recently headlined a fundraiser for her in Indian Wells, former First Lady Betty Ford, a longtime Rancho Mirage resident and the honorary co-chair of her campaign, and Mitt Romney.

Jim Stewart, chair of the Lincoln Club in Palm Springs, said Democrats are looking at the district with an eye to redistricting, and how new lines can be drawn in 2010 that will benefit left-leaning candidates.

“Mary Bono Mack is unbeatable,” he said. “They’re thinking about redistricting. Two years from now, Mary’s district is going to look a lot different. [Democrats] are looking at where voters are going to come out and that’s where Steve Pougnet is going to be running in the next two years.”

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By Clayton Trosclair

Berkeley, Calif.

Facing an uphill battle, proponents of a ballot measure to legalize marijuana are mapping out a campaign that will stress the millions of dollars in tax revenue that pot sales could provide.

The initiative, sponsored by Oakland marijuana magnate Richard Lee, would legitimize the sale of marijuana and allow pot shops to open their doors in cities that permit it. Local authorities could also decide how to tax and regulate marijuana sales, although it’s unclear if federal officials would tolerate such a bold and unprecedented move.

Many of the state’s most important politicians want nothing to do with the measure, which would allow anyone over the age of 21 to grow or possess a drug considered by the federal government to be highly addictive and of no medical value.

Despite lawmakers’ reluctance, political consultants working on the initiative claim a marijuana tax could contribute more than $1 billion toward reducing California’s $20 billion budget deficit. Opponents call that a pipe dream.

“As my wife says, that’s just bong economics,” said John Lovell, a lobbyist who represents a coalition of law enforcement groups that are against the measure.

In fact, there is uncertainty about how much tax revenue could be generated, or if federal officials will even allow the legalization of marijuana. According to the state Legislative Analyst’s Office, “The amount of all the various revenues that could be generated by this measure depend considerably on the extent to which the federal government enforces its laws against marijuana in California.”

Last February, US Attorney General Eric Holder said the Justice Department would no longer raid medical marijuana dispensaries that comply with state law. However, his office has not indicated if it would tolerate marijuana for people without a medical need.

A Republican political consultant predicted the issue would find little support from politicians outside the Bay Area.

“My guess is most if not all Republicans will oppose it and some Democrats will support it,” said Ray McNally, a partner in the Sacramento consulting firm McNally Temple & Associates. “Others running for statewide office will probably hide under the bed.”

Phone calls and emails to three gubernatorial candidates – Democrat Jerry Brown and Republicans Steve Poizner and Meg Whitman – were not returned. When he was governor, Brown signed a bill that allowed issuance of a traffic-ticket style punishment for possession of less than an ounce of marijuana.

Four Democratic candidates for Attorney General, Kamala Harris, Chris Kelly, Ted Lieu and Alberto Torrico, said they oppose the measure. Republican Tom Harman said he opposes it. Five other GOP candidates did not return phone calls seeking comment.

The 2010 campaign is better funded and organized than previous attempts to decriminalize marijuana.  Lee, founder of an Oakland medical marijuana dispensary and Oaksterdam University, a marijuana trade school, spent $1 million to gather 680,000 signatures calling for the initiative to be placed on the November ballot. The Secretary of State’s office is now checking to see whether at least 433,971 of those signatures – the minimum required for placement – are valid.

Lee’s corporate holding company, S.K. Seymour LLC, has also hired SCN Strategies, a San Francisco political consulting firm that has worked for Los Angeles Mayor Antonio Villaraigosa and Hillary Clinton’s 2008 presidential campaign. Lee has also contracted with Blue State Digital, an agency that offers advice on harnessing Internet technology and social media tools, and launched the website TaxCannabis.org.

“This is not a whim,” Dan Newman, a consultant with SCN Strategies, said. “The initiative is carefully crafted, well-funded, and professionally run. There will be TV ads, mail, sky writing – whatever it takes to communicate with voters – and a very active and engaged new media component.”

Lovell, the lobbyist for the state Police Chiefs Association, the Narcotics Officers Association and the Peace Officers Association, said opponents saw some of the same arguments in 2008, when voters rejected Proposition 5, a measure to limit punishment of drug offenders.

“We learned a couple of things from that,” he said, “We did not have to match the legalizers dollar for dollar in the campaign. They outspent us five to one. But our message was before voters and it resonated. That’s why we succeeded.

Polls show Californians’ attitudes about pot have softened since medical marijuana dispensaries began opening in 2004. In the two decades before that, a minority of voters favored the legalization and taxation of marijuana. Between 1983 and 2004, support grew from 35 percent to 39 percent, according to Field Polls.

But the past five years have seen an enormous shift in popular sentiment. In a Field Poll conducted in April 2009, 56 percent of voters said they were in favor of legalizing marijuana for recreational use and taxing its sale.

“When something changes I ask myself what happened, what events had an impact on voter attitudes,” said Mark DiCamillo, the director of the Field Poll. “The biggest thing I can think of is Initiative 215,” he said, referring to the ballot measure that legalized marijuana for medical purposes and took effect in 2004. “It seems to have moderated and taken away some of the public fears about marijuana.”

Yet analysts and pollsters agreed the latest survey reflects only moderate support.

“Fifty-six percent is a hard sell,” McNally, the Republican strategist, said. “You typically want to start out above 60 percent or above. Because as a campaign unfolds, support typically drops.

“I think this goes down. I’m not sure everyone is ready to have head shops all over the place,” he said. “That’s the other thing working against this initiative – some people have the sense that things are changing too fast. Like health care, it’s too much, too soon. In that kind of environment, do they really want to legalize marijuana?”

Steven Maviglio, the head of Forza Communications, a campaign firm in Sacramento that works with Democrats, agreed that marijuana supporters are facing an uphill battle.

“It’s going to be a bit of a challenge,” he said. “They have to make it look like mainstream California to appeal to moms and swing voters, not just potheads who want marijuana.”

On the other hand, he said, voters recognize that marijuana is a multi-billion dollar crop, and it makes fiscal sense to regulate an industry that isn’t paying its fair share of taxes.

“There has been more enthusiasm for this than anything I’ve seen in a long time,” he said. I was sitting in on a focus group the other day and people are voluntarily bringing this up,” Maviglio said.

“It’s quite horrific the amount pollution we cause in the way people are buried nowadays. We bury a whole Golden Gate Bridge every year in steel – a huge amount of materials and waste of electricity and space, “ said Jane Hillhouse.

She’s one of about a dozens vendors at the Green Funeral Fair, held at a non-denominational church in Berkeley, California.

She owns Final Footprint, a company that sells caskets made from renewable resources, such as bamboo, banana leaf, willow, pine and even cardboard.

“I have got some very beautiful bamboo caskets that were made in Indonesia,” Hillhouse says. “It’s completely biodegradable, every part, there’s no metal on them at all. It’s also lined in cotton, which is organic.”

Her products are used by a growing number of people who are concerned about the environmental impacts of burials.

Esmerelda Kent, a former costume designer, is here to show off her biodegradable burial shrouds. They range form $300 for a simple cotton one, to $1,000 for a silk-taffeta shroud lined with lavender and sage.

“We don’t believe in converting people,” Kent says.  “It’s a very personal choice what people choose to do. We just want to make other options available to people because we have a different vision, a different aesthetic. Our vision of  ‘mort-couture’ is to look beautiful in the last thing you’ll ever wear.”

Kent says the business of “mort couture” took off after one of her shrouds was featured in the HBO series “Six Feet Under.”

Liz O’Conell-Gates organized the green funeral expo. She’s a native of Ireland who says in this country, death and dying are taboo topics.

“The idea was to bring all topics related to grieving, mourning and catharsis thru art or whatever means, into the open.,” she says.  “And not have the topic of death be swept under the carpet as it seems to be done here.“

O’Connell-Gates says green funerals are not only better for the environment, but more personalized and cheaper for the family.

California’s only green burial ground – Fernwood Cemetery in Mill Valley – sent Raymond Soudah, a sales manager, to the fair.

“Theres no embalming, no concrete liners, you can be wrapped in a shroud and placed into the earth. And we don’t use regular headstones, we use natural rocks with engraving,” he says.

Jerrigrace Lyons is a self-described “death midwife.” She also teaches people how to hold a home funeral.

“This is very ancient and it’s still done around the world,” Lyons says.

We are actually restoring something that was always ours but people have forgotten. They didn’t know, don’t know what their legal rights are. That they can fill out and file their own death certificate, don’t know they can transport their loved one in a casket they built, and then drive them to the cemetery or crematorium themselves.”

The casket maker, Jane Hillhouse, says many people can’t appreciate a home funeral unless they’ve been to one.

“A home funeral is a very cathartic experience. It’s wonderful,” she says. “Otherwise you’re at a hospital and somebody dies and they’re whisked away and that’s it. It’s like the person never lived. It’s the strangest feeling. Which I only just experienced recently when my mother in law died. It’s so strange to me.”

To keep the funeral fair from being too morbid, Liz O’Connell-Grace invited artists and musicians to take part, including the Threshold Choir, which sings at the bedsides of dying people.

“We are disconnected from the reality that we all have a natural lifecycle, just like the plants, the crops, the seasons,” O’Connell-Gates says. “But with the baby boomers confronting their own mortality, confronting their parents’ mortality, I think especially in this part of the country. You know, Berkeley.”

If dying is all about becoming one with the earth, they argue, why delay the process with embalming fluids and heavy steel vaults?

And with 2.5 million Americans dying each year, green funeral advocates say it’s time to think about more sustainable practices.

Published September 7, 2009 on washingtonpost.com

TOKYO / Osamu Kouke has defined his life through hard work and family.  He presides over an izakaya – a cheery bar where he and his family dispense food, liquor, music and joy. It’s a vital community center, where patrons and workers serenade each other with tales of everday triumph and woe – the kind of place that’s becoming extinct.

Published September 7, 2009 on washingtonpost.com

TOKYO / Japan’s mating game has changed dramatically as fewer young people choose to get married. Finding a partner has become a tricky proposition because of evolving views on family and career, with many well-educated women now choosing work over marriage. Those who are serious about finding a spouse can get help from thousands of companies in the “marriage hunting” business.

Local government officials in China have been ordered to smoke nearly a quarter of a million packs of cigarettes in a move to boost the local economy during the global financial crisis.

The edict, issued by officials in Hubei province in central China, threatens to fine officials who “fail to meet their targets” or are caught smoking rival brands manufactured in neighbouring provinces.

Even local schools have been issued with a smoking quota for teachers, while one village was ordered to purchase 400 cartons of cigarettes a year for its officials, according to the local government’s website.

The move, which flies in the face of national anti-smoking policies set in Beijing, is aimed at boosting tax revenues and protecting local manufacturers from outside competition from China’s 100 cigarette makers.

Story at:

http://www.telegraph.co.uk/news/newstopics/howaboutthat/5271376/Chinese-ordered-to-smoke-more-to-boost-economy.html

“The winner won’t necessarily be pretty,” she added. “We care about the beauty of the soul and the morals.”

http://news.yahoo.com/s/ap/20090506/ap_on_re_mi_ea/ml_saudi_miss_beautiful_morals_1

“Straw bale homes like this one are beloved for their thick walls. At a practical level, the thermal mass means year-round comfort and low energy bills. The 2-foot thick walls of the Roble Road house soak up sunlight during the day and radiate heat at night. They provide at least three times the insulation value of a typical Bay Area home.

“When the sun goes down, you don’t immediately get cold in a straw bale house,” said John Swearingen, founder of Skillful Means in Berkeley. “The house retains heat, and your body has time to adjust.”

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/05/03/RE1F17AJ8C.DTL

The students in Ms. Scott’s fourth grade class at Prescott Elementary have yet to see her this year.

Every morning for two months now, they’ve shown up to their West Oakland campus and wondered which substitute teacher will take her place that day. A rotating cast of temporary teachers has been standing in for Ms. Scott while she’s away on extended medical leave, and since school began on Aug. 25, at least four substitutes have been assigned to her class.

Last year, the Oakland Unified School district rotated a roster of teachers through two classes at Prescott Elementary – a third-grade class and a fifth-grade class – for the entire year.

“They had subs all year long,” said Enomwoyi Booker, the school’s principal, while pointing out that some of those third-grade students are without a permanent teacher again this year in fourth grade. “So we’re talking about going on two years now, which is not good.”

The problem starts when teachers take extended leave from the classroom, but it is exacerbated by the state’s credentialing process, which allows substitutes to spend no more than thirty days in the same class unless they hold full teaching credentials. The vast majority do not. While this ensures that substitutes don’t become permanent stand-ins for fully qualified teachers, it also creates what Booker called a “revolving door” of substitutes on her campus.

Enomwoyi Booker, principal of Prescott Elementary School

She would like to keep the current substitute in place until Ms. Scott can return to work, but bound by California rules, she has to keep eye an on the calendar and hope the next substitute – the fifth one – works out as well.

It’s unclear how many Oakland children are being taught by substitutes on a regular basis. The district currently has about 2,700 teachers, and 26 of them have taken leave so far this year. Officials say up to 16 of these classes have been filled by substitutes.

State and federal laws permit teachers to take leave for several reasons, including sickness, the birth or adoption of a child, the illness of an immediate family member or when a family member is deployed with the military. These teachers are still under contract and cannot be replaced by new hires.

Louvenia Funes is the mother of twelve children, all of whom have attended class at Prescott Elementary. She wrote a letter in September to the principal and the board of education asking that her daughter be transferred out of Ms. Scott’s class.

“I want my child out of that classroom,” she said outside the school gate one afternoon, pulling the hand-written letter from an envelope in her purse. “Can you imagine having four parents in a month? Imagine. Kids get confused with just having one parent or two parents. Can you imagine having four, telling them four different things? It’s crazy.”

In Ms. Scott’s class and others throughout the district, students are left without the steady guidance of a permanent teacher. Parents and principals said this gives students the impression they can run amok.

“A lot of it starts out with behavior,” Booker said. “Without having a consistent person in there, it’s really hard to pull them in.”

Kate Perry, a school psychologist and an instructor at UC Berkeley’s School of Education, said it is integral for elementary students to have a reliable teacher in the room.

“I think one of the things that child development research has told us is that children thrive on consistency, especially in a field like teaching. The consistency of a teacher and the supportive presence of a teacher provides the foundation of all learning,” she said.

Anecdotal evidence from teachers and principals confirms that finding. Funes said her daughter has shown less interest in school this year because of all the chaos in her class.

“The classroom is out of control,” she said. “How’s a child going to learn when you have all these other kids not behaving? They should take the kids who don’t want to learn anything, call their parents and have them pick up these kids. It’s not fair to my child who wants to learn,” she said.

Prescott Elementary School

Booker said the two classes taught by substitutes last year did have more behavior problems, and their grades seemed to lag behind their peers. “We do know that there wasn’t a lot of consistent instruction happening,” she said.

Instructors usually have no background information on the students, leading to what psychologist Perry referred to as “a trial-by-fire situation.” As a result, substitutes have a hard time gauging how well students are performing and don’t know which materials need reinforcement. Parents said the problem is reflected in the homework assignments they see night after night.

“The (substitute) teachers give them assignments but don’t really explain how to do them,” Sandra Vezquez said in Spanish. A former teacher in Mexico, she now finds herself teaching science and math lessons to her fourth-grade son because he isn’t getting the information at school. She said he has been sad lately because he realizes he is not keeping pace with other kids his age.

Few studies have been conducted on students taught by substitutes, but one published last summer by researchers at Harvard University found a three-percent decline in student math scores for every ten days of teacher absences. That study focused only on fourth-grade teachers who were absent occasionally, not those who were out of the class for months on end.

Those who spend time with children said it doesn’t take much scientific research to see the differences between students who study with the same teacher every day and those who do not.

“Naturally these students are behind,” said Sarah Stewart, Prescott’s community liaison. “Even though they have their lesson plans, each sub is going to teach it differently. Sometimes they don’t even use it. So what do the students get? It’s play time,” she said.

Experts said children in these classes are at risk because every wasted day puts them farther behind in their academic career. When their class eventually gets a permanent teacher, they will have to catch up on months of missed skills.

Funes, the parent of a child in Ms. Scott’s class, called the ordeal a “damaging process” for her daughter.

“If a child can’t come home and tell you they learned one thing from class, there’s a problem,” she said. “That’s just a whole waste of the day.”