FRENCH POLYNESIA

Cruises through Tahiti’s isles

Go island hopping in the South Pacific, seeing the turquoise lagoons and green peaks of Tahiti and its islands during new eight-day French Polynesia cruises by small ship. The Variety Cruises tours will sail round trip from Papeete, Tahiti, visiting Bora Bora, Huahine, Raiatea, Tahaa and Moorea. Excursions will include snorkeling, hiking, Jeep tours and a chance to swim with sharks and rays as well as participating in cultural activities with local residents.

Dates: Departures Dec. 10, 2020-March 2021

Price: From $2,061 per person, double occupancy. Includes accommodations in double or twin cabins, meals, guided tours and activities. International airfare not included.

Info: Variety Cruises, (800) 319-7776, varietycruises.com/cruises/tahiti

— Rosemary McClure

UZBEKISTAN

Culture and cuisine

Immerse yourself in the culture and cuisine of Uzbekistan during Navruz, the Uzbek New Year, on an excursion offered by Mir Corp. Participants on the 10-day tour will explore the culinary tastes, architecture and UNESCO sites in the Silk Road cities of Bukhara, Khiva and Samarkand. Highlights include joining in Navruz celebrations, visits to the Narzulaev family ceramics workshop and the Urgut craft market, and a drive through the vast Kyzylkum Desert. Group size limited to 16.

Dates: March 16-25

Price: From $3,995 per person, double occupancy; single supplement available. Includes accommodations, most meals, ground transportation, train tickets, sightseeing tours and entrance fees, activities and excursions. International and in-country airfare not included.

Info: Mir Corp., (800) 424-7289, bit.ly/mirtouruzbekistan

— Anne Harnagel

ARGENTINA

Fishing expedition

Experience catch-and-release fishing for dorado, pira pita and pacu on a new expedition organized by Frontiers International Travel. The new Suinda Lodge on the Paraná River in Argentina’s Corrientes Province is home base for the five-day, four-night trip. Anglers will set out each morning in a custom skiff designed for the Paraná; between sessions there will be time for lunch and a siesta. Non-fishing activities such as bird watching are available. Group size limited to eight anglers each week.

Dates: Through May 31

Price: From $4,625 per person, double occupancy. Includes accommodations, meals, guide service and fishing equipment.

Info: Frontiers International Travel, (800) 245-1950, bit.ly/suindalodge

— Anne Harnagel

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The price of oil surged Friday as global investors were gripped with uncertainty over the potential repercussions after the United States killed Iran’s top general.

News that Gen. Qassem Suleimani, head of Iran’s elite Quds Force, was killed in an air attack at the Baghdad international airport prompted expectations of Iranian retaliation against U.S. and Israeli targets.

In previous flare-ups in tensions with the U.S., Iran has threatened the supply of oil that travels from the Persian Gulf to the rest of the world. About 20% of oil traded worldwide goes through the Strait of Hormuz, where the shipping lane is only two miles wide and tankers have come under attack this year.

The international benchmark for crude oil jumped 4.1%, or $2.70, to $68.95 a barrel in London trading.

“Revenge will come, maybe not overnight but it will come and until then we need to increase the geopolitical risk premium,” said Olivier Jakob, head of consultancy Petromatrix, in a note to investors.

He noted that Iran’s response may not be limited to the Strait of Hormuz.

In September, Yemen’s Iran-backed Houthi rebels launched drone attacks on the world’s largest oil processing facility in Saudi Arabia. The strike briefly took out about half of the supplies from the world’s largest oil exporter. The U.S. directly blamed Iran, which denied any involvement.

Launching attacks that can’t be easily linked back to Iran limits the chances of direct retaliation.

But Iran has also directly targeted tankers. This year it seized a British-flagged tanker, the Stena Impero, for several weeks. And it has shot down a U.S. military drone.

About 80% of the crude oil that goes through the Strait of Hormuz goes to countries in Asia, including China, Japan, India and South Korea.

But the rise in the global price of oil will affect other countries more widely, particularly oil-importing countries with big manufacturing sectors like Germany and Italy. Those countries fared worst in the stock market on Friday, with their main indexes falling 1.4% and 1.1%, respectively.

Health products powered by artificial intelligence are streaming into our lives, from virtual doctor apps to wearable sensors and drugstore chatbots.

IBM boasted that its AI could “outthink cancer.” Others say computer systems that read X-rays will make radiologists obsolete. AI can help doctors interpret MRIs of the heart, CT scans of the head and photographs of the back of the eye, and could potentially take over many mundane medical chores, freeing doctors to spend more time talking to patients, said Dr. Eric Topol, a cardiologist and executive vice president of Scripps Research in La Jolla.

“There’s nothing that I’ve seen in my 30-plus years studying medicine that could be as impactful and transformative” as AI, Topol said. Even the Food and Drug Administration ― which has approved more than 40 AI products in the last five years ― says “the potential of digital health is nothing short of revolutionary.”

Yet many health industry experts fear AI-based products won’t be able to match the hype. Some doctors and consumer advocates fear that the tech industry, which lives by the mantra “fail fast and fix it later,” is putting patients at risk ― and that regulators aren’t doing enough to keep consumers safe.

Early experiments in AI provide a reason for caution, said Mildred Cho, a professor of pediatrics at Stanford’s Center for Biomedical Ethics.

Systems developed in one hospital often flop when deployed in a different facility, Cho said. Software used in the care of millions of Americans has been shown to discriminate against minorities. And AI systems sometimes learn to make predictions based on factors that have less to do with disease than the brand of MRI machine used, the time a blood test is taken or whether a patient was visited by a chaplain.

In one case, AI software incorrectly concluded that people with pneumonia were less likely to die if they had asthma ― an error that could have led doctors to deprive asthma patients of the extra care they need.

“It’s only a matter of time before something like this leads to a serious health problem,” said Dr. Steven Nissen, chairman of cardiology at the Cleveland Clinic.

Medical AI, which pulled in $1.6 billion in venture capital funding in the third quarter alone, is “nearly at the peak of inflated expectations,” concluded a July report from research company Gartner. “As the reality gets tested, there will likely be a rough slide into the trough of disillusionment.”

That reality check could come in the form of disappointing results when AI products are ushered into the real world. Even Topol, the author of “Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again,” acknowledges that many AI products are little more than hot air.

Experts such as Dr. Bob Kocher, a partner at the venture capital firm Venrock, are blunter. “Most AI products have little evidence to support them,” Kocher said. Some risks won’t become apparent until an AI system has been used by large numbers of patients. “We’re going to keep discovering a whole bunch of risks and unintended consequences of using AI on medical data,” Kocher said.

None of the AI products sold in the U.S. have been tested in randomized clinical trials, the strongest source of medical evidence, Topol said. The first and only randomized trial of an AI system ― which found that colonoscopy with computer-aided diagnosis found more small polyps than standard colonoscopy ― was published online in October.

Few tech start-ups publish their research in peer-reviewed journals, which allow other scientists to scrutinize their work, according to a January article in the European Journal of Clinical Investigation. Such “stealth research” ― described only in press releases or promotional events ― often overstates a company’s accomplishments.

And although software developers may boast about the accuracy of their AI devices, experts note that AI models are mostly tested on computers, not in hospitals or other medical facilities. Using unproven software “may make patients into unwitting guinea pigs,” said Dr. Ron Li, medical informatics director for AI clinical integration at Stanford Health Care.

AI systems that learn to recognize patterns in data are often described as “black boxes” because even their developers don’t know how they reached their conclusions. Given that AI is so new ― and many of its risks unknown ― the field needs careful oversight, said Pilar Ossorio, a professor of law and bioethics at the University of Wisconsin-Madison.

Yet the majority of AI devices don’t require FDA approval. “None of the companies that I have invested in are covered by the FDA regulations,” Kocher said.

Legislation passed by Congress in 2016 ― and championed by the tech industry ― exempts many types of medical software from federal review, including certain fitness apps, electronic health records and tools that help doctors make medical decisions.

There’s been little research on whether the 320,000 medical apps now in use actually improve health, according to a report on AI published Dec. 17 by the National Academy of Medicine.

The FDA has long focused its attention on devices that pose the greatest threat to patients. And consumer advocates acknowledge that some devices ― such as ones that help people count their daily steps ― need less scrutiny than ones that diagnose or treat disease.

Some software developers don’t bother to apply for FDA clearance or authorization, even when legally required, according to a 2018 study in Annals of Internal Medicine.

Industry analysts say that AI developers have little interest in conducting expensive and time-consuming trials. “It’s not the main concern of these firms to submit themselves to rigorous evaluation that would be published in a peer-reviewed journal,” said Joachim Roski, a principal at Booz Allen Hamilton, a technology consulting firm, and coauthor of the National Academy’s report. “That’s not how the U.S. economy works.”

But Oren Etzioni, chief executive at the Allen Institute for AI in Seattle, said AI developers have a financial incentive to make sure their medical products are safe.

“If failing fast means a whole bunch of people will die, I don’t think we want to fail fast,” Etzioni said. “Nobody is going to be happy, including investors, if people die or are severely hurt.”

The FDA has come under fire in recent years for allowing the sale of dangerous medical devices, which have been linked by the International Consortium of Investigative Journalists to 80,000 deaths and 1.7 million injuries over the last decade.

Many of these devices were cleared for use through a controversial process called the 510(k) pathway, which allows companies to market “moderate-risk” products with no clinical testing as long as they’re deemed similar to existing devices.

In 2011, a committee of the National Academy of Medicine concluded the 510(k) process is so fundamentally flawed that the FDA should throw it out and start over.

Instead, the FDA is using the process to greenlight AI devices.

Of the 14 AI products authorized by the FDA in 2017 and 2018, 11 were cleared through the 510(k) process, according to a November article in JAMA. None of these appear to have had new clinical testing, the study said.

The FDA cleared an AI device designed to help diagnose liver and lung cancer in 2018 based on its similarity to imaging software approved 20 years earlier. That software had itself been cleared because it was deemed “substantially equivalent” to products marketed before 1976.

AI products cleared by the FDA today are largely “locked,” so that their calculations and results will not change after they enter the market, said Bakul Patel, director for digital health at the FDA’s Center for Devices and Radiological Health. The FDA has not yet authorized “unlocked” AI devices, whose results could vary from month to month in ways that developers cannot predict.

To deal with the flood of AI products, the FDA is testing a radically different approach to digital device regulation, focusing on evaluating companies, not products.

The FDA’s pilot “pre-certification” program, launched in 2017, is designed to “reduce the time and cost of market entry for software developers,” imposing the “least burdensome” system possible. FDA officials say they want to keep pace with AI software developers, who update their products much more frequently than makers of traditional devices, such as X-ray machines.

Scott Gottlieb said in 2017 while he was FDA commissioner that government regulators need to make sure its approach to innovative products “is efficient and that it fosters, not impedes, innovation.”

Under the plan, the FDA would pre-certify companies that “demonstrate a culture of quality and organizational excellence,” which would allow them to provide less upfront data about devices.

Pre-certified companies could then release devices with a “streamlined” review ― or no FDA review at all. Once products are on the market, companies will be responsible for monitoring their own products’ safety and reporting back to the FDA.

High-risk products, such as software used in pacemakers, will still get a comprehensive FDA evaluation.

But research shows that even low- and moderate-risk devices have been recalled due to serious risks to patients, said Diana Zuckerman, president of the National Center for Health Research. Johnson & Johnson, for example, has recalled hip implants and surgical mesh.

Some AI devices are more carefully tested than others. An AI-powered screening tool for diabetic eye disease was studied in 900 patients at 10 primary care offices before being approved in 2018. The manufacturer, IDx Technologies, worked with the FDA for eight years to get the test, sold as IDx-DR, right, said Dr. Michael Abramoff, the company’s founder and executive chairman.

IDx-DR is the first autonomous AI product ― one that can make a screening decision without a doctor. The company is now installing it in primary care clinics and grocery stores, where it can be operated by employees with a high school diploma.

Yet some AI-based innovations intended to improve care have had the opposite effect.

A Canadian company, for example, developed AI software to predict a person’s risk of Alzheimer’s based on their speech. Predictions were more accurate for some patients than others. “Difficulty finding the right word may be due to unfamiliarity with English, rather than to cognitive impairment,” said coauthor Frank Rudzicz, an associate professor of computer science at the University of Toronto.

Doctors at New York’s Mount Sinai Hospital hoped AI could help them use chest X-rays to predict which patients were at high risk of pneumonia. Although the system made accurate predictions from X-rays shot at Mount Sinai, the technology flopped when tested on images taken at other hospitals. Eventually, researchers realized the computer had merely learned to tell the difference between that hospital’s portable chest X-rays ― taken at a patient’s bedside ― with those taken in the radiology department. Doctors tend to use portable chest X-rays for patients too sick to leave their room, so it’s not surprising that these patients had a greater risk of lung infection.

DeepMind, a company owned by Google, has created an AI-based mobile app that can predict which hospitalized patients will develop acute kidney failure up to 48 hours in advance. A blog post on the DeepMind website described the system, used at a London hospital, as a “game changer.” But the AI system also produced two false alarms for every correct result, according to a July study in Nature. That may explain why patients’ kidney function didn’t improve, said Dr. Saurabh Jha, associate professor of radiology at the Hospital of the University of Pennsylvania. Any benefit from early detection of serious kidney problems may have been diluted by a high rate of “overdiagnosis,” in which the AI system flagged borderline kidney issues that didn’t need treatment, Jha said.

Google had no comment in response to Jha’s conclusions.

This story was written for Kaiser Health News, an editorially independent publication of the Kaiser Family Foundation.

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AFTER: After Juliette Hohnen bought two 1920 Venice cottages it 2014, the homes were taken down to framing, and then rebuilt with replicated gables and rooflines. 

(Steve Magner)

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AFTER: The former bungalows were initially dark. But the solution was to add vaulted ceilings punched with skylights. 

(Steve Magner)

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AFTER: The new kitchen’s custom cabinetry set off a fire engine red Bertazzoni range.  

(Steve Magner)

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AFTER: The master bedroom’s adjoining bathroom has white-paneled wainscoting sorrounding an elegant Waterworks Empire tub. 

(Steve Magner)

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AFTER: A new zero-edge pool links the two 1920 Venice cottages — one for Juliette Hohnen; the other for her two teenage sons. 

(Steve Magner)

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BEFORE: Juliette Hohnen renovated two dowdy 1920 Venice cottages with boxy layouts but managed to retain the history of the neighborhood. 

(Sherri Johnson)

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BEFORE: The rooms in the main house had a “terrible layout,” Juliette Hohnen says. They later were switched, favoring a linear flow, much like a New York City brownstone.  

(Sherri Johnson)

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BEFORE: The main home’s former utilitarian kitchen was useful but lacked charm and grace.  

(Sherri Johnson)

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BEFORE: Boxy rooms marked the character of two ragged 1920 Venice bungalows.  

(Sherri Johnson)

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BEFORE: The former backyard joining the two Venice cottages was a mere stretch of dirt. 

(Sherri Johnson)

Bucking the trend of building mega-modernist Venice houses, Juliette Hohnen instead decided to renovate a property’s two ragged cottages, imbuing them with a dash of the lysergic wonder that is Venice Beach.

“I just thought, I’m going to be the opposite of all the other real estate agents who make a lot of money and live in these modern houses,” said Hohnen, a Douglas Elliman agent and designer who finished renovating the 1920 cottages two years ago — with upgrades ongoing.

“So many in the area would look at this as a cash cow in the grand manner of going lot line to lot line, three stories,” added Brian Mullinix, her architectural designer and builder. “We agreed that these houses spoke to the history of the neighborhood.”

Hohnen bought the Milwood Avenue property for $1.95 million in 2014 and quickly took the homes down to framing, then rebuilt with replicated gables and rooflines. She lives in the front house; the back bungalow is for her teenage sons, Jack and Alfie Hohnen-Weber, from a previous marriage to actor Steven Weber.

Her sons use a now-soundproofed garage as a rehearsal and recording studio for their band, Jack and Alfie’s House.

As an agent, Hohnen draws on connections she made during her former 15-year career in entertainment television and print journalism, now transacting home deals for the likes of Adele, Elijah Wood and Ellen Page, among other notables. Her flip side is the self-described “insane houseoholic,” having renovated 10 homes, including three in Malibu and one in the Hamptons, on New York’s Long Island.

“I must control myself,” she said of buying three houses after her 2013 divorce and throwing the dice again to buy the Milwood property. Hohnen, who studied interior design at London’s Inchbald School of Design, said the shabby Milwood houses had a “terrible layout” with “nothing properly opening out to the garden.”

Rooms were wholly switched around in the main house. Now the kitchen, living and dining rooms all connect in a direct line, “almost like a New York City railroad brownstone,” Mullinix said.

Front and side decks were added to the front house, which still has two bedrooms. The back house’s former one-bedroom layout was expanded to two with a shared bathroom.

The total renovation cost: $700,000, which includes a new zero-edge pool that helps connect the homes.

The houses were also dark — solved after being reimagined with vaulted ceilings punched with skylights. The new height augments the spaces that hew to original footprints, with a combined total of 1,804 square feet.

The new lofty ceilings in both houses are French oak, with the front house floors done in a French oak chevron pattern; the rear house has walnut chevron floors.

Hohnen employed her eclectic design sense to achieve a boho chic look, which she further describes as “happy hippie deluxe.” The kaleidoscopic style is favored by those who dabble in crystals yet “must have all the very best,” said Hohnen, her trademark wry humor out in full force — and flavored by her Chelsea accent.

She said, during a visit, the musician Beck weighed in on the nonconformist design — it reminded him of a boutique hotel in London.

Hohnen both splurged and saved. Extravagances included reams of Peter Dunham and Raoul Textiles that she artfully tailored into shades and curtains — as well as bedcovers from India sourced at Hollywood at Home on La Cienega Boulevard. She augmented the looks with finds from world travels.

The warmly real effect includes splashes of high elegance — pricey spends such as a cluster of 12 ostrich-egg lights hung in the living room and six hand-blown teardrop lights that fall amid the kitchen’s open shelving and Mullinix’s custom cabinetry (Behr’s “Black Boudoir”). The dark cabinets help announce the fire engine red Bertazzoni range.

“Some people have vacations, and I have my light fixtures,” Hohnen mused of the lights bought at Bourgeois Boheme on Sunset Boulevard for $8,000 to $10,000 each.

Hohnen estimates they saved about $100,000 by forgoing metal windows for wood ones painted black on the inside and weatherized with blue metal on the outside. “As far as anyone’s concerned, they look like they’re metal windows but they’re not.” Alas, her secret’s now out.

The front home’s smallish master bedroom is clad in hemp wallpaper, which sets off a custom-built walnut bed made by Santa Monica’s Faithful Roots. The adjoining bathroom now has white paneled wainscoting — background to an elegant Waterworks Empire tub with a brass floor-mounted filler.

In the back house, the French oak ceilings continue down some walls, helping to create a hangout vibe for the “endless teenagers” who traipse through the property, Hohnen said.

A set of three “very, very expensive” Roche Bobois striped couches anchor the teenagers’ living room, which she said she “agonized over buying,” telling her sons: “‘Do not under any circumstances ruin these.’ And they basically used them as a spare bed for every teenager that’s ever walked through my house.”

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Found within a historic building in downtown Long Beach, this penthouse offers sweeping views, a massive wraparound balcony and Mills Act status, which helps save on property taxes. 

(Peter McMenamin)

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The penthouse has two bedrooms and two bathrooms in 2,810 square feet. 

(Peter McMenamin)

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The penthouse price: $2.9 million  

(Peter McMenamin)

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The building was added to the National Register of Historic Places in 2003. 

(Peter McMenamin)

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Every room has amazing panoramic views. 

(Peter McMenamin)

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The historic Insurance Exchange building in the heart of downtown Long Beach. 

(Peter McMenamin)

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Clad in wood shingles, this beach house boasts expansive living spaces and an unbeatable location.  

(Nicolai Real Estate)

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The home has three bedrooms and four bathrooms in 3,257 square feet. 

(Nicolai Real Estate)

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The price: $2.995 million. 

(Nicolai Real Estate)

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The kitchen. 

(Nicolai Real Estate)

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The home is offered for the first time in almost 50 years. 

(Nicolai Real Estate)

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5501 E. Seaside Walk, Long Beach. 

(Nicolai Real Estate)

In the high-caliber housing market of Los Angeles County, every neighborhood has a distinct style, offering a list of pros and cons that can leave even the surest of buyers second-guessing.

Better views lead to longer commutes. Living closer to the action may mean sacrificing space.

This series digs into these differences, pitting properties against each other in a head-to-head format and allowing the listing agents to proclaim why theirs is best.

Thanks to its historic attractions, stellar seafood spots and one of the world’s largest shipping ports, Long Beach has seen its population steadily rise over the last century.

Depending on the area, the average home there sells for between $500,000 and $800,000. But with a budget of a few million, buyers can scoop up some of the city’s most prime properties.

For $3 million, which would you prefer: a one-of-a-kind penthouse atop a historic building in downtown Long Beach, or a charming beachfront abode on the Peninsula?

Penthouse

Found within a historic building in downtown Long Beach, this unique penthouse offers sweeping views, a massive wraparound balcony and Mills Act status, which helps save on property taxes. It’s listed by Debra Kahookele of Re/Max Estate Properties.

Address: 207 E. Broadway, No. 801, Long Beach, CA 90802

Price: $2.9 million

Specs: Two bedrooms and two bathrooms in 2,810 square feet (5,055-square-foot lot)

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The agent’s pitch:

On the market for the first time, this custom-designed penthouse is perched on the rooftop of the historic Insurance Exchange building in the heart of downtown Long Beach. An elevator accesses the architectural floor plan, which uses glass panels to separate the three levels of living space.

Massive windows in every room allow for amazing panoramic views of the city and ocean, and glass double doors open to a wraparound balcony. Other highlights include 16-foot ceilings, walnut treads and floating walls.

The building was added to the National Register of Historic Places in 2003. Four years ago, it acquired Mills Act [status], which allows a reduction in property taxes in exchange for preservation of the property. To live in this building is a wonderful opportunity, but to live in this rooftop penthouse is a once-in-a-lifetime possibility.

Beach house

Clad in wood shingles, this charming beach house boasts expansive living spaces and an unbeatable location. It’s listed by Chase and Blake Nicolai of Nicolai Real Estate.

Address: 5501 E. Seaside Walk, Long Beach, CA 90803

Price: $2.995 million

Specs: Three bedrooms and four bathrooms in 3,257 square feet (2,906-square-foot lot)

The agent’s pitch:

Offered for the first time in almost 50 years, this iconic Peninsula home is positioned for spectacular ocean views that stretch the entire Long Beach coastline. The house is distinctively situated at the base of the Peninsula with no obstructions to its westerly view, giving it some of the most unique sightlines in the entire city.

The lower level is highlighted by a gracious living room with beautiful vaulted wood ceilings and windows that look out to the sand. As you head up the stairs, you are greeted by a panoramic outlook of Catalina Island, Alamitos Bay, downtown Long Beach and the distant mountains. With such dramatic vistas, spacious bedrooms, bright living areas, a kitchen on each level and a three-car garage, it leaves nothing to be desired.

This property presents itself as a rare opportunity for one to purchase an important piece of the Long Beach Peninsula. It’s a front-row seat for every great sunset.

The snow arrived just after Christmas, a fuzzy fleece draped over the local mountains. You can only imagine the local stir this caused … the post-holiday encore we won’t soon forget.

Nor will we forget Christmas itself. One of my sisters was in town, and I spoke in church, which is something of a challenge for a wise guy like me. To play things straight is my worst fear. I live for punchlines and wry remarks. Still, the church readings went well enough.

A giant orchestra played behind me, with a big church choir dressed to impress. Some 700 people attended, they say, including my buddies Charlie and Russ. My pals were there to support me or mock me later if I stumbled.

That’s what friends are for.

Look, reflection unnerves me, to borrow from Dorothy Parker. Like an old tractor, I’m better in forward than reverse. It’s 2020 now, a year that rolls off the tongue. I’m looking forward to a good one.

One possible omen: Just before the holidays, we bought a dozen eggs that all turned out to contain double yolks.

It was like spotting Jesus’ likeness in the sheen of the family Ford. The first few double-yolks seemed like sunny flukes, but for the entire carton to have them carried a major message. From Dorothy Parker maybe. Or my late wife, Posh: “Keep stirring the gravy, kid. Keep pouring that nog.”

To be sure, it was a sadly tender couple of weeks. Keeper of the light, I kept the fireplace going, bringing in logs from the garage while checking them for black widows because — well, you know our rotten luck.

Nobody ever wrote a children’s poem about a lethal spider. If it bit me, I’d bite it back. How dramatic would that be, the black widow and I both taking our last breaths just as the NFL playoffs were about to begin.

“What was he thinking, biting that spider at playoff time?” Pastor Chuck would ask.

“You know, he never handled confrontation well,” my pal Bittner would explain.

For the holiday, the lovely and patient older daughter was off visiting her fiance’s family, so we were missing them mightily. My sister flew down from Portland, Ore., to lend support, soothing us all with a pie made from scratch.

The kids were thrilled by this, since my sister is a professional artist and latticed the pie top in that way you see only in Nancy Meyers movies.

I responded by wrapping all the gifts in duct tape, just round and round, till they resembled basketballs. Then I splashed Baileys in my coffee and set off to find some last-minute tamales.

Some families have Norman Rockwell holidays. Ours has me.

“Dad, is it hard to be a dad?” my daughter Rapunzel asked, after I’d accidentally broadcast the inside of my pocket on Facebook Live.

You know, a friend says the best Christmas of all time was in 1721, year of Vivaldi’s “The Four Seasons” and Bach’s “Partita for Violin No. 2.”

The Christmas of 2019 will be remembered for other things. How one of the kids fell in the toilet … splash … “Frig! Who left the seat up!!!”

Or how the pet wolf dug up the yard, then lay down in the mud fully satisfied.

What bothered me wasn’t the vandalism so much; it was her total lack of remorse.

“What big ears you have, Grandma,” I keep telling White Fang, who never gets the reference. She just looks hungrily at me, wondering if I’d taste like cheese.

I’ll give her this: White Fang holds her head high, even after she mucks things up. Which I think is something we can all learn from.

As we can all learn from the holidays themselves. They are such a character study of America and of you and me.

I dread the January bills. I already realize that I overspent on the boy, just the way his mom did. I didn’t want there to be some austere difference in the day. If nothing else, I wanted him to feel overloved.

The best love, though, came courtesy of his aunt’s homemade pie, made with those double-yolk eggs. Or the cranberry-brie pull-apart his sister baked for Christmas dinner.

Or the game of Yahtzee later — the roll of the dice, the laughter, the holiday zizzle.

Yep, I think 2020 is going to be a good one, all right. Might be our best year in years.

[email protected]

Find photos of Chris Erskine’s holiday at latimes.com/lifestyle

SEATTLE — 

Washington state sued Johnson & Johnson on Thursday, claiming the company was negligent when it used deceptive marketing to say opioids were effective for treating pain and unlikely to cause addiction.

The multinational company that supplies raw materials used to make opiates drove the pharmaceutical industry to recklessly expand the production of opioids to the point where there was more than a two-week supply of daily doses for every person in the state, the lawsuit says.

“The human toll is staggering,” state Atty. Gen. Bob Ferguson said at a news conference.

The lawsuit, which seeks civil penalties and damages, was filed in King County Superior Court. It says the company violated the state’s Consumer Protection Act, and was negligent and a public nuisance.

Washington is also asking that the company forfeit profits made in the state as a result of its behavior. Ferguson said that figure is in the millions of dollars.

Janssen Pharmaceutical Inc., a Johnson & Johnson subsidiary named in the lawsuit, said its opioid marketing was “appropriate and responsible.”

“Janssen provided our prescription pain medicines for doctors treating patients suffering from severe pain and worked with regulators to ensure safe use — everything you’d expect a responsible company to do,” its statement said.

Ferguson said prescriptions and sales of opioids in Washington increased more than 500 percent from 1997 to 2011. He said that in 2011, at the peak of sales, more than 112 million daily doses of all prescription opioids were dispensed.

In November a judge in Oklahoma finalized an order directing Johnson & Johnson to pay that state $465 million to address the opioid crisis.

The judge said the company and its subsidiaries helped fuel the crisis with an aggressive and misleading marketing campaign that overstated how effective the drugs were for treating chronic pain and understated the risk of addiction.

LOUISVILLE, Ky.  — 

Kentucky’s new Republican attorney general has asked the FBI to investigate a flurry of pardons by former Gov. Matt Bevin.

The pardons have drawn criticism from both sides of the political aisle after media reports highlighted some that went to convicts who had wealthy or politically connected families.

Atty. Gen. Daniel Cameron wrote in a letter Monday that he had sent a formal request to the FBI to “investigate this matter.”

“I believe the pardon power should be used sparingly and only after great deliberation with due concern for public safety,” Cameron wrote in the letter addressed to two Democratic state lawmakers, who shared the letter Thursday.

Bevin, a Republican, issued hundreds of pardons between his electoral defeat on Nov. 5 and his final day in office on Dec. 9. His pardons included clemency for convicted killer Patrick Baker, whose family held a fundraiser for Bevin in 2018, and a convicted sex offender whose mother was married to a millionaire road contractor.

The pardons also have attracted the attention of Russell Coleman, the U.S. attorney for Kentucky’s Western District.

On Monday, Coleman said his office would review any pardon-related issues brought by state prosecutors or other law enforcement partners.

“I am particularly concerned about the risk to the public by those previously convicted of sex offenses, who by virtue of the state pardon, will not fall under any post-release supervision or be required to register as sex offenders,” Coleman said at a news conference.

Coleman was probably referring to the pardon of Micah Schoettle, convicted of raping a 9-year-old girl, who was in the second year of a 23-year prison sentence when Bevin pardoned him of rape, sodomy and other sexual crimes. The pardon also removed him from the state’s sex offender registry.

Bevin has said in defending the Schoettle pardon that there should have been physical evidence of rape and in his pardoning document he wrote that the prosecution of the case was “sloppy at best.”

Cameron, who took office Dec. 17, was responding to requests by two state lawmakers, Sen. Morgan McGarvey and Rep. Chris Harris, who were particularly concerned about the Baker case.

Baker was sentenced to 19 years in prison on convictions of reckless homicide and other crimes in a fatal 2014 home break-in in Knox County. Prosecutors say Baker and another man posed as police to gain entry to Donald Mills’ home and shot Mills in front of his wife. Bevin wrote in his pardoning order that Baker’s drug addictions led him to fall in with the wrong people and the evidence against Baker was “sketchy at best.”

The Courier Journal has reported that Baker’s family held a fundraiser at their home for Bevin in 2018, and another GOP donor who gave thousands to Bevin urged the former governor to pardon Baker.

The Kentucky Court of Appeals upheld Baker’s conviction a year ago, writing in a unanimous ruling that “Baker’s guilt was overwhelming.”

WASHINGTON
 — 

President Trump ordered the U.S. airstrike that killed Gen. Qassem Suleimani, the head of Iran’s elite Quds Force, on Friday at Baghdad’s international airport, the Pentagon said, a dramatic move that raised the possibility of a broader conflict in the Middle East.

“At the direction of the president, the U.S. military has taken decisive defensive action to protect U.S. personnel abroad,” the Pentagon said in a statement.

The Pentagon said that Suleimani “was actively developing plans to attack American diplomats and service members in Iraq and throughout the region.”

Trump did not have an immediate comment apart from tweeting an image of the U.S. flag.

The strike also killed Abu Mahdi Muhandis, the deputy commander of Iran-backed militias known as the Popular Mobilization Forces, or PMF, a senior Iraqi politician and a high-level security official confirmed to the Associated Press.

Suleimani was considered one of the most powerful figures in the region, responsible for spreading Iran’s influence in Iraq, Syria, Lebanon and elsewhere, often through violence. The U.S. also blamed him for approving an attack on the American Embassy in Baghdad this week.

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Two militia leaders loyal to Iran also confirmed the deaths, including an official with Kataib Hezbollah, which was involved in an attack on the U.S. Embassy this week.

The official, speaking on condition of anonymity, said Muhandis had arrived at the airport in a convoy to receive Suleimani, whose plane had arrived from either Lebanon or Syria. The airstrike occurred as soon as he descended from the plane to be greeted by Muhandis and his companions, killing them all.

The officials spoke on condition of anonymity because of the sensitivity of the subject and because they were not authorized to give official statements.

The senior politician said Suleimani’s body was identified by the ring he wore.

Republican hard-liners in Washington cheered Trump’s decision, with some describing Suleimani as a terrorist.

With some warning of Iranian counterattacks, Sen. Lindsey Graham (R-S.C.) tweeted a message to Tehran — “if you want more, you will get more.”

Sen. Chris Murphy (D-Conn.) expressed concerns about Trump single-handedly sparking a wider conflict.

“Did America just assassinate, without any congressional authorization, the second most powerful person in Iran, knowingly setting off a potential massive regional war?” he tweeted.

Mohammad Javad Zarif, the Iranian foreign minister, called the airstrike an “act of international terrorism” by “assassinating” the general. “The US bears responsibility for all consequences of its rogue adventurism,” he tweeted.

The airstrike begins a new and even more volatile chapter in Trump’s uneven foreign policy record.

None of his most championed causes — a peace deal between Israelis and Palestinians, disarmament of nuclear North Korea, the fall of Iran’s leadership — has produced desired results so far. To the contrary, especially with this week’s storming of the U.S. Embassy compound in Baghdad, those endeavors have suffered considerable setbacks.

Trump can point to a handful of accomplishments around the globe, such as the military raid that ended in the death of Islamic State leader Abu Bakr Baghdadi, and the House passage last month of a revamped trade deal with Mexico and Canada.

But rather than resolving long-standing conflicts that Trump once boasted would be simple to fix, he has been shown the limitations of both his power of persuasion and his notion that he can throw money, or the promise of profits, at a problem to solve it. That is especially the case in the Middle East, where there are strong sectarian or nationalist sentiments, or in a dictatorship like North Korea, where the leader is impervious to popular demands.

Trump branded his foreign policy as “America first.” Its hallmarks include trial balloons, unpredictability and treaty busting — and the desire to keep the world on its toes. He has alienated allies, courted adversaries and reduced U.S. troops in Syria, something that came at the expense of Kurdish allies who were killed when Turkey invaded to fill the breach.

Unlike most previous presidencies, Trump conducts a “top-down” policy that eschews the usual inter-agency deliberation examining the pros and cons of actions, and considering potential collateral damage.

“The president is a big believer that unpredictability gives him power which would solve a number of American challenges around the world,” said Jon Alterman, a former State Department official under President George W. Bush and global security expert at the Center for Strategic and International Studies. “It gives him some power, but there are negatives.”

Those include baffling foe and friend alike, as well as the American public and the foreign policy establishment, and creating a sense of unreliability.

With North Korea, despite becoming the first sitting president to step into the country, and two historic summits with North Korean leader Kim Jong Un, Trump has not reduced Kim’s arsenals or stopped construction of nuclear infrastructure by Pyongyang. In fact, the two sides have yet to even define “denuclearization.” After apparent rapprochement, rhetoric from North Korea has again heated up, and the testing of short-range missiles has intensified.

On the first day of the year, as Kim was threatening “shocking, offensive measures” and to unveil a new “strategic” weapon, Trump was again praising the North Korean.

“Look, he likes me, I like him, we get along,” Trump said at his Mar-a-Lago resort in Florida. “But he did sign a contract, he did sign an agreement talking about denuclearization…. I think he’s a man of his word so we’re going to find out, but I think he’s a man of his word.”

In fact, the “contract” that Trump referred to is only a vaguely worded agreement to shared goals of removing nuclear weapons from the Korean peninsula.

For Trump, some analysts say, his goal is not to resolve a problem but simply to appear to be tackling it, often without an enunciated goal.

“He looked at Iran and said he’d be tough. So he looks tough. He’ll declare: Mission accomplished!” said Daniel Byman, a former government official who is an associate dean at Georgetown University. “I don’t think he cares too much about outcomes.”

The attempt to isolate and cripple the Iranian government, following the decision to withdraw from the landmark Iran nuclear deal, has been one of the few consistent strategies in Trump’s foreign policy. The administration, in a “maximum-pressure campaign,” has placed tough sanctions on Iran’s oil industry, banks, Islamic Revolutionary Guard Corps and scores of individuals. The measures have floored Iran’s economy.

Yet the “malign behavior” that the administration says it wants to halt has apparently continued. The U.S. blamed Iran for rocket attacks in September on Saudi oil-production facilities but did not retaliate militarily. On Dec. 27, a barrage of rocket fire killed an American contractor on an Iraqi base in northern Iraq. It followed a sustained campaign blamed on Iraqi Shiite fighters from the pro-Iranian militia Kataib Hezbollah.

The U.S. responded, launching airstrikes that killed 25 people and wounded many more. The action infuriated Iraqis from the government, and across social and political lines. It led to this week’s attack on the U.S. Embassy in Baghdad, which was quelled, for the moment, by U.S. military reinforcements dispatched to the site.

Trump boasted the embassy was protected, saying there would be “no Benghazi” on his watch, alluding to U.S. facilities attacked in Libya in 2012, where the U.S. ambassador and three other Americans were killed. The incidents are hardly analogous: Libya was a lawless country and the buildings attacked were relatively vulnerable; the massive, 104-acre U.S. Embassy compound in Baghdad sits in a heavily fortified Green Zone, off-limits to most Iraqis.

That the Baghdad rampage could take place owed in part to the refusal of Iraqi security forces to stop the attackers, U.S. officials said, and underscores the failure of both Iraq and the U.S. to reduce Iran’s presence in Iraq.

Defense Secretary Mark Esper on Thursday acknowledged the problem.

Iraqi leaders must “get the Iranian influence out of the country,” Esper said. He warned that the Pentagon had “indications” that another attack on the embassy or other U.S. facilities may be planned, and said the U.S. government was prepared to act “preemptively.”

“The game has changed,” Esper said.

Speaking alongside Esper at a Pentagon briefing was Gen. Mark Milley, chairman of the Joint Chiefs of Staff, who said the more than 750 Marines and paratroopers rushed to Baghdad constituted adequate force.

“There is sufficient combat power there, air and ground, that anyone who attempts to overrun that will run into a buzz saw,” he said.

Kataib Hezbollah, for its part, suggested that its withdrawal from the embassy grounds was a tactical retreat and that it would begin working on legislation to oust “criminal invading foreign forces.”

Elsewhere in the Mideast, Trump’s efforts have stalled. After pledging to come up with a peace deal for Israel and the Palestinians to succeed where all before him failed, the president has largely abandoned the effort.

The last draft offered Palestinians economic benefits if they put aside for now their statehood aspirations — a nonstarter for most Palestinians.

Trump thus far has shown no signs of switching gears in his handling of these conflicts, even as the next weeks will prove daunting, Richard Haass, president of the Council on Foreign Relations, said Thursday on Twitter. According to Haass, Trump faces a crisis with Iran because he rejected diplomacy and one with North Korea because “he asked too much of diplomacy.”

Times staff writer Noah Bierman in Los Angeles contributed to this report.

BAGHDAD — 

Gen. Qassem Suleimani, the head of Iran’s elite Quds Force, was killed in a U.S. airstrike at Baghdad’s international airport Friday, the Pentagon confirmed.

“At the direction of the President, the U.S. military has taken decisive defensive action to protect U.S. personnel abroad by killing [Qassem Suleimani], the head of the Iranian Revolutionary Guard Corps-Quds Force, a U.S.-designated Foreign Terrorist Organization,” according to a statement.

The Pentagon said that Suleimani “was actively developing plans to attack American diplomats and service members in Iraq and throughout the region.”

President Trump did not have an immediate comment apart from tweeting an image of the U.S. flag.

The strike also killed Abu Mahdi Muhandis, the deputy commander of Iran-backed militias known as the Popular Mobilization Forces, or PMF, the officials said.

Their deaths are a potential turning point in the Middle East and are expected to draw severe retaliation from Iran and the forces it backs in the Middle East against Israel and American interests.

The Popular Mobilization Forces blamed the United States for the attack.

A senior Iraqi politician and a high-level security official confirmed to the Associated Press that Suleimani and Muhandis were among those killed in the attack. Two militia leaders loyal to Iran also confirmed the deaths, including an official with the Kataib Hezbollah, which was involved in an attack on the U.S. Embassy this week.

The official, speaking on condition of anonymity, said Muhandis had arrived to the airport in a convoy to receive Suleimani whose plane had arrived from either Lebanon or Syria. The airstrike occurred as soon as he descended from the plane to be greeted by Muhandis and his companions, killing them all.

The officials spoke on condition of anonymity because of the sensitivity of the subject and because they were not authorized to give official statements.

The senior politician said Suleimani’s body was identified by the ring he wore.

Suleimani had been rumored dead several times, including in a 2006 airplane crash that killed other military officials in northwestern Iran and after a 2012 bombing in Damascus that killed top aides of embattled Syrian President Bashar Assad. More recently, rumors circulated in November 2015 that Suleimani was killed or seriously wounded leading forces loyal to Assad as they fought around Syria’s Aleppo.

Earlier Friday, an official with an Iran-backed paramilitary force said that seven people were killed by a missile fired at Baghdad International Airport, blaming the United States.

The official with the group known as the Popular Mobilization Forces said the dead included its airport protocol officer, identifying him as Mohammed Reda.

A security official confirmed that seven people were killed in the attack on the airport, describing it as an airstrike. Earlier, Iraq’s Security Media Cell, which releases information regarding Iraqi security, said Katyusha rockets landed near the airport’s cargo hall, killing several people and setting two cars on fire.

It was not immediately clear who fired the missile or rockets or who was targeted. There was no immediate comment from the U.S.

The attack came amid tensions with the United States after a New Year’s Eve attack by Iran-backed militias on the U.S. Embassy in Baghdad. The two-day assault, which ended Wednesday, prompted President Trump to order about 750 U.S. soldiers deployed to the Middle East.

The breach at the embassy followed U.S. airstrikes on Sunday that killed 25 fighters of the Iran-backed militia in Iraq, the Kataib Hezbollah. The U.S. military said the strikes were in retaliation for last week’s killing of an American contractor in a rocket attack on an Iraqi military base that the U.S. blamed on the militia.

U.S. officials have suggested they were prepared to engage in further retaliatory attacks in Iraq.

“The game has changed,” Defense Secretary Mark Esper said Thursday, telling reporters that violent acts by Iran-backed Shiite militias in Iraq — including the rocket attack on Dec. 27 that killed one American — will be met with U.S. military force.

He said the Iraqi government has fallen short of its obligation to defend its American partner in the attack on the U.S. Embassy.

The developments also represent a major downturn in Iraq-U.S. relations that could further undermine U.S. influence in the region and American troops in Iraq and weaken Washington’s hand in its pressure campaign against Iran.