Sickle Cell Disease Essay Example for Free

Sickle Cell Disease Essay Sickle-Cell Anemia is a genetic blood disorder caused by the presence of an abnormal form of hemoglobin. These hemoglobin molecules tend to aggregate after unloading oxygen forming long, rod-like structures that force the red cells to assume a sickle shape. Unlike normal red cells, which are usually smooth and malleable, the sickle red cells cannot squeeze through small blood vessels. When the sickle cells block small blood vessels, the organs are deprived of blood and oxygen. This leads to periodic episodes of pain and damages the vital organs. Sickle red cells die after only about 10 to 20 days. Instead of the usual 120 days because they cannot be replaced fast enough, the blood is chronically short of red cells, causing anemia. The gene for sickle cell anemia must be inherited from both parents for the illness to occur in children. A child with only one copy of the gene may have sickle-cell traits but no symptoms of illness. Normally healthy blood cells are round shaped blood cells, they move through small blood vessels to carry oxygen to all parts of the body. People with sickle-cell disease their blood cells are not round they are become hard and sticky and look like a C-shaped farm tool called a â€Å"sickle†. The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious problems like infection, acute chest syndrome and stroke. Some of the common names for sickle-c ell disease are HbS disease, Hemoglobin S Disease, SCD, Sickle cell disorders, Sickle disorder due to hemoglobin S, and Anemia-Sickle Cell; Hemoglobin SS Disease (Hb SS). Sickle-cell disease is mostly inherited by African Americans, Mediterranean countries; Greece, Turkey, and Italy; the Arabian Peninsula, India, and Spanish-speaking regions; South America, Central America, and parts of the Caribbean. The three most common forms of the disease in the United States are Hemoglobin SS or sickle cell anemia, Hemoglobin SC disease, and Hemoglobin sickle beta-thalassemia (a form of Cooleys anemia). â€Å"Sickle cell disease is the most common inherited blood disorder in the United States, affecting 70,000 to 80,000 Americans. The disease is estimated to occur in 1 in 500 African Americans and 1 in 1,000 to 1,400 Hispanic Americans.† A person with the sickle cell trait does not have (and will never have) sickle cell disease. However, the presence of the trait may impact his/her children. A person with the trait carries one abnormal  hemoglobin gene inherited from one parent (S, E, C, etc.) and one normal hemoglobin gene from the other parent (type A ). Typically, sickle cell trait is the presence of hemoglobin AS.Sickle cell disease is not contagious; you cannot catch it. You inherit it from your parents. If, for example, one parent has normal hemoglobin ( type AA) and the second parent has abnormal hemoglobin ( type AS, or the sickle cell trait), there is a 50% chance that each child will have the sickle cell trait, but they will not have sickle cell disease ( type SS). The symptoms of sickle-cell disease usually occur after the age of 4 months. Painful episodes called crises- lasting hours to days; cause pain in the bone of the back, long bones, and chest. When the anemia becomes more severe, symptoms may be fatigue, paleness, rapid heart rate, shortness of breath, and yellowing of the eyes and skin (jaundice). Younger children with sickle cell anemia have attacks of abdominal pain. Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly. These are the symptoms, and sometimes crises can happen once a year or few times every year. The following symptoms may occur because small blood vessels may become blocked by the abnormal cells painful and prolonged erection (priapism), poor eyesight or blindness, problems with thinking or confusion caused by small strokes, and Ulcers on the lower legs (in adolescents and adults). Over time, the spleen no longer works. As a result, people with sickle cell anemia may have symptoms of infections like Bone infection (osteomyelitis), Gallbladder infection (cholecystitis), Lung infection (pneumonia), and Urinary tract infection. Other symptoms may include delayed growth and puberty, and painful joints caused by arthritis. Tests commonly performed to diagnose and monitor patients with sickle cell anemia are Bilirubin, Blood oxygen, Complete blood count (CBC), Hemoglobin electrophoresis, Serum creatinine, Serum potassium, and Sickle cell test. The treatments for people with sickle-cell disease are blood transfusions (may also be given regularly to prevent stroke), pain medicines, plenty of fluids, and Hydroxyurea (Hydrea). Hydroxyurea is a medicine that may help reduce the number of pain episodes (including chest pain and difficulty breathing) in some people. Antibiotics to prevent bacterial infections, which are common in children with sickle cell disease dialysis or kidney transplant for kidney disease, counseling for psychological complications,  gallbladder removal in people with gallstone disease, hip replacement for avascular necrosis of the hip, surgery for eye problems, treatment for overuse or abuse of narcotic pain medicines, and wound care for leg ulcers. For treatment some of the vaccinations are Haemophilus influenza vaccine (Hib), Pneumococcal conjugate vaccine (PCV), and Pneumococcal polysaccharide vaccine (PPV). There are a few common organizations that support sickle-cell they are American Sickle Cell Anemia Association, National Heart, Blood and Lung Institution, Sickle Cell Disease Association of America, U.S Center of Disease Control Prevention. Many people have been affected by S ickle-Cell Anemia and only a couple are cured. Although African Americans have a high occurrence of Sickle-Cell Anemia (1 in 500 African Americans), many other nationalities suffer from the disease. Sickle-Cell Anemia affects 8 out of 100,000 people worldwide. Sickle-Cell Anemia should start to be noticed, if not throughout the entire world, then at least America. The more awareness there is for this disease, the fewer death rates we will have as a country. Bibliography http://www.nlm.nih.gov/medlineplus/ency/article/000527.htm http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm http://ghr.nlm.nih.gov/condition/sickle-cell-disease http://kidshealth.org/parent/medical/heart/sickle_cell_anemia.html#a_Causes_of_Sickle_Cell_Disease http://www.cdc.gov/ncbddd/sicklecell/treatments.html

Resource Based View Strategy Formulation

Resource Based View Strategy Formulation Resource-based view (RBV) is a tool to determine strategic resources and how it affects the performance of the firm based solely on reviewing its internal environment while the external environment remains fixed. Firms using RBV competes in terms of their resources and capabilities. The aim of this paper is to study the factors that influence firms performance. The RBV emphasizes on the firms resources as the essential elements of competitive advantage and performance. It assumes two assumptions in examining sources of competitive advantage which are that the firms are heterogeneous in terms of the resources they control and that resource heterogeneity can continue over a period as the resources used to implement their strategies are not easily portable across firms (Bridoux, F, n.d).. The RBV method of analyzing firms performance is focused that other vital factors tend to be disregarded. Resources are not valuable of themselves; instead they are valuable because they allow firms to perform activities that in return create advantages for them. The competitive value of resources can be enhanced or eliminated by changes in technology, competitor behavior, or buyer needs which an inward focus on resources will overlook (Sheehan, N Foss, N, 2007). Resource uniqueness is essential as this differentiates between the firms. However, resource uniqueness is not sufficient to achieve sustainable competitive advantage and thus the resources must also be valuable, rare, imperfectly imitable and non-substitutable. RBV suggests that business processes that exploit valuable but common resources can only be a source of competitive equality; business processes that exploit valuable and rare resources can be a source of temporary competitive advantage; and business processes that exploit valuable, rare, and costly-to-imitate resources can be a source of sustained competitive advantage (Bridoux, F, n.d). The merits and demerits of RBV as the best strategy route One of the important contributions of RBV is the ability of it to measure and identify the internal environment of the firm. The importance of using RBV as a strategy route is to be able to work the inside-out approach. This means that companies using RBV focus on their internal strengths more as it is the root of their competitiveness. Furthermore, RBV recommends that effective management of operations can create uniqueness in the firms resources. Louis Vuitton is one firm in a competitive industry which has the edge over their competitors because of their product uniqueness. Louis Vuittons expertises are their design skills and manufacturing efficiency (R. Duane Ireland, Robert E. Hoskisson, Michael A. Hitt, 2008). While they may not be able to control the external environment, Louis Vuitton can use the RBV model and analyze their position and work on their strategies. Many organizations have been faced with dilemmas on how to use their resources strategically. Organizations that fail to efficiently convert their resources and capabilities into business processes cannot expect to recognize the potential competitive advantage of these resources. The RBV has little contribution in terms of predicting firm performance because of its nature of being tautological (Truijens, O. (n.d) and its focus is too narrow. Also, as a measure which only focuses on the internal environment, the RBV cannot be taken as the best strategy route. Many firms which focus mainly on the internal environment encounter competitive disadvantages to their business. For example, when IBM, a successful company achieved its success many of their competitors entered into the market. IBMs competitors included other big names such as Hewlett Packard (HP), Dell and Compaq (McNeilly, 2000). IBM did not pay close attention to their competitors because they were focused greatly on their in ternal strengths and not those of their competitors. Some other firms which have experienced failures from the strategies are Marlborough. Marlborough took the price cut strategy too far as they did not consider their competitors possible moves. The CEO of Marlborough started a price war by reducing their prices to attract consumers and gain more market share. However, their competitors also followed in reducing their prices which resulted in Marlborough facing losses. (McNeillly, 2000). RBV is not the only factor which determines performance of the firm. In industries such as the airline industry, other external factors such as timing and marketing are also essential. Entering into the industry requires good timing and this can be influenced by the economic position and consumer choice of quality and lower price. For example, Southwest airlines which are one of the well-known low cost carriers in the United States used the niche market strategy to maintain competitive advantage from its rivals. They avoided large airports, focused mainly on short flights which are ideal for families and business people, as well as excluded seating requirement and on flight meals to reduce their cost (Anonymous, 2010). Porter also mentions the common strategy of lowering cost, and product differentiation allows firms to access its strengths. Firms achieve superior positions based on being a cost leader or earning price premiums at the activity level (Anonymous, 2010). In the cost leader method of achieving sustainable competitive advantage, the firm would sell its products either at the average price to earn profits or below the average price to gain market share. The broader market usually adopts cost leadership. Wal-Mart is a cost leader. Their strategy was to form a close relationship with their suppliers which allowed them to reduce cost when purchasing in bulk (Walden University, 2010). Differentiation is another strategy mentioned by Porter. Firms produce products that vary from others and have unique features to compete against their competitors. This uniqueness of the product also allows firms to charge higher prices for their product. However, there are a few different types of differentia tion strategies. The few common ones include differentiation based on additional features, packaging, and design and positioning (Scribd, 2011). Louis Vuitton is an example of a firm that applies differentiation through design and positioning. Exploring processes, capabilities and the ability to appropriate rent and Porters industrial analysis Porters framework discusses the role of firms in formulating appropriate competitive strategy to achieve superior economic performance, and competitive approach. Also, the source of profits is not to be found in the firm but rather in the structure of the industry, especially the nature and balance of its competitive forces (Bridoux, F, n.d). However, the assumption of any relationship between firm performance and rent generation may be inaccurate. The RBV states that performance consists of rent generation and rent appropriation and we cannot predict firm performance from rent generation only. One such example is IBM. IBM assembled the strategic capabilities that built most of the modem for the personal computer industry. Yet Intel and Microsoft were ultimately able to appropriate a lot more of the related rent (Russell W. Coff, 1999). The factors that allow resources to generate rents should be valuable, rare, imperfectly imitable and non-substitutable. This issue was addressed by identifying the conditions under which a firms resources become valuable by bringing the external environment into the resource-based view. Through nurturing the internal competencies and applying them to an appropriate external environment, a firm can develop a viable strategy. Thus, for a firms resource to become valuable, it must allow the firm to exploit opportunities or neutralize threats in the firms environment (Russo, M Fouts, P, 1986). Resources as an option or real options refer to resources which are bought in present time and are either used or kept to be used in a later period. For example, land can be bought and used right away or it can be kept for use later. Real options create strategic flexibility for firms and when used effectively they can retain or increase in value. These types of resources are very useful in indus tries that have high competitiveness and use high technology. The pharmaceutical industry is one industry where there is high competitiveness. Firms such as Johnson Johnson, and Pfizer invest hugely in research and development in order to develop large numbers of drugs which can used to treat different illnesses although most of the time these drugs fail. Due to the uncertain nature of the products, these firms have to focus widely (R. Duane Ireland, Robert E. Hoskisson, Michael A. Hitt, 2008). However, firms resources on their own accord do not contribute to competitive advantage. Thus, these resources must be combined to form capabilities which in turn develop into core competencies and are used by firms to create value. Capabilities result from combining resources. Honda uses its capabilities in product design, engineering and manufacturing. Moreover, they place a great deal of emphasis on their workforce. Honda encourages their engineers to dream. This allows their employees to discover new things which add to their knowledge. This knowledge in turn will simplify their daily work. Core competencies are the capabilities which the firm pursuits and performs well. Core competencies have a competitive edge when the firms add value and outperform their competitors. The factors of core competencies which lead to a competitive advantage are valuable, rare, imperfectly imitable and non-substitutable (R. Duane Ireland, Robert E. Hoskisson, Michael A. Hitt 2008). Conclusion In conclusion, the RBV cannot be accepted as the best strategy route due its nature of being narrowly scoped and ignorant of the external environment. This measure does not provide accurate information on the firms performance. However, in a stable industry the RBV can be considered as one of the best strategy route. A firms performance should undertake many other factors which include timing, marketing, and advancement of technology, competitor behavior as well as the needs of consumers. I disagree that RBV is the best route as external factors are also very crucial in determining the performance and rent generation of firms as other external factors must also be considered. Porters external environment analysis focuses on the external factors that affect a firms performance. Dynamic industries focus more on the external environment thus preferring to use Porters theory In order for the RBV method to be more effective and efficient; it has to be studied along together with the exter nal environment. That way, firms are aware of their resources and capabilities and can nurture the internal competencies to apply them with appropriate external environment, which will allow the firm to develop practical approaches.

The French Revolution :: European Europe History

The French Revolution Gradually after the American Revolution, France had it's own Revolution in 1789. The French were very unhappy with their current status, jobs, and living conditions. They saw what the Americans did to achieve liberty, and how successful they were. Many of them had also read the writings of the philosophers and believed that change was necessary. Nevertheless, the main problems that led to the French Revolution were deep debt, competition between social classes, and the unlawful conduct of the king. Debt was one of the problems that led France toward a Revolution. France was badly in debt after participating in the American Revolution and after Kings Louis XIV's and Louis XVI's enormous expenses. In order to save France from bankruptcy, Louis XVI called on the Estates General for help. The Estates General was made up of the First (clergy), Second (nobility), and Third (everyone else) Estate. However there was a lot of conflict within the Third Estate, because it was made up of everyone who was not part of the royal family, clergy, or nobility. The Third Estate was very unsatisfied because although it contained over 80 percent of the population, it still had the same one vote as the other two Estates with fewer people. Thus it re-named itself the National Assembly in June of 1789 and claimed itself the representative body of the people. The Assembly did not aid the King in his financial troubles, yet it demanded many changes to France's absolute monarchy and legislative system. Many of the laws that were passed in France had also become extremely burdensome to the common people because they excluded the clergy and nobility from paying taxes. Louis XVI tried to help the economy, by raising taxes in 1786. But this only made matters worse, because peasants were unable to pay. Harvest was also poor and food very expensive. People were enraged of hearing stories of lavish parties at the fine houses and palaces, where a lot of food was served, which was either wasted or given to the dogs afterwards. The demand for manufactured goods fell, and many artisans, traders and farmers were without work. People were angry and began to revolt. In July of 1789, they stormed the Bastille killing many people, and in October of 1789 angry middleclass women marched to Versailles demanding that the royal family move to Paris and action be taken to help feed the people.

Big Cats in Asia Essay -- Animal Research

The relationship between human beings and the environment has always been in conflict. Our world these days is based on the economy and the ambitious interest people have in leaving nature behind. Nowadays, business is growing and so is the population, people’s priority is to make as much money as possible, but do they really care about the environment around them? Our greediness for money has led us to destroy forests and animal niches. However, there might still be hope for animals that were taken from their habitat to start over again, in a very slow process by stopping deforestation and increasing conservation areas. This essay is focused on the conflicts between the Siberian tigers human modified environment they now live in, and how this has been affecting them periodically to the point of becoming endangered, and how people around the world are trying to help by restoring their habitat. Tigers in crisis news write â€Å"almost all wild Siberian tigers live in the Southeast corner of Russia in the Sikhote-Alin mountain range east of the Amur River. Their range also includes northeastern of China and the Korean peninsula, and as far west as Mongolia. It is consider critically endangered species with the primary threats to its survival in the wild being poaching and habitat loss from intensive logging and development. It is estimated that the wild population of Siberian tigers at around 350-450 tigers†. (Introduction). Like Ruth Ashby said, â€Å"Once there were eight sub species of tigers today there are three of them†(22) Tigers occupy just 7% of their historic range due to the increase of population over the average global rate across the majority of the tiger’s habitat, therefore current tiger habitat extents through one of the mo... ...rticles/Killed%20for%20Cure%20-%20Trade%20in%20Tiger%20Bone.pdf>. O'Brien, T. G., Kinnaird, M. F. and Wibisono, H. T. (2003), Crouching tigers, hidden prey: Sumatran tiger and prey populations in a tropical forest landscape. Animal Conservation, 6: 131–139. doi: 10.1017/S1367943003003172 Sandberg, L. Anders, and Tor Sandberg. A Practical Environmental Education. Climate Change: Who's Carrying the Burden? : the Chilly Climates of the Global Environment Dilemma. Ottawa, ON: Canadian Centre for Policy Alternatives, 2010. 195-96. Print. Siberian Tiger at Tigers in Crisis." Tigers in Crisis - Information About Earth's Endangered Tigers. Web. . Wittier, John Greenleaf. "The Worship of Nature." The Complete Poetical Works of John Greenleaf Whittier. H.E.S ed. Boston: Houghton Mifflin, 1894. 141. Print. Reprinted

Teenage Suicide Essays -- Teenage Suicide Essays

Teenage Suicide Each day 86 Americans take their own lives and another 1,500 attempts to do so. Even more disturbing is that suicide among a young people nation wide have increased dramatically in recent years. In fact thousands of teenagers each year commit suicide. It is the third leading cause of death among young adults aged 15-24. With the first two leading causes being unintentional injury and homicide. There are many reasons why teenagers feel the need to take their own life. They are at a time in their life where they are strongly feeling stress, confusion, self doubt, pressure to succeed, and other fears while growing. Among the probable causes of teenage suicide are family problems, stress, drug and alcohol abuse, and depression. Depression and suicidal tendencies are caused by society today. What adolescents do not understand is that depression is a disease (Empfield, 2). With the proper medical treatment as well as psychiatric treatment one can overcome depression. For some teenagers, divorce, the formation of a new family or moving to a new community can be very unsettling. Leaving behind comfort when moving can result in anger toward parents, which is usually taken out at school or even on other children. The formation of a new family itself can be traumatic. What one child knew so well such as a father or mother, sisters and brothers, can be broken when they are "replaced" with new, particularly strange people who now have to share a home with this adolescent. Every day in America, 2,989 see their parents divorce (Empfield, 62). Young children take divorce the hardest for many reasons. It can even put them in a state of confusion. Since these young children are still growing, some of them still do not know wh... ...many adolescents in this country. Many adolescents do not realize that depression and suicidal feelings are treatable mental disorders. The first step is to recognize the illness. Thousands of books have tried to answer the question of why people kill themselves. To be summarized into three words: to stop pain. Sometimes the pain is physical, as in chronic or terminal illness. More often it is emotional, caused by a myriad of problems. In any case, suicide is not a random or senseless act, but an effective, if extreme, solution. Works Cited Dew, Diane. The Troubles Teens Face. [Http://www.dianedew.com/teens.htm]. Empfield, Maureen. Understanding Teenage Depression. New York: Henry Holt,2001. Kerns, Laurence L. Helping Your Depressed Child. Rockin: Prima Publishing, 1993. Suicide in the United States. [Http://www.cdc.gov/ncipc/factsheets/suifacts.htm].

Pygmalion vs. My Fair Lady Essay

The Academy Award-winning musical film My Fair Lady produced by George Cukor in 1964, was based on the play Pygmalion by George Bernard Shaw written in 1913. Although, the basic story line and underlying themes are the same, there are a number of differences between the two famous works. The most pronounced difference is that My Fair Lady had songs added to the dialogue. Furthermore, Pygmalion deals with many of the social issues that were occurring during the Victorian era in England, which is different from the musical which portrays what a person can do if they put forth a true effort. In My Fair Lady there is more emphasis on Eliza’s character developing her speech and going through all the unusual exercises’ such as speaking with marbles in her mouth and being hooked up to a machine while saying her vowels, than in the written play. This is probably due to the fact that in the play people should expect all of this to happen and don’t need to be told. Also, Cukor’s My Fair Lady did this in the musical because it adds entertainment value. When Eliza finally is able to speak well, Professor Higgins and Colonel Pickering decided to take her to meet Higgins’ mother to see how see would behave around other distinguished people of high class society. This is the same in both Pygmalion the play and My Fair Lady the musical, however, in the musical they take her to meet Professor Higgins’ mother at a horse race where as in the play they take Eliza to Higgins’ mother’s house. Also, in the play Eliza meets Mrs. Eynsford Hill, Clara, and Freddy at Higgins’ mother’s while in the musical she doesn’t meet Clara, only Mrs. Eynsford Hill and Freddy at the horse race. After Mr. Doolittle is made into a wealthy man, which happens in both works, he marries his live-in girlfriend. In the play, he visits Mrs. Higgin’s before going to the church to get married where as in the movie he doesn’t visit her at all. The first point in the play when you find out that Mr. Doolittle has become wealthy and is going to get married is when Eliza goes back to the street where she used to live and sees her father coming out of a bar. That is when he informs her that he is getting married the next. At the final test of Eliza’s improvement, the Ambassadors party, she meets the queen of Transylvania in the musical but she does not in the play. Actually, this entire scene is skipped in Shaw’s play. The end of the musical is open ended, leaving the readers to come up with their own ideas and feelings about what is going to happen next. Maybe Professor Higgins and Eliza Doolittle will live happily together like the myth that Pygmalion is based on, Pygmalion and Galetea. Although there are many contrasting events that occur in the musical and in the play they do have many things in common. They have the same characters, although some are developed more in one than in the other. The basic thought and idea’s are the same throughout the musical and play which is expected since My Fair Lady is based on Pygmalion. I enjoyed the musical more than the play because I feel like the musical went into a lot more depth of Eliza’s transformation. The songs and the actors in My Fair Lady really brought the story to life. For me, Rex Harrison’s portrayal of Professor Higgins was absolutely perfect; he was able to show more sides of Professor Higgins’ psyche than you could experience by reading the play. Pygmalion is the type of play that will never be forgotten, even though My Fair Lady is perhaps the most memorable movie based on Shaw’s play, there has been many other renditions, such as Pretty Woman, and there will probably many more made in the future.

Carrie Chapter One

News item from the Westover (Me.) weekly Enterprise, August 19, 1966: RAIN OF STONES REPORTED It was reliably reported by several persons that a rain of stones fell from a clear blue sky on Carlin Street in the town of Chamberlain on August 17th. The stones fell principally on the home of Mrs Margaret White, damaging the roof extensively and ruining two gutters and a downspout valued at approximately $25. Mrs White, a widow, lives with her three-year-old daughter, Carietta. Mrs White could not be reached for comment. Nobody was really surprised when it happened, not really, not at the subconscious level where savage things grow. On the surface, all the girls in the shower room were shocked, thrilled, ashamed, or simply glad that the White bitch had taken it in the mouth again. Some of them might also have claimed surprise, but of course their claim was untrue. Carrie had been going to school with some of them since the first grade, and this had been building since that time, building slowly and immutably, in accordance with all the laws that govern human nature, building with all the steadiness of a chain reaction approaching critical mass. What none of them knew, of course, was that Carrie White was telekinetic. Graffiti scratched on a desk of the Barker Street Grammar school in Chamberlain: Carrie White eats shit. The locker room was filled with shouts, echoes, and the subterranean sound of showers splashing on tile. The girls had been playing volleyball in Period One, and their morning sweat was light and eager. Girls stretched and writhed under the hot water, squalling, flicking water, squirting white bars of soap from hand to hand. Carrie stood among them stolidly a frog among swans. She was a chunky girl with pimples on her neck and back and buttocks, her wet hair completely without colour. It rested against her face with dispirited sogginess and she simply stood, head slightly bent, letting the water splat against her flesh and roll off. She looked the part of the sacrificial goat, the constant butt, believer in left-handed monkey wrenches, perpetual foul-up, and she was. She wished forlornly and constantly that Ewen High had individual-and thus private-showers, like the high schools at Andover or Boxford. They stared. They always stared. Showers turning off one by one, girls stepping out, removing pastel bathing caps, towelling, spraying deodorant, checking the clock over the door. Bras were hooked, underpants stepped into. Steam hung in the air; the place might have been an Egyptian bathhouse except for the constant rumble of the Jacuzzi whirlpool bath in the corner. Calls and catcalls rebounded with all the snap and flicker of billiard balls after a hard break. ‘-so Tommy said he hated it on me and I-‘ ‘-I'm going with my sister and her husband. He picks his nose but so does she, so they're very-‘ ‘-shower after school and-‘ ‘-too cheap to spend a goddam penny so Cindi and I-‘ Miss Desjardin, their slim, nonbreasted gym teacher, stepped in, craned her-neck around briefly, and slapped her hands together once, smartly. ‘What are you waiting for, Carrie? Doom? Bell in five minutes.' Her shorts were blinding white, her legs not too curved but striking in their unobtrusive muscularity. A silver whistle, won in college archery competition, hung around her neck. The girls giggled and Carrie looked up, her eyes slow and dazed from the heat and the steady, pounding roar of the water. ‘Ohuh?' It was a strangely froggy sound, grotesquely apt, and the girls giggled again. Sue Snell had whipped a towel from her hair with the speed of a magician embarking on a wondrous feat and began to comb rapidly. Miss Desjardin made an irritated cranking gesture at Carrie and stepped out. Carrie turned off the shower. It died in a drip and a gurgle. It wasn't until she stepped out that they all saw the blood running down her leg. From The Shadow Exploded. Documented Facts and Specific Conclusions Derived from the Case of Carietta White, by David R. Congress (Tulane University Press: 1981), p. 34: It can hardly be disputed that failure to note specific instances of telekinesis during the White girl's earlier years must be attributed to the conclusions offered by White and Steams in their paper Telekinesis: A Wild Talent Revisited-that the ability to move objects by effort of the will alone comes to the fore only in moments of extreme personal stress. The talent is well hidden indeed; how else could it have remained submerged for centuries with only the tip of the iceberg showing above a sea of quackery? We have only skimpy hearsay evidence upon which to lay our foundation in this case, but even this is enough to indicate that a ‘TK' potential of immense magnitude existed within Carrie White. The great tragedy is that we are now all Monday-morning quarterbacks †¦ ‘Per-iod!' The catcall came first from Chris Hargensen. It struck the tiled walls, rebounded, and struck again. Sue Snell gasped laughter from her nose and felt an odd, vexing mixture of hate, revulsion, exasperation, and pity. She just looked so dumb, standing there, not knowing what was going on. God, you'd think she never ‘PER-iod!' It was becoming a chant, an incantation. Someone in the back-ground (perhaps Hargensen again, Sue couldn't tell in the jungle of echoes) was yelling ‘Plug it up!' with hoarse, uninhibited abandon. ‘PER-iod, PER-iod, PER-iod!' Carrie stood dumbly in the centre of a forming circle, water rolling from her skin in beads. She stood like a patient ox, aware that the joke was on her (as always), dumbly embarrassed but unsurprised. Sue felt welling disgust as the first dark drops of menstrual blood struck the tile in dime-sized drops. ‘For God's sake Carrie, you got your period!' Sue cried. ‘Clean yourself up!' ‘Ohuh?' She looked around bovinely. Her hair stuck to her cheeks in a curving helmet shape. There was a cluster of acne on one shoulder. At sixteen, the elusive stamp of hurt was already marked clearly in her eyes. ‘She thinks they're for lipstick!' Ruth Grogan suddenly shouted with cryptic glee, and then burst into a shriek of laughter. Sue remembered the comment later and fitted it Into a general picture, but now it was only another senseless sound in the confusion. Sixteen? She was thinking. She must know what's happening, she†¦ More droplets of blood. Carrie still blinked around at her classmates in slow bewilderment. Helen Shyres turned around and made mock throwingup gestures. ‘You're bleeding!' Sue yelled suddenly, furiously. ‘You're bleeding, you big dumb pudding!' Carrie looked down at herself. She shrieked. The sound was very loud in the humid locker room. A tampon suddenly struck her in the chest and fell with a plop at her feet. A red flower stained the absorbent cotton and spread. Then the laughter, disgusted, contemptuous, horrified, seemed to rise and bloom into something jagged and ugly, and the girls were bombarding her with tampons and sanitary napkins, some from purses, some from the broken dispenser on the wall. They flew like snow and the chant became: ‘Plug it up. Plug it up. Plug it-‘ Sue was throwing them too, throwing and chanting with the rest, not really sure what she was doing – a charm had occurred to her mind and it glowed there like neon: There's no harm in it really no harm in it really no harm-It was still flashing and glowing, reassuringly, when Carrie suddenly began to howl and back away, flailing her arms and grunting and gobbling. The girls stopped, realizing that fission and explosion had finally been reached. It was at this point, when looking back, that some of them would claim surprise. Yet there had been all these years, all these years of let's short-sheet Carrie's bed at Christian Youth Camp and I found this love letter from Carrie to Flash Bobby Pickett let's copy it and pass it around and hide her underpants somewhere and put this snake in her shoe and duck her again, duck her again: Carrie tagging along stubbornly on biking trips, known one year as pudd'n and the next year as truck-face, always smelling sweaty, not able to catch up; catching poison ivy from urinating in the bushes and everyone finding out (hey, scratch-ass, your bum itch?). Billy Preston putting peanut butter in her hair that time she fell asleep in study hall; the pinches, the legs outstretched in school aisles to trip her up, the books knocked from her desk, the obscene postcard tucked into her purse; Carrie on the church picnic an d kneeling down clumsily to pray and the seam of her old madras skirt splitting along the zipper like the sound of a huge windbreakage; Carrie always missing the ball, even in kickball, failing on her face in Modern Dancing during their sophomore year and chipping a tooth, running into the net during volleyball; wearing stockings that were always run, running, or about to run, always showing sweat stains under the arms of her blouses; even the time Chris Hargensen called up after school from the Kelly Fruit Company downtown and asked her if she knew that pig poop was spelled C-A-R-R-I-E: Suddenly all this and the critical mass was reached. The ultimate shit-on, grossout, put-down, long searched for, was found. Fission. She backed away, howling in the new silence, fat forearms crossing her face, a tampon stuck in the middle of her pubic hair. The girls watched her, their eyes shining solemnly. Carrie backed into the side of one of the four large shower compartments and slowly collapsed into a sitting position. Slow, helpless groans jerked out of her. Her eyes rolled with wet whiteness, like the eyes of a hog in the slaughtering pen. Sue said slowly, hesitantly: ‘I think this must be the first time she ever-‘ That was when the door pumped open with a flat and hurried bang and Miss Desjardin burst in to see what the matter was. From The Shadow Exploded (p. 41): Both medical and psychological writers on the subject are in agreement that Carrie White's exceptionally late and traumatic commencement of the menstrual cycle might well have provided the trigger for her latent talent. It seems incredible that, as late as 1979, Carrie knew nothing of the mature woman's monthly cycle. It is nearly as incredible to believe that the girl's mother would permit her daughter to reach the age of nearly seventeen without consulting a gynaecologist concerning the daughter's failure to menstruate. Yet the facts are incontrovertible. When Carrie White realized she was bleeding from the vaginal opening, she had no idea of what was taking place. She was innocent of the entire concept of menstruation. One of her surviving classmates, Ruth Grogan, tells of entering the girls' locker room at Ewen High School the year before the events we are concerned with and seeing Carrie using a tampon to blot her lipstick with. At that time Miss Grogan said: ‘What the hell are you up to?' Miss White replied: ‘Isn't this right?' Miss Grogan then replied: ‘Sure. Sure it is.' Ruth Grogan let a number of her girl friends in on this (she later told this interviewer she thought it was ‘sorta cute'), and if anyone tried in the future to inform Carrie of the true purpose of what she was using to make up with, she apparently dismissed the explanation as an attempt to pull her leg. This was a facet of her life that she had become exceedingly wary of†¦ When the girls were gone to their Period Two classes and the bell had been silenced (several of them had slipped quietly out the back door before Miss Desjardin could begin to take names), Miss Desjardin employed the standard tactic for hysterics: She slapped Carrie smartly across the face. She hardly would have admitted the pleasure the act gave her, and she certainly would have denied that she regarded Carrie as a fat, whiny bag of lard. A first-year teacher, she still believed that she thought all children were good. Carrie looked up at her dumbly, face still contorted and working. ‘M-M-Miss D-D-Des-D-‘ ‘Get up,' Miss Desjardin said dispassionately. ‘Get up and tend to yourself.' ‘I'm bleeding to death!' Carrie screamed, and one blind, searching hand came up and clutched Miss Desjardin's white shorts. It left a bloody handprint. ‘I †¦ you . . .' The gym teacher's face contorted into a pucker of disgust, and she suddenly hurled Came, stumbling, to her feet ‘Get over there!' Carrie stood swaying between the showers and the wall with its dime sanitary-napkin dispenser, slumped over, breasts pointing at the floor, her arms dangling limply. She looked like an ape. Her eyes were shiny and blank. ‘Now,' Miss Desjardin said with hissing, deadly emphasis, ‘you take one of those napkins out †¦ no, never mind the coin slot, it's broken anyway†¦ take one and†¦ damn it, will you do it! You act as if you never had a period before.' ‘Period?' Carrie said. Her expression of complete unbelief was too genuine, too full of dumb and hopeless horror, to be ignored or denied. A terrible and black foreknowledge grew in Rita Desjardin's mind. It was incredible, could not be. She herself had begun menstruation shortly after her eleventh birthday and had gone to the head of the stairs to yell down excitedly: ‘Hey, Mum, I'm on the rag!' ‘Carrie?' she said now. She advanced toward the girl. ‘Carrie?' Carrie flinched away. At the same instant, a rack of softball bats in the corner fell over with a large, echoing bang. They rolled every which way, making Desjardin jump. ‘Carrie, is this your first period?' But now that the thought had been admitted, she hardly had to ask. The blood was dark and flowing with terrible heaviness. Both of Carrie's legs were smeared and splattered with it, as though she had waded through a river of blood. ‘It hurts,' Carrie groaned. ‘My stomach †¦' ‘That passes,' Miss Desjardin said. Pity and self-shame met in her and mixed uneasily. ‘You have to †¦ uh, stop the flow of blood. You-‘ There was a bright flash overhead, followed by a flashgunlike pop as a lightbulb sizzled and went out. Miss Desjardin cried out with surprise, and it occurred to her (the whole damn place is falling in) that this kind of thing always seemed to happen around Carrie when she was upset, as if bad luck dogged her every step. The thought was gone almost as quickly as it had come. She took one of the sanitary napkins from the broken dispenser and unwrapped it. ‘Look,' she said, ‘Like this-‘ From The Shadow Exploded (p. 54): Carrie White's mother, Margaret White, gave birth to her daughter on September 21, 1963, under circumstances which can only be termed bizarre. In fact, an overview of the Came White case leaves the careful student with one feeling ascendant over all others: that Carrie was the only issue of a family as odd as any that has ever been brought to popular attention. As noted earlier, Ralph White died in February of 1963 when a steel girder fell out of a carrying sling on a housing-project job in Portland. Mrs White continued to live alone in their suburban Chamberlain bungalow. Due to the White's near-fanatical fundamentalist religious beliefs, Mrs White had no friends to see her through her period of bereavement. And when her labour began seven months later, she was alone. At approximately 1:30 P.M. on September 21, the neighbours on Carlin Street began to hear screams from the White bungalow. The police, however, were not summoned to the scene until after 6:00 P.M. We are left with two unappetizing alternatives to explain this time lag: Either Mrs White's neighbours on the street did not wish to become involved in a police investigation, or dislike for her had become so strong that they deliberately adopted a wait-and-see attitude. Mrs Georgia McLaughlin, the only one of the three remaining residents who were on the street at that time and who would talk to me, said that she did not call the police because she thought the screams had something to do with ‘holy rollin'.' When the police did arrive at 6:22 P.M. the screams had become irregular. Mrs White was found in her bed upstairs, and the investigating officer, Thomas G. Mearton. at first thought she had been the victim of an assault. The bed was drenched with blood, and a butcher knife lay on the floor. It was only then that he saw the baby, still partially wrapped in the placental membrane, at Mrs White's breast. She had apparently cut the umbilical cord herself with the knife. It staggers both imagination and belief to advance the hypothesis that Mrs Margaret White did not know she was pregnant, or even understand what the word entails, and recent scholars such as J. W. Bankson and George Felding have made a more reasonable case for the hypothesis that the concept, linked irrevocably in her mind with the ‘sin' of intercourse, had been blocked entirely from her mind. She may simply have refused to believe that such a thing could happen to her. We have records of at least three letters to a friend in Kenosha, Wisconsin, that seem to prove conclusively that Mrs White believed, from her fifth month on, that she had ‘a cancer of the womanly parts' and would soon join her husband in heaven †¦ When Miss Desjardin led Carrie up to the office fifteen minutes later, the halls were mercifully empty. Classes droned onwards behind closed doors. Carrie's shrieks had finally ended, but she had continued to weep with steady regularity. Desjardin had finally placed the napkin herself, cleaned the girl up with wet paper towels, and gotten her back into her plain cotton underpants. She tried twice to explain the commonplace reality of menstruation, but Carrie clapped her hands over her ears and continued to cry. Mr Morton, the assistant principal, was out of his office in a flash when they entered. Billy deLois and Henry Trennant, two boys waiting for the lecture due them for cutting French I, goggled around from their chairs. ‘Come in,' Mr Morton said briskly. ‘Come right in.' He glared over Desjardin's shoulder at the boys, who were staring at the bloody handprint on her shorts. ‘What are YOU looking at?' ‘Blood,' Henry said, and smiled with a kind of vacuous surprise. ‘Two detention periods,' Morton snapped. He glanced down at the bloody handprint and blinked. He closed the door behind them and began pawing through the top drawer of his filing cabinet for a school accident form. ‘Are you all right, uh-?' ‘Carrie,' Desjardin supplied. ‘Carrie White.' Mr Morton had finally located an accident form. There was a large coffee stain on it. ‘You won't need that, Mr Morton.' ‘I suppose it was the trampoline. We just †¦ I won't?' ‘No. But I think Carrie should be allowed to go home for the rest of the day. She's had a rather frightening experience.' Her eyes flashed a signal which he caught but could not interpret. ‘Yes, okay, if you say so. Good. Fine.' Morton crumpled the form back into the filing cabinet, slammed it shut with his thumb in the drawer, and grunted. He whirled gracefully to the door, yanked it open, glared at Billy and Henry, and called: ‘Miss Fish, could we have a dismissal slip here, please? Carrie Wright.' ‘White,' said Miss Desjardin. ‘White,' Morton agreed. Billy deLois sniggered. ‘Week's detention!' Morton barked. A blood blister was forming under his thumbnail. Hurt like hell. Carrie's steady, monotonous weeping went on and on. Miss Fish brought the yellow dismissal slip and Morton scrawled his initials on it with his silver pocket pencil, wincing at the pressure on his wounded thumb. ‘Do you need a ride, Cassie?' he asked. ‘We can call a cab if you need one.' She shook her head. He noticed with distaste that a large bubble of green mucus had formed at one nostril. Morton looked over her head and at Miss Desjardin.