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Imagine knowing you have pancreatic cancer and your doctor is unwilling to tell you how bad it is because they’re uncomfortable.That’s the situation Dr. Ron Naito, a now-retired physician, found himself in this past August.“It’s never an easy task to tell someone they have a terminal illness. How can it be?” Naito says, sitting on a couch in his home in Portland, Oregon. “I mean it brings your own mortality into the picture for one thing.”Naito has stage 4 pancreatic cancer, and as a doctor himself, he knows full well what that means. It can mean a person only has months to live.“Of all the major cancers, the one with most dire of all prognoses is probably pancreatic,” Naito explains. “Particularly what I have, which is stage 4. And I don’t think he felt comfortable telling me or discussing it.”Not only was one specialist unwilling to discuss the severity of his illness, but Naito found out about the size of his tumor from a second specialist in a less than optimal way, as well. He overheard the doctor talking to a medical student just outside his open exam room door.“They were walking this way and they said, ‘5 centimeters.’ He told the medical student. Then, they were walking the other way,” he recalls. “And I heard the words, ‘very bad,’ and I knew it was me, obviously. I know that pancreatic cancer if they exceed 3 centimeters, it’s a negative sign.”The doctor never did talk to him face to face about the precise size of his tumor.Naito says he didn’t think it was “very professional,” but even so, he has no anger toward his doctors. Instead he says it highlights how easy it is for a doctor to be careless.“They’re not uncaring. It’s just that they don’t have any experience or training. Nobody’s there to guide them,” Naito says. “And there’s no book on this. I mean you can’t go to the medical school library and check out a book on how can you deliver a dire diagnosis to patients. That book does not exist. I don’t think.”That’s why Naito not only choosing to speak out in the months he has left--despite his weakness--but it’s also why he’s given Oregon Health and Science University’s Center for Ethics in Healthcare a grant so people like Dr. Katie Stowers can teach the next generation how to better deliver news to someone who’s dying.“Unfortunately, Dr. Naito’s experience is not an anomaly,” Stowers says.Stowers is the inaugural “Ronald Naito Director of Serious Illness Education” at OHSU. Medical students under Stowers’ guidance must now pass a unique final exam, delivering grim news in mock scenarios.“It’s not that doctors don’t want to do better. It’s not that doctors are bad or inhumane, it’s that they just haven’t been taught how to do this the right way,” Stowers says.Naito, who has outlived his prognosis but estimates he may only have about six months left, says doing it the right way all comes down to one thing.“When you’re talking to your patient that has terminal illness, you have to realize your doctor and patient roles become a little bit blurred,” he says, fighting back tear. “Because, basically, you’re just two souls. You’re two human beings meeting at a very deep level. You’re in charge with giving this other person the most devastating news they will receive in their lifetime potentially.”It’s a very crucial moment, Naito says. 3314

It has been more than a year since "House of Cards" actor Kevin Spacey posted anything to Twitter, but that changed today — Christmas Eve.Spacey's post comes after the announcement he is being charged with the sexual assault of a teenage boy that allegedly occurred in 2016. His tweet today reads, "Let Me Be Frank," the title of a video he posted to YouTube. In 375

India has disputed Pakistan's claims that its air force shot down two Indian fighter jets inside Pakistani airspace on Wednesday amid a potentially dangerous border crisis between the two nuclear-armed powers.The alleged incident comes a day after India said it launched airstrikes in Pakistan territory in the first such incursion by Indian Air Force planes since the India-Pakistan war of 1971.Pakistan denied that the airstrikes took place, saying only that Indian jets crossed its de factor border with India in the disputed Kashmir region and that they were pushed back.In a press conference Wednesday, the Indian foreign ministry said one of its Air Force pilots was missing after a plane was shot down in an aerial engagement with Pakistani military aircraft.That account differs from Pakistan's version of events, though CNN could not independently verify Pakistan or India's claims.Maj. Gen. Asif Ghafoor, Pakistan's chief military spokesperson, said in a tweet Wednesday that one Indian aircraft fell inside Pakistan-administered Kashmir, while another fell within the Indian-administered region of Kashmir.Two Indian pilots have been arrested, Ghafoor later said, with one pilot said to be receiving treatment for injuries in a military hospital.India did not say where its plane went down but a statement from Indian Foreign Ministry Spokesperson Raveesh Kumar, said an Indian Air Force plane (a MiG 21 Bison) shot down a Pakistani jet, which fell on the Pakistan side of the border.Kumar said one of its pilots is missing and acknowledged that "Pakistan has claimed that he is in their custody.""We are ascertaining the facts," he said.The escalating tensions come at a politically crucial time for India, which is scheduled to hold national elections by the end of May.Pakistan closed its airspace on Wednesday, according to the country's Civil Aviation Authority.Flights to several Indian airports were also suspended, according to multiple Indian airlines on Twitter.In separate tweets, Jet Airways, Vistara, Indigo and GoAir airlines announced the suspension of flights to airports at Amritsar, Chandigarh, Srinagar, Jammu & Leh.Earlier on Wednesday, Pakistan's Foreign Ministry said that Islamabad had carried out aerial strikes on "nonmilitary targets" across the line of control (LoC) from within Pakistani airspace, while accusing India of "carrying out acts of terror in Pakistan."Pakistan said its strike was "not a retaliation" to the Indian operation and stressed that Pakistan struck "nonmilitary target, avoiding human loss and collateral damage."According to the foreign ministry statement, the purpose of the strike was to demonstrate the country's self defense capabilities. "We have no intention of escalation, but are fully prepared to do so if forced into that paradigm. That is why we undertook the action with clear warning and in broad daylight," the statement said.Ghafoor said Pakistan's Air Force hit supply depots belonging to the Indian army during operations that targeted six Indian locations.Pakistan Prime Minister Imran Khan had previously promised retaliation "at the time and place of Pakistan's choosing" and directed the country's armed forces to remain prepared for all eventualities in response to the Indian strikes.'Not a military operation'Kashmir, a largely mountainous region located between India and Pakistan, has been bitterly contested by both countries following partition in 1947, leading to three wars and numerous other skirmishes.Skirmishes along the LoC have escalated since the alleged Indian airstrikes. On Tuesday, Pakistan troops opened fire at 15 places across the LoC in Jammu and Kashmir, injuring five Indian soldiers, army spokesperson Devender Anand told CNN.Earlier on Wednesday, Indian Foreign Affairs Minister Sushma Swaraj said the country does not want "further escalation" with Pakistan.Speaking at a foreign ministers meeting between Russia, India, and China in Wuzhen, China, on Wednesday, Swaraj said Tuesday's strike was "not a military operation" but "a preemptive strike against the terrorist infrastructure of Jaish-e-Mohammed."India blames the militant group Jaish-e-Mohammed (JeM) for a suicide car bomb attack in Indian-administered Kashmir, which killed 40 Indian paramilitary soldiers on February 14.India had previously said that Pakistan had a "direct hand" in the attack -- the deadliest on security forces since the beginning of the insurgency in the late 1980s. Pakistan has vehemently denied having a role in the incident.Swaraj said that Tuesday's pre-dawn operation was launched because of the "continuing refusal of Pakistan to acknowledge and act against terror groups on its territory."The military action was based on "credible information" that militants were planning other attacks in various parts of the country, Swaraj said.Two narrativesThe discrepancy between Delhi's account and what Pakistan is saying isn't novel.Back in 2016, following an attack on an Indian military installation in Kashmir that India blamed on Pakistan-based gunmen, Delhi carried out what it called "surgical strikes" -- sending troops across the de facto border to hit terrorist targets.Pakistan, however, denied that any such incursion had taken place, saying instead that there had only been an exchange of fire between the two sides.In its Foreign Ministry statement Wednesday, Pakistan said that "India has been trying to establish what they call 'a new normal' a thinly veiled term for doing acts of aggression at whatever pretext they wish on a given day. If India is striking at so called terrorist backers without a shred of evidence, we also retain reciprocal rights to retaliate against elements that enjoy Indian patronage while carrying out acts of terror in Pakistan."US Secretary of State Mike Pompeo spoke with his counterparts in India and Pakistan and urged both sides to "exercise restraint, and avoid escalation at any cost.""I also encouraged both ministers to prioritize direct communication and avoid further military activity," he said Wednesday, in the first statement by the US government over the incident.Harsh V Pant, a professor in international relations at King's College London, told CNN that for the past few decades the Indian government had chosen not to retaliate after terror attacks in Kashmir.But India is now at a point where it is choosing to escalate the situation, adding that India's military action follows public anger over the attack.China, which shares a border with both countries, called on Pakistan and India to "exercise restraint" after news of the airstrikes broke."Both India and Pakistan are important countries in South Asia," Chinese Foreign Ministry spokesperson Lu Kang said during a daily press briefing Tuesday. "We hope that both sides can exercise restraint, and take actions that can contribute to the region's stability and improve their mutual relationship, but not the opposite." 6952

LANSING, Mich. — Secretary of State Jocelyn Benson's office is working to add a third gender option on Michigan licenses.The possibility to add a non-binary option might be complete by 2021, according to 216

Iran's stockpiles of enriched low-grade uranium have exceeded the 300-kilogram limit set in a landmark 2015 nuclear deal, Foreign Minister Javad Zarif said on Monday according to the state-run IRNA news outlet.The move is thought to be Tehran's first major breach of the accord since US President Donald Trump withdrew from the agreement last year. The deal limited Iran's uranium enrichment in exchange for an easing of international sanctions.Zarif is one of the chief architects of the deal. Foreign Ministry Spokesperson Abbas Mousavi said Tehran's latest moves were reversible."We told the Europeans that if more practical, mature and complete measures were taken, Iran's reduction (to its) commitments could be reversed. Otherwise, we will continue," Mousavi said.Iran had threatened to surpass the maximum permitted amount of enriched uranium in retaliation to crippling US economic sanctions. During talks in Vienna Friday, European countries still party to the deal made a last-ditch effort to persuade Iran to back off from plans to breach the limit.Inspectors from the global nuclear watchdog, the International Atomic Energy Agency, are on the ground in Iran and are expected to report on the stockpiles."We are aware of the media reports related to Iran's stockpile of low-enriched uranium (LEU). Our inspectors are on the ground and they will report to headquarters as soon as the LEU stockpile has been verified," an IAEA spokesman said in an email to CNN.Iran said in May that it had quadrupled its production of low enriched uranium. The announcement ratcheted up tensions in the region and set off a series of provocative moves by the US and Iran.Last week, the US dispatched top-of-the-line F-22 stealth fighters to nearby Qatar. The deployment came a week after an Iranian surface-to-air missile shot down a US drone over the Strait of Hormuz, one of the world's most vital strategic shipping routes.Iran said the drone was in its airspace, but Washington said it was over international waters.The US has also blamed Iran for explosions on two oil tankers this month near the strait, as well as on four commercial ships off the coast of the United Arab Emirates last month. Iran has categorically denied responsibility for the ship attacks. 2272

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