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People around the world want the same thing from their doctors. First, do no harm. Second, take a look at this weird bump and tell me if I should get worried.

The job is basically the same in many countries around the world. But the pay is wildly different. The median salary for U.S. doctors is about $250,000 a year. In Western Europe, it's less than half that. In developing countries, the salaries are even lower.

Through insurance and out of our own pockets, we pay for doctors' services, just like we pay for all other kinds of goods and services.And yet, with lots of other things we buy, we often turn to imports to save money.

"We should think of doctors the same way we think of shirts," says the economist Dean Baker. "If we can get doctors at a lower cost from elsewhere in the world then we could save enormous amounts of money."

The big difference, of course, is that a bad t-shirt won't kill you.

So, in the name of protecting patients, we put a lot of barriers up to make it harder for foreign doctors to work in the U.S. Even for fully qualified doctors practicing in countries very similar to ours, it can take years of extra training to get licensed to practice in the U.S.

Many U.S. states recognize Canadian medical schools, and have tried to streamline the process for Canadian doctors to work here. But it can be complicated. Every state has its own bureaucracy and license application and requirements.

A Canadian critical care doctor I talked to moved with his wife to California, where he planned to practice. After nine months of paperwork and bureaucracy, he gave up and went back to Canada.

For doctors from other parts of the world, the process is guaranteed to take even longer. Foreign-trained doctors — even those with advanced skills, who have been practicing medicine for years — are required to repeat years of the basic residency training that doctors go through right after medical school.

"The process may be seen as perhaps cumbersome to practicing physicians," says Dr, Humayan Chaudry, President of the Federation of State Medical Boards. "But... the goal at the end of the day is to protect the public."

Chaudry says there simply isn't a way to evaluate the quality of medical training in every country around the world. And clearly, he says, it doesn't deter doctors from coming. Chaudry says that 22 percent of all the licensed doctors in the United States went to medical school outside the country.

But, Dean Baker argues, there should be even more foreign-trained doctors than there already are. A lot of poor and rural areas in the U.S. don't have enough doctors. And foreign-trained physicians are much more likely to specialize in primary care and go to work in such places.

Baker says that rather than have professionals spend years redoing their training, the U.S. should try to make the process more simple and transparent. He says we should tell young, aspiring doctors:

Here's what you have to do. Here are the courses you have to take. Here's is the test you have to pass. If you pass those tests you get to come to the United States and be a doctor just like anyone who was trained in the United States.

She covers her hair with a hijab, or a stocking cap, or sometimes a helmet. She has sharp eyes and a sly smile. But probably the most striking thing about Noor is how calm she is in the face of chaos.

As we got out of the car in a bombed-out neighborhood during that first trip, she led us around like we were on a tour. We started to hear shelling and gunfire, but Noor was unfazed.

"We're not even close to the front line yet," she said.

She walked us to what she called the back of the front line. It was the backside of a building. The only thing separating us from the front line was the building.

We started asking questions about a guy who was killed the day before. Turns out Noor knew him. He had been part of a team of rebel fighters, known as the Free Syrian Army, which helped pull the body of an old man out of some rubble. A government sniper had shot the man in the chest and killed him.

Noor says the rebel fighter provided cover by shooting at the government sniper. "At the same moment, two rebels ran into the street, dragged the body, and that's it."

Noor photographed the whole thing — the body of the old man being dragged out and the rebel who was shooting to provide cover. Now the rebel shooter is dead.

As we walked through the rubble of the ruined streets, she remembered him — her voice showing no emotion.

"He went to see his family last Saturday ... and then he came back here the next day. And he died," she said.

An Accidental War Photographer

It's this kind of experience that gives Noor credibility with the rebels in Aleppo. It means they give her access, and good access means good pictures.

When the Syrian uprising started nearly two years ago, Noor was a recent college graduate teaching English in a private school.

Protests kicked off around the country, but not the northern city of Aleppo, Noor's hometown.

That's because the business-minded city was more concerned with survival than politics. Noor says she'd go to protests that lasted only five minutes.

Then some in the protest movement took up arms, and last summer those rebel fighters brought the fight to Aleppo. At first, Noor did what she calls "woman things" — cooking for the rebels.

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It's been a rough voyage for the cruise-line industry in the past few years.

The engine room fire, power outage and ensuing problems aboard the stricken Carnival Triumph in recent days is far from the first recent major problem aboard a cruise ship. In 2010, for example, a similar fire, with a similar outcome, occurred aboard the Carnival Splendor. A year ago, there was the Costa Concordia disaster. And just this week, a lifeboat accident aboard a Thomson Cruises ship killed five crew members and caused the company to cancel the cruise and fly the passengers back home.

Ross Klein, a professor at Memorial University of Newfoundland who tracks cruise-line mishaps on his website CruiseJunkie.com, makes a direct connection between the growth of the cruise industry and the spate problems. "I think we are seeing more incidents because there are more ships," he says.

Related NPR Stories

The Two-Way

'Cruise From Hell' Was A Mix Of 'Survivor' And 'Lord Of The Flies'

Kansas Gov. Sam Brownback has put the state on what he calls a "glide path to zero" income tax. But that glide path is far from being clear or smooth.

On the face of it, Brownback seems to enjoy a remarkably strong political position. He's a conservative Republican, flanked by GOP supermajorities in both legislative chambers. His allies helped purge moderate Republicans from the state Senate in last year's election.

"I think the road is open," Brownback says. "I think we do provide an alternative model. I think we do provide a red-state model."

In 2012, Kansas eliminated the state income tax for about 190,000 small businesses and cut the rate substantially for high-income individuals.

"We're going from the highest-tax state in the region, to the lowest-tax state in the region," Brownback says.

“ I think the road is open. I think we do provide an alternative model. I think we do provide a red-state model.


The proposed marriage of American Airlines and US Airways announced Thursday may be the last in a series of industry mega-mergers, but history suggests combining two big carriers isn't easy.

"The history of airline mergers in the U.S. is good, bad and ugly," says Henry Harteveldt, a travel industry analyst at the consulting firm Hudson Crossing. He and many others point to the 2008 union of Delta and Northwest as the best merger in recent memory.

"Delta and Northwest had already been cooperating on a number of different issues," Harteveldt says. "They were members of the same airline alliance, they cooperated on certain international flying; they had a complementary route network; they had similar cultures; they had a similar approach to doing business."

Dealing With Pilot Seniority

Delta hired a former head of Northwest to lead the combined airline. And Daniel Kasper, a consultant at Compass Lexecon says, Delta did something else that was very smart. Pilots from both airlines wanted a deal and Delta told them it wouldn't happen unless they could agree in advance on how they would merge their seniority lists.


How The American-US Airways Merger Might Affect You


Inside Nigeria's Growing Film Industry

Zadie Smith first met Nick Laird when she submitted a short story to a collection he was editing. They were both undergraduates at the University of Cambridge. Her story, Laird told The Telegraph in an interview in July 2005, "...was just head-and-shoulders above anything else." Smith's career took off after that. Her first novel, White Teeth, was an international bestseller and won critical acclaim. Later, Laird said that going to literary parties with Smith made him feel "two feet tall." Even so, the two writers support each other – showing each other their unpublished work and exchanging advice.

Smith has also publicly described their relationship. In an essay published in the New York Review of Books, she explains that she and Laird work in the same library in New York — on different floors. At the end of the day, they tell each other about the people they have seen out and about, and re-enact the conversations they have overheard (at one point she says she couldn't wait to tell her husband about a cat-eyed teenager in a Pocahontas wig she saw "sashaying" down Broadway). "The advice one finds in ladies' magazines is usually to be feared," she writes. "But there is something in that old chestnut: 'shared interests.'"

For Valentine's Day, Morning Edition commentator Sandip Roy shares a family love story from 70 years ago.

I always knew that my mother's aunt Debika was the most beautiful of all the great-aunts. I didn't know that when she was young, she jumped off a moving train for love.

She is now 90. Bent with age, she shuffles with a walker. But she's still radiant, her hair perfectly dyed.

It sounds like a typical Bollywood story. Boy meets girl in pre-independence India. They fall in love. Her family says no way. The boy came from the same clan. That was regarded almost as marriage between siblings. And there were far more suitable boys for such a beauty, like the son of a top-ranking civil servant. Debika says her uncle and brother kept two guns handy to shoot over-eager Romeos on sight.

So one night in 1941, she decided to escape. She packed a bundle with everything she needed: a couple of blouses, a petticoat and two albums — one with family photos, the other with postcards of Hollywood movie stars like Norma Shearer and Claudette Colbert.

She put a roll of false hair on the pillow so it looked like she was sleeping. There were dozens of servants to be evaded, big dogs patrolling the yard and many locked doors. She retraces her steps for me more than 70 years later.

She left barefoot, in the kind of sari housemaids wore, to look like a young woman going to work in the breaking dawn. Her fiance was waiting to take her to the train station, but she panicked when she realized the taxi driver recognized her. She was afraid her powerful uncle would show up at the next station with guns. So the runaways decided to jump off before the station. Guards came running, but they nonchalantly strolled away as if they jumped off trains every day.

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This is the Magpie School of action filmmaking: Anytime things start to make so little sense that you might lose the audience, just throw something shiny up on screen to distract. Hence lots of slow-motion jumping and falling while fiery explosions billow up in the background. Cars seem to do more flying than driving, jumping off of overpasses or over other cars, rolling and flipping through the air. In one particularly inspired bit of lunatic misdirection, one of the Russian thugs chasing McClane delivers a menacing speech to the hero ... while loudly eating a carrot.

I have no recollection of what plot details were conveyed in that speech. But I do remember the carrot — and I'm guessing that's exactly the effect director John Moore was going for.

There's little left of the qualities that made the original Die Hard such a masterpiece — or even the things that made the substandard sequels marginally watchable. Where before McClane was out to save the life of a family member or a school full of kids, here — after the self-preservation that drives him in the opening sequence — he's fighting mostly to save his son's reputation and also to thwart a vaguely defined potential terrorist threat.

Humor has always been an essential element of McClane's appeal, but the attempts here aren't even in character. Are we really meant to believe that McClane would answer a cellphone call from his daughter in the midst of a car chase? Or knock out an innocent civilian who's (justifiably) yelling at him for running out into traffic?

Even McClane's trademark one-liners are fewer in number, generally clunkers, and often nearly drowned out by things going boom. It's difficult to tell if the mildly bemused air Willis carries with him through much of the movie is a character choice or just smug satisfaction that he's actually getting away with getting paid for this.

A Good Day to Die Hard does have one redeeming aspect: It has finally ended the debate over whether Die Hard 2 or 4 is the worst of the series. We finally have a clear loser.

Get recipes for Tropical Amaranth Porridge With Coconut Milk, Mango And Ginger, Saffron-Scented Millet Porridge, Savory Polenta Porridge With Poached Egg and Sunflower Apple Oat Bran Porridge.

Since what's said and written about a State of the Union address on the morning after can determine what's most remembered about such speeches, let's look at Wednesday's headlines:

— NPR's It's All Politics: "Obama To Congress: With Or Without You."

— The New York Times: "Obama Pledges Push to Lift Economy for Middle Class."

— CNN: "State Of The Union Brings Out More Of The 'Same Old, Same Old.' "

— Politico: "Obama Calls For 'Common Sense' Solutions."

— The Wall Street Journal: "Obama Urges Action On Expansive Agenda."

— Fox News: "Obama Presses For New Spending, Says Gun Control Bills 'Deserve A Vote.' "

— Bloomberg News: "Obama Paints Wider Role For Government In Middle Class."

— BBC News: "Obama Pledges To Reignite Economy."

— The Weekly Standard's Fred Barnes (conservative): "There He Goes Again."

— Firedoglake's Kevin Gosztola (liberal): "Afghanistan Drawdown & the Covert Drone War."

We welcome headline suggestions. Add them in the comments thread.

In honor of Valentine's Day, we're going to spend this week on 13.7 publishing love letters (really, chaste appreciations) to some of our biggest intellectual crushes.

These are the people our bloggers think you should know about, people who have had a significant influence on their lives and their thinking. As they're published, I'll keep a running list of the posts right here:

Stuart Kauffman on Conrad H. Waddington

Tania Lombrozo on Edward C. Tolman

Adam Frank on Karen Armstrong

Marcelo Gleiser on Johannes Kepler

I'll kick things off with my own quick nod to a fictional character. She's the unreal combination of brains and brawn from the Ghost in the Shell oeuvre known as "The Major."

A cyborg with the "ghost" of the real human she used to be, The Major could have been just another empty, entertaining action figure, fighting for all that's right in a world full of wrong. What we get with this character, instead, is a guide to the question: What does it mean to be human?

Adventure and intrigue lurk just around every corner for The Major and her team, known as Public Security Section 9. But what makes both Ghost in the Shell and The Major so interesting is the constant questioning of what it means to be human in a world where it is possible to leave your natural body behind to live inside a machine, or even out on the network as an un-embodied ghost.

Let the action, the big guns and cliffhangers, the futuristic world, pull you into the vortex. Once you're there, join The Major as she dives ever deeper into the human question. The answers you find will be your own, but you wouldn't have gotten there without her guiding hand.

How many points do you get for the word "scandale"?

A sidelight scandale flared in France this week after a deputy in the French National Assembly was shown playing Scrabble on his iPad during the ongoing debate over same-sex marriage.

Among the words that could be deciphered in photographs were "gache," which is French for wasted, and "mufle," which is cad or oaf.

The Scrabble player, Deputy Thomas Thevenoud, was as unapologetic as a French politician caught with a mistress, telling Le Parisien newspaper that he was part of a group of legislators who played the word game as debate rumbled on.

"I confirm that we were trying to keep our brain cells working at 3 in the morning," declared Mr. Thevenoud. "When we manage to get 102 points at 3 in the morning, I wouldn't say we are proud of our achievements, but it does reassure us somewhat."

Another deputy, Jerome Guedj, tweeted from the Assembly floor that he sometimes plays Scrabble, reads a newspaper and phones his plumber because drawn-out debates drift and drone into what he called "endless amendments" and "pointless discussions."

Lawmaker Marc Le Fur's Tweet

Oups ! Il ne s'agit pas de Guillaume Bachelay mais d'un autre Dput Socialiste ! Mes excuses Guillaume Bachelay. twitter.com/marclefur/stat…

— Marc Le Fur (@marclefur) February 5, 2013

Jack Lew, the man President Obama has chosen to help oversee the country's biggest banks, has said it plainly — he's no expert on banking. Lew said as much when the Senate was vetting him to head the White House Office of Management and Budget in 2010.

Sen. Bernie Sanders, I-Vt., asked Lew if he thought deregulation of Wall Street caused the financial crisis. Lew said he didn't consider himself the best person to answer that question.

"I don't consider myself an expert in some of these aspects of the financial industry," Lew said. "My experience in the financial industry has been as a manager, not as an investment adviser."

On Wednesday, Lew will again face a confirmation hearing, this time to be Treasury secretary. Members of the Senate Finance Committee are expected to question him about his knowledge of financial markets and his brief stint at Citigroup between the Clinton and Obama administrations.

Just A Manager

Insisting he was just a manager may be the way Lew will wash his hands of a messy time at Citigroup, when he was chief operating officer for one of the bank's riskiest investment units. By calling himself a "manager" at Citigroup, he can suggest he wasn't the one who made some of the financially disastrous decisions there.

And actually, for Lew's defenders now, "manager" already seems to be the go-to word. Robert Rubin, a former Treasury secretary and ex-Citigroup chairman, seized on the term during a recent phone interview. He's the one who helped Lew get a job at Citi.

"That was a job that required somebody who had managerial effectiveness, and Jack had been a very effective manager of the government and a very effective manager at NYU, and that's what they were looking for — manager," Rubin said.

To some people, the word "manager" suggests you're one of the people in charge, and they can't help but notice that Lew was at the helm of a company that suffered such massive losses — Citigroup got the biggest federal government bailout of any bank.

Republican Sen. Chuck Grassley of Iowa said he wants to know exactly what role Lew played in those losses.

"Did he contribute to the conditions at Citi that led to the bailout?" Grassley asked.

He also pointed out that Lew received a $940,000 bonus from Citigroup shortly before the bank got bailed out.

"I think we ought to know whether or not he gave Wall Street any favors, because he has to be independent from special interest and put the taxpayers first in this new role that he's playing," Grassley said.

More On Jack Lew

The Two-Way

Obama Settles On Jack Lew, His Chief Of Staff, For Treasury

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