For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

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India Executes Man Tied to 2001 Attack on Parliament

MUMBAI - India on Saturday on Saturday hanged a man who was convicted of an attack on India’s Parliament in 2001 that killed nine people.

The hanging of Afzal Guru, a 43-year-old militant with the group Jaish-e-Mohammad, comes more than a decade after the Dec. 13, 2001, suicide attack on India’s parliament in which five gunmen opened fire, killing nine people, including security officials and one journalist. The execution drew protests from human rights groups concerned about the growing use of capital punishment in such cases.

Mr. Guru was convicted of conspiracy in the plot and sentenced to death by a special court in 2002. In 2004, the Supreme Court of India upheld the call for death sentence.

After the execution, clashes broke out in Mr. Guru’s hometown of Sopore, and police and paramilitary units were called to the scene to restore order.Days before the execution, President Pranab Mukherjee had rejected a mercy plea by Mr. Guru’s wife, according to reports from the Press Trust of India, paving the way for Mr. Guru’s hanging in the Tihar Jail complex, officials said.

Mr. Guru was originally from Sopore, in the northern part of the Kashmir. The clashes following his execution came despite the fact that in the hours following the hanging the Kashmir valley was placed under strict curfew in the anticipation of trouble from separatist leaders, according to reports. Authorities in the Srinagar asked citizens to remain indoors. They also closed the national highway for one day.

Omar Abdullah, the Jammu and Kashmir chief minister, appealed for peace and calm.

“I understand there is certain degree of angst and there are some people who would like to take advantage of the situation,” Mr. Abdullah said. “I appeal to the people to allow us to get through this with peace and not to restore to violent protests.”

Congress Party officials said that the execution was a sign that India would not tolerate acts of terror.

“We have sent a message to the world that we cannot tolerate terrorism at any cost. Anybody committing any acts of terror will be punished,” said Rashid Alvi, a Congress Party spokesman. “People of our country and government have zero tolerance for terrorism.”

But the opposition Bharatiya Janta Party criticized the government’s delay in carrying out the execution.

“The attack on the Indian Parliament happened in 2001, that is 12 years ago, which was an attack on India,” said Ravi Shankar Prasad, the Bharatiya Janta Party spokesman.

On Nov. 21, 2012, India hanged Ajmal Kasab, the sole surviving gunman from the November 2008 terror attacks in Mumbai, ending an eight-year moratorium on the death penalty and drawing criticism from rights groups, which they reiterated Saturday.

“The hanging of Afzal Guru, following closely behind the hanging of Ajmal Kasab in November, shows a very worrying trend by the Indian government,” said Meenakshi Ganguly, South Asia director for Human Rights Watch. “Human Rights Watch opposes the death penalty in all circumstances as an inherently irreversible, inhumane punishment.”

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Northeast storm disrupts travel for sports teams

Several professional and college sports teams were forced to rearrange their travel plans as a massive storm swept through the Northeast.

The NBA's New York Knicks were stuck in Minnesota after playing the Timberwolves on Friday night, hoping to try to fly home sometime Saturday. The San Antonio Spurs were also staying overnight in Detroit after seeing their 11-game winning streak end against the Pistons, awaiting word on when they might be able to fly to New York for their game Sunday night at Brooklyn.

Airlines canceled more than 5,300 flights through Saturday, and New York City's three major airports and Boston's Logan Airport closed.

The New Jersey Nets planned to take a train home instead of flying from Washington D.C. after losing to the Wizards on Friday night.

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In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

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John E. Karlin, 1918-2013: John E. Karlin, Who Led the Way to All-Digit Dialing, Dies at 94

Courtesy of Alcatel-Lucent USA

John E. Karlin, a researcher at Bell Labs, studied ways to make the telephone easier to use.

A generation ago, when the poetry of PEnnsylvania and BUtterfield was about to give way to telephone numbers in unpoetic strings, a critical question arose: Would people be able to remember all seven digits long enough to dial them?

And when, not long afterward, the dial gave way to push buttons, new questions arose: round buttons, or square? How big should they be? Most crucially, how should they be arrayed? In a circle? A rectangle? An arc?

For decades after World War II, these questions were studied by a group of social scientists and engineers in New Jersey led by one man, a Bell Labs industrial psychologist named John E. Karlin.

By all accounts a modest man despite his variegated accomplishments (he had a doctorate in mathematical psychology, was trained in electrical engineering and had been a professional violinist), Mr. Karlin, who died on Jan. 28, at 94, was virtually unknown to the general public.

But his research, along with that of his subordinates, quietly yet emphatically defined the experience of using the telephone in the mid-20th century and afterward, from ushering in all-digit dialing to casting the shape of the keypad on touch-tone phones. And that keypad, in turn, would inform the design of a spate of other everyday objects.

It is not so much that Mr. Karlin trained midcentury Americans how to use the telephone. It is, rather, that by studying the psychological capabilities and limitations of ordinary people, he trained the telephone, then a rapidly proliferating but still fairly novel technology, to assume optimal form for use by midcentury Americans.

“He was the one who introduced the notion that behavioral sciences could answer some questions about telephone design,” Ed Israelski, an engineer who worked under Mr. Karlin at Bell Labs in the 1970s, said in a telephone interview on Wednesday.

In 2013, the 50th anniversary of the introduction of the touch-tone phone, the answers to those questions remain palpable at the press of a button. The rectangular design of the keypad, the shape of its buttons and the position of the numbers — with “1-2-3” on the top row instead of the bottom, as on a calculator — all sprang from empirical research conducted or overseen by Mr. Karlin.

The legacy of that research now extends far beyond the telephone: the keypad design Mr. Karlin shepherded into being has become the international standard on objects as diverse as A.T.M.’s, gas pumps, door locks, vending machines and medical equipment.

Mr. Karlin, associated from 1945 until his retirement in 1977 with Bell Labs, headquartered in Murray Hill, N.J., was widely considered the father of human-factors engineering in American industry.

A branch of industrial psychology that combines experimentation, engineering and product design, human-factors engineering is concerned with easing the awkward, often ill-considered marriage between man and machine. In seeking to design and improve technology based on what its users are mentally capable of, the discipline is the cognitive counterpart of ergonomics.

“Human-factors studies are different from market research and other kinds of studies in that we observe people’s behavior and record it, systematically and without bias,” Mr. Israelski said. “The hallmark of human-factors studies is they involve the actual observation of people doing things.”

Among the issues Mr. Karlin examined as the head of Bell Labs’ Human Factors Engineering department — the first department of its kind at an American company — were the optimal length for a phone cord (a study that involved gentle, successful sabotage) and the means by which rotary calls could be made efficiently after the numbers were moved from inside the finger holes, where they had nestled companionably for years, to the rim outside the dial.

John Elias Karlin was born in Johannesburg on Feb. 28, 1918, and reared nearby in Germiston, where his parents owned a grocery store and tearoom.

He earned a bachelor’s degree in philosophy, psychology and music, and a master’s degree in psychology, both from the University of Cape Town. Throughout his studies he was a violinist in the Cape Town Symphony Orchestra and the Cape Town String Quartet.

Moving to the United States, Mr. Karlin earned a Ph.D. from the University of Chicago in 1942. Afterward, he became a research associate at Harvard; he also studied electrical engineering there and at the Massachusetts Institute of Technology.

At Harvard, Mr. Karlin did research for the United States military on problems in psychoacoustics that were vital to the war effort — studying the ways, for instance, in which a bomber’s engine noise might distract its crew from their duties.

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At Least 26 Killed in Bombings Across Iraq

BAGHDAD - A series of explosions across Iraq killed at least 26 people Friday, continuing a spate of violence that has marked recent political turmoil and witnessed bombings now on seven consecutive Fridays.

The bombings come amid worsening sectarian tensions, with Sunnis and others saying that Prime Minister Nuri Kamal al-Maliki and his political bloc are seeking to monopolize power before provincial elections in April.

In a bird market in Khadumiya north of Baghdad the Shiite majority city, twin car bombs exploded, killing 16 people killed and wounding 45 others, according to security and medical sources. That blasts fit the pattern of deadly attacks on markets on Fridays, when they are typically crowded with people.

“I come to the bird market each Friday to sell and buy birds,” Waleed Salman, 28, said from his hospital bed after he was wounded in his leg and back in the bombing. “I love birds as they are a sample of peace, all we want is peace but we always find blood. I lost my birds and my people today.”

In Hilla province two car bombs exploded, one at a parking lot and another at a market in Shomali district south of Baghdad. The two explosions killed 10 people and wounded 40 others, security officials said.

 

 

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Illini buzzer-beater upsets No. 1 Hoosiers, 74-72

CHAMPAIGN, Ill. (AP) — At this rate, no one will want to be No. 1.

Indiana became the fifth straight top-ranked men's college basketball team to lose, falling to unranked Illinois 74-72 on a buzzer-beater by Tyler Griffey on Thursday night.

The senior forward took an inbounds pass with 0.9 seconds to play and made a wide-open layup. And, just like that, the Hoosiers — who moved into the top spot by beating then-No. 1 Michigan just a few days ago — went down.

Indiana coach Tom Crean, whose team has been No. 1 for a total of seven weeks this season after opening there, doesn't know why the top spot is suddenly so hard to hang on to.

"I can't answer that. I'm not sure," Crean said. "I just know that these games are 40-minute games. We played at a high level for most of the game."

The Hoosiers (20-3, 8-2 Big Ten) were in charge until the final 3 1/2 minutes when the Illini (16-8, 3-7 Big Ten) finally put together a run to take and then retake the lead.

"I know this: When we turn the ball over, we're not very good," Crean said. "And the biggest difference tonight was 28 points off turnovers to our 16."

Hoosiers guard Jordan Hulls said flatly that the top rank had nothing to do with Thursday's loss, even for a team that some worried might be looking past unranked, slumping Illinois to a meeting Sunday with No. 10 Ohio State.

"We just didn't execute when we needed to," he said.

If Indiana falls from No. 1 on Monday, No. 2 Florida might not be a candidate to replace the Hoosiers after the Gators' loss this week to Arkansas. That could put No. 3 Michigan back on top if they can make it to Monday without a loss.

For the Hoosiers, nothing could have been worse than the way Thursday's game ended.

With 0.9 seconds, Griffey left defenders Cody Zeller and Christian Watford behind on an inbounds play from the baseline, took the pass from Brandon Paul and delivered the uncontested buzzer-beater.

The shot sent hundreds of students onto the court, though they waited as officials checked the replay to make sure the clock hadn't beaten Griffey. Once the basket was upheld, Paul and fellow guard D.J. Richardson hugged and teared up in relief.

Illinois had endured an awful run since starting 12-0. The Illini had since lost eight of 11 and fallen to 10th in the 12-team Big Ten.

Griffey, who had struggled as bad as any Illini player, seemed surprised at how easily the winning shot came.

"I just made a simple curl cut and left two guys behind me, and Brandon got off a heck of a pass," he said. "Zeller and Watford were both right in front of me and just kind of stayed there."

Crean said the play was a lot like the other breakdowns in the Hoosiers' game that let Illinois climb back from a 12-point halftime deficit.

"We didn't communicate," he said.

Indiana's loss drops them into a three-way tie for first in the Big Ten with Michigan and Michigan State. The win moves the Illini up into a ninth-place tie with Iowa but, more importantly, provides a potential lifeline ahead of a meeting Sunday at No. 18 Minnesota.

"It was good to get back to having that toughness and togetherness and trust that we needed," Illinois coach John Groce said.

Illinois also added a plank to what may be one of the oddest resumes of any team in the country trying to make the NCAA tournament. Illinois has lost to Purdue, Northwestern and twice to Wisconsin. But coming into Thursday night, the Illini had already beaten three teams now in the top 15: No. 6 Gonzaga, No. 10 Ohio State and No. 14 Butler.

Before Thursday, Illinois hadn't beaten a No. 1 team since a win over Wake Forest in 2004.

Richardson had 23 points for Illinois, Paul had 21 and Griffey finished with 14 points and eight rebounds.

Zeller led Indiana with 14 points, while Will Sheehey had 13, Watford 12 and Hulls 11.

Indiana shot 50 percent from the field (25 of 50), 52.9 percent from 3-point range (9 of 17) and 93 percent from the free throw line (13 of 14). The Hoosiers led by an eight- to 10-point margin for most of the second half.

When 6-foot-11 Nnanna Egwu fouled out with just under 5 minutes to play, Indiana appeared in control. Watford made both free throws and, at 69-59, the Illini looked done.

But Richardson went on a one-man run, first burying back-to-back 3-pointers and then hitting a midrange jumper on the run to tie it at 70 with 1:17 to play.

With the clock under 30 seconds and the game tied at 72, Indiana had the ball for what would have been a last shot but Victor Oladipo coughed up the ball. Richardson picked it up and tried a breakaway layup that Oladipo just swatted out of bounds to set up the final play.

Groce credited Richardson for providing a spark.

"I thought he was absolutely terrific on both ends of the floor," Groce said. "He battled, he fought."

Griffey was benched several weeks ago after a blowout loss at Wisconsin. On a team that had lost its shooting touch, the senior forward had especially struggled. And, though one of Illinois' bigger players at 6-9, he wasn't adding much to the inside presence the Illini desperately needed.

Groce said that, even after he benched Griffey, he never gave up on him.

"I just have told him numerous times here I believe in him," the first-year Illinois coach said. "I do."

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Well: Old Age and Motorcycles Are a Dangerous Mix

If you’re over 40 and planning to hop on a motorcycle, take care. Compared with younger riders, the odds of being seriously injured are high.

That is the message of a new study, published this week in the journal Injury Prevention, which found that older bikers are three times as likely to be severely injured in a crash as younger riders.

The percentage of older bikers on the road is quickly rising, and their involvement in accidents is a growing concern. Nationwide, from 1990 to 2003, the percentage of motorcyclists over age 50 soared from roughly 1 in 10 to about 1 in 4. At the same time, the average age of riders involved in motorcycle crashes has also been climbing. Injury rates among those 65 and older jumped 145 percent from 2000 to 2006 alone.

Because of the increase in motorcycle ridership among older Americans, the researchers, led by Tracy Jackson, a graduate student in the epidemiology department at Brown University, wanted a closer look at their injury patterns. So she and her colleagues combed through a federal database of motorcycle crashes that were serious enough to require emergency medical care. That yielded about 1.5 million incidents involving motorcyclists 20 or older from 2001 to 2008.

The researchers then split them into groups: those in their 20s and 30s, another group between 40 and 59, and those 60 and older.

Over all, the study showed that injury rates for all three groups were on the rise. But the rise was steepest for the oldest riders. Compared with the youngest motorcyclists, those who were 60 and older were two and a half times as likely to end up with serious injuries, and three times as likely to be admitted to a hospital. The riders who were middle age were twice as likely as their younger counterparts to be hospitalized.

For older riders, the consequences of a collision were also especially alarming. Older and middle-aged bikers were more likely to sustain fractures and dislocations, and they had a far greater chance of ending up with injuries to internal organs, including brain damage.

The researchers speculated that it was very likely that a number of factors played a role in older riders’ higher injury rates. For one, declines in vision and reaction time may make older riders more prone to mistakes that end up in collisions. Another theory is that older riders tend to ride bigger bikes, “which may be more likely to roll or turn over,” Ms. Jackson said.

Then there is the greater fragility that comes with age. Older riders may be involved in the same types of accidents as younger riders, Ms. Jackson said, but in some cases, a collision that a 20-year-old would walk away from might send a 65-year-old to the hospital.

“Your bones become more brittle, and you lose muscle mass as you get older,” she said. “It could just be a matter of aging and the body being less durable.”

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European Leaders Struggle to Bridge Budget Gaps

BRUSSELS — European Union leaders on Friday morning edged closer to agreeing a budget worth nearly €1 trillion, or $1.3 trillion, to support farming, transportation and other infrastructure, as well as big research projects for the 27-nation bloc.

But after 15 hours of talks, the leaders were still seeking unanimity while also attempting to satisfy the wide array of national interests demanding attention.

The budget is negotiated every seven years and involves furious horse-trading as leaders focus on getting the best deal for their own countries’ citizens, rather than emphasizing pan-European considerations.

The marathon session was the second attempt to reach a deal on the funding package, which should run from 2014 to 2020, after the first attempt collapsed in November.

Another failure to strike a deal on a sum of money that represents only about 1 percent of the Union’s Gross Domestic Product would be a severe embarrassment for the leaders, who already have spent years bickering over how to save the euro.

The European Commission, the bloc’s policymaking arm, had sought an increase in the overall budget of around 5 percent to more than €1 trillion.

Herman Van Rompuy, the president of the European Council, which represents E.U. leaders, pruned that sum to about €973 billion at the previous summit in November.

On Friday morning, Mr. Van Rompuy presented further revisions lowering the overall sum to about €960 billion but holding down the amount of cash governments pay up-front to around €908 billion.

That formula was designed, in part, to satisfy countries like Britain and the Netherlands that pay more into the budget than they receive, while also accommodating the demands of countries like France and Italy that want to maintain generous payments for agriculture and infrastructure.

Some of the deepest cuts would be made to pan-European projects to improve transport, energy, and digital services that are overseen by the commission. About €1 billion in cuts would be made to the part of the budget used to employ 55,000 people, including 6,000 translators, most of them in Brussels, who run the Union’s day-to-day affairs.

Expert national advisors were reviewing the proposals on Friday morning, and leaders were expected to reconvene for further talks.

Leaders also were wrestling over demands by some countries to renew a system of rebates that raises the costs for other countries.

One of the complications in the current round of negotiations has been the call for budgetary rigor from leaders like David Cameron, the British prime minister, who says the Union should tighten its belt at a time when many European governments have been compelled to impose stringent budget cuts.

Mr. Cameron, in particular, has earned the enmity of some European leaders by demanding a renegotiation of Britain’s treaty with the Union and promised a referendum on his nation’s membership in 2017.

Reflecting growing irritation with Britain among a number of European leaders, Martin Schulz, the president of the European Parliament, told a news conference late on Thursday night that leaders should not go out of their way to appease Mr. Cameron.

Because Britain could be outside the bloc by later this decade, there was little need to make concessions to Mr. Cameron that potentially jeopardized “the security of our financial planning,” Mr. Schulz suggested.

Mr. Van Rompuy, the president of the European Council, had intended to start the session during the mid-afternoon on Thursday to force leaders to make their complaints clear in a roundtable session rather than being allowed to break into small groups.

But his plan was derailed, and the first roundtable session was delayed until late in the evening, as leaders formed the kind of pre-summit huddles that he seemingly wanted to avoid.

President François Hollande of France was an hour late to a meeting during the afternoon with Mr. Cameron, Angela Merkel, the German chancellor, and Mr. Van Rompuy.

Mr. Hollande’s lateness was a sign of French displeasure with British demands that included strict limits on agriculture spending cherished by French farmers, according to an E.U. diplomat, who spoke on condition of anonymity because of the sensitivity of the talks.

Even if leaders eventually agree to a deal, it faces still more hurdles before it becomes law at the European Parliament, which has the power to veto the budget.

Some of the most influential figures in Parliament have already signaled that they are prepared to reject a budget that foresees spending less on Europe in the years ahead.

Guy Verhofstadt, the head of the alliance of liberals in the Parliament, called on Thursday for a full-revision clause to be inserted into the budget, so that it could be increased after three years if economic conditions improved.

Mr. Schulz, the president of the Parliament, said on Thursday that he would not approve a budget that ended up widening the overall gap between the amount of cash paid up-front by governments and the somewhat higher amounts known as commitments, which make up the overall budget.

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At War Blog: Interview With Gen. John R. Allen on Leaving Afghanistan

The New York Times interviewed Gen. John. R. Allen on Sunday, a week before his scheduled departure from Afghanistan after 19 months as the commander of the American and allied forces.

Following are some of General Allen’s comments. Brief explanations have been provided in brackets.

On his relationship with President Hamid Karzai:

“I wanted him to understand that he was always going to have my loyalty and I was always going to work with him. In fact, I said a number of times, ‘I’m proud to have served you at the same time I served my own leadership, whether it’s a NATO leadership or U.S. leadership.’ Now, I wanted him to believe it because it happened to be true. I think our personalities meshed in that regard.”

“Now, we’ve had some tough times. This has been a time of really dramatic change for the campaign. When I got here, I measured success in how well we and how often we were fighting. Today, it’s a very different environment. The Afghans are virtually entirely in the lead across Afghanistan.”

“This is what I’ve learned about the president. If you listen to him, he’s got some pretty good ideas, and often the controversy that has arisen in the relationships hasn’t been because necessarily you disagree with the ideas. It’s because you haven’t listened to them early enough.”

“And sometimes it’s been strained. I don’t think he ever believed that actions that I have taken were ever intended to disadvantage him as the president, or not do everything I possibly could for the Afghan people. I told him, I’m prepared to die in this country on behalf of his people. I take that very seriously.”

On civilian casualties:

“I’ve met with the families of the casualties that we’ve inflicted. I’ve flown to the villages to personally apologize for the casualties, and do what I can to do the right thing for those families. I’ve taken measures with respect to the employment of certain kinds of fires.” ["Fires” is common military shorthand for a variety of munitions, from bullets to missiles to mortar shells.]

“We had a couple of pretty rough incidents where Afghans were killed by the delivery of aviation fires. I eventually said to President Karzai that civilian structures, tents, potential areas where civilians might be either taking refuge or hiding or living, I’m not going to deliver any more fires on those structures unless my troops are pinned down, can’t move, and the only option they have is to deliver fires on these structures, or I decide, the senior leader out here, I decide to deliver fires on these structures.”

“The civilian causalities as a result of air fires plummeted immediately. It was probably a decision I could have made long before that and none of our forces were put at risk, or at  greater risk because of this.”

On the aftermath of the burning of Korans at Bagram Air Base:

“I have to tell you, I thought this could be it for the relationship.

“I immediately got on the phone to a number of Afghan media outlets, immediately cut a video apologizing for this as sincerely as I could possibly appear and sound because this was going to be bad, it could be really bad. I called the president, I went to see him, apologized to him for this. It was completely inadvertent but this culture deserved that apology. We were in their home, so to speak. We are guests in their home and even though it was an accident, even though it was not intentional, we had made a bad mistake, a real error and the people deserved my apology, the president deserved my apology.

“He accepted it and I think in many respects, the personal nature of our relationship was what tempered the language coming out of the palace, the releases, his own engagement with the media and so on. Because of both of our actions, both of them supporting each other, we were able to keep this from being the result of a bad mistake from being something that could have really fractured the relationship.”

On the fallout in March after an American soldier killed 16 villagers in the southern Afghan district of Panjwai, which he first heard about when he was in the United States to testify before Congress:

“The first phone call was something of the effect of — we’ve got mixed reporting from Panjwai. We think an American soldier maybe shot some people and my response was, ‘All right. Let’s develop the situation quickly. Tell me what we got in front of us because we’ve got to make the Afghans in the loop on this.’ ”

“Then the phone calls started coming in and the numbers started going up and pretty quick and this is as bad a circumstance as you might have imagined.”

“I called President Karzai from home and we had a long conversation about it. I promised him once again that we would take all steps, measures, take all actions necessary to get to the bottom of this and we would do a full and complete investigation and those people necessary would be held accountable.”

“This was still unfolding. Was it one shooter? Was it multiple shooters? There were wild rumors associated with things that he had done in addition to shooting. So the information environment was wide open at this point. And both for the purposes of internal stability in Afghanistan and for the purposes of preserving our relationship we were working very, very hard to confirm what we knew to be the facts and try very hard to get after the rumors that were just flying.”

“Once again, when he could have been angry, when it could have been a very negative conversation, I mean, he was tutorial. He explained to me why this is bad for the relationship, why this is bad for the campaign, and why this will shake the confidence of the Afghan people, his personal gesture of measured conversation with me. He wasn’t angry.”

On why the United States should stay engaged in Afghanistan:

“I put it in the context of this has been worth it. This is bigger than anyone of us. It’s bigger than the president. It’s bigger than the president of Afghanistan, because this isn’t about today. This is about tomorrow. This is about doing all we can to facilitate President Karzai with his desire to be successful. But it’ll be about doing all we can do to set up his successor for success.”

On overcoming the skepticism of officials in Washington, who often express frustration with Mr. Karzai:

“For this president, at this moment of its history, Afghanistan’s history, to be able to hold together these tribes and these ethnic groups with these kinds of challenges has got to be one of the hardest jobs going. And so I try to paint the context of the challenges that he faces, the history from which he originates and how, conceivably, he will interpret our actions. He may not understand what we are trying to do, or may misinterpret what we’re trying to do or say. And frankly, one of the great things about our democracy is also one of the hardest things about our democracy: That is, we don’t always speak with the same voice.

“So he’ll hear a voice from one part of the government, it will be different for another part of the government and he’ll seek to square the differences. It’s not a criticism, it just is who we are. The farther you are away from Kabul, the farther you are away from the palace, the farther you are away from the history of this country in the complexities of society, the easier it is to generalize, frankly.”

On the need for the Afghan government to better serve its people and stamp out corruption within its ranks:

“We’ve worked very hard, obviously, to build a capacity in those. But when your ability to survive the night, or put food on the table was — well, for many years are a function of what tribe you were part of, or what group you were part of. And those patronage networks undertook economic opportunities which made them some respect, criminal patronage networks.

“They can only survive because institutions of governance are weak. And so now, we find ourselves in a death grip here — at this very moment when the future of the country relies on the strength of institutions. The criminal patronage networks recognize that their future, their survival can only be sustained by keeping these institutions weak. That’s the moment we find ourselves in, and the presidential directive on any anti-corruption and government reform and the Mutual Accountability Framework that came out of Tokyo.

“These created very helpful, very useful, both domestic and international expectations for reform. So we need to see us moving past the written word and the spoken word and start moving towards action. I think the president, if he were sitting here would tell you that they have achieved some good action, good results in his presidential decree. The Mutual Accountability Framework is constantly being audited to see that there’s progress on reform. But again, we’re still pretty fresh in the process and we’ve got to let this play out some more.”

On the future of the war and Afghanistan:

“Let me make sure I’m clear on this. Nothing is sure in a post-conflict society. But I think the indicators, as far as I’m concerned, are that we’re on the right trajectory. What you have to understand, what people have to understand is some of these reforms take a very long time. In an environment where human rights were crashed under multiple different invasions or civil wars or the Taliban, creating once again the kind of bias for human rights that we would all expect in the Western society, just doesn’t come easily to this country.

“Nothing will happen in this country without security. And that security is being purchased every single day by the Afghan National Security Forces. And then, on the platform of that security, this president has announced a program or platform that he intends to follow. Now, he’s moving forward in some areas, he’s having resistance in others, but we just have to expect this is going to take time. That’s where huge patience has to come in. That’s where the decade of transformation comes in.”

On the surge of “insider attacks” against Westerners that took place in 2012:

“The losses became to this particular means of attack became very troubling, very significant, and tragic. And while on the tactical level and on the operational level, we were able to deal with the problem. This was becoming a strategic crisis — a strategic crisis in capitals, a strategic crisis for the alliance — and the Taliban saw this. They knew this. They saw that. They saw that the future of the A.N.S.F. relied on our being close, partnered and advising inside the Afghan formations.

“We were very careful in our reaction to insider attacks. Not to wall ourselves off from the Afghans and create distance. I used to tell them, you may not be able to do anything about the linear distance that you have to deal with but there’s a lot you can do about your proximity and the closer you all feel to each other, the more secure you will be. And that’s in an environment where we’re transitioning to being advisers almost entirely across Afghanistan. That has to be one of the operative principles for philosophically how we’re going to live with the Afghans. You treat them like brothers. You live with them like they’re family. That reduces the unknowns, it reduces the potential for cultural affront, and it makes you more secure.”

“That doesn’t mean we’re not going to keep a close eye on the environment. We still have these people called Guardian Angels because there are enemies in the ranks and they’re waiting to take that shot.”

“We took a lot of measures and the numbers are down. But I don’t in any way want anybody to become complacent about the number being down. I don’t want anyone to lift up on the security measures that they’re taking or reduce the attentiveness that they have to the environment around them. So, I want everybody to be attentive and we’re going to periodically refresh our training both at the very lowest levels and for the units coming in. So, we’re not going to give up on this.”

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