Prescription deaths: Lawmaker wants cases reported to Medical Board

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The chairman of a state Senate committee that oversees the Medical Board said Monday he would introduce a bill requiring coroners to report all prescription drug deaths to the agency — a move aimed at helping authorities identify doctors whose prescribing practices may be harming patients.

Sen. Curren D. Price Jr., responding to a Times' report that authorities have failed to recognize how often people overdose on medications prescribed by their doctors, said the medical board needed coroners reports to improve oversight of potentially dangerous practices.

“There appears to be a disconnect between coroners and the Medical Board,” Price (D-Los Angeles), said in an interview. “Hopefully legislation will tighten that up and provide the kind of accountability we all expect.”

FULL COVERAGE: Legal drugs, deadly outcomes

The Times investigation published Sunday found that in nearly half of the accidental deaths from prescription drugs in four Southern California counties, the deceased had a doctor's prescription for at least one drug that caused or contributed to the death.

The investigation identified 3,733 deaths that involved prescription drugs in Los Angeles, Orange, San Diego and Ventura counties from 2006 through 2011. In 1,762 of those cases — 47% — drugs for which the deceased had a prescription were the sole cause or a contributing cause of death.

The Times found that prescription drug deaths often involved multiple drugs, sometimes prescribed by more than one doctor. In some cases, the deceased also mixed prescribed drugs with illegal drugs, alcohol or both.

The paper identified 71 Southern California physicians who prescribed drugs to three or more patients who later fatally overdosed. The doctors were primarily pain specialists, general practitioners and psychiatrists.

Price said that although there may be legitimate reasons for a doctor's prescriptions being linked to a death, “it’s cause for some further review.”

“I think a red flag goes up any time you have one [doctor] involved in several deaths,” he said. “And I think an investigation is not only warranted but called upon by the public.”

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'Skyfall' brings record Bond debut of $88.4M

LOS ANGELES (AP) — James Bond is cashing in at the box office.

"Skyfall," the 23rd film featuring the British super-spy, pulled in a franchise-record $88.4 million in its U.S. debut, bringing its worldwide total to more than $500 million since it began rolling out overseas in late October.

The top 20 movies at U.S. and Canadian theaters Friday through Sunday, followed by distribution studio, gross, number of theater locations, average receipts per location, total gross and number of weeks in release, as compiled Monday by Hollywood.com are:

1. "Skyfall," Sony, $88,364,714, 3,505 locations, $25,211 average, $90,564,714, one week.

2. "Wreck-It Ralph," Disney, $33,012,796, 3,752 locations, $8,799 average, $93,647,405, two weeks.

3. "Flight," Paramount, $14,785,097, 2,047 locations, $7,223 average, $47,455,396, two weeks.

4. "Argo," Warner Bros., $6,617,229, 2,763 locations, $2,395 average, $85,583,187, five weeks.

5. "Taken 2," Fox, $4,012,829, 2,487 locations, $1,614 average, $131,300,000, six weeks.

6. "Cloud Atlas," Warner Bros., $2,658,250, 2,023 locations, $1,314 average, $22,844,956, three weeks.

7. "The Man With the Iron Fists," Universal, $2,592,705, 1,872 locations, $1,385 average, $12,821,030, two weeks.

8. "Pitch Perfect," Universal, $2,573,350, 1,391 locations, $1,850 average, $59,099,993, seven weeks.

9. "Here Comes the Boom," Sony, $2,522,790, 2,044 locations, $1,234 average, $39,033,885, five weeks.

10. "Hotel Transylvania," Sony, $2,400,226, 2,566 locations, $935 average, $140,954,208, seven weeks.

11. "Paranormal Activity 4," Paramount, $1,980,033, 2,348 locations, $843 average, $52,600,612, four weeks.

12. "Sinister," Summit, $1,524,448, 1,554 locations, $981 average, $46,578,686, five weeks.

13. "Silent Hill: Revelation," Open Road Films, $1,300,137, 1,902 locations, $684 average, $16,383,406, three weeks.

14. "The Perks of Being a Wallflower," Summit, $1,132,924, 607 locations, $1,866 average, $14,614,770, eight weeks.

15. "Lincoln," Disney, $944,308, 11 locations, $85,846 average, $944,308, one week.

16. "Alex Cross," Summit, $911,973, 1,090 locations, $837 average, $24,603,042, four weeks.

17. "Fun Size," Paramount, $757,223, 1,301 locations, $582 average, $8,800,336, three weeks.

18. "Looper," Sony, $582,150, 491 locations, $1,186 average, $64,669,383, seven weeks.

19. "The Sessions," Fox, $545,550, 128 locations, $4,262 average, $1,655,222, four weeks.

20. "Seven Psychopaths," CBS Films, $404,812, 356 locations, $1,137 average, $14,098,469, five weeks.

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Universal and Focus are owned by NBC Universal, a unit of Comcast Corp.; Sony, Columbia, Sony Screen Gems and Sony Pictures Classics are units of Sony Corp.; Paramount is owned by Viacom Inc.; Disney, Pixar and Marvel are owned by The Walt Disney Co.; Miramax is owned by Filmyard Holdings LLC; 20th Century Fox and Fox Searchlight are owned by News Corp.; Warner Bros. and New Line are units of Time Warner Inc.; MGM is owned by a group of former creditors including Highland Capital, Anchorage Advisors and Carl Icahn; Lionsgate is owned by Lions Gate Entertainment Corp.; IFC is owned by AMC Networks Inc.; Rogue is owned by Relativity Media LLC.

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Lance Armstrong Cuts Officials Ties With His Livestrong Charity

In the wake of being stripped of his seven Tour de France titles for doping, Lance Armstrong last week cut all official ties with Livestrong, the charity he founded 15 years ago while he was treated for testicular cancer.

On Nov. 4, he resigned from the organization’s board of directors; he had previously stepped down as the chairman of the board Oct. 17. He has distanced himself from the charity to try to protect it from any damage caused by his doping controversy, the new board chairman, Jeff Garvey, said in a statement.

“Lance Armstrong was instrumental in changing the way the world views people affected by cancer,” Garvey said. “His devotion to serving survivors is unparalleled, and for 15 years, he committed himself to that cause with all his heart.”

Garvey said that the Armstrong family had donated nearly $7 million to the foundation and that the organization under Armstrong had raised close to $300 million to serve cancer survivors.

Last month, the United States Anti-Doping Agency made public its evidence in its doping case against Armstrong, saying he had doped and encouraged his teammates to dope so they could help him win races. He was subsequently barred from Olympic sports for life and was stripped of all the cycling titles he won from August 1998 on.

Since then, Armstrong has spent several weeks in Hawaii, out of the public eye. On Saturday, though, he posted a photograph on Twitter showing him at home in Austin, Tex. He is lounging on a couch with his seven yellow Tour jerseys framed on the wall in the background.

In the post, he said, “Back in Austin and just layin’ around.” The photograph had more than 400,000 page views as of Monday evening, with many people posting negative comments on the page.

“Lance, you have no moral conscious and it’s obvious many of your followers don’t either,” said one person who went by the Twitter handle “irobot,” who also posted that Armstrong needed “professional help.”

A person posting under the name “Aumann” said: “An art thief enjoying all his da Vincis.”

Other people posted words of support, including many who said they still thought Armstrong was the top cyclist in history.

“TomShelton” said of Armstrong’s seven Tour titles, “You earned all 7 of them no matter what is being said about you!”

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Board games are growing in popularity again

Blockbuster board games are unusual, but Days of Wonder has one in its Ticket to Ride.

The already-classic cardboard game, in which players strategize over how to build the best railway routes, was released in 2004 and has worldwide sales of "several hundred thousand units per year," said Eric Hautemont, co-founder of the Los Altos, Calif., game company.

That places it in the forefront of a blossoming independent game world, in which new titles such as monster bonanza King of Tokyo and kingdom-building game Dominion are fighting to join traditional classics such as Monopoly and Sorry.

PHOTOS: Video games-to-film adaptations

Driven by online word of mouth on board game websites such as BoardGameGeek and by the popularity of online digital games, including Days of Wonder's Small World, old-fashioned board games have acquired cult status and are growing in popularity.

The American board game thriller Pandemic and imports such as Carcassone and the Settlers of Catan are the titles most often cited as having fueled the table-top renaissance. They have been followed by hits such as the celebration of misery game Gloom, the civilization epic 7 Wonders and the galactic adventure Race for the Galaxy.

Days of Wonder's Hautemont estimated 900 games are released annually by about 40 active publishers, designed for a small but enthusiastic audience.

PHOTOS: Hollywood backlot moments

Russell Howell, 42, discovered the independent board game scene about five years ago, and today he maintains the LA Games group, which organizes gaming events at stores and coffeeshops around L.A.

"I found that designer board gaming held much of what I was looking for in a form of entertainment that video games quite often lacked: a personal connection," Howell said.

Designing and releasing a game is not cheap. Hautemont said Days of Wonder spends about $20,000 simply to develop a game. That's at the high end, but Hautemont's company grossed $7 million the year Ticket to Ride was released.

PHOTOS: Video game cameos in 'Wreck-It Ralph'

Most game publishers have more modest budgets. Journalist-turned-game designer/publisher Chris Kirkman budgeted $18,000 to $20,000 to develop, print and publish Carnival, his first game.

Matt Leacock, chief designer at social communications firm Sococo, once attempted to self-release the racing game Lunatix Loop. He unveiled Loop at the international gaming convention Spiel, held in Essen, Germany, which attracts more than 100,000 people.

"Each game probably cost me about $10, maybe $15," Leacock said. "I sold them for $25. That didn't cover all the incidentals, like the costs of booths and import taxes."

Leacock lost money and said, "I wouldn't encourage anyone to go that route. If you don't know what you're doing, you're just flooding the market with more bad product."

As a result, most who design or publish independent board games have supplemental incomes. Alf Seegert is a lecturer at the University of Utah, and last year he released the Road to Canterbury, a game inspired by Geoffrey Chaucer's "The Canterbury Tales," via Gryphon Games. Nathan McNair consults in finance compliance, and his Pandasaurus Games has specialized in re-releasing out-of-print or hard-to-find games such as Tammany Hall.

"The majority of board game designers do this as a hobby," Kirkman said. "It's hard for us as a publisher to make a living."

Hollywood may help. Cryptozoic Entertainment Inc. in Irvine has acquired licenses to make games of hit TV shows like "The Walking Dead" and "The Big Bang Theory," and now will produce games based on the upcoming trilogy of "Hobbit" films from director Peter Jackson.

The digital world has also helped. Online versions have fueled a growing appetite for the table-top games — in part because they are priced much lower. A board game that costs $50, such as Ticket to Ride, might have an Xbox version that sells for as little as $4.99.

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Mike D'Antoni to be next coach of the Lakers

Mike D'Antoni, not Phil Jackson, will be the next coach of the Lakers.

"We signed Mike D'Antoni to a multi-year deal," Lakers spokesman John Black said, mentioning the team's owner and top two executives. "Dr. [Jerry] Buss, Jim Buss and Mitch Kupchak were unanimous that Mike D'Antoni was the best coach for the team at this time."

D'Antoni, 61, coached the New York Knicks last season and the Phoenix Suns before that. He will officially take over the Lakers within a week or two, depending how quickly he recovers from knee-replacement surgery.

The Lakers will announce their new coach at a news conference as early as Tuesday but more likely later in the week. Bernie Bickerstaff will remain the team's interim coach for now.

D'Antoni signed a three-year deal for $12 million. The team holds an option for a fourth year.

Jackson was the overwhelming favorite to return to the Lakers until they heard his demands, which included a stake in team ownership, according to a person familiar with the situation.

"He was asking for the moon," said the person, who also declined to be identified because they are not authorized to discuss the situation.

The Lakers then moved quickly to sign D'Antoni. He replaces Mike Brown, who was fired Friday after the Lakers began the season 1-4, their worst start since 1993.

Earlier Sunday, Lakers guard Steve Nash said it would "be a coup" for the Lakers to bring back Jackson, but he also had kind words for D'Antoni.

"Obviously, I think everyone knows how much I love Mike," said Nash, who played four seasons and won two MVP awards under D'Antoni in Phoenix. "If he were the coach, it would be seamless and terrific for me, and I think the team as well.”

D’Antoni was most recently employed by the Knicks, when he was forced to resign under pressure last season after an 18-24 start.

Kobe Bryant did not hide his excitement for the prospect of Jackson returning but, like Nash, he was also on board with D'Antoni.

"They know how I feel about Phil. They know how I feel about D'Antoni," Bryant said Sunday. "I like them both."

D'Antoni's coaching staff with the Lakers likely will start with two longtime assistants -- his brother, Dan D'Antoni, and Phil Weber.

The new Lakers coach has a 388-339 coaching record in the NBA. He led the Suns to the Western Conference finals in 2005 and 2006 with Nash running the show.

Bryant became familiar as a boy with D'Antoni, who was a star in the Italian league in the 1980s, when Bryant's father also played in Italy. D'Antoni helped Olimpia Milano win five league titles and two European club titles. D'Antoni also worked with Bryant on the U.S. national team as an assistant.

ALSO:

Photos: Lakers Coach Mike D'Antoni

Lakers, Steve Nash playing waiting game

Interim Coach Bernie Bickerstaff tries to keep it simple

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Laughing in the storm: Comics don't shy from Sandy

NEW YORK (AP) — Comedian Dave Attell told a packed house at the Comedy Cellar that New York after Superstorm Sandy had a familiar feel. "It was dark. Toilets were backing up. ... It was pretty much like it always was."

Another comic, Paul Mecurio, told the same crowd that he got so many calls from worried family members that he started making things up about how bad it was.

"I'm drinking my own urine to survive," he joked.

New York's comedy clubs, some of which had to shut down or go on generator power in the aftermath of the storm, dealt with a bad situation like they always have — by turning Sandy into a running punchline.

"If they're going to do jokes on Sept. 12 about Sept. 11, then this thing isn't going to slow us down," said Vic Henley, the emcee of a show Oct. 28 at Gotham Comedy Club.

Sean Flynn, Gotham's operating manager, said comics were including the storm in their acts but had to be careful nonetheless not to make people feel worse than they already did.

"There's the old adage that tragedy plus time equals comedy. The variable is the time," he said. Still, he added: "You can't ignore the subject. That's what comedy's all about."

The Comedy Cellar, a regular stop for decades for the country's most notable comedians, was closed from Oct. 28 through Nov. 1, but reopened on Nov. 2 after a generator was brought in at a cost of several thousand dollars. Power didn't return until the next day, and the crowds came with it.

Everyone has a bad case of cabin fever," said Valerie Scott, the club's manager.

Mecurio said he thought the joke was on him when he got a call from the Comedy Cellar saying the club was going ahead with its show even though there was no light in the West Village. He headed downtown from the Upper East Side, hitting dark streets after midtown.

"It's pitch dark," he said. "And there's a room packed with people laughing. It was so surreal. ... I'm calling it the generator show. It was a really cool thing."

"You could feel there was something special about the show," he said. "The audiences were tempered in their mood. You could tell something was up, something was in the air. I knew it was cathartic for people."

He said a woman approached him after the show to thank him, saying: "You kind of brightened my day."

Sometimes, comics used the storm to get a laugh at the expense of the crowd, like when Mark Normand looked down from the Comedy Cellar stage at a man with a thin beard.

"I like the beard," he told him. "Is that because of Sandy? You couldn't get your razor working?"

And Attell used Sandy to mock a heckler, telling him: "You must have been a load of laughs without power."

At another point, Attell looked for positives in the storm.

"There's nothing better than Doomsday sex," he said.

Mecurio said he has made a point of including the storm and the havoc it caused whenever he takes the stage.

"I feel like as a comedian in the spirit of social satire, it's what we're supposed to do," he said. "It's the elephant in the room. How do you not do it?"

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Well: Quitting Smoking for Good

Few smokers would claim that it’s easy to quit. The addiction to nicotine is strong and repeatedly reinforced by circumstances that prompt smokers to light up.

Yet the millions who have successfully quit are proof that a smoke-free life is achievable, even by those who have been regular, even heavy, smokers for decades.

Today, 19 percent of American adults smoke, down from more than 42 percent half a century ago, when Luther Terry, the United States surgeon general, formed a committee to produce the first official report on the health effects of smoking. Ever-increasing restrictions on where people can smoke have helped to swell the ranks of former smokers.

Now, however, as we approach the American Cancer Society’s 37th Great American Smokeout on Thursday, the decline in adult smoking has stalled despite the economic downturn and the soaring price of cigarettes.

Currently, 45 million Americans are regular smokers who, if they remain smokers, can on average expect to live 10 fewer years. Half will die of a tobacco-related disease, and many others will suffer for years with smoking-caused illness. Smoking adds $96 billion to the annual cost of medical care in this country, Dr. Nancy A. Rigotti wrote in The Journal of the American Medical Association last month. Even as some adult smokers quit, their ranks are being swelled by the 800,000 teenagers who become regular smokers each year and by young adults who, through advertising and giveaways, are now the prime targets of the tobacco industry.

People ages 18 to 25 now have the nation’s highest smoking rate: 40 percent. I had to hold my breath the other day as dozens of 20-somethings streamed out of art gallery openings and lighted up. Do they not know how easy it is to get hooked on nicotine and how challenging it can be to escape this addiction?

Challenging, yes, but by no means impossible. on the Web you can download a “Guide to Quitting Smoking,” with detailed descriptions of all the tools and tips to help you become an ex-smoker once and for all.

Or consult the new book by Dr. Richard Brunswick, a retired family physician in Northampton, Mass., who says he’s helped hundreds of people escape the clutches of nicotine and smoking. (The printable parts of the book’s provocative title are “Can’t Quit? You Can Stop Smoking.”)

“There is no magic pill or formula for beating back nicotine addiction,” Dr. Brunswick said. “However, with a better understanding of why you smoke and the different tools you can use to control the urge to light up, you can stop being a slave to your cigarettes.”

Addiction and Withdrawal

Nicotine beats a direct path to the brain, where it provides both relaxation and a small energy boost. But few smokers realize that the stress and lethargy they are trying to relieve are a result of nicotine withdrawal, not some underlying distress. Break the addiction, and the ill feelings are likely to dissipate.

Physical withdrawal from nicotine is short-lived. Four days without it and the worst is over, with remaining symptoms gone within a month, Dr. Brunswick said. But emotional and circumstantial tugs to smoke can last much longer.

Depending on when and why you smoke, cues can include needing a break from work, having to focus on a challenging task, drinking coffee or alcohol, being with other people who smoke or in places you associate with smoking, finishing a meal or sexual activity, and feeling depressed or upset.

To break such links, you must first identify them and then replace them with other activities, like taking a walk, chewing sugar-free gum or taking deep breaths. These can help you control cravings until the urge passes.

If you’ve failed at quitting before, try to identify what went wrong and do things differently this time, Dr. Brunswick suggests. Most smokers need several attempts before they can become permanent ex-smokers.

Perhaps most important is to be sure you are serious about quitting; if not, wait until you are. Motivation is half the battle. Also, should you slip and have a cigarette after days or weeks of not smoking, don’t assume you’ve failed and give up. Just go right back to not smoking.

Aids for Quitting

Many if not most smokers need two kinds of assistance to become lasting ex-smokers: psychological support and medicinal aids. Only about 4 percent to 7 percent of people are able to quit smoking on any given attempt without help, the cancer society says.

All 50 states and the District of Columbia have free telephone-based support programs that connect would-be quitters to trained counselors. Together, you can plan a stop-smoking method that suits your smoking pattern and helps you avoid common pitfalls.

Online support groups and Nicotine Anonymous can help as well. To find a group, ask a local hospital or call the cancer society at (800) 227-2345. Consider telling relatives and friends about your intention to quit, and plan to spend time in smoke-free settings.

More than a dozen treatments can help you break the physical addiction to tobacco. Most popular is nicotine replacement therapy, sold both with and without a prescription. The Food and Drug Administration has approved five types: nicotine patches of varying strengths, gums, sprays, inhalers and lozenges that can curb withdrawal symptoms and help you gradually reduce your dependence on nicotine.

Two prescription drugs are also effective: an extended-release form of the antidepressant bupropion (Zyban or Wellbutrin), which reduces nicotine cravings, and varenicline (Chantix), which blocks nicotine receptors in the brain, reducing both the pleasurable effects of smoking and the symptoms of nicotine withdrawal. Combining a nicotine replacement with one of these drugs is often more effective than either approach alone.

Other suggested techniques, like hypnosis and acupuncture, have helped some people quit but lack strong proof of their effectiveness. Tobacco lozenges and pouches and nicotine lollipops and lip balms lack evidence as quitting aids, and no clinical trials have been published showing that electronic cigarettes can help people quit.

The cancer society suggests picking a “quit day”; ridding your home, car and workplace of smoking paraphernalia; choosing a stop-smoking plan, and stocking up on whatever aids you may need.

On the chosen day, keep active; drink lots of water and juices; use a nicotine replacement; change your routine if possible; and avoid alcohol, situations you associate with smoking and people who are smoking.

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Flights for Thanksgiving may be best holiday-season deal

If your grim financial situation means you have to choose between flying for either Thanksgiving or the December holidays, you may get a better deal flying for Turkey Day.

The national average price for a round-trip domestic flight for Thanksgiving is $420, about the same as a year ago, according to airline ticket data analyzed by the travel booking website Priceline.com. But the national average airfare for the span that includes Christmas and New Year's Eve is up 3%, to $444.

If you had booked Thanksgiving reservations in early October, you would have paid an average airfare of $393, while the average December holiday airfare, if booked at that time, was $430, according to Priceline.

But if you waited to book your Thanksgiving flight, you are not alone.

As of Oct. 26, 78% of Americans who say they plan to travel for Thanksgiving had yet to make reservations, according to the travel website Hotwire.

Travel experts say such procrastinators may regret waiting so long.

On the busiest travel days around Thanksgiving, the average flight will be 90% full, according to Airlines for America, the trade group for the nation's largest airlines.

In contrast, the average flight throughout 2011 was 82% full. Empty airline seats are increasingly hard to find as airlines have merged, cut less-profitable routes and consolidated flights on popular routes.

"Flight reductions have reduced the number of available seats and that, coupled with holiday travel demand, is enabling fares to creep upward," said Brian Ek, a travel expert for Priceline. "The good news is that Thanksgiving airfares are back to running about flat with last year so, if you can only travel for one end-of-year holiday, that's probably the one to pick."

U.S. satisfaction falls for airlines, rises for car rental firms

American travelers are increasingly dissatisfied with the nation's airlines, but they seem pretty happy with the country's car rental companies.

For the first nine months of this year, the U.S. Bureau of Transportation Statistics received 12,145 consumer complaints about airline services, up 33.5% compared with the first nine months of 2011.

Based on complaints filed to the bureau in September alone, the biggest sources of aggravation for fliers were flight delays, cancellations, problems with baggage, ticketing and reservations and, of course, customer service.

United Airlines had the most complaints in September with 211, followed by American Airlines with 162.

Meanwhile, customer satisfaction with rental car companies has increased for the third consecutive year, according to a study released last week by J.D. Power & Associates. In fact, the satisfaction level — reaching 769 on a 1,000-point scale — is the highest in seven years.

The greatest improvement in the satisfaction rating came from the shuttle van or bus service that car rental companies use to transport customers and the daily rates and fees, according to the study.

Another big factor in raising customer satisfaction: a warm smile. The study found that car rental customers give an average rating of 795 when they are greeted at the counter with a smile, while customers who don't get a smile give an average rating of 647.

Ryanair CEO opposes seat belt use

Seat belts on airplanes are useless.

That was the latest rant by Michael O'Leary, the chief executive for Ryanair, the ultra low-cost airline based in Ireland.

O'Leary, who opposes seat belts because he is pushing for standing-room sections of his planes, called aviation authorities who disagree with him "plonkers."

"Seat belts don't matter," O'Leary told the Telegraph. "If there ever was a crash on an aircraft, God forbid, a seat belt won't save you."

hugo.martin@latimes.com

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California's Iraq and Afghanistan war dead remembered

They came from Walker Basin, a speck of a community at the edge of the Sequoia National Forest. From the farm town of Reedley, where a barber gives boys joining the military free haircuts before they ship out.

They came from San Francisco. Los Angeles. San Diego.

When they died, photos went up on post office walls in their hometowns. On Veterans Day, there are parades and charity golf tournaments. Buddies gather at graves to drink to the ones who are gone.

In the 11 years since the wars began in Iraq and Afghanistan, 725 service members from California have been killed.

As all veterans are honored, the fallen are remembered

Many died young — 41% were not yet 22. Sixty-three were still teenagers.

They were fun-loving singles. Forty-seven were engaged. They were married, leaving behind 307 wives and husbands. They had children — 432 sons and daughters.

Forty of their obituaries noted that the Sept. 11 attacks spurred them to join up. Some were in elementary school when they watched the Twin Towers fall.

The scope of their loss can't be measured at one point in time. Life moves on, the wars are winding down. But towns, families and individual lives continue to be shaped by their absence.

Lately, 9-year-old Naomi Izabella Johnson has been asking a lot of questions about her father, Allen Johnson, a Special Forces medical sergeant from Los Molinos who was killed on foot-combat patrol in Khanaqin, Afghanistan, in 2005.

What was his favorite color? School subject? Animal? Book? Did he like mashed potatoes?

"It helps me for when I try to imagine him," she said.

Two months ago, her 10-year-old brother, Joshua, started crying inconsolably.

"What's wrong?" his mother, Eunice Johnson, recalled asking.

"I'm starting to forget — sometimes I can't see Daddy's face."

In Yuba City, Taylor Silva, 21, has been spending some time alone. Last week marked six months since her fiance, Chase Marta, 24, was killed by a roadside bomb in the Ghazni province of Afghanistan. He was one of more than 40 California service members to have died in the line of duty since last Veterans Day.

"I know his family and best friend have it just as hard. But we're all being a little quiet to each other because we're all a reminder to each other. His mom can't see me without crying," Silva said.

Seventeen women from California have been killed in the wars.

Hannah Gunterman McKinney of Redlands had told her father that the Army wouldn't send a new mother to Iraq. But she was deployed when her son, Todd Avery Gunterman, was just 1. Ten months later, in 2006, she was run over by a Humvee in Taji, north of Baghdad. She was 20.

She had joined the military as a way to earn money to go to fashion school. She reenlisted because she was a single mother and wanted to give her son financial stability. Now her parents are raising Todd Avery.

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War photography exhibit debuts in Houston museum

HOUSTON (AP) — It was a moment Nina Berman did not expect to capture when she entered an Illinois wedding studio in 2006. She knew Tyler Ziegel had been horribly injured, his face mutilated beyond recognition by a suicide bombing in the Iraq War. She knew he was marrying his pretty high school sweetheart, perfect in a white, voluminous dress.

It was their expressions that were surprising.

"People don't think this war has any impact on Americans? Well here it is," Berman says of the image of a somber bride staring blankly, unsmiling at the camera, her war-ravaged groom alongside her, his head down.

"This was even more shocking because we're used to this kind of over-the-top joy that feels a little put on, and then you see this picture where they look like survivors of something really serious," Berman added.

The photograph that won a first place prize in the World Press Photos Award contest will stand out from other battlefield images in an exhibit "WAR/PHOTOGRAPHY: Images of Armed Conflict and Its Aftermath" that debuts Sunday — Veterans Day — in the Houston Museum of Fine Arts. From there, the exhibit will travel to The Annenberg Space for Photography in Los Angeles, the Corcoran Gallery of Art in Washington and The Brooklyn Museum in Brooklyn, N.Y.

The exhibit was painstakingly built by co-curators Anne Wilkes Tucker and Will Michels after the museum purchased a print of the famous picture of the raising of the flag at Iwo Jima, taken Feb. 23, 1945, by Associated Press photographer Joe Rosenthal. The curators decided the museum didn't have enough conflict photos, Tucker said, and in 2004, the pair began traveling around the country and the world in search of pictures.

Over nearly eight years and after viewing more than 1 million pictures, Tucker and Michels created an exhibit that includes 480 objects, including photo albums, original magazines and old cameras, by 280 photographers from 26 countries.

Some are well-known — such as the Rosenthal's picture and another AP photograph, of a naked girl running from a napalm attack during the Vietnam War taken in 1972 by Huynh Cong "Nick" Ut. Others, such as the Incinerated Iraqi, of a man's burned body seen through the shattered windshield of his car, will be new to most viewers.

"The point of all the photographs is that when a conflict occurs, it lingers," Tucker said.

The pictures hang on stark gray walls, and some are in small rooms with warning signs at the entrance designed to allow visitors to decide whether they want to view images that can be brutal in their honesty.

"It's something that we did to that man. Americans did it, we did it intentionally and it's a haunting picture," Michels said of the image of the burned Iraqi that hangs inside one of the rooms.

In some images, such as Don McCullin's picture of a U.S. Marine throwing a grenade at a North Vietnamese soldier in Hue, it is clear the photographer was in danger when immortalizing the moment. Looking at his image, McCullin recalled deciding to travel to Hue instead of Khe Sahn, as he had initially planned.

"It was the best decision I ever made," he said, smiling slightly as he looked at the picture, explaining that he took a risk by standing behind the Marine.

"This hand took a bullet, shattered it. It looked like a cauliflower," he said, pointing to the still-upraised hand that threw the grenade. "So the people he was trying to kill were trying to kill him."

McCullin, who worked at that time for The Sunday Times in London, has covered conflicts all over the world, from Lebanon and Israel to Biafra. Now 77, McCullin says he wonders, still, whether the hundreds of photos he's taken have been worthwhile. At times, he said, he lost faith in what he was doing because when one war ends, another begins.

Yet he believes journalists and photographers must never stop telling about the "waste of man in war."

"After seeing so much of it, I'm tired of thinking, 'Why aren't the people who rule our lives ... getting it?' " McCullin said, adding that he'd like to drag them all into the exhibit for an hour.

Berman didn't see the conflicts unfold. Instead, she waited for the wounded to come home, seeking to tell a story about war's aftermath.

Her project on the wounded developed in 2003. The Iraq War was at its height, and there was still no database, she said, to find names of wounded warriors returning home. So she scoured local newspapers on the Internet.

In 2004 she published a book called "Purple Hearts" that includes photographs taken over nine months of 20 different people. All were photographed at home, not in hospitals where, she said, "there's this expectation that this will all work out fine."

The curators, meanwhile, chose to tell the story objectively — refusing through the images they chose or the exhibit they prepared to take a pro- or anti-war stance, a decision that has invited criticism and sparked debate.

And maybe, that is the point.

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Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP

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