The NewsHour with Jim Lehrer

JIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight a Newsmaker interview with House Democratic leader Dick Gephardt about his recent breaks with the President; a discussion about a new report that says cancer progress is coming from prevention, not treatment; a report from Oregon on new research on the brain; and a David Gergen dialogue about war. It all follows our summary of the news this Thursday.NEWS SUMMARY

JIM LEHRER: Lawyers in the Oklahoma City bombing trial presented their final arguments today in Denver. Prosecutor Larry Mackey painted Timothy McVeigh as a domestic terrorist and said a smorgasbord of evidence could lead the jury to only one conclusion: McVeigh was guilty of killing 168 people. Defense lawyer Stephen Jones said McVeigh had been convicted by public opinion and that much of the prosecution's case was based on emotion. Jury deliberations are expected to start tomorrow after the prosecution offers a rebuttal and the judge instructs the jury on the law. Clean-up efforts were ongoing in Central Texas today after Tuesday's devastating tornadoes. Residents of Jarrell, Texas, returned to their homes and businesses to gather whatever belongs remained. Twenty-seven people were killed and at least fifty homes were destroyed there. Officials said 22 people who had been missing have now been accounted for. Three deaths near Austin were also blamed on the tornadoes. Cancer deaths are on the decline but not because of treatment. That's the conclusion of a study published today in the "New England Journal of Medicine." The research was conducted by Dr. John Baylor of the University of Chicago. He said the drop was due to prevention and early diagnosis of the disease. He suggested the government spend less money on finding a cure and more on preventative measures. We'll have more on this story later in the program. President Clinton met in London today with Tony Blair, the new British prime minister. Mr. Clinton praised the labor leader's achievements and said there was an unbreakable alliance between the two countries based on shared values and common aspirations. At a joint news conference Mr. Clinton was asked about another newly-elected leader, Mohammad Khatami, the president of Iran, often described as a moderate.

PRESIDENT CLINTON: It's a very interesting development, and for those of us who don't feel privy to all the details of daily life in that country it's at least a reaffirmation of the democratic process there, and it's interesting, and it's hopeful. But from the point of view of the United States what we hoped for is a reconciliation with a country that does not believe that terrorism is a legitimate extension of political policies that would not use violence to wreck a peace process in the Middle East and would not be trying to develop weapons of mass destruction.

JIM LEHRER: The President was also asked about his political differences with House Democratic Leader Dick Gephardt. He declined to take the bait. In the last two weeks Gephardt has come out against the President on the balanced budget deal and Most Favored Nation trade status for China. Mr. Clinton said Gephardt has supported him on just about everything else. We'll have a Newsmaker interview with Gephardt right after this News Summary. Overseas today, Laurent Kabila was sworn in as president of the Democratic Republic of Congo, the former Zaire. The 56-year-old rebel leader acknowledged the crowd as he entered a stadium to take his oath. The presidents of Angola, Rwanda, Uganda, and Zambia attended the swearing in. Kabila promised presidential and legislative elections but not for two years. On the Sierra Leone story today a Pentagon spokesman said about 250 U.S. citizens will be evacuated tomorrow from that West African country. They were said to be at risk by the fighting and looting that have occurred since Sunday, when the democratically elected president was overthrown by a military coup. Nigerian troops landed in Sierra Leone today to support ousted government forces trying to regain control from the rebels. At a rally outside the State Department in Washington Sierra Leone's ambassador to the U.S., John Lee, called on the United States to intervene.

JOHN LEE: There are about 1200 United States Marines off the waters of Sierra Leone wanting to land there, rescue American citizens, put 'em on board, and then support the West African forces presently being assembled in Freetown. It's a reign of terror in Sierra Leone today. These people are wild savages. They are raping, looting, killing, bombing.

JIM LEHRER: The Pentagon spokesman said the U.S. troops would not intervene in Sierra Leone; they would only retrieve U.S. citizens stranded there. And that's it for the News Summary tonight. Now it's on to Dick Gephardt; cancer prevention; studying the brain; and a David Gergen dialogue. NEWSMAKER

JIM LEHRER: House Democratic Leader Dick Gephardt is first tonight. He follows this setup report by Spencer Michels.

SPENCER MICHELS: In recent weeks House Minority Leader Dick Gephardt has publicly distanced himself rom the Clinton administration on several important policy issues.

SPOKESMAN: The Minority Leader is recognized for five minutes.

SPENCER MICHELS: On May 20th, Gephardt went to the House floor and announced his opposition to the balanced budget agreement negotiated by the White House and the GOP Congress.

REP. DICK GEPHARDT: And in my view, this budget agreement is a budget of many deficits: a deficit of principle, a deficit of fairness, a deficit of tax justice, and worst of all, a deficit of dollars. I don't believe this budget is fair. I don't believe it invests properly in the future of our country and our economy and our people. And I do not believe the numbers will work, and I don't think there is a system in place to make sure that they do.

SPENCER MICHELS: On Tuesday, Gephardt came out against another Clinton priority--normalizing trade relations with China by renewing most favored nation status.

REP. DICK GEPHARDT: If you give normal trading status to a country that has no human rights and no worker rights, you are ensuring that you're going to be competing with a nation that has a very, very low standard of living with no hope that the standard of living will go up. In fact, in China's case, we believe there are about 2 million workers who are in prison who are manufacturing products, many of which are sold in the United States. So by accepting that kind of a relationship you're putting tremendous pressure on American wages and on the American standard of living.

SPENCER MICHELS: Gephardt's highly publicized differences with the President have led to speculation he is positioning himself for another presidential bid in the year 2000. Gephardt made a short- lived run for the Democratic nomination for President in 1988. In London today, in the midst of his European visit, President Clinton made no mention of presidential politics. He said recent statements by Congressman Gephardt simply were honest expressions of policy differences.

RITA BRAVER, CBS News: Mr. President, bearing--I'm sorry. I'm Rita Braver with CBS News. Bearing in mind your comments on the budget, I was wondering if you have been listening to your own minority leader. He is against you on the budget. He is against you on MFN, he is against you on expansion of NATO on a fast track. And I wondered if you could explain maybe whether you think it's you or he who represents the hearts and minds of the Democratic Party, and whether maybe you think there is--it's time for a new minority leader, or maybe you don't really want that Democratic majority you talked about at the beginning of the news conference.

PRESIDENT CLINTON: No, I think for one thing I think you know, I disagree with him about the--about the budget and MFN for China, and we've had some trade differences since I came here. Otherwise, he's supported me on just about everything. Individual people will have differences on individual issues, they'll see the world in different ways. But I think I did the right thing, and I think we're going to--I think the country will be immensely benefitted by it, and I think everybody that voted for it, in retrospect, will be happy. And those that didn't vote for it will be pleased that what they thought was wrong with it wasn't. That's what I think will happen.

SPENCER MICHELS: The President also pointed out that an overwhelming majority of Democrats in Congress sided with him and not Gephardt on the recent balanced budget plan.

JIM LEHRER: Now to that Newsmaker interview with Congressman Gephardt. I talked with him earlier this evening.

JIM LEHRER: Congressman Gephardt, welcome.

REP. RICHARD GEPHARDT, Minority Leader: Good to be with you.

JIM LEHRER: Let me ask you the same question President Clinton was asked today. Who represents the hearts and minds of the Democratic Party, he or you?

REP. RICHARD GEPHARDT: Well, I don't think that that's the right question. I think we agree on the vastmajority of issues, as he said. We've been together on most of the issues that have come before the Congress. The President and I see most issues eye to eye. No two individuals in any party ever agree on every issue, and we've had disagreements in the past on trade, on NAFTA, now on China MFN. Last year, I voted against MFN for China, so this is not a new issue for us. But, you know, reasonable people can disagree. I respect his opinion. I respect the stand he's taken on issues. We just don't agree on this. We can work our way through this disagreement, and we're going to announce together a re- presentation of the Families First agenda we had last year, with some new elements in it. And that, I think, will show the great unity that I believe exists in the Democratic Party.

JIM LEHRER: But for those who are watching and listening and what to know which is the position of the Democratic Party on these two major issues: the balanced budget agreement and MFN, which is-- which is the Democratic Party's position?

REP. RICHARD GEPHARDT: You know, I think there are some Democrats, the majority, who agreed with the President, that the budget deal was a good one and should be supported. Some of us, a minority of Democrats, felt differently. And for some of us, you know, I was in the Congress in 1981 when we voted for a budget. I didn't vote for it at the time. But there was a tax bill in that budget that I think is very reminiscent of the tax bill that we're looking at now. And I voted for that. It was one of the worst votes I've ever made since I've been in the Congress. It exploded the deficit. It's taken us 17 years to get over that tax bill and a lot of tough Democratic positions on reducing the deficit, and I don't want to do that again. I think it's unfair. I don't think this budget makes the necessary investments we need in the future of the country, and I don't think there are adequate safeguards in it to see that the deficit doesn't explode again. So reasonable people come to a different conclusion. I respect the President's effort to get the budget balanced. He's done more than most Republicans to get it balanced, and I think he's done what he thinks is right.

JIM LEHRER: Were you disappointed that an overwhelming majority of your House colleagues in the Democratic Party went with him, rather than you?

REP. RICHARD GEPHARDT: No. I told my colleagues in the caucus that on an issue this important, this long in running because you're voting for a five and a ten year budget here, that everyone should do what they believe is right in their heart and mind. And I think that's what Democrats did. And I believe that you could come to the conclusion that given all the alternatives that the budget was worth supporting; I could not do that. I cannot vote for a budget where over half the tax cuts goes to families who make over $100,000 a year. That's what I think this tax bill will be. Now it is true; you can vote for the budget and against the tax bill, but I don't want to do that. In 1981, I voted against the budget and for the tax bill. If I'm going to be against this tax bill--and I suspect I will be--I don't want to vote for the budget that encompasses this kind of a tax bill, and I also believe that it's really important that we invest in education, that we have, for instance, Head Start for every child who needs it. I think we ought to have Head Start for children zero to three. That is not in this budget; I think it should be. This is the budget for the next five years. I want Head Start in it.

JIM LEHRER: So this was a matter of personal principle to you, not party leadership, is that right?

REP. RICHARD GEPHARDT: Well, that's right. You know, I think that an issue like this--and there are other issues--people again in the same party come to different conclusions. You've got to vote for what you believe in your heart and mind is the right thing to do.

JIM LEHRER: Now, some of the punditry has centered on this--the possibility of your running for President in the year 2000. Does that play any part in your decision making on this?

REP. RICHARD GEPHARDT: It doesn't, and I think it's really almost ridiculous to be having a discussion now about what's going to happen in the year 2000. First of all, I got elected here in the third district in Missouri to represent my constituents now on issues that are in front of us in the country and in the third district in Missouri, and I'm trying to do that, and I've focused on that. That's my main responsibility. Secondly, as a party leader in the House, I've also focused on trying to win a majority in the House in 1998. That's the election that's in front of us. I think it's entirely counterproductive to be looking out three and a half years from now and worrying about something that may or may not happen. I have made no decision on that and won't for a long time. So to have all of this forced into every issue that we're talking about I think is counterproductive and I don't think gives the necessary importance that we ought to be giving to these very important issues that are in front of us right now. Who knows where we're all going to be three and a half years from now?

JIM LEHRER: Well, just concentrating on '98, do you believe the positions you took are the politically suitable positions for the Democratic Party in '98?

REP. RICHARD GEPHARDT: Well, I think for most people it is. I would never try to speak for all Democrats. I would never try to say that the positions that I believe are right are the positions that all other Democrats ought to take. I think what we'd have to do is try to find as many common positions as we can, but most of all we have to address things again from what in our own heart and mind is the right thing for our constituents, the right thing for the country, and that's what I've tried to do. I would remind you that we have an agenda we call Families First that House Democrats and Senate Democrats ran on in 1996. It was much like the President's platform and agenda in 1996. And it's an agenda we're proud of. It's about the kitchen table everyday problems American families face: health care, education, jobs, crime, pensions. You know, if you went out in my district door to door, as I often do here in St. Louis, those are the issues people would talk to you about. And it's a very different agenda than the Republican agenda, the Contract With America that they talked so much about in 1994 and 1996.

JIM LEHRER: Was it difficult for you, as the Democratic leader of the House, to make such public breaks with the President on major issues like this? Was it difficult just on that--on those grounds alone?

REP. RICHARD GEPHARDT: Well, you know, there have been some times--the vast minority of times--that I have disagreed with the President. I'm sure that other Democrats have from time to time disagreed with the President on important issues. In 1993, I disagreed with him on the North American Free Trade Agreement, and I argued strongly for my position. The President argued strongly for his position. And at the end of the day his position won; mine lost. But I thought the argument was healthy; I thought the disagreement was well presented on both sides in a democracy, whether the disagreement is between parties and within a party, I think that's what we're supposed to do. The public deserves an airing of issues like this. I think you can disagree with someone and still deeply respect them and like them, as I like the President and respect the President. It doesn't mean that we're not on the same wave length on most things. I talk to him two and three times a week. I believe he's trying to do his best to improve the country and do the right things for the country. I don't believe for a moment that his position on the budget or on NAFTA or on China, Most Favored Nation, means that he's not doing the best he possibly can for the country. We just disagree on these couple of issues. I think it's healthy to express this disagreement. I don't know if I'm right. I try to find the truth as best I can. There's a scripture in the Bible that says we all see through a glass darkly--and--and, you know, as I said, in 1981, I made a vote on a tax bill. We had tried an alternative; we lost, then it was whether you're for the only tax bill that was left--I decided we needed a tax cut. I voted for it. In retrospect, it wasn't the right vote. It didn't turn out the way I hoped it would turn out. And the same thing with many of these issues. I may not be entirely right. I may be proven wrong by what happens, but in my heart and mind this is what I think is best for the people I represent and for the country.

JIM LEHRER: The pundits, as you know, have had a field day about this--one of the other things they've said is you represent the old-fashioned Democratic Party and you're trying to pull it back from the center into the right, where President Clinton is trying to take it or has taken it. What do you think about that sort of thing?

REP. RICHARD GEPHARDT: Well, you know, these kind of sweeping statements I think are really misleading and not in touch with reality. I've said many times that we're all new Democrats now, and by that I mean all of us have an obligation, as Democrats who believe in certain values and beliefs and principles that I think are rooted in our party and that are shared by all Democrats, it is our job to translate those values and beliefs in today's circumstances. Now, there are a lot of circumstances. Trade, there's a whole variety of issues. I believe that the Democrat rooted in Democratic belief, in value and tradition can reach the conclusion that I've reached on China MFN. By the same token, I think another Democrat can have a different translation of those values in today's circumstances. I don't think that one is a new Democrat and one is an old Democrat. I think these are classifications that some in the media use to try to pigeonhole people into some kind of sweeping classification. I think when you get it into reality it doesn't mean anything. I think all of us are struggling. The President is struggling; I'm struggling; every other Democrat I hope is struggling to try to translate what I believe are our values into these circumstances. I think that's what Franklin Roosevelt did in his time, and I think that's what Jack Kennedy did in his time. Harry Truman did it in his time. That's what we ought to do. And, you know, later history will judge whether or not we made the right judgment.

JIM LEHRER: Do you believe the next major issue that your colleagues, you and your colleagues will have to vote on is the China MFN thing? Do you think the Democrats will go with you or the President on that?

REP. RICHARDGEPHARDT: I don't know, and I haven't surveyed it, and I'm not going to go, you know, try to talk people into my position. Again, I think most members have dealt with this. They know the issue, and they can reach their own conclusion. Some people may change their minds from where they've been in the past. For me, this issue is one that is very important for our country in the future. I think that we must stand for human rights all over the globe. And we must stand for getting our workers and businesses on a level playing field with other countries. And I think right now we're not on that level playing field with China. When you have prison labor making goods that come to the United States, when you have people being denied their human rights, freedom of speech, freedom to petition their own government, freedom to be free of being imprisoned against their will for doing nothing, then I think it is impossible to have a normal trading relationship with a country that behaves in that way. In the past, with countries like South Africa, we've taken a very strong position and said, no, we're not going to trade with countries like that until there are changes in the right direction. I think that's what we must do with China. I think enough is enough. We have tried a policy of just talking with them; we haven't gotten results. I think we can do better.

JIM LEHRER: All right. Congressman Gephardt, thank you very much.

REP. RICHARD GEPHARDT: Thank you. FOCUS - TREATMENT VS. PREVENTION

JIM LEHRER: The cancer story is next and to Elizabeth Farnsworth.

ELIZABETH FARNSWORTH: How successful has the war against cancer been? Not very, According to a report in today's issue of the "New England Journal of Medicine." The authors argue that treatments have fallen short of expectations and it's time for a different strategy against the disease, which still claims + million American lives a year. We're joined now by the lead author of the story, Dr. John Bailar, Chairman of the University of Chicago Medical Center's Department of Health Studies, and by Dr. David Nathan, president of the Dana-Farber Cancer Institute. He also chairs the National Institutes of Health Panel on Clinical Research. Dr. Bailar, briefly describe your study for us and its conclusions.

DR. JOHN BAILAR, University of Chicago Medical Center: We have been concerned very much about trends in cancer death rates, so we- -

ELIZABETH FARNSWORTH: About--

DR. JOHN BAILAR: About the trends in cancer death rate. How much is the risk for--of dying from cancer changing? What are the reasons for change? What kinds of cancer are involved? So we calculated the death rate year by year from 1970 up through 1994, the most recent year available, and then we have examined those data to try to find out what's going on.

ELIZABETH FARNSWORTH: And what did you find out?

DR. JOHN BAILAR: The most important thing from our point of view is that the death rate for cancer of all kinds has been rising until quite recently. I must say it wasn't rising fast. It was about 1 percent a year but very steadily. It may have flattened out and turned over, started down a little bit, but all the same the death rate for cancer, the risk of dying from cancer is higher now than it was when the war against cancer started in 1971.

ELIZABETH FARNSWORTH: And to you that indicates that the money that's gone to new treatments, new therapies, chemotherapy, that kind of thing has not been spent wisely.

DR. JOHN BAILAR: I think it's too strong to say it has not been spent wisely. It has not done what we all hoped and expected to accomplish. It's important to recognize that there have been some successes. There are many, many different forms of cancer--one hundred, two hundred, three hundred--it depends on how you count. Some have been going up. Some have been going down. But if you take them altogether, the trend is up.

ELIZABETH FARNSWORTH: Okay. Let's stop there for a minute. Dr. Nathan, what is your response to this study? What's your view of it?

DR. DAVID NATHAN, Dana-Farber Cancer Institute: Well, as Dr. Bailar knows, these are data that actually Phil Cole and his co- workers published recently, and the data do show what Dr. Bailar points out. They also show that the increase has not only plateaued but has, in fact, started to decline. I think Cole and his co- workers.

ELIZABETH FARNSWORTH: This is Dr. Cole of the University of Alabama who's a cancer researcher?

DR. DAVID NATHAN: Yeah. Cole and his co-workers pointed out that they too couldn't quite tell why the decline was taking place. They thought it was a little bit of a lot of things. Prevention techniques have improved; early diagnosis improved; and therapy has improved, so that, you know, I see this all as a very optimistic situation. I think we are starting to get on top of this problem, and I think Dr. Bailar would have to agree, it's very nice to see the curves beginning to plateau and, in fact, decline.

ELIZABETH FARNSWORTH: What about that?

DR. JOHN BAILAR: Well, first, we take strong exception to the analysis that Dr. Cole did. He got his--

ELIZABETH FARNSWORTH: We should say that the main--the headline of his report would be that cancer mortality rates are going down beginning in about '91 about--he thought about 2 percent a year, right?

DR. JOHN BAILAR: He thought the total of about 5 percent, as I recall.

ELIZABETH FARNSWORTH: From '91 until now.

DR. JOHN BAILAR: But he got that figure by projecting our current population and current cancer risks back to 1940 when the United States was a very different place; the distribution of ages in our population was different. Other diseases were having quite a different kind of impact. And we think 1940 is simply not an appropriate starting point for this.

ELIZABETH FARNSWORTH: But you do think that there's a plateau and that the cancer mortality rates are going down somewhat? Let's not- -

DR. JOHN BAILAR: Yes.

ELIZABETH FARNSWORTH: It's a debate over how much, but you think they are going down somewhat, but you think that the reasons for that are different than have bene publicized, is that right?

DR. JOHN BAILAR: That's right.

ELIZABETH FARNSWORTH: Why do you think they're going down a little bit, or plateauing?

DR. JOHN BAILAR: We think they have gone down perhaps 1 percent. I would like to wait a little bit longer to see this downturn confirmed, but if it isn't here yet, it's coming. When we look at the trends in different forms of cancer, as I have said, some going up, some going down, it's pretty clear that the overall picture is largely a reflection of how many people are getting cancer. The risks have gone up and down. To some extent it's a reflection of early diagnosis: mammography in women over the age of 50, the pap smear, other kinds of earlier diagnosis. We think that treatment has not had very much effect on a population-wide basis. There are some forms of cancer where treatment has been very effective, but they tend to be relatively uncommon.

ELIZABETH FARNSWORTH: Dr. Nathan, do you disagree with that, about the effectiveness of treatment?

DR. DAVID NATHAN: Well, the point that Dr. Bailar is making is that one form of treatment--chemotherapy--which I think he's referring to here, because I don't think Dr. Bailar would argue that surgery is an ineffective form of treatment, in fact, it's extremely important, or that radiotherapy is an ineffective form of treatment. Those have been the standbys of cancer treatment for a long time. It's chemotherapy that is probably the object of his inquiry here, and, of course, chemotherapy is, in fact, far more effective in young people than in old people, and cancer happens to be a disease which has an increasing risk as one ages. So one doesn't see the enormous value of chemotherapy in these cancer statistics. But, you know, I'm a doctor, and I take care of patients. And I take care of them one at a time. And when I started out doing cancer care in little children, I had a 100 percent failure. I didn't save a single child when I first went to the National Cancer Institute in 1956. And now my--my group at the Dana-Farber Cancer Institute and all around the world are salvaging children with cancer at a rate of 80 percent in childhood leukemia. Now, childhood leukemia is an uncommon disease, but it's awfully important if you happen to be a child with leukemia. So it really is--depending on how you look at this cup--half full or half empty--I think it's a triumph. But then again I take care of patients. Now--

ELIZABETH FARNSWORTH: Dr. Bailar.

DR. JOHN BAILAR: I think we might agree that the cup is half full.

ELIZABETH FARNSWORTH: Because you certainly are not recommending to people listening to us right now that they stop their treatment, right?

DR. JOHN BAILAR: Absolutely not.

ELIZABETH FARNSWORTH: However old they are.

DR. JOHN BAILAR: No. We are convinced that treatment has much to offer every person. Every person who has cancer or might have cancer deserves the earliest possible diagnosis and the best possible treatment. And that can save at least half of them, with a complete cure. It has a lot to offer for the ones who cannot be cured, and that also is very important. The problem--

ELIZABETH FARNSWORTH: You mean, in prolonging--making their life better.

DR. JOHN BAILAR: Making their lives better, as well as longer. They are much happier people. They preserve function. They can remain free. They stay on the job. They're in good communication with their relatives, their friends, with society. All of this is terribly important, but it isn't what we set out to do, which was to bring down the death rate. As I said, that's now a little bit higher than it was when we started.

ELIZABETH FARNSWORTH: What do you think should be done differently? What is the ratio right now between money spent on prevention and money spent on treatment?

DR. JOHN BAILAR: It's very hard to pin down.

ELIZABETH FARNSWORTH: I mean for research.

DR. JOHN BAILAR: It's hard to pin down the precise distribution of funds. The best estimate I can make is about four to one in favor of research on treatment. And I think that that should be tipped the other way to some degree, maybe two to one in favor of prevention. We're certainly not recommending that research on treatment be stopped.

ELIZABETH FARNSWORTH: Just a few examples of prevention. What would you do?

DR. JOHN BAILAR: Well, there are a lot of different approaches. One is to find out specific causes of individual cancers, individual forms of cancer, and get rid of them, such as turning away from the use of tobacco. There are some kinds of cancers that are caused by chemical hazards in the workplace. And we ought to deal with these wherever we can find the causes and remove them. But that is just the beginning of prevention.

ELIZABETH FARNSWORTH: Okay. Let me come back to that in a minute. Dr. Nathan, do you disagree about changing the--whether or not it's this ratio--changing the amount of money spent on prevention vis- a-vis treatment?

DR. DAVID NATHAN: Well, I must say that priority setting is one of the toughest problems in all of research and research administration. And the National Cancer Institute spends hours at the leadership level trying to decide where the best leads may be. After all, they depend on us. We are the investigators. Dr. Bailor is an investigator. I'm an investigator. And all they can do is receive applications from us and judge those by a process of peer review. There is not sitting around a guttering candle saying what percentage should go here and there. The National Cancer Institute has got to receive the best ideas they can and fund them. They can't fund all of them anyway because the budget won't allow it. Only about 25 percent of applications are actually funded in the end, and those are very, very hard decisions to make. Lord knows if somebody comes up with a great idea in prevention, we want to fund it, obviously. That would be terrific. But then if somebody has a wonderful idea that some compound that comes out of the bark of an unusual tree might help ovarian cancer, we want to pursue that too. It's very hard to know in advance. One has to take advantage of the science of the times. That's what National Cancer Institute tries to do.

ELIZABETH FARNSWORTH: Dr. Bailar, are you saying that given the mortality rate staying about the same--except I know in the case of young people they have changed quite a lot--

DR. JOHN BAILAR: Yes.

ELIZABETH FARNSWORTH: Are you saying that it's time to try prevention and see if that makes a difference in mortality rates?

DR. JOHN BAILAR: I'm saying it's time to get serious about research on prevention. We know how to prevent some cancers now, particularly the tobacco-related cancers. We do not know how to prevent a lot of other forms of cancer, and we need to learn what we can about that matter. Now, I must say right now that we have no guarantee that we'll ever be able to prevent all cancers, just as we have no guarantee that treatment will ever be fully effective. But we need to find out.

ELIZABETH FARNSWORTH: Okay. We have just a few seconds left, Dr. Nathan. Do you have anything else to add?

DR. DAVID NATHAN: The point is to do the best research possible in all phases: diagnosis, prevention, and treatment. If we do that, we'll get there, and, in fact, we are getting there. I'm very optimistic right now.

ELIZABETH FARNSWORTH: Well, thank you both very much for being with us.

JIM LEHRER: Still to come on the NewsHour tonight, brain development and a Gergen dialogue. FOCUS - BRAIN POWER

JIM LEHRER: Now, another medical story: the brain and how it develops. Scientific studies of babies' brains have begun to influence parents and policy makers. Lee Hochberg of Oregon Public Broadcasting reports.

LEE HOCHBERG: The facial expressions 16-month-old Joey Munson show in this laboratory experiment are not unusual. He's happy when his mom plays with him--but distraught when she leaves the room.

MOTHER: Mama's going to go bye-bye. [baby crying)

LEE HOCHBERG: What's interesting to University of Washington psychologist Geraldine Dawson, watching in the next room, is what's going on behind Joey's facial expressions, inside his young brain. Scientists have found that a baby's experiences--whether he's happy, whether he hears lots of music or speech, gets hugs and eye contact--actually change the physiological development of his brain--the quality and quantity of the electrical wiring between cells. And the better they're wired, the better his life will likely be.

GERALDINE DAWSON, Psychologist: What we're learning is that very early in life there are these periods when certain parts of the brain are being wired and that later in life that then these patterns will be very difficult to change.

LEE HOCHBERG: Scientists had thought the brain's wiring was complete at birth. But neurobiologists now believe this crackling noise inside the brains of infants is the sound of some 10 billion nerve cells connecting with each other, as in this animation; they're making the synapses that promote thought, emotion, and physical movement. Scientists now say the capability of those neural connections depends on whether the young child receives proper stimulation. It's a scientific confirmation of what seems like common sense. It's important what the baby sees, what the baby hears, even, says psychologist Dawson, whether the emotions he repeatedly feels are happy or unhappy.

GERALD DAWSON: What we believe is that by experiencing different emotions that you're stimulating different parts of the brain and that this then leads to connections between the synapses.

LEE HOCHBERG: Dawson studied the difference between the brains of infants whose mothers are happy and the brains of those whose mothers are depressed and unlikely to project happiness. She found that in the children of happy mothers the region of the brain specialized for joy showed considerable neural activity. But the brains of children with depressed mothers looked different.

GERALD DAWSON: What we found was that the area of the brain that was specialized for positive emotion showed less activity and the area of the brain that specialized for negative emotion showed more brain activity. In later life an individual like this will be more apt to respond negatively when they're stressed or they experience a negative event. They'll be less likely to feel positive about positive events in their environment.

LEE HOCHBERG: With language too the new science points to key periods when the infant's brain is being wired and needs the right kind of stimulation. University of Washington neuroscientist Pat Kuhl.

PAT KUHL, Neuroscientist: We used to think language began at the one year stage when kids started producing their first words and they started to understand words. Now what we're learning is well before the stage at which babies understand or produce any words at all, their hearing systems are beginning to be sculpted by language input.

LEE HOCHBERG: In a study, Kuhl sought to determine at exactly what age children's brains are being connected to learn language. She exposed infants to a "Ra" sound, and trained them to turn their heads when it changed to "La." American and Japanese children recognized the difference between "Ra" and "La" at the age of six months. When Kuhl repeated the experiment six months later, the Japanese children no longer could do so. She theorizes that between the ages of six and twelve months they had been exposed to Japanese, a language that doesn't distinguish between "Ra" and "La," so their brains had simply discarded the neural connections that had earlier helped them tell the two apart.

PAT KUHL: The baby's organizing; the brain is pruning some connections, maintaining others, and pruning some--this early period babiesare learning, something's going on, the brain is being sculpted and prepared for a particular language; it makes us pay attention to what goes on in that period.

LEE HOCHBERG: Kuhl says her findings suggest adults should talk frequently to their infants and test them early for hearing difficulties. As the infant's brain is being wired for language and emotion, connections also are being made for vision, also for mathematics and music and motor skills. The new insights have profound implications for parents and for policy makers. In April, the White House convened a conference on early child development.

HILLARY CLINTON: These experiences can determine whether children will grow up to be peaceful or violent citizens, focused or undisciplined workers, attentive or detached parents, themselves.

LEE HOCHBERG: First Lady Hillary Rodham Clinton asked physicians to suggest parents read to their young children, and she called for a greater investment in children aged zero to three. At the local level, some childcare centers have begun to structure their curricula around the new research. The school day for these two and three year olds at the Creative Children's Center in suburban Portland, Oregon, is jam-packed with sensory stimulation. Teacher Lucy Chaille says each activity is designed to stimulate a key area of children's brains.

LUCY CHAILLE, Preschool Teacher: If you can present color, music, sounds, textures, the brain is going to be making connections. The dendrites in the brain are just continuing to grow and thrive, and as you hear music in the environment, whether it's children singing, dancing, those things help the child, actually with patterning, puzzling, geometry, and it's just an exciting way, I think, of seeing the interconnections again in the brain and how it works.

LEE HOCHBERG: But child development experts note many children aren't fortunate enough to be in such attentive environments.

BOBBIE WEBER, Child Care Advocate: We also have a lot of very, very inadequate care, where children are kept in facilities that are close to sterile, where the numbers of children per adult are way too high.

LEE HOCHBERG: Bobbie Weber of the Oregon's Child Campaign, a collaborative public education effort of state and non-profit agencies, says good infant child care is rare and often cost prohibitive. She says even most working parents are unable to provide the stimulation that the brain research indicates is necessary.

BOBBIE WEBER: They don't have enough time; they don't have enough energy. The vast majority of families are trying to do what they know they need to do, and what the research tells us they need to do, but they're struggling, because the conditions for their success do not exist in their community.

LEE HOCHBERG: The state of Oregon is trying to help. It's integrating the brain research into its $8 million Healthy Start program in which social workers offer new moms and dads tips on good parenting.

MARY: There's activities that you can do to help stimulate the brain development.

PAULA: There's all kinds of things I wanted to know; like when he was in my womb, I heard the different things you could do, but I didn't know quite where to start.

MARY: So are you singing to him and talking to him?

PAULA: Well, the singing part, not much.

MARY: Actually they say some of the research in the first three years of life is the more you're talking to them, they're actually- -it is enhancing their math skills.

PAULA: Really?

MARY: Believe it or not. Yeah.

LEE HOCHBERG: Social worker Mary-Olivia Callow says some new parents are skeptical of the new research. But this mother wishes it had been developed when she was an infant.

PAULA BLAKE, Mother: I know there's a lot of potential that I have in me still and I wished that as a child that I would have-- somebody would have developed it better for me, helped me pursue it more. I could be, you know, an artist or something. Who knows?

LEE HOCHBERG: The state education campaign also gathers parents together to watch a recent television special about brain research. Even private companies have gotten involved. One pizza chain on the Oregon coast is distributing fliers about the new research with its pizza deliveries. The Oregon legislature is considering a $52 million a year package of bills for early childhood services that includes a child care tax credit for the working poor, required training for child care workers, and expansion of the state-funded Healthy Start and pre-kindergarten programs. And the governors of Florida and Minnesota have requested up to $150 million in new funding in their states. They say the new brain research should strengthen their case for increased public investment in early childhood services. DIALOGUE

JIM LEHRER: Finally tonight a Gergen dialogue. David Gergen, editor-at-large of "U.S. News & World Report," engages Paul Fussell, author of Doing Battle: The Making of a Skeptic.

DAVID GERGEN: Paul, World War II has entered American folklore as the good war, the last good war in many people's opinions. You had a very different experience and came to a very different conclusion. Tell us about it.

PAUL FUSSELL, Author, Doing Battle: Well, I think it was a good war in many ways. It was a war that stamped out evil on both sides of the United States, both the Atlantic and the Pacific. And it was a good war to the degree that medical treatment was much better than it ever had been before for the troops, and so on, but no war can be called a good thing. It is awful. It is hellish, irresponsible, murderous, corrupting, and I tried to show in my book wartime, the way that war corrupts, and not just people who fought it, but newspapers, journalism, the general popular language, and so on. We're just getting out of it now. But it's amazing how easy it is to shock people by suggesting it was a war and, therefore, it could not have been good. I'm fond of quoting Benjamin Franklin: "There's no such thing as a good war or a bad peace."

DAVID GERGEN: Your views are very much shaped by your own personal experiences. Let's talk about those .You grew up in Southern California, Pasadena, paradise, as you called it, went on to Pomona, and you seemed very much the innocent--

PAUL FUSSELL: Yes.

DAVID GERGEN: --coming out of that.

PAUL FUSSELL: Very much. I came from a privileged background.

DAVID GERGEN: And you then were called up during the Second World War, and you actually enjoyed boot camp.

PAUL FUSSELL: I did. I made the mistake of getting in the infantry. But at first it was rather fun. It was kind of athletic and lots of fun. It was fast, and amusing, and so forth, and then all of a sudden one realized what the infantry was for. It was for killing the maximum number of young men like you and on the other side, the Germans had that view, what they were doing, they were trying to kill us. And so after six months of that one became rather embittered about talk about how wonderful the war was. It was a wonderful war in many ways. It extricated appalling wickedness on the part of the Nazis.

DAVID GERGEN: But then you went off after your training--this was toward the end of the war--1944, you went off to Europe.

PAUL FUSSELL: Yes.

DAVID GERGEN: To fight.

PAUL FUSSELL: Exactly.

DAVID GERGEN: As a young second lieutenant.

PAUL FUSSELL: Exactly. Leading a rifle platoon, which is the absolute bottom of everything: authority, danger, and so on. And very few of those people survived.

DAVID GERGEN: Now, what opened your eyes?

PAUL FUSSELL: What opened my eyes? Well, it took a long time actually because it didn't happen all at once. But began opening my eyes was discovering that what I'd thought was a kind of fun setup of people marching in formation and wearing nice uniforms, nice patches on their shoulders and so on, gold bars, cross rifles, was an operation of mass murder closer to the criminalities known in New York and Chicago than anything noble. I should have known that already if I'd read enough, but I hadn't. And it took me a little while to get over that. But I think the moment that really jolted me worse was waking up one morning after we had relieved another unit on the front line in Alsace. This was in November, 1944, and I hadn't seen anything in the darkness when we arrived, but when dawn came, I noticed that we were lying in the midst of an immense field of dead German adolescent boys very much my age, very much people like me. And they'd been shot in various places. There were grenade fragments that hit them in various places. As I looked at those, I began to realize, God, this is what I'm doing here; I'm supposed to kill people like that, and, indeed, I can't survive unless I do so, while they're doing the same thing to me. And this is a "no win" situation, a classic. The only thing that's going to help is for the war to end, but I knew it wouldn't end because we had insisted upon unconditional surrender. It wouldn't end either until we got to Berlin or the Soviets got to Berlin, and found that the latter was the way it ended. And that's when I began to catch on about what war was and how we were really expendable, and that when we fell, other people would fill our ranks, and they would go on that way and go on that way and so on. And the people who were going to suffer were not the soldiers at all because once you're killed, you're out of it. You're in oblivion, as their families on both sides, the German and American.

DAVID GERGEN: Could you tell us for a moment about March 15, 1945.

PAUL FUSSELL: March 15, 1945. I was in an attack accompanied by my sergeant, who I'd been with all the way through training and knew very well, and another second lieutenant, who was in charge of the heavy machine guns, and we did pretty well until the action was almost over, and then the Germans performed a counterattack against us with a tank. And the tank shells came closer and closer and closer. And we were sort of trapped there on top of the German bunker, and I didn't want to run because I was afraid I'd start a panic or something like that, but finally a shell went off right overhead, and it killed both of them instantly. When I looked at my sergeant, I saw his skin changed from what we call flesh color to white, shirt-color white. I knew he was dead. I couldn't see the sergeant--I mean, the lieutenant on the machine guns because I couldn't turn around because I was being hit in the back and in the leg. And one of my men came and dragged me out of this carnage, and he got me to the medic, who helped resuscitate me and so on. But at that moment I thought I'd been killed, and I apparently had been metaphorically, because that moment caused me to meditate as follows: I was killed in 1945. Every month since then has been an absolute gift. And I've tried to enjoy them appropriately, and I've tried to exploit them appropriately, because I could so easily have been the third person killed on that occasion. And that shows how much luck has to do with it. Luck has much more to do with it than skill, alertness, training, knowledge, the things that you're invited to believe are so important. The important thing is luck, which you can't do anything about.

DAVID GERGEN: But yet, as much as you've celebrated these as gifts, each month that's passed, you also became very angry, and you became, as you say, a representative angry man in the 50's and 60's, and indeed, much of that anger pours forth in your memoir. Why the anger?

PAUL FUSSELL: Well, I hope I made it clear in my memoir was what made me really angry was suddenly watching the United States turn full circle and resuscitate the enemy, that is, the Soviet Union, that we've been celebrating all these years, not just for its success but for its bravery, clear-mindedness, virtue, and so on, and to be instantly replaced by another set of stage figures, the Germans. And that made me very bitter. This suggested that I hadn't really been fighting for any principles at all; I'd been fighting for stage notions or images that weren't at all certain, merely journalistic stuff.

DAVID GERGEN: Now, you've come through life then as a professor. You went on and got a Ph.D. at Harvard in English and taught English literature and poetry, and you quote much of it in your book. And you say that basically you've taken a stance of an ironist, of this dark, ironic sense of life.

PAUL FUSSELL: Yes.

DAVID GERGEN: What does that mean? What should people think about that?

PAUL FUSSELL: Irony is related to me, to the idea of tragedy, which is--you've lost already--you've lost already. Everything you touch is going to be defeated by time. You've lost. No matter what you make, no matter what you do, no matter what you achieve, you cannot win, because right behind you are other people who are going to do the same thing and going to wipe out your memory. So life is essentially ironic, but the distance between what you think will happen and what will happen is immense. And to be conscience of it all the time is to give you both a refined sense of humor and a refined sense of charity. It doesn't mean you stop your work or worse than you would otherwise. It's just that you don't feed your ego with the old materials. Everything you attempt is going to be not very good. It's hard for Americans to understand because this country is an 18th century country. And it was founded on optimism, founded on the sense that if we're all good people together, we're all going to be happy, and it's all going to be great. But that's not the way it is. We're still human beings, and we're our worst enemies consequently. And know that I think may not solve anything but at least it gives you a properly humorous outlook on things.

DAVID GERGEN: Paul Fussell, thank you very much.

PAUL FUSSELL: Thank you. RECAP

JIM LEHRER: Again the major stories of this Thursday, jurors of the Oklahoma City bombing trial heard closing arguments and are expected to begin deliberations tomorrow. Laurent Kabila was sworn in as president of Congo, formerly Zaire. He promised elections in two years. And a Pentagon spokesman said about 250 U.S. citizens will be evacuated from Sierra Leone because of violence there. We'll see you on-line and again here tomorrow evening with Shields & Gigot, among others. I'm Jim Lehrer. Thank you and good night.