The NewsHour with Jim Lehrer

GWEN IFILL: Good evening. I'm Gwen Ifill. Jim Lehrer is on vacation. On the NewsHour tonight, Elizabeth Farnsworth reports on the AIDS epidemic in Africa, beginning in the impoverished on of Malawi; we examine a new report on the sex differences in health care; Terence Smith looks at how the President, and the press, have handled his first 100 days in office; and NewsHour regular Michael Beschloss talks about the late Meg Greenfield's book "Washington." It all follows our summary of the news this Wednesday.

NEWS SUMMARY

GWEN IFILL: President Bush faced questions today about whether the U.S. would use military force to defend Taiwan. The issue came up in a series of interviews with various news organizations. A 1979 law requires the U.S. to provide Taiwan with weapons to defend itself against Mainland China. Beyond that, previous administrations have remained vague. Mr. Bush was first asked about the U.S. commitment on ABC's "Good Morning America."

CORRESPONDENT: I'm curious if you in your own mind feel that if Taiwan were attacked by China, do we have an obligation to defend the Taiwanese?

PRESIDENT GEORGE W. BUSH: Yes we do and the Chinese must understand that -- yes I would.

CORRESPONDENT: With the full force of American military?

PRESIDENT GEORGE W. BUSH: Whatever it took to help Taiwan defend herself.

GWEN IFILL: Separately, the President told the associated press, the use of American force is "certainly an option" if China ever invades Taiwan. Later, on CNN, he was asked to what the United States would do if Taiwan declared independence before any Chinese invasion

PRESIDENT GEORGE W. BUSH: I said I would do what it takes to have Taiwan defend herself, and the Chinese must understand that. Secondly I certainly hope Taiwan adheres to the one-China policy and a declaration of independence isn't the one China policy and we'll work with Taiwan to make sure that doesn't happen. We need a peaceful resolution of this issue.

GWEN IFILL: The President went on to say he was simply repeating the position he'd taken during his campaign. His comments followed his decision yesterday to sell advanced weapons to Taiwan, including submarines and destroyers. In Beijing today, China's Communist government protested the sale and threatened to scale back cooperation on arms control. Mr. Bush today also addressed other issues in reviewing his first 100 days in office. He said he'd compromise on a tax cut. He conceded it was likely to be less than the $1.6 trillion he wanted, but more than the $1.2 trillion the Senate approved in its budget outline. He also said the biggest mistake he'd made so far, was allowing himself to be labeled anti- environment and he said it's "unrealistic" to think, America is ready to ban abortion. The city of Davenport, Iowa watched and waited today after the Mississippi River crested there last night. Tom Bearden has our report.

TOM BEARDEN: Davenport's sandbag levy survived the night as the river reached what city officials hope was the crest of the flood of 2001 -- 22.3 feet -- just inches shy of the record set in 1993. Pumps are still keeping up with leak yang through the storm center system. City Public Works Director Dee Bruemmer briefed reporters on the situation this morning.

DEE BRUEMMER: We had some sloughing off of the earth and berm which we're adding more bags to this morning so there is some work still being done on that earth and berm. But we think that he can hold it here.

TOM BEARDEN: But she was quick to add there is still considerable danger.

DEE BRUEMMER: Oh, it's not over. Last night's rain kind of tells you that. We can't go sit in our vehicles and we have got to be very attentive. This is still, we're still waging some battles here. And you can't turn your back on a floodwall that has seven feet of water on it.

TOM BEARDEN: Bruemmer said city officials were looking forward to tomorrow's meeting with the Director of the Federal Emergency Management Agency, Joe Allbaugh. An Monday, Allbaugh was critical of the city's 1984 decision not to build a permanent floodwall and questioned whether taxpayers ought to continue paying repeated claims for damage under the federal flood insurance program.

JOSEPH ALLBAUGH: It is not fair to the American taxpayer to ask them time in and time out to pay for rebuilding.

TOM BEARDEN: Davenport Mayor Phil Yerington had responded angrily to those statements yesterday.

MAYOR PHIL YERINGTON: It's time to stand up and say let's sit down and work this out but don't make it look like we don't pay any dollars anywhere - we just sit here in the Midwest, we flood every three years, and we stand with our hands out, because that's not what's going on.

TOM BEARDEN: Bruemmer said the two spoke by telephone this morning.

DEE BRUEMMER: They are looking forward to meeting each other. He said he thought director showed his interest in what we're doing -- very interested in how we're doing flood protection and very compassionate for what's going on here. And so we're looking forward a very good meeting tomorrow.

TOM BEARDEN: The city hopes Allbaugh's visit will lead to a presidential disaster declaration making the city eligible for federal relief funding.

GWEN IFILL: 70 davenport homes are underwater. And city officials say they've spent at least $1 million dollars fighting the flood. The U.S. Supreme Court today heard arguments about restricting tobacco advertising. Massachusetts had tried to ban cigarette ads in stores near schools or playgrounds. But tobacco companies said they'd already agreed to stop using billboards in 1998 and the state, they said, had no authority to add to the existing federal curbs. The Massachusetts attorney general said the additional regulations are needed to protect children. Puerto Rico's governor today asked a federal judge to block Navy bombing exercises on the island of Vieques. The training has been suspended since March, but it's scheduled to resume Friday. In 1999, a Puerto Rican civilian guard was killed by stray bombs dropped from a Navy jet. The incident touched off angry protests. Police in the Philippines arrested and jailed former President Joseph Estrada today on corruption charges. Thousands of people protested the move and tried to prevent it. We have a report from Lindsay Hilsum of Independent Television News. (Crowd reacting )

LINDSAY HILSUM: As Mr. Estrada was taken away, his supporters made their feelings clear. There were scuffles and some arrests. They say their hero is being picked on because he's not a member of the Philippines' traditional elite, but one of them. Mr. Estrada was a movie star before he became a politician. He played Robin Hood-type characters, which is why he's popular with the poor. They camped outside his Manila house for days. In the end, however, their man gave himself up. Police were taking no chances as they drove him through the streets. The former President, who is accused of stealing $82 million, will be housed in a 12x18 foot cell -- described as spartan but cozy. After a medical examination, Mr. Estrada was photographed and fingerprinted.

GWEN IFILL: Estrada was forced from office last January after a popular revolt. The country's Vice President was sworn in to replace him. In economic news today the U.S. Commerce Department reported durable goods orders were up 3% in March after falling for two months. The increase was driven mostly by orders for tanks and ships. In a second report, the Department said new home sales jumped 4.2% in March to a record high. That's it for the News Summarytonight. Now it's on to, AIDS in Africa; women's health issues; the President and the press; and Meg Greenfield's "Washington."

FOCUS - AIDS IN AFRICA

GWEN IFILL: Tomorrow, African leaders will gather in Nigeria to confront their greatest health problem, one of the worst the world has ever known-- the death and devastation of AIDS. Elizabeth Farnsworth has just returned from Africa. Here is her first in a series of reports -- this one from Malawi, a country of 10 million people where nearly 1 million have the disease. A warning: This story contains strong and disturbing images.

ELIZABETH FARNSWORTH: It's hard to grasp the scope of the AIDS catastrophe engulfing southern Africa, until you see it up close: the hospitals overflowing with patients ill from pneumonia, meningitis, or TB -- opportunistic infections that kill as a result of AIDS; the desperately sick.... nearly all of them young; a 33 year old accountant, husband and father; a 26 year old bakery manager; and Issac Nakhupe--age 30 -- with a newborn at home. On this day his brother had to prop him up in bed. Children are sick too --- they get HIV from their mothers in utero, during birth, or while nursing. 11% of the one million with HIV/AIDS in Malawi are kids. This woman has three children; she probably has AIDS but there's no way to know, because this hospital often can't cover the cost of gloves or clean needles -- let alone the chemicals necessary to test widely for the disease. Dr. Ajib Phiri struggles to provide what care he can. He suffers from his own sorrow...

ELIZABETH FARNSWORTH: Have you lost friends and family yourself?

DR. AJIB PHIRI, Mulanje District Hospital: Yes, I have lost a sister -

ELIZABETH FARNSWORTH: To HIV?

DR. AJIB PHIRI: -- to HIV/AIDS.

ELIZABETH FARNSWORTH: When?

DR. AJIB PHIRI: It was three months ago.

ELIZABETH FARNSWORTH: Dr. Phiri's sister...... the sick in this hospital...... the almost 1 million in Malawi with HIV/AIDS. They join 25 million more in the region -- in Botswana, Zimbabwe, South Africa and the other sub-Saharan countries where rates of infection are higher than anywhere in the world. In some parts of these countries, including Malawi, 1/3 of all adults are infected. 17 million people in Africa have already died of AIDS... this is the scope of the African AIDS catastrophe, which Malawi's vice president says the rest of the world must begin to grasp....

VICE PRESIDENT JUSTIN MALEWEZI, Republic of Malawi: HIV/AIDS in Malawi and everywhere is more than a disease. It affects everyone; it affects all sectors of society, and everyone in Malawi is either affected or infected one way or the other. This is not an African problem; this is a world problem!

ELIZABETH FARNSWORTH: And there are questions the world must answer -- says nurse Maryline Mulemba of the group "Doctors Without Borders".... :

MARYLINE MULEMBA, Doctors Without Borders: Is the world ready to lose 1 million people in Malawi and 30 million people in Africa? I don't know if we really can afford this....I don't think....

ELIZABETH FARNSWORTH: Malawi, once called Nyasaland, is one of the 15 poorest countries in the world. it's also very beautiful --- especially Lake Malawi, which is rich with history. Dr. David Livingstone sailed north on these waters in his quest for the source of the Nile. But the colonial rulers that followed his explorations, and a post- independence dictatorship misused this country, and now the best land is planted in tea and tobacco for export, while most people barely survive on the corn, sorghum and beans they grow on tiny plots. Poverty -- with its accompanying malnutrition, worker migration and lack of education -- has helped fuel the epidemic, and scenes of sadness like this are now common. A three-month- old baby had died in the night in Ntonya Village not far from the southern border with Mozambique. A neighbor offered condolence and a prayer; she regularly visits the sick in this village--as part of a government health program supported by the U.S. non-profit, Project Hope. She said the baby probably died of AIDS. The mother died a few months ago; the father last year. The grandmother, Line Urwe, is caring for what's left of the family...five orphans. I asked her how she survives.

LINE URWE: (speaking through interpreter) It's difficult to take care of the children. I do piece work in the fields when I can, but it's hard.

ELIZABETH FARNSWORTH: Right now do you have enough to eat?

LINE URWE: We don't have enough food for the coming year because all of our crops were washed away with the floods.

ELIZABETH FARNSWORTH: There has often been hunger here and life expectancy has always been low...but villagers say they have never seen anything more devastating than AIDS.

INTERPRETER: Out here, there have always been diseases, but what we have now is different. our major concern is AIDS. In my lifetime, I've never seen anything like it.

MARYLINE MULEMBA: If you would say tomorrow one million people will die because of an earthquake, everybody will rush here and bring help; but people will die slowly and in silence more or less; the help coming in is still very slow.

ELIZABETH FARNSWORTH: The Malawi government, led by President Bakili Muluzi, has launched an effort -- highly praised by the United Nations and others -- to prevent more deaths. Here -- as elsewhere in Southern Africa -- the HIV/AIDS epidemic is spread mainly through vaginal sex between women and men. In every part of the country, billboards warn that "AIDS kills" and urge Malawians to "change their behavior." The government also mandates AIDS education in schools. The U.S. group, Project Hope, helps fund the "AIDS club" in this school in southern Malawi; and when we visited, the kids put on a show for their benefactors. (children singing) They sing --- "AIDS is almost everywhere. Boys and girls, don't forget that it can send you to the grave!" The government is also enlisting the help of traditional healers -- often referred to as "doctors" here -- -- who had in the past performed circumcision and other procedures without clean razor blades but who now know better. This healer is regularly preaching abstinence or safe sex...and advising patients like this one to get tested for HIV.

ELIZABETH FARNSWORTH: Do you know where you got HIV/AIDS? Do you have any idea how you caught it?

JACKSON ALLIE: (speaking through interpreter) Yes, I'm a carpenter, and I'm only 26. I move around a lot with my carpentry and go with lots of women, so I'm suspecting I got it from there.

ELIZABETH FARNSWORTH: Are you using a condom when you have sex?

JACKSON ALLIE: (speaking through interpreter) The doctor here has advised me to stop any sexual activity right now; so I've completely stopped while I'm taking this medication from her.

ELIZABETH FARNSWORTH: The healer claims the medication -- a potion made from tree roots -- cures AIDS, and in the absence of any other medical solution, many people, including highly educated ones, are seeking this kind of help. The vice president says the scientific validity of the potion is immaterial; what counts is the safe sex message.

VICE PRESIDENT JUSTICE MALEWEZI: When she gives her potion and says when I'm giving my potion there should be no sexual relationship, that is what it is important to me because it will prevent, help to prevent the transmission

ELIZABETH FARNSWORTH: The government is also doing what it can to improve care for those with AIDS but lacks the funds to do much, says the chief physician at Malawi's best public hospital, Queen Elizabeth in Blantyre.

ELIZABETH FARNSWORTH: I asked him why there isn't enough funding.

DR. C. M. NYRINDA: -- lack of money - -the lack of financial resources.

ELIZABETH FARNSWORTH: And is it just that the government doesn't have enough money or that they're not devoting the money?

DR. C. M. NYRINDA: The government hasn't got enough money. It's not only Ministry of Health - it all ministries - it's Ministry of Education, of Agriculture, it's all the ministries who are equally involved, but here we do feel we're talking life and death.

ELIZABETH FARNSWORTH: And so in villages like this one, where corn crops are uncertain, water is unclean, and some people are very sick, volunteers are stepping in to fill the gap. Goodwin Horiab is one of 72 members of a volunteer organization called SASO, the Salima HIV /AIDS Support Organization. He visits the sick in this village several times a week. He believes this woman -- Livetia Moluzi -- has AIDS. Her husband died a few years ago -- her daughter and a grandchild more recently. She lives with her three surviving children, one of whom is disabled from polio and with her orphaned grandchild, who does most of the chores.. Moluzi got an antibiotic at the hospital for sores on her head and special salts for rehydration...and Goodwin Horiab reminded her to take the medication as prescribed and to be sure to boil the water. But these medications can't save her life; and Goodwin Horiab said he's angry the AIDS drugs being used in developed countries are not available here.

GOODWIN HORIAB: (speaking through interpreter) Well, unfortunately everything good starts from those countries, and then the last scraps come to Africa. And we're always getting the bottom of everything. Since things have been that way, I guess with AIDS that's the way it's going to be.

MARYLINE MULEMBA: Of course we need to continue focusing on prevention, to try to reduce transmission and that less people get contaminated, but we need also to treat the ones who are infected because we can't afford to lose them all. And to be able to treat them we need to have the drugs in -- and we need to have the infrastructure to be able to do it.

ELIZABETH FARNSWORTH: Goodwin Horiab is convinced that he and other volunteers could be part of that infrastructure.

GOODWIN HORIAB: (speaking through interpreter) We have home-based care volunteers who have been trained to deliver medication. One way to do it would be to have the same home-based care people trained in AIDS treatment and come give the medication to patients.

ELIZABETH FARNSWORTH: SASO volunteers have already been trained to test for AIDS...and they said they could also monitor patients on AIDS drugs, if doctors had them to prescribe. The monitoring will be crucial because the virus develops resistance when pills aren't taken correctly. At Queen Elizabeth hospital in Blantyre, the government already has a very small pilot program providing antiretrovirals (ARV's) -- as they're called -- to a handful of people who can pay. But the government is also committed to making the ARV's much more available.

VICE PRESIDENT JUSTIN MALEWEZI: We are advocates for anti-retrovirals as part of the prevention as well as treatment, because, as you know, once a person is on the ARV's, the transmission rate is greatly reduced; so it is part of the prevention.

ELIZABETH FARNSWORTH: First there is much to do. The plan is to seek more financial help from abroad to get the chemicals and training to upgrade labs like this one. Pilot programs would test whether the pills can be safely administered to the very poor. Already, healthcare workers are being prepared to give the medication, which prevents mother-to-child -transmission, and groups like Doctors Without Borders are gearing up to help.

MARYLINE MULEMBA: If you want to do anti-retrovirals, it has to start somewhere, and we need to learn how to do it in this context, because actually nobody has done it in this context.

ELIZABETH FARNSWORTH: Malawi is negotiating now with a German pharmaceutical company to get the mother-to-child drug free or very cheaply, as are other governments in the region. But to serve all the people who need help, the vice president says a "huge" flow of aid from outside will be necessary. .

VICE PRESIDENT JUSTIN MALEWEZI: For Malawi the figure is about $4.6 billion over a five-year program.

ELIZABETH FARNSWORTH: So far, the United States, the United Nations and others have pledged only a little over $100 million for Malawi's anti-AIDS program. So for Livetia Moluzi and others who are sick here, the outlook is bleak. Four people have already died in these huts in the past three years. Livetia Moluzi wonders if she will be next.

GWEN IFILL: In Africa and in the West there is a growing debate over the best way to provide treatment. Elizabeth is preparing additional reports on AIDS in Africa, which will air next month; they will also feature Botswana and more on the debate over drugs, pricing, international assistance, and AIDS.

GWEN IFILL: Still to come on the NewsHour, women's health issues; the President and the press; and Meg Greenfield's Washington.

FOCUS - GENDER GAP

GWEN IFILL: Sex differences and medical research. We begin with some background from Susan Dentzer of our health unit, a partnership with the Henry J. Kaiser Family Foundation.

SUSAN DENTZER: For the past decade there has been a daunting awareness that differences between the sexes play a surprising large role in health and disease. Take heart disease. Research has shown that women are more likely than men to exhibit symptoms like shortness of breath and fatigue, rather than the classic chest pain. That fact has often led doctors to misdiagnosed women's complaints. What's more many debilitating autoimmune diseases like multiple sclerosis affect women eight to nine times more frequently than men. Yet, much of medical research seldom took such sex based differences into account. Phyllis Greenberger heads the Society for Women's Health Research.

PHYLLIS GREENBERGER: One of the things that was not happening, which was actually documented in an earlier report of public health service report that was women were routinely being included in clinical trials. And that's medical research. And if you're not having women in medical research, then you're not going to have the answers to these conditions.

SUSAN DENTZER: As a result, Congress passed legislation in the early 1990's, ordering that women be included in federally-funded trials testing new medical treatments. But there is growing evidence that sex based differences are more pervasive than previously thought. So the National Institute of Medicine issued a report called "Does Sex Matter?". Harvard immunologist Denise Faustman talked about the need to address the differences at a Washington press conference today.

DR. DENISE FAUSTMAN: For many, many years the protection of women drugs were predominantly examined during the approval stages and different phases of clinical trials in men not women to protect women from possible side effects from being pregnant. So many of the drugs we have on the market efficacy in women isn't known even though they're prescribed equally to men and women.

SUSAN DENTZER: The IOM report said sex-based differences can be seen from woman to tomb starting at the cellular level.

DR. MARY-LOU PARDUE: Female cells are in many cases having more genetic information expressed than male cells.

SUSAN DENTZER: The report urged to be taken into account more broadly at all levels in biomedical and health research.

GWEN IFILL: Joining me now is a member of the committee that produced today's report, Dr. Sally Shaywitz, a professor of pediatrics at the Yale University School of Medicine.

Welcome, Dr. Shaywitz.

SALLY SHAYWITZ: Thank you.

GWEN IFILL: So the bottom line in today's report is that men and women are different. What's the big deal?

SALLY SHAYWITZ: The big deal is that for the first time, we have followed evidence that sex matters, that sex is an important biologic variable that affects the health and well-being of people and that it becomes important to study sex differences. In the past, we've learned about sex differences as a byproduct of other research. But we've now been able to gather a corpus of evidence that shows that there are sex differences in the cell, at a molecular level, in organs, in organ systems, and sex differences that affect the health and well-being of people, so that we have matured enough in the study of sex differences to say that now is the time to really begin to study sex differences as important in and of themselves.

GWEN IFILL: But why now? A lot of the bits and pieces that you're describing we've discovered have been reported in various reports, but today it comes together in one report, which you all say is going to turn the corner. Why now?

SALLY SHAYWITZ: Well, why now is because the Institute of Medicine has done a thorough study and shown that at every level, there are important sex differences. But now we have to begin to design experiments so we can understand what do they mean? How can we best use this information to benefit the health and well-being of men and women?

GWEN IFILL: How many of the differences that you're talking about are the kind of hormonal differences we're all familiar with, and how many of them are physiological, biological, genetic?

SALLY SHAYWITZ: Well, that's the exciting thing about this report. This report was put together by the committee and understanding the biology of the sex and gender differences. In the past, people have focused, for example, on social and cultural explanations. But over the last several years, there's been a number of very exciting discoveries that have pointed to sex differences at very basic and fundamental biological levels. So the question is now, how can we use that information to further studies at this level, but also, to apply to the study of human health and disease?

GWEN IFILL: Which diseases are you talking about when you talk about studying specific diseases with an eye towards sex differences?

SALLY SHAYWITZ: Well, that's the exciting thing, is that because every cell has sex, and there are sex differences in every cell in the body and in every organ, we need to begin to study the cells at the basic level, but also expand that study and design studies so that we can find out about sex differences and disorders that affect the brain, the heart, the kidneys, liver. We know a great many. We know, for example, that there's a significant sex difference in the prevalence of many diseases and the severity of diseases.

GWEN IFILL: Which diseases, for example?

SALLY SHAYWITZ: Oh, heart disease, for example, what we call autoimmune diseases. Many of them, for example, rheumatoid arthritis, affect-- lupus-- affect-- thyroid disease-- affect primarily females. But there are some - a disorder called "Good Pastures" _- - that affect primarily males.

GWEN IFILL: We're not just talking about diseases that have their root in reproductive production.

SALLY SHAYWITZ: That's really such an important point. The exciting thing is that these differences have been found in all cells and in oral organs and, in fact, in the brain. So that it has been known that, for example, that there are sex differences in the brain involving reproductive functions. But more recently we've discovered sex differences in the brain that controls many other functions, including how we behave and how we speak.

GWEN IFILL: Now we use this... Now that we know this report shows us an understanding of why this exists, how do we use the findings in this report to prevent disease?

SALLY SHAYWITZ: All right, well, I think we have to first go further. And in the report, there are a number of recommendations that talk about barriers, and we have to address those barriers so that we can apply this knowledge. One barrier is simple terminology. People use the terms "sex" and "gender" interchangeably -- and science and the scientific process would be benefited by having consistent use of the terms.

GWEN IFILL: Why are they different?

SALLY SHAYWITZ: Well, one explanation that I think... That I find very appealing is that if you were to ask an archaeologist, and that archaeologist would tell you, "well, to know the sex of an individual, I would look at their bones." But if I wanted to know their gender, I'd probably look at their artifacts. So...

GWEN IFILL: Go ahead.

SALLY SHAYWITZ: So that we would say that the sex of a male or a female really reflects their reproductive organs and the chromosomes that led to that reproductive status, whereas the gender of an individual-- male or female-- would more reflect how that person identifies, how they see themselves, and how society views that individual.

GWEN IFILL: You have done some extensive research on sex differences involving the brain. Explain that to me.

SALLY SHAYWITZ: Well, that's very exciting. It's been known for a long time, for example, that if a male compared to a female had a stroke involving the left side of their brain, if the stroke occurred in a male, that male would be much more likely than a female to have the detriment in their verbal ability compared to a female, but the question was, why? And what's now possible because of an exciting new technology called functional magnetic resonance image. And essentially uses... If you had an MRI because you've had a headache or anything, it's the same scanner but a smart version. And you can have people in the scanner doing tasks. You can ask them, "do these two words rhyme?", For example. And we did that with a group of healthy men and healthy women, and we could see what parts of their brain were activated as they were trying to do this task. And when we examined the data, we found very significant differences between males and females. Males activated the left side of the brain, whereas females activated the left but the right as well. And what was even more interesting was that there was no difference in how accurate the males or females were or how quickly they could do the task. And I think this points out a very, very important finding -- that is that we're not talking about who's better and who's worse, because that's a silly question. What we're talking about is that it's possible for males and females to go about doing the task by different routes, but coming to the same result. So I think that's really important, and that gets back to what you asked me initially. I began by talking about the... what happens when a male versus a female has a stroke. So now we know, because males only have representation on the left -- if they have a stroke on the left side of the brain, that is going to have a profound impact on their language. But if a woman, a female has this, she still has the right side to call upon.

GWEN IFILL: Do the findings in this report more profoundly affect women's health or men's health or everyone's potentially?

SALLY SHAYWITZ: Well, I think our sense is, if we can understand... For example, women seem to be protected against heart disease until they are post menopausal; but if we can understand, for example, those protective factors better, we might have a clue to understanding why males tend to have heart symptoms earlier. So our belief, and I think it's a correct one, is by understanding sex differences that are so important, these will provide clues to better health for everyone, males and females.

GWEN IFILL: How do you sell this now in terms of practical implications, practical research, practical difference in the outcome?

SALLY SHAYWITZ: Well, I think what we need to do is, one, have an awareness of the importance of sex, as what we would say a biologic variable, so that studies can be designed to examine this; and an awareness, for example, among physicians; that it matters if you're prescribing a particular drug to a male or female. And, in fact, several drugs have been pulled off the market because they cause very serious arrhythmias in females. So this isn't just a theoretic issue. There are already known, profound sex differences that have major medical implications, but the more we can understand at the basic and cellular level that affect all cells, the better we can plan treatment and diagnose individuals and hopefully prevent disease.

GWEN IFILL: Several steps beyond Mars and Venus.

SALLY SHAYWITZ: I think so.

GWEN IFILL: Dr. Sally Shaywitz, thank you very much for joining us.

SALLY SHAYWITZ: What a pleasure. Thank you.

FOCUS - THE PRESIDENT AND THE PRESS

GWEN IFILL: As George W. Bush completes his first 100 days in office, media correspondent Terence Smith looks at the President and the press. (Cheers and applause )

TERENCE SMITH: The first 100 days, the so-called "honeymoon" period for a new President and the press. It is often the time when the media takes the measure of a man, and helps create an image that can last for an entire presidency.

ALEXIS SIMENDINGER: I think they have given him a very generous ride in the beginning.

SPOKESMAN: There's been relatively little controversy on the inside.

SPOKESMAN: Its very difficult for a honeymoon to last very long anymore, as President Bush is discovering.

TERENCE SMITH: The Presidential image is shaped on a daily basis.

ARI FLEISCHER: Good afternoon.

TERENCE SMITH: Ari Fleischer, the President's press secretary, says dealing with the White House press crops requires substance, patience, and humor.

ARI FLEISCHER: Sometimes I think the White House press won't be satisfied until there is President-came in the Oval Office, so they can watch him 24 hours a day with everything he does. We work very hard to work with the White House press corps, but I know always it will never be enough.

TERENCE SMITH: The White House media has grown in size and changed in attitude since John F. Kennedy first used television to craft his image.

SPOKESMAN: Washington's new State Department auditorium is the scene of John F. Kennedy's

first Presidential news conference, the first ever broadcast live to the nation.

KENNETH WALSH: He tried to ingratiate himself with the media.

TERENCE SMITH: Kenneth Walsh, White House correspondent for the "U.S. News and World Report," wrote the book "Feeding the Beast," about the relationship between Presidents and the press.

KENNETH WALSH: Largely because of the Watergate, and the Vietnam and the Clinton impeachment situation, we have a cynicism on our side in the media that's going to be very difficult to change. So I don't think you could replicate the Kennedy situation. There's just too much hostility in the air.

TERENCE SMITH: Nevertheless, most Presidents start out trying to have cordial relations with the White House media.

PRESIDENT LYNDON B JOHNSON: I always want to remain accessible. And I hope that the press will never be critical of me for being over accessible. (Laughs )

TERENCE SMITH: George W. Bush regularly jokes in front of the press. Here, he is asked if he has gotten Vice President Cheney a birthday present.

PRESIDENT GEORGE W. BUSH: As a matter of fact... ( Laughter ) some used coffee cake, perhaps.

ALEXIS SIMENDINGER: He has a very nice way with reporters in terms of rapport.

TERENCE SMITH: Alexis Simendinger covers the White House for "National Journal."

ALEXIS SIMENDINGER: He nicknames them, he remembers them from the campaign, he remembers things about their family life, their children.

PRESIDENT GEORGE W. BUSH: When's your baby due?

ALEXIS SIMENDINGER: He is very - a personable person, and he does try to relate to reporters one on one.

PRESIDENT GEORGE W. BUSH: Ann, good to see you.

ALEXIS SIMENDINGER: Does it change the way they cover him, not a bit. I don't think it changes their disposition toward his agenda or his policies at all.

TERENCE SMITH: The President has won points for his self-deprecating humor, which was on display before the recent Radio and Television Correspondents Association Dinner.

PRESIDENT GEORGE W. BUSH: I actually said this in New Hampshire. "I appreciate preservation. That's what you have to do to run for President. You gotta preserve." (Laughter) I don't have the slightest idea what I was saying there. (Laughter)

TERENCE SMITH: In his apparent ease with the press corps, George Bush may seem like his father, who spoke informally to the media, early and often.

PRESIDENT GEORGE W. BUSH: I hate to do this, but there has been a tremendous demand to answer a couple of questions.

TERENCE SMITH: Political scientist Martha Joynt Kumar has studied Presidents for a quarter century. She says the difference between the two Bushes are as striking as the similarities.

MARTHA JOYNT KUMAR: His son puts much more emphasis on communications than did his father. His father was not interested in communications, did not have a large communications apparatus that thought in terms of a message.

TERENCE SMITH: This Presidents' press style is more reminiscent of Ronald Reagan's. The great communicator has a tightly controlled White House communications operation and press access to the President was so limited, that reporters took to shouting questions at him on the White House lawn.

REPORTER: We haven't heard from you in a while.

PRESIDENT RONALD REAGAN: What?

REPORTER: We haven't heard from you in a while. What have you got to say?

SPOKESMAN: People just, in the end, didn't care about a lot of the issues that we in the media were focused on with Reagan, whether he was engaged enough, whether he had the energy to be President, whether he was smart enough -- some of the things today we see will President Bush.

TERENCE SMITH: For George W. Bush, "managing the message" is key. The President has five or six themes that he and his staff hammer home.

PRESIDENT GEORGE W. BUSH: It is in our nation's best interest to have long term tax relief. And that has been my focus all along.

BILL PLANTE: Bush himself is far more involved and interested, I think, than Ronald Reagan was.

TERENCE SMITH: CBS news correspondent Bill Plante has covered Presidents Reagan, Clinton, and now Bush.

BILL PLANTE: They have managed the message successfully in that what they have done on a day-to-day basis generally tracks what they want to talk about. What we want to talk about isn't always the same thing.

TERENCE SMITH: Ari Fleischer is not apologetic. This White House, he says, will continue to deliver its message any way it can.

PRESIDENT GEORGE W. BUSH: I like to get out of Washington, Bill.

TERENCE SMITH: Including the using local media, which some say may be less critical, and more sympathetic.

ARI FLEISCHER: The White House press corps, the Washington press corps, typically covers what I call the "sport" of this business. "In a victory for... Today President Bush." And the substance of what President Bush proposed is typically toward the bottom of the story. The local press corps covers much more of the policy toward the top of the story. They are much less interested in telling their readers who won and who lost.

TERENCE SMITH: But efforts to control the story of the day can backfire. Outside events have a way of inserting themselves.

TERENCE SMITH: Is there such a thing as controlling the message too much?

ALEXIS SIMENDINGER: Usually, what you see is a press corps that rebels against that -- especially a press corps that is very tightly, physically, geographically confined to a secure place like the White House is.

SPOKESMAN: Watch the cables.

ALEXIS SIMENDINGER: All Presidents, I think, find out sooner or later that the down side is that if you don't tell your story yourself, and if you are not candid enough to try to open up the doors to the questioning press corps, that they will find a way to tell the story for you, and this is not usually a way that you like.

TERENCE SMITH: George W. Bush and his staff are painfully aware of the early communications mistakes made by previous Presidents, including the first President Bush. This administration seems determined not to repeat those mistakes, and they have assembled a team of aides that includes some very well versed in the ways of Washington.

MARTHA JOYNT KUMAR: In a sense, you create your own luck. Republicans come in a far more organized manner than democrats in recent years have tended to do. They didn't focus during their transition in setting up their White House, getting things organized.

TERENCE SMITH: In fact, by general consensus, Bill Clinton squandered his honeymoon with self-inflicted political wounds over gays in the military and aborted cabinet nominations.

BILL PLANTE: There was too much going on and too much of what was going on was controversial. There was disorder everywhere, chaos, people screaming in and out of the Oval Office, endless meetings, late night pizza, people wearing jeans. You name it. So there was no shortage of stories out here in January, February, March of 1993.

TERENCE SMITH: And Plante says, controversies surrounding bill Clinton as he left the White House-- the pardons, the pricey New York office space-- were a boon to the incoming Bush administration.

BILL PLANTE: He came into office with this enormous gift. The gift was the way Bill Clinton left his place. I mean, by comparison he had to look good, at least for a little while.

TERENCE SMITH: Ari Fleischer thinks the press went too far.

ARI FLEISCHER: The Washington press corps couldn't let the poor man go. The American people already had.

TERENCE SMITH: So you think it was overkill?

ARI FLEISCHER: I do.

TERENCE SMITH: The press secretary describes the early coverage of the President as "fair," but even he recognizes that the honeymoon will not last when contentious issues arise.

ARI FLEISCHER: Invariably the press coverage turns, it always will, and now we are into the serious policy mode. I'd like to say that the rubber is hitting the road.

TERENCE SMITH: And the continuous cycle of news, on cable, local television and the Internet, raises the stakes.

BILL PLANTE: This keeps everybody on edge all the time. Forces the administration, any administration, to respond more quickly than they might have.

TERENCE SMITH: Does that affect, or at least potentially affect the honeymoon, and a President's standing with the press?

BILL PLANTE: It has potential effect on everything the White House. Missteps are easier.

SPOKESMAN: 15 seconds...

TERENCE SMITH: Because news travels so quickly, and is universally available...

SPOKESMAN: In Washington today...

TERENCE SMITH: ...Editors and producers today demand more "edge" in stories out of the White House.

KENNETH WALSH: The feeling is that if you do a hard-edged story that is about conflict, and that is critical, you are much more likely to get played in your news organizations, have the story taken seriously, and played up, than if you do a positive story. The idea of conflict, the idea of criticism is the coin of the realm.

TERENCE SMITH: In the inside-the- beltway world of Washington, can it be... that straight reporting of a new Presidents agenda is no longer considered... news?

ARI FLEISCHER: There is a problem in the media, and the problem is that viewership is declining, readership is declining, and I think journalists have to fundamentally ask themselves why? Are they distancing themselves too much from the readers and the viewers they serve? Is their mindset fundamentally different from the people who they serve? And that is something that I think particularly the Washington press corps has to examine.

TERENCE SMITH: In the meantime, as the traditional honeymoon period slips away, Ken Walsh believes the true George W. Bush is becoming apparent.

KENNETH WALSH: He is not the easygoing guy that often comes across because he does want to get some things accomplished. I think the question with him is, is he flexible enough to deal with changing circumstances that every presidency deals with? That, I think, is the subtext of this 100-day period.

TERENCE SMITH: The next 100 days may provide the answers.

CONVERSATION

GWEN IFILL: Finally tonight, another in our series of conversations about new books and to Margaret Warner.

MARGARET WARNER: The author is Meg Greenfield, the Pulitzer Prize winning editorial page winner of the "Washington Post" and a "Newsweek" columnist. The book is "Washington," a city she began covering as a reporter in 1961. She became one of its most influential women before dying of lung cancer in 1999. Greenfield began writing this book in secrecy in the early 1990's. Shortly before her death, she asked Presidential historian and NewsHour regular Michael Beschloss to be her literary executor, and to make sure that the book would be published. Michael Beschloss joins me now. Welcome.

MICHAEL BESCHLOSS: Thanks, Margaret.

MARGARET WARNER: Tell us, Meg Greenfield, though she was a "Newsweek" columnist wasn't exactly a household name nationwide. Tell us a little bit more about her.

MICHAEL BESCHLOSS: Well, she was this enormously bright, funny, determined, curious woman -- came out of Seattle, went to Smith, studied English literature at Cambridge in England, and then she felt sort of a bohemian. She lived in Greenwich Village in the 1950s and decided to go into journalism -- came down to Washington in 1961, and probably more surprising to her than almost anything else, wound up one of the most powerful women in Washington and one of the most powerful women in American journalism.

MARGARET WARNER: She also said it surprised her she became so fascinated by Washington. I mean, because she originally came not thinking... She said something about, "well, I just drifted about into journalism while I waited to decide what I really wanted to do."

MICHAEL BESCHLOSS: That's it. You know, she wanted to write novels. That's what she thought she would do in life. And when she came to Washington in '61, it was sort of a detour. She was filming. She had sort of a New York attitude toward the petty doings in Washington, and what happened was the city took her over and she became captivated by it.

MARGARET WARNER: And that's what really comes through in the book, don't you think? I mean, it's really her... It's almost like a cultural journey anthropology into this political Washington.

MICHAEL BESCHLOSS: But, you know, if you knew her, here she was almost the embodiment of the Eastern establishment in certain ways with this very responsible job. At the same time, I didn't know until I began reading this manuscript how much it was sort of a daily struggle for her to keep from becoming one of these Washington creatures. It was almost as if every morning she looked in the mirror and said, "have I become one of them yet?"

MARGARET WARNER: In trying to explain Washington, she seemed to come to the decision that political Washington works the way it does because of the kinds of people it attracts. Tell us a little bit about that.

MICHAEL BESCHLOSS: She said it was not the kind of place that people would come here whose childhoods were the kind where you put the cat in the dryer. It was more sort of the school Presidents, the good children, she said, the head kids -- you know, a city full of successful people all pitted against one another.

MARGARET WARNER: And then she said that the behavior of political Washington rewards, though, really extracts the price.

MICHAEL BESCHLOSS: That's right. What she worried about, both in herself and also about people here, was that you have to live such a controlled life, especially with a much more intrusive press that she was a part of that, that you get into a situation where people are no longer themselves, that the guy you once knew and liked suddenly when you talked to him in the grocery store he talks to you asif he's orating at the United Nations. You know, she says, "there are people here who say I never say anything that I wouldn't want to read in the newspaper." And she says, "what a way to live."

MARGARET WARNER: Yeah, she said that people come to Washington... She said, "It's as if they're put in a witness protection program, given a new identity, and then live most of the time in the disguise, and that the Washington public figure tends to forget who he is, and the reinvented person takes over the real person."

MICHAEL BESCHLOSS: That's right. And she felt that the city had an awful lot of fakery in it, and increasingly so. And she also thought that that was one reason why Americans in many ways hate Washington. It's not the idea of the city, but the fact that they see it in many ways sort of phony.

MARGARET WARNER: Then, of course, journalists came in for some criticism from her, or some explication but criticism.

MICHAEL BESCHLOSS: She worried about the fact that although journalism got a lot tougher on politicians, as it should, especially in something like Watergate, it in a way got a little bit too far. The journalists got a little bit estranged from their subjects to the point of being unwilling in some cases to have dinner with politicians because you think you might be compromised. What she would say is, "have dinner with the politician, but have a strong enough character so that if the politician does something wrong, you take him apart."

MARGARET WARNER: She did... Her analogy was for Washington-- politicians, journalists, lobbyists, everyone in this little world-- that the best analogy was high school.

MICHAEL BESCHLOSS: Everyone wanting to be popular and sort of, you know, everyone wanting to sort of get ahead of everyone else, and it's not always a relaxing place. And one of the surprises to me was she was very candid about the fact that at the end of her life, she wondered if she should have done this a little differently. She worried about the fact that she had never married. She thought maybe professional life took too much for women particularly. And the other thing was she said, you know, "I began to admire Stanley Kowalski," you know, that character in "A Streetcar Named Desire." And I thought, here's this woman who is so known for being so official and controlled, reasoned, deliberate, saying maybe she thought that the guy who acted out of his passions had something after all.

MARGARET WARNER: There are some things missing in this book. If people are expecting a sort of tell-all or kiss-and-tell about a lot of these people that she covered and she mentions, don't you think they'll be disappointed? I mean, I found myself hungering for more anecdotes and more examples.

MICHAEL BESCHLOSS: It's not sort of, you know, a tell-all of "people I met and dinners I ate." And she was very determined not do that, because especially when she was dying, she wanted to sort of leave this almost as a last testament. "This is what the city is like," but even more than that, for someone who comes to Washington, "beware, make sure you don't become one of these creatures."

MARGARET WARNER: She also, even though you said she does talk a little bit about our regrets, I was struck by... I mean, here's this woman with this fascinating story to tell, a woman... a young woman came here when women weren't making it in journalism and all the struggles she had, all the people she knew. And yet you don't... again, I hungered for more about her and her feelings.

MICHAEL BESCHLOSS: And I think to some extent that sort of reflectsthe fact that she wanted to be in some way detached from all of this because she thought she might be compromised, and that's one of the regrets she had. But you know, she talks about the early years she spent here. She was not allowed to go into the press club to use the wire service machine because she was a woman. She was harassed.

MARGARET WARNER: How about the Senator she went to see who first reached into his desk drawer and said, "oh, little lady I have..." And he gave her French perfume?

MICHAEL BESCHLOSS: And that was not very long ago. That's the thing that a woman had to deal with really in the late 1960s.

MARGARET WARNER: Now, finally her ultimate resonance was, of course, not telling anyone-- virtually anyone, even her best friends-- about this book. How did you come to know about it, and why do you think she was so secretive about it?

MICHAEL BESCHLOSS: That was sort of a metaphor. She wanted chambers of her life that other people in Washington couldn't touch and didn't know about. She told me in the early '90s she was writing this book, told very few other people. At the end, she made me her literary executor, but even then she didn't give me the disks on which this book was written until about a week or two ago before she died. And she took me into her office in her wheelchair-- she was very ill-- and pulled these disks out from behind books and under pieces of paper and from behind drawers. And I read them. And I finally went back to see her, and I said, "I pledge to you this book will be published." And she died the next day.

MARGARET WARNER: How much of...it was all on different disks and on different papers. How much editing did you have to do? How much is this book is Meg Greenfield and how much editor Michael Beschloss?

MICHAEL BESCHLOSS: It's 100% hers. The one thing I didn't want to do as you see with some books is sort of write what I think she might have said, or what I might have heard in a conversation somewhere. What I did was I took what was on the disks and assembled them-- because there wasn't much sign of the structure she wanted-- and sort of find places where she had said things in the best way so that, you know, between these two hard covers you hear what I think is very much that unforgettable voice that we all read for a very long time.

MARGARET WARNER: Michael Beschloss, thanks very much.

MICHAEL BESCHLOSS: Thanks, Margaret.

RECAP

GWEN IFILL: Again, the major stories of this Wednesday. President Bush said the use of U.S. Military force to defend Taiwan was "certainly an option" if China ever invades the island. But he said that was simply reiterating his long-standing position. And Mr. Bush also said he'd compromise on a tax cut. He conceded it was likely to be less than the $1.6 trillion he wanted. We'll see you online and again here tomorrow evening. I'm Gwen Ifill. Thank you and good night.