IT'S ALL IN YOUR MIND:

In the summer of 2012 Carol Brennan started to feel pain in her right shoulder. Her GP prescribed painkillers but they did little to ease her discomfort. Nor did physiotherapy. Brennan's shoulder became so sore that she had to give up yoga, Pilates, even knitting. Standing upright, the 63-year-old academic was unable to raise her arm more than 45 degrees from her hip. Lying down offered little relief. The only way she could sleep was on her stomach with her right arm hanging over the edge of the bed. When she was finally referred to a specialist in late 2013, Brennan told him: "I can barely sleep and when I do I dream about pain."

Shoulder pain is a common complaint, especially among people over 50, accounting for more than 2 per cent of all primary care consultations in the UK. Usually the soreness concerns the shoulder joint, where the long bone in the upper arm, the humerus, fits loosely into the shoulder blade, like a ball and socket. The pain occurs when tendons attached to the humerus rub or catch on nearby tissue or on the acromion, the bone that extends over the joint.

More than 40 years ago, doctors proposed a surgical remedy for such shoulder pain. Removing a small area of tissue and acromial bone would increase the space around the tendon so it no longer caught or rubbed. It was a minor procedure greatly eased by advances in keyhole surgery, which allows slender tools to be passed through little cuts in the skin. Subacromial decompression, as the surgery became known, is now one of the most common operations in orthopaedics. In the UK, 30,000 are performed each year, costing the NHS £150m.

By coincidence, the specialist Brennan was referred to lived in the same village as her on the outskirts of Oxford. Andy Carr, who is now 60, is a widely respected academic surgeon and had performed the shoulder operation many times. He told Brennan that because her pain had lasted so long she was now in a position where surgery was usually offered. But first, he wanted to see whether she would consider taking part in a study of people with persistent shoulder pain.

At Oxford University's Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, which he heads, Carr was conducting a clinical trial of decompression surgery, to assess its effectiveness. He explained to Brennan that if she agreed to participate she would be randomly assigned to one of three groups. The first would receive regular surgery. The second set would get "placebo surgery", with all the surgical procedures identical to the normal operation except that no bone or tissue would be removed. Patients in these two groups would not know if they'd had the real or sham surgery. The third group would receive no treatment.

"My immediate reaction was: yes, of course I'll do it, because that's the sort of person I am," Brennan told me when we met recently for coffee in an Oxford bookshop. "But I was concerned that I might end up in the 'do nothing' category, as I was already at my wits' end."

To Brennan's relief she was assigned for surgery. In January 2014, she was shown to a ward at the Nuffield Orthopaedic Centre, where she changed into a hospital gown and was given a general anaesthetic. Inside the operating theatre, Carr made two tiny incisions in Brennan's right shoulder: one at the back for the endoscope, a thin tube fitted with a light and camera that relays pictures to a monitor, and another at the side of the shoulder to allow entry for the tool with a rotating burr used to shave bone. The procedure took around 30 minutes.

When Brennan awoke in the recovery room, she discovered she was unable to talk, an upsetting side effect of an anaesthesia that lasts for a day. Her arm was painful, heavily bandaged and in a sling. Her son drove her home. After a few days she was allowed to remove the sling and gently use her arm. When she returned to the hospital for a consultation a month later she was downbeat. "I said to the nurse: I'm still so sore. This is a disaster."

Then, as if she were slowly recovering from an illness, the pain began to subside and her mobility returned. After six months, she was able to do some light yoga and Pilates again. After a year she had gone from "a nine to a two" on the one-to-ten scale, which is the most common tool used by doctors to assess pain and requires the patient to put a number to their level of discomfort. "To all intents and purposes I was cured," she said.

OUR TWO REPUBLICAN PARTIES:

LACKING THE NH ADVANTAGE:

[H]er chances of capturing New Hampshire were viewed with such a jaundiced eye by local media that one of Harris' first exchanges during a two-day swing -- with an in-state reporter -- included a not-so-subtle reminder that she waited weeks after announcing her White House bid to travel to the Granite State.

"We're glad you're here," the reporter told Harris. Then he asked whether her absence helped feed the perception that New Hampshire isn't a high priority.

Another interviewer -- this one on ABC affiliate WMUR -- was more direct: "We haven't seen much of you in the previous two years. Why was that?" he asked. "The narrative is out there, I guess, that 'Sen. Harris is focusing elsewhere.'" [...]

Harris didn't campaign in New Hampshire in the midterms -- and her team has sketched out paths to the Democratic nomination that run through the other early states and to Super Tuesday. Harris traveled to South Carolina before and after her presidential announcement and was in Iowa for her recent CNN town hall. She launched her campaign in Oakland, Calif., and has returned to her home state to raise money and lock down endorsements.

Some of it may be structural. New Hampshire's open primary, which allows independents to participate, can favor mavericks and ideologues. Harris doesn't fit in either camp.

PETE WILSON MADE IT THE CANARY IN DONALD'S COAL MINE:

A battle over the state party chairmanship offers two competing visions for the future. One embraces President Donald Trump; the other focuses on the nuts and bolts of party building and organizing.

The two approaches aren't complementary. Trump, who lost California by 30 percentage points in 2016, is highly unpopular there: Nearly two-thirds of California's voters disapprove of his performance as president.

"What it really comes down to is whether a party's first obligation is to motivate its base -- or to reach out beyond that base,'' said Dan Schnur, a former GOP strategist and adviser to Sen. John McCain who is a professor at the University of Southern California's Annenberg School for Communication and Journalism and is now an independent. "We'll see what they decide."

As it stands, the Republican Party in the nation's most populous state is barely breathing. The midterm elections saw the landslide victory of Democratic Gov. Gavin Newsom, Democrats win supermajorities in both state legislative chambers and the flipping of seven GOP House seats.

ALWAYS BET ON THE dEEP sTATE:

The FBI developed a backup plan to protect evidence in its Russia investigation soon after the firing of FBI Director James Comey in the event that other senior officials were dismissed as well, according to a person with knowledge of the discussions.

The plan was crafted in the chaotic days after Comey was fired, when the FBI began investigating whether President Donald Trump had obstructed justice and whether he might be, wittingly or not, in league with the Russians.

The goal was to ensure that the information collected under the investigations, which included probes of Trump associates and possible coordination between Russia and the Trump campaign, would survive the firings or reassignments of top law enforcement officials. Those officials included special counsel Robert Mueller, who was appointed eight days after Trump fired Comey in May 2017.

HERE'S YOUR COATS, WHAT'S YOUR HURRY?:

Trump is still "enraged" about Coats's congressional testimony on national security threats last month, believing that the director undercut the president's authority when he shared intelligence assessments about Iran, North Korea and the Islamic State that are at odds with many of Trump's public statements, said one adviser who spoke with the president over the weekend. [...]

Last July, Coats was being interviewed onstage at the annual Aspen Security Forum when the White House announced via tweet that Russian President Vladi­mir Putin had been invited to Washington.

Coats was clearly taken by surprise and made little effort to hide his displeasure.

"Okaaaay," Coats said. "That's going to be special." The audience erupted in laughter.

In the same interview, with NBC News's Andrea Mitchell, Coats also said no one had asked him if it was a good idea for Trump to meet privately with Putin at a summit meeting in Helsinki. Trump didn't allow any Cabinet officials or aides to attend the meeting, and several officials have said they couldn't get a reliable account of the conversation between the two leaders, which was attended only by two interpreters, The Washington Post has reported.

Coats said that he hadn't been told what happened in the meeting. If asked, he said, he'd have advised the president against speaking one-on-one with Putin and that U.S. security officials were concerned there were no notes taken.

Asked whether it was possible Putin had secretly recorded the more-than-two-hour meeting, Coats answered, "That risk is always there."

Trump was livid, and believed that Coats was trying to embarrass him in a room filled with high-ranking current and former national security officials, many of them outspoken critics of the president, a senior U.S. official said at the time.