Doctor and Patient: The Drawn Out Process of the Medical Lawsuit

She was one of the most highly sought radiologists in her hospital, a doctor with the uncanny ability to divine the source of maladies from the shadows of black and white X-ray films.

But one afternoon my colleague revealed that she had been named in a lawsuit, accused of overlooking an irregularity on a scan several years earlier. The plaintiff suing believed my colleague had missed the first sign of a now rampant cancer.

While other radiologists tried to assure her that the “irregularity” was well within what might be considered normal, my colleague became consumed by the what-if’s. What if she had lingered longer on the fateful film? What if she had doubled-checked her reading before signing off on the report?

She began staying late at the hospital to review, and review again, her work. And she worried about her professional reputation, asking herself if colleagues were avoiding her and wondering if she would have trouble renewing her license or hospital privileges. At home she felt distracted, and her husband complained that she had become easy to anger.

After almost a year of worry, my colleague went to court and was cleared. But it was, at best, a Pyrrhic victory. “I lost year of my life,” she told me. “That lawsuit completely consumed me.”

She was not the first colleague to recount such an experience. And far from overstating the issue, doctors may in fact be underestimating the extent to which malpractice not only consumes their time but also undermines their ability to care for patients, according to a new study in Health Affairs.

For more than 150 years, the medical malpractice system has loomed over health care, and doctors, the vast majority of whom will face a lawsuit sometime in their professional lives, remain ever vocal in their criticism of the system. But with few malpractice claims resulting in payments and liability premiums holding steady or even declining, doctors have started to shift their focus from the financial aspects of malpractice to the untold hours spent focused on lawsuits instead of patient care.

Now researchers are putting numbers to those doctors’ assertions. For the current study, they combed through the malpractice claims records of more than 40,000 doctors covered by a national liability insurer. They took note of the length of each claim, any payments made, severity of the injury and the specialty practiced by the physician being sued.

Most claims required almost two years to resolve from initiation of the lawsuit — and almost four years from the event in question. Cases that resulted in payment or that involved more severe patient injuries almost always took longer.

The researchers then looked at the proportion of a doctor’s career spent on an open claim. They discovered that on average, doctors spent more than four years of their careers — more time than they spent in medical school — working through one or more lawsuits. Certain specialists were more vulnerable than others. Neurosurgeons, for example, averaged well over 10 years, or more than a quarter of their professional lives, embroiled in lawsuits.

“These findings help to show why doctors care so intensely about malpractice and what they might face over the course of a lifetime,” said Seth A. Seabury, lead author and a senior economist at the RAND Corporation in Santa Monica, Calif.

The results also underscored what plaintiffs must endure. Previous studies have shown that when medical errors occur, patients prefer to have physicians acknowledge the mistake quickly and apologize as soon as possible. Though less than 5 percent of all errors lead to a malpractice claim, lengthy claims drag out the process and, in certain cases, hold up what may be appropriate compensation.

Patients not directly involved can be affected as well. A legitimate malpractice lawsuit sometimes results in doctors or even entire institutions changing how they practice in order to prevent similar events. Lengthy legal wrangling can slow down these potentially important improvements.

While the findings are only an indirect measure of the extent to which malpractice claims can affect doctors’ and patients’ lives, the study makes clear the importance of considering time, as well as cost, when looking at malpractice reform.

“If we could get these cases resolved faster, we might be able to improve the efficiency of the system, lower costs and even improve quality of care for patients,” Dr. Seabury said.

“Having these things drag on is a problem for doctors and patients.”

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Davos 2013: On Russia's To-Do List at Davos: Buff Image

DAVOS, SWITZERLAND — This year at Davos, the Russians are working hard to make a splash.

There is a House of Russia near a main hotel and a media center for Russia at the opposite end of this ski village. And then there is the bevy of Russian politicians, business folk and cultural figures on hand trying to encourage more foreign investment and correct what many of them privately concede is a poor image abroad.

Even Dmitri A. Medvedev, the former president and now prime minister, whose political standing in Russia was tarnished by a swap of offices with Vladimir V. Putin announced in September 2011, subjected himself to a highly unusual spectacle here.

Scores of Russian experts had worked with the World Economic Forum, as the conference here is known, on a presentation they called Scenarios for Russia.

The session on Wednesday, with Mr. Medvedev gamely sitting through the judgment before speaking himself, sketched out three ways that Russia, whose economy is heavily dependent on oil and gas extraction, could develop in the near future.

Based on assumptions like falling energy prices, regional inequalities and even an open split among Russian elites, none of the three possibilities was particularly optimistic. In addition, when the audience was asked to vote on the most needed development for Russia’s near future, it overwhelmingly chose the need to improve governance and overhaul government.

Given recent developments in Moscow, that may come as no surprise. Many political analysts see moves like the recent clampdown on demonstrations and the banning of American adoptions of Russian children as signals that the government is digging in, rather than opening up to change.

Mr. Medvedev’s response, though, was more tepid than many in the audience presumably hoped to hear. He simply repeated past promises, so far unrealized, that Russia will respond positively to demographic, political and economic shifts that could change the status quo.

Sergey Guriyev, a Russian economist, presented perhaps the gloomiest situation: A schism in the Russian elite that could force eventual, possibly sudden, change, in a country still haunted by memories of the 1917 Bolshevik Revolution and all that followed.

The status quo “is not sustainable simply because the Russian middle class will grow and demand reforms,” Mr. Guriyev said.

Over the past 10 years, oil and gas riches trickled down to a new middle class, he argued. “Now, more income doesn’t make people happy,” he said, adding that this Russian class “is unprecedentedly educated and rich for a country with such outdated political institutions.”

Unlike Prime Minister David Cameron of Britain, whose experience on the hustings of British politics lend him an ability to think on his feet and deliver punchy lines, Mr. Medvedev barely opened up to questioning from an audience that was about half the size of the one that packed the hall to hear Mr. Cameron on Thursday, a day after his gamble on European Union membership.

In private conversation, Russian businessmen deplored what they saw as a missed opportunity for Mr. Medvedev to give a forceful speech to the Davos crowd. But foreign investors invited to private sessions with the prime minister later Wednesday and earlier Thursday were much less inclined to criticize him.

Like the Russian business community, these investors are reluctant to speak on the record, citing the uncertainty of doing business in the country. What they also do not speak much about is the healthy return on their money.

While Russian business and the state accounted for most of the estimated $400 billion said by officials to have been invested in 2012, foreign investors get a good return on their money — some in high double digits, one banker said.

Russians often particularly cite China as a rival for foreign attention and money. Ruben Vardanian, a financier now at Russia’s giant Sberbank, said that while many businesspeople, domestic and foreign, saw that their activities “are much more profitable in Russia than in China,” the Chinese gave a greater sense of certainty.

While the circle of foreigners now interested in Russia is widening, Mr. Vardanian told a meeting of mostly Russian reporters, foreigners still often lament that “we can’t understand the rules of the game.”

“They don’t want to deal with, say, Mr. Vardanian, who is then replaced by Mr. Ivanov, and then by Mr. X,” he said. “They want to deal with rules.”

This article has been revised to reflect the following correction:

Correction: January 25, 2013

An earlier version of this article misspelled the first name of Ruben Vardanian, a financier at Sberbank, as Reuben.

This article has been revised to reflect the following correction:

Correction: January 25, 2013

An earlier version of the correction for this article misspelled the first name of Ruben Vardanian. It is Ruben, not Reuben.

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Britain Warns of ‘Imminent’ Threat to Westerners in Benghazi

LONDON — Days after the deadly hostage crisis in Algeria, Britain on Thursday announced a “specific, imminent threat to Westerners” in neighboring Libya and urged any British citizens in the eastern Libyan city of Benghazi to leave immediately.

Travel advice updated by the British Foreign Office also warned against “all but essential travel” to several other Libyan cities, citing a “high threat from terrorism” and a possibility of retaliatory attacks targeting Western interest in the region after the French military intervention in Mali, which preceded last week’s Islamist attack on a remote Algerian gas field near the Libyan border.

The Foreign Office did not describe the nature of the reported threat in Benghazi, where an attack on the United States diplomatic compound in September killed four Americans including Ambassador J. Christopher Stevens.

Since September, the British authorities have warned against all travel to Benghazi.

Earlier this week, a senior Algerian official said that several Egyptian members of the squad that attacked the Algerian gas complex were also among those who had attacked the American mission in Benghazi.

The Egyptians were among 29 kidnappers killed by Algerian forces during the four-day siege of the gas plant in which at least 37 foreign hostages and one Algerian died. Three militants were captured alive and one of them, under interrogation by Algerian security forces, recounted the Egyptians’ involvement in both attacks, the Algerian official said.

“We are aware of a specific, imminent threat to Westerners in Benghazi,” the Foreign Office advisory said. “We advise against all travel to Benghazi and urge any British nationals who are there against our advice to leave immediately.”

In other Libyan places, it said, “there is a high threat from terrorism. Attacks could be indiscriminate, including in places frequented by expatriates and foreign travelers.” The advisory did not specifically link its warnings to the kidnappings in Algeria.

Foreign Office officials declined to elaborate on the warnings.

As the crisis in Algeria unfolded, Prime Minister David Cameron of Britain repeatedly warned that Al Qaeda-linked extremists and other Islamist militants in North Africa presented a growing threat to Western interests.

“Just as we have reduced the scale of the Al Qaeda threat in other parts of the world, including in Pakistan and Afghanistan, so it has grown in other parts of the world,” he said. “We need to be equally concerned about that, and equally focused on it.”

During the Algerian hostage crisis, the kidnappers depicted their attack as linked to the French intervention in Mali, in turn provoked by a lightning advance south by Islamists who have turned Mali’s desert north into a separatist redoubt.

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Samsung’s iPad mini rival, the Galaxy Note 8.0 tablet, revealed in leaked images

While Samsung (005930) has had tremendous success over the past year with its Galaxy brand of smartphones, the company hasn’t been able to generated the same amount of buzz for its Galaxy tablet line just yet. But now SamMobile points us to the first leaked pictures of Samsung’s new Galaxy Note 8.0 that the company hopes will become its flagship tablet in 2013. The pictures, posted on Italian website DDAY, show an 8-inch white tablet that looks like a large Galaxy S III and features thicker side bezels than Apple’s (AAPL) recently released iPad mini. The pictures also show off the new tablet display’s 16:10 aspect ratio with a resolution of 1280 x 800 pixels, which packs more pixels per inch than the iPad mini display and its 1,024 x 768 resolution. We’ll get our first official glimpse of the Galaxy Note 8.0 when Samsung shows it off at Mobile World Congress next month.

[More from BGR: The ultimate humiliation: Dell now getting advice from the ‘Dell Dude’ on how to fix company]

This article was originally published on BGR.com

Gadgets News Headlines – Yahoo! News

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NCAA announces problems with Miami investigation

CORAL GABLES, Fla. (AP) — The NCAA's probe of Miami's athletic compliance practices is ramping up again.

Only this time, the Hurricanes aren't exactly the subject of the inquiry.

In a bizarre twist, the college sports' governing body is being investigated after NCAA President Mark Emmert acknowledged on Wednesday "a very severe issue of improper conduct" by former investigators working the long, complex Miami case.

The NCAA said its investigation was based, at least in part, on information that it should not have had access to, the testimony of those who appeared under subpoena to be deposed in the bankruptcy case involving former Miami booster Nevin Shapiro, one of the most notorious Ponzi scheme architects in history.

The NCAA does not have subpoena power. Shapiro's attorney did, and used it — and apparently entered into some sort of contractual agreement with the NCAA, one that apparently either was not or should never have been approved.

"We cannot have the NCAA bringing forward an allegation ... that was collected by processes none of us could stand for," Emmert said. "We're going to move it as fast as possible, but we have to get this right."

Speaking Thursday from Providence, R.I. in a telephone interview, Shapiro's attorney, Maria Elena Perez, told The Associated Press that she has done nothing wrong.

"The dubious party is not me. What I have done is 150 percent above board," Perez said.

Perez said she could not divulge the nature of whatever her contract status with the NCAA, though said she is planning to release a statement in the coming days after meeting with her own attorney.

"I am a victim of the enforcement staff," said Perez, who is a Miami graduate. "Me."

The revelations Wednesday mean the notice of allegations against Miami — the NCAA's findings of wrongdoing, a document that was nearly completed and was expected to be released by the end of this week — will be delayed for at least a few more weeks, if not longer. The long-term ramifications could be more damning for the NCAA, especially if the outside investigator they have commissioned to look into the mess finds more problems.

"As we have done since the beginning, we will continue to work with the NCAA and now with their outside investigator hoping for a swift resolution of the investigation and our case," Miami President Donna Shalala said.

Emmert said two depositions are involved in this allegation of improper conduct by former enforcement-office staffers. One of those two depositions was given Dec. 19, 2011, by former Miami equipment-room staffer Sean Allen — who has been linked to Shapiro and many of the allegations that he made against the university.

Among the questions Allen was asked in that deposition:

— "Did you ever witness Mr. Shapiro paying any money to any University of Miami football or basketball players?"

— "Would it be fair to say that Mr. Shapiro did, in fact, confer various financial benefits on the University of Miami Athletic Program and its players?"

— "Did you ever overhear any of the coaches or any other staff for the University of Miami providing Mr. Shapiro with inside information regarding, you know, the condition of any particular athlete for the purposes of Mr. Shapiro's gambling?"

It's unknown which of Allen's answers caught the NCAA investigators' attention.

What is known publicly now, and has been suspected by some for months, is that those investigators never should have known those questions were asked.

"How in the world can you get this far without it being recognized that this was an inappropriate way to proceed?" Emmert asked.

That's the question that the NCAA wants answered, and fast.

Emmert spoke angrily at times during a half-hour conference call to discuss the findings, in which he revealed that he briefed the NCAA's executive committee and the Division I board presidents with some information about the Miami matter. He said he developed a better understanding of what went on in the days that followed, which led to the hiring of Kenneth L. Wainstein of the firm Cadwalader, Wickersham & Taft LLP to conduct the external review of what happened.

Wainstein, Emmert said, will begin his probe on Thursday, with the NCAA hoping that he can finish within two weeks.

"We want to make sure that any evidence that's brought forward is appropriately collected and it has the integrity that we expect and demand," Emmert said.

It was part of a stunning day for Hurricane athletics: The 25th-ranked men's basketball team routed No. 1 Duke later Wednesday, 90-63.

Emmert said the NCAA was trying to find out why part of the investigation was based on depositions specific to the bankruptcy case against Shapiro, who will have to repay $82.7 million to his victims as part of his sentence. And the timing of this also is curious. Several people who were to be named in the NCAA's notice of allegations against Miami have been told that the document was in the final stages of preparation — and one person who spoke with the AP said at least one person who was to face a charge of wrongdoing was told the letter was scheduled for delivery to Miami on Tuesday.

Now it's anyone's guess when that will happen.

Emmert said the NCAA learned of the alleged misconduct, in part, through legal bills presented by Shapiro's attorney for work that was not properly approved by the organization's general counsel's office.

"One of the questions that has to be answered, unequivocally, is what was the nature of that contractual arrangement and what was all the activity that that individual was involved with," Emmert said. "There is some uncertainty about all of that and it's one of the first orders of business for the firm that we've hired to investigate."

The Hurricanes' athletic compliance practices have been probed by the NCAA for nearly two years. Allegations of wrongdoing involving Miami's football and men's basketball programs became widely known in August 2011 when Yahoo Sports published accusations brought by Shapiro, who is serving a 20-year term in federal prison for masterminding a $930 million Ponzi scheme.

Miami has self-imposed two football postseason bans in response to the investigation. The Hurricanes also would have played in the Atlantic Coast Conference championship game this past season, meaning they could have qualified for the Orange Bowl.

"In my two-and-a-half years I've certainly never seen anything like this, and don't want to see it again," Emmert said.

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Well: Can You Read the Face of Victory?

Picture a tennis player in the moment he scores a critical point and wins a tournament. Now picture his opponent in the instant he loses the point that narrowly cost him the title. Can you tell one facial expression from the other, the look of defeat from the face of victory?

Try your hand at the images below, of professional tennis players at competitive tournaments. All were included in a new study that suggests that the more intense an emotion, the harder it is to distinguish it in a facial expression.

(Photos: Reuters/ASAP)

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The researchers found that when overwhelming feelings set in, the subtle cues that convey emotion are lost, and facial expressions tend to blur. The face of joy and celebration often appears no different from the look of grief and devastation. Winning looks like losing. Pain resembles pleasure.

But that is not the case when it comes to body language. In fact, the new study found, people are better able to identify extreme emotions by reading body language than by looking solely at facial expressions. But even though we pick up on cues from the neck down to interpret emotion, we instinctively assume that it is the face that tells us everything, said Hillel Aviezer, a psychologist who carried out the new research with colleagues at Princeton University.

“When emotions run high, the face becomes more malleable: it’s not clear if there’s positivity or negativity going on there,” he said. “People have this illusion that they’re reading all this information in the face. We found that the face is ambiguous in these situations and the body is critical.”

Dr. Aviezer and his colleagues, who published their work in the journal Science, carried out four experiments in which subjects were asked to identify emotions by looking at photographs of people in various situations. In some cases, the subjects were shown facial expressions alone. In others, they looked at body language, either alone or in combination with faces. The researchers chose photographs taken in moments when emotions were running high – as professional tennis players celebrated or agonized, as loved ones grieved at funerals, as needles punctured skin during painful body piercings.

According to classic behavioral theories, facial expressions are universal indicators of mood and emotion. So the more intense a particular emotion, the easier it should be to identify in the face. But the study showed the exact opposite. As emotions peaked in intensity, expressions became distorted, similar to the way cranking up the volume on a stereo makes the music unrecognizable.

“When emotions are extremely high, it’s as if the speakers are blaring and the signal is degraded,” said Dr. Aviezer, who is now at Hebrew University in Jerusalem. “When the volume is that high, it’s hard to tell what song is playing.”

In one experiment, three groups of 15 people were shown photographs of professional tennis players winning and losing points in critical matches. When the subjects were shown the players’ expressions alone — separated from their bodies — they correctly identified their emotion only half of the time, which was no better than chance. When they looked at images of just the body with the face removed — or the body with the face intact — they were far more accurate at identifying emotions. Yet when asked, 80 percent said they were relying on the facial expressions alone. Twenty percent said they were going by body and facial cues together, and not a single one said they were looking only for gestures from the neck down.

Then, the researchers scrambled the photos, mixing faces and bodies together. The upset faces of players were randomly spliced onto the bodies of celebrating players, and vice versa.

When asked to judge the emotions, the subjects answered according to the body language. The facial expression did not seem to matter. If a losing face was spliced onto a celebrating body, the subjects tended to guess victory and jubilation. If they were looking at the face of an exuberant player placed on the body of an anguished player, the subjects guessed defeat and disappointment.

Although they were not aware of it, the subjects were clearly looking at body language, Dr. Aviezer said. Clenched fists, for example, suggested victory and celebration, while open or outstretched hands indicated a player’s disappointment.

In another experiment, the researchers looked at four other emotional “peaks.” For pain, they used the faces of men and women undergoing piercings. Grief was captured in images of mourners at a funeral. For joy, they used images of people on the reality television show “Extreme Makeover: Home Edition,” capturing their impassioned faces at the very moment they were shown their beautiful, brand new homes. And for pleasure, they went with a rather risqué option: images from an erotic Web site that showed faces at the height of orgasm.

Once again, the subjects could not correctly guess the emotions by looking at facial expressions alone. In fact, they were more likely to interpret “positive” faces as being “negative” more than the actual negative ones. When faces showing pleasure were spliced onto the body of someone in pain, for example, the subjects relied on body language and were often unaware that the facial expression was conveying the opposite emotion.

“There’s this point on ‘Extreme Makeover’ where people see their new house for the first time and the camera is on their face, so we have these wonderful photos of their expressions,” Dr. Aviezer said. “At that moment, they look like the most miserable people in the world. For a few seconds, it’s as if they are seeing their house burn down. They don’t look like you would expect.”

The researchers noted that they were not suggesting that facial expressions never indicate specific feelings – only that when the emotion is intense and at its peak, for those first few seconds, the expression is ambiguous. Dr. Aviezer said the facial musculature simply might not be suited for accurately conveying extremely intense feelings – in part because in the real world, so much of that is conveyed through situational context.

And this may not be limited to facial cues.

“Consider intense vocal expressions of grief versus joy or pleasure versus pain,” the researchers wrote in their paper. For example, imagine sitting in a coffee shop and hearing someone behind you shriek. Is it immediately obvious whether the emotion is a positive or negative one?

“When people are experiencing a very high level of excitation,” Dr. Aviezer said, “then we see this overlap in expressions.”

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The Lede Blog: Clinton Testifies on Benghazi Attacks

Visit NBCNews.com for breaking news, world news, and news about the economy

The Lede is following Secretary of State Hillary Rodham Clinton’s testimony before the Senate Foreign Relations Committee about the Sept. 11, 2012, attacks on the American Consulate in the eastern city of Benghazi, Libya, that killed Ambassador Chris Stevens and three other Americans.

Mrs. Clinton had been scheduled to testify before Congress last month, but an illness, a concussion and a blood clot near her brain forced her to postpone her appearance.

As our colleagues Michael R. Gordon and Eric Schmitt reported, four State Department officials were removed from their posts on last month after an independent panel criticized the “grossly inadequate” security at a diplomatic compound in Benghazi.

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Google Earnings Reveal Beginnings of a Facebook Problem on Search Revenue

Google beat Wall Street expectations with its fourth-quarter revenues of $ 14.42 billion, but the value of its ads continue to decline, an especially tricky problem with the company’s new search competition from Facebook. Google’s average cost-per-click decreased 6 percent from one year ago, meaning each ad it runs on its biggest business has less value than it did a year ago, continuing a fairly troubling trend for the search giant. It still managed to keep up its paid clicks by getting more and more people to use Google.

RELATED: Google Is Trying to Fix Its Targeted Ad Attitude Problem

Google has managed to offset the decline in click value with that kind of growth for almost a year now, but Facebook’s new Graph Search has the potential to offer users more personalized social-search results — and that could mean higher value for the ads next to them. How much longer can Google can maintain its delicate balance by sheer market power remains to be seen. The company is trying desperately to change its fate with a push for more Google+ integration, which would put advertisers closer to more personal Googling. But so far that hasn’t worked, if the earnings report is any indication. Google’s bet on volume will surely face a test from Facebook’s gamble on the future of social search, no matter what the rival CEOs are saying.

Social Media News Headlines – Yahoo! News

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Williams loses to Stephens; Federer advances

MELBOURNE, Australia (AP) — Serena Williams was only thinking out loud when she muttered this Australian Open had been "the worst two weeks."

Not long after a courtside microphone picked up those comments during her quarterfinal with 19-year-old American Sloane Stephens, things got a whole lot worse.

Stephens outplayed Williams, whose movement and serves had been slowed by a back injury, and beat the 15-time Grand Slam champion 3-6, 7-5, 6-4. It marked Williams' first loss since Aug. 17, and her first defeat at a Grand Slam tournament since last year's French Open.

Four-time Australian Open winner Roger Federer, a 17-time Grand Slam champion, looked for a while like he might join Williams on the sideline. But Federer eked out a 7-6 (4), 4-6, 7-6 (4), 3-6, 6-3 win over 2008 finalist Jo-Wilfried Tsonga in a match that lasted 3 hours, 34 minutes.

Federer, who broke Tsonga in the fourth game of the deciding set, converted his fifth match point while serving after Tsonga saved four match points in the previous game. Federer, who advanced to the semifinals for the 10th consecutive year at Melbourne Park, will play U.S. Open champion Andy Murray on Friday.

"I thought he played very aggressive," Federer said. "I love those four-set or five-set thrillers and I was part of one tonight."

Murray beat Jeremy Chardy of France 6-4, 6-1, 6-2. The other men's semifinal has defending champion Novak Djokovic playing David Ferrer on Thursday

Williams' downer of a Grand Slam Down Under started badly when she turned her right ankle in her opening match at Melbourne Park.

"I've had a tough two weeks between the ankle ... and my back, which started hurting," Williams said. "A lot of stuff."

While Williams packed for home — she and sister Venus have also lost in doubles — Stephens advanced to her first Grand Slam semifinal Wednesday night against defending champion Victoria Azarenka.

The top-seeded Azarenka beat Svetlana Kuznetsova 7-5, 6-1 in the early quarterfinal at Rod Laver Arena. Maria Sharapova, who has lost only nine games in five matches, plays Li Na in the other semifinal.

Williams hurt her back in the eighth game of the second set and things got progressively worse. She yelled at herself on several occasions, and smashed a racket into the court, earning a $1,500 fine from tournament officials.

"I was running to the net for a drop shot," said Williams, describing the injury. "As I went to hit it, it was on the backhand. I even screamed on the court. I totally locked up after that."

She reiterated after the match that her injuries had made this Australian Open difficult for her.

"Absolutely, I'm almost relieved that it's over because there's only so much I felt I could do," she said. "I've been thrown a lot of (curve) balls these two weeks."

Stephens has coped well this week, and the magnitude of her accomplishment only hit her while she was warming down after the match.

"I was stretching, and I was like, 'I'm in the semis of a Grand Slam.' I was like, 'Whoa. It wasn't as hard as I thought,'" she said. "To be in the semis of a Grand Slam is definitely a good accomplishment. A lot of hard work."

The No. 29-seeded Stephens hadn't been given much of a chance of beating Williams, who lost only four matches in 2012 and was in contention to regain the No. 1 ranking at age 31.

Williams' latest winning streak included a straight-set win over Stephens at the Brisbane International this month.

Stephens wasn't even sure that she could beat Williams until she woke up Tuesday.

"When I got up, I was like, 'Look, Dude, like, you can do this.' Like, 'Go out and play and do your best," she said.

Williams walked around the net to congratulate Stephens, who then clapped her hand on her racket and waved to the crowd, a look of disbelief on her face.

Stephens has said she had a photo of Williams in her room when she was a child, and had long admired the Williams sisters.

"This is so crazy. Oh my goodness," Stephens said, wiping away tears in her post-match TV interview. "I think I'll put a poster of myself (up) now."

Azarenka, with her most famous fan Redfoo sitting in the crowd wearing a shirt reminding her to keep calm, overcame some early jitters to beat Kuznetsova.

After dropping serve in a long fourth game that went to deuce 10 times, Azarenka recovered to dominate the rest of the match against Kuznetsova, a two-time major winner who was floating dangerously in the draw with a No. 75 ranking as she recovers from a knee injury.

Azarenka's American rapper friend returned from a concert in Malaysia to attend the quarterfinal match.

Wearing a red sleeveless T-shirt that read "Keep Calm and Bring Out the Bottles," the name of his next single, Redfoo stood, clapped and yelled "Come on, Vika!" during the tight first set.

Williams' loss was a boost for Azarenka, who lost all five head-to-heads against the American in 2012 and is 1-11 in their career meetings.

Tsonga said he was in a "bad mood" because he lost despite playing a good match against Federer.

"I was solid. I was there every time," he said. "I just gave my best today, so I'm proud of that."

The 25-year-old Murray had his service broken for only the second time while serving for the match. But he broke back immediately to clinch a quarterfinal victory.

Murray discounted comments in the British media that he was upset with an almost full schedule of day matches while Federer was given cooler night slots on Rod Laver Arena.

"The scheduling for me is part and parcel of playing in really any tennis tournament," Murray said. "It's tough to make the schedule perfect for every single player."

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Well: Have a Health Question? Ask Well

The Well section of The New York Times is starting a new online featured called Ask Well. If you have a question about fitness, nutrition, illness or family health, the staff of The New York Times Health section is ready to help you find the answer.

How do you solve the problem of back pain caused by sitting in an office chair all day? Do you still need the flu shot even if you’ve had the flu? What’s the best way to heal tennis elbow? Those are some of the questions we’ve already answered in Ask Well.

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Tara Parker-Pope speaks about Ask Well.

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All questions submitted to Ask Well will be reviewed by the health staff. We’ll post selected questions and let readers vote on those they would most like to see answered. You can ask a question, vote for your favorites and read answered questions on the Ask Well Questions Page.

While Ask Well is not a source for personal medical advice (only your doctor can give you that), we can offer readers health information from the experts and guide you to various resources to help you make informed decisions. So let’s get started. Tell us what’s on your mind, and Ask Well will provide the answers.

Ask Well

Your health questions answered by Times journalists and experts.

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