A prep course for the month-long World Cup soccer tournament, a worldwide pheno

 heart of a child , '' is a very complex study . The author of the book that cel

ebrates identity perhaps wrestled with his own identity . The program explores w

hether he used drugs or gave them to the young girls he entertained and photogra

phed . After all , the `` Alice '' stories , unlike most books of the times , ar

e conspicuously without morals . The master of nonsense was also a scholar of lo

gic . Queen Victoria , after reading `` Alice 's Adventures in Wonderland , '' s

aid she wanted to read Carroll 's next book , which turned out to be a treatise 

on simultaneous linear equations . Upcoming `` Great Books '' programs will stud

y H.G. Wells 's `` War of the Worlds '' ( June 11 ) and `` The Art of War '' ( J

une 18 ) .

 New research has found that acetaminophen doesn't reduce the pain during and im

mediately following circumcision . While acetominophen is safe and easily admini

stered to newborns , the researchers said , `` the pain of circumcision is too s

evere to be controlled by a mild analgesic . '' Acetaminophen ( the active ingre

dient in Tylenol ) does seems to work against persistent discomfort at six hours

 after circumcision , however , according to a study by University of Rochester 

School of Medicine and Dentistry researchers . The study appears in last month '

s Pediatrics , published by the American Academy of Pediatrics . About 86 percen

t of American male newborns undergo circumcision , the most common surgical proc

edure performed on males in this country , the study said . Most of these circum

cisions are done without painkillers . A local anesthetic procedure called dorsa

l penile nerve block has been found effective against circumcision pain , the re

searchers said , but is not widely used because of concerns about its safety , t

he time it takes to administer and a continued belief that babies don't feel muc

h pain . The new study , in line with previous research , concluded that circumc

ised newborns do experience great and persistent pain during and after the surge

ry , based on crying , increased heart and breathing rates and other measurement

s . The discomfort from the surgery also seemed to interfere with breastfeeding 

in some newborns , who required formula supplements . Breast-feeding takes more-

active participation on the part of newborns , who have to learn to latch on to 

the breast and suckle , than the more-free-flowing bottle , said Cynthia R. Howa

rd , the lead researcher on the study . After circumcision , babies can be more 

difficult to awaken , and this may frustrate mothers who themselves are just lea

rning to breast-feed , she added . Howard said she plans to follow up this study

 to see if there is any long-term impact on breast-feeding . The researchers con

cluded `` it is imperative '' that a safe and easily administered painkiller be 

found and used for the large number of newborns receiving circumcisions in this 

country .

 Breast milk has long been appreciated for the nourishment it provides and for i

ts rich supply of antibodies that help newborns fight infections . Now research 

suggests that breasts also produce large quantities of a hormone that may aid th

e development of a newborn 's brain and sexual organs , and may also affect the 

health of the mother 's breast itself . Scientists said the findings , which wer

e made in experiments on rats but appear to be true for humans as well , strengt

hen the argument for breast feeding and may lead to new strategies for fighting 

breast cancer . Researchers have known for years that the hormone , gonadotropin

-releasing hormone ( GnRH ) , is made in the hypothalamus of the brain in adults

 , where it influences sex-organ growth , the reproductive cycle and sexual beha

vior in rats and people . Pregnant women also make the hormone in the placenta ,

 where it gets passed to the embryo and has a major influence on fetal brain dev

elopment . Now researchers at the Weizmann Institute of Science in Rehovet , Isr

ael , have found that in lactating rats large amounts of GnRH are made in breast

 tissues . The hormone is probably also made in human breast tissues , they said

 , since human breast milk has been found to be loaded with the hormone . The re

searchers , led by neuroendocrinologist Yitzhak Koch , propose that the GnRH in 

breast milk may help complete certain aspects of brain or sex-organ development 

left unfinished during the fetus ' stay in the uterus . Breast-milk GnRH may be 

especially important to a newborn rat , since rat brains are still largely undev

eloped even after birth . Human brains are more fully developed at birth , so th

e importance of GnRH in human breast milk remains uncertain . But even human bra

ins change substantially in the first years of life and may benefit from the hor

mone , Koch and others said . `` It could be important for the physiology of the

 developing baby , '' said Donald Pfaff , a neurobiologist at Rockefeller Univer

sity in New York . But he stressed that further experiments are needed to see wh

ether the hormone can survive in the digestive tract of a suckling newborn or is

 deactivated there . Sergio R. Ojeda , head of neuroscience at the Oregon Region

al Primate Center in Beaverton , said researchers discovered a few years ago tha

t breast milk contains fatty acids , which are critical for growth , and taurine

 , which aids in the absorption of nutrients , and that baby formula companies h

ad subsequently added those ingredients to their products . He said GnRH may be 

the latest such discovery , and he predicted that further research would bring o

ther hormonal benefits of breast milk to light . Margaret Wierman , an endocrino

logist at the University of Colorado Health Sciences Center , said the new findi

ng was potentially important for women too because many breast-cancer cells grow

 in response to GnRH . She said studies of how the production of GnRH is regulat

ed in the breast may someday lead to new ways of blocking breast-cancer growth .

 The new research appears in this week 's issue of the Proceedings of the Nation

al Academy of Sciences .

 It was the surgical head nurse who turned the South African hospital upside dow

n . She needed a gynecologist , and it made perfect sense to her to choose Dr. E

.T. Mokgokong , who would soon become deputy head of obstetrics and gynecology a

t the University of Natal . Except that it was 20 years ago at the height of apa

rtheid and the nurse was white and Dr. Mokgokong is black . `` She caused comple

te pandemonium in the hospital , '' the doctor recalled . After all , it was a b

lack hospital . Although the staff was mostly white , the patients were black . 

Why wouldn't the nurse go to the hospital for whites ? `` She told them : ` My g

ynie is Dr. Mokgokong , ' ' ' he continued . Very delicate , very shocking . He 

remembers her asking the disapproving white staff : `` Whose body is going to be

 examined ? '' That stamp of approval helped establish him in the old South Afri

ca . It also convinced him that an academic degree and the stethoscope were the 

most potent weapons he could wield against the apartheid government . This month

 , a new era began as blacks who represent four-fifths of the population took co

ntrol of the government . One of the most immediate challenges is to build a nat

ional health-care system to meet the needs of a swelling non-white population . 

Black children have death rates that are 12 times higher than white , according 

to government figures . Diseases such as typhoid and tuberculosis , rare among w

hites , are major killers of South African blacks . More than half the children 

admitted to a black teaching hospital last year were found to be suffering from 

malnutrition . A critical problem is the lack of black health-care professionals

 . Currently there are about 1,200 black physicians for an estimated population 

of 30 million . This compares with 25,000 white doctors for about 5 million whit

es . For decades Mokgokong , 63 , has been a kind of education warrior on the he

alth-care battlefield . He heads the Medical University of Southern Africa ( Med

unsa ) , founded in 1978 for black students . Last week , he was in Washington t

o receive an award from Medical Education for South African Blacks , a non-profi

t organization that funds medical scholarships . Mokgokong grew up on a farm , t

he youngest of seven children . His father was a teacher and Lutheran minister .

 At 19 , he passed the standard examinations to enter a university . After earni

ng a science degree at Fort Hare University , Mokgokong received his medical deg

ree at the University of Natal in 1962 . He belongs to South Africa 's pioneer b

lack generation of `` First-&-Onlys '' : First black on the university faculty ,

 one of the only blacks on the hospital teaching staff ; first & only black to h

ead a South African medical school . `` First-&-Only '' pioneers ( blacks or wom

en or members of any outsider group ) can break the barriers of the discriminati

ng culture but not its rules . They survive and even excel by working within the

 system and in the process they target the culture 's limits . First Mokgokong b

roke the ability barrier when he decided to specialize in obstetrics and gynecol

ogy and pursue a career on the prestigious track of academic medicine . `` The e

arly days were very difficult , '' he said . `` We were always taking the job of

 a white . '' Meanwhile , Mokgokong had to prove he was not only just as good as

 his white counterparts , but better . That 's why it was a turning point when t

he surgical head nurse chose him to be her doctor . He also had a mentor in the 

chief of the ob-gyn department . `` I became his blue-eyed boy , '' he jokingly 

recalled . But eventually `` First-&-Onlys '' crack up against the culture 's gl

ass ceiling . When his department chief retired , Mokgokong applied for the dire

ctor 's job and was passed over . A few years later , he crossed a personal and 

political Rubicon and switched to the all-black medical school . The move was hi

ghly controversial . To many in South Africa , Medunsa was seen as a tool of apa

rtheid to keep blacks separate and disenfranchised . To some , learning itself w

as a form of submission . `` Liberation first , education later '' was the revol

utionary slogan . But to an education warrior like Mokgokong , it was the other 

way around . Education equaled liberation . Spare the book , he believed , and s

poil the child 's future . He consulted his political friends , some of them in 

exile , and got their backing to go to Medunsa because , as he said , `` the ins

titution in the long run will be a training area for black people . '' Today rou

ghly 60 percent of practicing black physicians in South Africa are graduates of 

Medunsa . While other universities are opening the door to black applicants , Me

dunsa remains the primary medical training ground for blacks . Yet , in the euph

oria of liberation , Mokgokong is not resting on his laurels . Apartheid may be 

overturned , but his education war goes on . He has already started with his fam

ily . One son is a neurosurgeon , another is a general practitioner , his wife i

s a social worker . `` I hope we can keep our level head and not go into a dicta

torship to deal with the violence , '' he said . `` The main thing is to bring b

ack the culture of learning and teaching . ''

 In what may be a new record , the most recent U.S. policy on Haiti , whose cent

erpiece is tougher sanctions , was declared futile even before it came into effe

ct on May 21 . Among widely opposing views on every other aspect of Haitian poli

cy , all sides agreed on just one point : that the still untested sanctions woul

d not suffice to drive Haiti 's military regime from power . Administration offi

cials , who had just devised the policy , freely but anonymously admitted as muc

h to reporters . Supporters of Jean-Bertrand Aristide , who only a few weeks bef

ore were fiercely urging tighter sanctions , agreed . Their earlier conviction t

hat `` sanctions had never been given a chance '' because the old set was too we

ak shifted almost overnight to the view that unmistakable readiness to use force

 was necessary . The president , listing reasons why an invasion would be in the

 U.S. interest , was described by aides as trying to build public support for mi

litary action . If , as seems nearly certain , the sanctions don't do the job , 

the administration will have far fewer options than it had a few weeks ago . A p

olicy designed to buy time and options already seems to have achieved the revers

e . Now , abandoning sanctions on the grounds that the necessary conditions for 

democracy don't exist today in Haiti , would seem too stark a retreat . Indefini

te negotiations would seem obviously fruitless . Tightening the sanctions still 

further risks destabilizing the Dominican Republic and would bring unacceptable 

suffering for Haitians . The remaining option unless President Aristide were to 

voluntarily step aside is an invasion . Five arguments have been advanced in fav

or of such a step : that U.S. values and post-Cold War global strategy demand th

at we `` restore democracy '' to Haiti ; that U.S. credibility is unacceptably h

armed by thugs who `` thumb their noses '' at us ; that restoring President Aris

tide is the only way to reduce the number of refugees heading our way ; that rem

oving the current military leaders will reduce drug trafficking to the United St

ates ; that only such an all out-effort can dispel charges of a racist policy . 

Close inspection reveals glaring weaknesses in most of these arguments . Haitian

 drug trafficking , for example , is not a large source of what 's on America 's

 streets . If that were motive for an invasion , a dozen other countries should 

come first . Other reasons offered by President Clinton-Haiti 's proximity , the

 fact that many Haitians live here and Americans live in Haiti , and the fact th

at Haiti and Cuba are the only remaining non-democracies in the hemisphere are a

ccurate descriptions but hardly reasons for military action . What is noteworthy

 about this list is that only the first argument addresses Haiti 's problems ; t

he rest address our own . Making foreign policy with an eye to domestic opinion 

is one thing . Making foreign policy to resolve domestic concerns with only an o

ccasional eye to the actual problems abroad is quite another , and unlikely to e

nd successfully . `` Restoring democracy , '' therefore , is the crux of the mat

ter . But is it also a delusion ? We can reinstate a freely elected president wh

o is the choice of most Haitians . But a single election does not create a democ

racy . The election that brought President Aristide to power was an aberration i

n Haitian politics , made possible only by the presence of large teams of foreig

n observers . The political norm is rampant corruption , stolen or canceled elec

tions , coups d' etat and violence . Democracy can only be homegrown . An establ

ished democracy that has been usurped can be restored through outside force . A 

fledgling democracy , receptive to the rule of law and to the right of peaceful 

political dissent , can be helped along . But it is questionable and worthy of a

 serious debate that has not occurred whether Haiti can be lastingly helped at t

his point in its political evolution through armed intervention . To leave behin

d a functioning democracy in Haiti , an invasion would have to : disarm the mili

tary ; reinstate Aristide ; prevent the traditional violent retribution against 

those leaving power ; create Haiti 's first well-trained , civilian controlled p

olice , distinct from the military ; keep order for months to years ; uproot and

 remove antidemocractic elements of the military and economic elite ; provide ma

ssive development assistance , get along with Aristide through thick and thin ; 

help forge a moderate political consensus , and be prepared to re-intervene if i

t collapses . These tasks get harder and more dangerous as the liberators become

 occupiers and the large initial force shrinks to a smaller number of peace enfo

rcers . Lives will be lost to paid and random violence . At what point would the

 United States declare its job done ? Invasion advocates argue that it could be 

very early , with the longer , harder job turned over to an ad hoc international

 coalition or U.N. peace-keeping force . Other countries can be expected to hold

 a different view . Moreover , a U.N. force would have to be vetoed by the Unite

d States , since its open-ended mandate could not meet the conditions of the pre

sident 's new peace-keeping policy . If democracy cannot be restored because it 

hasn't previously existed in Haiti , Americans will have to decide how they feel

 about military action for the purpose of keeping out refugees or as a means of 

demonstrating the president 's toughness . The threat to American credibility , 

however , does not come from Port-au-Prince . It lies in the possibility that we

 will start something we cannot finish out of little more than frustration , or 

become hopelessly tangled in a policy riddled with internal contradictions becau

se it is principally designed to meet domestic imperatives .

 WASHINGTON Some people in the federal government never get a pat on the back . 

Ever hear anybody loving up the IRS ( `` Gee , great tax ! '' ) ? Or the Postal 

Service ( `` Really quick and cheap ! '' ) ? Or the Border Patrol ( `` Boy , tho

se people willn't dare try that again ! '' ) ? Or the U.S. . Agency for Internat

ional Development , charged with administering foreign aid , one of the nation '

s favorite spending priorities . ( `` Wow , I loved the way you took the $ 5 mil

lion that was supposed to pay for my children 's textbooks and built that beauti

ful bridge in Milcamagnesia ! '' ) . One school of thought holds that shepherdin

g foreign aid through Congress is what transformed House Appropriations Committe

e Chairman David R . Obey , D-Wis. , into such a cuddly guy . Jay Byrne , AID 's

 press spokesman , put it another way : `` Let 's just say foreign assistance do

esn't have much of a constituency . Every time you turn a corner there 's someon

e standing there with a baseball bat . '' In an effort to lighten up his troops 

, Byrne ( and others , he insists ) in March devised a `` Stress Management Prog

ram , '' a copy of which was obtained by The Washington Post . The basic princip

le : `` You all want to stay stressed , and stress is good for moral ! '' Stress

 may also have caused this spelling lapse , but so what ? Stress `` helps you av

oid responsibility , '' the manifesto said . `` This gets you off the hook for a

ll the mundane chores ; let someone else take care of them . '' In other words ,

 blame the proofreader . Byrne , 32 , once worked in former Boston mayor Raymond

 L. Flynn 's office , where , he acknowledged , `` people had more fun '' than t

hey do wandering around among the egomaniacs down here . What a surprise . Accor

ding to Byrne , AID has been especially stressed because `` dramatic changes '' 

have made the agency `` what we like to call the number one laboratory for reinv

enting government . '' In the Clinton administration this sort of reinvention qu

ack-quack is slang for layoffs and budget cutbacks , but Byrne makes a convincin

g case that other stuff is happening , too . When last you tuned in , Byrne note

d , AID was always being accused of running expensive , inefficient , hugely stu

pid projects whose only apparent purpose was to keep corrupt Third World dictato

rships from going communist . `` When we ( the Clintonites ) first showed up , '

' Byrne noted , `` nine out of 10 phone calls from journalists focused on potent

ial abuses , dissatisfaction and misunderstanding . '' Now the communists are go

ne , Byrne said , `` the Cold War dictums no longer apply , '' and AID is shutti

ng down in 23 countries . Some of these are long-term friendlies who have allege

dly `` graduated '' ( Thailand , Costa Rica , Botswana ) to become `` developed 

countries . '' Others are short-term friendly `` graduates '' who apparently wer

e always developed , they just didn't know it ( Estonia , the former Czechoslova

kia ) . And a few are Third World dictatorships where nothing good ever seems to

 happen ( Zaire ) . So the good news for foreign aid haters is that we 're cutti

ng all these countries off . Maybe they no longer need us , as AID would have us

 believe , or maybe we no longer need them , since nobody 's going communist any

more . Whatever , it should be noted that this is not real money . Of the $ 7 bi

llion in the current foreign aid budget , Byrne says , only $ 2 billion is fundi

ng `` sustainable development '' projects in the Third World . The rest is eithe

r being used to keep old friends from throttling each other ( Israel and Egypt )

 or to keep new friends from getting crazy ( the former Soviet Union ) . So , if

 you 've only got $ 2 billion to massage , tempers can get short . Also , Byrne 

said nobody can smoke in the office anymore , `` which has caused quite a bit of

 stress , '' and relations with AID 's closest associates , the State Department

 and the U.S. . Information Agency , remain snarly . Thus the stress manifesto r

ecommends `` worry about things you cannot control , '' including Voice of Ameri

ca foreign aid editorials , which the AID press office must painstakingly read a

nd clear , even though , `` frankly , you wonder who 's interested , '' Byrne sa

id . The manifesto also notes that `` stress helps you seem important . Evidence

 : the State Department , '' but Byrne refused to expand on this statement . Lat

er , however , he admitted that `` you are reminding me that at the time we wrot

e this , it was a lot of fun . '' And good for moral .

 Charles Durning tucked away his D-Day memories 50 years ago . They were so pain

ful he 's rarely unpacked them since . Durning is the only survivor of a unit th