Adam Gaffney in the Boston Review:

In the spring of 2009, with the battle over the Affordable Care Act (ACA) in full swing, President Barack Obama called his aides into the oval office for an unusual meeting. As the New York Times reported, the topic of conversation was a recent New Yorker essay titled the “The Cost Conundrum.” It was written by the Harvard surgeon and writer Atul Gawande, now the CEO of Haven—the new Amazon-Berkshire Hathaway-JPMorgan Chase health care venture. His influential story—“required reading in the White House,” the Times called it—described a journey down into the heart of health care darkness: McAllen, Texas, a poor city at the southern tip of the state with some of the highest health care spending in the nation.

What was the root of McAllen’s high costs—and, by extension, of all of ours? Gawande quickly cracks the case. “There is overutilization here,” a general surgeon tells him during the trip, “pure and simple.” Patients went to the doctor too often, had too many operations, spent too much time at the hospital, and received too many days of home care. “The primary cause of McAllen’s extreme costs,” Gawande concludes, “was, very simply, the across-the-board overuse of medicine.”

More here.

Olga Tokarczuk at n+1:

I have a practical build. I’m petite, compact. My stomach is tight, small, undemanding. My lungs and my shoulders are strong. I’m not on any prescriptions—not even the pill—and I don’t wear glasses. I cut my hair with clippers, once every three months, and I use almost no makeup. My teeth are healthy, perhaps a bit uneven, but intact, and I have just one old filling, which I believe is located in my lower left canine. My liver function is within the normal range. As is my pancreas. Both my right and left kidneys are in great shape. My abdominal aorta is normal. My bladder works. Hemoglobin 12.7. Leukocytes 4.5. Hematocrit 41.6. Platelets 228. Cholesterol 204. Creatinine 1.0. Bilirubin 4.2. And so on. My IQ—if you put any stock in that kind of thing—is 121; it’s passable. My spatial reasoning is particularly advanced, almost eidetic, though my laterality is lousy. Personality unstable, or not entirely reliable. Age all in your mind. Gender grammatical. I actually buy my books in paperback, so that I can leave them without remorse on the plat­form, for someone else to find. I don’t collect anything.

more here.

Zadie Smith at the NYRB:

“Re-examine all you have been told,” Whitman tells us, “and dismiss whatever insults your own soul.” Full disclosure: what insults my soul is the idea—popular in the culture just now, and presented in widely variant degrees of complexity—that we can and should write only about people who are fundamentally “like” us: racially, sexually, genetically, nationally, politically, personally. That only an intimate authorial autobiographical connection with a character can be the rightful basis of a fiction. I do not believe that. I could not have written a single one of my books if I did. But I feel no sense of triumph in my apostasy. It might well be that we simply don’t want or need novels like mine anymore, or any of the kinds of fictions that, in order to exist, must fundamentally disagree with the new theory of “likeness.” It may be that the whole category of what we used to call fiction is becoming lost to us. And if enough people turn from the concept of fiction as it was once understood, then fighting this transformation will be like going to war against the neologism “impactful” or mourning the loss of the modal verb “shall.” As it is with language, so it goes with culture: what is not used or wanted dies. What is needed blooms and spreads.

more here.

Lucy Scholes at The Paris Review:

In the aftermath of the dissolution of Pressburger and Powell’s partnership in the late fifties, Pressburger turned to novels. The first, Killing a Mouse on a Sunday, published in 1961, is set during the aftermath of the Spanish Civil War and tells the story of a once notorious bandit, now a tired old man living in exile in France who resolves to cross the border back into Spain, despite the danger to his life, to visit his dying mother. In an interview published in the Daily Mail at the time, Pressburger explained that after years of “communal” creativity in the world of film, he wanted to “prove I could do something on my own.” The novel met with favorable reviews, was quickly translated into a dozen languages, and adapted for the big screen in 1964 as Behold a Pale Horse, directed by Fred Zinnemann and starring Gregory Peck, Omar Sharif, and Anthony Quinn. (That the film itself died a quick death didn’t really matter.) Everything was set for Pressburger’s second novel to build on this success. Unfortunately, this wasn’t to be. The Glass Pearls, published in 1966, was a much darker, grittier tale about a Nazi war criminal hiding in plain sight in the dingy streets of London’s Pimlico. It garnered one lone review, a damning write-up in the Times Literary Supplement. The book barely sold its initial print run of four thousand copies, immediately sinking without a trace. And yet, despite the reception it received at the time, The Glass Pearls is a truly remarkable work. It deserves to be recognized both for its own virtuosity, and as an important addition to the genre of Holocaust literature.

more here.

Jessica Wynne Lockhart in Smithsonian:

In August, marine biologists Johnny Gaskell and Peter Mumby and a team of researchers boarded a boat headed into unknown waters off the coasts of Australia. For 14 long hours, they ploughed over 200 nautical miles, a Google Maps cache as their only guide. Just before dawn, they arrived at their destination of a previously uncharted blue hole—a cavernous opening descending through the seafloor. After the rough night, Mumby was rewarded with something he hadn’t seen in his 30-year career. The reef surrounding the blue hole had nearly 100 percent healthy coral cover. Such a find is rare in the Great Barrier Reef, where coral bleaching events in 2016 and 2017 led to headlines proclaiming the reef “dead.”

“It made me think, ‘this is the story that people need to hear,’” Mumby says.

The expedition from Daydream Island off the coast of Queensland was a pilot program to test the methodology for the Great Reef Census, a citizen science project headed by Andy Ridley, founder of the annual conservation event Earth Hour. His latest organization, Citizens of the Great Barrier Reef, has set the ambitious goal of surveying the entire 1,400-mile-long reef system in 2020. “We’re trying to gain a broader understanding on the status of the reef—what’s been damaged, where the high value corals are, what’s recovering and what’s not,” Ridley says. While considered one of the best managed reef systems in the world, much of the Great Barrier Reef remains un-surveyed, mainly owing to its sheer size. Currently, data (much of it outdated) only exists on about 1,000 of the Great Barrier’s estimated 3,000 individual reefs, while a mere 100 reefs are actively monitored.

More here.

Hettie O’Brien in New Statesman:

The car, wrote the French thinker André Gorz, “supports in everyone the illusion that each individual can seek his or her own benefit at the expense of everyone else”. Writing in 1973, Gorz was frustrated by a paradox: cars had once been a luxury, invented to provide the wealthy with the unprecedented privilege of travelling much faster than everyone else. But they later became a necessity – objects considered so vital that people were willing to take on debt to acquire them. “This practical devaluation has not yet been followed by an ideological devaluation,” Gorz observed. Cars are still treated as a “sacred cow” – rather than an antisocial product.

Have cars made people happier? As a commuter (one who admittedly can’t drive), I’d argue not. They are an emblem of individualism, represented by former prime minister Margaret Thatcher’s embrace of private car ownership (in 1986, she cut the ribbon on the final stretch of the M25). Whether speeding along cycle paths or seated on a bus, journeying to work in London and many other cities is often slowed – and imperilled – by steel boxes regularly carrying only a single individual. They occupy scarce public space and emit noxious fumes.

More than anything, cars seem increasingly inappropriate in a world endangered by climate change.

More here.

Meditation on Dusk

The driven rhythm of crickets
behind sporadic croaking of frogs
mesmerizes me. Sitting on the steps
of my porch, I wonder at the glory
of all this noise. These are the sounds
of dusk, a time when, like the day,
I darken. A shiver of lost time jolts my body
like an electric shock, a ghost of a childhood
memory clutches my chest, the mystery
of nature renders me a thread of a fragment
of nothing. I am never less sure
of my existence as I am when I hear
unseen beings tear the edges of the day
from the universe, folding us all into darkness.

by Diane Elayne Dees
from Ecotheo Review

Crawford Kilian in The Tyee:

Thomas Piketty’s new book Capital and Ideology won’t be available in English until next March. At 1,150 pages, it will likely be more bought than read. But some of its ideas are already causing a stir, and one insight in particular could explain how the Canadian election will go.

In a 180-page report published in March 2018, Piketty documented a remarkable shift in the political “cleavages” of Britain, France, and the U.S. Those cleavages certainly apply to Canada and other nations as well.

“In the 1950s-1960s,” Piketty writes, “the vote for ‘left-wing’ (socialist-labour-democratic) parties was associated with lower education and lower income voters. This corresponds to what one might label a ‘class-based’ party system: lower class voters from the different dimensions (lower education voters, lower income voters, etc.) tend to vote for the same party or coalition, while upper and middle class voters from the different dimensions tend to vote for the other party or coalition.”

Having won the Second World War, the U.S. and its allies designed an economic system that would reward workers with job stability and relatively high income. This was not out of the goodness of their hearts; the late British historian Tony Judt argued that Western governments had seen workers turn communist after the First World War, while the middle classes turned fascist. They forestalled a repeat by imposing various forms of social democracy on themselves: health care, respect for unions, greater access to education, high tax rates on the wealthy.

More here.

Kenan Malik in Pandaemonium:

Some sporting moments achieve mythical status because of their sheer audacity. Muhammad Ali’s ‘rumble in the jungle’ defeat of George Foreman in Kinshasa in 1974 to regain his world heavyweight title comes to mind.

Others astound with a seemingly impossible perfection such as Nadia Comăneci’s perfect 10 in gymnastics at the 1976 Montreal Olympic Games.

And then there are those that astonish by redefining one’s perception of what it’s possible for a human being to achieve.

Eliud Kipchoge’s completion of a marathon in under two hours was one of those moments. People have long dreamt of, even predicted, a sub-two hour marathon. But the possibility of breaking the two-hour mark had seemed more for the imagination than for the road. On Saturday we witnessed imagination being given form.

More here.

Bjorn Lomborg in the New York Post:

As it is becoming obvious that political responses to global warming such as the Paris treaty are not working, environmentalists are urging us to consider the climate impact of our personal actions. Don’t eat meat, don’t drive a gasoline-powered car and don’t fly, they say. But these individual actions won’t make a substantial difference to our planet, and such demands divert attention away from the solutions that are needed.

Even if all 4.5 billion flights this year were stopped from taking off, and the same happened every year until 2100, temperatures would be reduced by just 0.054 degrees, using mainstream climate models — equivalent to delaying climate change by less than one year by 2100.

Nor will we solve global warming by giving up meat. Going vegetarian is difficult — one US survey shows 84 percent fail, most in less than a year. Those who succeed will only reduce their personal emissions by about 2 percent.

More here.

Robert Pollack in Edge:

How do we understand that our 100,000-fold excess of numbers on this planet, plus what we do to feed ourselves, makes us a tumor on the body of the planet? I don’t want the future that involves some end to us, which is a kind of surgery of the planet. That’s not anybody’s wish. How do we revert ourselves to normal while we can? How do we re-enter the world of natural selection, not by punishing each other, but by volunteering to take success as meaning success and survival of the future, not success in stuff now? How do we do that? We don’t have a language for that.

(ROBERT POLLACK is a professor of biological sciences, and also serves as director of the University Seminars at Columbia University.)

I’m asking myself what’s most important to do in the time I have. I’m very grateful for the time I have. I’m astounded at the difference between where I am and where I was in my memory, and astounded at the absence of a future stability to meet the stability that I had when I was growing up.

I was born in 1940. I’ve lived through the period of the greatest hegemony of American power and democracy and military might, with you and everybody else my age. We’ve lived seventy years without a nuclear war, after the use of nuclear weapons once. I look at my students who have remained the same age for the forty years I’ve been teaching them as I’ve gotten forty years older, and I wonder what their lives will be when they’re my age, what their grandchildren’s lives will be. That’s what’s on my mind. I don’t think it’s a political question at all. It’s an existential question. It may be a religious question. It is certainly an emotionally driven question. I’m a scientist, so I guess I have to say as well that it’s a scientific question. When I think about it as a scientific question, I think about it in terms of my work.

More here.

Celestial Navigation

Heather Mac Donald in The Christian Science Monitor:

Tech mogul Marc Benioff has been winning media accolades for his declaration that “capitalism, as we know it, is dead.” The billionaire founder and CEO of Salesforce, a cloud-based customer-relations company, has launched an advertising blitz promoting his new book, Trailblazer, which calls for a “more fair, equal and sustainable capitalism,” as Benioff put it in a New York Times op-ed on Monday. This “new capitalism” would not “just take from society but truly give back and have a positive impact,” Benioff maintains.

…Fortunately for anyone seeking to evaluate what the new capitalism might entail, Benioff has provided a concrete example of a CEO solving “social challenges”—the challenge in this case being San Francisco’s festering homeless problem. Salesforce is headquartered in San Francisco and is the city’s biggest employer. In 2018, Benioff, in conjunction with San Francisco’s most fearsome advocacy group, the Coalition on Homelessness, put a new tax on the local ballot to double the taxpayer dollars already going to the city’s main homelessness agency. Proposition C would impose an extra 0.5 percent gross-receipts sales tax on companies with more than $50 million in annual revenue, raising an estimated $250 million to $300 million, all of which would be funneled into the homelessness-industrial complex.

To Benioff, the issue was clear: “Are you for the homeless or not for the homeless? For me, it’s binary. I’m for the homeless,” he told the San Francisco Chronicle.

More here.

More here.

Henry Marsh in the New York Times:

Throughout my career as a neurosurgeon, I have worked closely with oncologists. Many of my patients have cancer of the brain — one of the deadliest of the near-infinite number of cancers. I have always viewed my oncological colleagues with complicated, contradictory feelings. On the one hand, I’m in awe of their work, which can be so emotionally demanding. On the other, I suspect they don’t always know when to stop.

There’s an old joke in medical circles: “Why should you never give an oncologist a screwdriver?” The answer: “Because they will open the coffin and carry on treating the patient.”

Azra Raza, an oncologist at Columbia University, vividly illustrates this tug-of-war in her book “The First Cell: And the Human Costs of Pursuing Cancer to the Last.” It is, in many ways, a cry of protest against the disease that killed her husband (also an oncologist) and, over time, most of her patients. When it comes to cancer, Raza knows firsthand how hard it is to reconcile compassion with science and hope with realism.

More here.  [And congratulations to my sister on her excellent book!]

Stephanie Merritt in The Guardian:

Unlike Hillary Clinton, who used the same title for her memoir, Hanif Kureishi attaches a question mark to What Happened?, making clear that this collection of essays and stories is an interrogation of the recent past and not merely a dispassionate account of events. There is a note of incredulity, too, in his question, and this desire to comprehend and come to terms with the cultural and political shifts of the past decade runs through the book.

What Happened? serves as a postscript to Kureishi’s Collected Essays, published in 2011, which brought together the best of his journalism and nonfiction over the previous three decades. Many of the pieces here revisit similar themes and preoccupations, particularly around ideas of race, religion and cultural identity. Why Should We Do What God Says? and Fanatics, Fundamentalists and Fascists cast an eye back to the 1989 fatwa against his friend Salman Rushdie, and the far-reaching ripples of that event for free speech, the western perception of Islam, and the hardening and polarising of ideologies. “The contemporary view of Muslims is the mirror image of the current far-right ideology overtaking the west: sexist, homophobic, insular, monocultural, combative,” he writes in the latter piece, before calling for a different kind of radicalism among the young, a movement of solidarity to tackle the creeping fascism and fearful power-grabbing of their elders.

More here.

David Byrne in Reasons To Be Cheerful:

In New York, where I live, whenever there’s a big holiday weekend, the traffic on Friday as folks leave town turns much of Manhattan into a hot, fume-filled parking lot. On those days, one can often walk faster than the traffic is moving. That may be the exception, but congestion in many cities has reached the point where getting around by car at certain times of day is almost not an option.

Folks who live in L.A., for example, simply rule out driving to other parts of the city at certain hours. (The old “nobody goes there anymore, it’s too crowded” problem.) These drivers have synced their lives to the ebb and flow of other people’s cars, a sad but logical response, since congestion costs Americans more than $1,300 per year and 97 hours of their time. When you consider than almost half of Americans would find themselves in a financial crisis if they got hit with a $400 expense, it’s pretty clear that car-based lifestyles in cities aren’t sustainable.

So why do we keep driving? The simple answer is, in some cities, many of us have little choice. The Barcelona Institute for Global Health says that 60 percent of urban infrastructure is devoted to cars. Years of prioritizing driving at the expense of walking, biking and mass transit have left many people no viable alternative to private vehicles.

More here.

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