Dr Robert Gallo, a biomedical researcher, is renowned for his role in the discovery of human immunodeficiency virus (HIV) as the infectious agent responsible for AIDS and in the development of HIV blood tests. He co-founded Profectus BioSciences, Inc., a biotechnology company. Profectus develops and commercializes technologies to reduce the morbidity and mortality caused by human viral diseases. He is also a co-founder and scientific director of Global Virus Network. He is the director and co-founder of the Institute of Human Virology at the University of Maryland School of Medicine. In November 2011, Dr Gallo was named the first Homer & Martha Gudelsky Distinguished Professor in Medicine.

Azra Raza, author of The First Cell: And the Human Costs of Pursuing Cancer to the Last, oncologist and professor of medicine at Columbia University, and 3QD editor, decided to speak to more than 20 leading cancer investigators and ask each of them the same five questions listed below. She videotaped the interviews and over the next months we will be posting them here one at a time each Monday. Please keep in mind that Azra and the rest of us at 3QD neither endorse nor oppose any of the answers given by the researchers as part of this project. Their views are their own. One can browse all previous interviews here.

1. We were treating acute myeloid leukemia (AML) with 7+3 (7 days of the drug cytosine arabinoside and 3 days of daunomycin) in 1977. We are still doing the same in 2019. What is the best way forward to change it by 2028?

2. There are 3.5 million papers on cancer, 135,000 in 2017 alone. There is a staggering disconnect between great scientific insights and translation to improved therapy. What are we doing wrong?

3. The fact that children respond to the same treatment better than adults seems to suggest that the cancer biology is different and also that the host is different. Since most cancers increase with age, even having good therapy may not matter as the host is decrepit. Solution?

4. You have great knowledge and experience in the field. If you were given limitless resources to plan a cure for cancer, what will you do?

5. Offering patients with advanced stage non-curable cancer, palliative but toxic treatments is a service or disservice in the current therapeutic landscape?

by Rafaël Newman

In the spring of 1991 I crossed the German-Polish border at Görlitz and travelled through Zgorzelec, the city’s one-time other half across the river Neisse, into Poland.

The Gulf War had just ended, and the streets of Berlin, where I was spending the year at the Freie Universität, were still littered with cardboard coffins, relics of protest against the US-led intervention in Iraq. A recent visit to the Theater am Schiffbauerdamm, to see the Berliner Ensemble perform Brecht’s Die Maßnahme, had been disrupted by activists clambering on stage with a banner that read, “THIS IS WAR: NO MORE EVERYDAY LIFE”, a neatly ironic iteration of the playwright’s own tactic of estrangement as a defense against complacency and the hypocritical respite provided by bourgeois entertainment. Moreover, whispered confabs at the Staatsbibliothek with fellow students at my American grad school also currently abroad were being met with glares of more than usually acid disapproval from locals. So it seemed like a good time to get out of town for a while.

A recently acquired Berlin friend had planned a car trip to Poland to visit family – or rather, the Polish friends who had assisted his German relatives when they were made to leave their “ancestral” home on the Baltic following the Second World War, when that part of Germany was “restored” to Poland, for a new residence on the Rhine – and I invited myself along for part of the ride: from Berlin, by way of Görlitz/Zgorzelec, to Breslau, now Wrocław, where I would part company with my friend before he headed north to Gdynia, his family’s former home. Read more »

by R. Passov

The British Boxing Board of Control (BBBofC) provides a short history of boxing. It’s an ancient sport. The Romans fought each other wearing cestus, sometimes to the death. Before them so the Greeks. In the fourth century AD, tired of the violence, the Romans outlaw the sport.

According to the BBBofC, fourteen hundred years pass before boxing re-appears in London as an organized sport for bettors. In 1719, a James Figg is recognized as the First Heavyweight Champion. His protégé, John Broughton introduces rules. A century later, John Graham fighting for the 8^th Marquis of Queensberry, codifies the rules as the Queensberry Rules, which still govern the sport:

A boxer shall wear gloves. Wrestling is not allowed. The match is no longer a fight to the finish. Rounds shall last for three minutes. A boxer must rise before a 10 second count and the match shall be fought in a standardized ring – more or less.

Queensberry Rules also include – No shoes or boots with springs and a man hanging off the ropes with his toes off the ground shall be considered down. Read more »

by Brooks Riley

by Bill Murray

Americans stood as implacable enemies of National Socialism. As an American myself, on the anniversary of the Berlin Wall’s fall, I want to tell you about my dear friend the Nazi soldier.

“I don’t like Polish people,” he says, and raises an eyebrow suggesting “How could anybody, really?” 

Among other things, it’s common knowledge their language is incomprehensible. 

At 90, he has earned his opinions. 

He’s gray and a little severe, turned out today in a light spring jacket, tan sweater and shirt with matching scarf. He takes small steps, pitched forward just a little. He’s tall, thin, bright and upright, and he walks us up and down the streets of Wittenberg all day long.

We suggested a visit and he’s determined we make the day of it. We’ve come all this way, haven’t we?

His father was born in Poland, but mind you, Poland’s borders waved like a battle flag. When his father was born Posen was German. Today it is Poznan, in Poland.

His father fought the Great War riding great horses for the Kaiser, a dragooneer fighting hand to hand with lances. Imagine. His father owed oaths to three sovereigns in his lifetime: Kaiser Wilhelm, the Weimar government and the Third Reich. Imagine that, too.

Erich was born in 1929.  Read more »

by Bill Benzon

AI – artificial intelligence – is all the rage these days. Most of the raging, I suspect, is a branding strategy. It is hype. Some of it isn’t, and that’s important. Alas, distinguishing between the hype and the true goods is not easy, even for experts – some of whom have their own dreams, aspirations, and illusions. Here’s my 2 cents on what we do and do not know.

And it’s only that: 2¢. Not a nickel or a dime more, much less a 50 cent piece.

What are computers, animal, vegetable, or mineral?

One of the problems we have in understanding the computer in its various forms is deciding what kind of thing it is, and therefore what sorts of tasks are suitable to it. The computer is ontologically ambiguous. Can it think, or only calculate? Is it a brain or only a machine?

The steam locomotive, the so-called iron horse, posed a similar problem in the nineteenth century. It is obviously a mechanism and it is inherently inanimate. Yet it is capable of autonomous motion, something heretofore only within the capacity of animals and humans. So, is it animate or not? Consider this passage from Henry David Thoreau’s “Sound” chapter in Walden (1854):

When I meet the engine with its train of cars moving off with planetary motion … with its steam cloud like a banner streaming behind in gold and silver wreaths … as if this traveling demigod, this cloud-compeller, would ere long take the sunset sky for the livery of his train; when I hear the iron horse make the hills echo with his snort like thunder, shaking the earth with his feet, and breathing fire and smoke from his nostrils, (what kind of winged horse or fiery dragon they will put into the new Mythology I don’t know), it seems as if the earth had got a race now worthy to inhabit it.

What was Thoreau doing when he wrote of an “iron horse” and a “fiery dragon”? He certainly recognized them as figures. He knew that the thing about which he was talking was some glorified mechanical contraption. He knew it was neither horse nor dragon, nor was it living. Read more »

The river Eisack flows into Franzensfeste in the South Tyrol from the north on a clear night, November 10, 2019.

by Akim Reinhardt

Stuck is a new weekly serial appearing at 3QD every Monday through early April. A table of contents can be found here.

Prologue: Full of Sound and Fury

Last year we drove across the country. We had one cassette tape to listen to on the entire trip. I don’t remember what it was. —Steven Wright

You sing it in the shower and in the car. You slap your thighs and lip sync at work. Eventually you try to ignore it, but on and on it goes. You often don’t remember when it began. Worst of all, you have no idea how to make it stop. Good, bad, or otherwise, the song has a hold on you, and there’s nothing you can do about it.

Then, poof! It’s gone.

You don’t know what you did. Probably nothing. Nor can you pinpoint a specific moment when the song slipped away, unnoticed. While it was here, there was no escaping it. But when you weren’t looking, it magically flittered away, like pixie dust losing its shimmer in the breeze; the spell has been broken and you are finally free.

I’m no different from other people, except when I am.

Left to its own devices, my mind will usually fill the blank spots with music. Walking down the street, cooking dinner, lazing around the house: most activities are accompanied by a random soundtrack in my head. Even while doing something that requires substantial concentration, such as writing this book for example, I usually hear music.

Simply put, music clings to me. All kinds, really. Any genre. Rock, blues, pop, folk, jazz, hip hop, classical, avante-garde, whatever. Things I like, things I don’t. A song I heard on the radio. The theme to a TV program. Something playing in the supermarket, or blaring out the window of someone else’s car, or honestly from lord knows where. From far and wide, it finds me and holds on tight. Pieces of songs, scraps of this and that, melodies and chords, beats and rhythms parade through my brain, one after the next, a vast array of sound, ever changing.

Until a something gets stuck. Some folks call it an “earworm.” Read more »

by Pranab Bardhan

As a development economist I am celebrating, along with my co-professionals, the award of the Nobel Prize this year to three of our best development economists, Abhijit Banerjee, Esther Duflo and Michael  Kremer. Even though the brilliance of these three economists has illuminated a whole range of subjects in our discipline, invariably, the write-ups in the media have referred to their great service to the cause of tackling global poverty, with their experimental approach, particularly the use of Randomized Control Trial (RCT).

Of course, the Prize as such is not for great policy achievements in poverty reduction (if it were, the Chinese policy-makers enabling the lifting of nearly half a billion people above the poverty line in their country would have got prior attention), but for methodological breakthroughs, which the pioneering effort in extensive application of RCT in field experiments in several poor countries clearly is.

I should also proudly point out that these three economists did some of their major work while they were active members of a MacArthur Foundation-funded international research group on Inequality that I co-directed for more than 10 years starting in the mid-1990’s. Duflo was the youngest member of our group; incidentally, the French speakers (including, apart from Duflo, Thomas Piketty, Philippe Aghion, Roland Benabou, and Jean-Marie Baland) and the Bengalis (apart from myself, Abhijit Banerjee and Dilip Mookherjee) were together nearly half in strength in this group of about 18 members from different countries and social science disciplines.

The media write-ups on the Nobel Prize (including in leading magazines like The Economist), however, give a somewhat misleading impression about the evolution of thinking in development economics, as if after decades of pontification on structural transformation and prudential macro-economic policy and associated cross-country statistical exercises to understand the mainsprings of growth and development, the practitioners of RCT  finally came along focusing our attention to the micro level, and providing us with a magic key, the so-called ‘gold standard’ in assessing poverty alleviation policies, telling us what ‘works’ at the ground level of policy intervention and what does not. Read more »

by Elizabeth S. Bernstein

Feminists are often accused of downgrading motherhood. The accusation is ridiculous: motherhood hit rock bottom long before the new feminist wave broke. —Germaine Greer (1984) ¹

What sort of picture does the phrase “stay-at-home mother” call to mind? Searching images and stock photos online, you may find a reasonably diverse looking group of contemporary women with young children. There are, after all, millions of mothers at home in the United States today – over a third of those with children under the age of six – and they are a demographically diverse lot.

But there is also a particular variant of the photos on offer which tends to be favored by editors looking for illustrations of at-home mothering. It is the image of that iconic housewife of the 1950s, in her apron and heels. The woman who, these many decades later, is still our foil. The woman whose fate we were saved from by second-wave feminism.

This woman, the story goes, had been influenced by men to devote herself to her children to an excessive degree. The very essence of the “feminine mystique” Betty Friedan decried was that it urged postwar wives to find their fulfillment in “sexual passivity, acceptance of male domination, and nurturing motherhood.” ² Read more »

by Syed Tasnim Raza

When I was a young attending surgeon on the faculty in the Division of Cardiothoracic Surgery, one of the things I got frequently called for was management of malignant pleural or pericardial effusions. Once a patient develops malignant pleural or pericardial effusion the median survival is only two months, so I would do things that would relieve the acute symptoms and perhaps try to prevent fluid from reaccumulating, but nothing drastic or major. One evening in late October, one of the nurses who had known me called to say that her father was being treated for lung cancer but had to be admitted with a large pleural effusion and that she and her father’s Oncologist would like me to manage it. I met the fine 72-year old retired banker, and while he was short of breath even as he talked, he was in a very upbeat mood. I decided to insert a chest tube to drain the pleural fluid and relieve his symptoms. As I was doing the procedure at the bedside the patient mentioned to me that his oncologist has assured him that once his fluid is out he will start him on a new regimen of chemotherapy and he should expect to live for a few more years. I was disturbed to hear the false hope he was being given.

Later on, his daughter asked me what I thought of his prognosis and I asked her if I should be honest. She said yes, please. I explained to her that I was concerned by the false hope the oncologist had given her father, that he may indeed live many more years, but the chances are he will not see Christmas in the following year, and at least he should be prepared for such an outcome. The next day the patient asked me directly and I gave the same answer, in other words one should hope to live long and beat the odds, but always be prepared for the alternative. After he was discharged and went home, he organized a big Thanksgiving dinner for his extended family, including his three sisters he had not seen in many years. He died in mid-December of that year. I went to his funeral and his daughter and wife hugged me and thanked me profusely for being so honest and what a wonderful Thanksgiving he had before he died. And he was able to say goodbye to his loved ones. In my own practice I have felt that it is good to give patients hope, but it should be realistic and honest.

In her remarkable book “The First Cell,” Azra (full disclosure: Azra is my younger sister) has been brutally honest at every level. Read more »

by Ali Minai

Your love stirs the ocean into reckless storms.
At your feet, the clouds drop their pearls.
Dark smoke rises in the sky, a fire burns
Where your love’s lightning strikes the earth.

These energetic lines open Moon and Sun: Rumi’s Rubaiyat, Zara Houshmand’s brilliant translation of selected ruba’iyat – quatrains – by Molana Jalaluddin Rumi, and set the tone for an inspiring and exhilarating sojourn through the passions of the peerless Sage of Konya.

It has become almost a cliché to cite Rumi’s status as the most widely read poet in America today. If that is so, it is only because of the many translations of his works into English by poets as distinct as Robert Bly and Coleman Barks. Clearly, all of these translations have something that touches the hearts of 21^st century Americans in ways that even modern American poets seldom do. Perhaps it is because this poet who lived thousands of miles away and eight centuries ago has a strikingly modern sensibility – a directness of expression and connection that, couched in appropriate words, can grab a reader across the gulf of centuries. But finding those words also requires a creative act – a re-ignition of the original fire, so to speak. In many cases, translations of Rumi have succeeded by glossing over the complexity of the original, or injecting it with a little modern – even Western – attitude. Most translations have drawn on Rumi’s matchless didactic work, the Masnavi, which is a tapestry of poetic tales embedded within tales, each taking the reader to deep ethical and existential insights. Unlike most other classical Persian poetry, the Masnavi is written in a direct – almost modern – voice. As such, poems from it can be – and have been – translated well by focusing on the stories they tell and the moral conclusions they reach, without worrying too much about replicating Rumi’s poetic diction. The other body of Rumi’s work that has been translated extensively are his ghazals from the Divan-e Shams-e Tabrizi, ranging from A.J. Arberry’s beautiful literal translations to Nader Khalili’s more poetic ones and the impressionistic renditions of Kabir Helminski – all satisfying and lacking in distinctive ways, as must always be the case in translations of this genre. The task undertaken by Zara Houshmand in Moon and Sun is distinct from all these predecessors. Read more »

Dr. Larry Norton, a breast oncologist, is well-known as a leader in the development of drug treatments for breast cancer. His research has established the importance of using sequential combinations of drugs — a strategy aimed to overcome different drug sensitivities among the cells in a tumor. He has served in leadership positions in several national cancer-related organizations, including serving as president of the American Society of Clinical Oncology (ASCO) in 2001-2002, and is chairman of the board of directors of the ASCO Foundation. Currently, Dr. Norton is serving as the Senior Vice President at Memorial Sloan Kettering Cancer Center and a Professor of Medicine at Weill-Cornell Medical College with over 350 published articles and book chapters to his name.

Azra Raza, author of The First Cell: And the Human Costs of Pursuing Cancer to the Last, oncologist and professor of medicine at Columbia University, and 3QD editor, decided to speak to more than 20 leading cancer investigators and ask each of them the same five questions listed below. She videotaped the interviews and over the next months we will be posting them here one at a time each Monday. Please keep in mind that Azra and the rest of us at 3QD neither endorse nor oppose any of the answers given by the researchers as part of this project. Their views are their own. One can browse all previous interviews here.

1. We were treating acute myeloid leukemia (AML) with 7+3 (7 days of the drug cytosine arabinoside and 3 days of daunomycin) in 1977. We are still doing the same in 2019. What is the best way forward to change it by 2028?

2. There are 3.5 million papers on cancer, 135,000 in 2017 alone. There is a staggering disconnect between great scientific insights and translation to improved therapy. What are we doing wrong?

3. The fact that children respond to the same treatment better than adults seems to suggest that the cancer biology is different and also that the host is different. Since most cancers increase with age, even having good therapy may not matter as the host is decrepit. Solution?

4. You have great knowledge and experience in the field. If you were given limitless resources to plan a cure for cancer, what will you do?

5. Offering patients with advanced stage non-curable cancer, palliative but toxic treatments is a service or disservice in the current therapeutic landscape?

by Anitra Pavlico

“Vivi felice (live happily)” —Domenico Scarlatti, in the introduction to his Essercizi per Gravicembalo (Exercises for Harpsichord), 1738

Domenico Scarlatti (1685-1757) refuses to be put into any particular category, despite generations of music historians’ efforts. Scarlatti scholar W. Dean Sutcliffe begins his 2003 book The Keyboard Sonatas of Domenico Scarlatti and Eighteenth-Century Musical Style with the blunt statement, “Domenico Scarlatti does not belong.” Scarlatti was born in Italy, but spent the last thirty years of his life in Spain. He was not quite Baroque, not quite Classical. In his review of the Sutcliffe book, Michael Talbot describes Scarlatti as a “cult figure” who is “neither inside nor outside the canon. He is not seminal in the sense of forming a link in a historical chain either of composers or of performers, but his influence is clearly perceptible in the literature of keyboard instruments from Haydn to Ligeti.” As disparate as their styles might appear, Franz Liszt was an early champion of Scarlatti’s sonatas, and was perhaps the first to perform them publicly. Chopin was also an admirer. Talbot says that Beethoven must have written the second movement of his Op. 54 piano sonata with the ghost of Scarlatti looking over his shoulder. 

Sutcliffe views the concept of “disdain” as central to Scarlatti’s approach: the term, first applied to the composer by Italian musicologist Giorgio Pestelli, connotes a deliberate rejection of convention. Scarlatti is well-versed in, but does not fully adopt, the conventions of the galant musical language in vogue at the time. In short, the galant style was a response to the complexity of the Baroque period and featured simpler melodies, phrasing, and harmonies. Rules are well and good for lesser composers, apparently, but Scarlatti reportedly was of the opinion that his deviations from the rules were “sanctioned by the pleasure that they gave the ear.” Janet Schmalfeldt writes that Scarlatti is “intriguing” in his evasion of stylistic classification, a “smart move” on his part: he was seemingly ahead of his time, given the modern disillusionment with stylistic categories and sharp boundaries between historical periods. Read more »

by Michael Klenk

Moral psychology has shaken up moral philosophy in recent years (see, e.g., here and here). The upheaval is welcome. Understanding better how ethical judgements work should eventually lead to positive behaviour change. For example, we might hope for more altruism to solve collective action problems like climate change, and less in-group vs out-group thinking, to curb racism.

So far, however, moral psychology’s impact on ethical conduct has mostly been within the narrow confines of academic journals. The philosophers who took up moral psychological findings mainly focus on rather abstract questions about the theory of knowledge and methodology in ethics. For example, a significant debate concerns the question of whether moral judgments remain warranted given evidence of their psychological origin (see, for example, some of my previous blogs here and here).

Notwithstanding the fascinating nature of such meta-ethical questions, it is a long way from progress in these theoretical debates to effecting positive behavioural change in people. Indeed, moral psychology’s practical impact has not been a focus of much academic work yet.

Our hope may rest on what we can call ‘trickle-down ethics,’ where the revelations of ethicists trickle down to all of society eventually. Moral psychology may impact moral philosophy, and so the impact of moral psychology on moral philosophy may finally be felt in practice, too. However, there is no clear evidence for the success of trickle-down ethics, and blindly trusting it can be frustrating. After all, engaging in moral philosophy is a way to understand what ought to be done, and why, and then to do it – not merely hoping that something eventually gets done. Even if moral philosophy as a discipline has illuminated the ‘understanding’ part, we leave the ‘practice part’ almost entirely to an ill-founded hope in trickle-down ethics. So, blind trust in trickle-down ethics is probably up for a displeasing reality check, especially if the frail prospect of trickle-down economics is any indicator. Read more »

by Brooks Riley

by Shadab Zeest Hashmi

One autumn I’m suddenly taller than my mother. The euphoria of wearing her heels and blouses will, for an instant, distract me from the loss of inhabiting the innocence of a child’s body—the hundred scents and stains of tumbling on grass, the anthills and hot powdery breath of brick-walls climbed, the textures of twigs and nodes of branches and wet doll hair and rubber bands, kite paper and tamarind-candy wrappers, the cicada-like sound of pencil sharpeners, the popping of coca cola bottle caps, of cracking pine nuts in the long winter evenings— will blunt and vanish, one by one.

That the sensory life is dulled just as the cerebral life is intensified, is no accident; at school, boys and girls are separated for a special talk on how the changing body requires a set of rules, a sense of restraint. The talk is grave and ends with alarming details of the impending burden of academic work that will make or break us. As if the process of adapting to a new life in a new body were not hard enough, we are told that we are under scrutiny for following the prescribed path of success as well as for containing the challenges that gender poses.

The body is as unforgiving as the social norms it finds itself in the clutches of; it is more often a tempest than a temple. Growing pains, at least for girls, must be strictly private. How you decipher and piece together the physical, emotional and social puzzle of your life is entirely and urgently your own responsibility and never without open and free scrutiny and judgement. The present is a perpetual shore to an ocean of future anxiety; there is no turning back. Without sisters or close female company, I am alone now in this space of being a girl and I always will be as a woman. Read more »

by Chris Horner

The question of how to program AI to behave morally has exercised a lot of people, for a long time. Most famous, perhaps, are the three rules for robots that Isaac Asimov introduced in his SF stories: (1) A robot may not injure a human being or, through inaction, allow a human being to come to harm; (2) A robot must obey orders given it by human beings except where such orders would conflict with the First Law; (3) A robot must protect its own existence as long as such protection does not conflict with the First or Second Law. These have been discussed, amended, extended and criticised at great length ever since Asimov published them in 1942, and with the current interest in ‘intelligent AI’ it seems they will be subject for debate for some time to come.  But I think the difficulties of coming up with effective rules of this kind are more interesting for what they tell us about the difficulties of any rule or duty based morality for humans than they are for the question of ‘AI morality’. 

Duty based – the jargon term is ‘deontological’ – morality seem to run into problems as soon as we imagine them being applied. Duties can easily seem to clash or lead to unwelcome outcomes – one might think that lying would be justified if it meant protecting an innocent person from a violent person set on harming them, for instance. So which duties should take precedence in the infinite number of future situations in which they might be applied? Answering a question like that involves more than coming up with a sequence of rules, as there seems to be something one needs to add to any would-be moral agent for them to really exercise an adequate moral judgment. Considering the problems around this is more than a philosophical parlour game as it should lead us into more realistic ways of thinking about what it takes to act well in the real world. What we are looking for, I think, is an approach that takes into account the need for genuinely autonomous moral thinking, but also connects the moral agent to the the complicated social world in which we live. Read more »

On the tarmac at Innsbruck airport just before boarding this Airbus A320 jet to Berlin last week. It is always exciting to land at or takeoff from Innsbruck because of the surrounding high mountains.