Joseph R. Bertino, MD, is University Professor of medicine and pharmacology, UMDNJ-Robert Wood Johnson Medical School and has previously served as director of the Yale Cancer Center and chair of the Molecular Pharmacology and Therapeutics Program at Memorial Sloan-Kettering. He is the author and co-author of more than 400 scientific publications and the founding editor of the Journal of Clinical Oncology. His research is focused on curative treatments for leukemia and lymphoma and has helped shape optimal methotrexate administration schedules. Currently, his laboratory is studying gene therapy and stem cell research. He has received the Rosenthal Award from the American Association of Clinical Research, the Karnofsky Award from the American Society for Clinical Oncology, and the American Cancer Society Medal of Honor for his accomplishments in the field of research.

Azra Raza, author of the forthcoming book 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 Joseph Shieber

One of the masterful conceits of Socrates’s discussion of tyranny in Plato’s Republic is a surprising claim that Socrates makes at the outset of the dialogues, and one that serves as a guiding thread throughout. You would expect that if someone is going to criticize tyranny, they would do so because of the harms done to the victims of tyranny. But Socrates claims that he can show that tyranny actually harms the tyrant himself. In fact, Socrates even claims that the harms to the tyrant are greater than those done to his victims.

I thought of this brilliant rhetorical strategy as I read Daniel Markovits’s recent essay in the Atlantic Monthly, “Meritocracy’s Miserable Winners”.

Markovits deploys the Socratic maneuver from The Republic in service of a critique of meritocracy. The one side of the critique, that meritocracy harms those that it excludes from its gifts, is the one that you might expect. But the other side of the critique, that meritocracy harms its beneficiaries, those who reap enormous wealth and status from meritocratic institutions, is the one that might surprise you.

I want to get to the more original aspect of Markovits’s critique of meritocracy – his claim that it harms its beneficiaries – in a moment. But I first want to consider his critique of meritocracy on the basis of its harms to those excluded from its rewards. Read more »

What To Say To Rain

I would like to beat down
into the world too
& make everything growing glisten.

…

What to Say to Sky After a Storm

It’s too late
when the silver sun blinks awake
we already learned how to live
in our soft bodies in the wind
& dream through the shadows of rain.

…

What to Say to Night

Thanks for the moon. You knew
to leave a light on in the long hallway
and I believe the shadow of the Earth
that gouges it out is an accident.

…

What to Say to Write

There is nothing to say
except
the whole sky blossoms sometimes
into billows & light
& the wooden bowl of peaches on the oak table
speaks to how something
keeps on giving–we should say
if we deserve this.

by Katie Poore

As a child, author and poet Annie Dillard would traipse through her neighborhood, searching for ideal places to stash pennies where others might find them. In her novel Pilgrim at Tinker Creek, a meditation on the natural world surrounding her home in a rural Virginia valley, she tells us she would nestle them “at the roots of a sycamore,” or perhaps “in a hole left by a chipped-off piece of sidewalk.” She would draw arrows pointing toward the penny in chalk, sometimes writing tantalizing promises down the block: “SURPRISE AHEAD” or “MONEY THIS WAY.”

She wanted to give innocent passersby “a free gift from the universe,” she says. In her six-year-old mind, these pennies were just that: potent and grand indicators of a larger existential goodness, near-divine symbols of worldly benevolence.

Reading about this childish endeavor is endearing, and even admirable. It’s hard to imagine many children go about their days attempting to introduce such undeserved and good-natured whimsy into the lives of complete strangers.

But I know I never would have picked up Dillard’s penny. If I had followed her arrows at all, I’m certain I’d have seen the penny and rolled my eyes, leaving my gift from the universe behind. Let some other crestfallen explorer settle for such a scant cosmic prize.

But this is precisely Dillard’s point: How many gifts do we elect to bypass simply because they are too small? The chapter in which she recounts this tale is called “Seeing,” which begs the question: How blind are we? How resistant to wonder have we made ourselves, and how unaccommodating of the universe’s gifts? As Dillard phrases it: “Who gets excited by a mere penny?” Read more »

by Brooks Riley

by Mindy Clegg

Forty years ago, a band from Manchester recorded and released their first full length album. It arrived after a year or so of gigs, an EP, and several tracks on a sampler LP put out by their new (and newly created) label, Factory Records. Thanks to producer Martin Hannett, it sounded unlike anything else at the time, much to the chagrin of the band, who hoped to capture their manic live spirit to vinyl. They didn’t feel the album was quite punk enough. Instead, they made a postpunk masterpiece that still speaks to the modern listener 40 years on.

One can argue that much of the punk or postpunk music from the late 70s and early 80s has taken on a dated feel in terms of production, musical structure, lyrics, or all of the above. History has moved on, after all. That historical distance does not detract from the music or diminish its cultural and historical importance; it’s just that some of the bands are far more time-bound than others. Not Joy Division, though. All aspects of the album manage to be of their time and still relevant. At the risk of dancing about architecture, I will explore why this album both represents its historical moment AND speaks to us with a fresh voice today. Joy Division’s overall body of work reflects the nature of the second half of the twentieth century, the dark overtones of our hyperconsumerist age. This album sounds fresh 40 years on precisely because it represents historical processes that continue to work themselves out across time and space while giving emotional resonance to our Ballardian world.¹ Read more »

I was about to board this Frecciargento fast train from Bozen to Verona last week when I noticed how nicely the shape of the train matched the shape of the mountain in the background.

by Tamuira Reid

The apartment in West Harlem, five buildings down on the left. The apartment just past the pawn shop, across from the Rite-Aid, parallel to the barber’s where all the pretty boys hangout waiting to get a Friday night shave. The apartment past the deli were you get cheese and pickle sandwiches and the all-night liquor store and the ATM machine no one is dumb enough to use.

The apartment at the top of the stairs with the impossibly high ceilings and the blue bathroom door, the door you labor behind for twelve hours before going to the hospital, your body threatening to push another body out. The apartment where you bring him home, his pink baby body covered in muslin and sweat. The apartment with the wide cracked stoop where you rest with his father just long enough to catch your breath, to say holy shit, he’s beautiful.

The apartment you now stand in front of, seven years later, holding onto a box of birthday-wrapped legos and your son’s hand. The apartment at Broadway and 138^th. The apartment on the way to the party. The apartment half-way down a steep hill, the hill you lug your grocery bags down, and the hill you climb with your luggage. The apartment with a broken oven but perfect sunlight and enough closets to hide things in. The apartment in an old brownstone next to other old brownstones, framed by planter boxes filled with tulips and beer cans and night club fliers. The apartment owned by an angry old man and his needy young wife, a man who is stretched so thin he could give two fucks when you tell him the heat is out. The apartment where you sleep in a pile for warmth, arms and legs wrapped around one another, the baby squished between across the two of you. Read more »

by Shawn Crawford

Preachers at our Baptist church had to ask for an Amen. We weren’t just going to spontaneously let one loose. God can’t drive a parked car, my youth minister would say. Meaning you had to exert your own will as well in the pursuit of a righteous life. When it came to the Holy Spirit, we rarely even tried the ignition.

After the death of Christ, the apostles found themselves a pretty sorry lot. Scared and convinced they were the next candidates for execution, most went into hiding. What transformed them was not merely the appearance of the resurrected Jesus, but the gift of the Holy Spirit, and this gift came to them through the sound of a rushing wind and tongues of fire that descended from heaven and “came to rest on each of them” (Acts 2.3). The depiction of this event generally involves little candle flames hovering over the Apostles. As if that wasn’t cool enough, the first thing that happened for the Apostles was the ability to speak in languages they had never known. Which came in handy, because it just so happened Jews all over the world had gathered in Jerusalem for Pentecost, a derivation of a Greek word that means “fifty” and denoted the fiftieth day after Passover and the beginning of the next Jewish holiday Shavuot. Peter gave the first sermon on the need for repentance and baptism, the Christian church began, and the word Pentecost became associated with the Holy Spirit and speaking in tongues, which would eventually spawn a focus on such practices in Pentecostal churches. Read more »

by Michael Liss

I don’t know a lot about guns.

I live in New York, which has comparatively restrictive gun laws, I don’t own any, I don’t hunt (and didn’t grow up hunting), and I wasn’t in the service. I don’t have the emotional bonds that others who grew up around them might. The entire sum of my personal experience was several years of summer-camp riflery practice: .22 caliber single-action rifles that might have been previously used in the Boer War. We marched them over to a “range” consisting of a shack with mattresses on the floor, a lot of tree-stumps, and a contraption with pulleys and clotheslines to move the targets, and competed for NRA sharpshooter patches.

That is just about my last firsthand memory of guns, so, to reiterate, I just don’t know very much about them. I also can’t tell you about makes, models, types; whether a particular firearm is an “assault weapon”; or which one (or six) John Wick would pick. As I can’t speak knowledgeably about guns themselves, I’m going to stay in my lane as a lawyer who writes about history and politics, and talk about guns and gun control in that context. In doing so, I expect to irritate virtually everyone who reads this.

First, the Second Amendment exists. It doesn’t matter whether you or I agree with it—it’s there. We can argue about what the Framers intent was when they wrote it, or the intent of the voters of the States that ratified it, but you can’t wish it away. This is not an endorsement of unlimited guns in every hand and every place, and it is certainly not a moral judgment. It is just a reflection of reality. When government acts restrictively on guns, it takes something from gun owners, and the entire legal analysis from that point forward hinges on whether it is taking too much. Read more »

Neo Matloga. Unknown Title. 2018.

More here and here.

Currently showing at Zeitz Museum, Cape Town.

by Rafaël Newman

I am employed two or three weekends a month as a minder or “Betreuer” at a treatment centre and halfway house for recovering drug addicts in Zurich. My duties include spending the night at the facility as the lone member of supervisory staff, eating meals with the clients, supervising their activities and accompanying their outings, taking urine samples and administering breathalyzer tests, distributing a variety of antidepressants and other prescription meds, and joining them for sessions of meditation and self-led group therapy.

Our clients typically come from the Swiss middle and working class, are predominantly white and “European”, and have in common with other addicts of my acquaintance a marked tendency to egocentrism and either a concomitant failure of empathy or, in reaction to the affective over-sensitivity that has come to be associated with addiction (particularly in the case of celebrity overdose victims such as Philip Seymour Hoffman), a self-protective closing of the border between self and other, whether by chemical, behavioral, or neurotic means.

Among my unspoken responsibilities as a minder, therefore, and in line with the principles of the self-help program that serve the center as an unofficial “philosophy”, is the performance of a living example: of empathy in action; of open-mindedness regarding others and their sensibilities or “struggles”; of humility and the will to serve, rather than simply to use, exploit, and consume. And as a consequence, the recovering addicts in my charge are, implicitly, to learn how to belong to a group rather than to go it alone, as they have been wont to do in active addiction. Read more »

Michael Caligiuri, a renowned physician-scientist is the President of City of Hope National Medical Center, and Deana and Steve Campbell Physician-in-Chief Distinguished Chair. He directed The Ohio State University Comprehensive Cancer Center for 14 years prior as well as being the chief executive officer of The James Cancer Hospital and Solove Research Institute for 10 years. Caligiuri’s research focuses on the development and activation of human natural killer cells and their modulation for the treatment of leukemia, myeloma, and glioblastoma. He is a fellow and the immediate past president of the American Association for Cancer Research and has been elected to the National Academy of Medicine (NAM), one of the highest honors in the fields of health and medicine.

Azra Raza, author of the forthcoming book 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 Eric J. Weiner

Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare. —Audre Lorde

As I write this introduction, I struggle against becoming overwhelmed by too many things: The mass shootings that occur on a regular basis; the daily gun-related murder and maiming that occur throughout the country everyday; the normalization of white supremacy/nationalism; the poverty you can see in the eyes of children in shelters and on the street; a twittering billionaire president who mugs for the cameras of “the enemy of the people” as children are concentrated in “camps” at the southern border; the increase in crimes against immigrants, African Americans, Jews, Muslims, women, and gay people; the gouging prices of life saving drugs like insulin; and the smugness of those in congress who summer far from the death and chaos, muttering to the press about mental illness, second amendment rights, the “free” market, cultural deficits, and anything else that might distract from the callousness and cynicism that drives what poses for public policy these days. And I could go on.

But I know that if I am overwhelmed then I will not have the energy to resist, talk back, confront, fight, struggle, reflect, transform, teach, and renew.  In this essay, I will discuss what it means to develop what I am calling a praxis of pleasure as both a strategy and tactic of resistance. As a tactic, a la Michel de Certeau, it is a practice of reclaiming a modicum of power within an established geography of inequitable power relationships. As a strategy, it is a guide toward living well so that we may rise to fight another day. Read more »

by Brooks Riley

by Bill Murray

Thirty years ago this week two million people joined hands forming a human chain across 676 kilometers of Estonia, Latvia and Lithuania. Known as the Baltic Way, the visually arresting stunt was a cinematic cri de coeur for freedom.

In time freedom was theirs. The Russian military fled, sometimes trashing their barracks and looting along the way the way. As a measure of the state in which the Soviet Union left the Baltics, still now, thirty years on it takes around seven hours to travel by train between Tallinn and Riga, the capitals of two European countries separated by scarcely 200 miles. Imagine.

The Estonian and Latvian railways have finally co-ordinated their timetables, but you still have to walk across the platform to change trains at the border. By contrast, the drive takes perhaps four and a half hours, and, as both are now Schengen countries, your vehicle breezes through the abandoned border post without slowing down.

Much of that drive, after the tidy Estonian border town of Parnu, takes you south along the coast of the Gulf of Riga. Estonia and Latvia are lovely during this early bit of Baltic autumn, grasses with full summer growth waving in fields skirting Baltic shores. Read more »

by Sarah Firisen

I’ve just come back from a lovely vacation in Ireland. We did a lot of driving and usually had the radio on, often to RTE, the state run station (the equivalent to the BBC in the UK). At least once an hour an advertisement would come on reminding people that they need to get a TV license, which costs 160 Euros, $177 a year. I grew up in the UK, where a license is 154.50 sterling,  $187 a year, and remember the ads when I was a child that warned of the TV detector van coming around and catching people who hadn’t paid their license. Of course, that was in the days of very obvious exterior antennas on houses. When TV licenses were first issued in the UK after the second world war, they funded the single BBC channel. Even when I was a child, there were only 3 channels, then when I was a teen 4, and two of those were the BBC. In the UK today, a license is needed for any device that is  “installed or used” for “receiving a television programme at the same time (or virtually the same time) as it is received by members of the public”. In Ireland, as the many ads I heard made clear, the license is for a physical TV, regardless of what it’s used for, including gaming or streaming YouTube videos. In the UK, you don’t need a license if you watch anything else on your TV, including using catch-up devices and players for BBC shows, except if you use the BBC iPlayer services, but you do need a license if you watch live TV or use the BBC iPlayer on any device.  

Listening to these repeated ads in Ireland, it struck me how regressive this license charge is. Reading up on the differences in the UK, their rules seem fairer at least. On my return, I read that Ireland is actually changing its licensing rules in the future and that “The Government is to scrap the current licence fee and replace it with a charge that will hit virtually every Irish home, regardless of whether a television set is present…It will mean that anyone with a laptop, a tablet or a smartphone at home will be liable to pay.” 

I’m not really debating the virtue or utility of such licenses. There’s clearly a valid debate about the need for state owned TV and radio stations in this day and age, but that’s not my point to debate here either. Rather, my thoughts are about government’s ability to keep pace with technological changes. Read more »

Self-portrait in reflection on the entrance doors of the showroom of famous chandelier-maker, Faustig, in Brixen, South Tyrol, in October of 2014.