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Health

Atomic Bamboozle at the Hollywood and Kiggins Theatres

After the catastrophe in Fukushima, Germany’s governing parties, abiding by a societal consensus reached as early as Chernobyl, decided in 2011 to phase out the last remaining nuclear reactors. It finally happened exactly a month ago, on April 15th, 2023.

Nuclear Power in Germany: Finally History!

Not so for the rest of Europe, where 12 of the 27 EU-nations insist that nuclear power is the way to go. They prolong the run times for old power plants and build new ones, with Poland planning to react 6 new reactors, and Holland, Great Britain Hungary and Slovakia not far behind. The largest producer of nuclear energy, 2nd only to the U.S., is, of course, France. They have 56 reactors, with 14 new ones in the planning stages.

This is all the more astounding since France has been facing a fiasco: they do not have enough electricity to meet domestic needs, much less export for economic gain, since in 2022 more than half of its reactors had to be shut down, at least temporarily, because of grave cracks, corrosion and general decay in its aging facilities, and because the summer heat and drought affected the cooling towers, with not enough water available, forcing them to be turned off. They are also grappling with political scandals around the falsification of documents that assured the safety of faulty construction materials for new reactors.

The fact that one clings to a path once chosen even if it makes no longer any sense is called “escalating commitment.” If done by you or me – “hey I stick with a job I don’t love, because I invested so much to get to this position in the first place” – it will only harm ourselves. Done by governments, it can harm a nation, or more.

Here in the U.S. we are seeing a version of this, with people granting that the old nuclear plants were bad, but also loudly proclaiming that the new small modular reactors (SMRs) will solve our energy crisis and propel us into a cleaner, cheaper future.

It ain’t so.

To find out why, you can watch Atomic Bamboozle at the Hollywood Theatre or at the Kiggins Theatre in Vancouver, WA, in case you missed the showing at Cinema 21 that I also advertised, some 2 months earlier. Highly recommended, given my vested interest in this film as part of the production team. The documentary will be shown in conjunction with PORTRAIT 2: TROJAN, a meditative short film on the day that the Trojan Nuclear Plant was imploded and decommissioned, by Portland-based artist and filmmaker Vanessa Renwick. In case my recommendation isn’t enough, here’s on from a more familiar name:

Here is the trailer for the film.

Of particular interest for the upcoming showings are several speakers, Joshua Frank and Kamil Khan among them, who will, in turn, introduce the project, and participated in a panel discussion.

Joshua Frank wrote Atomic Days – The Untold Story of the most Toxic Place in America. The book conveys the calamitous risks and staggering costs attached to nuclear power. The author is emphatically describing the threats implicit to all forms of nuclear energy production, not just from the left over underground tanks iat Hanford, currently corroding during ever delayed clean-up activities tagged at $677 billion and growing, tanks that are leaking radioactive broth from its 56 millions of radioactive waste into the ground water and Columbia river at Hanford, and that before the damage from a potential catastrophic earthquake.

There are also related, but perhaps less familiar perspectives that need to be amplified. Here is one of the relevant commentaries on the book:

Frank, by the way, will be also on site for a discussion/community reading of his book on Saturday, June 10th 3:30 – 5 pm at the Goldendale Community Library in the context of one of the most interesting and effective programs offered by the Fort Vancouver Regional Libraries: Revolutionary Reads. (Details in link.)

Kamil Khan is the new executive director of Oregon Physicians for Social Responsibility, who just recently moved to Portland. Hailing originally from Pakistan, a nuclear-capable power, he is, in his own words, aware of some of the implications of its use.

“What those celebrations of (underground nuclear testing) did not factor was the environmental and social costs of testing, maintaining, and expanding the nuclear arsenal. I firsthand saw the ramifications of a bloated military budget and the divestment from necessary social programs as a result. I was also privy to the lack of political stability and scapegoating of “enemy” countries; this nuclear flexing was a compounded abomination to the very real human suffering occurring on the daily.”

Other speakers and panel discussants are

• Jan Haaken, director and documentary filmmaker
• Samantha Praus, producer
• Lloyd Marbet, executive director Oregon Conservancy Foundation
• Patricia Kullberg, Oregon Physicians for Social Responsibility, moderator.

Photographs today are from the Hanford site and region, where the documentary film crew spent time last summer. Music is self explanatory…

May 21, 3:00 PM – 5:00 PM

Hollywood Theatre, 4122 NE Sandy Blvd. (Tickets available via link)

Jun 07, 7:00 PM

Kiggins Theatre, 1011 Main St, Vancouver, WA 98660

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A Curtain of Clouds

Walk with me. Make sure you bring the rubber boots which I, as per usual, forgot on Monday.

It was a spectacularly beautiful day along the Columbia river, with cloudscapes encouraging all kinds of fantasies and re-interpretations. They also made you wonder what would appear if you lifted them. Were they hiding Mt. Hood, or Mt. St. Helens, or would a peek of Mt. Adams appear? Those speculations relied, of course, on the general knowledge that those mountains are situated in the approximate location you were staring at.

What happens when you lift clouds without having the faintest idea what the background will reveal? Pleasant surprise, useful information, or a wish they’d hung in the air forever given what you discover?

These thoughts were rumbling since I had just read a fascinating new paper by two Yale psychologists, Woo-Kyoung Ahn and Annalise Perricone. In essence their research looks at the consequences of providing genetic information to people, information concerned with their potential susceptibility to mental disorders like depression, Alzheimer’s disease, alcohol abuse or eating disorders. (I’m summarizing below.)

Would you like to receive that information? Hand it over, hey, all knowledge is good! Allows for personalized treatments, specific interventions! What could possibly go wrong?

A lot, as it turns out, and not always what you’d predict. Information can harm you, and curiously enough, both the kind of information that confirms genetic susceptibility to a disease or its opposite, the reassurance that you don’t have the genes that might contribute to a problem.

Let’s say you learn that you have an elevated genetic risk of living with depression. Would you change your behavior in ways that might affect the emergence or severity of the disease? As it turns out, people generally don’t. That failure to do so is closely connected to our general misunderstanding of how genes work: most of us think they are immutable, that we can’t change anything about their expression. “Genes are destiny,” is the assumption. This mistaken belief is called psychological essentialism, where genes are believed to provide the essence for the characteristics observed in a person. Take height, for example. People tie a person’s height to their genetic make-up – never mind that an environmental manipulation, the absence of presence of sufficient nutrition, can stunt growth in any given individual.

Now add prognostic pessimism, our general belief that mental disease is pretty resistant to treatment.

“The extent to which one believes that one’s mental disorder has a genetic origin is positively associated with the extent to which one believes that mental disorders are untreatable or inevitable . For instance, the more individuals with depression attribute their symptoms to genetic factors, the more pessimistic they are about their own prognoses.”

Once you’re in this loop – knowing you have an elevated genetic risk and doubting treatment efficacy, the clinical consequences are dire, since your negative expectations will affect the treatment course.

However, we are able to intervene if we teach people about the malleability of genes, and how genetic expression can be counteracted, even shut down, with environmental interventions. Learning about this, people actually become more optimistic about the prognosis. Lots of clinical programs now use that kind of education to help people understand that genes do not mean a certain destiny.

Unfortunately, even if we are able to help people look more confidently at a future where their genetic risk is not all that counts, we have so far no comparable mediations of how they look at the past. When people learn that they have a genetic predisposition for depression, for example, they start to interpret their experienced symptoms as much worse than they actually were. Study after study show memory distortions of the severity of symptoms once you learn about your genetic risk. That exaggerated belief, of course, affects one’s expectation in therapeutic efficacy, a self-fulfilling prophecy.

___

What about learning that you do not have an elevated risk for a particular condition?

That, too, can produce harm. Let’s say you enjoy drinking, or eating, in ways that border on abuse, or so you fear. Receiving the results from your genetic test that you do not have an elevated risk for Alcohol Abuse Disorder or Eating Disorder can now become a risk factor, as you think you’ve been given green light to continue or even increase your behavior. The feedback affects your interpretation of the seriousness of the harm you might expose yourself to, a false reassurance that can have disastrous consequences.

Lifting the clouds of ignorance? Maybe not.

The birds didn’t care, one way or another. Flocks of snow geese huddled in great masses against the wind.

Sandhill cranes starting their track north.

Harrier hawk, hungry as always,

bald eagle surveying his kingdom,

and ibis and herons doing their thing,

all just on autopilot as their nature demands. No mediations required. No pessimism to optimism. Just BEING.

Debussy on clouds for your listening pleasure.

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What they don’t tell you

(Welcome to the new subscribers – come for the nature, stay for the rest!)

Want to come on a hike with me? Follow along, explore the beauty of the Lacamas Heritage Trail!

At least that’s what I thought two weeks ago when we still had night frosts and the mornings were cold, with brilliant light. All long shades, blues and golds, a balm for the eyes.

Some source – PDX Monthly or The Mercury or some such – had recommended the hike as an easy start to hiking season. Located in WA, some 40 minutes north by car, it’s not exactly around the corner but I thought, give it a try!

As the photographs will show you, looking on one side of the trail, there’s plenty of beauty to see. The path winds along a small lake through some old growth forest, including Madrona trees, and occasional glimpses of Mt. Hood on a cloud-free day.

What they don’t tell you: on the other side of the trail, you pass right by a golf course, plenty of condos and then McMansion after McMansion overlooking the water, with fences and signs for private property, both sheltering the property owners and their access to private docks for water sports. I don’t call that a hike. The seven miles (it’s a there and back) really are a stroll through suburbia on steroids, although a nice one if you live close by and want your daily exercise. Which countless people did, so that it was more like a group walking event. Not my idea of a day in nature. (Note, though, the path was so groomed that it is really wheelchair accessible and easy for people with limitations on walking, a big plus.)

The whole concept of what we see and what we don’t, or what we don’t know if the telling is in the fine print or there’s no telling at all, was on my mind this week for a number of reasons.

Take data protection, for example.

In general, we have little protection against the abuse of private data. Just last months, three state A.G.s brought a lawsuit against Google that claims the company deceived customers into giving up sensitive data. While customers were told they could avoid location trackers by choosing the right account setting, their data were nonetheless syphoned through a backdoor. In addition, rules favoring the company are often hidden in legalistic language that no-one bothers to read, or provided with opt-out options for notice and consent that are often obscured enough that the average consumer doesn’t have a clue.

I don’t know if you use a health app, for instance, one of those things that track fitness, nutrition, sleep and other health-related metrics. According to a Gallup poll conducted 2 years ago, in the United States about one in five women between the ages of 18 and 49 currently use them. At this point the numbers might even be higher. Some of the most widely used tools are apps that track your menstrual cycle – period trackers like Flo or Clue, which have 50 million and 10 million downloads respectively. Apple has its own cycle tracking for the iPhone and the Apple Watch.

The advantages of these tracking systems are obvious. You can track fertility if you want to get pregnant, you are warned about missed periods, you might discover patterns to be discussed with your doctor, and so on.

What they don’t tell you, though, is that there are huge red flags regarding your privacy. Generally, and this might surprise you, consumer health apps do NOT have to comply with a federal privacy law called the Health Insurance Portability and Accountability Act, known as HIPAA, which specifically covers patient data collected by and shared among doctors, hospitals, labs and health insurers in the U.S. Europe, by the way, is way ahead of the game, they have stricter controls. (Ref.)

Many of these apps tell you, indeed, promise you, that your personal data will be protected. Yet the Federal Trade Commission has revealed how many of the data collected by these firms are nonetheless illegally shared with third parties. Once received by Facebook or Google, these data are used to send specifically targeted ads to you. Pregnant? Buy maternity clothes! Oily skin around your period? Buy this pimple cream!

Ok, maybe being showered with cringe-inducing ads is the price you’re willing to pay for having the practical advantages of health apps. What about this, though? In 2019 the state of Missouri monitored the Planned Parenthood health apps, looking at women’s menstrual cycle to identify those who had (failed) abortions. In a world of changing laws, data might very well be used for surveillance of criminalized behavior. Reproductive surveillance is theoretically and practically as possible as contact tracing or any other set of data used by agencies that you never dreamt would get their hands on your information.

And just yesterday we learned, that women’s most personal data, their DNA, collected to help solve a case when they were the victim of a rape crime, has been used, without any information or permission, to identify them if there is suspicion that they themselves were involved in a crime at some point.

San Francisco’s DA Chesa Boudin made it clear that if DNA from a rape kit was used without consent for purposes other than investigating the underlying rape case, it may be a violation of constitutional protections against unreasonable searches and seizures as well as California’s Victims’ Bill of Rights. As of now, nobody has a clue how often and how long this has been going on.

Rape is one of the most underreported crimes of all. Women are hesitant to come forward for numerous, justified reasons, shame, vile treatment in trials, dreaded accusations of being a liar if the defendant is not convicted, among them. If you add to that the possibility that the preservation of your DNA opens you to arrest in an unrelated situation, it functions as a huge deterrent to reporting and cooperating with law enforcement.

It really is no longer just about what they don’t tell you, or in such small print that it is easily overlooked. We have to decide, fully aware that data might be illegally distributed or analyzed, if we really want to share them at all. Reverse from a what they don’t tell you to a determined: What I won’t tell you!

Music today are the energizing four seasons by Piazzolla – getting ready for spring hikes on this end!

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Role Models.

It was difficult not to think about reproductive rights across the last few days. Besides the looming Supreme Court decisions or Texas laws, there was the NYT featuring two films about abortion and the Jane Collective over the weekend. Among others, they interviewed Judith Arcana, a member of the Janes, a group based in Chicago providing help with abortions before it was legal. I had portrayed her when she participated in our own documentary, Our Bodies our Doctors, some years back.

Two minutes later, an invitation arrived from the National Council of Jewish Women to join in the upcoming ReproShabbat (1/28/2022), celebrating the critical importance of reproductive health access, reproductive rights, and reproductive justice, and to learn more about Judaism’s approach to these issues.

And then I chanced on an article in The Nation featuring Portland’s Queen of the Bolsheviks, a lesbian medical doctor and reproductive rights activist in the early 1900s. Hah! Instead of complaining about the miseries of 2022 I could write about a fighter, Marie Equi, a colorful figure and tireless organizer, defying the laws of her (and, as it looks, soon our) times as an abortion provider. Besides, it gave me opportunity to walk the city and photograph the places where she had lived, practiced and is buried (with a bit of other city scenery thrown in. Of help was a nifty if dated walking tour guide to PDX’s gay history.)

Corner of 11th and SW Stark – Used to be the Norton Hotel where Equi lived for some time. Is now the Mark Spencer.

How can you not be intrigued by a woman who used a whip on a wage-withholding employer of her girlfriend, only to have friends auction the thing off when he fails to pay and take that money in compensation? A woman who was one of the first medical doctors in the U.S. and pioneered a sliding scale of payments for her patients according to their ability to pay? A woman who traveled to San Francisco after the 1906 earthquake to help victims? Who was arrested multiple times as a labor organizer, a pacifist and a political opponent, spending hard prison time in San Quentin State Prison?

SW Broadway and Stark – used to be the Hotel Oregon where she rented, now Hotel Lucia.
Medical practice at 6th and SW Washington.

Dr. Marie Equi was a firebrand, born in New Bedford, MA in 1872 and died in Portland in 1952.

She moved to The Dalles in 1893, then San Francisco, then to Portland, having relationships with a number of different women, all interesting and progressively fighting for women’s empowerment in their own right, among them likely Margaret Sanger. She lived and co-parented an adopted daughter for many years with Harriet Speckart, the niece of Olympia Brewing Company founder Leo Schmidt, who did not abandon the relationship despite various threats by her family to revoke her inheritance. 

729 SW Alder used to be the Medical Building holding her office. Later known as the PArk Building.
current visitor to the neighborhood….

I learned much from an article on reproductive justice published by the Oregon Historical Society and written by Oregonian historian, Michael Helquist. He also wrote a biography of Equi’s life, published by OHSU press, Marie Equi – Radical Politics and Outlaw Passions. It reminded me how so much of the abortion laws had their origin in turf wars – the male medical profession trying to dislodge the traditionally female providers like midwives and nurses from gynecological care around the turn of the century, and the White, Christian population fearing minority status with an influx of immigrants. It became a fight for White babies to be born.

Pioneer Court House, Sixth and Morrison where Equi’s sedition trial took place.
Building adjacent to Pioneer Square

Equi fought – for suffrage (Oregon instituted the right to vote for women in 1912, eventually,) for labor rights, for birth control. She got into physical altercations with the police or other doctors, and was claimed to have had enough insider knowledge to blackmail people so that she got off on several trials. Eventually she got caught. It was a speech protesting WW I which had her convicted of sedition and put into prison, where she suffered from recurring bouts of tuberculosis.

President Woodrow Wilson commuted her sentence after a year and she returned home to Portland.

Old Weinhard’s Brewery, 1908, where she walked by on Burnside St
U.S. National Bank Building opened in 1917, close to where Equi worked.

The years after her return were devoted to her medical practice and a life with IWW leader Elizabeth Gurley Flynn until the latter returned to the East Cost. Equi suffered a heart attack in 1930 and sold her practice. In 1950 she fell so badly that she had to spend a year at Good Sam, the local hospital, and then retire to a nursing home in Gresham, a suburb of Portland. She died in 1952 and is buried next to Harriet Speckart at Wilhelm’s Portland Memorial. (Photograph is the backside of the Mausoleum.)

The backside of the Mausoleum, as seen on my frequent walks at Oaks bottom.
In the meantime, there is a building boom and wall art crops up in unexpected locations.

The woman probably never moped once in her life – engaged in intersecting political movements for women’s rights, free speech and pacifism, while juggling lovers, dealing with the competition and providing hands-on help for countless patients. Remind me of her when next my kvetching gets onto your nerves, I might stop… also, unicorns.

Equi would have liked this song.

Or this one from almost 30 years ago.

And of course the eternal Malvina Reynolds…

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Pipe Dreams

Looking into the endless gray this week, all I wanted was color. The rain hammered on my roof during the nights, with leaf-stuffed gutters overflowing, water gushing by my window. Of course! Drainpipes! The solution to filling my eyes with color and pattern and my brain with delightful memories of prior travels. Thus today’s barrage of photographs, since pipes held my interest for years on end, always with faint plans to use them eventually for abstract montages.

Of course you don’t get away today with just admiring rusting pipes. Too pressing the problem – in Portland and elsewhere – of health issues associated with lead in the water.

The nation, for the most part, knows about Flint, MI and the water troubles they experienced. The crisis there has become synonymous with environmental disaster. Turns out, Portland is worse.

Since the late 1990s, samples have shown Portland exceeding the federal safety threshold for lead 11 times. In 2017, after Portland had once again surpassed that threshold, OHA required the water bureau to build a corrosion control treatment facility, according to Salis’ letter. Water from the Bull Run watershed is naturally corrosive, which can cause lead from copper plumbing and fixtures to leech into people’s homes. By building a facility to make Portland’s water less corrosive, the bureau expects to reduce the amount of lead dissolving from old plumbing into stagnant water. The facility is slated to be completed by April. (Ref.)

Here is the water bureau’s January 2022 response after decades of complaints:

Some of the actions the Water Bureau is taking include:

  • Treating the drinking water to reduce lead and copper;
  • Offering free lead-in-water testing to all residential customers and childcare providers;
  • Increased education and outreach to customers through mailings to multifamily residences and all homes built between 1970 – 1985; 
  • Actively managing drinking water in the distribution system to maintain the effectiveness of corrosion control treatment; And
  • Proactively partnering with the Oregon Health Authority and Multnomah County Health Department.

I leave it to you to assess the quality of government/management in this city when you consider this problem was known for 30 years now.

In case you’re worried: The water bureau offers free lead-in-water testing to all residential customers and childcare providers. People can contact the LeadLine at leadline.org or 503-988-4000 to receive a free lead-in-water test.

And since we are in a practical mood today, here are 9 gutter fails that are slowly killing your house….only half joking, a beloved neighbor of ours had utterly expensive damage from rain water making its way into the walls and house foundation.

Children are, of course, the ones most at risk. They are often exposed to multiple sources of lead contamination: the water they drink, the dust they inhale from the paint used in older houses or contaminated soil in poorer neighborhoods often build adjacent to industrial sites. Parents who work in certain industries – automotive repair shops for example – can inadvertently bring lead particles home on their clothing. Kids are also surrounded by toys that expose them to lead:

“Lead softens the plastic and makes it more flexible so that it can go back to its original shape. It may also be used in plastic toys to stabilize molecules from heat. Lead dust can be formed when plastic is exposed to sunlight, air, and detergents that break down the chemical bond between the lead and plastics.” The CDC recommends to keep plastic toys away from young children who put their hands in their mouths after or during play.

Lead poisoning has serious consequences, developmental delay and learning difficulties included. Here is a link to the Mayo Clinic site that describes what to be on the look-out for symptoms.

And if all this is not enough justification to dig into my drainpipe archives, then maybe this is: Drainpipes are having a moment after homophobic Politician arrested at Gay Sex Party. (A right-wing Hungarian politician tried to avoid being arrested at a party in Belgium during lockdown by climbing out of the windows and down a drain pipe.) Everything that puts shade on the ruling Fidesz party is welcome….. (a rival lawmaker in Hungarian parliament, Zoltán Varga, reportedly brought a drainpipe to the floor of the legislature to use as a prop in a recent speech railing against the ruling Fidesz party’s hypocrisy.)

And here is a piece of music that captures sounds of rain and multiple rhythms when it runs, or dips or plops or gushes down the pipes…beautiful composition by John Luther Adams (2009.)

Let’s end with Ford Maddox Ford. (The entire wonderfully snarky poem can be read here.)

In the Little Old Market-Place

(To the memory of A. V.)

It rains, it rains,
From gutters and drains
And gargoyles and gables:
It drips from the tables
That tell us the tolls upon grains,
Oxen, asses, sheep, turkeys and fowls
Set into the rain-soaked wall
Of the old Town Hall.

Here’s to the next 8 days that are supposed to be entirely dry!

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Vaccination Refusal

In this country, partisanship, age and level of education are predictors of who refuses to get a vaccine against Covid-19 in all its variants, or who is skeptical about the severity or the danger of the disease. Even though more people are now willing to get the shot, attitudes have hardened among those who don’t, encouraged by a never-ending stream of conspiracy theories or ideological battle cries by influencers on the far Right and conservative media. Refusal has also intensified for many during recent discussions of vaccination mandates, with multiple law suits filed against the Biden administration’s vaccination requirements. Deeply republican states have imposed policies that ban vaccine mandates or prohibit requiring proof of vaccination.

Vaccination levels are also low among those who have difficulties accessing vaccination opportunities in rural areas, who lack transporation or time off from work because every penny of income is essential and cannot be endangered. So there are structural variables of access and economics, independent of ideological considerations.

The third group of unvaccinated people are those among us who have no choice due to pre-existing conditions or compromised immune systems. If you consider that 15% of the world’s population lives with disabilities (some of which preclude vaccination) according to the World Health Organization, we are taking huge numbers of people whose only protection can come from those who surround them and behave accordingly. And that number does not even include those under active treatment for cancer or other life threatening diseases at any given point in time.

Those who refuse vaccination on ideological grounds often insist that they have a “natural right” of self determination and if that freedom includes the endangerment of others, so be it. Conspiracy theories about “chip implantation” or some such aside, there is an underlying agreement among vaccine skeptics that disease is a process of natural selection, where the strong will live and the weak will be culled. No need to listen to the (deeply mistrusted) science selling the advantages of vaccination. Solidarity with the young, the old, the sick is simply off the table in groups that believe in nothing but individualism and the “survival of the fittest.” In some cases religious considerations about G-d’s will or beckoning paradise add to the determination to carry vaccination refusal as a political flag. Above all, it is about “freedom” to reject the state’s interference with your own body (unless you are a woman, when decisions about bodily integrity are ripped out of your hands in case of pregnancy. Yesterday’s opinion piece by Michelle Goldberg in the NYT (linked above) was brilliant in showing the contradiction.)

In Europe we see additional variants on the theme. Within the far Right there is an explicit anti-Semitic streak that associates vaccinations with sinister Jewish plans for world domination, making an extra buck or at least a push away from the “natural.” Cartoons like the one below are from another era (published by 3rd Reich vaccination opponents in The Stürmer in 1933)), yet deeply embedded in contemporary neo-Nazi discourse.

I feel uneasy, since poison and Jews never add up to anything good.

There is also, however, a different group of German, Swiss and Austrian vaccine deniers who have previously not allied with the far Right. These are often educated middle-class citizens (more than half of them have finished their university education, and 67% consider themselves to be middle class, 23% of the surveyed said they had cast their ballots for the Greens in Germany’s 2017 federal election. Eighteen percent voted for the Left party and 15% for the far-right Alternative for Germany (AfD) and they are in their 40s and 50s.(Ref.)

There are many educators and medical professionals among them, who swear by homeopathy or are adherents of the Rudolf Steiner/ Waldorf School movement around anthroposophy. The German South-West is a stronghold of the anthroposophical movement.

Officially, educators and administrations of Waldorf Schools are not prohibiting inoculations; however if you look at the rates in which kids in these institutions are inoculated for dangerous childhood diseases like the measles or whooping cough, you find the numbers way below the national average.

What lies beneath their vaccination refusal, now extended to the current Covid pandemic? Historically (and particularly during the third Reich) people considered a strong immune system to be sufficient to ward off disease, and that system was created and sustained by a romanticized “natural living,” a diet free of poison, physical exertion in sunlight and fresh air. All things modern – large cities, poor immigrants, technology and mass culture were seen as the enemy of health, external agents poisoning the immune system and sickening the body.

Rudolf Steiner added to that a theory rooted in occultism. He preached that humans reincarnate in ever new bodies. (Note, I do not judge the belief held by billions on this planet that reincarnation is part of the life cycle. I do have problems with the specifics touted by Steiner attached to his philosophy.) Only high fever in a child’s body allowed reincarnated kids to take root in that new space, which until then was dominated by the mother’s “protein” which needed to be replaced by the child’s own “protein.” Only then could emerge a true representation of this new person’s identity. Furthermore, illness has special meaning in this never-ending cycle of re-incarnation. It educates us to the fact of what has gone wrong in a previous life and provides karmic balance for earlier misbehavior. (Steiner even named specific illnesses for specific misdeeds – I’m not going there.)

There was an additional racist element present in his theorizing as well. Bacteria and viruses were considered of demonic nature, specifically the astral demons and putrescence of earlier, “inferior peoples” – the Mongols, for example, who carried their foul nature to the Germanic nations in their mass migrations. (No, I am not making this up. (Ref. To find his own words, go here.)

The new version for the current epidemic, in its extreme form, states that vaccination prevents you from receiving the karmic insights brought by the messenger disease. You might protect your body, but your soul will not be able to grow. Should you die, the healing experience for your soul will put you on fast track in the next life, so nothing is lost. Healing is all well and good, but suffering has a place in the world that is irreplaceable for spiritual growth. (Note, this approach is a legally recognized field of study in Germany for medical doctors who want to specialize in this sub- discipline.)

And before you shake your head and wonder who would subscribe to this, demonstrations against vaccination have drawn up to 40.000 people in individual cities on a given weekend, mixing Querdenker (the equivalent of Qanon), neo-Nazis and Steiner adherents. A useful article from the Council for European Studies (in English) on the history of the movement can be found here. Generalized science aggressions has morphed into increasingly violent behavior – hospital personnel, schools, doctors who offer inoculation, and even bystanders have been attacked and in one case killed.

I find it remarkable how in times of crisis all the long-held prejudices, stereotypes and nationally rooted beliefs make an outspoken come-back. Anti-Semitism and stereotyping esotericism, buried deep after 1945, are raising their ugly head. Racism in this country is no longer subdued, but proudly presented in calls for a return to the good-ole-times, with racial hierarchies re-established and intact. Simply asking people to put their beliefs aside is not going to cut it. If the only way out from the danger of the pandemic and new viral mutations is world-wide vaccination, then countries have to come together and impose vaccination mandates, legal requirements that no-one can escape other than for medical reasons. It has been done before. (Since 1809 in the U.S., 1807 in Germany.) It can be done again.

There’s a Drop of Hope, though, from the Francis Crick Institute in London. Their vaccination center had 12 international artists in residence who wrote poetry about inoculation collected under above title. You can find the poems here and the intro explains the interactive poetry project. Sensible, moving and perceptive takes on vaccination.

1807 was also the year this Beethoven piece was written (or transcribed from his violin concerto op. 61.)

Brooding photographs were taken late yesterday. Should reincarnation occur against scientific odds, I’ll put in a request to be a tree. Preferably not at aspen, though, I’ve done enough trembling in this life time. Red chestnut would be nice. Oak will do, too.

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Stigmatism and Health

This essay was supposed to be up on Monday, but we lost power for literally 4 full days, with no heat, no internet, no telephone. Luckily the contents are not bound to a specific time; I tried to convey general knowledge by health psychologists, oncologists and research teams about what we know about stigmatized diseases.

A dear friend sent me an extraordinarily beautiful piece of music. It will be your reward after making it through the troubling and/or enraging facts I am going to introduce today.

I want to talk about the consequences of being diagnosed with a disease that is generally stigmatized in our society, consequences that affect both the individual patient and also the general fight against the disease. I will need to cover some general statistics, but my focus will be on the psychological and societal effects of living with or dying of a disease that carries a large stigma. (I have by now read widely on the issue, but am too tired to put all the references in order – you just have to trust me. General sources for many of the details can be found here and here. These were the most recent data I could find, maybe lagging by two years or so.)

It used to be the case that AIDS was the prototypical stigmatized disease. General homophobia had plowed the ground for condemnation of sexual “lifestyle” choices that resulted in this deadly illness. People were judged to be, if not deserving (according to bigots), then at least responsible for their own fate, given their sexual behavior. In addition to carrying the stigma of being gay, they now were perceived to be spreaders of the plague, usurpers of medical resources that could have been devoted elsewhere.

Many patients internalized a sense of shame or guilt (even if they acquired the disease through non-sexual contact like blood transfusions) and suffered from the taboo to reveal it. But patients were also diagnosed relatively young and increasingly able to live long, full lives on pharmacological regimens; subsequently, many of them had the years and motivation to become advocates and fundraisers that pushed research in to treatment and cures forward.

These age characteristics are not true for lung cancer, another deadly scourge that carries the great stigma of having been self inflicted, through smoking. Lung cancer can be triggered by genetic factors, by external pollutants like asbestos and radon, by exposure to second hand smoke – but about 80% of patients do have a smoking history, often barely remembered in their youth, stopped long ago, which comes back to haunt them.

The disease has a dreadful prognosis, when detected late which is mostly the case (only 16% are detected early, I am one of the lucky ones.) More than half of people with lung cancer die within one year of being diagnosed. It is the leading cancer death among men and women (these days almost as many women are diagnosed as are men,) killing more than colon, breast, and prostate cancers combined. Blacks die from lung cancer in larger numbers than Whites, even though they smoke less than their counterparts. Mediating factors seem to be worse access to good health care, genetic factors, co-morbidity of other ailments, and additional exposure to environmental pollutants.

The guilt over having smoked, or fear of being judged as a morally weak person for giving in to the addiction (never mind that the product, cigarettes, is made addictive and cleverly advertised to promote sales) has many patients wait to go to the doctor until it is too late. It also leads to self recrimination and depression which are not conducive to an engaged fight against the disease. Lung cancer patients have one of the highest rate of refusing treatment because some of them feel they deserve their fate.

The hesitancy to admit to a lung cancer diagnosis for fear of being shunned isolates people, preventing joint advocacy for better treatment conditions. Being on average diagnosed around age 70 and having such short survival rates does not help either with advocacy. As a result, non-profit fundraising for research and treatment developments is woefully meager, complicated by the fact that people do not want to give money to people who they feel caused their own suffering.

The money raised for breast cancer, for example, is five-fold compared to what lung cancer receives. In absolute terms, lung cancer accounts for 32% of cancer deaths while receiving 10% of governmental cancer research funding. The difference is staggering and has a “spill over” effect—fewer dollars attracts fewer researchers which leads to fewer breakthroughs. We do start to see targeted therapies and immunotherapies, but it is sparse in comparison to other cancer research successes.

Here is the crux: many oncological researchers advance a “utilitarian” argument, insisting that it is not lives saved that matter but years of life overall – and that is of course correlated to the age of diagnosis (again late in life for lung cancer) and the speed of spread of the particular cancer. Saving a 40 year-old with a cancer that has less of a tendency to ravage all parts of your body in no time, gains more years of life than saving several crones for a short while before they come down with likely metastases. It is a rational argument, and a devastating one, not unlike the considerations we have seen in Covid-19 situations where limited resources led to triage decisions that involved statistical life expectancy. I get it.

I think the tendency to hold people responsible for their own fate – you should never have smoked!! – can be sourced back to a much deeper psychological need, the maintenance of an illusion of control. “If I do the right thing, nothing bad will happen to me. If they didn’t do the right thing, then no wonder that bad things ensued…” – That logic protects you from the disquieting fear that something ripping your breath away and taking the very source of life with it might lurk haphazardly around every corner. But the logic also requires to stick to blaming the victims in obvious ways, even if they were young, uneducated or unknowing, acquiring the seeds of the cancer in the 1960s and 70s.

To stigmatize – describe or regard as worthy of disgrace or great disapproval – for a single behavior, irrespective the qualities of a patient as a whole, allows distancing from the fear of a miserable death.

A cruel assessment, from the perspective of the patient, let me tell you.

Photographs are of posters in an exhibition about smoking and advertisement at the Museum der Arbeit In Hamburg, Germany.

Music as promised. Dedicated to my Beloved the day after Valentine’s Day, since I could not make it through all this without him.

A shout-out also to the cardiothoracic surgeon Dr. David G. Tse and the oncologist Dr. Dilip Babu, both at Kaiser Permanente. Their medical expertise was matched by their kindness, both valuable in more ways than I can count.

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Thoughts on Vaccination

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It looks like we will be able to get vaccinated to be (somewhat) protected against Covid-19 in the near future. Or will we? There are many questions attached to the issues of vaccines: their development, their approval, their distribution, their side effects and the (un)willingness of the population to be inoculated, to name a few. I’ll try and report on some of these issues today, including the fascinating fact of people volunteering to be infected with the virus in so-called challenge trials for vaccine development that risk their deaths, given the absence of definitive treatment options for the disease when it hits you hard.

First a lightning round on what vaccines do in general: they basically fake the disease without making you sick, helping the body develop protective immune responses so when the actual crud arrives you have a shield. There are three established ways to accomplish this and one that has never been approved before but seems to be a valuable candidate in the fight against Covid-19.

For one you can take a virus, inactivate it so it can no longer multiply in your body and expose your system to it to develop a defense. Successfully done in cases of the flu, polio, hepatitis A, and rabies, for example. Secondly you can work with a viral vector that carries the immobilized virus. Loosely put, scientists use DNA as a vector (often from chimpanzee adenoviruses) that your own system copies into RNA and then acts with a protective response. It worked for Ebola, some retroviruses, and small pox among others. Third, there are protein-based vaccines, which work with viral proteins only from the spike of the virus that tries to invade your cells. These vaccines are historically very safe and effective, among others protecting against hepatitis B virus, shingles, and whooping cough. And last, there are genetic vaccines, which introduce genes directly as either DNA or messenger RNA, which is used by the cell as a template to build a protein through a process of translation, then activating the protective response. They are easier to manufacture and distribute, but we have never used them before outside cancer research, and they also will require 2 doses.

Ok, let’s say you have developed something that seems to work, like Pfizer, Moderna, Astra Seneca and various other international pharmaceutic industries claim. Now what? You need approval – usually only given for vaccines that can prove to protect for longer than a year. We have no data on that and do not know how long each vaccine will protect you. This is particularly relevant in the light of the fact that we now have cases of re-infection after 4 months.

Then you need to manufacture on a grand scale, under sterile conditions. There are shortages of the glass containers and the custom bags that line the bioreactors in which vaccines are produced. In some cases, the vaccine ingredients are so unstable that they need to be kept at insanely cold temperatures( – 94 degrees Fahrenheit!) and expire after 10 days, a problem for distribution that relies on dry ice – also in short supply, as are syringes. The vaccine must be mixed at the administration site with a sterile liquid — usually water — and given within six hours of creating the solution. Since the vaccine will be shipped in cases with a high volume of doses, rural communities may not have the population, or infrastructure, to administer a case of doses while still cold. Hospitals across the country might also not have funds available to buy the fancy freezers that can be used where there is lots of electricity. (Ref.)

Then you have to decide who gets it first, since vaccines will be in limited supply (to achieve herd immunity, we need to inoculate about 5 billion people across the world, but we, if all get approved, are only likely to have enough for 2.5 billion people, given that the vaccine needs two doses.) First responders, health professional and old people, who are the most at risk? Younger people who are the super spreaders? People in certain areas of the country, so-called hotspots? Decision vary from country to country and are based on political reasons as well as medical evaluations. Details of allocation issues can be found here.

Given that we need more vaccines, people are trying to speed up development, and one way to do so is to run studies that use far fewer than the 10thousands of participants in normal randomized trials where you wait for people to get naturally infected, a process that takes time.

These faster studies are called “challenge” trials in which half of a group of a hundred or so participants gets actively infected with the virus, with the other half being the control group after they all received the developing vaccine. No longer using your gardener’s son (as Edward Jenner did in 1796 with small pox), or prison- or developing world populations who sign up under duress or are simply forced, these trials use volunteers. The World Health Organization has established complex protocols to insure ethical proceedings, but the ethics are still a hot topic of debate.

Would you sign up to be infected by this disease when we have no known treatments that are certain to cure? Would you risk long-term impairment, even if you can avoid death under the stellar medical care these programs provide? Would you agree to isolation for months on end to be under close supervision? Well, 37.000 people have signed up for this since May alone. PBS aired a segment on the One Day Sooner website that calls for volunteers and had an insane response.

When journalists from the Radiolab Podcast asked participants for their reason they found them all over the map. From gas station attendants to Nobel Prize Winners in Physics, they calculated the gain for humanity vs. their own vulnerability, they wanted to protect their parents, or escape boredom, they felt they were dying in a short time anyhow and might as well help science, they urged a commitment to our nation and community after these years of division, they wanted to have a voice at the table for underrepresented communities, and so on. It’s an interesting short listen, if you ignore the small numbers of respondents.

In contrast to those willing to face the disease personally and help develop vaccines against it, there are the many who are not willing to be vaccinated in the first place. There are multiple reasons why they might refuse. For one, there is a large anti-vaccine and anti-science movement in this country, amplified by the partisan divide in the Covid-19 case of acknowledging the danger of the disease. If it is all a hoax, why would I allow the state to prick me with a needle and have me suffer the side-effects (by all reports getting the vaccine will make you feel sick for a bit, with fevers and aches common) or worse inject some – insert your favorite conspiracy theory here – into me. The Lancet reports: “31 million people follow anti-vaccine groups on Facebook, with 17 million people subscribing to similar accounts on YouTube. The CCDH calculated that the anti-vaccine movement could realise US$1 billion in annual revenues for social media firms.” They are also an easy target for further radicalization.

Secondly, there are understandable reason for subparts of the population to be wary of being exposed to unproven substances. The experience of poor and people of color populations in our history has been exposure to forced experimentation in combination with much reduced access to good health care and pre- existing, poverty-related vulnerabilities. A devastating summary can be found here. Suffice it to say that the Nazi defense (!) at the Nürnberg Trial used the fact of experimentation by the US Army and the University of Chicago that infected prison population with malaria in the 1940s, and many such other cases, as justification for “international practice.” Current estimates say that only 42% of the US population is willing to get vaccinated, a number too low to achieve a win in the fight against the disease (and a number much lower than comparable choices in other western nations.)

In sum, do we know if and when we will get vaccinated? Can we trust the voices that claim we’ll be well into it at the beginning of next year? I fear so many things can go wrong, so many factors will influence distribution and allocation, that there is no way to be sure. But I do know that the minute the scientific sources I trust give the green light, I will still wait a month or two to see how things unfold and also give priority to those with a more and immediate need for limited supplies. But then I will stand in line and do my part to protect the community as a whole. No worries, you’ll hear about it!

Photographs are from my local Jackson Middle School on whose fields I walk my dog. The students have decorated their buildings with totem pole-like assemblages with abundant creativity – made me think again how hard these times are on children and how much we owe them to make this a better, less dangerous and more equitable world.

And here is music from illness-induced periods of social isolation of various composers. I found the source here.

Chopin wrote this while isolated during a bout with tuberculosis.

Stravinsky wrote this while recovering from typhoid (contracted from eating oysters…) in a nursing home.

And Rachmaninoff transcribed and played this after he was stricken with the Spanish Flu upon arrival in the US in 1918.


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Gardens

By all reports, people are emptying nursery shelves of edible plants and seed catalogues are running out of products to ship because we are back in Victory Garden mode. With all that war-related terminology – fighting the invisible enemy – it’s no wonder that old war concepts are making a come-back.

Planting additional gardens to provide food was originally started in WW I, ironically to save our European allies from starvation- their farms had become battlefields and their farm workers soldiers. US citizens were asked to grow their own food so that we could send more industrially produced foods to Europe. During WW II 20 million additional gardens produced 40% of the nation’s food; the process included administrative manuals to help citizens with planting and pest control, and instructions for canning and preserving to help with excess crops. Here is an interesting re-counting of the history. And here is an incredible historical propaganda video sporting a patriotic family doing their share towards the war effort in a HUGE (quarter acre) victory garden, mostly dug by a horse and tended by a 14-year old who inhales enough pesticides to be guaranteed lung cancer – (as a side commentary, every one in the film has a name, Dad and Grandpa Holder, Dick and Jane, and then there is…. mother! Also, Jane likes to garden in penny loafers. Just saying.)

Food insecurity is indeed a monster raising its ugly head even higher in times of mass unemployment and disrupted supply chains. Yes, I’m speaking of today, not 1944. The statistics from just 2 years ago are staggering – over 37 million Americans, including 1 million children, lacked consistent access to enough food for an active healthy life. African-Americans are hit twice as hard compared to Whites when it comes to hunger. (Which reminds me: if you read one single thing today that I link to, read this: Kendi on the causes for disproportionate suffering experienced by minority populations facing Covid-19.)

Extra vegetable gardens, with now so much more need for food arising, are indeed a good idea. That is if you have a plot, as small as 2 by 6 feet, that gets 6-8 hours of sun a day, an inclination to get your hands dirty and a nursery that can still provides some seedlings and bags of soil or other stuff to plant in. Never gardened before? Luckily you don’t have to rely on James Burdett’s 1943 book, The Victory Garden Manual. He was the founder of the National Garden Bureau, a non-profit organization “that exists to educate, inspire, and motivate people to increase the use of plants in homes, gardens, and workplaces by being the marketing arm of the gardening industry.”

Yes, they market, oh do they market, but they do so cleverly to help the un-initiated find the joy of gardening. Their latest effort, Victory Garden 2.0, is a step by step internet tool that I can actually see being successful in adding food to the food banks. They offer instructions for raised-bed or container gardens of various types, a salad garden, a kitchen garden, a high yield garden and a giving garden – for the hungry. Everything is spelled out – from soil preparation to pest control to what kinds of seed you need, how to plant, space, water, pollinate – you name it. Example below. The link goes into way more detail.

Way to go.

While waiting for vegetables to grow, I’m getting anticipatory pleasure from fruit-tree blossoms – not my own, since my garden is too shady, although I have one ancient pear tree that yields about 4 exemplars per year, worm-eaten in my pesticide-free zone, but pears none-the-less….

Music today by Béla Bartók who seemed to appreciate certain kinds of vegetables:  

“And then, after moving to America in 1940, he and his wife visited Los Angeles where he first encountered the avocado pear while eating a version of Waldorf salad. ‘This is a fruit somewhat like a cucumber in size and colour,’ he carefully recorded. ‘But it is quite buttery in texture, so it can be spread on bread. Its flavour is something like an almond but not so sweet. It has a place in this celebrated fruit salad which consists of green salad, apple, celery, pineapple, raw tomato and mayonnaise.”

Schiff’s playing is tight, and the second movement of the 3rd piano concerto sounds at times as if the ducks have gotten lose in the garden…

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Meadows

One of my earliest memories concerns an escape, a short-lived flight from the confines of a sanatorium on an island in the North sea, Norderney, where I had been shipped for one of my perennial recuperation stints from childhood disease. Measles, Mumps, Scarlet fever, Whooping cough – I forget. I ran away onto a street that was being resurfaced, the smell of fresh tar sweetly tickling my nose, towards a meadow filled with buttercups, into which I threw myself and rolled around as any self-respecting four-year-old would do. Is it just me, or are old memories coming up in force these days, as if the sense of end times triggers a perusal of one’s life?

Ok, let’s cut the dramatic flair, and get to the point of the story. I have caught myself daydreaming that if and when testing for anti-bodies is widely available I will get the test and upon testing positive will re-experience that same sense of freedom of the meadow of yore – running out of confinement into a sunny, yellow, brilliant, sweet smelling world. Hah.

Here is the trick – the promise of an anti-body test, however sensitively testing who had the dreaded crud and who not, is one that is misleading and likely creating a dangerous situation. Here is the deal, more or less in the words of my Beloved who has brilliantly taught the underlying principles of Bayes’ Theorem for years. (Hearing it’s mathematics you are shutting off? DON’T! It’ll really be interesting, I promise.)

Let’s assume we have a test that we trust – it finds antibodies 94% of the time in people who did indeed have the disease and misses them only 6% of them time. It is also correct 96% of the time for those people who don’t have antibodies showing that they did not yet catch Covid-19 and gives us only 4% of false alarms – detecting antibodies, when you really didn’t have the disease. So far so good? We have a hit rate of 94%, a miss rate of 6% and a false alarm rate of 4%. To repeat, this is pretty encouraging: If you really do have the antibodies, there’s a 94% chance that the test will (correctly) confirm that you have the antibodies. If you really DON’T have the antibodies, there’s only a 4% chance that the test will (falsely!) say you do have the antibodies. That’s the false alarm number.

Here is the problem, though. Let’s assume that we give the test to the entire population of U.S. citizens, for sake of argument let’s round them to 330,000,000. If 1% of that population actually had the virus, over 3 million people were sick in other words, we would correctly detect the antibodies in 94% of these people, or precisely in 3,102,000 cases. So far so good.

Now let’s look at the remaining 99% of citizens who did not yet catch the virus. We had said earlier that the false alarm rate for these cases was low, around 4%, where a test said it found antibodies when you really didn’t have them because you never had the virus. We are talking about 326,700,000 people in this population of uninfected people of whom 4% would be 13,068,000. Over 13 million people, in other words, would be told they had the virus, when they actually didn’t, because even a small false alarm rate becomes a big number when it is applied to a huge number of people in a particular category (here the not-yet infected.) Again, 3 million people would get a correct assessment of their status – you previously had the crud and don’t have to fear infection- and over 13 million would get the same message incorrectly. IN OTHER WORDS, the test is wrong four-times more often than it’s right!

How would you, as an individual, know in which group you are if the test comes back positive? Yes, you had the cough, some fever, all the known symptoms, but they could just as well have been from the hideous rhino virus going around this spring – but if the test tells you you have antibodies to Covid 19 it is more likely mistaken than not. The real up-shot is, of course, that it gives many, many people who tested positively a sense of security that might be false and expose them to infection if they go back out into the world going about their business as they used to. But, since they’re not safe, we’re on our way toward disaster.

Many people find this confusing, because, after all, we said that the test detects Covid 94% of the time. How could that sort of test be WRONG more often than not? The key is to understand what that 94% actually is. The 94% (officially called the test’s “sensitivity”) is the ability to detect the virus when it’s there. That’s not the same as the test’s accuracy (which is the test’s ability to tell whether you’ve got the virus or not). Accuracy can be (and, in this case, IS) rather low if you give a sensitive test a lot of opportunity to be wrong. That’s because the false alarm rate is a small percentage, but — again – it’s a small percent of a big number, and that’s a lot of errors. That’s what drives down the overall accuracy.

Note that all this would change if and when a larger percentage of the population actual had indeed been ill, say 30 million people instead of 1 million which was our assumed number. But also note, that there are other troubles associated with testing beyond the issues discussed so far. The podcast below and the NYT article from yesterday spell those out.

https://slate.com/podcasts/what-next-tbd/2020/03/where-are-coronavirus-tests

Meadows have to wait, folks, like it or not, until we have a vaccine. (Or at least meadows where you meet other people – you can still enjoy them tout seul….)

Photographs today are from last week’s walk at a local meadow and my current backyard, daisies, dandelions (!) and all.

And here is a spring symphony.… Schumann’s 1st, op. 38

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