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The Deadly Fentanyl Fraud Between the Doctor and the Pharmacist

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George Otto was a doctor who hadn’t paid his taxes and needed to earn extra to get square with the Canada Revenue Agency. Shereen El-Azrak was a pharmacist trying to provide for extended family in Canada and Cairo. As Brett Popplewell reports at Toronto Life, the pair worked with two drug-addicted dealers to purvey Fentanyl on the street in Ontario, Canada, at $350 CDN a patch, putting addicted Canadians at risk of overdose and death. And the reason? Simply to pad their own pockets.

He’d turn on his computer and write patient charts before his first appointments started filing into the clinic at around 10 a.m. He often treated as many as 80 people in a 10-hour shift. Then, after he was done seeing patients for the day, he’d begin his other work. The work no one could find out about. The work that would destroy his life, along with hundreds of others.

At some point after teaming up with Otto, El-Azrak brought him a new proposal. In recent months, she’d developed a lucrative side hustle, dispensing fraudulent fentanyl scripts. She worked with a few other doctors, who would write the scripts and pass them to drug dealers, who would sell them on the street. He could earn as much as $9,000 per week if he came on as a primary partner. Otto, no stranger to gaming the system, quickly agreed.

In June 2015 alone, Otto took home $33,000 from the scheme. The cash helped pay for the extravagant life he’d set up for himself and his family. It kept his jacuzzi hot and his Lexus fuelled. He had no idea who was using those fentanyl patches in Sudbury, who was overdosing, who was dying. Those people were so far removed from the life he’d built that they didn’t matter to him at all.

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Stand By Your Dictator

Syrian President Bashar al-Assad (foreground L), his wife Asma visit the exhibition dedicated to French painter Claude Monet at the Grand Palais on December 11, 2010 in Paris at the end of their official visit in France. AFP PHOTO MIGUEL MEDINA (Photo credit should read MIGUEL MEDINA/AFP via Getty Images)

For some historical background on the war in Syria, read “The Graffiti Kids Who Sparked the Syrian War,” by Mark MacKinnon at The Globe and Mail.

Asma Assad, wife of Syrian dictator Bashar al-Assad, isn’t content to raise the kids while her husband oversees torture and violent attacks on his own citizens in a bid to squash a rebellion that has been ongoing for ten years. In this startling profile at 1843, Nicolas Pelham reveals that the London-born first lady of Syria has been ruthless in acquiring power, wealth, and influence at home with dubious “improvement” projects under a sham called the Syria Trust for Development, all while courting favor with the West, pretending to be someone other than a wife solely dedicated to her husband’s ongoing tyranny.

The UN gave up trying to count the war’s death toll in 2016, when it had already reached nearly half a million. More than 10m Syrians are refugees.

In the first year of the uprising she advertised for a gardener and spent £250,000 on furniture. To circumvent sanctions she sent her hairdresser shopping in Dubai and used an alias when ordering from Harrods.

As the war continued, Bashar became more ruthless. One Western diplomat recalls the slow escalation of violence – using artillery against civilians, then air raids, then barrel-bombs. “They would…use it once, there’d be an outcry, but not to the point of international intervention,” said the diplomat. “So they would roll it out, and that would become the new normal.” International condemnation of Bashar’s crimes grew, yet this incremental choking of Syria, rather than all-out attack, helped forestall intervention.

On August 21st 2013 new footage appeared, showing people in the rebel-held suburbs of Damascus with bubbles foaming at their noses and mouths, and their limbs jerking. Hundreds died. A UN investigation later confirmed that they had been killed by sarin, a nerve gas. It was the worst chemical-weapons attack anywhere since Saddam Hussein had gassed Kurds in Halabja in 1988.

The financial success and ruthless machinations have eroded Asma’s carefully cultivated image. “Some still love her, put her photo on their Instagram page. But most now perceive her as a sneaky greedy person,” said one Syrian businessman. These days, though, no one accuses Asma of failing to understand how Syria works.

Late last year residents of the Damascus neighbourhood where Asma lives noticed a surreal change in the landscape. An old statue depicting a lauded colonel was joined by a new one: a vast sculpture of a horse’s head, at the direction of Asma’s business associates. Locals complained about the extravagance. According to reports in Gulf newspapers, the authorities had the horse’s head removed. Hours later it was back. The message was clear: in post-war Syria, Asma calls the shots.

State media gives increasing air time to “the Lady of Jasmine”. Huge posters of her image have been spotted in her parents’ hometown of Homs, covering entire housing blocks. Uniquely for a Syrian First Lady, ministers have taken to displaying her portrait in their offices alongside Bashar’s.

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Good Naked vs. Bad Naked

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At GQ, novelist Mary H.K. Choi is confronted with the “miserly calculus” of love and the true nature of intimacy when her parents fall ill across the country and her then-distant partner says that her need to see them reveals she’s weak. Choi suggests that there’s a certain generosity in truly seeing someone, recognizing and loving them even when their ugly motivations and petty behaviours are on full display.

In the ninth and final season of Seinfeld, there’s an episode called “The Apology.” It’s the one where Jerry dates a nudist named Melissa and distinctions are made between good naked (brushing hair) and bad naked (opening jars; crouching). The crux is that there’s something decidedly off-putting about the dispensation of effort. Good naked presumes an unguardedness, the rousing tenderness of a perceived vulnerability. It’s happening upon my partner asleep, his hair curling riotously against his brow. The quiet and warmth of small hours, bodies pressed upon each other as an eyelid flutters open.

Sheltering in place is bad naked. It is deeply and intensely unsexy watching your romantic interest cope. The constant exposure to less-than-telegenic micro-expressions. An intolerable aspect of yourself clocked in your spouse. The sweatpants. A cozy but misshapen “housecoat.” What a novel and alarmingly survivalist pathogen does to human aging when you’ve both just turned 40, that moment when everything slackens with an almost audible sigh of defeat.

But confronted by my husband’s unalloyed contempt that day in the park, when he told me I was weak for wanting to see my dying parents, I felt true intimacy for the first time in months. The admission was a tonic. It wasn’t just truthful. It was an advanced truth. It was not just bad naked. It was beyond naked. He’d called me weak because he hated me. And he hated me because he was scared.

Because good naked is a lie. The truth of my own hideousness is disgusting even to me. As unassailably repellent as the smell of an earring back. The ugliest parts of me revel in the craven parts of him. Because so far there are no conditions by which he doesn’t love me, no matter his reluctance.

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Pop Culture Portrays OCD as a Blessing. It’s Not.

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We’ve been fortunate to publish Lisa Whittington-Hill in the past. Learn why Courtney Love deserves to be the girl with the most cake. Check out “Live Through This: Courtney Love at 55.”

At The Walrus, Lisa Whittington-Hill looks at how media has portrayed people with obsessive compulsive disorder (OCD) “as Type A clean freaks, Sheldon Cooper–like nerds, productivity machines, or eccentric weirdos.” With characteristic wit, Whittington-Hill says that these stereotypical portrayals betray the true experience of people with OCD. Pervasive, inaccurate stereotypes have allowed some to misuse the term to refer to someone who simply prefers organization over disorder. Think Monica Geller from Friends. Whittington-Hill says that living with OCD — a mental illness — exacts a far greater toll and for her, one that she pays by isolating from others.

The obsessions—the unbidden thoughts driving the compulsions—are comparatively less discussed. When I try to explain my OCD to people, they don’t understand the fears and anxieties that drive these compulsions or what the repeated actions are meant to accomplish. I don’t check taps because I am really into ornate faucet design. I do it because it is the only way to quiet my brain.

I once heard OCD described, very accurately, as a record skipping in your head. The checking routine I have before I leave my apartment can take anywhere from thirty minutes, on a very good day, to two hours, on a very bad one. There is a voice in my head that won’t go away, repeating: “You must check the fridge door to make sure it is closed, or the fridge will defrost. All your food will go bad and your kitchen will flood. It will destroy your apartment and the one below it.” I pray that my foot won’t hit the overflowing recycling bag in my kitchen that sits directly across from the fridge. If my foot hits it, it disrupts my very specific, everything-in-its-place checking routine, and I have to start all over again. Repeatedly checking the door helps to calm all the fears I have about what disasters could happen if the door were left open. These fears may seem irrational, even ridiculous, to others, but they are very real to me.

My OCD makes me feel like a bad friend, a bad coworker, and a bad daughter. I can’t show up places on time and I feel like I am always apologizing for being late. I can’t travel easily and I avoid doing so whenever I can. If I do have to travel, I start dreading it months in advance. My pre-leaving-my-apartment routine is nothing compared to my routine for leaving my apartment for a vacation. I often cancel plans so I can avoid having to leave my house at all—the thought of going through my checking is too exhausting to contemplate.

As a result, I isolate myself. I live in fear of people laughing at me, which they have. I avoid relationships because I can’t imagine someone staying at my house for a night. “Just go to bed. I’ll be there in a couple of hours, after I check the windows repeatedly to make sure they are closed because I am worried that, if they aren’t, someone will somehow scale the side of my building, climb three floors, cut the window screen, and enter the bedroom to kill us.”

Who’s in the mood for romance now?

I RECENTLY REALIZED that I went three months without using my stove, reasoning that, if I never turned it on, then I didn’t have to worry about checking it. If food needed to be heated, I microwaved it or used boiling water from a kettle, or else I didn’t eat it at all. That lasted until I began to think about checking the microwave and kettle, at which point I switched to sandwiches and cereal. My OCD has cost me so many moments and opportunities.

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Why Mother Maybelle Carter’s Work Was Never Done

Country singer songwriters The Carter Family (Maybelle Carter on Guitar, Helen Carter on accordion, Ernie Newton on Bass with dancers June Carter Cash and Anita Carter) on stage at the Grand Ole Opry in 1951 in Nashville, Tennessee. (Photo by Bob Grannis/Getty Images)

In rural America in the early part of last century, women who did full-time labor to keep households and farms running while raising children were considered unemployed unless they earned a wage. Country music pioneer Mother Maybellle Carter often did double duty, laboring at home by day, raising children, and playing shows at night for years. When she and her daughters formed a singing group called “Mother Maybelle and the Carter Sisters,” Maybelle took the girls on the road, sometimes playing two shows a day, six days a week, washing and pressing clothes and preparing the girls to sing and play on stage. Her double duties — which never really ended for the duration of her life —  included looking after Johnny Cash and helping him overcome addiction. At NPR, Jessica Wilkerson examines the many labors of Mother Maybelle and the women of her time.

The success of the Carter Family band also hinged on women’s labor. Maybelle may have abandoned wage work in the mills that attracted a generation of Appalachian girls, but she did not give up on the idea of earning a living. Modern working women, Maybelle and Sara blazed a new path in popular music and flouted gender conventions as front women in a band, with Sara on lead vocals and Maybelle lead guitar, unheard of at the time. But that path wasn’t always easy or glamorous.

Mother Maybelle and the Carter Sisters “were a self-contained road show,” doing all the work to set up a live show, without staff. Maybelle sewed many of the matching dresses the girls wore, pressed them before showtime and did the girls’ hair. June Carter Cash recalled, “We never went onstage with a wrinkle or uncurled hair.”

When you listen to Maybelle play the guitar, you can hear a lifetime and more of labor. It’s the work of her mother passing down the songs that accompanied mountain women as they weeded the garden or rocked a baby to sleep. It’s the work of Sara and Maybelle stealing moments to create music, of the mill girls working at a warping machine in the new textile factories, the life that Maybelle escaped. It’s the work of A.P. Carter and Lesley Riddle collecting songs, and Maybelle catching the songs in her fingers, recreating them for new audiences. Those songs provided moments of respite, too, for people who flocked to concerts or tuned in on the radio after hours of work on a farm or in the coal mines. The Carter Family worked so that people could relax. We can hear the work of soothing the weary, through gospel songs that promised better days ahead and old ballads that reassured listeners that they were not the first to suffer. Maybelle’s melodies supported her family, providing them a comfortable life when few women could say the same. Maybelle Carter chased the music and worked herself to the bone to give the world country music. And when those melodies were no longer as valuable, she patched together other kinds of work to make ends meet, because that’s what people like her do.

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Congratulations, You Now Own a Newspaper

ALASKA, UNITED STATES - 1994/01/01: USA, Alaska, Inside Passage, Skagway, Main Street. (Photo by Wolfgang Kaehler/LightRocket via Getty Images)

At Columbia Journalism Review, Lauren Harris reports on the gritty determination of Melinda Munson and Gretchen Wehmhoff, a duo who became the owners of the Skagway News in a give-away. The pair, who are taking the paper into the modern age, are committed to making the publication a success — despite the effects of Covid-19 on a tourist town dependent on visiting cruise ships to survive.

IN 2019, LARRY PERSILY, owner of the Skagway News, announced that he would give away his local Alaskan publication to a person or a pair demonstrating journalistic skill, self-motivation, grit, and—above all—affectionate dedication to the quirks and quiddities of rural small-town reporting. National news outlets picked up the story as a sort of lark, emphasizing the remote and small-town nature of Skagway, the rarity of the giveaway, and then, in a few short lines, the challenges of sustaining critical local news coverage. In such stories, Persily was a Willy Wonka figure, courting a successor.

Among the applicants were Melinda Munson and Gretchen Wehmhoff, teachers in the Anchorage area who cowrote a blog for Alaskan families. Munson and Wehmhoff envisioned a dream job not unlike that conjured in headlines: the freedom to write and the promise of a place in a tight-knit community. Over the course of months, Munson and Wehmhoff had several intense phone interviews with Persily; for some, they met in a room in the school building with the lights off, to avoid drawing the attention of their principal.

Persily took over the paper’s management in 2019, working from Anchorage—a distance of nearly eight hundred miles from Skagway, which he quickly came to believe was too far.

“You gotta be part of the town,” Persily says. “You gotta go to the basketball games. You gotta be a trusted part of the community.” He discounted applicants who envisioned doing the job “for a couple years” or who wondered about how much they could contribute annually to an IRA. “Small-town papers need small-town editors,” he says. “I wanted an owner who was going to live there happily ever after.”

GRETCHEN WEHMHOFF AND MELINDA MUNSON make a winning pair. Wehmhoff is garrulous and lively; Munson is eloquent and tempered. Munson writes and edits, in addition to managing childcare and remote schooling for six kids; Wehmhoff does everything else. Each shows an obvious faith in the other’s capabilities.

“Gretchen is a Renaissance lady: she can do layout, ads, business,” Munson says. “When Gretchen writes, she spits it out on the paper, then hands it to me to edit.”

“I wipe up a little bit of the spit,” Wehmhoff responds.

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When Death Came to Mauritius

TOPSHOT - An aerial view taken in Mauritius on August 17, 2020, shows the MV Wakashio bulk carrier, belonging to a Japanese company but Panamanian-flagged, that had run aground and broke into two parts near Blue Bay Marine Park. (Photo by - / AFP) (Photo by -/AFP via Getty Images)

On July 25th, 2020, the container ship MV Wakashio ran aground off the coast of Mauritius, an area known for “some of the world’s clearest lagoons, most pristine ecosystems, (and) healthiest fish.” The ship eventually broke in two, spilling oil into Point D’Esnay, contaminating the coastline’s vegetation and sea life. As Ariel Saramandi recounts in this essay at Granta, when the government failed to act quickly, the citizens of Mauritius took action. The community made booms to soak up oil and protested against government indifference and inaction — despite the threat of being arrested for criticizing the authorities.

We have our superlative reputation to protect, after all: some of the world’s clearest lagoons, most pristine ecosystems, healthiest fish. Tourism is the heart of the economy. The majority of the island’s most opulent hotels are found on the east coast. Plus, the government is heavily invested in the fishing industry. Our fish exports are a 250-million-dollar business, and parastatal fish farms dot the south-eastern lagoon. We are confident that the Wakashio will be removed imminently from the reef: it’s in the government’s self-interest. We hear talk of international assistance and are reassured.

Meanwhile, images show filaments of an oily substance on the shore. Then images show the ship beginning to tilt. The Minister of Fisheries said the photos ‘appeared to be manipulated and deceptive.’ ‘The ship is not sinking and will not sink,’ he said on 5 August 2020.6 All is under control.

The next day thick black streaks coat our lagoon. Oil like lacquer on the water.

Against all international recommendations, despite our outcry and outrage, the government sank half of the Wakashio in great haste on 24 August. Two days later, melon-headed whales washed up around the south-eastern coast. Dead, mutilated, glossy bodies. Authorities haul them onto the back of pickup trucks, tails hanging out. Authorities cover them in white sheets. Videos of dying whales bobbing helpless in the ocean. Video of a mother whale trying to nudge her dying baby above the waves so that it can breathe; she watches as it dies, then dies a little while later, too. Fishermen say the ship was sunk in a whale breeding ground, that some of the corpses they found were of pregnant females.

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“People are dying waiting”

TORRENCE, CA - DECEMBER 29: Hospital doctors and nurses treat Covid-19 patients in a makeshift ICU wing on the West Oeste at Harbor UCLA Medical Center on Tuesday, Dec. 29, 2020 in Torrence, CA. The hospital has no open beds for incoming patients and have worked tirelessly to create additional beds for the influx of Covid-19 patients. (Dania Maxwell / Los Angeles Times via Getty Images)

At ProPublica, reporters David Armstrong and Marshall Allen tell the story of 53-year-old Miguel Fernandez, a Latino man from California who contracted the virus last fall. The center of a tight-knit, multigenerational family, Miguel fought for his life in hospital as his loved ones pushed to get him life-saving extracorporeal membrane oxygenation treatment — a specialized therapy that doctors are now in the horrific position of having to reserve for younger patients with the best chance of surviving, as critically ill COVID-19 patients overwhelm a healthcare system stretched far beyond usual limits.

But starting in early November, the daily number of COVID-19 hospitalizations surged in Los Angeles County, rising eightfold between then and the wave’s crest, which arrived just after New Year’s Day. Within weeks, overflowing hospitals faced exactly the types of care-rationing decisions experts had feared. Hospitals set up tents to increase capacity, and ambulances circled for hours as they waited for beds to open. By early January, Los Angeles County emergency medical personnel were directed to conserve supplemental oxygen by only administering it to the neediest patients, and to stop transporting to hospitals cardiac arrest patients who couldn’t be revived in the field. State officials dispatched refrigerated trucks and thousands of body bags to the region.

Miguel didn’t want to go to the hospital. He knew people like him were dying. Latino Angelenos have suffered the highest COVID-19 death rate in Los Angeles County — almost twice the rate of Blacks and about three times the rate for whites.

The separation was especially difficult for Alejandrina, who had been married to Miguel since 1991. Miguel liked to tease her when she watched her Mexican telenovelas: Why do you watch those shows when you have me? On Mother’s Day earlier in the year, Miguel had surprised her by buying a pair of rings, getting down on one knee and proposing again. The couple made plans to renew their vows on their 30th wedding anniversary this summer. When he became sick with COVID-19, Miguel assured Alejandrina he would get better so they could get married again. She promised she would wait for him.

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“Addiction is a thief of your goodbyes”

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In this moving essay at The Rumpus, Heather Stokes recounts what addiction has stolen from her and her mother. A bother and uncle addicted to crack stole not only possessions from the family house, but most importantly Heather and her mom’s personal safety and any chance at stability. Eventually, a boyfriend’s coke addiction costs Heather her freedom, after she embezzles from her job to help feed his habit.

Her pause snapped me back into the conversation. I disinterestedly responded, “I’m sorry, can you ask the question again?”

“What do you feel addiction has stolen from you?”

I knew that she was more than likely referring to my own addictions, but I did not want to talk about those. Instead, I went back in time, back to a time before I knew that substances and people were not meant to be abused. The many years my uncle, brother, and father spent in and out of prison, leaving my mother and I alone—years that robbed me of having a father, of having a stable male presence in our family. Years that morphed into the “I’ll just do it myself” attitude that haunts my relationships to this day. I thought about the shame I felt as I walked past the neighborhood bodega, eyes fixed to the ground, to avoid making eye contact with my brother who stood outside, shaking in the middle of three-day crack cocaine binge.

These were the silent losses. The things that are not talked about in the glamorization of addiction played out on your favorite television shows. Things left unspoken between family. Like opening the kitchen cabinet to find a little corner ripped off the roll of aluminum foil—my uncle used them to construct his aspirin bottle crack pipes. Cut-off straws that were useless to drink your Pepsi with made the perfect suction for inhaling poison; I would often find them discarded under the crab apple tree in front of our house. Some mornings, I would even find my uncle discarded there with them, his disheveled body wrapped around the tree, surrounded by rotten crab apples as if the poison had seeped into them, too.

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“A Series of Small Collapses Caused by Continual Neglect”

CLEVELAND, OHIO, UNITED STATES - 2020/09/29: Protesters wearing masks march through University Circle while holding up placards and banners during the protest. In reaction to the presidential debates being held in Cleveland, protesters gathered to protest against President Donald Trump and show support to black lives. The initial protest began with speeches at Wade Lagoon, and proceeded with a march throughout University Circle that ended at Wade Lagoon. Stragglers from the initial protest went downtown towards the intersection of 105th St. and Chester Ave. where police were stationed. (Photo by Stephen Zenner/SOPA Images/LightRocket via Getty Images)

In this deeply moving essay at The Baffler, Hanif Abdurraqib reflects on the protests of last summer and the ongoing fight for equality with a mix of grief and pride. As he considers those who protest systemic racism in America, he says “… yes, it is thrilling to see a generation that has harnessed their firsthand knowledge, their resources, their steadfast care for each other, and their rage, and channeled it into multilayered action.” But he yearns for a day when the time and energy and fortitude required to protest can be “freed up not only for other fights but for other endeavors that make newer uses of their time.”

What pushes people out into the street and what pushes them to organize might be sparked in a single moment, but before that moment, and often stretching on long after, is a series of small collapses caused by continual neglect.

A series of small collapses is how they come to be radicalized.

We were there because it was necessary that we be there. Because someone we loved was in the streets and they needed protection or care or simply someone else they knew to add to the long braid of someones blocking traffic and holding the line when cops descended with their sprays or their horses or their hands on their weapons.

The grief of this moment, this life, is torrential. More for some than others, of course. But in the midst of it, one small, distinct grief that I have been focused on is the grief that sits alongside the immense pride and excitement I feel watching young activists step fully into themselves and realize they are entirely unmoved by and unafraid of power. I had that inside of me when I was a teenager, and a lot of the people I lived with and hung around did too. But so few of us actually knew what to do with it. We knew we hated that cops were in our schools and in our neighborhoods—their primary function to inject fear into the day-to-day movements of largely marginalized kids from largely marginalized communities. But it didn’t seem like there was much to do with that rage except funnel it back into our own ecosystems, our own selves. We knew our anger but not our capacity to organize.

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