Search Results for: San Francisco Magazine

Longreads Best of 2017: All of Our No. 1 Story Picks

All through December, we’ll be featuring Longreads’ Best of 2017. Here’s a list of every story that was chosen as No. 1 in our weekly Top 5 email.

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How We Got There from Here

Michael Stipe and Peter Buck of R.E.M., 1985. (Paul Natkin/Getty Images)

Anna Armstrong | Longreads | December 2017 | 12 minutes (2,903 words)

 

“Jefferson, I think we’re lost.” — Little America, R.E.M.

The distance between Rodeo and Santa Cruz is just over 90 miles. For the most part the drive is unremarkable — urban, industrial cities and rural, unincorporated towns along the Eastshore Freeway, shaping the wasteland east of San Francisco Bay. But then the interstate gives way to Highway 17 and you begin the ascent to another world. The road is a thin, curlicue curved by the green Santa Cruz Mountains.

As a child I made this trip many times with my parents in our wood-paneled station wagon packed tightly with my five siblings and me — my gaze resting out the window, tracking the miles by the three-minute pop songs on the radio while an endless imaginary flat-panel saw tethered to my slight wrist sliced through the redwoods. Our destination? The historic Santa Cruz Beach Boardwalk.

The winding highway was a signal that we were close to the magical unworldliness of rickety wooden roller coasters, salty ocean breezes, barefoot children, bikinied girls, sun-kissed boys, a symphony of voices, crashing waves, tinny arcade bells, the smells and tastes of corn dogs and candied apples — and far, far away from the broke-down, shuttered place of stillness, silence, and late-to-bloom fondness in the rearview mirror. What separated Santa Cruz from Rodeo was not just miles but a tangible joy you could hold in your hands. Coming home sunburned, exhausted, happy — sleeping through the curves of the highway, waking abruptly in time to see the straight line to home.

June 1985. I was 17 years old and newly licensed. I was preparing to make the trek from home to Santa Cruz in my very first car, a 1972 Chevy Malibu that braved a Black Flag bumper sticker in a town that just didn’t get it. The destination? A very different type of spectacle: A rock ‘n’ roll show. The Athens, GA band R.E.M were scheduled to play the Santa Cruz Civic Auditorium.

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Peter Thiel Makes Sure His Kids Are All Right

(Neilson Barnard/Getty Images for New York Times)

Some people never leave college behind; the philosophies they develop as an undergrad stay with them for a lifetime. For Peter Thiel, that means periodically revisiting his 30-year-old love child, The Stanford Review, to make sure the magazine he founded in 1987 still has the independent streak that disrupts the status quo on campus

The Review was where Thiel could test out his formative contrarian options, “generally reflecting on his vision for the paper as a vehicle for stirring the pot and breaking up politically correct platitudes,” writes Andrew Granato in his Stanford Politics profile of Thiel’s relationship with the student magazine.

Although Thiel hasn’t been the editor-in-chief of the magazine since 1989, he still keeps an eye on his baby. This means giving money to the Review — lots and lots of money — and checking in from time to time in person. “Thiel continues to meet with the publication’s editors,” writes Granato, “and he is substantially more open with them about his beliefs than he is with the general public, including on highly controversial issues like race and immigration.”

Highlighting both the intimacy and exclusivity of these gatherings, one email invitation to such an event in 2015, shared by a former editor, reads in part: “Hi, We will be having a Review dinner at Peter Thiel’s house next Wednesday…This is not an open invite; please do not talk about this opportunity with anyone else, especially at the [Review staff] meetings.”

Thiel’s influence on the autonomous Review’s on-campus activity should not be overstated: Students are always in control of the paper, and Thiel does not attempt to orchestrate their conduct. The great majority of The Review’s activity involves its independent writing and reporting on the issues of the day and its weekly meetings, which often feature boisterous political debates. (Amy Shen ’18, the current executive editor, says she enjoys the meetings as a place where “you are judged on the basis of your ideas and nothing else.”)

But Thiel does occasionally host dinners and reunions with Review editors at local restaurants as well as his home in San Francisco, give suggestions of issues to focus on, donate money, and de facto lead a burgeoning network of alumni concentrated in Silicon Valley, many of whom have worked with or for Thiel directly.

As one former editor put it, “[Thiel] sees The Review as his people.”

Speaking about Thiel, many Review and ex-Review affiliates insisted on anonymity. They clearly respect him. Mackenzie Yaryura ’17, a former editor-in-chief, says, “my only experience is that [Thiel’s] been really welcoming, really interesting, being willing to answer questions and share knowledge.”

To what degree does Thiel still care about The Review’s activities on campus?

One former editor believed “he obviously had zero interest in getting to know us as individuals. He was there to figure out what was going on on the campus.” Harry Elliott voiced that “to be honest the thing which most Review alums are really interested in, not just or specifically Peter, is: they want to know what the issues de jour are, what the average Stanford student is like, and what we are doing to try and ensure that viewpoints that are usually not heard as heard.”

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Unreal Estate: A Reading List About Our Shifting Vision of Home

Does anyone still remember Unhappy Hipsters, a Tumblr blog born in 2010, just months after the Great Recession officially ended? The concept was simple and irresistible. Each post contained a photo of a domestic interior from a Dwell-like magazine (or, just as often, from Dwell itself), and the photo had to include a person: a teenager lounging with a book on a nordic-looking wooden bed, a couple having a silent breakfast in a vast, concrete-floor kitchen. A caption accompanied each image, projecting a mix of smugness and existential angst onto the people occupying these impossibly streamlined spaces (“So focused on erecting a structure that would be impervious to atmospheric whims, he’d forgotten the obvious: an exit,” read a caption below an image of a man standing on a balcony of a glass-and-steel stilt house).

There’s nothing new about wanting to catch a glimpse of other people’s (nicer-than-yours) houses; what Unhappy Hipsters deftly added was an extra layer of vindictiveness to an otherwise common, aspirational voyeurism. Revisiting some of these old posts today, they feel at once naive and prophetic. In the intervening years, owning a house and designing one’s own space haven’t lost their allure as class markers and so-called #lifegoals. But they’ve also acquired a tinge of bitterness: you either can’t afford it (millennials, meet avocado toast!), can’t do it right (unlike everyone on Pinterest, Instagram, et al.), or risk trying too hard (at which point: surprise! You’re the Unhappy Hipster — in 2017, when both “unhappiness” and “hipsterism” have lost just about all meaning).

The way we organize and reshape our living quarters has always reflected, in some way, desires, hopes, and anxieties that transcended individuals. It was true when married couples started sharing the same bedroom and outhouses began to disappear in favor of indoor plumbing; it’s true today when we buy a vintage lamp or encounter a luxury bathroom almost the size of the bedroom it adjoins. Where does the current unease around the spaces we inhabit come from? What is unique about our attitude toward a supposedly universal concept like “home”? Here are four recent reads that try to address these questions.

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“No Fatties”: When Health Care Hurts

Illustration by Hannah Perry

Carey Purcell  |  Longreads  |  October 2017  | 4280 words (16 minutes)

Kasey Smith began gaining weight as a teenager. The numbers on the scale started increasing overnight, and no matter how few calories she consumed, they continued to go up. “It will even out,” she thought, crediting the change to puberty and hormones. But it didn’t, and her hair and skin began changing as well. “Something was definitely wrong.”

Each medical appointment, and there were many, concluded with doctors telling her to go on a diet. Smith (not her real name) remembers telling the endocrinologist about her frustrations with burning off the 900 calories she consumed each day and still gaining weight. “He looked at me and said, ‘Maybe you can cut back your McDonald’s to twice a week.’ I was stunned silent, and I went into the bathroom and broke down. ‘He doesn’t believe me. He thinks I’m just fucking with him.’”

As Smith’s weight went up, her food intake went down. Her mother signed her up for Nutrisystem, and her diet hung on the fridge for everyone in her family to see. Shame and humiliation narrowed her life down to three questions: what to eat, what not to eat, and how to burn more calories. She began to form dangerous habits, sometimes eating little more than lettuce.

Smith ultimately received a diagnosis of polycystic ovary syndrome, a hormonal disorder that can lead to excess male hormones, irregular menstrual cycles, and weight gain. She was prescribed Metformin and quickly began to lose weight, but the damage had been done. The 18-year-old developed anorexia, leaving for college at 130 pounds and coming back four months later and 30 pounds lighter, her hair falling out in clumps.

No one thought anything was wrong.

“I would go to the doctor, and there were no red flags. It was ‘You look fantastic!’ Not ‘This is alarming.’” Smith continued starving herself for another year until she ended up in the hospital, undergoing a colectomy to remove a foot and a half of her intestines, which had twisted as a result of her severe calorie restriction.

One year after the surgery, her worst nightmare returned: She was gaining weight. Celiac disease was the cause this time, but it wasn’t diagnosed until after Smith was in the habit of purging the little food she ate every day. She would regularly run in the park and pass out afterward. “I would starve all day, then I’d eat something at night, then I would purge it. In my head, I’m thinking, ‘I’m literally not consuming anything. The weight has to fall off.’”

She realized she needed professional help, and Smith found a therapist who specialized in eating disorders and began treatment at The Renfrew Center, a residential facility in Pennsylvania. She continues to struggle with discussing her weight at medical appointments. After she told her endocrinologist about her treatment at Renfrew, his reply was “I see you need to lose some weight.”

* * *

According to the National Association to Advance Fat Acceptance, one out of three doctors responds to obesity negatively and associates it with poor hygiene, hostility, dishonesty, and noncompliance, viewing fat patients as “lazy, lacking in self-control, non-compliant, unintelligent, weak-willed and dishonest.”

“Doctors may think they are doing their jobs by focusing on patients’ weights,” said Dr. Rebecca Puhl, deputy director of the Rudd Center for Food Policy and Obesity. But the effects of weight discrimination, both physical and mental, can be harmful to patients. “I do see this in health providers just as much as the general population, which is that maybe stigma isn’t such a bad thing. Maybe it will motivate people to lose weight. Maybe it will provide incentives for weight loss. But that is not what we see in research. We see the opposite — that in fact, stigmatizing people about their weight actually reinforces behaviors in health that increase body weight and obesity.”

The doctor looked at me and said, ‘Maybe you can cut back your McDonald’s to twice a week.’

As weight discrimination has increased in recent years — roughly 40 percent of adults report having experienced some form of weight stigma — so have obesity rates. A positive correlation between experiencing weight bias and developing eating disorders has been documented, and two studies have reported that overweight children are more likely to binge after being teased about their weight. Nor do these habits change as we age. In a 2006 study of more than 2,000 overweight and obese women who were part of a weight loss support group, 79 percent said they turned to food after experiencing weight stigma. Another common response: refusing to diet.

Johanna Tan encountered that stigma when she gained 80 pounds in three months after beginning the hormonal birth control Depo-Provera. Her doctor suggested weight loss, and she chose a weight loss clinic. In the weeks after undergoing her doctor-mediated diet of 500 to 800 calories a day, Tan began experiencing episodes of chest pain so severe she made more than one trip to the emergency room. Her general practitioner blamed her symptoms on her large breasts. “Never mind that my boobs have always been this big, and this was a new symptom,” Tan said, laughing wryly as she explained she had been performing special exercises and getting massage treatments to help ease the symptoms. But it wasn’t her breasts that were causing the pain, it was her gallbladder. Gallstones had blocked her common bile duct, and if left untreated it could cause acute liver failure. The cause of the gallstones? Rapid weight loss. Neither Tan’s weight gain nor her loss had been correctly assessed by her doctors. (Depo-Provera lists weight gain as a common side effect. When Tan voiced concerns to one doctor, she was told, “Everyone gets more hungry. You just need to not eat more.”)

The assumption that any health issues a fat person experiences can be chalked up to weight has not gone unnoticed by the fat community. Marilyn Wann was motivated to pursue fat activism after what she describes as her Really Bad Day, when a man she was dating told her he was embarrassed to introduce her to his friends because of her weight, and she was denied health insurance because Blue Shield of California deemed her morbidly obese.

“This double whammy of social and institutional exclusion based on my weight woke me up,” she said. “Until then, I had hoped to avoid the impact of anti-fat attitudes by avoiding the whole topic. But hiding and silence and avoidance didn’t keep the yuck from finding me. So I recognized that I had to come out as a fat person. The next day, I went to a copy store and made up business cards for my new print zine, which I decided to call FAT!SO? — ‘For People Who Don’t Apologize for Their Size!’ Immediately, my life became less stressful. Of course, I still encounter anti-fat attitudes and weight-based exclusions, but I have drawn a line between me and the hatefulness. It makes a huge difference.”

Wann still experiences bias, especially at the doctor. “I know before I enter the door that the whole system prioritizes its prejudice over my well-being,” she said. “The prejudice is what’s necessary to the institution as it stands. The medical establishment, the insurance agencies, public health agencies that are government-based have always advanced their agenda on the back of fat people. … The institutions of our supposed health systems — in the government agencies, in the insurance companies, in all of the medical practices — are saturated or have deeply ingrained anti-fat bigotry.”

Establishing the balance of information and compassion while discussing a patient’s weight is constantly on Rebecca Zuckerman’s mind. “It puts medical professionals in a weird catch-22,” said Zuckerman, a fourth-year medical student at the Pritzker School of Medicine at the University of Chicago, who understands the motivation of fat activists but whose education includes the negative medical impacts of obesity. “It’s something I’ve struggled with personally. You can only explain it and tell people their options. You can ask if it’s OK to talk about weight loss or give more information. If they say, ‘No, I don’t want to hear it,’ you have to respect that.”

Still, the intense schedule of medical professionals, who are often allotted only 15 to 20 minutes per patient, often results in less-than-ideal communication. It’s easier to reach for the quickest conclusion: telling the patient to lose weight. Says Zuckerman, “A lot of doctors and nurses experience burnout, and they start losing empathy and don’t view the patients as people anymore. Your hands are tied to stay within those 20 minutes. Everyone’s trying to make more money, and the doctors are a cog in the wheel.”

That’s along with pervasive stereotyping about fat people in the medical community. In a study of 318 family physicians, two-thirds reported that their obese patients lacked self-control, and 39 percent stated that their obese patients were lazy. Even health care professionals specializing in nutrition thought poorly of their obese patients: “Attitudes toward obesity and the obese among professionals,” a study in the Journal of the American Dietetic Association, reports that 87 percent of health care professionals specializing in nutrition believe that obese persons are indulgent, 74 percent believe that they have family problems, and 32 percent believe that they lack willpower. In 2013, the American Medical Association labeled obesity a disease.

The misdiagnoses that occur lead directly to poor health outcomes. Johanna Tan ultimately spent three years in pain, leading to four weeks of hospitalization, a series of invasive surgical procedures, and lengthy rehab — procedures that wouldn’t have been necessary had the gallstones been caught earlier. While she was enduring severe pain following her first surgery and struggling to complete her postsurgical rehab, the hospital staff accused her of being lazy. “I spent two weeks in hospital post-surgery,” she said, “copping abuse for being lazy and not participating in my own rehab, before they realized they fucked up.” Tan said the nurses were condescending, saying, “I know it hurts. It’s major surgery. You still have to get up.” The pain didn’t ease until her doctors realized they had missed some gallstones and had to perform a second surgery. Tan wasn’t able to walk more than 10 feet at a time for the first month following her surgeries. It took six months for her to be able to walk further than a block.

* * *

Fat patients also often find themselves facing off with doctors who refuse to write prescriptions or referrals until patients lose an arbitrary amount of weight, a common scenario for those seeking joint replacement surgery. Despite being in “crazy amounts of pain,” Melinda Belles-Preston was required to lose 30 pounds before receiving an operation on her hips. Losing between one and two pounds a week, a healthy pace according to the Centers for Disease Control, would delay her surgery by several months. Heavier patients see longer lags. A required loss of 50 to 100 pounds can postpone a procedure for months or even years unless the patient undergoes weight loss surgery. Without surgery, the time spent in pain is prolonged, opening the door to painkiller dependence. It took Belles-Preston roughly six months to lose the weight, and she was in pain the entire time.

“Going in nutrient-deprived and starved is probably not a good way to send someone into heart surgery or major any surgery,” Wann said; her tone made it clear she was stating what she thought should be obvious. “Someone who’s been losing weight may have worse outcomes than someone who’s stayed the same weight. … It’s amazing how someone can just look at you and decide how a random number of pounds can shift you from someone who doesn’t deserve care to someone who does.”

Pain management was barely discussed when Virgie Tovar, activist and author of Hot & Heavy: Fierce Fat Girls on Life, Love & Fashion, went to the doctor after being injured on an amusement park ride. Suffering what she described as “debilitating back spasms” that made movement “electrifyingly painful,” she was told she had to lose weight before anything could be done for her. “It was like this dogged commitment to not helping me until I was at a different weight,” she recalled. “Let’s say I lose weight at what is considered a normal pace that doesn’t endanger a person’s life. For me to get to the weight you’re talking about is like 10 years. So I just get to be in pain until I’m at that weight. And if I’m still in pain after a decade of weight loss, then you’ll think about taking care of this?”

Ideally, preventive care helps patients avoid catastrophic health problems, but it’s not always accessible to fat patients, whether because of issues with doctors, issues with technology, or both. Fat patients have been refused medical screenings, such as Pap smears, mammograms, and colonoscopies, that are considered routine and vital for thin patients. The American Cancer Society advises women to get mammograms yearly beginning at age 45 and colonoscopies every 10 years beginning at age 50, but fat people often struggle to find facilities that will perform the screenings and are told they cannot fit in the machines.

A required loss of 50 to 100 pounds can postpone a procedure for months or even years… It took Belles-Preston roughly six months to lose the weight, and she was in pain the entire time.

The importance of an MRI comes from its ability to provide higher-quality images. But the machines that provide those images are small, and other options, like CAT scans or ultrasound, don’t provide a comparable alternative. “All those scans need to penetrate the body to create an image. If a body is larger and has more fat tissue to penetrate, the image quality is poorer and blurrier, and it’s harder to make out structures,” Zuckerman explained. “It’s harder for skilled radiologists to diagnose things in patients who are larger for that reason. … The fact is, MRI machines are tiny. Some people literally cannot fit in them. So we do something else like an ultrasound or CT that is not quite as good. It’s better than nothing, but it doesn’t give us the image quality that an MRI does. You run the risk of missing something because the picture that you’re getting is not clear.”

The need for hospital equipment that can accommodate fat people has grown, and imaging devices are now available. This equipment is not available everywhere, however, and sometimes patients are referred to their local zoos. When Wann called the San Francisco Zoo’s medical department to ask about accessing its technology, the person on the phone sighed and said, “I wish people would stop saying that,” referring to requests to use the department’s CT and MRI scanners. While vet schools and zoos have larger-capacity devices, they can’t allow human subjects, and scanning humans in machines intended for animal subjects is banned by formal policies in most facilities. “That’s really beyond their certification,” explained Wann. They’re not licensed as an institution to practice medicine on people. Their entire institutional certification is being put on the line because our human medical system refuses to accommodate people above a certain size. It draws an arbitrary line and says, ‘Go beyond this line, and they’re monsters.’”

Without being properly screened, patients can’t be diagnosed. A 2008 review of previously published studies, 32 in total, reported that white, female, obese patients were less likely to be screened for breast and cervical cancer. A study from 2006 reported that only 68 percent of women with a BMI of greater than 55 were given Pap tests, while 86 percent of other women were tested.

In some cases, this is a result of fat patients opting out of health care entirely, even if they otherwise have the ability to access health care facilities and are insured: According to the International Journal of Obesity, 19 percent of participants reported that if they felt stigmatized about their weight by their doctor, they would avoid future medical appointments, and 21 percent said they would seek a new doctor.

“Fat people don’t go to the doctor often. They tend to avoid it,” writer and activist Kitty Stryker said. “A lot of fat people are ashamed of being naked. They don’t want to be touched. When I say I have a lower-back problem, I know they’re going to say, ‘Lose some weight, and that will go away.’ So what’s the point? Why bother continuing to try to get to the root of my health problems when I know the only thing they will ever tell me is ‘Lose weight’?”


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Patients often face added risk beyond concerns of being dismissed or the necessary treatment being denied: the possibility of weight loss treatments and procedures being strenuously suggested at inopportune or irrelevant moments. While the American Academy of Family Physicians recommends screening for obesity along with monthly sessions of counseling and behavioral interventions, the timing of these suggestions is crucial to the impact of motivational interviewing — and execution is often poor. Tan was mid-Pap smear when her doctor asked if she wanted a Weight Watchers pamphlet.

“The speculum’s already in and open. And she says, ‘I can tell you’re getting upset. Do you want me to continue?’” Tan recalled in disbelief. “I said yes because I didn’t want to have to make another appointment for my Pap smear. I was so mad, I was crying at this point. I couldn’t move. I couldn’t yell. She said, ‘I can tell I’ve made you upset, but weight is a serious issue.’”

Although familiar with the prejudice that came with her weight, Belles-Preston was still shocked when her general practitioner recommended weight loss surgery — while she was pregnant. “I walked out of the room. It was so incredibly offensive to me. I’m coming to you for medical advice about my pregnancy, and you’re talking to me about weight loss surgery, which is the furthest thing from my mind.”

“I have tons of resources and attitudes for confronting this kind of stuff, and it can still kill me,” Wann said as I marveled at her calm approach to discussing prejudice so severe it can result in death. “I understand not going [to the doctor]. I think it’s self-protective to some extent.… Every time I go to any kind of medical appointment I anticipate facing weight bias. I anticipate being denied the sort of services thin people would receive with no problem or being targeted for weight-based treatments that I don’t want and could harm me. I’m not interested in stomach amputation or stomach squeezing. I don’t think those are therapeutic practices in any sense. Every time I go see a doctor I’m aware they may casually say the only thing they want me to do is have my stomach cut off.”

* * *

The effects of that bias were traumatizing and long-lasting for Tan. Triggered by her uncomfortable experiences in hospital environments, Tan’s first job as an audiologist after graduate school provoked frequent panic attacks because of its location at a hospital. “I used to have to go to work early so that I could tamp down the panic associated with being in a hospital at all,” she said. “This fear of hospitals hasn’t quite gone away. Most recently, a few months ago, we had to spend a few days in ICU as my partner’s dad passed, and just being back in ICU rattled me so badly it was a month before I could stop popping several Valium a day.”

It was the adversarial relationship she had developed with doctors and nurses that contributed to Tan’s panic. And she’s not alone. For many, thin means healthy and fat means unhealthy. So small and slender equates with good health and is encouraged by medical providers, often resulting in strained relationships with their patients.

The idea that the lower the weight, the healthier the person, escalated into life-threatening conditions for Smith, who was frequently complimented on how healthy she looked while she was starving herself. “When you’re restricting [calories] you can brag about it,” she said, recalling her preparation for the colectomy. “[Doctors] asked, ‘Are you eating well and exercising?’ I said, ‘I’m very healthy. I exercise all the time. I only eat vegetables.’ It’s a funny dichotomy. Just because the scale is low does not mean that you’re healthy. A lot of doctors forget to be careful of that.”

But as the number on the scale climbs, the less flattering characteristics — greed, lack of control, messiness, lack of self-care, laziness, automatic unhealthiness — are associated with fat people, only to be furthered by the media’s portrayal of fat characters, who are typically the butt of jokes or seen as slovenly and undesirable. Women are often the punch lines, much more than men. BMI standards also are more harsh for women than for men, which is apparent in the statistics regarding weight loss surgery: Obesity rates in America are split fifty-fifty between genders, but 80 percent of bariatric surgeries are performed on women. In a 2014 study from Kansas State University, 72.8 percent to 94 percent of overweight and obese men were satisfied with their health as compared with 56.7 percent to 85 percent of overweight and obese women. There’s a reason all the stories and sources here are about and told by women.

“The truth is that there are reasons why fit people live longer, better lives,” Tovar said. “It’s because the entire culture is constructed to benefit them.” Weight discrimination is associated with an increase in mortality risk of nearly 60 percent for both women and men.

Fat activists are working to provide recourse at the community level; patients share the names of fat-friendly doctors or establishments, and Wann uses her social networks to help people get referrals for doctors and other medical providers. She also assists people with planning responses to doctors and providers who inflict weight bias. Fat activist Stef Maruch maintains a list of doctors who do not inflict bias or are fat positive, and Wann encourages people to update it whenever they can. NAAFA also publishes brochures and tool kits to assist fat people in navigating bias and fighting anti-fat legislation. A monthly newsletter updates recipients with the latest research and provides referrals to practical tools like products made for people of size. After Hurricane Harvey devastated Texas, NAAFA released a special-edition newsletter and sent plus-size clothing and supplies.

Obesity rates in America are split fifty-fifty between genders, but 80 percent of bariatric surgeries are performed on women.

The organization has also updated the brochure it gives health care providers treating fat patients. It was last updated in 2011, and per the recommendation of one of NAAFA’s advisers, its language is being revised to be much more aggressive when discussing weight bias with medical professionals. “Up until this point we’ve been trying to inform and be a little bit gentle,” explained Peggy Howell, NAAFA’s vice chairman and public relations director, citing the research scientists, Ph.D.s, and professors in medicine, law, nutrition, social work and more who serve on NAAFA’s advisory board. “The advisers came back and said, ‘I think we need to take a different approach. I think we need to be more assertive about this. There are lots of studies that support that this bias does more harm than good to the patients.’” The nonprofit’s 2011 brochure states, “NAAFA is working to help ensure that health care providers provide the best possible care by keeping in mind the special needs of their fat patients.” The new brochure reads, “We currently live in an environment that stigmatizes anyone who does not meet the aesthetic or medically defined categories of an ‘attractive’ or ‘healthy’ weight… [it] creates and sustains fat phobia and oppression, which includes weight bias, prejudice, stigma, discrimination, bullying, violence, and cultural imperialism. … Sometimes the internalized biases of health care providers directly contribute to further stigmatization of fat people.”

There is some movement on the medical end as well, driven by health care providers seeking training and resources. The Rudd Center has developed educational videos, which have been tested and found to reduce weight bias. Viewing the two 17-minute films — “Weight Prejudice: Myths and Facts” and “Weight Bias in Health Care” — resulted in improvement in attitudes toward obese people. The Rudd Center has also created a media repository of 400-plus photos and more than 80 B-roll videos that portray children and adults with obesity in non-stigmatizing ways, intended as a resource of respectful, rather than stereotypical, images for the media as well as scientists and health professionals to use when making educational presentations.

“We’ve created online courses and all different kinds of resources to use to try to increase awareness about this issue and educate providers that this is more than a social justice issue,” Puhl said. “This is a full public health issue. The stigma is making their patients’ health worse.”

For many fat people, the response is too little, too late. “I would rather doctors have signs on their door saying, ‘I don’t treat fat people,’” Wann said. “It would save everyone time and money if they had a sign on their door that said, ‘No fatties.’ At least they would be honest and own their bias.”

***

Carey Purcell is a New-York based writer who covers culture, politics and current events from a feminist perspective. She has been published in The New York Times, Vanity Fair, Politico and other publications. She has been a featured guest on AM Joy and Good Morning America, and her writing can be read at CareyPurcell.com.

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Editor: Michelle Weber
Illustrator: Hannah Perry
Fact checker: Matt Giles
Copy-editor: Sylvia Tan

Take Me Home

Photo of the Victory Monument (Patuxai) by Dan Lundberg (CC BY-SA 2.0)

Kathryn Kefauver Goldberg | Longreads | September 2017 | 16 minutes (4,596 words)

 

I.

When I moved to Laos in 1998, there was almost no violent crime. The landlocked country had five million people, 57 languages, and 90 million unexploded bombs in the ground. In the 10th-poorest nation in the world, Lao people focused on food, festivals, and family. Buddhism thrived. In my house in Vientiane, the salty scent of the Mekong River drifted through my screens. I was 25, and my first six months there, I rarely thought of the killings that had launched me overseas.

I lived between a temple and a beer shop, the two great traditions of solace: the monks and the drunks. My excessive sleep, a portable artifact of PTSD, blended well in Laos. All around the partially paved capital, people napped in hammocks strung on half-built buildings, on tables of stacked silk at the market, and in tuk-tuks parked in the shade of banyans. My Lao colleagues at our United Nations outpost snoozed right at their desks. I did, too.

So the morning my boss, Patrick, sauntered into my office, he found me cheek to notebook. The monsoon clattered beyond the window. I’d passed out pondering the prospect of turning 26 in two weeks’ time. Birthdays, like rain, stirred up the muck. I was alive. Others were not. Read more…

My Journey to the Heart of the FOIA Request

Illustration by J.D. Reeves

Spenser Mestel | Longreads | September 2017 | 21 minutes (5,400 words)

On July 2, 1972, Angela Davis was sitting in the Plateau Seven restaurant in Santa Clara County, California, a few blocks from the courthouse where she’d spent the previous 13 weeks on trial for criminal conspiracy, kidnapping, and murder. The jury had just started deliberating, and Davis was eating with Rodney Barnette, a friend and former Black Panther. While the two talked, a local reporter emerged from the courthouse pressroom with news for Davis’s family and the activists gathered there: Four black men had hijacked a Western Airlines 727 jetliner carrying 98 passengers and were en route from Seattle to San Francisco. (Later it was confirmed there were only two hijackers, one man and one woman.) Not only were the hijackers demanding $500,000 and four parachutes, but they also wanted these items delivered by Davis, who was to stand on the runway of San Francisco International Airport in a white dress.

When the news reached the restaurant, several patrons around Davis and Barnette suddenly surrounded the pair’s table; these were in fact FBI agents dressed in civilian clothes. Almost a year earlier, Davis had been charged in California with aiding and abetting a murder. Though she hadn’t been at the scene, authorities alleged that guns she’d purchased were used to kill a superior-court judge. The Black Panthers relied on sympathetic Vietnam veterans, like Rodney Barnette, to acquire arms and train new members to use them. Barnette, however, had left the Panthers four years earlier following a suspicious interaction. At a meeting, a stranger claiming to be part of the “Panther Underground” had called Barnette into a back office and told him to beat members who arrived late. Barnette objected. (“We can’t do that to our own people,” he said an interview later. “How could we differentiate the police beating people, and us beating people?”) The man suggested he leave the group.

“I always thought he was some FBI agent,” Barnette would tell an interviewer in 2017. “Some agent provocateur or informant that all of a sudden appeared to try to split the party up.” This unnerving feeling of suspicion persisted even after Barnette left the Panthers. The FBI continued to interview his family members in Ohio, Massachusetts, and Los Angeles, where Barnette had moved and gotten a job as a letter carrier. Despite stellar evaluations from his superiors, in 1969 Barnette was fired from the Postal Service, after less than a year on the job, for living with a woman he wasn’t married to, which qualified at the time as “conduct unbecoming a government employee.”

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The End of ‘Rolling Stone’ As We Know It

33-year-old editor and publisher Jann Wenner at the 1979 relaunch of 'Look' magazine, which would last only a year. (AP Photo/Suzanne Vlamis)

In the end, Jann Wenner was always going to sell Rolling Stone. The current timing is certainly unprompted and a bit of a surprise — Wenner, along with his son Gus, the president and chief operating officer of Wenner Media, announced this week the magazine is now open for bids — but there had been indications in recent years that the once groundbreaking magazine would soon be top edited by someone other than Wenner.

Wenner has passed on opportunities to sell Rolling Stone in the past, including an offer of $500 million that he turned down two decades ago. But in 2017, the timing was too good to pass up. This year is the 50th anniversary of Rolling Stone‘s founding, and not only is the occasion being marked with an HBO documentary co-directed by Alex Gibney, Knopf is publishing the first major Wenner biography this fall, written by Joe Hagan. (Full disclosure: I fact-checked the book.)

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Ta-Nehisi Coates Takes on the Trump Presidency

Photo by Paul Marotta / Getty Images

In the spring of 1963, James Baldwin was interviewed for the documentary, Take this Hammer, which followed the local African-American community in San Francisco. Seated, wearing a crisp collared shirt, an ascot tie, and smoking a cigarette, the author spoke about the creation of a class of pariahs in America.

Well, I know this. Anyone’s who’s tried to live knows this: That what you say about anyone else reveals you. What I think of you as being is dictated by my own necessities, my own psychology, my own fears and desires. I’m not describing you when I talk about you, I’m describing me. Now, here in this country, we’ve got something called a nigger. We have invented the nigger. I didn’t invent him. White people invented him. I’ve always known. I had to know by the time I was 17 years old, what you were describing was not me, and what you were afraid of was not me, it has to be… Something you were afraid of, you invested me with…

In an excerpt at The Atlantic from his upcoming book about the Obama administration and its legacy, We Were Eight Years in PowerTa-Nehisi Coates riffs on Baldwin’s analysis to construct an incisive look at the foundations of Donald Trump’s political ascent.

For Trump, it almost seems that the fact of Obama, the fact of a black president, insulted him personally. The insult intensified when Obama and Seth Meyers publicly humiliated him at the White House Correspondents’ Dinner in 2011. But the bloody heirloom ensures the last laugh. Replacing Obama is not enough—Trump has made the negation of Obama’s legacy the foundation of his own. And this too is whiteness. “Race is an idea, not a fact,” the historian Nell Irvin Painter has written, and essential to the construct of a “white race” is the idea of not being a nigger. Before Barack Obama, niggers could be manufactured out of Sister Souljahs, Willie Hortons, and Dusky Sallys. But Donald Trump arrived in the wake of something more potent—an entire nigger presidency with nigger health care, nigger climate accords, and nigger justice reform, all of which could be targeted for destruction or redemption, thus reifying the idea of being white. Trump truly is something new—the first president whose entire political existence hinges on the fact of a black president. And so it will not suffice to say that Trump is a white man like all the others who rose to become president. He must be called by his rightful honorific—America’s first white president.

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Putting Creativity on Your Tab

Paul J. Richards / AFP / Getty Images

At 1843, Emma Hogan reports that in Silicon Valley, microdosing LSD is the new “body-hacking” tool everyone from engineers to CEOs is using to boost productivity and creativity. Interestingly, while apparently everyone is doing it, users are reluctant to have their real names appear in print. Psychedelic secrets, man! Peace out.

Every three days Nathan (not his real name), a 27-year-old venture capitalist in San Francisco, ingests 15 micrograms of lysergic acid diethylamide (commonly known as LSD or acid). The microdose of the psychedelic drug – which generally requires at least 100 micrograms to cause a high – gives him the gentlest of buzzes. It makes him feel far more productive, he says, but nobody else in the office knows that he is doing it. “I view it as my little treat. My secret vitamin,” he says. “It’s like taking spinach and you’re Popeye.”

San Francisco appears to be at the epicentre of the new trend, just as it was during the original craze five decades ago. Tim Ferriss, an angel investor and author, claimed in 2015 in an interview with CNN that “the billionaires I know, almost without exception, use hallucinogens on a regular basis.” Few billionaires are as open about their usage as Ferriss suggests. Steve Jobs was an exception: he spoke frequently about how “taking LSD was a profound experience, one of the most important things in my life”. In Walter Isaacson’s 2011 biography, the Apple CEO is quoted as joking that Microsoft would be a more original company if Bill Gates, its founder, had experienced psychedelics.

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