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Yentl Syndrome: A Deadly Data Bias Against Women

Illustration by Homestead

Caroline Criado Perez | An excerpt adapted from Invisible Women: Data Bias in a World Designed for Men | Harry N. Abrams | 22 minutes (5,929 words)

In the 1983 film Yentl, Barbra Streisand plays a young Jewish woman in Poland who pretends to be a man in order to receive an education. The film’s premise has made its way into medical lore as “Yentl syndrome,” which describes the phenomenon whereby women are misdiagnosed and poorly treated unless their symptoms or diseases conform to that of men. Sometimes, Yentl syndrome can prove fatal.

If I were to ask you to picture someone in the throes of a heart attack, you most likely would think of a man in his late middle age, possibly overweight, clutching at his heart in agony. That’s certainly what a Google image search offers up. You’re unlikely to think of a woman: heart disease is a male thing. But this stereotype is misleading. A recent analysis of data from 22 million people from North America, Europe, Asia and Australasia found that women from lower socio-economic backgrounds are 25% more likely to suffer a heart attack than men in the same income bracket.

Since 1989, cardiovascular disease has been the leading cause of death in US women and, following a heart attack, women are more likely to die than men. This disparity in deaths has been the case since 1984, and young women appear to be particularly at risk: in 2016 the British Medical Journal reported that young women were almost twice as likely as men to die in hospital. This may be in part because doctors aren’t spotting at-risk women: in 2016, the American Heart Association also raised concerns about a number of risk-prediction models “commonly used” in patients with acute coronary syndrome, because they were developed in patient populations that were at least two-thirds male. The performance of these risk-prediction models in women “is not well established.”

Common preventative methods may also not work as well in women. Acetylsalicylic acid (aspirin) has been found to be effective in preventing a first heart attack in men, but a 2005 paper found that it had a “nonsignificant” effect in women aged between forty-five and sixty-five. Prior to this study, the authors noted, there had been “few similar data in women.” A more recent study from 2011 found that not only was aspirin ineffective for women, it was potentially harmful “in the majority of patients.” Similarly, a 2015 study found that taking a low dose of aspirin every other day “is ineffective or harmful in the majority of women in primary prevention” of cancer or heart disease. Read more…

How I Became ‘Rich’

Illustration by Homestead

Stacy Torres | Longreads | June 2019 | 11 minutes (2,629 words)

On my first two trips to Hawai‘i I photographed things people who live there might consider mundane: red dirt along a paved road, sunlit hibiscus draped over a parking lot wall, blue-faced Zebra Doves so calm I almost tripped over them because they didn’t skitter away like the nervous pigeons back home in New York City. The only palm trees I’d ever seen before appeared on postcards, television, and luau-themed party decorations. In Hawai‘i I wasted no time filling my camera with pictures of real ones: swaying palms against a light-filled morning sky, baby palms trees in the midday sun, and full-grown trees wrapped in twinkling lights under an aspirin moon.

The first trip, in 2009, happened by accident. At least it felt that way. My then-boyfriend wanted to go somewhere tropical. I wanted to go somewhere interesting, though I had no inkling of the plan he was hatching when I mentioned Hawai‘i. I figured this discussion was just another of the fantasy trips we often took in our heads after watching the Travel Channel. Neither of us had passports or much money. But my boyfriend’s job as a New York City public high school special education teacher had wrecked him. For the past few years, half the teachers at his school left by year’s end. C. stood on the verge of quitting too. Instead, he started drinking on the train ride to work in the mornings. Then he took his tax refund and booked us a trip to paradise.

At first he refused to tell me where we were going. “Block off a week,” C. said. I’m going to need you not to be interrupted.” I pressed for details. After about age 12, I’d stopped liking surprises. By then I’d learned they could herald sudden bad news, such as when I awoke to find my mother applying antiseptic to a knife slice on my father’s temple after he got mugged coming home from work. Worry grew about some emergency lurking behind his request, a not unreasonable idea given the last few rocky years. Only after several days of persistent badgering, he divulged, “We’re going somewhere.” I grew more fearful. Where were we going? Why?

We didn’t go places, except the occasional day-trip to Philadelphia on a $10 round-trip Chinatown bus ticket. Sometimes we hopped an Atlantic City casino bus out of Port Authority. We got most of the bus fare back in a cash voucher to be redeemed at Harrah’s, but we dumped that and a few more bucks into the penny and nickel slots. Lucky Lemmings was our machine of choice. We always fooled ourselves into believing riches lay just one more pull away, and cheered when we hit a bonus game. The cute animated lemmings delighted us when they dived from the cliff, or trampolined off a lavender walrus’s back into caves marked with different credit amounts. If we got really lucky, the machine rewarded us with a lemming stampede, and they continued jumping in and out of the caves, green bills swirling and swooshing in their tracks, and manic jangly beeping ramped up as we racked up more credits. We never knew when to stop and usually returned home losers.
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On Truth and Lying in the Extra German Sense

Illustration by Homestead

Rebecca Schuman | Longreads | June 2019 | 15 minutes (3,962 words)

Would you like to know if you’ve gained weight? If you’re annoying, or too talkative, or not as smart as you think? If you’re doing something, literally anything, the wrong way? Just ask a German and they will tell you immediately. Germans do not do this to hurt your feelings. There isn’t even a single long word in German for “hurt feelings,” they just translate the English directly (verletzte Gefühle), and everyone knows that direct translation from the English is how Germans demonstrate their disdain. There is, however, a common and beloved expression for an individual who makes a big show of having hurt feelings, and that is beleidigte Leberwurst, or a perennially “insulted liver sausage,” because hurt fee-fees are for weak non-German babies.

After all, Germans are just being direct: unmittelbar, or literally translated, “unmediated.” Their assertions are simply unverblümt, or “not putting a flower on it.” They’re not mean, they’re freimütig, or “free-hearted.” They’re just being forthright: offen, “open,” which is a good thing, ja? Germans couldn’t even begin to imagine why being brutally honest would hurt someone in the first place! If the truth hurts you, isn’t that more your fault than the truth’s?

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We Still Don’t Know How to Navigate the Cultural Legacy of Eugenics

Illustration by Tom Peake

Audrey Farley | Longreads | June 2019 | 13 minutes (3,381 words)

 

On May 28, Justice Clarence Thomas issued an eyebrow-raising opinion. It concurred with the Supreme Court’s decision to uphold an Indiana law that requires abortion providers to follow a certain protocol to dispose of fetal remains and prohibits abortions on the sole basis of a fetus’s sex, race, or disability. It wasn’t the justice’s position that caught attention, but rather his method. In speaking to the law’s second provision on selective abortions, Thomas launched into a history of eugenics, the debunked science of racial improvement that gained popularity in the early decades of the 20th century.

Arguing that abortion is “an act rife with the potential for eugenic manipulation,” the justice offered a lengthy discussion of the origins of the birth-control movement in the United States. In this discussion, written for the benefit of other courts considering abortion laws, Thomas explains how Planned Parenthood grew in tandem with state-sterilization campaigns, providing the foundation for the legalized abortion movement. (As historians corrected, legal abortion preceded birth control, as it was not regulated until the 19th century.) The justice cites the disturbing rhetoric of Planned Parenthood’s founder, Margaret Sanger, who wrote in The Pivot of Civilization that birth control was a means of reducing the “ever increasing, unceasingly spawning class of human beings who never should have been born at all.” While conceding that Sanger did not support abortion, Thomas nonetheless argues that “Sanger’s arguments about the eugenic value of birth control in securing ‘the elimination of the unfit’ apply with even greater force to abortion, making it significantly more effective as a tool of eugenics.”

Thomas does not offer concrete evidence that American women actually abort fetuses solely because of sex, race, or disability. Nor does he explore the possible reasons for abortions related to these criteria, such as financial hardship or the lack of societal support for individuals with chronic conditions. His grievance with abortion boils down to this point: the practice is ill-borne. This claim is inaccurate, for reasons that historians swiftly noted; it also obscures the fact that eugenics did in fact initiate many traditions in this country, not all of which are perceived to be heinous today. Thomas’s incautious opinion, which echoes other voices in the abortion debate, unwittingly invites a more nuanced discussion of eugenics’ legacies.

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‘The Underland Is a Deeply Human Realm’: Getting Down with Robert Macfarlane

Cave of the Hands, Santa Cruz Province, Patagonia, Argentina. (Getty/Buenaventuramariano)

Tobias Carroll   | Longreads | June 2019 | 9 minutes (2,254 words)

Robert Macfarlane’s writings exist in a liminal, twilit place where language and landscape dissolve into one another. He writes vividly about outdoor spaces, borders, and the way in which one type of territory transforms subtly into another. And, as befits a writer who’s conscious of how the act of writing influences the spaces he’s writing about, he’s made language itself central to much of his work. His 2015 book Landmarks, for example, meanders through the long-lost definitions of a massive array of terms that were once used to describe very specific parts of the landscape; their loss is to some extent due to humanity having become increasingly urban, but also speaks to larger questions about our alienation from the world around us.

Macfarlane’s work is often focused on very particular places, while the greater issues he raises are universal. His new book, Underland, descends into a quite literally overlooked landscape: the one beneath our feet. He chronicles journeys to isolated caves, the man-made caverns below cities, and scientific research facilities whose underground isolation is essential to their mission. Underland reflects Macfarlane’s continued interest in language, but the nature of time is also a running theme within the book. What does it mean to enter a subterranean space that hasn’t been viewed by human eyes in thousands of years? What does it mean to create a space that may exist long after today’s civilizations have vanished? Throughout this book, Macfarlane wrestles with grand questions about humanity and its effects on the natural world. Even as he proceeds into hidden and obscured spaces, his concerns are deeply human. Read more…

Editor’s Roundtable: From WeEarth to The Aunt-o-Sphere (Podcast)

Photo by Spencer Platt/Getty Images

On our June 14, 2019 roundtable episode of the Longreads Podcast, Editor-in-Chief Mike Dang, Audience Editor Catherine Cusick, Senior Editor Kelly Stout, and Books Editor Dana Snitzky shared what they’ve been reading and nominated stories for the Weekly Top 5 Longreads.

This week, the editors discuss stories in New York Magazine, The New York Times, The Outline, and CrimeReads.


Subscribe and listen now everywhere you get your podcasts.


0:36 The I in We. (, June 10, 2019, New York Magazine

“I have said it once, I will say it again: I want nothing to do with colonies on other planets run by start-upy white dudes.” – Kelly Stout

New York Magazine’s look at WeWork founder Adam Neumann and how, like other start-up founders before him, he has built a company based on cultural hegemony and a cult of personality. The team discusses the absurdity of late-stage capitalism as it is depicted in the piece, as well as the seemingly capitalist communism ideology behind WeWork, which seems to take all of the bad of communism, but none of the good. They also consider the jargon of start-ups and venture capital and question the use of the word ‘community’ as a misleading placeholder for the idea of a network.

12:05 The Making of a YouTube Radical. (, June 8, 2019, The New York Times)

“How to get someone to revert or… I guess blue-pilling isn’t a thing?” – Mike Dang

“Throw up the red pill.” – Kelly Stout

How do you use the Youtube algorithm against right-wing radicals? That’s the question answered by this piece from The New York Times. It follows the story of Caleb Cain, a young, white 20-something who considered himself liberal, but then found himself falling prey to the entertaining tactics used by right-wing Youtubers to gain audiences.

The team discusses the now common refrain that Youtube’s algorithm is dangerous and questions whether it is possible to use it for good. They talk about how we can’t wait around for Youtube to fix the problem and how the left-wing Youtubers who emerge in the piece, mimick the successful aesthetic choices of the right-wing to win back audiences. The team also talks about the strange feeling of watching people you know change their political views drastically and about the challenges of having constructive conversations about privilege in our ‘shut down’ culture.

21:19 There is nothing more depressing than “positive news.” (Joanna Mang, June 12, 2019, The Outline)

“I feel like the question underneath it all is what do I do with mental health management in my news consumption?” – Catherine Cusick

The team weighs the dangers of the trend toward positive news as examined in this critique from the Outline. They talk about Mang’s observation that those who are making money off of “unlikely animal friends” and “dads who beatbox with their babies” are also passively encouraging distrust of news outlets that publish stories about society’s problems, and turning viewers away from having to do anything substantive in response. They consider the idea that bad news encourages a liberal world view by compelling readers to action whereas a retreat from this type of news is a retreat into conservatism. Lastly, they touch on how awareness of this plays into Longreads‘ weekly recommendations.

31:44 The Rise and Fall of the Bank Robbery Capital of the World. (Peter Houlahan, June 11, 2019, CrimeReads)

“I do really love pieces that can teach me something in that tone… in an entertaining way while still covering all the bases. That’s like the sweet spot.”  – Catherine Cusick

In the ’80s in Los Angeles, a bank was robbed every hour of every day, reads the subhead to this book excerpt published by CrimeReads. The piece lays out the lesser-known history of a string of polite bank robberies in the ’80s and the convenience-oriented banks that located themselves next to freeway on-ramps, inadvertently creating the perfect getaway route for criminals. The team discusses using entertainment as an engagement technique and how when this is done in concert with sound reporting, it makes for an ideal Longreads pick.

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Produced by Longreads and Charts & Leisure.

The Top 5 Longreads of the Week

A huge fire on the backlot of Universal Studios burns in the Hollywood Hills on June 1, 2008 in Universal City, California. (Trixie Textor/Getty Images)

This week, we’re sharing stories from Jody Rosen, Reeves Wiedeman, Rebecca Liu, Sara Rimer, and Will Hodge.

Sign up to receive this list free every Friday in your inbox. Read more…

We Could Have Had Electric Cars from the Very Beginning

An advertisement depicts a Baker Electric automobile, the Baker Queen Victoria, driven by a young woman, 1909. (Stock Montage/Getty Images)

Dan Albert | An excerpt adapted from Are We There Yet? : The American Automobile Past, Present, and Driverless | W. W. Norton & Co. | June 2019 | 25 minutes (6,750 words)

Most people reasonably expect the story of the evolution of the automobile to begin with the invention of the automobile itself. I’ve disappointed enough people in my life already, so I give you the Jesuit Rat Car of 1672. In that year, missionary Ferdinand Verbiest created a steam wagon to bring the Emperor of China to Jesus, but the car was only big enough to carry a rat.

If you don’t like the Jesuit Rat Car as an automotive first, you might consider Nicolas-Joseph Cugnot’s cannon hauler of 1769. A product of the French army’s skunk works, it was canceled in beta testing. In 1790, Nathan Read got the first American patent for a steam-powered wagon, a remarkable feat because the US Patent Office itself had yet to be invented. Perhaps that counts. In London, Richard Trevithick set a Georgian coach body atop a steam boiler and eight-foot wheels, creating the first giraffe-less carriage. In 1805, American Oliver Evans drove his harbor dredge, the Orukter Amphibolos, down the streets of Philadelphia in hopes of enticing investors for a car business. Philadelphia cobblestone street paving gave horses purchase but shook the Orukter so violently that the wheels broke. Let’s call his the first amphibious car. Read more…

Father’s Little Helper

Illustration by Eric Peterson

Scott Korb | Longreads | June 2019 | 14 minutes (3,467 words)

I.

Some of what you’re reading I was writing a few hours after taking half a Valium, prescribed by my doctor, partly for anxiety and partly for general neck and shoulder pain, and also a tingle and numbness that I was then feeling down my left arm into my fingers. It began with a yoga pose. It’s hard to know now what exactly I wrote while under the drug’s influence, such as it was. When I took the Valium I was 39; now I’m 41.

These 40-odd years, if Schopenhauer is right, have given me the text of my life. “The next 30,” he says, will “supply the commentary,” of which this, I hope, is an early part.

The pharmacist, who was younger than me, with slick hair, and whom I’d gotten to know a little over the years since my wife was treated for breast cancer, used the word spasm when referring to the orders faxed over from my doctor’s office. I nodded, yes, muscle spasms, even though that didn’t seem right; maybe I don’t know what spasm means. I said nothing about the low-grade anxiety I’ve felt for much of my life, which has gotten worse since my wife’s treatments finished up. “Low and slow,” he recommended. So I took half a pill. I’d never taken one before, and I’m cautious.

While discussing the pain in my neck and shoulder, the facial tics I’ve had my whole life, I also told the doctor I’m reluctant to take drugs, even Ibuprofen, though my wife has told me Valium can be fun. She recalls a day just before Father’s Day, 2014, wandering through New York City’s West Village, buying me expensive t-shirts in the late-spring heat, a week after major surgery, without a worry in the world.

I decided to take the Valium in advance of an MRI my doctor had prescribed to capture images of my cervical spine, hunting for disease. The pill would help get me through the test.
Read more…

The I in We

Longreads Pick

How WeWork — a company based on founder Adam Neumann’s vision of a “capitalist kibbutz” — became a sleek, dystopian, mammoth-sized tech unicorn.

Published: Jun 10, 2019
Length: 28 minutes (7,040 words)