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The Unforgiving Minute

Getty, CSA Images/Mod Art Collection

Laurie Penny | Longreads | November 2017 | 12 minutes (3,175 words)

“I’m sick of being asked to suffer so a man can grow.”

– Alexandra Petri

“Everyone. Fucking. Knew.”

– Scott Rosenberg

This is actually happening.

The so-called “revelations” about endemic male sexual aggression in Hollywood, in the media, in politics, in the tech world, and in communities large and small have not stopped, despite every conceivable effort to dismiss, discredit, shame, and belittle the survivors coming forward to demand a different world. The most uncomfortable revelation is the fact that none of this, really, was that revelatory.

A great many people knew. Maybe they didn’t know all of it, but they knew enough to feel tainted by a complicity that hobbled their compassion.

It turns out that this isn’t about individual monsters. It never was. This is about structural violence, about a culture that decided long ago that women’s agency and dignity were worth sacrificing to protect the reputation of powerful men and the institutions that enabled their entitlement. Everyone, including the “good guys,” knew it was happening. We just didn’t think it was all that wrong. At least, not wrong enough to make a fuss about, because the people groping their callous, violent way through life knew they’d get away with it, and most of the men around them were permitted the luxury of ignorance.

Except that now that seems to be changing. Now, Old Dinosaurs are wondering how to negotiate with an oncoming asteroid. Current or former Stupid Young Men are in a state of panic about their imminent introduction to the concept of “consequences,” leading to the question: what, precisely, is the age when men are expected to take responsibility for their behavior?

The answer, with any luck, is “The Digital One.”

Very few men seem sure what to do in this situation. I have been asked, repeatedly, what men and boys ought to be doing now. How should we behave differently? How guilty should we be feeling? What do women actually want?

Good. You’re finally asking. I suspect that if more of you had asked that question earlier, if you’d asked it often, and if you’d paid attention to the answers, we wouldn’t have to have this conversation — which nobody wants to be having — right now. It’s a shame, honestly, that it had to come to this. But here we are, and here we’re going to stay while powerful scumbags all over the world take a break from public life to spend more time with the police, and while people who’ve nursed private hurts for years start putting the puzzle pieces together until they recognize the shape of injustice.

I’m sorry; you’re new here. The notion that women’s agency and dignity might be more important than men’s right to act like grabby children whenever they want may feel like uncharted territory, but some of us have lived here all along. You don’t know your way around, and the whole place seems full of hidden terrors, and you’re tired and scared and being here makes you feel ignorant and powerless. You haven’t learned the language — they didn’t offer it at your school — and you wish you knew how to ask basic questions, like where is the nearest station, and how much is that sandwich, and do you know the name of a good defense lawyer? You wish you knew how to translate simple ideas, like: I’m hungry, and I’m lonely, and my entire life I’ve let my fear of women’s rejection control my behavior and that fear seemed so overwhelming that it didn’t matter who got hurt as long as I didn’t have to feel it and everyone else seemed to agree and now I don’t know who to be or how to act, or I think there’s a train leaving soon and I might need to be on it. Read more…

Cast by Chronic Illness Into a Limiting Role

Illustration by Giselle Potter

Maris Kreizman | Longreads | November 2017 | 10 minutes (2,462 words)

 

In junior high, I had my heart set on attending a famous performing arts sleep-away camp in upstate New York. All I’d ever wanted from the time I was 4 and saw a local production of Oliver! was to be a Broadway star. I could barely contain my jealousy of all the child actors who were making it big in musical theater that year, 1990: the orphans of Les Miz, the orphans of The Secret Garden, the orphans of Annie. I had the talent to be an orphan too! I just needed a chance to go away from home, I reasoned, because very few successful orphan characters are discovered living with their parents.

If only I could attend French Woods, the place where Natasha Lyonne and Zooey Deschanel had spent their summers — a destination for suburban preteens on the East Coast who had Broadway ambitions, kids who perhaps idolized Bernadette Peters (me) and had strong opinions about Andrew Lloyd Weber’s early work (also me). I had always fit in just fine in my New Jersey town, but I knew I would find my people at French Woods.

Instead, I found myself at the Clara Barton Camp for girls with diabetes. I wrote my parents a “please come pick me up or I will die” letter after my first night.

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An Oregon Wolf, Profiled

Emma Marris’s Outside story on OR4, the first male wolf to start a pack in Oregon since the 1940s, is a biography of a 21st-century predator told largely through the eyes of Russ Morgan, the field biologist who’d tracked him for more than six years. Marris weaves together uneasy questions about the scientist and his subject: What does preservation mean when, in order to survive, wildlife can’t transgress human definitions of acceptable behavior? What happens to the subjects we observe when we transpose surveillance technology from the human realm into the animal realm? Whose landscape is it, anyway?

The bureaucracy of wildlife management is part oxymoron, part paradox. The tensions are apparent from the moment that Morgan, the stoic biologist, places the first tracking collar around the neck of a tranquilized OR4.

Six months after their first meeting, on February 12, 2010, the black male got a collar and a name. Morgan used the signal from OR2 to track the family by helicopter. When he found the wolves, he had to try and pick the alpha male out of a half-dozen adult-sized wolves coursing through the rocky defiles of Road Canyon in lower Grouse Creek, just a few miles from the elk site. It was easy enough to spot OR2, and she had a companion running beside her, keeping close. Morgan figured he’d found his alpha.

Wolves are so fast — they can do bursts of 38 miles per hour, ten faster than Usain Bolt — that Morgan’s helicopter pilot struggled to keep up, while Morgan, leaning out the door, tried desperately to get a clear shot at the alpha’s rump. Suddenly, the big black wolf tripped over brush and rolled in a somersault. When he righted himself, he sat down and started barking and howling at the chopper, inadvertently concealing his backside.

“When he flipped over, I could see the rotor wash flattening his hair,” Morgan says. “He was frustrated. He gets pretty frustrated when he is being chased.” Finally, the wolf stood and Morgan got a shot off. Darted, the animal slowed, sat, and then went to sleep in the snow. The terrain was too steep to land, so the pilot dipped into the ravine, where Morgan stepped out with his kit. The helicopter took off, and Morgan shared a moment with the unconscious alpha. As he weighed him — 115 pounds, the largest wolf ever recorded in Oregon — took blood samples, and affixed tags and a collar, the black wolf officially became OR4, a wild animal with a name. A wild animal with his DNA on file.

OR2 wasn’t happy about any of it. She stood a couple hundred yards away while Morgan worked, howling continuously.

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How Much is Too Much to Save a Dying Cat?

Max Oppenheim/Getty

s.e. smith | Longreads | November 2017 | 17 minutes (4,363 words)

The veterinarian looks anxious as she enters the room, clearly dreading the conversation she must have many times a night on the late shift at the emergency clinic.

Yes, your pet is dying. No, I’m afraid there’s not much we can do, she is bracing herself to say.

Her scrubs are a rich maroon, coordinating with the jewel-toned surroundings of the hushed exam room in the swanky clinic. Thick doors block the sound from outside, the interstitial space where they’ve left me alone in an echoing silence with a grim steel table and a box of tissues after the technician rushed my cat to the back, somewhere in the bowels of the hospital. The last time I saw her she was gasping for air, eyes huge, expression: betrayed.

I wonder if I will see her again.

It’s the largest veterinary clinic I’ve ever been in and it feels more like a spa, down to the powder blue polo shirts the receptionists all wear. The stack of euthanasia authorizations left out on the counter are the only sign this place is perhaps not what it seems. I have driven a long way to come here, because it is Easter weekend and my vet isn’t in the office, but this cannot wait.

Oddly, I find myself wanting to reassure the vet, to tuck her loose strand of hair behind her ear and offer her a cup of tea from the space-age machine out in the horrifically depressing lobby, filled with people sitting in little clumps with strained faces.

“I know,” I say as she sits opposite me, searching for words, and her shoulders slump in relief. “I knew the cancer would spread eventually, but is there anything we can do to make her comfortable?”

On my way in, struggling with the weight of my cat’s carrier and my bag, I passed a couple carrying one of those cardboard boxes they use to send cats home from the shelter, the takeout container that is supposed to presage many years of happy life together, cartoon kittens and puppies stenciled along the sides. It swung with a peculiar, empty lightness, bouncing in an almost sprightly way that felt at odds with the stricken looks on their faces.

There is a stark finality in the empty cat carrier.

You can take this, your cat won’t be needing it anymore.

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Bringing Up the Bodies: How NecroSearch Helps Police to Locate the Dead

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At 5280, Robert Sanchez profiles members of NecroSearch, a Colorado-based volunteer organization made up of dedicated lab experts, scientists, and skilled technicians. NecroSearchers apply decades of specialized experience to help law enforcement officers locate dead bodies. Their reward? Bringing closure to the families of the deceased.

In the past three decades, NecroSearch has helped police and district attorneys with more than 300 cases in 40 states and on four continents. Fifteen bodies have been discovered as a result of that work. They’ve been found in mine shafts and in landfills, hidden under a pile of rocks in the Rocky Mountains, and buried under a suburban patio in Arizona. Once, a victim was discovered stuffed inside the trunk of a car that had been dumped into the Missouri River. Another time, a body was tangled in a Northern California redwood’s root system. When a Tennessee suspect learned authorities enlisted NecroSearch to find his missing wife, the man referred to the group as a bunch of “high-tech witch doctors.”

Just before Christmas in 1985, the coroner in Glenwood Springs asked France for help identifying 12 victims who’d died in a gas-plant explosion. When she arrived, France realized it was just her. Victims were battered and blown apart, many of them burned beyond recognition. Almost immediately, emotions roiled inside her. “It was a defining moment,” she said. She had an epiphany. “I decided I needed to take all those things I was feeling, put them in a box with a bow around it, and put that box on a shelf in my mind,” France told me. “I had to separate emotion from the science.” She worked two straight days to identify the victims, pulling remains out of body bags stored inside the morgue cooler. When she was done, she turned them over to the coroner for burial. “And then,” she said, “I went on with my life.”

“I will think about all of this forever,” France told me as she sat in a chair inside her front office. She was squeezing a miniature foam brain of an orangutan like a stress ball. “I’ve seen too much to forget,” she said. “How can you not have trauma when you do what I do? There will come a time when I have to say I’m done.”

A few months ago, Clark Davenport met me at a bookstore in downtown Denver. The 75-year-old geophysicist was a few weeks from leaving for Russia on a NecroSearch-approved trip during which he would help look for the remains of Grand Duke Michael Alexandrovich, the youngest brother of Tsar Nicholas II. The two men—along with Nicholas’ wife, Alexandra, and three daughters—famously had been murdered and buried in clandestine graves by Bolshevik rebels a year after the February Revolution in 1917. With the rest of the murdered Romanovs discovered in the early 1990s, finding the grand duke was considered the last piece of a historical puzzle. The trip would be Davenport’s fifth to Russia in the past decade. It was work that filled him with excitement and gave him a much-needed respite from the dozen or so ongoing, more pressing NecroSearch cases in which he was involved.

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Lost and Found

Longreads Pick

Robert Sanchez profiles members of NecroSearch, a Colorado-based volunteer organization made up of dedicated lab experts, scientists, and skilled technicians. NecroSearchers apply decades of specialized experience to help law enforcement officers locate dead bodies. Their reward? Bringing closure to the families of the deceased.

Source: 5280 Magazine
Published: Nov 1, 2017
Length: 20 minutes (5,206 words)

The Intimacy of an Android: An Interview With Alex Mar

(Cait Opperman / Wired)

Alex Mar’s cover story for Wired‘s November issue, “Love in the Time of Robots” is an epic look at the life and work of Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who has spent his life and career in pursuit of a more perfect android. He has made copies of his friends, family, and himself with his “Geminoid” project, and he delights in the moment when a human confronts its twin. What could have been a simple profile of Ishiguro goes much, much deeper — at nearly 12,000 words, it is one of the longest features that Wired has run in print — as Mar explores the origins of human nature and intimacy, and the desire to turn to a robot for comfort or companionship. “Most of us already allow technology to mediate what was once simple, direct human interaction,” Mar writes, “what really is the difference?” I spoke with Mar via email about her experience with Ishiguro and the freedom of writing at a length far beyond the typical magazine feature.

***

How many times did you meet with Hiroshi Ishiguro? How did your understanding of him and his work change with each meeting?

I’ve been in touch with Hiroshi for over two years and we spent about three weeks in each other’s constant company in Japan, between Osaka and Tokyo. He was immediately forthcoming with me, very open and direct. We had a great, natural rapport from our first Skype chat, and that was a big part of why I decided to pursue the story. Almost immediately he announced himself as less of a roboticist and more of an artist, which I could relate to more than an engineer’s perspective — he was turned on by big concepts and risk-taking.

Over time he did become more open about his family, a subject that’s pretty verboten for him, as he’s always been a firm believer in keeping his family life separate from his public, professional life. (Ironic, considering his first major experiment was an android copy of his then 5-year-old daughter.) He’s a charismatic figure, and he and his work have gotten plenty of press coverage internationally over the years. It took a moment for him to realize I was also interested in very minute details about his life — his childhood, his personal habits — things that he at first dismissed as too boring to discuss. It’s funny how often people assume that the kind of minutia that really makes a story, the intimate stuff, isn’t worth mentioning.

Ishiguro closely studies the small physical cues involved in human interaction in order to build a better android. (He notices, for example, that people never sit completely still.) But you seem to think his understanding of humanity is lacking. How did your understanding of his work change over time?

I don’t know if Hiroshi’s understanding of humanity is lacking any more than yours or mine. It’s more that his project is immense and requires a lot of hubris. He’s studying, measuring, and trying to replicate something that remains pretty intangible: the human presence, which the Japanese call sonzai-kan. The ineffable thing that signals to us that we’re sitting across from a living, breathing, thinking, feeling person. Plenty of people would call that a soul — something that, by definition, is impossible to replicate. So I think the bigger question here is: Do you think that human-ness is something that we can measure and weigh and build from scratch? Hiroshi’s answer to that, at least in public, is a resounding yes. But in private, I think that Hiroshi is conflicted. Personally, he seems to be struggling with his own deep desire for human connection — he spoke to me repeatedly of his feelings of loneliness — and I don’t know if he’ll ever be able to reconcile that with his work.

When did you suspect you would have to be a part of this story? How did you decide how much of yourself to put in?

I consider myself a “literary” non-fiction writer, but not a particularly confessional one. I believe in using the first person sparingly in journalism; in my longform stories I’ve tended to use it more as a light-handed framing device. But with my first book, Witches of America, about the present-day witchcraft movement around the country, I was surprised and a little bit horrified when I realized I needed to go all-in and insert myself as a character. I needed to be honest with myself and the reader about my curiosity about witchcraft, and to be frank about how subjective my experience of these Pagan rituals was — there’s no “objective” way to take part in a religious ceremony. My approach to the book became very personal and immersive, and any other approach would have felt dishonest.

When I returned from my first reporting trip to Japan, I had that feeling again: The subject of the story required a writer who was also a stand-in for the audience. I had to be able to describe in a very immediate way the experience of being around those androids, of being immersed in Hiroshi’s world and his way of thinking about humanity. When events in my personal life began to get all tangled up with the ideas I was absorbing in Hiroshi’s labs, I felt the only honest way to write this story was to weave that in.

Do you think that inventors who work at the edge of what is technically possible — with artificial intelligence, virtual reality, and so on — lose sight of what humans actually want, what we actually need? It seems like much of what Silicon Valley provides serves the interests of a narrow subset of people in the name of helping humanity.

It seems to me that the goal of a lot of research and development is to anticipate a need, or perhaps to create a desire where previously there was none. Android development is less about a concrete need — a robot doesn’t have to have a human face to perform surgery, or rescue someone from a war zone — but it does seem like an extension of the parts of our lives technology has already colonized. So many of our relationships are already virtual or text-based: entire friendships with people we almost never see in person, interactions with avatars people have created to stand in for themselves online. I’m willing to bet that internet porn, for those who are more or less addicted to it, is rewiring their sexual instincts and, to a degree, eliminating the need for actual human contact. And what about the constant need for affirmation that Instagram or Facebook satisfies? Are we really interacting with humans when we’re interacting on social media, or would that shot of cortisol to the brain be just as satisfying coming from a bot? If you go down this rabbit hole, it becomes possible to imagine a market for android companions, whether platonic or sexual, that goes beyond a “narrow subset” of people.

But putting that longer-term apocalyptic talk aside, here’s something else to consider: AI, android science, VR, etc. — these are clearly male-dominated fields, whether we’re talking about Japan or the U.S. Therefore the needs and desires research and development is addressing are, for the most part, the needs and desires of men — the fantasies of men projected onto the not-so-distant future. When I learned that Hiroshi had produced some two dozen attractive female androids, I thought, of course they were female, young-looking, and pretty. He may be a radical, independent thinker, but he’s ultimately following the dictates of an industry built by men.

This is one of the longest features Wired has ever run in print, over 12,000 words. Was having that kind of length helpful for this subject, or was it unwieldy at times to tell a story of that length?

My very first draft of the story was close to this length, and it felt natural. I’m very grateful that Wired was willing to give it that space, about twice their typical feature length. I think there was a consensus that this story needed that kind of room because of how it continues to evolve all the way to the last page. Hiroshi’s work has a breadth of scope that requires that much space if you’re going to push beyond “man who creates good-looking androids” terrain to get to something deeper. My editor Mark Robinson was a real believer in the piece and wanted to avoid any cuts that might subtract from what he thought made it different and strange and intimate.

There’s also the fact that, for whatever reason, 12,000 words is a sweet spot for me with magazine features. I like to hurl myself into the subject and write my way out of it, and it seems to land at that length nearly every time. But I believe that every story has a length that it naturally wants to land at, once you’re plugged into the writing process. That’s why it’s so valuable to have magazines that are willing to take this kind of risk and go long. This kind of freedom is the greatest gift an editor can give you.

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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.”

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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

How Does It Feel? An Alternative American History, Told With Folk Music

Daniel Wolff | Grown-Up Anger: The Connected Mysteries of Bob Dylan, Woody Guthrie, and the Calumet Massacre of 1913 | Harper| June 2017 | 18 minutes (4,937 words) 

This story is recommended by Longreads contributing editor Dana Snitzky.

* * *

An alien way of life.

You could say the silence started in Calumet in 1913. Word spread that the doors opened inward, that no one was to blame. What followed was a great quiet, a hundred years of agreed-upon untruth.

Or you could say it began just afterward, during the patriotic rush of the First World War and the Palmer Raids that followed. The Wobblies were crushed, the call for a workers’ alternative stilled.

Or you could say it began after the Second World War. If you see the two global conflicts as a single long realignment of power, then after America emerged as a superpower, its century-long Red Scare kicked back in with a vengeance. That’s how Elizabeth Gurley Flynn saw it. She traced the “hysterical and fear laden” atmosphere of the late 1940s back to when she was a union maid visiting Joe Hill in prison. “Now,” she said, “it is part of the American tradition.” In other words, once the nation of immigrants had defined itself, had determined an American Way, it also established the opposite: an Un-American Way.

In 1918, it was the U.S. Senate’s Overman Committee investigating Bolsheviks. In 1930, the Fish Committee looked into William Z. Foster and other communist influences. Eight years later, it was the establishment of the House Committee on Un-American Activities, which continued to operate through the fifties. “The real issue,” as HUAC’s first chairman, Martin Dies, put it, was “between Americanism on the one hand and alienism on the other.”

No one did more to define the Un-American than J. Edgar Hoover. His career began in 1917 jailing “disloyal aliens” as part of President Woodrow Wilson’s Justice Department. Soon Hoover was in charge of carrying out the Palmer Raids. By 1924, he was head of the nation’s Federal Bureau of Investigation. When he appeared before the Senate Internal Security Committee in 1948, he testified to “some thirty-five years of infiltration of an alien way of life in what we have been proud to call our constitutional republic.” That math put the beginning of the infiltration—and the silence—in 1913.

Hoover testified as the Popular Front was making one last national effort. Henry Wallace, former vice president under FDR, had mounted a third-party run for the presidency. Seeing little difference between Democrat Harry Truman and Republican Thomas Dewey, Wallace vowed to establish “the century of the common man.” That included expanded health care, the nationalization of the energy industry, and cooperation with Russia instead of Cold War. Attacking what he called the Red Scare “witch hunt,” Wallace proclaimed, “those who fear communism lack faith in democracy.”

What was left of the Popular Front rallied around him. Alan Lomax headed up a “musical desk” and brought in Guthrie, Seeger, Hays, and others. People’s Songs churned out tunes, including a fiddle-and-guitar blues by Guthrie: “The road is rocky, but it won’t be rocky long / Gonna vote for Wallace: he can righten all our wrongs.” Read more…

We’re All Mad Here: Weinstein, Women, and the Language of Lunacy

Illustration by Kjell Reigstad

Laurie Penny | Longreads | October 2017 | 13 minutes (3,709 words)

We’re through the looking glass now. As women all over the world come forward to talk about their experiences of sexual violence, all our old certainties about what was and was not normal are peeling away like dead skin.

It’s not just Hollywood and it’s not just Silicon Valley. It’s not just the White House or Fox News.

It’s everywhere.

It’s happening in the art world and in mainstream political parties. It’s happening in the London radical left and in the Bay Area burner community. It’s happening in academia and in the media and in the legal profession. I recently heard that it was happening in the goddamn Lindy Hop dance scene, which I didn’t even know was a thing. Men with influence and status who have spent years or decades treating their community like an all-you-can-grope sexual-harassment buffet are suddenly being presented with the bill. Names are being named. A lot of women have realized that they were never crazy, that even if they were crazy they were also right all along, and — how shall I put this? — they (we) are pissed.

“It’s like finding out aliens exist,” said a friend of mine last night. He was two gins in and trying to process why he never spoke up, over a twenty-year period, about a mutual friend who is facing public allegations of sexual violence. “Back in the day we’d all heard stories about it, but… well, the people telling them were all a bit crazy. You know, messed up. So nobody believed them.”

I took a sip of tea to calm down, and suggested that perhaps the reason these people were messed up — if they were messed up — was because they had been, you know, sexually assaulted. I reminded him that some of us had always known. I knew. But then, what did I know? I’m just some crazy girl.

Read more…