Friday, September 30, 2016

The Terrorist Inside My Husband's Brain

I am writing to share a story with you, specifically for you. My hope is that it will help you understand your patients along with their spouses and caregivers a little more. And as for the research you do, perhaps this will add a few more faces behind the why you do what you do. I am sure there are already so many.

This is a personal story, sadly tragic and heartbreaking, but by sharing this information with you I know that you can help make a difference in the lives of others.

As you may know, my husband Robin Williams had the little-known but deadly Lewy body disease (LBD). He died from suicide in 2014 at the end of an intense, confusing, and relatively swift persecution at the hand of this disease's symptoms and pathology. He was not alone in his traumatic experience with this neurologic disease. As you may know, almost 1.5 million nationwide are suffering similarly right now.

Although not alone, his case was extreme. Not until the coroner's report, 3 months after his death, would I learn that it was diffuse LBD that took him. All 4 of the doctors I met with afterwards and who had reviewed his records indicated his was one of the worst pathologies they had seen. He had about 40% loss of dopamine neurons and almost no neurons were free of Lewy bodies throughout the entire brain and brainstem.

Robin is and will always be a larger-than-life spirit who was inside the body of a normal man with a human brain. He just happened to be that 1 in 6 who is affected by brain disease.

Not only did I lose my husband to LBD, I lost my best friend. Robin and I had in each other a safe harbor of unconditional love that we had both always longed for. For 7 years together, we got to tell each other our greatest hopes and fears without any judgment, just safety. As we said often to one another, we were each other's anchor and mojo: that magical elixir of feeling grounded and inspired at the same time by each other's presence.

One of my favorite bedrock things we would do together was review how our days went. Often, this was more than just at the end of the day. It did not matter if we were both working at home, traveling together, or if he was on the road. We would discuss our joys and triumphs, our fears and insecurities, and our concerns. Any obstacles life threw at us individually or as a couple were somehow surmountable because we had each other.

When LBD began sending a firestorm of symptoms our way, this foundation of friendship and love was our armor.

The colors were changing and the air was crisp; it was already late October of 2013 and our second wedding anniversary. Robin had been under his doctors' care. He had been struggling with symptoms that seemed unrelated: constipation, urinary difficulty, heartburn, sleeplessness and insomnia, and a poor sense of smell—and lots of stress. He also had a slight tremor in his left hand that would come and go. For the time being, that was attributed to a previous shoulder injury.

On this particular weekend, he started having gut discomfort. Having been by my husband's side for many years already, I knew his normal reactions when it came to fear and anxiety. What would follow was markedly out of character for him. His fear and anxiety skyrocketed to a point that was alarming. I wondered privately, Is my husband a hypochondriac? Not until after Robin left us would I discover that a sudden and prolonged spike in fear and anxiety can be an early indication of LBD.

He was tested for diverticulitis and the results were negative. Like the rest of the symptoms that followed, they seemed to come and go at random times. Some symptoms were more prevalent than others, but these increased in frequency and severity over the next 10 months.

By wintertime, problems with paranoia, delusions and looping, insomnia, memory, and high cortisol levels—just to name a few—were settling in hard. Psychotherapy and other medical help was becoming a constant in trying to manage and solve these seemingly disparate conditions.

I was getting accustomed to the two of us spending more time in reviewing our days. The subjects though were starting to fall predominantly in the category of fear and anxiety. These concerns that used to have a normal range of tenor were beginning to lodge at a high frequency for him. Once the coroner's report was reviewed, a doctor was able to point out to me that there was a high concentration of Lewy bodies within the amygdala. This likely caused the acute paranoia and out-of-character emotional responses he was having. How I wish he could have known why he was struggling, that it was not a weakness in his heart, spirit, or character.

In early April, Robin had a panic attack. He was in Vancouver, filming Night at the Museum 3. His doctor recommended an antipsychotic medication to help with the anxiety. It seemed to make things better in some ways, but far worse in others. Quickly we searched for something else. Not until after he left us would I discover that antipsychotic medications often make things worse for people with LBD. Also, Robin had a high sensitivity to medications and sometimes his reactions were unpredictable. This is apparently a common theme in people with LBD.

During the filming of the movie, Robin was having trouble remembering even one line for his scenes, while just 3 years prior he had played in a full 5-month season of the Broadway production Bengal Tiger at the Baghdad Zoo, often doing two shows a day with hundreds of lines—and not one mistake. This loss of memory and inability to control his anxiety was devastating to him.

While I was on a photo shoot at Phoenix Lake, capturing scenes to paint, he called several times. He was very concerned with insecurities he was having about himself and interactions with others. We went over every detail. The fears were unfounded and I could not convince him otherwise. I was powerless in helping him see his own brilliance.

For the first time, my own reasoning had no effect in helping my husband find the light through the tunnels of his fear. I felt his disbelief in the truths I was saying. My heart and my hope were shattered temporarily. We had reached a place we had never been before. My husband was trapped in the twisted architecture of his neurons and no matter what I did I could not pull him out.

In early May, the movie wrapped and he came home from Vancouver—like a 747 airplane coming in with no landing gear. I have since learned that people with LBD who are highly intelligent may appear to be okay for longer initially, but then, it is as though the dam suddenly breaks and they cannot hold it back anymore. In Robin's case, on top of being a genius, he was a Julliard-trained actor. I will never know the true depth of his suffering, nor just how hard he was fighting. But from where I stood, I saw the bravest man in the world playing the hardest role of his life.

Robin was losing his mind and he was aware of it. Can you imagine the pain he felt as he experienced himself disintegrating? And not from something he would ever know the name of, or understand? Neither he, nor anyone could stop it—no amount of intelligence or love could hold it back.

Powerless and frozen, I stood in the darkness of not knowing what was happening to my husband. Was it a single source, a single terrorist, or was this a combo pack of disease raining down on him?

He kept saying, “I just want to reboot my brain.” Doctor appointments, testing, and psychiatry kept us in perpetual motion. Countless blood tests, urine tests, plus rechecks of cortisol levels and lymph nodes. A brain scan was done, looking for a possible tumor on his pituitary gland, and his cardiologist rechecked his heart. Everything came back negative, except for high cortisol levels. We wanted to be happy about all the negative test results, but Robin and I both had a deep sense that something was terribly wrong.

by Susan Schneider Williams, Neurology | Read more:
Image: via:

Beck

Thursday, September 29, 2016


Bruna Massadas, Telephone series, 2015
via:

Blink Wireless Security Cameras Run for Two Years on a Pair of AA Batteries

Over the last year or so we’ve seen an uptick in availability of small and relatively cheap wireless security cameras. I mean truly wireless, using Wi-Fi to transmit data and batteries to provide power. That magical combination of features allows this new breed of cameras to be placed almost anywhere in, or around, a home. So I jumped at the chance when Immedia’s Blink offered to send me a couple of the tiny cameras we first previewed at CES in January.

Blink cameras are sold as one ($99), two ($169), three ($229), or five ($349) camera systems, with each additional camera costing $75. The camera itself shoots 720p video and features a microphone, temperature sensor, and an adjustable LED lamp that can easily illuminate an entire room when the camera’s motion sensor is tripped. Every camera system ships with a small sync module that joins your local Wi-Fi and then acts as a communication hub for the Blink cameras. The camera itself is small, about two-thirds the size of a deck of cards and weighing barely more than the two AA batteries you slot into the back. And after a Wednesday firmware update, Blink cameras can now function for more than two years before requiring a battery change based upon typical usage.

I’ve been living for a few weeks with two Blink systems. A three-camera system installed in my home and a one-camera system in a little one-room surf shack I make use of when conditions allow. Both were dead simple to set up from my iPhone (there’s also an Android app), taking less than five minutes to go from unboxing to seeing live video. In daily usage, the cameras do exactly what they’re supposed to do. My home system is set up to automatically arm itself every night and to disarm itself in the morning before the house begins to stir. Conversely, I manually arm the beach house whenever I’m not there. While the systems haven’t caught any criminals, the home Blink did alert me when my son came home after I had been unable to reach him for several hours (dead phone) one night; and the beach Blink confirmed my suspicions that the guy who sold me the shack was showing it off to perspective buyers without my permission.

by Thomas Ricker, The Verge | Read more:
Image: Thomas Ricker

SSC Endorses Clinton, Johnson, or Stein

Many conservatives make the argument against utopianism. The millenarian longing for a world where all systems are destroyed, all problems are solved, and everything is permissible – that’s dangerous whether it comes from Puritans or Communists. These same conservatives have traced this longing through leftist history from Lenin through social justice.

Which of the candidates in this election are millennarian? If Sanders were still in, I’d say fine, he qualifies. If Stein were in, same, no contest. But Hillary? The left and right both critique Hillary the same way. She’s too in bed with the system. Corporations love her. Politicians love her. All she wants to do is make little tweaks – a better tax policy here, a new foreign policy doctrine there. The critiques are right. Hillary represents complete safety from millennialism.

Trump’s policy ideas are mostly silly, but no one cares, because he’s not really running on policy. He’s running on making America great again, fighting the special interests, and defying the mainstream media. Nobody cares what policies he’ll implement after he does this, because his campaign is more an expression of rage at these things than anything else.

In my review of Singer on Marx, I wrote that:
I’d always heard that Marx was long on condemnations of capitalism and short on blueprints for communism, and the couple of Marx’s works I read in college confirmed he really didn’t talk about that very much. It seemed like a pretty big gap. I figured…he’d probably made a few vague plans, like “Oh, decisions will be made by a committee of workers,” and “Property will be held in common and consensus democracy will choose who gets what,” and felt like the rest was just details. That’s the sort of error I could at least sympathize with, despite its horrendous consequences. 
But in fact Marx was philosophically opposed, as a matter of principle, to any planning about the structure of communist governments or economies. He would come out and say “It is irresponsible to talk about how communist governments and economies will work.” He believed it was a scientific law, analogous to the laws of physics, that once capitalism was removed, a perfect communist government would form of its own accord. There might be some very light planning, a couple of discussions, but these would just be epiphenomena of the governing historical laws working themselves out. Just as, a dam having been removed, a river will eventually reach the sea somehow, so capitalism having been removed society will eventually reach a perfect state of freedom and cooperation.
Singer blames Hegel. Hegel viewed all human history as the World-Spirit trying to recognize and incarnate itself. As it overcomes its various confusions and false dichotomies, it advances into forms that more completely incarnate the World-Spirit and then moves onto the next problem. Finally, it ends with the World-Spirit completely incarnated – possibly in the form of early 19th century Prussia – and everything is great forever.
Marx famously exports Hegel’s mysticism into a materialistic version where the World-Spirit operates upon class relations rather than the interconnectedness of all things, and where you don’t come out and call it the World-Spirit – but he basically keeps the system intact. So once the World-Spirit resolves the dichotomy between Capitalist and Proletariat, then it can more completely incarnate itself and move on to the next problem. Except that this is the final problem (the proof of this is trivial and is left as exercise for the reader) so the World-Spirit becomes fully incarnate and everything is great forever. And you want to plan for how that should happen? Are you saying you know better than the World-Spirit, Comrade?
I am starting to think I was previously a little too charitable toward Marx. My objections were of the sort “You didn’t really consider the idea of welfare capitalism with a social safety net” or “communist society is very difficult to implement in principle,” whereas they should have looked more like “You are basically just telling us to destroy all of the institutions that sustain human civilization and trust that what is baaaasically a giant planet-sized ghost will make sure everything works out.”
And since then, one of the central principles behind my philosophy has been “Don’t destroy all existing systems and hope a planet-sized ghost makes everything work out”. Systems are hard. Institutions are hard. If your goal is to replace the current systems with better ones, then destroying the current system is 1% of the work, and building the better ones is 99% of it. Throughout history, dozens of movements have doomed entire civilizations by focusing on the “destroying the current system” step and expecting the “build a better one” step to happen on its own. That never works. The best parts of conservativism are the ones that guard this insight and shout it at a world too prone to taking shortcuts.

Donald Trump does not represent those best parts of conservativism. To transform his movement into Marxism, just replace “the bourgeoisie” with “the coastal elites” and “false consciousness” with “PC speech”. Just replace the assumption that everything will work itself out once power is in the hands of the workers, with the assumption that everything will work itself out once power is in the hands of “real Americans”. Just replace the hand-waving lack of plans with what to do after the Revolution with a hand-waving lack of plans what to do after the election. In both cases, the sheer virtue of the movement, and the apocalyptic purification of the rich people keeping everyone else down, is supposed to mean everything will just turn out okay on its own. That never works. 

A commenter on here the other day quoted an Atlantic article complaining that “The press takes [Trump] literally, but not seriously; his supporters take him seriously, but not literally”. Well, count me in that second group. I don’t think he’s literal. I think when he talks about building a wall and keeping out Muslims, he’s metaphorically saying “I’m going to fight for you, the real Americans”. When he talks about tariffs and trade deals, he’s metaphorically saying “I’m going to fight for you, the real Americans”. Fine. But neither of those two things are a plan. The problem with getting every American a job isn’t that nobody has been fighting for them, the problem with getting every American a job is that getting 100% employment in a modern economy is a really hard problem.

Donald Trump not only has no solution to that problem, he doesn’t even understand the question. He lives in a world where there is no such thing as intelligence, only loyalty. If we haven’t solved all of our problems yet, it’s because the Department of Problem-Solving was insufficiently loyal, and didn’t try hard enough. His only promise is to fill that department with loyal people who really want the problem solved.

I’ve never been fully comfortable with the Left because I feel like they often make the same error – the only reason there’s still poverty is because the corporate-run government is full of traitors who refuse to make the completely great, no-downsides policy of raising the minimum wage. One of the right’s great redeeming features has been an awareness of these kinds of tradeoffs. But this election, it’s Hillary who sounds restrained and realistic, and Trump who wants the moon on a silver platter (“It will be the best moon you’ve ever seen. And the silver platter is going to be yuuuuuge!”) (...)

Okay, but what about the real reason Trump is so popular?

When I talk to Trump supporters, it’s not usually about doubting climate change, or thinking Trump will take the conservative movement in the right direction, or even immigration. It’s about the feeling that a group of arrogant, intolerant, sanctimonious elites have seized control of a lot of national culture and are using it mostly to spread falsehood and belittle anybody different than them. And Trump is both uniquely separate from these elites and uniquely repugnant to them – which makes him look pretty good to everyone else.

This is definitely true. Please vote Hillary anyway.

Aside from the fact that getting back at annoying people isn’t worth eroding the foundations of civil society – do you really think a Trump election is going to hurt these people at all? Make them question anything? “Oh, 51% of the American people disagree with me, I guess that means I’ve got a lot of self-reflecting to do.” Of course not. A Trump election would just confirm for them exactly what they already believe – that the average American is a stupid racist who needs to be kept as far away from public life as possible. If Trump gets elected, sure, the editorial pages will be full of howls of despair the next day, but underneath the howls will be quiet satisfaction that the world is exactly the way they believed it to be.

The right sometimes argues that modern leftism is analogous to early millenarian Christianity. They argue this, and then they say “You know what would stop these people in their tracks? A strong imperial figure who persecutes them. That’s definitely going to make them fade away quietly. There is no way this can possibly go wrong.”

Leftism has never been about controlling the government, and really the government is one of the areas it controls least effectively – even now both houses of Congress, most state legislatures, most governors, etc, are Republican. When people say that the Left is in control, they’re talking about academia, the media, the arts, and national culture writ large. But all of these things have a tendency to define themselves in opposition to the government. When the left controls the government, this is awkward and tends to involve a lot of infighting. When the right controls the government, it gets easy. If Trump controls the government, it gets ridiculously easy.

This has real-world effects. Millennials are more conservative than previous generations. Andrew Gelman, who is usually right about everything, says:
If you look at the cohort of young voters who came of age during George W. Bush’s presidency, they’re mostly Democrats, which makes sense as Bush was a highly unpopular Republican. The young voters who came of age during Obama’s presidency are more split, which makes sense because Obama is neither popular nor unpopular; he has an approval of about 50%
I would prefer the next generation end up leaning more to the right, because that will cancel out younger people’s natural tendency to lean left and make them pretty moderate and so low-variance. I definitely don’t want an unpopular far-right presidency, because then they’re going to lean left, which will combined with the natural leftiness of the young and make them super left. And this is the sort of thing that affects the culture!

by Scott Alexander, Slate Star Codex |  Read more:
Image: Mercury News Daily via:

Pentagon’s 5,000-Strong Cyber Force Passes Key Operational Step

[ed. See also: Security Experts Agree: The NSA Was Hacked]

A 5,000-person Pentagon force created to bolster military computer networks and initiate cyber attacks against terror groups should be ready to carry out its mission by the end of the week, a key step in improving the U.S.’s ability to respond to hacks by overseas adversaries.

The Cyber Mission Force will reach "initial operational capability” by Friday, said Colonel Daniel J.W. King, a Cyber Command spokesman, in an e-mail. The group’s 133 teams have met basic criteria on personnel, training, resources and equipment, but all of them aren’t necessarily ready to launch attacks, he said.

The force, which falls under the U.S. Cyber Command created in 2009, likely will focus on the highest priorities, such as risks from Russia, China, Iran and terrorist groups including Islamic State, according to Bob Stasio, a fellow at the Truman National Security Project and former chief of operations at the National Security Agency’s Cyber Operations Center.

Until the force becomes fully operational, which is planned in 2018, the question officials directing it will ask first will be, “What’s the minimum operation I need against the biggest threats that I have today -- the closest alligators to the boat," Stasio said.

Previously, cyber operations were scattered in silos across Cyber Command, the NSA and other military branches, according to Stasio. The new centralized force will help cut through the bureaucracy, he added. Officials plan to expand the force by another 1,200 people as part of the process of becoming fully combat ready.

"We continue to generate the mission force," Admiral Michael Rogers, who heads Cyber Command and the NSA, said in a Sept. 13 speech in Washington. "At the same time, we got to tell ourselves we are not where we need to be in this mission."

The operational capability designation means the Pentagon has better streamlined cyber activities across its bureaucracy, but analysts say it doesn’t necessarily reflect greater security chops as defense officials try to keep up with fast-evolving technology and threats.

"What it means is we have the people, the tools, we’ve practiced and we’re ready," said Mark Young, chief security officer and senior vice president at IronNet Cybersecurity Inc. and a former senior executive at Cyber Command. (...)

Setting up the force is also a sign that cyber is more "baked into" the military’s overall strategy, while providing defense officials a grasp of how much it needs to spend on cybersecurity, said Dave Aitel, chief executive officer of Immunity Inc. and a former NSA computer scientist. In its 2017 information technology budget, the Defense Department requested $6.8 billion for cyber operations. (...)

"You have to kind of look at it as if you’re building a whole new Navy, that’s a very expensive operation," Aitel said. "It gives them better buckets to throw money into and know where that money is going."

by Nafeesa Syeed, Bloomberg |  Read more:
Image: Simon Dawson/Bloomberg

Wednesday, September 28, 2016


Kiwako Suzuki

via:
[ed. For my new pal, Tako.]

Party paella
photo: markk

What It's Like to Have Irritable Bowel Syndrome

I wake up one morning certain that I’ve become three months pregnant overnight. The farting starts immediately. I skip breakfast, spend a half hour searching for pants I can zip over my bloated stomach, and then hurry to work and sit at my desk by the door of a tiny office crammed with four editors. My belly doesn’t rumble, but buzzes and shrieks. I shift in my chair to hide the cacophony.

Four hours pass. I take trips to the bathroom to stand in the stall and let it all out. My boss calls me into her office and I rise, suck it in, and waddle to her. Yes, of course I’ll look at the brochure. Lunch time arrives. I cautiously eat some bread and peanut butter, then smell something rankish and panic. Did I just leak gas without knowing? No, someone is heating a cheesy burrito in the microwave.

Exhausted at the end of the day, I flatulate my way back home. I eat my first real meal of the day and continue to pass wind every 10 minutes, like clockwork, until bedtime. The funk makes it hard to sleep. The next morning, I rush to the bathroom, decide to risk breakfast, then stop at the door on my way out to run back for round two. I arrive 10 minutes late to work, tired already, and endure the same routine for two weeks before my bowels settle down and declare defeat.

The cause of my plight is irritable bowel syndrome (IBS)—a disorder where the brain and the gut don’t communicate as they should. It’s a functional disorder, which means that it comes from a problem with the way a normal body function is carried out, instead of something foreign, like a virus. And unlike other illnesses that don’t involve foreign assassins—cancer, for example—IBS will not show up on any tests or examinations.

IBS’s issue is abnormal colon motility—the contraction of muscles in the intestines and the way food moves through them—where the colon is extra sensitive and tends to spasm when stimulated by things like food or stress. These spasms can cause food to move too quickly through the digestive tract (diarrhea) or get stuck (constipation). People with IBS can also be extra-sensitive to the goings-on in their gut, and feel pain from small pockets of gas, for instance, when others would feel nothing.

The disorder is common, affecting 10 to 15 percent of adults, and twice as many women as men. Since the cause of the disorder is unknown, treatments are often aimed at the symptoms: laxatives, stool hardeners, changes in diet, supplements, and even psychotherapy. Psychotherapy often addresses stress management, but also deals with the emotional side effects of having a persistent, incurable, mostly invisible, and dinner-conversation-taboo disorder.

I learned that I had IBS as a sophomore in college, a few weeks before winter finals. The first step in treating it, I was told, was to keep a food log: For a few months, I had to write down everything I ate, every day, and how I felt afterward. I also had to reduce stress. I lasted about three days before giving up the log—who has time for that?—and reducing stress as a college student with looming finals was not an option. Besides, I wasn’t convinced that IBS was what I really had; maybe the doctor had missed something, maybe it was a passing bug.

I finished college with on-off symptoms, making visits to doctors whenever I felt particularly bad, certain that this time we’d catch something terrible lurking in my bowels. I even scooped my poop into vials and sent them to a laboratory to look for bugs. At one point, I had a bout of panic attacks as I cycled through all the things I could have: endometriosis, colon cancer, a gut-bursting alien.

As a student I’d had enough breaks in the day to hide in my room and recuperate, but after graduating it became much more difficult. In addition to struggling at work, I made excuses not to meet friends; often, I was just too tired to spend a night ballooning with gas or fretting over the geometry and mechanics of airflow between a bathroom and living room. I dreaded dates with a new significant other. What if I fart on him while he’s the big spoon? I’d reject being physical with excuses like headaches or fatigue.

Some researchers believe that the issue in IBS lies in the brain-gut connection, a mysterious link whereby the goings-on in a person’s gut are believed to influence not only mood, but some of the core facets of personality. The connection is why people feel nauseated, for example, before giving an important speech. The brain sends signals to the gut, such as, what if I mess up, and all my great auntie’s prophecies of failure and depravity come true? To which the gut responds with butterflies or violent, vomitous stage fright. Or instead, the gut might signal food poisoning! to the brain, to which the brain responds with, that hurts, and, quick find a bathroom!  (...)

One emerging theory for IBS is that there is, in fact, an imbalance of serotonin in the gut: Those with diarrhea have too much, those with constipation have too little, and both run the risk of serotonin-induced mood swings.

At a particularly low point, I Googled “IBS symptoms” and discovered some forums dedicated to IBS sufferers and others with gastrointestinal disorders. On one, an anonymous person wrote: “It seems that my whole life is dominated by my bowel to the extent that some days I am afraid to leave the house.” Another person lamented the disorder’s invisibility: “This disease does not 'show' on the outside, so even good friends are not always understanding. I am aware of this so I keep it to myself.” IBS is not a life-threatening disorder, but some people become incapacitated by it. They quit work, stop traveling, and withdraw completely. Some fall into a deep depression that exacerbates the brain-gut feedback loop and intensifies their symptoms.

Like me, many people with IBS are too embarrassed to talk openly about it, or think that because it’s invisible or not serious that somehow their symptoms don’t matter. They also try to shove their lives into a neat little box in hopes of keeping their disorder from bothering anybody else.

by Anne McGovern, The Atlantic |  Read more:
Image: David Leahy/Getty

The Company That Wants to Fight Your Medical Bills

But there's a catch.

[ed. There's certainly a pressing need for a service like Remedy but it doesn't sound like this is it. Between the first salvo of a doctor or hospital's billing statement, followed by insurance company weaseling, then various back and forth negotiations and some final resolution (while different billing statements and coverage notices are being sent to the patient) who knows what the final bill will be, if one can even tell it is a final bill? Not to mention the details of what actually was performed and correctly billed in the first place. No wonder it's confusing. Remedy seems to take care of the last issue, ie., looking at billing codes and checking for errors, but that's about all. This seems like such a massive untapped market (concierge services for medical billing) that it's frankly astounding to me that no one has made a better effort at capturing it.]

If you’re the special kind of person who’s interested in medical billing, I’ve had an exciting past few months. One day this spring, I was frantically chopping carrots after work when I noticed that my left hand was covered in lukewarm blood. When I washed it off, I saw my skin splaying open to reveal my pale-blue thumb joint. That necessitated not one, but two trips to an urgent-care center, a strange hybrid of an emergency room and doctor’s office where payment can be similarly muddled.

I also got a new mouthguard, something my doctor says I must wear, or else I will grind my teeth away to tiny nubs while I sleep. I tried to pretend the little session where they make a mold of your mouth using what looks and tastes like melted-down Crocs was a 15-minute spa retreat from my work emails. My bubble was burst when, on my way out, the front-desk woman told me the mouthguard would cost more than $400, which I let her charge to my credit card because the alternative was to press my sawed-off hand to my nub-toothed mouth and run screaming out the door.

Another doctor I see regularly told me “I don’t deal with insurance,” with the same nonchalance that 20-somethings with rich parents say they “didn’t feel like having roommates” to explain their one-bedroom condos. She has no in-network equivalent.

These experiences softened me up for a pitch from Remedy, a new start-up that aims to help people fight their medical bills. Though estimates of billing errors vary widely, at least 10 to 30 percent of medical bills contain a mistake. I figured my recent medical misadventures might make Remedy worth my while.

Remedy was founded in 2015 by John Schulte, a software engineer, Marija Ringwelski, a public-health worker, and Victor Echevarria, a former executive at the errand startup TaskRabbit. Echevarria sought to apply TaskRabbit’s duty-delegating model to disputing medical bills, another chore many can’t wait to offload. By the end of November, Remedy had raised $1.9 million from investors, and it’s expected to formally launch this week.

At first, Remedy relied on individuals texting the company photos of bills they found dubious. Before long, though, the team realized people “felt they were being taken advantage of and wanted a constant protector,” Echevarria told me. Now users connect their insurance to the platform and have Remedy scrutinize every one of their claims. To the layman, disputing medical errors can prove so tedious and complicated, Echevarria said, that “it makes cancelling Comcast look like the simplest thing in the world.”

Remedy’s bill-sleuthing is performed in part by a network of medical-billing contractors who work on each patient’s “cases” on their own schedule. For any errors uncovered, providers are supposed to refund the money directly to the Remedy user. Remedy is free to use, but it takes a 20 percent cut of the savings they find, up to $99 for a single bill. (Though the company said that $99 cap could change.)

Remedy said that based on “research from CMS [The Centers for Medicare & Medicaid Services], statistics from academia, and independent investigations,” medical errors are responsible for $120 to $150 billion in overcharges each year. It uses that figure, divided by the population of insured Americans, to bolster its claim that it would save the average family $1,000 per year.

It’s not clear yet how much money Remedy would save for the average healthy-ish person, however. Echevarria told me Remedy focuses on the mistakes made by doctors’ offices, rather than on bargaining with insurers. In the U.S., all diagnoses are assigned a code, and an improper code might lead to a denied claim, as might a clerical error like a misspelled name. It’s easy and common for doctors or billing clearinghouses to make these mistakes, Echevarria said. Insurers, meanwhile, are so strict in what they cover that negotiating with them can be like “banging your head against a wall of futility, even for us,” he said. Still, the company said it would appeal some denied claims, like those for services that should have been covered by the plan.

Since its founding, the company says it has discovered errors in half of its users’ bills. For patients who can’t afford their bills, Remedy said they will help set up monthly payment plans for free. Eventually, Echevarria said, “our hope is to negotiate for discounts in every single case” where a patient desires one. In my case, though, steep, correct bills weren’t reduced; I got an email from Remedy saying “everything checks out” with my three-figure mouthguard.

The service can make things a bit awkward with your medical providers. My no-insurance doctor sent me a worried email when Remedy asked her about my tab. Without thinking, I sheepishly apologized for the inconvenience. Several billing experts told me I should have argued with the dentist about my mouthguard bill rather than paying it, but the reason I turned to Remedy was because I find haggling with doctors to be more painful than, well, pulling teeth. Remedy says its service is actually good for doctors, since sometimes patients simply dodge bills they feel are unfair. (...)

Bell said that while services like Remedy might make financial sense for some, we shouldn’t lose sight of the underlying problem: Medical bills are too high and too wrong, too often.

“Do we really want to encourage the growth of a new industry to scrutinize inaccurate bills?” he said in an email. “The dead elephant in the room is that if the consumer had been billed correctly, they would not need this service.”

by Olga Khazan, The Atlantic |  Read more:
Image: Karin Schermbrucker / AP

Fly-Along Companions Offer a Way for Older People to Travel

Janet Robertson, a documentary filmmaker in New York, helps look after her uncle, Vincent Fahey. He is nearly 87 and loves to travel.

But she can’t always accompany Uncle Vin, who needs some day-to-day assistance. So when he wanted to visit London this past spring, Ms. Robertson did what others have started doing: She hired a skilled traveling companion for her older loved one.

For the London trip, Ms. Robertson found Doug Iannelli, owner of Flying Companions in Atlanta, to accompany her uncle.

Mr. Iannelli managed the travel reservations and logistics, slept in an adjoining hotel room and otherwise accompanied Mr. Fahey full time as they took in the museums, restaurants and tourist sites. When needed, Mr. Iannelli provided a wheelchair and made sure they took frequent rest breaks.

In all, the seven-day trip cost about $10,000. And Ms. Robertson stayed in touch with the pair via text messages and photos.

“I felt more comfortable because I could follow along,” Ms. Robertson said.

The business of providing traveling companions for older adults is still new enough that there are no good statistics on who or how many provide such services. But they are cropping up — not only in the United States but in Europe and Asia — to cater to aging populations who have leisure time and money but diminished capacity for the rigors of travel.

Whether it is older people on vacation or grandparents wanting to join their far-flung families for weddings and graduations, there is a growing number of seniors willing to travel but needing help moving through airport security lines, managing luggage and navigating busy terminals and bustling hotel lobbies.

Travelers 65 and older now make up nearly 20 percent of domestic leisure passengers in the United States, according to the research firm TNS TravelsAmerica. That percentage is almost certain to grow; the federal government has forecast that the number of adults 85 and older in this country, which was six million in 2013, will reach 14.6 million in 2040. (...)

Mr. Iannelli began his business nine years ago after helping a friend with disabilities fly to Minnesota.

“I realized there must also be people with nonmedical challenges that need help traveling,” he said. Since then, Mr. Iannelli said, he has flown worldwide with hundreds of clients.

The services aren’t cheap. Clients pay for the travel companion’s tickets, the companion’s hotel room if necessary, meals, incidentals and fees for the service. Mr. Iannelli said the price to accompany a client on a plane trip within the United States — including his fees and travel costs for all parties — might range from $2,800 to $4,500 for coach airfare. Business or first class, of course, would cost more.

Some companion services provide personal care like medication reminders, dressing, bathing and feeding. And for those with specific medical needs, traveling nurse services are available.

by Julie Weed, NY Times |  Read more:
Image: Dustin Chambers

Japanese sweets
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What’s ‘A Prairie Home Companion’ Without Garrison Keillor?

"Here they come,” said the security guard, mopping sweat from his brow. He was tall and bald but not imposing, and he worried that the searing heat would lead to too much drinking. It was 3 p.m. on June 11, and the gates to the Ravinia outdoor theater in Highland Park, Ill., had just opened. People streamed in carrying coolers and lawn chairs, checkered blankets and wineglasses, plasticware full of crackers, melons and deviled eggs. They politely competed for swatches of grass in the shade of oak trees mounted with thank you for not smoking signs.

They wore old Cubs shirts and sun hats of all colors. A stuffed bald eagle perched atop one of the coolers. Vendors sold bottles of wine for $40. The security guard’s concerns proved well founded; the Malbec went quickly, then the Moscato. Lawn space dwindled, and with it some of the crowd’s civility. An old man struggled under the weight of two folding chairs. His wife worried aloud that he’d have a heart attack. “Keep walking!” he snapped.

They had come to see Garrison Keillor one last time. The creator and host of “A Prairie Home Companion” had for four decades gently skewered their baby-boomer sensibilities with fake ads for rhubarb pie and stories about family life that descended into jokes about plagues of rats and apocalyptic climate change. “There’s something about this kind of humor people my age can appreciate,” said Tim Balster, a gray-haired magician I met in the crowd. “It’s like a quilt.” Balster had been listening to “Prairie Home” for 33 of his 52 years. He loved nothing more than to hear the aging writer breathing deeply, his nose right next to the mike. “It draws you in,” he said, “like a moth to the flame.”

Now that was ending. Only four shows remained before Keillor would depart, relinquishing hosting duties to a 35-year-old mandolin player from California named Chris Thile, who was appearing as a musical guest for this show. As we sat in the grass, Balster noted that Keillor left the show once before, when he married a Danish woman, only to return. It was true. But this hiatus occurred during the Reagan administration, when Keillor, now 74, was still a relatively young man. Nevertheless, Balster said, “I’m holding out hope.”

An hour or so before the gates opened, I watched Thile prepare for the show in a dressing room in the Ravinia’s backstage area, then head for the stage entrance, where he crossed paths unexpectedly with Keillor. Keillor is 6-foot-3, a looming and still presence; Thile is fence-post thin with a pronounced jawline and unruly dirty-blond hair. He projects a focused, constant energy, and today his boyishness was amplified by a retainer in his mouth, a corrective measure to address problems left over from a childhood without dental insurance. Thile was already dressed for the performance in a collared shirt; Keillor, who is known for rewriting scripts until the last possible minute, wore a T-shirt.

“How’s it going?” Thile asked.

“How would I know?” Keillor said, without making eye contact.

Thile retreated to his dressing room to warm up on his mandolin, a rare 1924 Gibson built by the renowned luthier Lloyd Loar. He played arpeggios, his long fingers hopping around the fretboard, and sang in a clear falsetto: “Da da da da.” Thile’s voice is a staccato tenor. A critic once memorably wrote that Keillor’s baritone sounded “precision-engineered to narrate a documentary about glaciers”; Thile would be more suited to announcing a pickup football game played by peregrine falcons. He put on a tie: “There’s that.” But he looked a little nervous.

Internally, executives at American Public Media, the nonprofit that produces and distributes “A Prairie Home Companion,” liken Thile’s ascent to Jimmy Fallon’s taking Jay Leno’s seat. The comparison sells short the jarring nature of the shift. Leno didn’t conceive of “The Tonight Show” or write most of the jokes himself, as is the case with Keillor and “Prairie Home.” More peculiar still, Thile is not a writer-raconteur in the mode of Keillor, but a musician, and one who prefers technical, challenging terrain.

The transition brings with it more than one existential question — whether “A Prairie Home Companion” can possibly go on without Garrison Keillor’s voice, and whether there’s even a place for such a show in modern America. (...)

Keillor’s creation has always been an easy mark for jokes; in the popular imagination, the show is a sort of comfort food for the overeducated. (“Be more funny!” Homer Simpson once yelled at a cartoon version of Keillor.) But those who see Keillor as the bard of the white picket fence neglect how dark his humor could be: In a 2011 Lake Wobegon monologue, Keillor rhapsodized about putting a dead aunt out back to freeze. (“She was not a great beauty, and death did nothing to improve her.”) And the show has been remarkably popular, commanding more than four million weekly listeners at its peak. Minnesota Public Radio sold the publisher of its “Prairie Home”-themed product catalog, Rivertown Trading Company, for $120 million in 1998.

It was on the strength of Keillor’s audience that Bill Kling, the former president of Minnesota Public Radio, started National Public Radio’s first big competitor, American Public Radio. The show helped public radio stretch away from its staple diet of hard news; Ira Glass and Sarah Koenig owe Keillor a debt. So do a lot of people in Nashville. Over the past four decades, there has been no greater megaphone for acoustic music than “A Prairie Home Companion.” A partial list of artists who played the show includes Emmylou Harris, Chet Atkins, Gillian Welch and David Rawlings, Taj Mahal, Bonnie Raitt, Willie Nelson, Keb’ Mo’, Wilco, Mark Knopfler and Iris Dement, not to mention lesser-known talents like Aoife O’Donovan and Sarah Jarosz. “He was down there away from the Top 40,” Harris told me, “which is a necessary thing.”

But the show never changed much, and in the podcast era, “Prairie Home” has come to feel anachronistic rather than subversive. Keillor’s habit of mocking millennial culture hasn’t helped; the show’s terrestrial audience has declined by 500,000 in the past five years, to 3.1 million. Its average listener age is 59.

by Abe Streep, NY Times |  Read more:
Image: Mark Peterson/Redux, for The New York Times

Tuesday, September 27, 2016

What Happened to Netflix?

Netflix wants to get exclusive.

According to CFO David Wells, the platform plans to go all-in on its growing slate of original programming, which includes popular television shows like “Orange Is the New Black” and “Jessica Jones” and its less successful film lineup. In 2014, Netflix offered Adam Sandler a four-picture deal that produced critical duds like “The Ridiculous 6” and “The Do-Over.” The company, which has struggled with a consistent brand model, has also produced misfires like the toothless Ricky Gervais satire “Special Correspondents” and “XOXO,” a saccharine love letter to EDM. The recent “Tallulah,” a sharply observed Ellen Page dramedy about a slacker who accidentally kidnaps a baby, though, has shown Netflix to be headed in the right direction. 

Wells, addressing the Goldman Sachs Communacopia Conference on Thursday, said that the company’s goal is a 50/50 divide between Originals and licensed content, the library of contemporary and classic films on which the platform made its name. He claimed that Netflix is “one third to halfway” to reaching that mark. 

This shouldn’t be surprising to anyone who has been a longtime Netflix subscriber. When the service, which launched in 1997, gained in popularity in the early to mid-2000s, it was marketed on its boundlessness. Here was a company that could provide consumers what their local video store couldn’t—a seemingly endless catalog of films. If Ed, the guy with the spaghetti hair at the corner Blockbuster Video, thought Fellini was a type of cocktail, Netflix had “8 ½” and “City of Women” available whenever you wanted, provided you had made your peace with the capricious whims of the U.S. postal service. 

In 2016, DVDs have become a niche service for Netflix, with just 4.5 million subscribers left. The platform even tried to spin its mail service off into a different company with the failed launch of Qwikster in 2011. 

Streaming offered an incredible opportunity for the industry leader to bring its coveted library to a mass audience, but that promise has never quite materialized. The appeal of Spotify, for instance, is that the music streaming service offers nearly every song to which you could dream of listening, as long as it isn’t produced by Taylor Swift. If the new Frank Ocean, Beyoncé, or Kanye West album isn’t available—due to exclusive deals through Spotify’s competitors—just wait a couple of weeks. It will be.

 That utopic vision of infinite access was perhaps never possible for Netflix, as The Verge’s Bryan Bishop astutely points out. The streaming wars have gone too nuclear—with the company’s rivals shelling out unthinkable sums to play keep-away from the biggest kid on the block. Housing all nine seasons of “Seinfeld” cost Hulu $180 million, while Amazon is home to critically acclaimed shows like “Mr. Robot” and “Orphan Black.” Netflix, though, has backed away from its ever-shrinking digital library with a fierce intensity reserved usually for Donald Trump gaffes. Its film selection of today is less enviable than serviceable, filled with the kinds of movies one might watch drunk on a plane (see: “The Switch,” “Scary Movie”). “Netflix is no longer where you go to find something great,” Bloomberg’s Megan McArdle once wrote, “it’s where you go to kill some time with whatever it has available.” There are gems in each section, to be sure, and it’s hard to harbor a grudge toward any streaming platform that houses Otto Preminger’s stupendous film noir “Laura,” the best movie ever made about a guy who wants to have sex with a painting.

If Netflix killed its DVD selection, which in turn killed the video store, the service never devised a sustainable way to replace either one of those options, and it’s no longer trying.

by Nico Lang, Salon | Read more:
Image: uncredited

'Fully Loaded' Kodi Boxes Go to Court

[ed. A friend mentioned Kodi boxes to me a while ago as an alternative to cable and said you could get all subscription services for free once you purchased the device. Sounds like the legality of the technology will soon be tested (at least the 'fully loaded' part for people who don't want to search for and install the component programs themselves).  See also: What's the best fully loaded Kodi box?]

Selling 'fully loaded' Kodi boxes that can access subscription content for free could soon become illegal as a court case concerning the equipment is set to get under way.

Brian Thompson of Middlesbrough is accused of selling equipment that "facilitated the circumvention" of copyright protection rules.

The equipment mentioned refers to so-called 'fully loaded' boxes which use the increasingly popular Kodi open-source media centre software which brings together videos, music, games, and photos onto one platform.

Formerly known as Xbox Media Centre (XBMC) the software has been developed so it can now be used on several devices, including the Amazon Fire TV Stick and Apple TV, without those companies' official support.

By pre-loading set-top boxes with the software, some sellers are able to offer ready-to-use streaming devices, which customers can modify using third-party add-ons to gain access to pirated content or subscription-based services for free.

Sellers that provide these Kodi boxes with the third-party software pre-installed are said to be providing 'fully loaded' boxes.

In the upcoming court case, brought by Middlesbrough Council, Thompson is accused of providing this type of equipment to his customers, and has not entered a plea.

Speaking to the Gazette Live, he stated that he doesn't consider the boxes to be illegal and intends to challenge the charges, which follow an 18 month investigation.

Kodi developers have made clear on numerous occasions that they do not support piracy extensions or add-ons, and say they maintain a "neutral stance on what users do with their own software".

by Joe Roberts, Trusted Reviews |  Read more:
Image: via:

A Transitional Moment for Sake

Earlier this month the U.S. Department of Agriculture announced a change in international policy that will change the way American consumers drink and buy sake.

From now on, in the U.S., “Japanese sake” will be protected under the Geographic Indicators laws—the same ones that say Champagne can come from only one region in France, and Parmigiano Reggiano can be labeled as such only if it comes from one specific area of Italy. In exchange, Japan will similarly recognize the terms “Tennessee Whiskey” and “Bourbon Whiskey.”

These distinctions are important because of whiskey’s popularity in Japan and sake’s increasing prevalence in the U.S. At the moment, an estimated 70 percent of the sake sold in the U.S. is made domestically, thanks to California-based producers such as Ozeki and Takara as well as newer, small-scale operators such as Dovetail, in Massachusetts, and Oregon’s SakeOne. But you may not know it, because all sake that’s sold in the U.S., whether it comes from Japan or not, has been labeled simply “sake”—until now.

A Transitional Moment

Naming aside, sake has been undergoing a change on both sides of the Pacific as brewers experiment with the rice-wine fermentation process to get a broader variety and depth of tastes.

It’s all about doing less to get more, says Beau Timken, owner of San Francisco-based True Sake, the first sake-only store in the U.S. when it opened in 2003. “They’re getting bolder, bigger, more prominent flavors, and more layers of flavor” by letting the sake do what it wants to do. For most breweries, that means pulling back on additions such as lactic acid and water and doing things the way their great-grandfathers did.

Producers such as Shiokawa, Born, and Dassai are creating richer, more complex sakes that add new layers of spice and textural interest to their sakes. Such venues as San Francisco’s Nara, New York’s Momosan Ramen & Sake, and Sosharu in London are offering chances to see a the new, wider range of today’s sake.

Premium sake—not the hot stuff served at your sushi takeout joint—is mostly junmai, pure rice sake, as opposed to honjozo, which includes a small amount of brewer’s alcohol to lighten the texture and the body, or futsushu, the mass-market value buys that make up nearly 80 percent of the market.

In the junmai category, taste can vary significantly as well, depending on how much the rice is milled. Straight junmai is the least milled and is typically earthy and full-bodied; daiginjo is the least milled and often floral and silky. Ginjo is somewhere between those two.

The Terms to Know

A label may not have words like “natural” or “no added alcohol,” but sake brewers like to let you know what they’re doing. So here are four terms, besides “Japanese sake,” to look for:

by Jim Clarke, Bloomberg |  Read more:
Image: Innovative Dining Group

Monday, September 26, 2016


Austin Briggs
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Native Soil

Natasha Boteilho lives in Oahu’s arid Waianae Valley on a jot of land held in trust for native Hawaiians. Here on Hawaii’s most densely populated island—where the highest per-capita homeless population in the United States continues to swell and the average price of a single-family home is three-quarters of a million dollars—that’s no small thing. The turquoise waters that lap against golden beaches lie next to jammed highways. Even the wildlife is exploding: A cacophonous feral-chicken epidemic provides the background noise to islanders’ daily lives.

Boteilho’s property was originally awarded to her grandfather by virtue of a federal law enacted in 1920 to stabilize a Hawaiian race left withering and landless after a century of colonization. Boteilho’s mother took over the land lease next, and then, in 2011, the homestead was passed on to her. A stay-at-home mother of three girls, the 39-year-old Boteilho resides with her husband and children in the three-bedroom house her grandfather built at the base of an eroded shield volcano.

But this is where Boteilho’s familial succession will end. None of Boteilho’s daughters—ages 2, 5, and 10—are eligible to inherit the land their great-grandfather settled in 1951. Simply put: They don’t have enough Hawaiian blood. “If I passed away tomorrow, my children would not be able to get my house,” Boteilho said. “That scares me.”

When Congress passed the Hawaiian Homes Commission Act of 1920, the native Hawaiian race was quickly vanishing. The legislation was a reaction to the large numbers of Hawaiians who had been forced off their lands when white businessmen moved to the islands during the early 1800s. The foreigners built sprawling pineapple and sugarcane plantations and imported a new working class to tend to them. The Hawaiians, meanwhile, receded to crowded urban zones where extrinsic diseases, for which they had no immunity, hacked away at their numbers. In 1778, when white men first set foot on the Hawaiian Islands, there were an estimated 683,000 full-blooded Hawaiians living there, according to the Pew Research Center. By 1919, that population was just 22,600. The Hawaiian Homes Commission Act attempted to combat the decline by creating a 200,000-acre land trust to serve as neighborhoods, farms, and ranches for those who could prove at least 50 percent Hawaiian ancestry.

“The Hawaiian race is passing,” testified Prince Jonah Kuhio Kalaniana’ole before the U.S. House of Representatives in 1920. “And if conditions continue to exist as they do today, this splendid race of people, my people, will pass from the face of the Earth.” A born royal and a delegate to Congress, Kuhio was the visionary sponsor of the law that established Hawaiian homesteading. Despite his fight for a lower blood quantum, the law specifies that Hawaiians are eligible to apply for 99-year land leases at $1 per year on the condition that they prove they are at least half-blooded Hawaiians. The law further stipulates that a homestead lease can be passed on to a leaseholder’s child or grandchild—so long as that heir can prove at least 25 percent Hawaiian ancestry.Families are finding that a dilution of the Hawaiian blood pool means they must face the forfeiture of land they have called home for decades.

But that was nearly 100 years ago. Today, incentivizing a race of people to preserve bloodlines by offering them free property seems, well, anachronistic. It is also likely in part why, on Friday, the U.S. Department of the Interior announced a pathway for the Native Hawaiian community to create its own unified government, one that could initiate a discrete relationship with the U.S. federal government. “The United States has a long-standing policy of supporting self-governance for native peoples,” said Interior Secretary Sally Jewell. “Yet, the benefits of the government-to-government relationship have long been denied to native Hawaiians, one of our nation’s largest indigenous communities.” The native Hawaiian population is in fact on the upswing, nearing 300,000. But that figure includes mixed-race residents, which makes it all the more unclear as to how—or when—any sovereign Hawaiian leadership that does arise would affect the land-trusts issue.

In the meantime, as the homestead communities age, the land leases are passing into the hands of the third and fourth generations, and some families are finding that a slow dilution of the Hawaiian blood pool means they must face the impending forfeiture of the land they have called home for decades. Fewer and fewer homesteading descendants have the minimum 25 percent Hawaiian-blood requirement to keep the land within their family lineages. Those folks have just two options: They can sell any improvements made to the property, such as a house, to the state agency that manages the trust lands, or they can sell them to any half-blooded Hawaiian. In either case, thousands of would-be homesteaders in the post-millennial generation will have to move.

“My grandson will have to go look for where to live,” said Robin Danner, a homestead leaseholder and the chairwoman of the Sovereign Councils of the Hawaiian Homelands Assembly. “That is not what Kuhio intended.” The assembly, whose membership includes more than 30 homestead neighborhood associations, is campaigning for a policy change that would reduce the blood-quantum requirement for succession to one-32nd, the same percentage that Kuhio originally championed. Easing the qualifications, proponents say, would ensure that future generations of Hawaiians aren’t cut off from one of their people’s most valuable benefits: land. Not to mention, an all-but-free place to live in one of the nation’s most expensive housing markets.

“When you take the land back, you haven’t just done a disservice to that one person who now has to move and find another place to live; you’ve done a disservice to the entire lineage,” Danner said. “You have wiped out an entire line. For thousands of indigenous people, this is their place on the planet and now they’re getting unhooked.” (...)

Of course, not all Hawaiians are in favor of reducing the metrics for successive homesteading—even among indigenous Hawaiians. There are 10,000 homestead leaseholders across the state, but there are 29,000 frustrated Hawaiians on a waiting list. Worse: There are thousands of acres of trust lands sitting vacant. The state won’t issue leases in these areas because there are no roads, no water infrastructure, and no electricity hookups—for which the government says, there is no money. What’s more, in addition to waiting indefinitely for idle land, all of the waitlisted have an at least 50 percent blood quantum. They, unsurprisingly, argue that they should retain priority over the descendants of leaseholders whose bloodlines have thinned to the point of disqualification. In February, Hawaiian lawmakers did consider a bill to reduce the blood requirement for homesteaders. But the bill failed. (Such a policy change would have also required congressional approval—and no one has any real idea of what mainland politicians would make of the whole situation.)

by Brittany Lyte, The Atlantic |  Read more:
Image: Chris Wattie / Reuters

Bill Nunn Was More Than Radio Raheem

[ed. Oct, 1952 - Sept, 2016]

"I’m minding my business,” Eric Garner says. “Please just leave me alone.”

Images can shatter us. A minute-long YouTube video from two years ago, “Radio Raheem and the Gentle Giant,” tries to teach us this. The video intercuts footage of Garner, the “gentle giant” of the title, constrained in a chokehold by the Staten Island police, with a fictional rendition of the same thing: the death of Radio Raheem in Spike Lee’s 1989 masterpiece, Do the Right Thing. In the YouTube video, the two moments bleed into one. As Garner is shoved, Radio Raheem is shoved; as Garner falls to the ground with an officer’s arm crooked tight around his neck, Radio Raheem is pulled skyward by the police baton crushing his. The video was edited and posted online by Spike Lee himself, just four days after Garner’s death. It has an unambiguous point: History will seem to repeat itself so long as violence does.

I was but one of many people to immediately think of Radio Raheem in the summer of 2014, as the uncannily familiar footage of Garner’s death made my own nightmare, as a black man, come to life every day, everywhere I looked. That’s in part thanks to Lee and his vision of police violence, which, he predicted, would keep coming back to bite us in the collective ass. But most of the thanks is owed to the man who acted the part: Bill Nunn, whose performance made Radio Raheem come alive incisively, compassionately.

Nunn died of cancer Saturday, at 62, in his hometown of Pittsburgh. Lee announced his passing on Instagram. “My Dear Friend,” Lee wrote, posting an image of Radio Raheem mid-monologue, that iconic flattop haircut and those fist-spanning words, LOVE and HATE, emblazoned on his knuckles in brass. “My Dear Morehouse Brother.” The post is as mournful as it is exuberant. “RADIO RAHEEM WILL ALWAYS BE FIGHTING DA POWERS DAT BE.”

On Facebook, Lee posted a picture of Radio Raheem’s kicks, that fated pair of white, red, and gray–accented Nike Air Revolutions we see trembling above the concrete as he dies. An odd way for Lee to commemorate the occasion, perhaps, but then, Radio Raheem’s style was his substance. His look was his politics. And his look was Bill Nunn. Nunn, the 6-foot-3 son of the legendary Pittsburgh Steelers scout of the same name, knew his body. He knew his size, his face. He worked his precisely contoured jaw and severe brow, his large frame and ample baritone, like his supporting players. If Lee’s language was the thesis, Nunn’s body and manner were the supporting evidence, masterfully wielded to manifest Radio Raheem’s most radical ideas. You cannot imagine Radio Raheem without a sense of his size and heft and skin tone, his Ali-esque footwork during a lesson on LOVE and HATE, backed by all the luscious browns and reds of Bed-Stuy on an impossibly hot day. It’s to the point that I can’t imagine black cinema — thus American cinema, thus world cinema — without that body. And that’s on the basis of a performance composed almost entirely of a philosophy lesson (“Let me tell you the story of Right Hand, Left Hand …”), a fight in a pizzeria, and a death scene. (...)

Still, none of the other characters he played lived, or died, as spectacularly or vitally as Radio Raheem. There was his style, that “BED-STUY DO OR DIE” shirt on his back, those Public Enemy vibes blasting from his shoulders, his whole body offering up a fresh catalogue of black pride for the hip-hop era — the kind of pride unafraid to mark the blocks of Brooklyn with eardrum-busting fits of black expression, confident enough to demand a white pizzeria owner in a black neighborhood hang a few black faces on his wall.

by K. Austin Collins, The Ringer |  Read more:
Image: Do The Right Thing

Hell on Earth

Thinking about future punishment.

Even in my most religious moments, I have never been able to take the idea of hell seriously. Prevailing Christian theology asks us to believe that an all-powerful, all-knowing being would do what no human parent could ever do: create tens of billions of flawed and fragile creatures, pluck out a few favourites to shower in transcendent love, and send the rest to an eternity of unrelenting torment. That story has always seemed like an intellectual relic to me, a holdover from barbarism, or worse, a myth meant to coerce belief. But stripped of the religious particulars, I can see the appeal of hell as an instrument of justice, a way of righting wrongs beyond the grave. Especially in unusual circumstances.

Take the case of Adolf Hitler. On the afternoon of 29 April 1945, Hitler was stashed deep in his Berlin bunker, watching his Third Reich collapse, when he received word that Benito Mussolini was dead. Hitler was aghast at the news, not because he’d lost yet another ally, but because of the way Mussolini had died. The Italian dictator had been trying to slink into Switzerland when he was caught, shot, and dragged to a public square in Milan, where a furious mob kicked and spat on his body, before hanging it upside down on a meat hook.

Worried that he might meet a similar fate, Hitler decided to test the strength of his cyanide capsules by feeding a few of them to his dog, Blondie. By midafternoon on the following day, 30 April, the Red Army was rampaging through Berlin, and the Fuhrer’s empire had shrunk to a small island of land in the city centre. Rather than fight to the end and risk capture, Hitler bit into one of his cyanide pills, and fired a bullet into his head for good measure. When the Soviets reached the bunker two days later, his body had been burned and his ashes buried, in a shallow bomb crater just above ground.

It is hard to avoid the conclusion that Hitler got off easy, given the scope and viciousness of his crimes. We might have moved beyond the Code of Hammurabi and ‘an eye for an eye’, but most of us still feel that a killer of millions deserves something sterner than a quick and painless suicide. But does anyone ever deserve hell?

That used to be a question for theologians, but in the age of human enhancement, a new set of thinkers is taking it up. As biotech companies pour billions into life extension technologies, some have suggested that our cruelest criminals could be kept alive indefinitely, to serve sentences spanning millennia or longer. Even without life extension, private prison firms could one day develop drugs that make time pass more slowly, so that an inmate’s 10-year sentence feels like an eternity. One way or another, humans could soon be in a position to create an artificial hell.

At the University of Oxford, a team of scholars led by the philosopher Rebecca Roache has begun thinking about the ways futuristic technologies might transform punishment. In January, I spoke with Roache and her colleagues Anders Sandberg and Hannah Maslen about emotional enhancement, ‘supercrimes’, and the ethics of eternal damnation. What follows is a condensed and edited transcript of our conversation.

Suppose we develop the ability to radically expand the human lifespan, so that people are regularly living for more than 500 years. Would that allow judges to fit punishments to crimes more precisely?

Roache: When I began researching this topic, I was thinking a lot about Daniel Pelka, a four-year-old boy who was starved and beaten to death [in 2012] by his mother and stepfather here in the UK. I had wondered whether the best way to achieve justice in cases like that was to prolong death as long as possible. Some crimes are so bad they require a really long period of punishment, and a lot of people seem to get out of that punishment by dying. And so I thought, why not make prison sentences for particularly odious criminals worse by extending their lives?

But I soon realised it’s not that simple. In the US, for instance, the vast majority of people on death row appeal to have their sentences reduced to life imprisonment. That suggests that a quick stint in prison followed by death is seen as a worse fate than a long prison sentence. And so, if you extend the life of a prisoner to give them a longer sentence, you might end up giving them a more lenient punishment.

The life-extension scenario may sound futuristic, but if you look closely you can already see it in action, as people begin to live longer lives than before. If you look at the enormous prison population in the US, you find an astronomical number of elderly prisoners, including quite a few with pacemakers. When I went digging around in medical journals, I found all these interesting papers about the treatment of pacemaker patients in prison.

Suppose prisons become more humane in the future, so that they resemble Norwegian prisons instead of those you see in America or North Korea. Is it possible that correctional facilities could become truly correctional in the age of long lifespans, by taking a more sustained approach to rehabilitation?

Roache: If people could live for centuries or millennia, you would obviously have more time to reform them, but you would also run into a tricky philosophical issue having to do with personal identity. A lot of philosophers who have written about personal identity wonder whether identity can be sustained over an extremely long lifespan. Even if your body makes it to 1,000 years, the thinking goes, that body is actually inhabited by a succession of persons over time rather than a single continuous person. And so, if you put someone in prison for a crime they committed at 40, they might, strictly speaking, be an entirely different person at 940. And that means you are effectively punishing one person for a crime committed by someone else. Most of us would think that unjust.

Let’s say that life expansion therapies become a normal part of the human condition, so that it’s not just elites who have access to them, it’s everyone. At what point would it become unethical to withhold these therapies from prisoners?

Roache: In that situation it would probably be inappropriate to view them as an enhancement, or something extra. If these therapies were truly universal, it’s more likely that people would come to think of them as life-saving technologies. And if you withheld them from prisoners in that scenario, you would effectively be denying them medical treatment, and today we consider that inhumane. My personal suspicion is that once life extension becomes more or less universal, people will begin to see it as a positive right, like health care in most industrialised nations today. Indeed, it’s interesting to note that in the US, prisoners sometimes receive better health care than uninsured people. You have to wonder about the incentives a system like that creates. (...)

Is mental suffering a necessary component of imprisonment?

Roache: There is a long-standing philosophical question as to how bad the prison experience should be. Retributivists, those who think the point of prisons is to punish, tend to think that it should be quite unpleasant, whereas consequentialists tend to be more concerned with a prison’s reformative effects, and its larger social costs. There are a number of prisons that offer prisoners constructive activities to participate in, including sports leagues, art classes, and even yoga. That practice seems to reflect the view that confinement, or the deprivation of liberty, is itself enough of a punishment. Of course, even for consequentialists, there has to be some level of suffering involved in punishment, because consequentialists are very concerned about deterrence.

by Ross Andersen, Aeon |  Read more:
Image: Martin Barraud/Gallery Stock

Sunday, September 25, 2016

Arnold Palmer (Sept., 1929 - Sept., 2016)

The End of Farc

In their 52-year fight against the Colombian state, Farc rebels used assault rifles, shrapnel-filled gas canisters, homemade landmines and mortar shells.

Those weapons are now set to be silenced forever as part of a historic peace deal with the government, to be signed on Monday. Once the demobilisation of the Revolutionary Armed Forces of Colombia is complete, their arsenal will be melted down into three monuments that will mark the end of Latin America’s longest-running conflict – and decades of armed uprisings in the region.

“This is an agreement with the last of the great guerrilla movements that emerged in the context of the cold war,” said Gonzalo Sánchez, director of the National Centre of Historical Memory in Bogotá. “There might be other episodes, but strategically the armed project, the armed utopia, is closing its cycle with Farc.”

Like many other Marxist and Maoist followers of the “armed struggle”, the Farc were inspired by the audacious exploits of Fidel Castro and Che Guevara, who set out to Cuba on the rickety fishing vessel Granma with just 80 men in 1956, and went on to overthrow dictator Fulgencio Batista three years later.

It was certainly not the first armed rebellion in Latin America, which had witnessed numerous bloody independence campaigns against Spain in the 19th century and a smattering of communist militias in the 1940s. But the Cuban rebels’ success ignited a fresh blaze of revolutionary fervour across the continent that was fuelled by cold war politics, military coups, US backing for rightwing dictators and the murderous suppression of more moderate leftwing activists.

In the 1960s and 70s, guerrilla groups sprang up in every country in the region except Costa Rica: the Sandinista National Liberation Front (FSLN) in Nicaragua, the 8th October Revolutionary Movement (MR*8) in Brazil, the Armed Forces of National Liberation (FALN) in Venezuela, the People’s Revolutionary Army (ERP) and Montoneros in Argentina, the Tupamaros in Uruguay, the Revolutionary Left Movement (MIR) in Chile. These and many others carried out assassinations, hijacks, kidnappings, bank robberies and attacks on military and political targets.

In Central America, they were among the factors that led to bloody civil wars in El Salvador, Guatemala and Nicaragua, where the Cuban-trained Sandinista guerrilla Daniel Ortega – who was once arrested for robbing a bank with a machine gun – secured power through revolution in 1979 and was then elected president of Nicaragua.

In South America, however, the communist militants made little headway. After Che Guevara was executed in Bolivia, Cuba and the Soviet Union cooled their enthusiasm to export armed struggle. Funding and weapons supplies – never very great in the first place – were cut. Splintered, outgunned and rarely able to secure popular support outside of remote strongholds, the guerrillas never came close to seizing power through military force.

Instead, many turned to the ballot box after the restoration of democracy in much of Latin America in the 1980s took away much of their raison d’etre. Some reached the highest office.Dilma Rousseff, a member of a clandestine Marxist group who was arrested and tortured after a gun was found in her handbag, became president of Brazil. José ‘Pepe’ Mujica, a Tupamaro who was shot and imprisoned in the 1970s, became president of Uruguay. Dozens of other former guerrillas became senators and congressmen.

Elsewhere, armed groups were sporadically active in countries that were slow to move towards democracy – such as Mexico, which had to wait until 2000 for its first change of government in more than 70 years.

The Zapatista Army of National Liberation staged high-profile military campaigns in 1994, but is now committed to peaceful means. “They are 21st-century guerrillas, shooting off more press bulletins than bullets,” said Eduardo Pizarro, a Colombian sociologist and conflict expert. The Guerrero-based Popular Revolutionary Army, however, staged attacks on oil facilities as recently as 2007 and has since been blamed for kidnappings and violent demonstrations.

The longest-enduring groups, however, are in Peru, Paraguay and Colombia – all countries that are not coincidentally centres of drug production and smuggling, which is a source of funds and guns.

by Jonathan Watts and Sibylla Brodzinsky, The Guardian |  Read more:
Image: uncredited