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Blame the Media? The NY Times Coverage of Clinton v. Trump Was Lacking

- 53 min 15 sec ago
According to Columbia Journalism Review, the most influential mainstream media was gossip-prone and failed to inform the public about what mattered.

For months, readers of the New York Times and other influential mainstream media have heard about how “fake news” soiled 2016’s election. But they haven’t heard how poorly the Times and its peers covered the election, especially in its pivotal final months.

Now a major report in the renowned Columbia Journalism Review has presented a detailed analysis showing the most influential mainstream media—with the New York Times as Exhibit A—was as superficial and scandal-obsessed as any online outlet trafficking in political gossip in the 2016 campaign.

“We agree that fake news and misinformation are real problems that deserve serious attention. We also agree that social media and other online technologies have contributed to deep-seated problems in democratic discourse such as increasing polarization and erosion of support for traditional sources of authority,” Duncan J. Watts and David M. Rothschild write in a lengthy article, "Don’t blame the election on fake news. Blame it on the media." “Nonetheless, we believe that the volume of reporting around fake news, and the role of tech companies in disseminating those falsehoods, is both disproportionate to its likely influence in the outcome of the election and diverts attention from the culpability of the mainstream media itself.”

Their investigation suggests mainstream media were far more influential than the most partisan and propagandistic social media, yet they make a larger and more important point. As any American who paid attention to the 2016 election can attest, mainstream media loved covering Trump like a never-ending Super Bowl of play-by-play idiocies and outrages. Crucially, they went overboard in covering Hillary Clinton’s flaws, starting with her dumb decision to use a private email server as secretary of state.

But Watts and Rothschild single out the Times for especially vacuous coverage.

“It seems incredible that only five out of 150 front-page articles that the New York Times ran over the last, most critical months of the election, attempted to compare the candidate’s policies, while only 10 described the policies of either candidate in any detail,” they noted. “In just six days, the New York Times ran as many cover stories about Hillary Clinton’s emails as they did about all policy issues combined in the 69 days leading up to the election.”

The not-advertised truth about mainstream outlets, including National Public Radio, is that much of their political coverage takes its cues from a handful of print outlets, either by rewriting their stories or quickly doing in-house versions. Here, the CJR authors found the trend-setting Times and its peers were favoring political gossip over substance and applying different editorial standards to their coverage of Clinton and Trump.

Their analysis compared the major focus of coverage of each campaign. Though the authors don’t put it quite this way, it’s clear the national political press was tired of a wonky candidate they knew, especially compared to the very novel newcomer who kept surprising them. An upside-down dynamic ensued. Trump was treated with kid gloves for lightweight policy and ugly personality traits. Meanwhile, Clinton was tarred for personal foibles, such her use of a private email server, while her detailed policy prescriptions were all but ignored.

“What did all these stories talk about?” they write, referring to the mainstream coverage in the 69 days before the election. “The research team investigated this question, counting sentences that appeared in mainstream media sources and classifying each as detailing one of several Clinton- or Trump-related issues. In particular, they classified each sentence as describing either a scandal (e.g., Clinton’s emails, Trump’s taxes) or a policy issue (Clinton and jobs, Trump and immigration). They found roughly four times as many Clinton-related sentences that described scandals as opposed to policies, whereas Trump-related sentences were one-and-a-half times as likely to be about policy as scandal.”

A year after the campaign ended, the daily fog of campaign coverage revealed some striking and deeply disturbing patterns, the authors reveal.  

“Given the sheer number of scandals in which Trump was implicated—sexual assault; the Trump Foundation; Trump University; redlining in his real-estate developments; insulting a Gold Star family; numerous instances of racist, misogynist, and otherwise offensive speech—it is striking that the media devoted more attention to his policies than to his personal failings. Even more striking, the various Clinton-related email scandals—her use of a private email server while secretary of state, as well as the DNC and John Podesta hacks—accounted for more sentences than all of Trump’s scandals combined (65,000 vs. 40,000) and more than twice as many as were devoted to all of her policy positions.”

The authors then take a harder look at the Times’ front page. Their report classifies stories in three ways: “miscellaneous” for horse-race coverage of who’s ahead; “personal/scandal;” and “policy,” noting whether policy details were given or not.

“Of the 150 front-page articles that discussed the campaign in some way, we classified slightly over half (80) as Campaign Miscellaneous,” they write. “Slightly over a third (54) were Personal/Scandal, with 29 focused on Trump and 25 on Clinton. Finally, just over 10 percent (16) of articles discussed Policy, of which six had no details, four provided details on Trump’s policy only, one on Clinton’s policy only, and five made some comparison between the two candidates’ policies.”

The authors do the same analysis for other leading mainstream media, including the Washington Post, and found the same pattern. “The results for the full corpus were similar: Of the 1,433 articles that mentioned Trump or Clinton, 291 were devoted to scandals or other personal matters while only 70 mentioned policy, and of these only 60 mentioned any details of either candidate’s positions,” they write.

Stepping backward, they conclude that mainstream media colossally failed to serve the public in a manner that cannot be blamed on the propaganda spread on social media.

“The problem is this,” they write, continuing: 

“As has become clear since the election, there were profound differences between the two candidates’ policies, and these differences are already proving enormously consequential to the American people. Under President Trump, the Affordable Care Act is being actively dismantled, environmental and consumer protections are being rolled back, international alliances and treaties are being threatened, and immigration policy has been thrown into turmoil, among other dramatic changes. In light of the stark policy choices facing voters in the 2016 election, it seems incredible that only five out of 150 front-page articles that the New York Times ran over the last, most critical months of the election, attempted to compare the candidate’s policies, while only 10 described the policies of either candidate in any detail.”

The authors note this pattern was especially damaging between October 29 and Nov. 3, 2016, six days that followed then-FBI Director James Comey’s decision to announce that the FBI was revisiting its examination of Clinton’s email server use. (Comey later said there was nothing new, but the political damage was done.)  

“To reiterate, in just six days, the New York Times ran as many cover stories about Hillary Clinton’s emails as they did about all policy issues combined in the 69 days leading up to the election (and that does not include the three additional articles on October 18, and November 6 and 7, or the two articles on the emails taken from John Podesta),” the authors write. “This intense focus on the email scandal cannot be written off as inconsequential: The Comey incident and its subsequent impact on Clinton’s approval rating among undecided voters could very well have tipped the election.”

The Times’ obsession with scandal is not unique, they add, before speculating on what may have been reporters and editors’ motives.

“To be clear, we do not believe the Times’ coverage was worse than other mainstream news organizations, so much as it was typical of a broader failure of mainstream journalism to inform audiences of the very real and consequential issues at stake,” they write. “In retrospect, it seems clear that the press in general made the mistake of assuming a Clinton victory was inevitable, and were setting themselves as credible critics of the next administration.”

“Possibly this mistake arose from the failure of journalists to get out of their hermetic bubble,” they continue. “Possibly it was their misinterpretation of available polling data, which showed all along that a Trump victory, albeit unlikely, was far from inconceivable. These were understandable mistakes, but they were still mistakes. Yet, rather than acknowledging the possible impact their collective failure of imagination could have had on the election outcome, the mainstream news community has instead focused its critical attention everywhere but on themselves: fake news, Russian hackers, technology companies, algorithmic ranking, the alt-right, even on the American public.”

That last point is particularly salient one year into the Trump presidency. Mainstream media organizations have been collaborating with Facebook, Google and other big online platforms to combat “fake news” by establishing new “trust standards” that grade content based on metrics they have collectively established. Independent media like AlterNet are not part of these discussions, even though these standards will generally downgrade analysis and opinion journalism, compared to mainstream media reports.

As Edward S. Herman wrote for the Monthly Review, before his recent death, “It has been amusing to watch the New York Times and other mainstream media outlets express their dismay over the rise and spread of ‘fake news.’ These publications take it as an obvious truth that what they provide is straightforward, unbiased, fact-based reporting. They do offer such news, but they also provide a steady flow of their own varied forms of fake news, often by disseminating false or misleading information supplied to them by the national security state, other branches of government, and sites of corporate power.”

“Mainstream media fake news is especially likely where a party line is quickly formed on a topic, with any deviations therefore immediately dismissed as naïve, unpatriotic, or simply wrong,” wrote Herman, who co-authored 2008’s Manufacturing Consent with Noam Chomsky.    

The Columbia Journalism Review’s analysis of the most influential mainstream media coverage in 2016 shows that the “party line,” as Herman put it, failed journalism’s basic mission to represent the public before the powerful.

There’s no ambiguity surrounding the results: Donald Trump’s America is taking hold. The GOP Congress is dismantling safety nets and raiding the middle class to enrich the wealthy. And mainstream news is still dominated by personal scandals before policy impacts.   

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For-Profit Medical Companies Are Making Tons of Money Taking Poor Peoples’ Blood

- 1 hour 25 min ago
Donors hope to get $30 a pop for their plasma, but sometimes they aren't even paid what they're promised.

Here’s another example of wealthy corporations sucking poor people dry—literally. While many good samaritans donate blood or bone marrow out of good will, others sell their bodily fluids on a biweekly basis just so they can make ends meet. Multimillion-dollar medical companies know this, and eagerly take advantage. The for-profit plasma donation industry has been quietly targeting poor Americans for decades, and sometimes, the donors aren’t even paid what they’re promised.

Plasma is used to manufacture medicines that help people with diseases like blood-clotting and immune deficiency disorders. According to ABC, 94 percent of the plasma used internationally comes from the U.S. Four out of 5 American plasma centers are located in poorer neighborhoods around the country, and are frequented mainly by poor people who need to supplement their income with the extra money they receive from donating. These donors receive $30 to $40 per donation on average. Compare that to the biotech companies that turn a profit from the plasma, estimated to be a $19.7 billion global industry.

Darryl Lorenzo Wellington, who wrote in a piece for the Atlantic that he donated plasma to pay his rent one month, explains how for-profit plasma companies are well aware they are making money off of poor donors. He writes, “the number of centers in the United States ballooned during the Great Recession, with 100 new centers opening and total donations leaping from 12.5 million in 2006 to more than 23 million in 2011.”

Some reports show that donors who frequent these for-profit plasma donation centers don’t end up being paid the amount they were promised.

At this point big business is stealing blood from the poor through plasma centers. They say they'll pay blood donors (in poor areas) but do so on debit cards with high fees. Actual blood money. https://t.co/BlOOavDt5E

— Matt Stoller (@matthewstoller) December 8, 2017

As one plasma donor wrote in a complaint on RipoffReport:

“Bio life plasma Mankato pays $20 the first donation of the week and 50 for the second[. T]he problem is you can't get to all your money because of the car[d] that they use to pay you is in $10 increments which no ATMs around have so therefore you have to pay every time you use the stupid card when you happen to have a week where it's off also they charge You a monthly fee just for having the card therefore if you do get a $50 donation and are able to take it out for whatever reason you have overdraft on said card so therefore you can't get your money you have to use their card and guess what they make money off of it these people are bloodsucking vampires.”

Wellington confirms this unfair payment process: "'Plassers' [donors] receive payments on a special debit card that extracts a surcharge whenever they use it.”

It’s a cruel move for people who come to plasma donation centers as a last resort. One donor told ABC, “I donate specifically for the money because I work a minimum wage job. I work as a cashier and a stocker. I used to work as a repair technician for 14 bucks an hour, so I’m used to more than what I’m getting.”

Another donor in Kansas City who has a day job at Burger King said he makes donating a regular part of his routine. “I go Fridays and Sundays. Right arm I use Friday. Other I use Sunday. I switch up every time.”

Not everyone in the health industry is a fan of for-profit plasma. The Atlantic writes, “Hospitals, Red Cross units, and nonprofit agencies relying on voluntary donations reject the plasma center model because cash incentives for whole blood may give donors an incentive to lie [about their health histories], heightening risks of a tainted supply. Such risks are higher overall for whole blood, too.”

One expert on the subject finds the practice notably creepy. “For a majority of people, apparently, it’s relatively safe. We really don’t know the long-term effects because it’s a relatively new phenomenon," Roger Kobayashi, a clinical professor of immunology at UCLA, told ABC. However, he said that what used to be “a simple gift of life has now evolved into a multi-national, highly profitable corporate enterprise.”

“What was once an act of altruism has now evolved into an act of necessity or desperation,” Kobayashi said.

The Plasma Protein Therapeutics Association said in a statement to ABC News, "Source plasma donation is safe and is highly regulated. Donors must meet criteria defined by the U.S. Food and Drug Administration and voluntary industry standards. Healthy, committed donors are the foundation of plasma-derived therapies."

Yet if donors are desperate enough, there’s no way to monitor the possibility that they’ll lie about their medical history.

The plasma industry has a surprisingly shady history. In the '60s and '70s, the Atlantic writes, for-profit plasma companies used to source donors from prisons, sometimes paying them just $5 per donation to cut costs. As a result, many people got sick. According to the Atlantic, “Roughly 50 percent of American hemophiliacs contracted HIV from bad plasma-based pharmaceuticals (a much higher infection rate than that suffered by gay men at the time).”

One plasma donor told the Atlantic, “Hearing all this, I never want to walk into those places again.”

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Brain-Wave Treatment for Alzheimer's Is Promising, but the First Human Subject Is Left Behind

- 3 hours 12 min ago
An Alzheimer’s patient sees improvement‚ but declines again when the study ends.

Peg Gleason, who is 83 and lives in San Francisco, was the first to sign up for the initial human trial of an MIT-backed experimental treatment for Alzheimer’s disease last January. 

The trial had a slightly eccentric setting at the warehouse offices of TheraNova, a San Francisco-based medical-device developer. Seven days a week for seven months, until the study ended, Peg and her husband Ed, 85, were dropped off by Uber at a side door and taken to a small room inside an old metal vault.

The experimenters were “all very good and smart people, and they were all 32-and-a-half-years old,” Ed, a retired product manager for AT&T, joked. 

“They put very large sunglasses on Peg with the lenses blacked out,” he said in a phone interview, in which Peg also participated. “[They] taped very small LED lights to them, so that when you put them on, all you saw were the four little lights on each lens. And they would be calibrated to flicker at 40 hertz.” 

Along with the glasses, Peg was fitted with earphones that played a tone at 40 hertz, and pads on each hand that vibrated at that frequency. The treatment lasted an hour a day, with another 15 minutes for post-trial cognitive testing, and then the Gleasons were driven home.

The San Francisco experiment began last January, a month after Nature published an MIT study reporting that exposure to LED lights flickering at 40 hertz (40 cycles per second) was linked to a sharp reduction in beta-amyloid plaques—clumps of abnormal proteins—in the visual cortex of mice bred to develop an Alzheimer’s-like disease. 

Neurons in the brain sometimes fire in synchrony, producing brain waves. Brain waves around 40 hertz, in the so-called gamma band—a frequency associated with higher-order cognitive functions, such as working memory and spatial navigation—have long been known to be impaired in Alzheimer’s disease and some other brain-based disorders. 

Disrupted gamma activity is also characteristic ofmice bred to develop Alzheimer’s disease, MIT professor of neuroscience Li-Huei Tsai, the lead author of the Nature paper, explained in a presentation to a congressional panel last July.

But after experimental mice spent just one hour daily for a week in a box fitted with LED lights flickering at 40 hertz, she said, their gamma brain waves rebounded, and amyloid plaques were reduced by half.

Photo Credit: Coalition for Life Sciences

The mice were also able to learn again. “They can remember an object in an environment, they can remember a place and they can navigate better,” Tsai said.

What happened? Tsai said that the 40-hertz flicker “entrained” the mice’s brain waves to follow along, syncing in the gamma frequency. Such syncing was first demonstrated in cats in the 1990s, she said, pointing at a GIF of a cat staring at a blinking light.

It’s not clear how, Tsai went on, but restoring the mice’s gamma brain waves also revived their microglia, the brain immune cells that clear toxic substances like amyloid and that are “on strike” in Alzheimer’s disease. 

“These janitor cells, the microglia, become active again,” Tsai said. “They become larger in size, their branches become more complex, and there are just more of them. But more importantly, they are very busy gobbling up this amyloid.” 

Tsai said that neurofibrillary tangles, another marker of Alzheimer’s, “disappeared” in the experimental mice. Blood vessels in their brains also changed, with the lumens—the interior channels—dilating twofold.

“But it doesn’t stop there,” she said. “In the Alzheimer’s brain, a large number of neurons die, and the brain becomes smaller.” Six to eight weeks of daily exposure to 40-hertz light, however, “protected the brain cells from dying, it prevented the brain from shrinking. And the synaptic connections, the density, is restored.”

Most spectacular, and what made Tsai “speechless,” was that the effects spread beyond the visual cortex to the rest of the brain, “including the hippocampus, the memory center, and the prefrontal cortex, the part of the brain known to be important for making decisions and performing executive functions.” 

Photo Credit: Coalition for Life Sciences

When the lights were stopped, however, even for only 12 hours, the amyloid plaques rebounded. And the flickering had to be at 40 hertz; other frequencies or random flickering had no effect. 

Tsai and her colleagues checked and rechecked their findings. “We were excited, but we were also very anxious,” she said. “It was such an unbelievable and unexpected result. We just had this anxiety to repeat it as many different times as possible, to get as many different people to repeat it.”

“In my wildest dreams, I never thought I would come upon this kind of observations, this profound, this sort of hard-to-believe,” Tsai, who directs MIT’s Picower Institute for Learning and Memory, said on an Amazing Things podcast. 

Last fall, soon before their Nature paper was published, Tsai and her lead co-author, MIT professor Edward S. Boyden, founded a startup, Cognito Therapeutics. Backed by MIT and with venture capital funding, the firm aims to develop “device-based” therapies for Alzheimer’s and other neurodegenerative diseases.

Cognito engaged TheraNova in San Francisco for the human feasibility study last January. Ed and Peg Gleason learned of it from a flyer passed along by a friend at the University of California Medical Center. 

They had little to lose; there is no cure for Alzheimer’s, the most common form of dementia. It does not kill quickly, but over months or years as the brain progressively fails and victims lose all ability to communicate or care for themselves. Alzheimer’s is now the third leading cause of death among older Americans.

Photo Credit: Coalition for Life Sciences

Peg was diagnosed in 2011, when an MRI during a routine physical found shrinkage in her frontal lobe.

“When she explained that it was Alzheimer’s, I looked at her and said, ‘No, no, that’s not me, I don’t have anything wrong with me,” Peg said. She ran out of the doctor’s office, crying. In the six years since, her short-term memory has declined. She rarely remembers events from earlier in the day, even something memorable, like a visit from one of their six children. 

But within days of beginning the trial at TheraNova, Peg’s memory improved. She began to remember events from the day before, not always, but far more often. Their children remarked on it. 

Peg also seemed mildly euphoric after the sessions, telling Ed she felt good. “It would last for two or three hours after every treatment,” Ed said.

The researchers seemed sanguine about the results as well. Two staff members told Ed that everyone in the pilot study—five people were enrolled in all—was showing improvement.

About a month into the trial, however, the experimenters announced a hiatus. “They said, ‘We’re going to stop the study and evaluate,’ Ed said. “I don’t know what they were thinking. I would not like to think that we were guinea pigs, and that they wanted to see if there was, you know, a recession, a bad effect.”

But within a few days, Peg declined. "I told them," Ed said, "the plaque is coming back; it’s like the fog coming in from the ocean."

The researchers were noncommittal. “They would say, ‘The time is up for the study, we’re going to review where we are.’” 

After eight days, Ed got a call that the trial was resuming, and a car would pick them up again the next day. The daily sessions continued after that without a break, except for a few weekend days, until mid-August. 

Then, with a week and a half’s notice, the study ended. The researchers said the trials were being moved to Boston, where Cognito is based. 

Immediately, Peg drooped again. By late September, five weeks after the study ended, there was a significant decline in her short-term memory. Ed said, "her anxiety and sundowning became more pronounced, and there’s more confusion.”

For the first time, she failed to recognize Ed. A few times, she thought Ed was her father. She also wandered off twice, something that had not happened before.

Peg's grandmother died of Alzheimer’s, as did her older sister two years ago. 

“The one thing I want to know," Peg said, "is how much I’m going to expect. I don’t want to hurt him or the kids.”

As the trial came to a close, Ed began asking the researchers to allow Peg to continue her daily treatments, or for help putting together a device to use at home. He’d been told they were assembled with off-the shelf components and powered with 9-volt batteries. The 40-hertz lights should be simple enough to replicate by someone with electrical engineering skills; several YouTube accounts had already posted schematics. 

But Ed didn’t know anyone with those skills other than the TheraNova engineers. And verifying that a light is truly flickering at 40 hertz requires an oscilloscope, which costs thousands. Still, he ordered a $40 string of 40-hertz LED lights from a new online business, gammalighttherapy.com, that was founded in mid-August (its website refers to the MIT research), and a "gamma bulb" from another. 

He also searched out 40-hertz sound on YouTube videos posted by New Age and brain hacking enthusiasts, who have long used the tones in meditation; they point to studies at the University of Wisconsin that found strong gamma brain-wave activity in meditating Tibetan Buddhist monks. 

He and Peg began listening to the sound together on earphones for an hour every day. It seemed to help, but in the evenings Peg’s confusion returned. Ed continued to call and email the researchers at Cognito and TheraNova, asking for their help and growing angry when they did not respond.

On September 27, 12 days after Ed’s last email, Cognito general manager and president Zach Malchano wrote back. He said he was very sorry to hear of Peg's decline, but that no further trials were planned for San Francisco, and the company could not provide access to an unapproved medical device.  

Malchano declined to be interviewed, but emailed a statement that said Cognito would not allow access to investigational devices, even under a compassionate-use program, because of the early stage of the research and Cognito’s “size and resources." Malchano also wrote: "Many of us at Cognito have personal connections to the disease and are working as quickly and as hard as we can to study the effectiveness of this technology in trials necessary to understand the potential effectiveness and safety of this approach." 

The Food and Drug Administration approves almost every compassionate use request for seriously ill patients who lack therapeutic alternatives—but only if the medical developer agrees.

Ed says it is unethical of the researchers to abandon Peg to her disease. 

“We are guinea pigs; we signed the paper,” Ed said, “But if you know the plaque is coming back in the mice, then you can assume the plaque is coming back in the people, and you have to address that. That’s your moral responsibility.”

A friend puts it more starkly: “It’s like testing to see whether a life raft works, and throwing the person back in the water.”

There’s something reminiscent of Flowers for Algernon in the Gleasons’ experience: eager scientists, a seeming improvement and then rapid, hopeless regression. Ed contends that the MIT scientists, whose research was partly funded by federal grants, are also wrong to seek ownership of technology and concepts that aren’t particularly novel.

“They can’t patent 40 hertz any more than General Motors can patent 40 mph,” he said. 

Other researchers, in fact, have investigated gamma brain-wave-inducing devices in human subjects. A 2016 University of Toronto study reported improved cognition in Alzheimer’s patients after six sessions in vibroacoustic therapeutic chairs with built-in speakers set at 40 hertz.

Devices to entrain brain waves via audiovisual stimulation have also been used by psychotherapists and sold to the public for a decade.

Psychologist Ruth Olmstead, who authored a 2005 Journal of Neurotherapy paper about audiovisual entrainment for learning disabilities, sells a “Synaptic Stimulus Trainer” with a headset that looks like the device used in the San Francisco study. Like other such devices that claim to increase creativity, treat depression and sleep disorders, or help children with learning disorders, it is marketed with a disclaimer that it is only for “recreational” purposes.

For her part, Li-Huei Tsai says she doubts exposure to 40-hertz LED lights could do harm, but that DIY attempts at brain-wave entrainment at some intensities could potentially be dangerous. 

Results from the “extensive, rigorous, really well-controlled, blinded” studies that are necessary, Tsai said in a phone interview, might be available in three or four years. She declined to answer questions about the TheraNova study, or the 12-patient study now underway in Boston.

In her summer presentation to Congress and on the podcast, Tsai was less guarded, saying she was hopeful that 40-hertz research would yield noninvasive treatments that could be “life-changing for millions.”

“My dream is that perhaps one day we can try to create a ‘gamma society,’” Tsai said. “We can try to change our lighting system(s) at home, or on the streets, the refresh rate of computer monitors or TV, so people can get exposure to the gamma flicker more readily, to create a healthy society.”

Peg Gleason will be long past helping before then; probably long before clinical trials are done. As of mid-November, her confusion and sundowning had continued to grow worse. She was mistaking Ed for her father again. She didn’t want to listen to the sound or look at the lights, and he’d given up searching for another device. He hoped to be able to keep taking care of her at home. On December 7, he emailed: 

"Peg has declined. When she entered the study she was seen as stage three of seven, she stayed in 3 for the whole trial until August, At the end of trials she immediately regressed to 4 in my opinion. When she fell and got an infection she went to 5 Now, the last week she has entered 6, Our support group leader said the decline can be quick, We will see. I'm determined to keep her at home as even the best and most expensive places are a sad end. I promised myself and Peg that I would accompany her at home to the end with the help of my children and grandchildren."

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PressTV-‘Trump provoking N Korea into nuclear war with US’

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US President Donald Trump and other officials in his administration are provoking North Korea – a nuclear power– into a war with the United States, a journalist and political analyst in London says.   Adam Garrie, an author and managing editor of The Duran news website, made the remarks in an interview with Press TV […]

Patagonia Joins Native Tribes and Environmental Groups to Sue the Trump Administration Over Utah Land

- 3 hours 35 min ago
Trump's massive land grab is the largest elimination of protected land in U.S. history.

The outdoor retailer Patagonia announced this week that it intends to join forces with a coalition of Native American tribes and environmental groups and file a lawsuit against the Trump administration. Like the environmental groups and tribes, Patagonia said it will sue Trump and members of his administration over their unprecedented decision to dismantle two million acres of public national monument land in Utah—Bears Ears and Grand Staircase-Escalante.

The move by Trump's administration is by far the largest elimination of protected public land in U.S. history. No president has ever attempted to abolish such an enormous region of public land before. Most presidents have added to public land protections, if anything.

The coalition of conservation groups that have already filed lawsuits includes the Wilderness Society, the Natural Resources Defense Council, the Sierra Club and seven other groups as plaintiffs. A coalition of five Native American Indian tribes has also already filed suit against the president and members of his administration. All parties filing suits are arguing that the administration does not have the legal authority to shrink the land's National Monument designation or remove any protections.

The various court cases over the national monument land could take years to settle, and could be landmark cases that set a precedent for the future of land protections. 

“The President stole your land.” This message is plastered in big white font against a black backdrop on Patagonia's new website landing page.

Yvon Chouinard, Patagonia's CEO and founder, has called Trump's land grab illegal, and told CNN:

"It seems the only thing this administration understands is lawsuits. I think it's a shame that only 4% of American lands are national parks. Costa Rica's got 10%. Chile will now have way more parks than we have. We need more, not less. This government is evil and I'm not going to sit back and let evil win.… I'm going to sue him."

Valley of the Gods, Bears Ears, Utah. (Credit: Bureau of Land Managment/ Flickr CC)

A "Take Action Now" link below Patagonia's message takes readers to a petition and pages of information on what's at stake and the Trump administration’s ignominious move.

The land at stake is sacred to several Native American tribes, and prior to Patagonia's announcement, the five-tribe coalition joined forces to sue, on Monday, Dec. 4. The tribes are alleging that Trump's dismantling of protections for the monuments violates the U.S. Constitution and Antiquities Act of 1906. The Antiquities Act, signed by famous public lands-preserving president Theodore Roosevelt, gives the president authority to create national monuments to preserve significant natural, cultural or otherwise alluring federal lands for future use. The act was born out of concerns over the safety and preservation of Native American artifacts and ruins.

The Bears Ears and Grand Staircase-Escalante National Monuments are not just sacred to Native Americans, but also precious to the millions of people who come from around the world to visit the gravity-defying rock formations and majestic desert-scapes.

Trump's move would make these ancient spaces vulnerable to the predations of mining, logging and oil extraction. Presidents Barack Obama and Bill Clinton used the Antiquities Act to prevent oil, gas and mining companies from reaping these pristine lands. Trump wants to give these extractive industries a green light.

Other outdoor brands, including REI, have banded together with Patagonia in the effort against the Trump administration’s massive land grab. Patagonia and REI have a long and storied history of standing up in the name of the environment and public lands. Patagonia criticized Trump when he backed out of the Paris Climate Agreement, and the company donates 1 percent of its annual sales to environmental activism (amounting to a $10 million donation in 2017).

But launching a lawsuit against a presidential administration is unprecedented for any brand.

REI states on its website:

“The nation’s outdoors have benefited from longstanding support on both the left and the right of the political spectrum. Today’s decision hurts the people who love these places. Americans enjoy our public lands in every part of the country, irrespective of politics. Not only have hikers, cyclists, climbers and hunters enjoyed national monuments, but economies have been built around them through outfitters, guides and retailers. The $887 billion outdoor recreation economy employs over 7.6 million people in good, sustainable jobs.”

Devil's Garden, Escalante. (Credit: John Fowler / Flickr CC.)

Successful lawsuits against Trump's administration would make it clear that the Antiquities Act is strictly for giving land to the public, not stealing it back to give to the oil and mining industries to exploit.

You can read more about Trump's land grab and ways to take action on Patagonia's website.  Related Stories

Video: Relief That Kills: Millions of Americans prescribed opioids become fatally addicted every year

RINF - 3 hours 35 min ago
22000 Americans are dying every year, overdosing on prescription painkillers. In 64 out of 100 cases, misuse began with people using opioids that were not prescribed to them. Linked to that… Via Youtube

Russia’s Pulling Out of Syria… Why Can’t We?

RINF - 3 hours 52 min ago
With ISIS defeated in Syria, Russian President Putin announced this week that he was withdrawing the bulk of Russian military equipment and personnel. Russian assistance was requested by the Syrian government as ISIS and al-Qaeda appeared poised to take control of the country. Meanwhile, the US has just admitted it has more than four times […]

Video: Asia’s tallest wooden tower burns to ground

RINF - 4 hours 36 min ago
A huge blaze has engulfed and destroyed a 16-story wooden tower, known as the tallest of its kind in Asia, after a fire raged through a monastery in Sichuan Province, southwest China. RT LIVE… Via Youtube

Prison Planet.com » Verified Liberals Lose Their Shit Over Trump Tweet About Senator Gillibrand

RINF - 4 hours 42 min ago
“This reads like sexual harassment” Steve WatsonPrison Planet.comDecember 12, 2017 The liberal blue check army on Twitter has gone ape over another of President Trump’s tweets, this time aimed at Senator Kirsten Gillibrand, whom he said will ‘do anything’ for campaign contributions. Lightweight Senator Kirsten Gillibrand, a total flunky for Chuck Schumer and someone who […]

Stop & search finds more drugs on white suspects, yet police continue to target black people — RT UK News

RINF - 4 hours 45 min ago
Published time: 12 Dec, 2017 18:03 White suspects are more likely to be found with drugs during police stop and searches, yet black people remain eight times more likely to be targeted. Campaigners say the disparity amounts to “institutional racism.” A report by Her Majesty’s Inspectorate of Constabulary and Fire and Rescue Services (HMICFRS) described […]

Disbelief as Boston Globe confirms median net worth of black Bostonians is $8 — RT US News

RINF - 4 hours 48 min ago
The Boston Globe had to explain there were no typographical errors in its report about Boston’s black community. Readers contacted the paper after it reported the median net worth of African-American households in the Boston area is a paltry $8. The Boston Globe’s Spotlight investigation team cited the statistic in its first installment of a […]

PressTV-UK Brexit negotiator is ‘undermining trust’: EU

RINF - 4 hours 54 min ago
The European Union’s top Brexit legislator has denounced Britain’s Brexit Minister David Davis for his comments that last week’s deal between the EU and the UK was merely “a statement of intent.” Guy Verhofstadt, the European Parliament’s Brexit coordinator, said on Tuesday that Davis’s description of the agreement was “unacceptable.” He called the deal a […]

Bad Week for 2 US Puppets

RINF - 4 hours 55 min ago
It was a bad week for two former puppets of the American Empire. In Ukraine, former Georgian president Mikheil Saakashvili was chased out of his apartment onto the roof where he threatened to jump. Police arrested him, but Saakashvili’s supporters surrounded the police van, smashed the front window, and pulled Saakashvili from the vehicle. Immediately afterwards, […]

Internet equality in question again: perspectives on Net Neutrality

Open Democracy - 5 hours 12 min ago

As the US regulator seeks to erase Net Neutrality, we ask a number of commentators to share their views on this momentous decision.

Net Neutrality is the principle that Internet Service Providers should not decide what content web users get when they connect to the internet – if I pay for internet bandwidth then decide to visit YouTube or a personal blog or openDemocracy, then I get to see whichever of those sites I request, so long as I haven’t run out of my agreed bandwidth allowance.

Its proponents say that it is what allows web users to see all web sites at the same speed – no site gets to pay an ISP to load preferentially on the web, which would be a major advantage. It’s what makes any site, big or small, rich or poor, accessible to all – it’s what lets good sites and good ideas rise up no matter who runs them, they say.

The US regulator in charge of enforcing Net Neutrality regulations is pushing to dismantle legal protections for it with a vote this Thursday 14th of December. Civil society organisations are fiercely opposing it

If the US makes this change, a serious precedent will be set to reverse Net Neutrality globally and the open web could change for good. We sought a few perspectives, for and against, on this critical issue.

“Net Neutrality is once again under attack. Ajit Pai, Chairman of the FCC, has announced his plan to “restore internet freedom” which is, as it turns out is not your freedom as a consumer to use the bandwidth you have purchased as you see fit, but rather the freedom of your ISP to charge you for whatever it wants to.

“So if you don’t want to wind up with the Portugal situation from above, go ahead and call Congress. Thankfully the website Battle for the Net makes this super easy. Do it!”

Albert Wenger, Technology writer and investor

This infographic shows how commercial providers might break down internet packages without Net Neutrality protections to stop them.

“Net neutrality echoes engineering arguments about network design that took place in the 1980s. Most engineers came to realize that modern networks need flexibility to support diverse applications, so the losing side turned to the legal/policy community to force its preferences on ISPs.

“The public, largely oblivious to the technical costs neutrality imposes on innovation, incorrectly sees Title II as a protector of free speech. Our experience of the Internet shows that its major problems come from advertising-supported platforms such as Twitter and Facebook that censor speech and reward trolls. Net neutrality doesn’t solve any real problems.”

Richard Bennett, Engineer and publisher, High Tech Forum

Supporters of net neutrality protest outside a Federal Building in Los Angeles, California on November 28, 2017. The activists gathered in protest of the Federal Communications Commission Chairman, Ajit Pai’s, plan to repeal the Obama era net neutrality regulations. Ronen Tivony/PA Images. All rights reserved.

“There’s roughly 6,000 internet and telecommunications providers in Ukraine. But national legislation does not in any way directly regulate net neutrality, and domestic providers of internet services operate as they see fit. Several of them directly violate the principle of net neutrality: for instance, for several years in a row Ukrainian mobile operators have offered tariff plans whereby users do not have to pay for social network traffic or streaming services (or if they do, then at a reduced rate).

This gives the advantage to the big services — Facebook, Twitter, Youtube. One important detail: until recently, Russian internet companies were also part of this group, but in May 2017 the authorities blocked the Russian social networks VKontakte, Odnoklassniki, the Yandex search engine and email service Mail.ru. Access to these online resources is now blocked at the provider level. So now we can say that Facebook has strengthened its monopoly, having become the main social media provider for Ukrainian internet providers.”

Vitaly Atanasov, Ukrainian journalist and administrator of a Telegram channel on digital capitalism.

“The Internet was born neutral and therefore open, non-discriminatory, diverse and free. Net neutrality is essential to guarantee that everyone has the freedom to choose what information seeks, receives and imparts on the Internet and that everyone has access to the same opportunities. The neutral digital ecosystem, where everyone is able to innovate without asking for permission, has grown to become what it is today thanks to that fundamental principle. Every lose of that basic openness to the interest of a few Internet service providers will always cause essential harms to our freedoms, democracy and society.”

XNet, Internet and democracy activist’s network

Rights:  CC by NC 4.0

PressTV-Trump rejects sexual accusations as ‘fabricated’

RINF - 5 hours 35 min ago
US President Donald Trump dismisses accusations of sexual misconduct, saying he’s the target of “false accusations and fabricated stories of women he does not know.” Trump took to Twitter on Tuesday to lash out at the three women who have accused him of sexual misconduct and urged Congress to investigate his behavior. Jessica Leeds, Samantha […]

New York protest demands end to killings in the Philippines

Fight Back News - 6 hours 24 min ago

New York, NY - On the evening of Dec. 10, approximately 70 activists gathered at the Philippine Consulate in on 5th Avenue to protest the regime of President Duterte and to demand an end to its state-sanctioned mass killings.

The rally was held on International Human Rights Day, a time to remember and reinforce the need for democracy and human rights, and to highlight the crimes against the people of the Philippines under the Duterte’s rule.

Since Rodrigo Duterte took power there has been a wave of human rights abuses. It began with the Drug Wars, which Duterte claimed was a way to cleanse the Philippines of crimes, but instead were used to murder over 13,000 civilians. Second, Duterte has reinstated martial law in Mindanao, hurting indigenous people. Most recently, Duterte forces have murdered militant fighters for democracy and named the Communist Party of the Philippines (CPP) as a terrorist organization.

The escalation of human rights abuses against people supporting the National Democratic movement began shortly after President Donald Trump’s visit.

The rally aimed to stand in solidarity with those fighting the Philippines, remember the struggles of those who died at the hands of repression, and wage forward in the fight for liberation. The event was organized by Bayan USA and was attended by members of a multitude of different organizations such as: Migrante, Gabriella NY, Anakbayan NY and NJ, NYC Students for Justice in Palestine, Committee to Stop FBI Repression - NY, and the Samidoun Palestinian Prisoners Solidarity Network.

In between speeches, the chants rang out from the people, including “No justice, no peace! No more war in the Philippines,” and “U.S. imperialist, number one terrorist!”

Organizers used a projector to shine slogans onto the walls of the consulate with phrases such as, “Fight against the fascist U.S.-Duterte regime” throughout the night’s event.

Mike Legaspi, from Bayan USA, closed the rally saying, “Rodrigo Duterte, like all the other puppet presidents, will be relegated to the garbage bin of history. It's been a little of a year since he's been president and when he came in, people of the Philippines were so optimistic. A lot of people who organize for that National Democratic movement were also optimistic because they thought he would bring an end to the decades long civil war through peace talks. He did initially open up peace talks with the National Democratic movement of the Philippines and the CPP, but he has recently cancelled these peace talks. Now Duterte and his military supporters have deemed the CPP as a terrorist. But Duterte has gone beyond this and said that the legal democratic mass movement is also terrorist. That means that he's looking for terrorists when all he has to do is look in the mirror.”

Editorial: Don't Let the Tech Giants Undermine AlterNet's Fight Against Trump

- 6 hours 36 min ago
Independent journalism is more important than ever in the era of Trump.

This fall we shared the disconcerting story of how new threats to democracy were undermining independent, progressive media like AlterNet.

Many readers responded to our call to action, and we are so grateful for the support.

The painful reality is that it’s not just Donald Trump and the right wing wreaking mind-boggling destruction on our society. Google and Facebook, giant monopolies we all use every day, have also become a serious threat to journalism and democracy. This makes it more difficult to challenge Trump.

In June, Google, under the guise of fighting fake news, and addressing the worries of corporate advertisers, implemented an algorithm change called Project Owl. It seemed like a good idea: Fighting fake news, often one of Trump's tools, is a top priority for us. 

But we and other progressive sites quickly discovered that Project Owl, while trying to eliminate fake news, hurt us by dramatically reducing the visibility of our content. We saw a sharp drop-off in traffic from Facebook as well.

How We Were Impacted

The new algorithm reduced our Google search traffic by more than 40 percent. The changes at Facebook also had a dramatic effect. Suddenly, 2 million fewer people were reading AlterNet stories every month, and millions more across the internet were not accessing progressive content.

We are suddenly faced with the reality that independent, progressive news sites have become inconvenient to the bottom line of the Google and Facebook duopoly.

The impact of Project Owl has been to invisibly censor independent news, while at the same time boost the standing of a group of mainstream print and broadcast outlets that have collaborated with these platforms to “solve” the fake-news crisis.

Take a look at our data below:

Independent Media Squeezed by the Tech Monopolies

AlterNet is currently receiving roughly 300,000 visits a week (1.2 million a month) from Google. At the beginning of 2017, AlterNet’s traffic had reached as many as 800,000 weekly visitors (3.3 million a month) from Google. The steep decline starting in early June coincided with Google’s announcement that it was changing its algorithm to reduce referral traffic from hate groups and notorious right-wing fake news operations.

In addition, Facebook is now sending an audience size to AlterNet only half of what it was in the first five months of the year; we were getting 2.3 million visitors a month through May, and it cratered to 1.2 million each month by the fall.

Overall, AlterNet’s monthly traffic has stabilized since August between 3 and 3.5 million unique visitors, but we are missing millions of visits a month that we had been getting for years. That’s a lot of people who are not being exposed to the counter-narrative against the corporate media and its enablers of the hard-right Trump agenda.

The Good News

Faced with this crisis, we appealed to you, our community. The response was fantastic, with financial contributions and support. As a result, we have stabilized our short-term advertising revenue for now.

Unfortunately, the larger duopoly information problem still exists. We must dedicate ourselves to a long-term fight. Other sites like Salon, Democracy Now, Media Matters and many more have had significant traffic drops. And it could get worse. 

The bottom line, as scholar Jonathan Taplin’s recent op-ed "Can the Tech Giants be Stopped?" makes quite clear, is that “Digital technology has become critical to the personal and economic well-being of everyone on the planet, but decisions about how it is designed, operated and developed have never been voted on by anyone… It is time for that to change.”

What We Are Doing About the Duopoly Problem

AlterNet feels that the long-term future of independent media is at risk. Progressive media is a crucial element in fighting back and stopping a total right-wing and corporate takeover. Tech giants have a firm grip over the information channels, and we must aggressively resist their attempts to marginalize our voices.

We all need to fight back. Working with the Media Consortium, in January 2018, we plan to bring together the independent media sector to better understand the issues and prepare to fight back.

  • We call on Google to rescind the algorithm changes made under Project Owl and instead consider adopting a more transparent method of determining what is fake news.
  • We call on the public, the FTC and Congress to consider regulating Facebook and Google as monopoly platforms for the distribution of content.

What About Trump and the Right Wing?

Despite the monopoly challenges, AlterNet is fiercely fighting the Trump agenda every day, 24/7. White supremacy, toxic masculinity, anti-science, anti-immigrant, anti-democracy—these are all essential elements of the Trump administration and the rabid right-wingers in Congress.

AlterNet still has one of the biggest audiences in progressive online media. We need your support to continue to provide all of our readers with the reporting and analysis necessary to fight back and make it through the crisis we face as a news organization, and as a democracy at large.

Can we count on you to help?

Warmly,

 

Don Hazen
Executive Editor, AlterNet

 

P.S.: If you'd like to make a donation to AlterNet, click here. Your contribution is 100% tax-deductible.


 

Could the end of Britain’s tabloid-driven migration policy be in sight?

Open Democracy - 7 hours 9 min ago

Right now, there’s a political window for a more sensible, positive approach to migration that could boost regional economies, strengthen productivity and help achieve trade deals, a new report finds.

Image: Just a few of the Daily Express's anti-migrant front pages

Veterans of the migration debate know better than to predict the future. But following years of continued growth, it seems like immigration to the UK may have finally peaked. This slowdown, alongside the outcome of the EU referendum, has influenced the tone of the debate. According to the polling, migration has fallen down the public’s list of concerns. And politicians seem to have taken note.

The Government has been taking tentative steps towards a more rational approach towards international students, highly skilled migrants and EU workers. Today, for example, immigration minister Brandon Lewis announced that the government would streamline the application process for EU migrants to achieve 'settled status', from a controversial 85-page form to a short online process - something the IPPR called for back in March. And in general, rather than deferring to the whims of the right-wing press, the approach now seems to be to let the Migration Advisory Committee, a panel of independent experts, arbitrate. 

We should take full advantage of this possibly brief period of calm. Following years of tabloid-driven crisis management, here is an opportunity to take stock and set out what the country aims to achieve through its immigration policy.

So what should be the aims? As underlined by IPPR’s Commission on Economic Justice, the UK economy faces big challenges – from stagnant wage and productivity growth, to widening regional inequality and trade imbalances. Our call is for migration policy to be designed not in isolation but with the explicit aim of taking on these problems. In our report, we set out how to do this.

Take widening regional inequality. At present, migration flows reflect the disparities which divide the UK – skilled migrants concentrate disproportionately in the parts of the country where there are the most jobs and opportunities. Our analysis shows that new migration is effectively zero in many parts of the UK today.

Rather than address this challenge, current policy decisions are exacerbating these inequalities. The wage thresholds used to determine whether migrants qualify for skilled visas reflect London salaries. So parts of the country where wages are lower find it harder to compete. Reversing this would be relatively simple: thresholds for areas outside the capital and the South East could be set at a lower level creating an incentive for international talent to flow in that direction. This more level playing field is essential for parts of the UK which are increasing held back by population decline and skills shortages, such as Scotland and the North East.

Smarter immigration policies could also be part of the solution to the UK’s productivity puzzle. On the one hand, the current system of work permits could be actively used to incentivise employers to invest in improving the skills and working conditions of UK workers. Employers who can demonstrate that they offer good terms and invest in training could earn the status of Trusted Sponsors. In return they would benefit from a series of perks, such as more flexibility, less bureaucracy and smaller fees. And the immigration system could work much harder to ensure that the UK remains a destination of choice for international talent – from engineers and programmers to world class architects and designers. In the wake of Brexit, attracting these people is going to take more work than before. The UK should launch a Global Talent Visa to ensure it can still compete.

Until now, the UK has failed to translate growing migration flows into stronger trading links. At present Germany has a better trade balance with India than the UK, despite the fact that its sub-continental diaspora is comparatively tiny. This is despite the evidence that migrants are a powerful asset when it comes to opening new markets, particularly in services. Their skills and networks help lower the social, linguistic and cultural barriers which can act as a stronger inhibitor than tariffs and customs. Pilots suggest that programmes which actively engage migrants currently in the UK could boost trade with key emerging countries.

For too long the migration debate has taken place at fever pitch. Bad policy decisions have ensued. It’s time for a fresh start. 

Sideboxes Related stories:  Another lonely Skype Christmas, thanks to the ‘minimum income requirement’? Post-facts, post-gains: the economics of labour migration after Brexit Free Movement Plus: a third way on the Brexit/migration debate Rights:  CC by NC 4.0

Principled pragmatism: defending normative Europe

Open Democracy - 7 hours 22 min ago

European security and defence policy, once propelled by Franco-British cooperation, has been held back of late by Nato enthusiasts. Without the UK, can the Commission advance a new Defence Action Plan? Book review.

Israeli Prime Minister Benjamin Netanyahu and the EU foreign policy chief Federica Mogherini are at the EU foreign ministers' meeting in Brussels on December 11, 2017. EU/Press Association. All rights reserved.During the referendum on British membership of the European Union, one of the many charges against the European Union put forward by the leave campaign was fear of a European army. There has also been talk of an emerging European ‘security-industrial complex’ as a range of surveillance systems are introduced as part of EU counter-terror measures and as defence research and defence co-operation are stepped up (see Chris Jones, oD, 31 August 2017).

But the situation is much more complex and contradictory than these negative depictions suggest. It is important that those of us who still believe in ‘normative Europe’ – the idea of the European Union as a peace and human rights project – understand these contradictions and the possibilities they open up for a more transformational agenda.

Nathalie Tocci’s book is a useful corrective to the more pessimistic portrayals of current developments within the European Union. Tocci is Director of the Italian Institute for International Affairs and advisor to Federica Mogherini, the High Representative for Common Foreign and Security Policy and Vice President of the European Commission. She was tasked with drafting two documents – an initial statement of the strategic context facing the EU, presented to the European Council in June 2015, entitled The European Union in a Changing Global Environment: A More Connected, Contested and Complex World, which paved the way for a European strategy document, presented to the European Council the day after the Brexit vote, entitled Shared Vision, Common Action: A Stronger Europe. A Global Strategy for the European Union’s Foreign and Security Policy’ (EUGS).

The book, ‘Framing the EU Global Strategy’, offers a fascinating insight into how these collective documents are produced, even though both documents are unusual in that they both involved greater public consultation than normally happens, while at the same time – probably owing to the deft steerage of both Mogherini and Tocci – they both manage to be coherent and readable. It provides a guide to reading the global strategy and an explanation of some of the concepts developed in the strategy document, and also gives some indication of what has happened since in terms of implementation.

The book starts by way of a contrast to the European Security Strategy (ESS) produced when Javier Solana was High Representative, entitled ‘A Secure Europe in a Better World’ and approved by the European Council in December 2003. First of all, the EUGS is a global strategy not a security strategy even though, of course, it includes security. It is global not only in the sense of encompassing EU relations with the whole world but also in the sense of bringing together a whole range of instruments. Mogherini, like Cathy Ashton before her, is double hatted. She represents both the European Council, composed of member states where the main instruments are defence and diplomacy, and the European Commission, where the instruments are much broader including aid, development policy, conditionality, dialogue, humanitarian assistance, support for civil society, research and education, transport and so on – that is, all the necessary twenty-first century components of a global strategy.  

Secondly, the ESS is a strategic vision rather than an actionable policy document. The policy options were much easier for Solana in the early 2000s so he was keen to get agreement on the overall direction of ESDP rather than specific policies, which might have diluted and complicated the document. The global strategy as can be seen from its website has become a policy framework for Mogherini and her team.

Thirdly, and most importantly, the international context has utterly changed. The ESS was drafted in a mood of optimism about the international liberal order despite the US invasion of Iraq earlier that year. Indeed it was a European response to the invasion – an attempt to overcome the cleavage created by the support of some countries for the invasion (most notably the UK and Spain). It represented a contrast to the US National Security Strategy published that year, which made the case for pre-emptive defence (the illegal grounds on which the invasion was justified) and counter-proliferation as a new militaristic approach to the spread of nuclear weapons; the ESS counterposed ‘preventive engagement’. The most successful example of that was the negotiations with Iran initiated by Solana but completed under Cathy Ashton.

The situation facing the EU in 2015 as Mogherini assumed her dual EU role, was very different and about to get worse. There were internal cleavages over the euro, over refugees and migrants and over the aggressive role of Russia; and far from moving towards a liberal international order, the EU faces worsening violence and disorder in its southern neighbourhood, especially Syria, Libya, Mali, Somalia, DRC, S. Sudan, Yemen and more; growing reversals of democratic achievements especially in Turkey and Egypt; not to mention, growing geopolitical rivalries as well as poverty and deprivation, climate change, and transnational crime.

The aim of the EUGS was to preserve the transformational agenda of the ESS while being realistic about the context. The second part of Tocci’s title, ‘A Stronger Europe in a Fragile World’ is a deliberate play on the title of the ESS – ‘ A More Secure Europe in a Better World’– and a statement of ambition. Tocci explains this in terms of a ‘pragmatic philosophy’ that ‘looks at the world as it is and not as it [the EU] would like to see it… that entails a rejection of universal truths, an emphasis on the practical consequences of acts and a focus on local practices and dynamics… In doing so, however, the Union should not fall into the trap of cultural relativism. EU pragmatism should be principled. While different pathways, recipes and models are to be embraced, international law and its underlying norms should be the benchmark of what is acceptable to the EU and what is not.’ Loc. 1314

In terms of content, the EUGS is divided into four sections: interests, principles, priorities and ‘from vision to action’. Some argued that it ought to begin with values rather than interests. But as Tocci points out, any constructivist understands that interests and values are much the same. ‘Our interests and our values go hand in hand. We have an interest in promoting our values in the world. At the same time our fundamental values are embedded in our interests.’ Interests, as laid out in the EUGS, include security, prosperity, democracy, and a rules-based global order. As Tocci points out, the fourth is necessary for the first three:‘When walls and fences are built to keep away refugees in search of protection in the EU, the moral blow to our internal democratic system is incalculable.’

Principles include engagement, responsibility, unity and partnership. Priorities include security; the resilience of states and societies in the East and South; an integrated approach to conflicts and crises; cooperative regional orders; and global governance for the twenty-first century. The last part of the EUGS contains concrete proposals for a more, credible, responsive and joined-up union.

In terms of implementation, it is the defence and security part and the conflict and crises part that has, in the jargon, been actioned. In the case of defence and security, this is where  the critics get nervous. The reason for the prioritisation of security is partly public opinion. Eurobarometer figures show that public support for European security is greater than any other area even in the UK. But another reason is Brexit.

Although the European Security and Defence Policy (ESDP) was originally propelled forward by Franco-British cooperation in the Blair years, Conservative governments have acted as a brake on European security co-operation, since they favour NATO. Now without the UK, the Commission has been able to produce a European Defence Action Plan and is providing financial incentives for developing joint defence capabilities (funding would be exempt from the Stability and Growth pact, e.g. austerity constraints) and is supporting defence research projects.

External crisis response

But what is proposed for European defence is very different from classic national and Nato defence and this has to be understood. National and Nato defence are about defending borders from geo-political threats; they are about planning for the next war. European defence, EUGS argues, is about external crisis response – peace-keeping for example, building the security and defence capabilities of partners, and about the protection of the Union and its citizens. This last is about citizens rather than territory. It is about the cross-over between internal and external security, and about new issues like cyber security, or terrorism or the protection of critical infrastructure. It is more about policing and intelligence than tanks and aircraft.

In other words European defence and security policy does not consist of a European army. It involves a different combination of capabilities designed for situations other than classic inter-state war. It is an expression of the EU as a new kind of polity, not a super-state in the making but a regional organisation aimed at preserving the advantages of trans-European society by extending those advantages outwards. Of course there are some inconsistent elements in the EUGS, and Tocci duly explains how difficult it was to escape from certain facets of geographical reasoning.

And of course, Mogherini faces huge obstacles. Many member states are moving in opposite directions, building walls and fences and dismantling the machinery of rights. The traditional defence industries are keen to get in on the act and may impose their own trajectories on defence co-operation. Meanwhile, the whole European response to migrants has constructed a self-reproducing border industry, with counter-terror imperatives leading to terrifying degrees of surveillance. However, it must be pointed out that EU cyber security policy emphasises human rights and privacy in contrast to national policies ( see Genevieve Schmeder and Emmanuel Darmois, oD). But a reading of Tocci’s book demonstrates the earnest commitment of the collective effort involved in the EUGS to lay out a new kind of twenty-first century approach to peace and security.

One final comment. The EUGS was steered through by two powerful women. I am left with the question of what role gender played, not only in the personal resistance they must have faced, but in the elaboration of a more inclusive, less muscular, and, as Mogherini points out in her forward, more ‘incisive’, conception of security.

Sideboxes Related stories:  The ongoing march of the EU’s security-industrial complex Cybersecurity: the case for a European approach EU-Russia relations: towards a pro-active agenda Country or region:  EU Topics:  Conflict Democracy and government Ideas International politics Rights:  CC by NC 4.0

Nothing Protects Black Women From Dying in Pregnancy and Childbirth

- 8 hours 7 min ago
Not education. Not income. Not even being an expert on racial disparities in health care.

This story was co-published with NPR.

On a melancholy Saturday this past February, Shalon Irving’s “village” — the friends and family she had assembled to support her as a single mother — gathered at a funeral home in a prosperous black neighborhood in southwest Atlanta to say goodbye and send her home. The afternoon light was gray but bright, flooding through tall arched windows and pouring past white columns, illuminating the flag that covered her casket. Sprays of callas and roses dotted the room like giant corsages, flanking photos from happier times: Shalon in a slinky maternity dress, sprawled across her couch with her puppy; Shalon, sleepy-eyed and cradling the tiny head of her newborn daughter, Soleil. In one portrait Shalon wore a vibrant smile and the crisp uniform of the Commissioned Corps of the U.S. Public Health Service, where she had been a lieutenant commander. Many of the mourners were similarly attired. Shalon’s father, Samuel, surveyed the rows of somber faces from the lectern. “I’ve never been in a room with so many doctors,” he marveled. “… I’ve never seen so many Ph.D.s.”

At 36, Shalon had been part of their elite ranks — an epidemiologist at the Centers for Disease Control and Prevention, the preeminent public health institution in the U.S. There she had focused on trying to understand how structural inequality, trauma and violence made people sick. “She wanted to expose how peoples’ limited health options were leading to poor health outcomes. To kind of uncover and undo the victim blaming that sometimes happens where it’s like, ‘Poor people don’t care about their health,’” said Rashid Njai, her mentor at the agency. Her Twitter bio declared: “I see inequity wherever it exists, call it by name, and work to eliminate it.”

Much of Shalon’s research had focused on how childhood experiences affect health over a lifetime. Her discovery in mid-2016 that she was pregnant with her first child had been unexpected and thrilling.

Then the unthinkable had happened. Three weeks after giving birth, Shalon had collapsed and died.

The sadness in the chapel was crushing. Shalon’s long-divorced parents had already buried both their sons; she had been their last remaining child. Wanda Irving had been especially close to her daughter — role model, traveling companion, emotional touchstone. She sat in the front row in a black suit and veiled hat, her face a portrait of unfathomable grief. Sometimes she held Soleil, fussing with her pink blanket. Sometimes Samuel held her, or one of Shalon’s friends.

A few of Shalon’s villagers rose to pay tribute; others sat quietly, poring through their funeral programs. Daniel Sellers, Shalon’s cousin from Ohio and the baby’s godfather, spoke for all of them when he promised Wanda that she would not have to raise her only grandchild alone. “People say to me, ‘She won’t know her mother.’ That’s not true,” Sellers said. “Her mother is in each and every one of you, each and every one of us. … This child is a gift to us. When you remember this child, you remember the love that God has pushed down through her for all of us. Soleil is our gift.”

Underneath the numb despair was a profound sense of failure — and an acute understanding of what Shalon’s death represented. The researcher working to eradicate disparities in health access and outcomes had become a symbol of one of the most troublesome health disparities facing black women in the U.S. today, disproportionately high rates of maternal mortality. The main federal agency seeking to understand why so many American women — especially black women — die and nearly die from complications of pregnancy and childbirth had lost one of its own. Even Shalon’s many advantages — her B.A. in sociology, her two master’s degrees and dual-subject Ph.D., her gold-plated insurance and rock-solid support system — had not been enough to ensure her survival. If a village this powerful hadn’t been able to protect her, was any black woman safe?

The memorial service drew to a close, the bugle strains of “Taps” as plaintive as a howl. Two members of the U.S. Honor Guard removed the flag from Shalon’s coffin and held it aloft. Then they folded it into a precise triangle small enough for Wanda and Samuel to hold next to their hearts.

In recent years, as high rates of maternal mortality in the U.S. have alarmed researchers, one statistic has been especially concerning. According to the CDC, black mothers in the U.S. die at three to four times the rate of white mothers, one of the widest of all racial disparities in women’s health. Put another way, a black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, but 300 percent more likely to die from pregnancy- or childbirth-related causes. In a national study of five medical complications that are common causes of maternal death and injury, black women were two to three times more likely to die than white women who had the same condition.

That imbalance has persisted for decades, and in some places, it continues to grow. In New York City, for example, black mothers are 12 times more likely to die than white mothers, according to the most recent data; from 2001 to 2005, their risk of death was seven times higher. Researchers say that widening gap reflects a dramatic improvement for white women but not for blacks.

The disproportionate toll on African Americans is the main reason the U.S. maternal mortality rate is so much higher than that of other affluent countries. Black expectant and new mothers in the U.S. die at about the same rate as women in countries such as Mexico and Uzbekistan, the World Health Organization estimates.

What’s more, even relatively well-off black women like Shalon Irving die or nearly die at higher rates than whites. Again, New York City offers a startling example: A 2016 analysis of five years of data found that black college-educated mothers who gave birth in local hospitals were more likely to suffer severe complications of pregnancy or childbirth than white women who never graduated from high school.

The fact that someone with Shalon’s social and economic advantages is at higher risk highlights how profound the inequities really are, said Raegan McDonald-Mosley, the chief medical officer for Planned Parenthood Federation of America, who met her in graduate school at Johns Hopkins University and was one of her closest friends. “It tells you that you can’t educate your way out of this problem. You can’t health-care-access your way out of this problem. There’s something inherently wrong with the system that’s not valuing the lives of black women equally to white women.”

For much of American history, these types of disparities were largely blamed on blacks’ supposed innate susceptibility to illness — their “mass of imperfections,” as one doctor wrote in 1903 — and their own behavior. But now many social scientists and medical researchers agree, the problem isn’t race but racism.

The systemic problems start with the type of social inequities that Shalon studied — differential access to healthy food and clean drinking water, safe neighborhoods and good schools, decent jobs and reliable transportation. Black women are more likely to be uninsured outside of pregnancy, when Medicaid kicks in, and thus more likely to start prenatal care later and to lose coverage in the postpartum period. They are more likely to have chronic conditions such as obesity, diabetes, and hypertension that make having a baby more dangerous. The hospitals where they give birth are often the products of historical segregation, lower in quality than those where white mothers deliver, with significantly higher rates of life-threatening complications.

Those problems are amplified by unconscious biases that are embedded throughout the medical system, affecting quality of care in stark and subtle ways. In the more than 200 stories of African-American mothers that ProPublica and NPR have collected over the past year, the feeling of being devalued and disrespected by medical providers was a constant theme. The young Florida mother-to-be whose breathing problems were blamed on obesity when in fact her lungs were filling with fluid and her heart was failing. The Arizona mother whose anesthesiologist assumed she smoked marijuana because of the way she did her hair. The Chicago-area businesswoman with a high-risk pregnancy who was so upset at her doctor’s attitude that she changed OB-GYNs in her seventh month, only to suffer a fatal postpartum stroke.

Over and over, black women told of medical providers who equated being African American with being poor, uneducated, noncompliant and unworthy. “Sometimes you just know in your bones when someone feels contempt for you based on your race,” said one Brooklyn woman who took to bringing her white husband or in-laws to every prenatal visit.

Hakima Tafunzi Payne, a mother of nine in Kansas City, Missouri, who used to be a labor-and-delivery nurse and still attends births as a student midwife, has seen this cultural divide as both patient and caregiver. “The nursing culture is white, middle-class, and female, so is largely built around that identity. Anything that doesn’t fit that identity is suspect,” she said. Payne, who is also a nurse educator lecturing on unconscious bias for professional organizations, recalled “the conversations that took place behind the nurse’s station that just made assumptions — a lot of victim blaming, ‘If those people would only do blah, blah, blah, things would be different.’”

Black expectant and new mothers frequently told us that doctors and nurses didn’t take their pain seriously — a phenomenon borne out by numerous studies that show pain is often undertreated in black patients for conditions from appendicitis to cancer. When Patrisse Cullors, a cofounder of the Black Lives Matters movement who has become an activist to improve black maternal care, had an emergency C-section in Los Angeles in March 2016, the surgeon “never explained what he was doing to me,” she said. The pain medication didn’t work: “My mother basically had to scream at the doctors to give me the proper pain meds.” When white people advocate for themselves or their family members, she said, providers “think they’re acting reasonably. When black people are advocating for our family members, we’re complaining, we’re being uppity, we don’t know what we're talking about, we’re exaggerating.”

Limited diversity in the medical profession contributes to the black mothers’ sense of alienation. Blacks make up 6 percent of doctors (though 11 percent of OB-GYNs), 3 percent of medical school faculty and less than 2 percent of National Institutes of Health-funded principal investigators. “That's a real problem that across the spectrum that [black women] are not feeling listened to and respected—that’s a structural problem,” said Monica McLemore, a nursing professor at the University of California­, San Francisco, who has conducted focus groups with dozens of mothers as part of a $50 million initiative to reduce preterm births. “The health sector doesn’t want to admit how much of this is about us.”

But it’s the discrimination that black women experience in the rest of their lives — the double-whammy of race and gender — that may ultimately be the most significant factor in poor maternal outcomes. An expanding field of research shows that the stress of being a black woman in American society can take a significant physical toll during pregnancy and childbirth.

“It’s chronic stress that just happens all the time — there is never a period where there’s rest from it, it’s everywhere, it’s in the air, it’s just affecting everything,” said Fleda Mask Jackson, an Atlanta researcher and member of the Black Mamas Matter Alliance who studies disparities in birth outcomes.

It’s a type of stress from which education and class provide no protection. “When you interview these doctors and lawyers and business executives, when you interview African-American college graduates, it’s not like their lives have been a walk in the park,” said Michael Lu, a longtime disparities researcher and former head of the Maternal and Child Health Bureau of the Health Resources and Services Administration, the main federal agency funding programs for mothers and infants. “It’s the experience of having to work harder than anybody else just to get equal pay and equal respect. It’s being followed around when you’re shopping at a nice store, or being stopped by the police when you’re driving in a nice neighborhood.”

Arline Geronimus, a professor at the University of Michigan School of Public Health, coined the term “weathering” for how this continuous stress wears away at the body. Weathering “causes a lot of different health vulnerabilities and increases susceptibility to infection,” she said, “but also early onset of chronic diseases, in particular, hypertension and diabetes” — conditions that disproportionately affect blacks at much younger ages than whites. It accelerates aging at the cellular level; in a 2010 study, Geronimus and colleagues found that the telomeres (chromosomal markers of aging) of black women in their 40s and 50s appeared 7 1/2 years older on average than those of whites.

Weathering can have particularly serious repercussions in pregnancy and childbirth, the most physiologically complex time in a woman’s life. Stress has been linked to one of the most common and consequential pregnancy complications, preterm birth. Black women are 48 percent more likely than whites to deliver prematurely (and, closely related, black infants are twice as likely as white babies to die before their first birthday). Here again, income and education aren’t protective. 

The effects on the mother’s health may also be far-reaching. Maternal age is an important risk factor for many severe pregnancy-related complications, as well as for chronic diseases that can affect pregnancy, like hypertension. “As women get older, birth outcomes get worse,” Lu said. “If that happens in the 40s for white women, it actually starts to happen for African-American women in their 30s.”

This means that for black women, the risks for pregnancy likely start at an earlier age than many clinicians — and women— realize, and the effects on their bodies may be much greater than for white women. This doesn’t mean that pregnancy should be thought of as inherently scary or dangerous for black women (or anyone). It does mean, in Geronimus’ view, that “a black woman of any social class, as early as her mid-20s, should be attended to differently” — with greater awareness of the potential challenges ahead.

That’s a paradigm shift that professional organizations and providers have barely begun to wrap their heads around. “There may be individual doctors or hospitals that are doing it [accounting for the higher risk of black women], but ... there’s not much of that going on,” Lu said. Should doctors and clinicians be taking into consideration this added layer of vulnerability?

“Yeah,” Lu said. “I truly think they should.”

Shalon Irving’s history is almost a textbook example of the kinds of strains and stresses that make high-achieving black women vulnerable. The child of two Dartmouth graduates, she grew up in Portland, Oregon, where her father’s father was pastor of a black church. Even in its current liberal incarnation, Portland is one of the whitest large cities in the U.S.

Thirty years ago, Portland was a much more uncomfortable place to be black. African-American life there was often characterized by social isolation, which Geronimus’ research suggests can be especially stressful. Samuel Irving spent years working as a railroad engineer; he got a law degree and later ran a city agency, but felt his prospects were still constrained by his race. Wanda held various jobs in marketing and communications, including at the U.S. Forest Service. In elementary school, Shalon was sometimes the only African-American kid in her class. “There were many mornings where she would stand outside banging on the door wanting to come back into the house because she didn’t want to go to school,” her mother recently recalled.

Shalon’s strategy for fitting in was to be smarter than everyone else. She read voraciously, wrote a column for a black-owned weekly newspaper and skipped a grade. Books and writing helped her cope with trauma and sorrow — first the death of her 20-month-old brother Simone in a car accident when she was six, then the fracturing of her parents’ marriage, then the diagnosis of her beloved older brother, Sam III, with a virulent form of early-onset multiple sclerosis when he was 17. Amid all the family troubles, Shalon was funny and driven, with a fierce sense of loyalty and “a moral compass that was amazing,” her mother said. She was also overweight and often anxious, given to daydreaming (as she later put it) about “alternative realities where people hadn’t died and things had not been lost.” When it came time to go away to college, she chose the historically black Hampton University in Virginia. “She wanted to feel that nurturing environment,” Wanda said. “She had had enough.”

By then, Shalon had noticed that many of her relatives — her mother’s mother, her aunts, her far-flung cousins — died in their 30s and 40s. Her brother, Sam III, sardonically joked that the family had a “death gene,” but Shalon didn’t think that was funny. “She didn’t understand why there was such a disparity with other families that had all these long lives,” Wanda said. Shalon nagged her father to stop smoking and her mother to lose weight. She set an example, shedding nearly 100 pounds while managing to graduate summa cum laude. At the start of graduate school at Purdue University, she was a svelte 138 pounds, “very classy and elegant, a lot like her mom,” said Bianca Pryor, a master’s student in consumer behavior who became one of what Shalon called her cherished circle of “sister friends.”

They were all bearing the same burden. “There’s this feeling that we’re carrying the expectations of generations, the first ones trying to climb the corporate ladder, trying to climb in academe,” said Pryor, now a marketing executive in New York City. “There is this idea that we have to work twice as hard as everyone else. But there’s also, ‘I’m first-generation, I don’t know the ropes, I don’t how to use my social capital.’ There’s a bit of shame in that … this constant checking in with yourself — am I doing this right?”

Shalon set the bar especially high: She was pursuing a double Ph.D. in sociology and gerontology, focusing on themes she would return to often — the long-term effects of early childhood trauma and maltreatment, the impact of the parent-child relationship on lifelong health. She finished in under five years, once again with top honors — “one of the best writers I’ve had in my academic career,” her adviser, sociologist Kenneth Ferraro, said.

She tried teaching, then decided to pursue a second master’s degree, this time from Johns Hopkins. She was also juggling family responsibilities. Wanda had followed Shalon around the country, earning her own master’s degree and working in nonprofit management. “They were like the ‘Gilmore Girls,’” Pryor said. In 2008, Sam III joined them in Baltimore to take part in a study on an experimental MS therapy. With his family’s support, he’d managed to finish college and run a poetry-slam nonprofit for kids. His next goal was to walk across the stage to receive his diploma instead of using his wheelchair. In February 2009, while he was doing physical rehab to regain strength in his legs, a blood clot traveled to his lung, killing him at the age of 32. Afterward, Wanda and Shalon clung to each other more tightly than ever.

In 2011 came what Ferraro called Shalon’s “change-the-world opportunity” — a consulting gig at the CDC with Michelle Obama’s “Let’s Move!” initiative. Soon she joined the agency’s prestigious Epidemic Intelligence Service, a training program in applied epidemiology — in her case, with a focus on community health — whose members served as first responders in health emergencies. As part of the uniformed ranks of the U.S. Public Health Service, she could eventually discharge her student debt — more than $165,000 for Hopkins alone — travel, buy a house. “The permanence was very appealing,” Pryor said.

What Shalon wasn’t prepared for was how unfulfilled she was. After Johns Hopkins, she had worked on the frontlines helping at-risk infants, teenage girls and mothers with HIV/AIDS. She was passionate about improving food and housing security to reduce people’s risk for high blood pressure and other cardiovascular problems, but felt like much of her CDC research ended up sitting on a shelf. It bothered her that she rarely met the people behind the data she was analyzing. “She might see the numbers, but I don’t think she actually saw that little girl or little boy have a healthier lunch,” Pryor said.

The stress and frustration triggered the old corrosive self-doubts. But gradually, Shalon saw a way out of the box. She joined the CDC’s Division of Violence Prevention, refocusing on issues around trauma and domestic abuse— a mission she saw as “liberating” for African-American women, Wanda said. She started a coaching business called Inclusivity Standard to advise young people from disadvantaged backgrounds who wanted to get into college or grad school, as well as organizations seeking to become more diverse. She enlisted her mother, now working as a consultant, and Pryor to join her team. And she decided to write a self-help book, on the theory that many people in the communities she cared about couldn’t afford psychotherapy or didn’t trust it. “She was one of those people — one thing is just not enough,” said her coauthor Habiba Tran, a therapist and life coach with a multicultural clientele. “One modality is just not enough. One way of [reaching people] is just not enough.”

Shalon couldn’t remember a time when she didn’t want to be a mother. But her romantic life had been a “20-year dating debacle,” she admitted in the manuscript of her self-help book, in part because “I am deathly scared of heartbreak and disappointment, and letting people in comes with the very real risk of both.”

In 2014, when Shalon was 34, medical problems forced the issue. For years she’d been suffering from uterine fibroids — non-malignant tumors that affect up to 80 percent of black women, leading to heavy menstrual bleeding, anemia and pelvic pain. No one knows what causes fibroids or why blacks are so susceptible. What is known is that the tumors can interfere with fertility — indeed, black women are nearly twice as likely to have infertility problems as whites, and when they undergo treatment, there’s much less likelihood that the treatments will succeed. Surgery bought her a little time, but her OB-GYN urged her not to delay getting pregnant much longer.

Shalon had spent her adult years defying stereotypes about black women; now she wrestled with the reality that by embracing single motherhood, she could become one. The financial risk was substantial — she’d just purchased a town house in the quiet Sandy Springs area north of Atlanta, and her CDC insurance only covered artificial insemination for wives using their husbands’ sperm. In Portland, no one would have blinked an eye at an unmarried professional woman having a child on her own, but in Atlanta, “there is very much a vibe there that things should happen in a certain order,” Pryor said. “And Shalon was not having that at all. She was like, ‘Nope, this is what it is.’”

The gamble — funded with her parents’ help — ended in a series of devastating failures. In September 2015, in the midst of one unsuccessful insemination treatment, Shalon was alarmed to discover that her right arm had become swollen and hard. Doctors found a blood clot and diagnosed her with Factor V Leiden, a genetic mutation that makes blood prone to abnormal clumping. Suddenly a part of the family’s medical mystery was solved. Wanda’s mother had died of a pulmonary embolism, so had Sam III, so had other members of their extended family. But no one had been tested for the mutation, which is primarily associated with European ancestry. Had they known they carried it, maybe Sam’s deadly blood clot could have been prevented. It was a what-if too painful to dwell on.

By April 2016, Shalon had given up. She had a new boyfriend and she was on her way to Puerto Rico to help with the CDC’S Zika response, working to prevent the spread of the virus to expectant mothers and their unborn babies. There she discovered she’d gotten pregnant by accident. Her excitement was tempered by fear that the baby might have contracted Zika, which can cause microcephaly and other birth defects. But a barrage of medical tests confirmed all was well.

More good news: A few weeks later Pryor learned she was pregnant, too. “All right,” she told Shalon, “let’s finally go after our rainbows and unicorns! Because for so long it was just dark clouds and rain.”

In reality, Shalon’s many risk factors — including her clotting disorder, her fibroid surgery, the 36 years of wear and tear on her telomeres, her weight — boded a challenging nine months. She also had a history of high blood pressure, though it was now under control without medication. “If I was the doctor taking care of her, I'd be like, ‘Oh, this is going to be a tough one,’” her OB-GYN friend Raegan McDonald-Mosley said.

Shalon got through the physical challenges surprisingly well. Her team at Emory University, one of the premier health systems in the South, had no trouble managing her clotting disorder with the blood thinner Lovenox. They worried that scarring from the fibroid surgery could result in a rupture if her uterus stretched too much, so they scheduled a C-section at 37 weeks. At several points, Shalon’s blood pressure did spike, Wanda said, but doctors ruled out preeclampsia (pregnancy-induced hypertension) and the numbers always fell back to normal.

Wanda blamed stress. There was the painful end to Shalon’s romance with her baby’s father and her dashed hopes of raising their child together. There were worries about money and panic attacks about the difficulties of being a black single mother in the South in the era of Trayvon Martin and Tamir Rice. Shalon told everyone she was hoping for a girl.

Steeped in research about how social support could buffer against stress and adversity, Shalon joined online groups for single moms and assembled a stalwart community she could quickly deploy for help. “She was all about the village,” Rashid Njai said. “She’d say, ‘I’m making sure that when I have my baby, the village is activated and ready to go.’”

She poured more of her anxious energy into finishing the first draft of the book. She sent Tran the manuscript on Jan. 2, the day before the planned C-section, then typed one last note to her child. Boy or girl, its nickname would be Sunny, in honor of her brother Sam, her “sunshine.”

“You will always be my most important accomplishment,” she wrote. “No words have been created to adequately capture the fear and love and excitement that I feel right now.”

Until recently, much of the discussion about maternal mortality has focused on pregnancy and childbirth. But according to the most recent CDC data, more than half of maternal deaths occur in the postpartum period, and one-third happen seven or more days after delivery. For American women in general, postpartum care can be dangerously inadequate — often no more than a single appointment four to six weeks after going home. “If you’ve had a cesarean delivery, if you’ve had preeclampsia, if you’ve had gestational diabetes or diabetes, if you go home on an anticoagulant — all those women need to be seen significantly sooner than six weeks,” said Haywood Brown, a professor at Duke University medical school. Brown has made reforming postpartum care one of his main initiatives as president of the American Congress of Obstetricians and Gynecologists.

The dangers of sporadic postpartum care may be particularly great for black mothers. African Americans have higher rates of C-section and are more than twice as likely to be readmitted to the hospital in the month following the surgery. They have disproportionate rates of preeclampsia and peripartum cardiomyopathy (a type of heart failure), two leading killers in the days and weeks after delivery. They’re twice as likely as white women to have postpartum depression, which contributes to poor outcomes, but they are much less likely to receive mental health treatment. If they experience discrimination or disrespect during pregnancy or childbirth, they may be more likely to skip postpartum visits to check on their own health (they do keep pediatrician appointments for their babies). Lack of paid maternity leave and childcare can create additional hurdles. In one study published earlier this year, two-thirds of low-income black women never made it to their doctor visit.

Meanwhile, many providers wrongly assume that the risks end when the baby is born — and that women who came through pregnancy and delivery without problems will stay healthy. In the case of black women, providers may not understand their true biological risks or evaluate those risks in a big-picture way. “The maternal experience isn’t over right at delivery. All of the due diligence that gets applied during the prenatal period needs to continue into the postpartum period,” said Eleni Tsigas, executive director of the Preeclampsia Foundation.

It’s not just doctors and nurses who need to think differently. Like a lot of expectant mothers, Shalon had an elaborate plan for how she wanted to give birth, even including what she wanted her surgical team to talk about (nothing political) and who would announce the baby’s gender (her mother, not a doctor or nurse). But like most pregnant women, she didn’t have a postpartum care plan for herself. “It was just trusting in the system that things were gonna go okay,” Wanda said. “And that if something came up, she’d be able to handle it.”

The birth was “a beautiful time,” Wanda said. Shalon did so well that she convinced her doctor to let her and Soleil — French for “sun” — leave the hospital after two nights (three or four nights are more typical). Then at home, “things got real,” Pryor said. “It was Shalon and her mom trying to figure things out, and the late nights, and trying to get baby on schedule. Shalon was very honest. She told me, ‘Friend, this is hard.’”

C-sections have much higher complication rates than vaginal births. In Shalon’s case, the trouble — a painful lump on her incision — emerged a few days after she went home. The first doctor she saw, on Jan. 12, said it was nothing, but as she and her mother were leaving his office, they ran into her longtime OB-GYN, Elizabeth Collins. Collins took a look and diagnosed a hematoma — blood trapped in layers of healing skin, something that happens in about 1 percent of C-sections. The OB-GYN drained the “fluctuant mass” (as her notes described it), and “copious bloody non-purulent material” poured out from the one-inch incision. Collins also arranged for a visiting nurse to come by the house every other day to change the dressing. Collins didn’t respond to a request for comment.

Over the next two weeks, Shalon’s records show three more visits to Emory and two nursing visits at home. She feared that the incision wasn’t healing fast enough, perhaps because the blood thinners she was taking to prevent an embolism —another C-section risk — were hampering coagulation. But a wound specialist said everything looked OK. Shalon was worried about Soleil, too: Breastfeeding was harder than expected, and she’d stopped taking narcotic painkillers because she thought they were making the baby groggy. But less powerful painkillers weren’t working; between the pain and the anxiety, she was hardly sleeping. “Patient has poor endurance,” the visiting nurse noted on Jan. 16. “Leaving the home is a TAXING and CONSIDERABLE effort.”

What troubled the nurse most, though, was Shalon’s blood pressure. On Jan. 16 it was 158/100, high enough to raise concerns about postpartum preeclampsia, which can lead to seizures and stroke. But Shalon didn’t have other symptoms, such as headache or blurred vision. She made an appointment to see the OB-GYN for the next day, then ended up being too overwhelmed to go, the visiting nurse noted on Jan. 18. In that same record, the nurse wrote that Shalon had to change the dressing on her wound “sometimes several times a day due to large amounts of red drainage. This is adding to her stress as a new mom.” Her pain was 5 on a scale of 10, preventing her from “sleeping/relaxing.” Overall, Shalon told the nurse, “it just doesn’t feel right.” When the nurse measured her blood pressure on the cuff Shalon kept at home, the reading was 158/112. On the nurse’s equipment, the reading was 174/118.

“We provide caring and compassionate care to all of our patients,” the Visiting Nurse Health System said in an email. “She was in our care for less than four days but we gave the very best care we could.”

Under current ACOG guidelines, blood pressure readings that high should trigger more aggressive action, such as an immediate trip to the doctor for further evaluation, possibly medication and more careful monitoring. A history of hypertension and multiple other risks should raise more red flags, Tsigas said. “We need to look holistically at the risk factors irrespective of whether or not she had a diagnosis of preeclampsia,” she said. “If somebody has a whole plateful of risk factors, how are you treating them differently?” High blood pressure in the postpartum period should always be considered an emergency, she said.

“It would have made sense to admit her to the hospital for a complete work-up, including chest xray, an echocardiogram to evaluate for heart failure, and titration of her medication (both pain meds and hypertension meds) to sort out what she needed to feel OK and get [her] blood pressure out of the severe range,” wrote one doctor, a leading expert on postpartum care, who agreed to look at Shalon’s records at ProPublica’s request, but asked not to be identified. “Education on signs / symptoms of stroke seems insufficient — we don’t want to wait until someone is having a stroke to get their BP treated. A next-day follow-up for a BP of 174/118 seems questionable for a postpartum woman. Same-day assessment in her provider’s office, or in the ER, would have been very much within the bounds of common practice.”

Instead, Shalon was given an appointment for the following day, Jan. 19, with an OB-GYN at Women’s Center at Emory St. Joseph’s, which handled her primary care. By then, Shalon’s blood pressure had fallen, and there were “no symptoms concerning for postpartum [preeclampsia],” the doctor wrote in his notes. He wrote that Shalon was healing “appropriately” and thought her jumps in blood pressure were likely related to “poor pain control.” Wanda and Shalon left feeling more frustrated than ever.

At home over the next couple of days, Wanda noticed that one of Shalon’s legs was larger than the other. “She said, ‘Yeah, I know, Mom, and my knee hurts, I can’t bend it.”

When McDonald-Mosley looked over the voluminous medical records a few months later, what jumped out at her was the sense that Shalon’s caregivers didn’t seem to think of her as a patient who needed a heightened level of attention, despite the complexity of her pregnancy.

“She had all these risk factors. If you’re gonna pick someone who’s going to have a problem, it’s gonna be her. … She needs to be treated with caution.” The fact that her symptoms defied easy categorization was all the more reason to be vigilant, McDonald-Mosley said. “There were all these opportunities to identify that something was going wrong. To act on them sooner and they were missed. At multiple levels. At multiple parts of the health care system. They were missed.”

Shalon’s other friends were growing uneasy, too. Back in New York, Bianca Pryor had her own pregnancy emergency — her son was born very prematurely, at 24 weeks — so she couldn’t be in Atlanta. But she and Shalon talked often by phone. “She knew so much about her body one would think she was an M.D. and not a Ph.D. To hear her be concerned about her legs — that worried me.” Pryor encouraged her, “‘Friend, are you getting out of the house? Are you going for your walks? She told me, ‘No, I’m on my chaise lounge, and that’s about as much as I can do.’”

Habiba Tran was so upset at Shalon’s condition that she took her frustrations out on her friend. “I was cussing her out. ‘Go to the f— ing doctor.’ She’s like, ‘I called them. I talked to them. I went to see them. Get off my back.’”

On the morning of Tuesday, Jan. 24, Shalon took a selfie with her father, who’d been visiting for a week, then sent him to the airport to catch a flight back to Portland. Towards noon, she and Wanda and the baby drove to the Emory Women’s Center one more time. This time, Shalon saw a nurse practitioner. “We said, ‘Look, there's something wrong here, she’s not feeling well,’” Wanda recalled. “‘One leg is larger than the other, she’s still gaining weight’— nine pounds in 10 days — ‘the blood pressure is still up, there’s gotta be something wrong.”

The nurse’s records confirmed Shalon had swelling in both legs, with more swelling in the right one. She noted that Shalon had complained of “some mild headaches” and her blood pressure was back up to 163/99, but she didn’t have other preeclampsia signs, like blurred vision. She checked the incision — “warm dry no [sign/symptom] of infection” — and noted Shalon’s mental state (“cooperative, appropriate mood & affect, normal judgment”). She ordered an ultrasound to check the legs for blood clots, as well as preeclampsia screening.

Both tests came back negative. As Wanda remembers it, Shalon was insistent: “There is something wrong, I know my body. I don’t feel well, my legs are swollen, I’m gaining weight. I’m not voiding. I’m drinking a lot of water, but I’m retaining the water.” Before sending Shalon home, the nurse gave her a prescription for the blood pressure medication nifedipine, which is often used to treat pregnancy-related hypertension.

Emory Healthcare “is dedicated to the highest quality patient care,” it said in an email. It declined to answer questions about Shalon’s care, citing patient confidentiality.

Shalon and Wanda stopped at the pharmacy, then decided to go out to dinner with the baby. While they ate, they talked about a trip Shalon had planned for the three of them to take in just a few weeks. Ever since Sam III had died, Wanda and Shalon made a point of traveling someplace special on painful anniversaries. To mark his 40th birthday and the eighth anniversary of his death, Shalon had gotten the idea of going to Dubai. (“It’s cheap,” Shalon had told Wanda. “The money is worth so much more there. It’s supposed to be beautiful.”) She had long ago purchased their tickets and ordered the baby’s passport. Now Wanda was worried — would she be feeling well enough to make such a big trip with an infant? Shalon wasn’t willing to give up hope just yet. Wanda recalls her saying, “I’ll be fine, I’ll be fine.”

They got home and sat in Shalon’s bedroom for a while, laughing and playing with the baby. Around 8:30 p.m., Shalon suddenly declared, “I just don’t know, Mom, I just don’t feel well.” She took one of the blood pressure pills. An hour later, while she and Wanda were chatting, Shalon clutched her heart, gasped and passed out.

Paramedics arrived to find Shalon on the floor near the foot of her bed “pulseless and not breathing…” They tried to stabilize her, then rushed her to Atlanta’s Northside Hospital, just a couple of miles from her home. In the emergency room, doctors discovered that the breathing tube had been “incorrectly placed,” according to the ambulance service report — into her esophagus instead of her lungs. She never regained consciousness. Four days later, on Jan. 28, Wanda and Samuel withdrew life support and she died.

The news spread quickly among her colleagues at the CDC. William Callaghan, chief of the maternal and infant health branch, recalled in March that his boss, who had visited Shalon at the hospital, called to let him know. “It was a chilling phone call,” said Callaghan, one of the nation’s leading researchers on maternal mortality. “It certainly takes, in that moment, what I do, it made it very, very, very concrete. ... This was not about data, this was not about whether it was going up or it was going down. It was about this tragic event that happened to this woman, her family.”

Northside declined to do an autopsy, telling Wanda and Samuel that none was required, they recalled. (The hospital declined to comment.) So Wanda paid $4,500 for an autopsy by the medical examiners in neighboring DeKalb County. The report came back three months later. Noting that Shalon’s heart showed signs of damage consistent with hypertension, it attributed her death to complications of high blood pressure.

Wanda always knew she would be spending a lot of time caring for her granddaughter. She and Shalon loved the idea of the three of them making their way in the world together, trying to change it for the better.

Instead, Wanda has had to find a way to go on without her daughter and best friend. She took a break from her consultant work and moved into Shalon’s cozy townhouse, now crowded with baby books and gear, to assume her new role. Soleil was colicky, prone to gastric problems that kept both of them up all night. Shalon’s villagers stopped by often to help, but much of the time Wanda was on her own. Her grief was most acute at nights, but she couldn’t let it interfere with her duties to Soleil.

Eventually the colic went away and Soleil thrived. In June, Wanda and her five-month-old granddaughter went to Chattanooga for the annual meeting of U.S. Public Health Service scientists. A new honor — the Shalon Irving Memorial (Junior) Scientist Officer of the Year Award — had been created to celebrate Shalon’s legacy, and Wanda had been asked to say a few words. She handed the baby to one of Shalon’s CDC colleagues and took the small stage.

“Striving for excellence is a choice,” she told the audience through barely suppressed tears. “It is a commitment. … It’s a struggle to become the person you want to be. It’s harder than you want. It takes longer than you want. And it takes more out of you than you expected it should.”

Shalon personified excellence, Wanda said. “I don’t know if Shalon became the woman that she ultimately wanted to be. But I do know that she wanted to be the woman she was.”

She also knew how Shalon wanted to raise her daughter, and she was determined to do the same: reading to her, traveling with her, taking her to gymnastic and music classes. “She wanted Soleil to go to Montessori school, so I’m looking for a Montessori school for her,” Wanda said. “She wanted her to be christened, we got her christened.” Wanda and Soleil have developed a routine: Every morning they say hello to the photos of Shalon on the living room walls. Every evening they say goodnight. Sometimes Wanda shows Soleil the flag from her mother’s casket, now encased in a wooden frame. She set aside other mementos for later — the academic writings, the certificates and awards, the manuscript of her book with Tran. If all goes according to plan, it will be published early next year.

One Saturday afternoon in October, Wanda received another book, this one compiled by Shalon’s friends from the Epidemic Intelligence Service and entitled “Letters to Soleil.” She put the baby on her lap and said, “I’m gonna read you some letters about your mom.” One thing Wanda has tried never to do is cry in front of Soleil. But as she began reading aloud, she was sobbing. “And Soleil just kept looking at me — she couldn’t understand what was going on. And about a minute later she took my glasses off with her hands and put them down and then laid her head right on my chest and started patting me. Which made me cry all the more.”

Shalon was a letter-writer too. One day not long after the funeral, Wanda found a note that her daughter had written to her two years earlier, around the sixth anniversary of Sam III’s death. Shalon had left it among the other important items in her computer, trusting that if something ever happened to her, Wanda would find it. The letter reads like a premonition of her own death: Shalon wasn’t afraid for herself, but agonized over how it would affect her mother.

I am sorry that I have left you. On the particular day that I am writing this I have no idea how that may have occurred but know that I would never choose to leave.

I know it seems impossible right now, but please do not let this break you. I want you to be happy and smile. I want you to know that I am being watched after by my brothers and grandma and that we are all watching you. Please try not to cry. Use your energy instead to feel my love through time and space. Nothing can break the bond we have and you will forever be my mommy and I your baby girl!

Now 11 months old, Soleil has her mother’s precociousness, energy and headstrong yet sweet disposition. Like the sun she was named for, “she just lights up a room when she smiles,” Wanda said. She comes into Wanda’s bed every night and wakes her early to play. “She’ll bite my nose and kick me — ‘Nana, time to get up! Time to get up!’” And so Wanda does.

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